Leading the Charge to Blood Cancer Discoveries

According to the Leukemia and Lymphoma Society, approximately 1.5 million people in the United States are living with or are in remission from leukemia or lymphoma. UVA hematologist/oncologist Dr. Michael E. Williams, the Byrd S. Leavell Professor of Medicine and Professor of Pathology at UVA School of Medicine, has been at the forefront of combating those diseases in the laboratory and the clinic for over 30 years. Williams is a world-leading expert in non-Hodgkin lymphoma (NHL), Hodgkin's disease, mantle cell lymphoma, and chronic lymphocytic leukemia (CLL). In addition to treating patients, he has worked tirelessly with colleagues throughout his career to discover new treatments and therapies for these diseases and has contributed to numerous scientific breakthroughs leading to improved patient outcomes.

Dr. Williams has served on committees and boards of numerous national and international research and lymphoma educational organizations. And at UVA, he has taken on various administrative roles, including serving as Chief of the Hematology/Oncology Division. During this time, he worked with UVA Cancer Center and School of Medicine leaders to recruit more than 25 new faculty members, most of whom are clinical and research investigators that have expanded the depth and breadth of cancer and blood disease services offered at UVA. He has served as the Physician Lead for the Oncology Service Line and the Associate Director for Clinical Affairs at the UVA Comprehensive Cancer Center for the past five years.  

We asked him to reflect on his achievements and what lies ahead for his work.

Q. During your highly successful career, you've greatly improved our understanding and treatment of blood cancers. Would you please give us a snapshot of your accomplishments?

A. I was fortunate to have entered the field during a time of rapid advances in understanding, diagnosing, and managing blood cancers, including lymphomas, leukemias, and myeloma. During the first half of my career, I had an active research laboratory focused on the molecular underpinnings of lymphoma. My esteemed colleague, Dr. Steven Swerdlow from the University of Pittsburgh, and I discovered a mutation almost uniformly present in a subtype of NHL now called mantle cell lymphoma. This molecular event triggers this type of cancer and provided a mechanism to define and study this specific lymphoma subtype. At that time, there were no effective treatments, and patient survival was relatively short in most cases. Happily, we now have an array of effective therapies to control this type of lymphoma and put it into remission. People are now living many years longer with this disease, although a cure remains elusive for most patients. It's very satisfying that much of what we've learned in the biology and treatment of mantle cell lymphoma has applications in related blood malignancies, so it's had a positive ripple effect.

Q. Your patients and their families have praised your exceptional clinical care and kindness, and you were recently recognized with the UVA School of Medicine's Master Clinician Award. What is your patient treatment philosophy?

A. My approach is shared by my colleagues at UVA Comprehensive Cancer Center: We understand that a cancer diagnosis is a life-changing event. Your world goes upside down in a hurry. We also recognize how important it is for patients to see experts—hematologists, oncologists, surgeons, or radiation therapists —quickly. We provide sophisticated diagnostic testing, including pathology, molecular diagnostics, and specialized imaging, to determine the specifics of their particular lymphoma, leukemia, or other malignancy. This enables us to optimize their treatment and provide the best chance for a positive outcome. It's also important to listen carefully to patients and families and to assist them in understanding their disease, the array of tests and imaging that informs treatment options, and the support systems they have or need to navigate treatment and follow-up.

Furthermore, we have superb nursing and staff colleagues in our clinics and infusion centers and RN care coordinators who are readily available contacts for disease teams. Our Hematologic Malignancies Clinic in the Emily Couric Clinical Cancer Center building was recognized again this year with a national Press Ganey Pinnacle of Excellence Award. It's the only clinic at  UVA Health to have achieved this honor, which requires three consecutive years of top-tier patient evaluations to be eligible for consideration. Our patients are grateful. They recognize what's happening here and want to help us improve through their support.

Q. You indicated that you are working on clinical trials for mantle cell lymphoma treatments. How are those progressing?

A. We continue to work on human clinical studies across all types of lymphoma and  CLL, including laboratory-based preclinical research that identifies optimal non-chemotherapy treatment regimens and explores mechanisms of treatment resistance that lead to relapse. In this translational research program, we study patient tumor cells using in vitro models to understand which vulnerable cellular targets can be pursued therapeutically. This helps optimize the treatment and the best method to combine anti-cancer agents to achieve better, deeper, faster, and more durable responses that are essential in ultimately achieving a cure.

Using samples from patients – with consent – allows us to work from the bedside back to the bench, informing why some tumor cell characteristics correlate with a good response to particular therapeutic agents. Conversely, those with less response help us explore new approaches to improve treatment and better understand the disease.

Dr. Craig Portell, Associate Professor and Head of the Hematologic Malignancies Program, joined us from the Cleveland Clinic ten years ago and currently leads our research and clinical group. He works in tandem with our stem cell transplantation and cellular therapeutics group, along with our clinical research and laboratory-based staff.

Q. You're also helping to cultivate and train the next generation of researchers in this field. How are you working with them, and what do you see on the horizon?  

A. The most satisfying part of an academic career is training the next generation of clinicians and investigators. It's great to see how committed and enthusiastic they are about the field, and equally wonderful to help them continue the progress made in the last 30 years. Many of the faculty recruits mentioned earlier are now highly productive and nationally known, making advances in new therapeutics and new diagnostics in multidisciplinary research. They continue to move our field forward and improve outcomes for patients with blood cancers and many other malignancies.

Q. What is the role of private philanthropy in moving your work forward?

A. Private philanthropy and other funding are essential for all types of research, whether it's basic bench laboratory research, translational research that brings the best science to the bedside, or clinical trials designed to develop the most promising new treatments for patients. Government funding is a significant part of this, and some funding from pharmaceutical industry partners has helped develop the most promising novel drugs. But to run our operation, do the essential translational research, and conduct other aspects of clinical trials depends on private philanthropy. There are many opportunities for grateful patients, their families, and other donors who want to see progress to support this vital work.

Q. How is UVA's Comprehensive Cancer Center positioned to discover new treatments for blood diseases?

A. This is an incredibly dynamic field. The progress in cancer patient care, outcomes, and survival has been astonishing, but there's still a long way to go. These are complex diseases, and not everyone achieves the desired remission and cure, so we will continue to work on this challenge. This drives us daily while pursuing our research, and it makes UVA Comprehensive Cancer Center well-positioned to continue leading tomorrow's breakthroughs.

The researchers and teams assembled in this time of rapid progress are world-class. We will continue to build on that expertise to bring new treatments to patients in Virginia, across the country, and the world. It's a gratifying aspect of an academic career when the reach and impact go well beyond the person sitting across from you in the exam room. We will continue to strive for improved therapies that give every patient hope for a positive outcome.

This article was authored by Rick Kessel.