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Albert Einstein College of Medicine

1300 Morris Park Ave
Bronx, NY 10461
United States

The leading cause of death among children diagnosed with bone tumors is metastasis, or the spread of the tumor from its initial location to other places in the body. Decades of clinical trials aimed at making chemotherapy stronger or more intense have not improved the survival of children who are diagnosed with a metastatic bone tumor nor of children who suffer a metastatic relapse. The impact of the organisms living in a patient’s intestinal tract on the progression of adult cancers is being intensively studied, but there have been no such studies in children.

The RUNX1 gene is commonly mutated in childhood blood cancers. RUNX1 is a transcription factor, which is a protein that regulates how and when other genes are turned on. While we have assumed that the reason RUNX1 mutations promote cancer is due to its activity in gene regulation, growing literature suggests that RUNX1 may play a less-studied role in preventing the accumulation of DNA damage.

It has been previously established that intrathecal methotrexate administration in patients with acute lymphoblastic leukemia or non-Hodgkin lymphoma is associated with neurotoxic side effects concerning cognitive function. The drug memantine, which is currently used to treat dementia related to Alzheimer’s disease, was tested on rats treated with intrathecal methotrexate. The study showed that it protected them from developing spatial memory deficits.

Germline mutations in RUNX1 causes affected individuals to have problems with bleeding and proper blood clotting. These patients also have an increased chance of developing a form of blood cancer during their lifetime, but what predicts whether cancer will form or not is unknown. This means we also don’t know how to stop the development of blood cancer in these patients. The mutations in RUNX1 cause the loss of RUNX1 activity.