Dr. Sangeetha Venugopal, M.D., M.S., is a distinguished physician-scientist specializing in hematology at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. As an assistant professor of hematology, Dr. Venugopal focuses on advancing research and improving clinical outcomes for patients with blood disorders, particularly myelodysplastic syndromes (MDS) and their precursor conditions. Venugopal is recognized for her groundbreaking research linking tobacco smoking to increased genetic mutations and disease progression in MDS. Her recent study, presented at the American Society of Hematology (ASH) annual meeting, highlighted the significant role of smoking cessation in mitigating disease risk and improving survival outcomes for MDS patients. She briefly talks about how tobacco smoking contributes to MDS pathogenesis, showing a dose-response relationship between smoking intensity and genetic mutations (ASXL1, SF3B1, U2AF1, ZRSR2). Smoking accelerates disease progression, reduces survival, and necessitates smoking cessation counseling as part of MDS management. Future research will explore the impact of early-life smoking on later MDS development.
Scott Douglas Jacobsen: Can you summarize the key findings of your study from the ASH annual meeting?
Dr. Sangeetha Venugopal: Summary: We have shown that tobacco smoking potentially contributes to the multi-step molecular pathogenesis of MDS.
We demonstrated a dose-response relationship with smoking meaning the heavier someone smokes, the chances of accumulation of mutations are high,
Tobacco smoking is associated with disease progression of MDS and impacts survival adversely.
Jacobsen: What genetic mutations are associated with smoking in MDS patients?
Venugopal: ASXL1, SF3B1, U2AF1, and ZRSR2
Jacobsen: How did your study establish a dose-response relationship between smoking intensity and genetic mutations?
Venugopal: After adjustment for sex, age and disease group, the number of mutations increased significantly with the pack-year (PY) smoked (p=0.006), and those at the 75th and 90th percentiles of PY had 1.8 and 3.5 times the number of mutations, respectively, compared to non-smokers, indicating a dose-response relationship. i.e.,those in the 90th percentile of pack-year smoking had double the number of mutations compared to those in the 75th percentile
Jacobsen: What are the implications of the findings for the clinical management of MDS or its precursor conditions?
Venugopal: When anyone gets diagnosed with MDS or precursor condition who also smoke, must be counselled to quit smoking. Because this study clearly shows that tobacco smoking is associated with disease progression and impacts survival adversely.
Jacobsen: What role does smoking cessation counseling play in the treatment plan for patients with MDS?
Venugopal: When anyone gets saddled with a new diagnosis of cancer,first question to come up is dietary and lifestyle modification. At the outset, physicians discuss about maintaining a healthy lifestyle and smoking cessation is an important lifestyle modification
Jacobsen: How does your study contribute to the existing body of knowledge regarding smoking and blood cancers?
Venugopal: We know that smoking is an epidemiological risk factor. This study shows that smoking is also associated with disease progression and impacts survival adversely
Jacobsen: What are the next steps in your research?
Venugopal: To evaluate if smoking at an young age contributes to the development of MDS at an older age.
Jacobsen: Thank you for the opportunity and your time, Dr. Venugopal.
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Scott Douglas Jacobsen is the publisher of In-Sight Publishing (ISBN: 978-1-0692343) and Editor-in-Chief of In-Sight: Interviews (ISSN: 2369-6885). He writes for The Good Men Project, The Humanist, International Policy Digest (ISSN: 2332-9416), and other media. He is a member in good standing of numerous media organizations.
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Photo credit: University of Miami.
