OICR Investigator Dr. Antastasia Tikhonova led an important discovery about what happens to the bone marrow during a well-known precancerous condition.
A first-ever discovery about how bone marrow changes in people at a higher risk of developing cancer could offer a strategy to prevent the disease before it starts.
Dr. Anastasia Tikhonova and her lab discovered that people with a pre-cancerous condition called clonal hematopoiesis had areas of inflammation in their bone marrow that appear to play a role in the development of cancer.
Clonal hematopoiesis is a condition that becomes more common as people age. A blood-forming stem cell in bone marrow undergoes a genetic mutation that gives it an advantage over other cells. As the mutated cell multiplies and makes up a bigger proportion of a person’s blood, it can significantly increase their risk of blood cancers and cardiovascular disease.
Tikhonova and colleagues wanted to understand what happened around those mutated cells in the bone marrow and what influence it might have on the early stages of cancer. In a study published in Nature Immunology, they discovered that the bone marrow of individuals with clonal hematopoiesis contains distinct pockets of inflammation, enriched in cells called fibroblasts. These findings suggest that changes in the bone marrow environment may create conditions that favour the expansion of mutated blood cells, potentially contributing to cancer development over time.
“This is a completely new discovery, and it raises an exciting possibility,” says Tikhonova, a Senior Scientist at Princess Margaret Cancer Centre and Assistant Professor of Medical Biophysics at the University of Toronto. “Instead of waiting for cancer to develop, could we target these early changes in the bone marrow to help prevent it?”
Tikhonova says that targeting these inflammatory pockets could potentially make the bone marrow environment less favourable for mutated blood cells, limiting their expansion and reducing the risk of progression to blood cancer.
While further research is needed, the discovery opens up an exciting new direction for cancer prevention. The findings have already attracted interest from researchers in academia and industry, and existing drugs that target inflammation and fibroblast-associated pathways could offer opportunities for future therapeutic investigation. The hope is that one day, it may be possible to intervene before clonal hematopoiesis progresses to blood cancer.
“My hope is that one day we can prevent certain types of blood cancer before they even develop,” says Dr. Tikhonova, who led the study alongside Dr. Alicia Aguilar-Navarro and Gibran Edun. “If we can identify and intervene in the earliest stages of disease, we have an opportunity not only to save lives, but also to spare patients and their families the tremendous burden of cancer treatment. Prevention could make an enormous difference, both for individuals and for our healthcare system.”
