When it comes to leukemia, finding a close relative who is a match for a stem cell transplant is usually a positive step on a treatment journey.
That was not the case in Ryan White’s journey with acute myeloid leukemia (AML). Hereditary genetic testing showed both Ryan and his family member carried the same inherited genetic variant associated with the development of leukemia, so they would not be a suitable donor.
The testing was done as part of Canada’s first clinical program focused on heredity myeloid malignancies developed by hematologist Dr. Amy Trottier and the IWK Clinical Genomics laboratory. The testing helps identify inherited genetic variants associated with myeloid cancers, including acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and related disorders.
Today, IWK Health is one of only two centres in Canada offering this specialized testing and interpretation for hereditary myeloid malignancies. It’s been providing the testing to patients across the Maritimes (Ryan lives in PEI) and is now set to become the referral centre for the rest of Canada.
Without hereditary testing, Ryan’s transplant team would not have known that the underlying cancer predisposition was shared within the family. Armed with this knowledge, an alternative donor was identified, and Ryan's care was tailored based on the unique genetic factors contributing to his disease.
"Relapsed acute myeloid leukemia, particularly when the disease returns within a year of remission as it did in Ryan's case, is typically associated with a very poor prognosis," said Dr. Trottier. "Through our collaboration with IWK Clinical Genomics laboratory, we were able to use hereditary genetic testing to identify the underlying genetic cause of Ryan's leukemia and tailor both his treatment and stem cell donor selection. That information helped transform what would ordinarily be considered a dismal prognosis into a much more favorable one."
Ryan was blown away by the process.
“That they could take my blood, look at my genetics and then be able take that and lean on that expertise from IWK and tailor my treatment plan for optimal results,” he said. “I had no idea it could be that precise.”