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We visited and toured Van Andel Institute (VAI) yesterday, their work continues to amaze me. The Michelle Marie Lunn Hope Foundation (MLHOPE) also provided a donation ($28,000). Researcher Tim J. Triche Jr. Ph.D informed us that the foundation helped fund this research “Clonal evolution informs clinical management of very late relapsing pre-B ALL” authored by Jason Hall, Peter Huang, Abhinav B. Nagulapally, Sheryl Alberta, Austin Goodyke, Joseph Zagorski, Lynn Vanderlaan, James Fahner, Julie Steinbrecher, Alicia Sherwood, Deanna Mitchell, Giselle Sauliner Sholler, and Timothy J Triche Jr.. It is to be published soon (Haw et al. 2019 Cold Spring Harb Mole Case Study 5: a004556).According to the paper, “B-cell acute lymphoblastic leukemia (B-ALL) is the most common cancer observed in children (Downing et al. 2012). In the United States in 2019, there will be an estimated 5930 new ALL cases, accounting for 0.3% of all cancer diagnoses, and 1500 deaths (Siegel et al. 2019).”. MLHOPE was founded to help those with blood cancers and fund research because, in 2007, Michelle Lunn was one of the “new” cases and one of the deaths. She participated in a Clinical Trial, COG-AALL0232 “Phase III Randomized Study of Dexamethasone Versus Prednisone During Induction and High-Dose Methotrexate With Leucovorin Rescue Versus Escalating-Dose Methotrexate Without Leucovorin Rescue During Interim Maintenance I in Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia.”. This research directly aligns with the mission of MLHOPE.

We first visited the Triche Laboratory, which develops statistical and mathematical methods to dissect pediatric and adult cancers, with a focus on cancers of the blood in children. We saw them working with gene sequencers the size of harmonicas. There were two plugged into USB ports on a laptop. They said it could sequence overnight. There were many researchers in the area working on multiple studies.Then we were off to the Flow Cytometry, and Rachael Sheridan, Ph.D., SCYM(ASCP), explained what happens there. It turns out, it is very simple. They start with a sample, analyze every cell, sort them and put the ones with the characteristics that the researcher wants into a 2.5” by 3” tray. Each tray has 384 wells (each well is the size of a pin mark), each well gets a little water and one cell. The computer had different graphs which told her about each cell. The systems use lasers, electrical charges, and other science-fiction magic to accomplish these tasks.After the trays are full, they go to the Genomics Core, so we followed them.

Marie Adams, M.S., meet us and explained what happened next. The first device the trays hit is the Mosquito (I did not make this up. It is what they call it.), which grabs the DNA/RNA out of each well. The genetic samples move on to the big quick gene sequencers. They sequence the contents of the tray in a few hours and provide 80-90 GB of genetics data for each well.I spoke with one of the data staff. That day he was analyzing a group of 700 people genetics (~126 TB) to determine “normal”, then what wasn’t normal. The analysis represented just one part of a research project. Not sure how large the overall datasets would be.Some takeaways;· VAI is certainly technology advanced.· Progress is being made on understanding, treating and eliminating cancer.· There is still work to do.

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