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Understanding the role of extracellular vesicles in acute myeloid leukemia

How does the microenvironment affect how acute myeloid leukemia develops, and what new and improved therapies will help us to target it? A Queen’s University investigator aims to answer these questions with her New Investigator award from the Terry Fox Research Institute.

“There’s a clear unmet need to improve survival outcomes in the acute myeloid leukemia space,” says Dr. Sheela Abraham, principal investigator at Queen’s University. “If we don’t understand the mechanisms behind this cancer, we’re never going to find a cure.”

Acute myeloid leukemia (AML) is the most common type of leukemia found in adults, however, the prognosis significantly differs depending on the patient’s age. With treatment, patients 65 and over have a 10 per cent or less chance of survival, whereas patients under age 45 have a 62 per cent chance of surviving at least five years after diagnosis.

To improve survival outcomes, Dr. Abraham will focus on the role of the microenvironment, particularly the role of extracellular vesicles (EVs) in cancer initiation, progression and remission.

More specifically, she will focus on EVs located in the bone marrow to understand if and how they support leukemic stem cells (LSC), which are responsible for the development and maintenance of leukemia.

“Extracellular vesicles are well-studied in the blood; however, there’s a missing link in that EVs found in the blood may not reflect what’s really going on in the bone, where leukemia begins and thrives. By understanding these overlooked bone marrow interactions, our results may highlight how LSCs establish a permissive environment, evade elimination and perpetuate disease,” she says.

Extracellular vesicles are tiny cell fragments released by all cells in the body. When released by cancer cells, it’s thought that their bioactive cargo may contain important information facilitating the exchange of messages between cells. But do EVs make AML worse? To find out, Dr. Abraham and her team will explore how LSCs communicate with other cells using extracellular vesicles.

She will also compare the composition of EVs in the bone marrow of patients diagnosed with AML with those of a healthy individual to see if they help or hinder the development of leukemia. Finally, she will investigate whether the behaviour of EVs can be targeted as a new and improved type of therapy.

Dr. Abraham hopes this groundwork will open the doors to future drug discoveries and contribute to earlier detection, ultimately improving survival outcomes for patients with this disease.