President Elect International Society for Advancement of Cytometry Dr Paul K Wallace

05 February 2016, International visits and visitors

Dr Paul K Wallace – President Elect International Society for Advancement of Cytometry begins our visiting scientist programme for 2016

To list visiting American, Dr Paul K Wallace’s qualifications and accomplishments would take several pages, but at the same time it neatly provides a three-decade masterclass in medical research, and its uptake into clinical practice; in particular HIV and cancer.

He gives a vivid account of the socio-political and scientific effort to find a reliable diagnostic tool for HIV in the early 1980s, and the part his area of expertise – flow cytometry – played, when the levels of CD4 cells – immune cells – in a person with HIV were measured as drastically reduced from those in a healthy subject. It was understood that the virus attacked and killed these cells, but an accurate measure provides the benchmark for when to start anti-retroviral treatment. Flow cytometry, now is used in many diagnostic laboratories worldwide, to monitor patients with HIV, to measure stem cells for bone marrow transplant and for the early diagnosis and treatment of patients with blood cancers.

Fast-forward 35 years and Paul K Wallace is Professor of Oncology at Roswell Park Cancer Institute (RPCI) in Buffalo, New York and the Director of their Flow and Image Cytometry Facility. He and fellow American Dr Kathy Muirhead, and Malaghan Institute’s Kylie Price are hosting a three-day Flow Cytometry workshop, here, for internal and external scientists.

The workshop focuses on two different types of cell proliferation, the first, “DNA cell cycle analysis” looks at the life cycle of a cell as it doubles its DNA content prior to division. The workshop discussed how this technique is used to define how aggressive a patient’s cancer is and whether a more intensive treatment was warranted. The second type of cell proliferation measures the expansion of different cell populations. Dr Wallace uses this technique to judge the effectiveness of different therapeutic cancer vaccines, looking for an expansion of immune cells capable of kill cancer cells.

Workshop participants have access to a scientist whose workplace is the only upstate New York facility to hold the National Cancer Institute designation of "comprehensive cancer center" and to serve as a member of America’s National Comprehensive Cancer Network.

Roswell Park Cancer Institute, established in 1898, was originally run out of three small rooms. Today it has over 3,000 plus staff working across patient services all with one mission, to understand prevent and cure cancer. Its founder, Dr Roswell Park, predicted deaths in America from communicable/infectious diseases would be overtaken by non-communicable diseases such as cancer.  The progress of medical research and clinical improvements around so-called 21st century diseases could not have happened without his very early inspiration and instigation.

Dr Wallace says, “Foresight like that, combined with generations of research, has translated into advances in both the diagnosis of cancers and increasingly better therapies. While cancer rates look to still be rising, more people are living longer with their illness.  In blood cancers, my specialty area, we know that after treatment, when patients are in remission, small numbers of cancer cells may still remain in the bone marrow of some patients.  Flow technology is now able to measure these levels of ‘minimal residual disease’ to affect patient treatments.  Equally, a patient’s individual early responses to different drug therapies can be monitored to measure benefit.  Instead of staying with a therapy that may have reduced impact, patient monitoring can improve decision-making and outcomes. Thus, flow cytometry has moved into the realm of personalised medicine.”

He continues, “Dr Roswell Park would certainly be galvanised by the recent announcement to cure cancer/s within the next five years. The will is certainly there, and it is probably the right time to muster the troops using this specific timeframe. My field of Immunology has entered clinical practice for a small number of cancers using antibodies and killer T cells to target and kill tumors and recently personalized vaccines to enhance the patient’s immune response to their cancer. I believe that combinations of surgery, radiation and chemotherapy can be used to eliminate most tumor cells and then the immune system can be turned on to search for and destroy any residual cancer affecting a cure of the patient. Genomics is uncovering gene-specific links to disease and wellness. As we gain more knowledge about the mechanisms that keep us in ‘wellness’ eventually it may be possible for more cancers to be eradicated or become manageable chronic diseases. Instrumentation like flow cytometry will no doubt advance to stay part of this process of change.”

Additional to Dr Wallace’s research, patient-centered work, and incoming Presidential responsibilities to the worldwide Flow Cytometry community, he also offers his time to create cytometry education training modules for CYTO University, International Society for Advancement of Cytometry – ISAC’s – on-line portal  And the co-authors of these modules? Unsurprisingly they are two other busy people; Dr Kathy Muirhead and Kylie Price.