Ep185: Dr. Lachelle Weeks on Predicting Leukemia Risk At Scale

Episode Summary

Executive Summary: Dr. Lachelle Weeks, a physician-scientist at Dana-Farber Cancer Institute, discusses her work on early detection and prevention of myeloid blood cancers like acute myeloid leukemia. She describes clonal hematopoiesis as a precursor state, her development of a risk score to stratify patients, and a project using AI to analyze blood cell images for pre-screening. Weeks also addresses health disparities affecting Black and Hispanic patients and emphasizes patient communication and equity in research.

Main Topics: Early Detection and Prevention of Leukemia (Priority: 5/5): Weeks aims to prevent leukemia deaths through screening, risk stratification, and early intervention, using clonal hematopoiesis as a precursor state. Clonal Hematopoiesis and Risk Stratification (Priority: 5/5): Clonal hematopoiesis involves mutations in blood cells that increase cancer risk; Weeks developed a risk score (CHRS) to identify high-risk individuals (1% of those with precursors). AI and Computer Vision for Blood Cancer Screening (Priority: 4/5): Weeks uses deep learning on peripheral blood smear images to predict high-risk populations, aiming to reduce unnecessary genetic testing and anxiety. Health Disparities in Blood Cancer Diagnosis (Priority: 4/5): Black and Hispanic patients are underdiagnosed for myelodysplastic syndrome due to referral biases; Weeks works to address these inequities through unbiased algorithms and community outreach. Personal Journey and Career Path (Priority: 3/5): Weeks shares her background from Newark, NJ, to Wellesley College, MD-PhD at Case Western, and her focus on leukemia after clinical experiences. Patient Communication and Science Outreach (Priority: 3/5): Weeks emphasizes clear communication with patients, creating videos to explain clonal hematopoiesis, and ensuring research findings are accessible. Future Directions and Clinical Trials (Priority: 4/5): Weeks is leading a trial using low-dose chemotherapy for high-risk clonal hematopoiesis and envisions large-scale screening studies within 10 years.

Key Arguments: Leukemia can be prevented through early detection and intervention, similar to colon cancer screening. Clonal hematopoiesis is a common precursor in older adults, but only 1% of those with it are at high risk for cancer. AI analysis of routine blood smear images can pre-screen populations to identify high-risk individuals without universal genetic testing. Health disparities in blood cancer diagnosis stem from systemic biases in referral patterns, not biological differences. Patient education and clear communication are essential for effective screening and reducing anxiety.

Data Points: Prevalence of clonal hematopoiesis: 15-20% - Percentage of people over 65 with mutations associated with blood cancers. High-risk proportion: 1% - Of those with clonal hematopoiesis, only 1% are at high risk for developing blood cancer within 10 years. Risk for high-risk group: 50% - High-risk individuals have a 50% chance of developing blood cancer within 10 years. Low-risk threshold: <1% - Low-risk individuals have less than 1% risk of developing blood cancer in 10 years. Fundraising amount: $1.2 million - Raised by the Timmerman Traverse for Damon Runyon team in 2024.

Pivotal Quotes: "I believe that one day we'll get to a place where people don't have to die of leukemia, where we can actually prevent leukemias from happening." — Dr. Lachelle Weeks: Opening statement on her audacious goal for leukemia prevention. "I had no idea that my family wasn't rich until I met actual rich people." — Dr. Lachelle Weeks: Reflecting on her transition from a public school in Newark to a private school with wealthier students. "It would be really nice if I could do science, but do science where the results of the research actually affect people faster." — Dr. Lachelle Weeks: Explaining her motivation to pursue an MD-PhD program to bridge research and clinical impact.

Implications: This work could revolutionize blood cancer screening by making it inexpensive, unbiased, and widely accessible, potentially reducing disparities and enabling preventive treatments. It sets the stage for large-scale studies and clinical trials that may transform leukemia from a deadly disease to a preventable one.