Biography

Ms. Kleinerman received a B.A. from Washington University in 1971 and a M.P.H. in 1979 from Boston University School of Public Health. Ms. Kleinerman joined the NCI Epidemiology and Biostatistics Program in 1979, and she is currently a staff scientist in the Radiation Epidemiology Branch. She was awarded a NIH Individual Merit Award in 2007 for research providing the first definitive evidence of gene-environment interactions underlying excess cancer risks in retinoblastoma, the NCI DCEG Award for Outstanding Research Paper by a Staff Scientist in 2000 on lung cancer following Retinoblastoma, and a NIH Group Merit Award for the first broad-based description of applications of radiation dosimetry to epidemiological studies, an invaluable international resource.

Research Interests

• Gene-environment interaction in retinoblastoma patients
• Cancer in Ataxia-Telangiectasia patients and their relatives
• Interventional radiation and fluroscopically-guided procedures
• Biodosimetry

Research

Retinoblastoma

Children with hereditary retinoblastoma (Rb) are at exceptionally high risk of sarcomas, melanoma and brain tumors due to a germline mutation in their RB-1 gene, which encodes the cell cycle regulatory protein pRb. In collaboration with the Genetics Epidemiology Branch, we continue to investigate cancer incidence and mortality in a series of 1,850 one-year survivors of RB to learn whether these patients continue to be at risk of sarcomas as they age as well as typical epithelial tumors of adulthood. We identified a striking excess of leiomyosarcomas in patients 35 years and later after Rb diagnosis. Efforts are underway to identify specific mutations in the Rb-1 gene in hereditary patients who develop second cancers.

Cancer Risk in Relatives of Ataxia-Telangiectasia Patients

Heterozygote carriers of mutations in the ATM gene, especially mothers of A-T patients, appear to be at increased risk of breast cancer. In a collaborative effort with the Nordic cancer registries, investigators in the United Kingdom, France the Genetics Epidemiology Branch, we are pooling data to investigate the risk of breast and other cancer in family members of AT patients and analyzing the mutation status of their ATM genes to identify genotype-phenotype associations.

Keywords

Ataxia-Telangiectasia, breast cancer, radiotherapy, retinoblastoma, RB-1 gene, second primary cancers, interventional radiation

Selected Publications

• Kleinerman RA et al. Risk of soft tissue sarcomas by individual subtype in survivors of hereditary retinoblastoma. JNCI 99;24-31, 2007.
• Chaturvedi A et al. Second cancers among 104760 survivors of cervical cancer: Evaluation of long-term risk. JNCI 99;1634-43, 2007.
• Kleinerman RA et al. Risk of new cancers after radiotherapy in long-term survivors of retinoblastoma: An extended follow-up. JCO 23;2272-79, 2005.
• Kim KP et al. Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys 94;211-27, 2008.

Collaborators

DCEG Collaborators

• Amy Berrington, Andre Bouville, Joseph F. Fraumeni, Jr., Ethel Gilbert, Martha Linet, Lindsay Morton, Elaine Ron, Alice Sigurdson, Ph.D., Steve Simon, Peggy Tucker, Chu-Ling Yu

Other Scientific Collaborators

• David Abramson, M.D. and Katherine Beaverson, M.S., New York Presbyterian Hospital, New York, NY
• Anne-Lise Borresen-Dale, Norwegian Radium Hospital, Oslo, Norway
• Gabriel Chodick, Ph.D. University of Tel Aviv, School of Public Health, Tel Aviv, Israel
• Graca Dores, M.D., VA Medical Center, Oklahoma, OK
• Eric Holowaty, Ph.D., Ontario Cancer Foundation, Canada
• Heikki Joensuu, M.D. Helsinki University Central Hospital, Finland
• Froydis Langmark, Norway Cancer Registry
• Charles Lynch, M.D. Iowa State Cancer Registry
• Jorgen Olsen, Danish Cancer Society, Copenhagen, Denmark
• Johanna Seddon, Massachusetts General Hospital, Boston, MA
• Hans Storm, M.D. Danish Cancer Soceity, Copenhagen, Denmark
• Marilyn Stovall, Ph.D., University of Texas M.D. Anderson Cancer Center, Houston, TX
• James Tucker, Ph.D., Wayne State University, Detroit, MI