Blood cancer researcher aims to stop the disease before it starts

With most cancers, the terrible challenge is that by the time doctors make a diagnosis, the disease has taken root and is often beyond the reach of curative treatment.

But in blood cancers, there’s a window before the cancer emerges, sometimes spanning years or even decades, when seeing it coming might be possible.

Sushree Sahoo wants to peer into that window and stop cancers there, before they start. Sahoo, assistant professor with Virginia Tech’s Fralin Biomedical Research Institute (FBRI) at its Cancer Research Center in Washington, D.C., is focused on the earliest, often invisible stages of blood cancer. The institute has eight research centers within its organization with two focused on cancer research and working together in an integrated fashion — one on the Roanoke Health Sciences and Technology campus and the other on the Children’s National Research & Innovation Campus in Washington, D.C.

“This early phase is still poorly understood because our clinical system is designed to detect cancer after it has already progressed,” Sahoo said. “My lab is working to identify markers that can reveal risk earlier and allow intervention before cancer develops.”

Sahoo’s research centers on myelodysplastic syndromes (MDS) and acute myeloid leukemia, conditions in which the bone marrow’s blood-producing system becomes unstable. Abnormal cells crowd out healthy ones, causing anemia, low white blood cell counts, and low platelets. In severe cases MDS progresses into one of the most aggressive blood cancers known. In both children and adults, the genetic mutations that lead to these diseases can be present for years, or even decades, without producing symptoms.

“As blood cells divide, they acquire changes. Most are harmless, but some give certain cells an advantage and can push them toward cancer,” Sahoo said.

Sahoo’s previous research found that roughly 15 percent of pediatric MDS patients carry an inherited mutation predisposing them to blood disorders, yet in about 60 percent of those children, the disease never progresses. Their bodies generate adaptive responses that halt it entirely, with no treatment at all.

“They can completely cure themselves,” said Sahoo, who also holds an appointment in the Department of Biomedical Sciences and Pathobiology in the Virginia-Maryland College of Veterinary Medicine. “We are interested in understanding both paths: Why do some cells continue toward cancer, while others adapt in ways that maintain function and delay or prevent disease? If we can understand these differences, we may be able to shift the balance away from cancer and toward protection.”

The implications reach beyond pediatrics. Her lab studies measurable signals in the blood, known as biomarkers, that can indicate which direction a patient’s system is heading, giving doctors the tools to monitor risk and intervene earlier.

Sahoo’s lab also investigates clonal hematopoiesis, a process in which a single, mutated blood stem cell quietly expands over time, often years before any signs of disease. Detecting these early clonal changes could give clinicians a crucial window to act.

Sahoo joined Virginia Tech from St. Jude’s Children’s Research Hospital, where she was a postdoctoral fellow. Her recruitment to the university’s Fralin Biomedical Research Institute was supported by the Red Gates Foundation. She was drawn to the position by the leadership of the Cancer Research Center — D.C., Christopher Hourigan, professor and director of the center. His research also centers on leukemia.

“We are looking to recruit not just world-class scientists for the FBRI Cancer Research Center in Washington, D.C., but true research leaders capable of having real impact in the ways that we prevent, diagnose, monitor, and treat,” Hourigan said. “I didn’t know Dr. Sahoo previously, but I knew of her important work on inherited predisposition for myelodysplastic syndromes. I had actually used one of her papers while teaching physicians in training to become oncologists. I am excited by the expertise and interests across the basic-translational spectrum for those with this terrible blood cancer that she’ll bring to our growing center.”

Sahoo was also attracted to the center’s collaborative structure, with colleagues approaching cancer from different angles, including prostate and brain cancer. That opportunity for cross-disciplinary exchange rarely exists under one roof, she said.

The center’s location in Washington, D.C., a rich and concentrated research ecosystem with close interactions with Children’s National Hospital, was also a draw.

“Virginia Tech has the vision and the commitment to build something meaningful here,” Sahoo said. “It is exciting to be part of that.”