An Interview with Richard D. Press, M.D., Ph.D. about the new Calreticulin Test
Recently, the Knight Diagnostic Laboratories pioneered a new blood test that can help diagnose early-stage blood diseases before they turn into life-threatening leukemias. Below is an an interview with Richard D. Press, M.D., Ph.D.
Director, Molecular Pathology and Molecular Diagnostics Laboratories,
Knight Diagnostic Laboratories, Oregon Health & Science University
Professor of Pathology, OHSU, that explains the benefits and the break-through this new test represents.
Briefly provide, in lay terms, tell us about the big-picture significance of the findings presented at ASH and why the Knight Diagnostic Laboratories responded by developing the first test to use the new information.
RP: Myeloproliferative Neoplasms (MPN's) are early-stage blood diseases that are common and treatable, but when untreated, can evolve into life-threatening leukemias. MPN diseases often come to the attention of physicians when a patient has an abnormal blood cell count after a routine "CBC" (complete blood count) blood test - such as might be done as part of a routine screening physical exam.
Early diagnosis, which will be much enhanced with the calreticulin test, will help distinguish true MPN's from other much more common causes of altered blood cell counts, such as temporary infections. It is important to diagnose true MPN's as early as possible, when they are treatable, and before they evolve into harder-to-treat leukemia - which is exactly what the calreticulin test will help do.
Tell us a little bit about this disease, roughly how many people it impacts annually.
RP: The incidence of Myelodysplastic/ Myeloproliferative Neoplasms varies widely, ranging from approximately 3 per 100,000 individuals older than 60 years annually for chronic myelomonocytic leukemia (CMML) to as few as 0.13 per 100,000 children from birth to 14 years annually for juvenile myelomonocytic leukemia (JMML).
Also if symptoms for this disease aren’t readily detectible, how will patient know they need the test? Is this condition something medical professional look for when the patient has some other common diseases?
RP: Physicians will usually suspect a possible MPN diagnosis after they see a change in the CBC blood count - the platelet count, red blood cell count, and/or white blood cell count - and these CBC tests are one of the most common "screening" tests that physicians perform as part of routine adult well-person care. Patients with early-stage MPN will very often have no signs or symptoms. Later-stage MPN's may cause fatigue, easy bruising, bleeding, blood clots, and susceptibility to infections.
How will the test help patients?
RP: This test will distinguish the MPN diagnosis from other very common benign causes of altered blood cell counts (which often require no treatment). The treatment for MPN is quite different and quite successful. The failure to recognize an MPN, means that the patient has an increased chance of the MPN turning into a much more severe leukemia.
How does this example of innovation illustrate the labs role in improving delivery of medicine and turning scientific discovery into an improvement in clinical care? Why will this diagnostic test and the others offered by the Knight labs be important to how medicine is delivered going forward?
RP: Because of unique Knight capabilities, with a diagnostic lab embedded within the research-driven cancer institute, research discoveries, such as the association of calreticulin mutations with MPN's, can be quickly transitioned into diagnostic tests that can be made available to patients.