Research Summary

Juvenile myelomonocytic leukemia (JMML) is a blood cancer that affects young children and is often difficult to diagnose and treat. Currently available therapies cure only half of patients, with some children experiencing an aggressive disease course while a rare group get better with very little treatment. We have now shown that presence of secondary mutations at diagnosis predicts a poor outcome. We have also shown that DNA methylation profiling can identify patients most likely to experience favorable outcomes.

We are currently running a clinical trial through the Children's Oncology Group for patients with relapsed and refractory JMML. This trial is testing the safety and efficacy of the oral MEK inhibitor, trametinib. This trial is based on extensive pre-clinical testing and a strong genomic rationale. This trial marks an important step towards more effectively treating patients with Ras driven leukemia using targeted agents.

Our next trial will risk-stratify patients with newly diagnosed JMML to receive different therapies tailored to the risk of relapse predicted by both the number of mutations and DNA methylation signatures at diagnosis.

Research Funding

  • January 1, 2017 - December 31, 2021 - Targeting SETBP1 in Myeloproliferative Disorders, Principal Investigator. Sponsor: NIH/NHLBI, Sponsor Award ID: K08HL135434
  • January 1, 2017 - December 31, 2021 - Targeting SETBP1 in Myeloproliferative Disorders, Principal Investigator. Sponsor: NIH/NHLBI, Sponsor Award ID: K08HL135434
  • January 1, 2017 - December 31, 2021 - Targeting SETBP1 in Myeloproliferative Disorders, Principal Investigator. Sponsor: NIH/NHLBI, Sponsor Award ID: K08HL135434
  • January 1, 2017 - December 31, 2021 - Targeting SETBP1 in Myeloproliferative Disorders, Principal Investigator. Sponsor: NIH/NHLBI, Sponsor Award ID: K08HL135434

Education

Yeshiva University, New York, B.A., 06/03, Biology
Stony Brook School of Medicine, New York, M.D., 06/08, Medicine
NYPH - Weill Cornell Medical Center, New York, Residency, 06/11, Pediatrics
University of California, San Francisco, Fellowship, 07/14, Pediatric Heme/Onc

Honors & Awards

  • 2008
    Barry S. Coller International Research Award, Stony Brook University
  • 2008
    Global Public Health Intern, Naval Medical Research Center, Peru
  • 2012-2013
    Trainee on NIH T32 Grant, “Research Training in Childhood Cancer”
  • 2013
    AACR “Molecular Biology in Clinical Oncology” workshop, Aspen, CO
  • 2014-2016
    St. Baldrick’s Foundation Fellowship Award
  • 2014
    ASH Annual Meeting Abstract Achievement Award, San Francisco, CA
  • 2014
    JMML Symposium Abstract Award San Francisco, CA
  • 2015-2017
    NIH Extramural Loan Repayment Program Award for Pediatric Research
  • 2015-2017
    Alex’s Lemonade Stand Foundation, Young Investigator Award
  • 2015
    Northwestern Mutual Foundation Research Award
  • 2015
    SIOP Young Investigator Award, Cape Town, South Africa
  • 2016
    ASH/EHA Translational Training in Hematology Program, Milan/Copenhagen/San Diego
  • 2016
    American Cancer Society , Individual Research Award
  • 2016-2018
    Rally Foundation for Childhood Cancer, Research Award
  • 2017-2021
    NIH K08 Award, National Heart Lung Blood Institute

Selected Publications

  1. Morales CE, Stieglitz E, Kogan SC, Loh ML, Braun BS. Nf1 and Sh2b3 mutations cooperate in vivo in a mouse model of juvenile myelomonocytic leukemia. Blood Adv. 2021 Sep 28; 5(18):3587-3591.  View on PubMed
  2. Kitazawa H, Okuno Y, Muramatsu H, Aoki K, Murakami N, Wakamatsu M, Suzuki K, Narita K, Kataoka S, Ichikawa D, Hamada M, Taniguchi R, Kawashima N, Nishikawa E, Narita A, Nishio N, Hama A, Loh ML, Stieglitz E, Kojima S, Takahashi Y. A simple and robust methylation test for risk stratification of patients with juvenile myelomonocytic leukemia. Blood Adv. 2021 Sep 27.  View on PubMed
  3. Yan Y, Dong L, Chen C, Bunting KD, Li Q, Stieglitz E, Loh ML, Qu CK. JMML tumor cells disrupt normal hematopoietic stem cells by imposing inflammatory stress through overproduction of IL-1β. Blood Adv. 2021 09 23.  View on PubMed
  4. Miltiadous O, Petrova-Drus K, Kaicker S, Mathew S, Kluk M, Geyer JT, Rodriguez-Sanchez MI, Bouvier N, Inghirami GG, Stieglitz E, Nafa K, Benayed R, Richardson M, Anderson W, Benhamida J, You D, Londono D, Kung AL, Prockop S, Roshal M, Zhang Y, Shukla NN. Successful treatment and integrated genomic analysis of an infant with FIP1L1-RARA fusion-associated myeloid neoplasm. Blood Adv. 2021 Sep 22.  View on PubMed
  5. Wintering A, Dvorak CC, Stieglitz E, Loh ML. Juvenile myelomonocytic leukemia in the molecular era: a clinician's guide to diagnosis, risk-stratification, and treatment. Blood Adv. 2021 Sep 15.  View on PubMed
  6. Behnert A, Lee AG, Young EP, Breese MR, Leung SG, Behroozfard I, Maruffi M, Sweet-Cordero EA, Dvorak CC, Chu J, Stieglitz E. NUP98-NSD1 Driven MDS/MPN in Childhood Masquerading as JMML. J Pediatr Hematol Oncol. 2021 08 01; 43(6):e808-e811.  View on PubMed
  7. Behnert A, Meyer J, Parsa JY, Hechmer A, Loh ML, Olshen A, de Smith AJ, Stieglitz E. Exploring the genetic and epigenetic origins of juvenile myelomonocytic leukemia using newborn screening samples. Leukemia. 2021 Jun 28.  View on PubMed
  8. Nix MA, Mandal K, Geng H, Paranjape N, Lin YT, Rivera JM, Marcoulis M, White KL, Whitman JD, Bapat SP, Parker KR, Ramirez J, Deucher A, Phojanokong P, Steri V, Fattahi F, Hann BC, Satpathy AT, Manglik A, Stieglitz E, Wiita AP. Surface Proteomics Reveals CD72 as a Target for In Vitro-Evolved Nanobody-Based CAR-T Cells in KMT2A/MLL1-Rearranged B-ALL. Cancer Discov. 2021 Aug; 11(8):2032-2049.  View on PubMed
  9. Kennedy AL, Myers KC, Bowman J, Gibson CJ, Camarda ND, Furutani E, Muscato GM, Klein RH, Ballotti K, Liu S, Harris CE, Galvin A, Malsch M, Dale D, Gansner JM, Nakano TA, Bertuch A, Vlachos A, Lipton JM, Castillo P, Connelly J, Churpek J, Edwards JR, Hijiya N, Ho RH, Hofmann I, Huang JN, Keel S, Lamble A, Lau BW, Norkin M, Stieglitz E, Stock W, Walkovich K, Boettcher S, Brendel C, Fleming MD, Davies SM, Weller EA, Bahl C, Carter SL, Shimamura A, Lindsley RC. Distinct genetic pathways define pre-malignant versus compensatory clonal hematopoiesis in Shwachman-Diamond syndrome. Nat Commun. 2021 02 26; 12(1):1334.  View on PubMed
  10. Pikman Y, Tasian SK, Sulis ML, Stevenson K, Blonquist TM, Apsel Winger B, Cooper TM, Pauly M, Maloney KW, Burke MJ, Brown PA, Gossai N, McNeer JL, Shukla NN, Cole PD, Kahn JM, Chen J, Barth MJ, Magee JA, Gennarini L, Adhav AA, Clinton CM, Ocasio-Martinez N, Gotti G, Li Y, Lin S, Imamovic A, Tognon CE, Patel T, Faust HL, Contreras CF, Cremer A, Cortopassi WA, Garrido Ruiz D, Jacobson MP, Dharia NV, Su A, Robichaud AL, Saur Conway A, Tarlock K, Stieglitz E, Place AE, Puissant A, Hunger SP, Kim AS, Lindeman NI, Gore L, Janeway KA, Silverman LB, Tyner JW, Harris MH, Loh ML, Stegmaier K. Matched Targeted Therapy for Pediatric Patients with Relapsed, Refractory, or High-Risk Leukemias: A Report from the LEAP Consortium. Cancer Discov. 2021 Jun; 11(6):1424-1439.  View on PubMed
  11. Hecht A, Meyer JA, Behnert A, Wong E, Chehab F, Olshen A, Hechmer A, Aftandilian C, Bhat R, Choi SW, Chonat S, Farrar JE, Fluchel M, Frangoul H, Han JH, Kolb EA, Kuo DJ, MacMillan ML, Maese L, Maloney KW, Narendran A, Oshrine B, Schultz KR, Sulis ML, Van Mater D, Tasian SK, Hofmann WK, Loh ML, Stieglitz E. Molecular and phenotypic diversity of CBL-mutated juvenile myelomonocytic leukemia. Haematologica. 2020 12 30; Online ahead of print.  View on PubMed
  12. Pikman Y, Stieglitz E. Targeting the Ras pathway in pediatric hematologic malignancies. Curr Opin Pediatr. 2021 02 01; 33(1):49-58.  View on PubMed
  13. Alyssa L. Kennedy, Kasiani C. Myers, James Bowman, Christopher J. Gibson, Gwen M. Muscato, Robert Klein, Kaitlyn Ballotti, Nicholas Camarda, Elissa M. Furutani, Chad E. Harris, Shanshan Liu, Ashley Galvin, Maggie Malsch, David C. Dale, John M Gansner, Taizo A. Nakano, Alison A. Bertuch, Adrianna Vlachos, Jeff H. Lipton, Paul Castillo, James Connelly, John Edwards, Nobuko Hijiya, Richard Ho, Inga Hofmann, James N Huang, Sioban B. Keel, Adam J. Lamble, Bonnie W Lau, Kelly J. Walkovich, Maxim Norkin, Wendy Stock, Steffen Boettcher, Christian Brendel, Elliot Stieglitz, Mark D. Fleming, Stella M. Davies, Edie A. Weller, Chris Bahl, Scott L. Carter, Akiko Shimamura, R. Coleman Lindsley. Distinct Genetic Pathways Define Leukemia Predisposition Versus Adaptive Clonal Hematopoiesis in Shwachman-Diamond Syndrome. Blood. 2020 Nov 5; 136(Supplement 1):35-36.  View on PubMed
  14. Astrid Behnert, Julia Meyer, Jahan-Yar Parsa, Aaron Hechmer, Mignon L. Loh, Adam B. Olshen, Adam J. de Smith, Elliot Stieglitz. Genetic Alterations Precede DNA Methylation Changes in Juvenile Myelomonocytic Leukemia. Blood. 2020 Nov 5; 136(Supplement 1):19-20.  View on PubMed
  15. Levinson A, Lee AG, Martell HJ, Breese MR, Zaloudek C, Van Ziffle J, Laguna B, Leung SG, Chen MD, Chen LM, Pfeil J, Ladwig NR, Shah AT, Behroozfard I, Rao AA, Salama SR, Sweet-Cordero EA, Stieglitz E. Complete Response to PD-1 Inhibition in an Adolescent With Relapsed Clear Cell Adenocarcinoma of the Cervix Predicted by Neoepitope Burden and APOBEC Signature. JCO Precis Oncol. 2020; 4.  View on PubMed
  16. Schönung M, Meyer J, Nöllke P, Olshen AB, Hartmann M, Murakami N, Wakamatsu M, Okuno Y, Plass C, Loh ML, Niemeyer CM, Muramatsu H, Flotho C, Stieglitz E, Lipka DB. International Consensus Definition of DNA Methylation Subgroups in Juvenile Myelomonocytic Leukemia. Clin Cancer Res. 2021 01 01; 27(1):158-168.  View on PubMed
  17. Contreras CF, Higham CS, Behnert A, Kim K, Stieglitz E, Tasian SK. Clinical utilization of blinatumomab and inotuzumab immunotherapy in children with relapsed or refractory B-acute lymphoblastic leukemia. Pediatr Blood Cancer. 2021 01; 68(1):e28718.  View on PubMed
  18. Fabrizio VA, Kernan NA, Boulad F, Cancio M, Allen J, Higman M, Margossian SP, Mauguen A, Prockop S, Scaradavou A, Shah N, Spitzer B, Stieglitz E, Yeager N, O'Reilly RJ, Brentjens RJ, Jan Boelens J, Curran KJ. Low toxicity and favorable overall survival in relapsed/refractory B-ALL following CAR T cells and CD34-selected T-cell depleted allogeneic hematopoietic cell transplant. Bone Marrow Transplant. 2020 11; 55(11):2160-2169.  View on PubMed
  19. Dueck ME, Lin R, Zayac A, Gallagher S, Chao AK, Jiang L, Datwani SS, Hung P, Stieglitz E. Precision cancer monitoring using a novel, fully integrated, microfluidic array partitioning digital PCR platform. Sci Rep. 2019 12 20; 9(1):19606.  View on PubMed
  20. Friend BD, Bailey-Olson M, Melton A, Shimano KA, Kharbanda S, Higham C, Winestone LE, Huang J, Stieglitz E, Dvorak CC. The impact of total body irradiation-based regimens on outcomes in children and young adults with acute lymphoblastic leukemia undergoing allogeneic hematopoietic stem cell transplantation. Pediatr Blood Cancer. 2020 02; 67(2):e28079.  View on PubMed

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