Blood cancer's "energy addiction" could be its biggest weakness

Scientists at the University of Colorado Anschutz Cancer Center have identified a surprising metabolic vulnerability in the stem cells behind high-risk myelodysplastic syndromes (MDS) — an aggressive blood cancer that can evolve into acute myeloid leukemia (AML). Published in Blood Cancer Discovery, the study found that MDS stem cells are far more dependent on nicotinamide adenine dinucleotide (NAD) than healthy blood-forming stem cells, essentially developing an "energy addiction."

When researchers blocked NAMPT — the key enzyme in the NAD recycling pathway — cancer stem cells were thrown into an energy crisis and selectively weakened. Healthy stem cells, by contrast, were able to adapt and compensate. Experiments using patient-derived MDS cells and animal models confirmed that disrupting NAD metabolism reduced the number of disease-driving stem cells, with clinical trials now being planned.

By the Numbers:

• 10,000–20,000 people are diagnosed with MDS in the U.S. each year
• MDS primarily affects older adults and can progress to AML, one of the most difficult-to-treat leukemias

Why it matters: Current MDS treatments are limited and often not curative. Targeting the NAD pathway offers a more precise approach — one that exploits a key biological difference between cancer and normal cells — potentially paving the way for therapies that are both more effective and less harmful to healthy tissue.