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Pediatrics / Shand Research Lab

Shand Research Lab

Mission: Reduce relapse in high-risk ALL by developing immunotherapy that targets the leukemia microenvironment upfront.

Leukemic Cells

Preventing Leukemia Immune Escape

Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood, with 3-4 new cases/million per year in the United States. Despite significant advances in chemotherapy treatment, relapse of ALL remains the leading cause of cancer death in children and young adults. Microscopic residual disease that is left after the early phase of chemotherapy is the strongest predictor of relapse. Most new therapies for ALL are designed to kill leukemic cells once the patient has relapsed. We aim to develop therapies that can be used in conjunction with early phase chemotherapy to interfere with immunologic "survival pathways" activated in the human bone marrow niche to prevent relapse.

Major Research Areas

The Role of Immunologic "Danger Signaling" in Leukemia Immune Escape

Leukemic cells in some patients with ALL carry molecular features that place them at higher risk for relapse than patients that do not carry those features. We are studying how the immune system in these high-risk patients responds to "danger signals" released by their leukemic cells after early-phase chemotherapy. This will help us design treatments that enhance both innate and adaptive anti-leukemia immunity in the microscopic residual disease setting.