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New view of leukemia cells identifies best treatment options, Stanford researchers say

STANFORD, Calif. - People diagnosed with acute myelogenous leukemia usually receive the most commonly effective chemotherapy as a first line of attack, but it doesn't work for everyone. Faced with these resistant cancers, doctors move on to the next most effective treatment or perhaps a drug still in development. This process is time-consuming and can cost patients years of damaging therapy with no remission.

Speeding up this lengthy process is one goal of research by Garry Nolan, PhD, associate professor of microbiology and immunology at the Stanford University School of Medicine. He reports a new technique for getting AML patients on the right drug the first time in the July 23 issue of Cell.

Although all people with AML have a cancer of the same type of white blood cells, those cells behave very differently from person to person. By watching those behaviors, Nolan said doctors could quickly identify patients who need stronger treatment or less common chemotherapy drugs.

AML is the most common form of leukemia, with about 10,500 new cases diagnosed each year. The cancerous white blood cells divide out of control and drown out the other types of cells normally present in the blood. People with the disease tend to bruise easily because their blood doesn't contain enough platelets to clot, and they have a shortage of red blood cells, causing fatigue.

Nolan equates his technique to figuring out which people in a room are more aggressive, noting that you can't always tell at first glance. "But if I go around and kick everybody in the shin, I can see their response and learn something about that person," he said. Exposing cancer cells to different molecules is like kicking them in the shin, and Nolan's technique is the snapshot that reveals how the cell behaved. Those cells that simply look surprised are fairly normal and will probably respond well to drugs; those that glower need special treatment.

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