Acute myeloid leukemia (AML) is a rare, highly fatal, blood cancer. Although the majority of younger patients treated with chemotherapy will achieve an initial apparent “complete remission”, subsequent treatment with either further chemotherapy or allogeneic hematopoietic cell transplantation (alloHCT) cannot prevent subsequent death from leukemic relapse in many individuals. The outlook is often especially suboptimal for those diagnosed with AML but not eligible for this intensive therapy due to advanced age or medical co-morbidity. Recent advances in the scientific understanding of the genetic diversity of AML has led to the development of targeted therapies, but the optimal way to integrate such agents into a comprehensive approach for an individual AML patient has yet to be defined. The Myeloid Malignancies Section was established to investigate the“detection, prevention and treatment of AML relapse, in particular using non-transplantation immunotherapy”.
Dr. Hourigan’s research focuses on three complementary approaches that are united by an overriding theme of performing translational research in order to find ways to detect, prevent and treat AML relapse. These efforts are strengthened by collaborations with a variety of clinical colleagues from leukemia and transplant centers from around the world.
The first research goal of Dr. Hourigan’s lab is to develop tools for the high sensitivity detection of residual AML after treatment that could help predict patients who may be at risk of relapse and whom may benefit from additional therapy. Such tools may also be able to quantify the efficacy of therapeutic interventions, particularly those given in remission with the intent of preventing relapse. This “measurable residual disease” (MRD) concept is the foundation for a personalized medicine approach to AML, now being tested in international trials. A second, and related, area of research undertaken by Dr. Hourigan’s lab involves the detection and monitoring of specific leukemia immune responses in patients, particularly before and after immunotherapy. New developments in immunotherapy and the powerful graft-versus-leukemia effect already observed after alloHCT all offer hope that AML is potentially susceptible to control by the immune system in the non-SCT setting. By analyzing the “immune health” of AML patients the team hopes to determine predictive biomarkers of the ability to respond to immunotherapy and to search for immune prognostic markers associated with successful long-term clinical outcomes. Finally, while the first two research efforts are “bedside-to-bench” in nature, the third mission of the section is to translate insights from the laboratory back to the clinic, with several clinical trials of both high sensitivity diagnostics and immunotherapy for AML patients performed at the NIH clinical center.
The work carried out by Dr. Hourigan’s laboratory should help bring clinicians one step closer to developing personalized and effective treatment approaches for AML.
Opening of the Myeloid Malignancies Clinic and PEARL15 Clinical Protocol
Opening of the Myeloid Malignancies Clinic and PEARL15 Clinical Protocol at NIH, July 2015.
Meet the Team
Christopher Hourigan, M.D., D.Phil.
Christopher Hourigan received both his medical degree and D. Phil. in Human Immunology from Oxford University. After residency training in medicine at Guy’s and St. Thomas’ Hospital in London and the Johns Hopkins Bayview Medical Center in Baltimore, he joined the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital where he was both a clinical fellow in medical oncology and a postdoctoral research fellow in the Immunology and Immunotherapy research program. He is ABIM board certified in Internal Medicine, Hematology and Medical Oncology. Dr. Hourigan came to the NHLBI in 2012. After almost three years as an Assistant Clinical Investigator, Dr Hourigan was appointed as an Investigator in March 2015. Dr. Hourigan is a Fellow of the Royal College of Physicians, and the recipient of the NHLBI Directors Award, the NHLBI Orloff Award, the NIH Bench to Bedside Award, the NIH Directors Challenge Innovation Award, an American College of Physicians Early Career Physician Award, the American Society for Clinical Investigation (ASCI) Young Physician-Scientist Award and the Presidential Early Career Award for Scientists and Engineers (PECASE).