LONDON (WOWO) — Genetic changes in blood cells may reveal how certain blood cancers are likely to progress years before worsening disease becomes apparent through routine blood tests, according to new research involving long-term genetic monitoring of patients.

The study, published in Cancer Discovery, followed 30 people with myeloproliferative neoplasms, or MPNs, a group of chronic blood cancers that develop in the bone marrow and cause abnormal production of blood cells. Researchers combined repeated DNA sequencing with nearly 8,000 blood-count results and detailed clinical histories to track how the diseases changed over time.

The research was conducted by scientists at the Wellcome Sanger Institute and collaborators at Cambridge University Hospitals. Some patients were followed for as long as 25 years, with researchers analyzing more than 450 samples to trace how populations of abnormal blood cells evolved.

The central finding was a difference between patients whose MPNs remained stable and those whose diseases eventually became more serious.

Patients with stable disease generally had relatively steady populations of blood cells and did not acquire additional cancer-driving mutations over time.

Patients whose disease progressed, however, often developed additional genetic changes years before the clinical deterioration became apparent.

The researchers found several routes by which MPNs could progress to more serious disease, including myelofibrosis — a condition involving scarring of the bone marrow — and acute myeloid leukemia, or AML. In some patients, cancerous cells accumulated mutations step by step, while in others, a separate abnormal cell population eventually developed into leukemia.

The findings suggest that the biological trajectory of some blood cancers may be detectable long before doctors can see the consequences through conventional monitoring.

Wellcome Sanger researchers described the progression as being “encoded” in the genome years in advance, meaning genetic information could potentially provide an early warning of which patients are more likely to experience worsening disease.

The research could eventually contribute to a more personalized approach to monitoring blood cancer patients.

Rather than relying only on periodic blood counts, doctors could potentially use repeated genetic testing to watch for mutations associated with higher-risk disease.

That could allow physicians to increase monitoring for patients whose DNA begins showing concerning changes, potentially catching progression earlier.

But experts caution that this research is not yet a routine clinical test or a reason for patients to immediately change treatment.

Abhishek Chilkulwar, an oncologist with Orlando Health who was not involved in the research, described the findings as an important step toward precision medicine in blood cancer care.

He called it a “striking demonstration” that genetic changes can provide clues about a cancer’s future course long before outward signs become apparent.

The practical application in the near term, he said, would be closer monitoring rather than automatically starting new treatment.

That could mean more frequent blood counts or, when medically appropriate, additional bone marrow testing for patients whose genetic profiles indicate an elevated risk.

Chilkulwar also cautioned against treating a high-risk mutation as an indication that a patient should immediately undergo evaluation for a stem-cell transplant. Transplant is generally reserved for patients whose disease has actually progressed to serious conditions such as myelofibrosis or AML.

The study also produced an important finding involving patients diagnosed with so-called triple-negative essential thrombocythemia.

MPNs are commonly associated with mutations involving the JAK2, CALR or MPL genes. Some patients do not have any of those three mutations, yet can still receive an MPN diagnosis based largely on the appearance of their bone marrow cells.

Researchers examined blood-cell “family trees” from these patients and found patterns consistent with normal age-related blood-cell development rather than the evolution expected from a malignant cancer.

Three patients in the study had triple-negative essential thrombocythemia, but researchers found no genetic evidence of cancer in their samples.

The finding raises questions about whether some patients currently classified as having a blood cancer may instead have a nonmalignant condition that resembles one.

That could eventually affect decisions about long-term cancer treatment and monitoring, although the researchers say additional investigation is needed before changing clinical practice.

The study also examined the effects of treatment on DNA.

Researchers identified recognizable patterns of mutations associated with hydroxycarbamide, also known as hydroxyurea, a medication commonly used to control abnormal blood counts in people with MPNs.

A separate mutational pattern was associated with azacitidine, another drug used in the treatment of certain blood cancers.

Importantly, researchers said the study did not establish that hydroxyurea causes leukemia. The observed genetic patterns show that treatment can leave detectable marks in blood-cell DNA, but that is different from demonstrating that the medication causes malignant transformation.

The study’s relatively small size is an important limitation. Only 30 patients were followed, meaning the findings need to be tested in substantially larger groups before genetic monitoring can be relied upon to predict individual patients’ outcomes.

The results also do not mean that every patient with an MPN will develop leukemia or myelofibrosis, nor that a particular mutation guarantees progression.

Instead, researchers say the work demonstrates how cancer can evolve over long periods and shows the potential value of repeatedly examining the genetic makeup of blood cells.

The ultimate goal is to identify patients at elevated risk early enough that doctors could intervene before serious progression occurs.

Researchers say future studies could investigate whether drugs specifically targeting high-risk mutations might delay or prevent progression in patients identified through genetic monitoring.

For now, the research represents a promising step toward a system in which a patient’s DNA could provide doctors with an earlier warning about the direction a blood cancer is taking — potentially years before conventional testing reveals that the disease has begun to worsen.