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Published in Cancer Discovery, the study was led by researchers at the Wellcome Sanger Institute and their collaborators. The team combined genetic analysis with detailed clinical records to investigate how chronic blood cancers can develop over several decades. The findings were also presented at the American Association of Cancer Research (AACR) Conference in San Diego.

How Chronic Blood Cancers Develop

Myeloproliferative neoplasms (MPNs) are a group of rare, long-lasting blood cancers that begin in the bone marrow, where blood cells are produced. In people with MPNs, the bone marrow makes certain blood cells in an uncontrolled way.

Around 40,000 people in the UK are living with MPNs, and approximately 4,000 new cases are diagnosed each year.[1] These cancers often progress slowly. They can begin with mutations, or changes in DNA, that arise very early in life, followed by additional mutations that accumulate over several decades.[2]

Most MPNs are associated with mutations in the JAK2, CALR or MPL genes. However, around 10 percent of patients do not have any of these common genetic changes.

In these cases, doctors may diagnose cancer largely by examining the appearance of cells in the bone marrow. As a result, some patients could receive cancer treatment, including chemotherapy, without definitive genetic evidence that they have an underlying blood cancer.

Why Some Cases Worsen

The course of chronic blood cancer varies widely between patients. Some people feel well for years and need only mild treatment while their disease remains stable. Others eventually develop more serious conditions, including leukemia or myelofibrosis, which causes scarring in the bone marrow.

Doctors cannot always determine in advance whose disease will remain stable and whose will progress. The researchers therefore investigated whether genetic changes could reveal which patients were at greater risk. They also examined whether people who lacked the common MPN mutations truly had blood cancer.

The team followed 30 patients with chronic blood cancers, primarily MPNs. They combined whole-genome sequencing with extensive clinical information, including nearly 8,000 blood test results, treatment records and disease data.[3]

More than 450 samples were examined through repeated genomic testing. Some patients were monitored through routine clinical care for as long as 25 years.

Building Family Trees of Blood Cells

The long follow-up period connected genomic research at the Sanger Institute with routine patient care at Cambridge University Hospitals NHS Foundation Trust. This allowed the scientists to observe how blood cell populations changed over time and provided a broader view of how cancers evolve.

Using DNA taken from blood cells, the researchers created genetic 'family trees'. These reconstructions allowed them to trace the origins of cancer clones, groups of genetically identical cells that later contributed to disease progression.

The analysis revealed distinct patterns of evolution among patients with MPNs.

People whose disease remained clinically stable tended to have genetically 'steady' blood cell populations that acquired few or no additional mutations. By contrast, patients whose disease progressed developed new DNA changes over time.

The results suggest that progression in chronic blood cancers may be biologically 'encoded' years before a patient's condition visibly deteriorates. Mutations linked to future progression may be detectable long before symptoms worsen or standard clinical tests reveal a major change.

Some Diagnoses May Reflect Normal Aging

The researchers also examined patients who lacked mutations in JAK2, CALR or MPL.

They reconstructed 'family trees' from around 200 blood cell genomes belonging to these patients. Instead of finding patterns typical of cancer, the scientists observed changes that were more consistent with normal aging.

This finding challenges the assumption that everyone with certain unusual bone marrow features has a true blood cancer. Some people currently placed in this disease category may instead have biological characteristics that are different from those seen in genuine MPNs.

The results suggest that doctors may need to reconsider how these patients are diagnosed and managed. They also support new British Society for Haematology guidelines for investigating people without JAK2, CALR or MPL mutations.[4,5]

These guidelines recommend that some patients initially be described as having thrombocytosis without JAK2, CALR or MPL mutations, rather than being immediately diagnosed with blood cancer. Thrombocytosis means a high platelet count without clear genetic evidence of cancer.

Toward Regular Genomic Monitoring

The study highlights several possible clinical benefits of using genomic information more routinely in cancer care. Genetic testing could help doctors distinguish stable disease from cancers that are likely to progress, refine uncertain diagnoses and guide the development of more precise treatments.

In the future, regular genomic tests could allow clinicians to identify high-risk patients years before their disease worsens. That could create opportunities to intervene earlier while avoiding unnecessary treatment for people whose blood changes may not be cancerous.

Dr. Daniel Leongamornlert, first author at the Wellcome Sanger Institute, said: "We followed patients with myeloproliferative neoplasms over many years and used genome sequencing and clinical history to trace how blood cell populations changed over time. By reconstructing the ancestry of cells, we were able to see different evolutionary patterns between patients who had stable disease compared to others who progressed."

Dr. Dani Skirrow, Research Information Manager at Cancer Research UK, who part-funded the study, said: "We're in a golden age of research where advances in technology mean we can rapidly read DNA to find the errors in the code that can lead to cancer. Collaboratively, our researchers have read huge amounts of DNA to build up a detailed picture of how certain blood cancers can start, grow and behave, revealing some changes that could help us predict cancer years in advance. This type of discovery research is essential to improve how we monitor people at risk of blood cancer, and to help us find better ways to prevent, detect and treat the disease so people can live longer, better lives."

Dr. Jyoti Nangalia, senior author at the Wellcome Sanger Institute and Honorary Consultant Haematologist at Cambridge University Hospitals NHS Foundation Trust, said: "These are patients we have cared for and followed in our clinic for over 15 years. It can be incredibly difficult to predict how their cancers might change over time. By combining long-term clinical care with regular genomic analysis, we've been able to watch how the genetic code of their disease evolves in advance of clinical changes. The patterns we have found will help doctors develop better monitoring strategies, refine diagnosis and lead to better patient outcomes in the long run."

One Patient's Decades-Long Experience

Alan Everitt, 77, has received care at Cambridge University Hospitals NHS Foundation Trust for more than three decades. He was diagnosed in 1992 with essential thrombocythemia (ET), a rare form of MPN that causes the body to produce too many platelets, the blood cells involved in clotting.

His condition later progressed to myelofibrosis, which causes scar tissue to develop in the bone marrow. He has also experienced recurrent skin cancers.

Alan Everitt, from Hardwick, Cambridgeshire, said: "It's been reassuring to be cared for over so many years by both the hematology and plastic surgery teams at Addenbrooke's Hospital in Cambridge. I have always felt well supported and I'm grateful for the care and feedback at every step. Living with a blood cancer for such a long time has come with many challenges, and I hope that taking part in this research will help make a difference for future patients whose cancer is likely to progress over time, as mine has."

Notes:

1. Blood Cancer UK. Myeloproliferative neoplasms (MPN). Available at: https://bloodcancer.org.uk/understanding-blood-cancer/myeloproliferative-neoplasms/ (Last accessed: April 2026)
2. N. Williams et al. (2022). 'Life histories of myeloproliferative neoplasms inferred from phylogenies.' Nature. DOI: 10.1038/s41586-021-04312-6
3. Blood and bone marrow samples were obtained from patients recruited at Cambridge University Hospitals NHS Foundation Trust. Clinical data regarding the patients including blood counts and treatment history were collected using the electronic health record (EHR) systems. Whole blood and skin biopsies were obtained during routine clinical visits with buccal swab or T-cell samples from patients for matched 'normal' material.
4. A. Godfrey et al. (2026). 'Investigation and management of thrombocytosis without JAK2, CALR or MPL mutations: A British Society for Haematology Guideline'. British Journal of Haematology. DOI: 10.1111/bjh.70260
5. New British Society for Haematology guidelines recommend describing some patients as having thrombocytosis without JAK2, CALR or MPL mutations -- meaning a high platelet count without clear genetic evidence of cancer -- rather than initially diagnosing them with a blood cancer.

This research was supported in part by Wellcome and Cancer Research UK. %!s()

The jet went down on Friday near the Miramar airbase in San Diego. “The pilot ejected, was transported to a local medical facility in stable condition for evaluation and treatment of non-life-threatening injuries,” the Marine Corps said in a statement.

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Aerial video from a news helicopter showed a plume of black smoke rising from the wreckage in a dirt field, with multiple military and firefighting vehicles and people standing nearby. What appeared to be white flame retardant covered the ground, and at least one person was spraying the wreckage with a fire hose.

Candace Hadley, a spokesperson for San Diego Fire, said firefighters were on scene to respond to a vegetation fire that sparked near the crash site. She referred additional questions to Marine Corps Air Station Miramar.

The base used to host the Navy fighter pilot training school depicted in the original Top Gun movie and was known as “Fightertown USA” in its heyday. The school was relocated to Naval Air Station Fallon in Nevada in 1996 after the base was transferred to the Marine Corps.

The US Marine Corps, Navy and Air Force together have more than 630 F-35s, according to a 2024 analysis by the Government Accountability Office. The F-35B is one of several versions, and has an engine designed for short takeoffs and vertical landings. A single F-35B costs about $109m. The report estimated that the overall F-35 programme will cost roughly $2 trillion after the military buys more than 1,800 more jets and operates them for decades to come.

At least seven other military aircraft have crashed in the United States this year, according to the Flight Safety Foundation’s Aviation Safety Network database.

The most serious incident involved a B-52 bomber that crashed shortly after taking off in California’s Mojave Desert in June, killing all eight people on board. %!s()

It marked his second time at the festival, having played in 2018, and came after a rocky start to the month. On July 9, the musician pulled out of Cowboys Music Festival after sharing a vulnerable post earlier that week in which he addressed being called an “industry plant.” Fellow artists, celebs and fans responded with their support of the musician, including SZA, Lauren Jauregui, Alyssa Milano, and more. 

Onstage at Lolla, he appeared to put that all behind him, delivering a full throttle and very sweaty set. In an epic moment during the fest, the star brought up a fan from the swell of the crowd, Katie from Michigan, and handed her his guitar and pick. The duo launched into fan-favorite song “Fleabag” with Katie helming the ax, delivering a high-voltage performance that ended with Yungblud jumping off the stage to high fave and embrace more fans. The singer closed with Idols ballad “Zombie.”

The singer born Dominic Harrison drew a massive crowd to his set on the Bud Light stage. And among his fans are fellow musicians. He performed with Black Sabbath for what turned out to be Ozzy Osbourne’s final concert and performed a tribute to him at the MTV VMA Awards last September. He then teamed up with Aerosmith for a collaborative EP last November, and he released a new version of “Zombie” featuring the Smashing Pumpkins earlier this year. While he played a couple hours before the Pumpkins took the same stage as headliners on Friday, they did not join him for the song. Instead, Pumpkins frontman Billy Corgan joined Yungblud last night during his Lollapalooza after show at the Riviera.

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Touring on his fourth and latest album, he highlighted songs from it, beginning with opener “Hello Heaven, Hello.” He paid tribute to Ozzy and Black Sabbath with “Changes” and also nodded to his Aerosmith collab with a performance of “My Only Angel.” It was a raucous return to form, which his fervent fans welcomed, in light of his previous nixed shows.

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In an interview with Rolling Stone’s Music Now in January, he addressed that he had previously canceled some shows to consciously take better care of himself. “I always get myself checked after every tour I do, especially after this year. I have a tendency to run and run until the wheels fall off,” he said. “I think that’s how I’m built. It was the first time that I had medical advice. They were like, you got 18 months touring coming up. We think you should knock a couple gigs on the head at the end of this year. And I’m pretty grateful for that, to be honest, because it’s been such a mental year to be able to have the time to actually comprehend it and process it in my head. I go back out on tour in January and it runs till mid-’27 now. So I think it’s important to take that time and really process what’s going on and be grateful for it.” %!s()

Soldiers in the Guard’s Counterdrug Program and members of the 10th Civil Support Team learned to use the system, built by Anduril, to spot and target drones.

The system combines different highly sensitive sensors and software with advanced recognition technology. The system includes WISP, the Long Range Camera Tower, the Pulsar frequency sensor and Lattice software.

The system tracks drones in real-time and feeds data gathered from diverse sensors into a single channel for military personnel to evaluate.

In addition to being able to distinguish between drones, birds and other objects in the atmosphere, the system leverages sophisticated artificial intelligence capabilities that allow it to pinpoint the potential locations of hostile drone operators.

Deterring Hazardous Materials

The 10th Civil Support Team is the Guard’s response unit for biological and chemical attacks and frequently performs national security-related missions.

Lt. Col. Wes Watson, director of the Commander’s Action Group for Counter-small Unmanned Aircraft Systems, said that the unit is concerned with drones being used to drop hazardous materials.

"CSTs have been exploring ways to defeat this delivery mechanism [drones] for years and would be vital in the response to a downed drone suspected of carrying a WMD [weapon of mass destruction],” Lt. Col. Wes Watson, director of the Commander’s Action Group for Counter-small Unmanned Aircraft Systems, said in a statement.

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Guardsmen spent two weeks of intensive training learning to use the detection system and plan to deploy it to provide security at large-scale public events.

“From our groundbreaking work in our Counterdrug program to the recent acquisition of an Anduril system as a byproduct of FIFA prep, we are getting after the challenges here with law, policy and domestic employment," Maj. Gen. Gent Welsh, adjutant general of the Washington National Guard, said in a statement.

The Guard troops plan to continue training with the new technology alongside federal agency partners including the FBI and Department of Homeland Security to gain further expertise in using it to detect drone threats within the United States. %!s()

“The FIFA Forward Enterprise project was intended to provide a basis for further strengthening our FIFA Member Associations and our sport worldwide, especially in those countries where support is most needed. And more so, as we said from the outset, to do this only if a majority of the FIFA Member Associations were in support and always subject to a consultation process with them, the FIFA Council, the Confederations and wider stakeholders,” Infantino said in a statement on Friday.

“Having listened carefully to all the views, it has become clear that the project has created divisions of a nature that, regardless of the level of support, are no longer in the interest of the objective set out in the first place,” he continued. “Our purpose has always been — and will always be — to unite and improve. As a result, this proposal will not proceed.”

The proposed plan would have consisted of FIFA setting up a new entity, FIFA Forward Enterprise (FFE), that would bundle soccer associated money-making operations while a significant stake would be sold to private investors. 20 percent of the company would have been sold to Thrive Capital, an invest group run by Joshua Kushner, the brother of President Donald Trump’s son-in-law, Jared Kushner.

Backlash was immediate, with European soccer body UEFA saying on Thursday that if the plan went through, it would boycott FIFA events, including the World Cup. Three of the four semi-finalists of the 2026 men’s World Cup hailed from Europe, including this year’s champion, Spain.

Earlier this week, U.K. Prime Minister Andy Burnham released a statement online that read, “football does not belong to investors. It belongs to the people who fill the stands and who stand on the touchline week in, week out, rain or shine. The World Cup is not a product. It is the greatest competition in world sport, and it was never anyone’s to sell. Dress the deal up however you like. Once you have sold a piece of it, you have sold out.”

Infantino’s statement continued, “Moving forward, my intent is to bring all interested parties back together in the coming days and weeks in the spirit of shared interest in our game, and with the objective to continue growing football everywhere, particularly in those countries that mostly need our support.”
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