iCare for Cancer Patients

The purpose of this study is to use genomic information from individual patients to create simulation avatars that will be used to predict novel drug combinations with therapeutic potential.

As part of normal clinical care, subjects will undergo peripheral blood draws and biopsies for disease assessment of their cancer. In cases of hematological malignancies, bone marrow aspiration & biopsy are routinely performed. As part of this project, the following will be done to the samples collected and with clinical outcomes data: donate peripheral blood specimens whenever blood is already being drawn for clinical purposes. donate bone marrow aspiration samples whenever a bone marrow aspiration procedure is already being done for clinical purposes. donate saliva whenever blood draw is already being done for clinical purposes. allow the investigators to perform gene mutation profiling. allow the investigators to study gene mutation results. allow the investigators to perform pharmacogenetic profiling. allow the investigators to study pharmacogenetic profiles. allow the investigators to examine chromosome copy number variations. allow the investigators to examine genomic methylation. allow the investigators to quantify metabolomics/cytokines.

Myelodysplastic Syndromes, Acute Myeloid Leukemia, Acute Myelogenous Leukemia, Acute Lymphoid Leukemia, Leukemia, Acute Lymphoblastic, Multiple Myeloma, Myelofibrosis

Patients with acute myeloid leukemia will have blood, bone marrow aspirate, and saliva collected from them as part of routine care.

Patients with acute lymphoblastic leukemia will have blood, bone marrow aspirate , and saliva collected from them as part of routine care.

Patients with myeloplastic syndrome will have blood, bone marrow aspirate, and saliva collected from them as part of routine care.

Patients with myelofibrosis will have blood, bone marrow aspirate, and saliva collected from them as part of routine care.

Patients with multiple myeloma will have blood, bone marrow aspirate, and saliva collected from them as part of routine care.

Molecular diagnostic testing will be performed on peripheral blood, bone marrow aspirate and saliva samples that will be collected from each patient as part of routine care. Tests performed may include: cytogenetics, FISH, chromosome copy number variation, next generation DNA sequencing, methylation, and metabolomics.

The overall response rate (ORR) is defined as achieving a complete remission (CR), partial remission (PR), and/or hematological improvement based on 2006 International Working Group (IWG) criteria (Cheson, et al. Blood 2006).

Toxicity will be assessed by the National Cancer Institute (NCI) Common Toxicity Criteria (CTC) v 4. Adverse event incidences will be compared to individual pharmacogenetic gene variants.

The disease free survival will be analyzed using Kaplan-Meier method and comparisons made to computer predicted response.

The overall survival will be analyzed using Kaplan-Meier method and comparisons made to computer predicted response.

Inclusion Criteria: Individuals known or suspected of having a blood cancer or hematologic disorder Individuals with presence of extramedullary disease Capable of providing informed consent. Exclusion Criteria: Does not have a blood cancer or a hematologic disorder