Surviving Cancer and Becoming a Leukemia Researcher

When Aaron Viny, MD, was diagnosed with acute lymphoblastic leukemia (ALL) at age 20, he found himself in a space few people understood. Too old for pediatric cancer care, too young for traditional adult protocols, he belonged to a group now known as adolescents and young adults (AYAs) with cancer.

More than two decades later, Dr. Viny is a physician-scientist, leukemia specialist, and researcher at Columbia, where the questions he once faced as a patient now influence the therapies he provides and the research he leads.

Looking back on the ways his cancer diagnosis shaped his life, his research, and the patients he cares for today, Dr. Viny tells his story.

I am a 23-year survivor of ALL.

Even now, saying those words feels surreal.

When I was diagnosed at age 20, I occupied a strange place in medicine. ALL is commonly thought of as a childhood cancer. It also occurs in older adults. But patients my age—referred to now as AYAs—fell somewhere in between.

At the time, we didn't fully understand what that meant. Should young adults be treated more like children or more like adults? Which clinical trials were appropriate? Which therapies would provide the best chance of survival while preserving our futures? Those questions became deeply personal.

I had always wanted to become a physician. Cancer didn't change that dream. If anything, it intensified it. When I look back at the frightened 20-year-old who was trying to survive leukemia while dreaming of medical school, I could never have imagined where this journey would lead.

My therapy included a bone marrow transplant, where my body received a new immune system. My younger brother was the donor. This type of treatment has significant risks, but for me, it was a cure.

On the one-year anniversary of my transplant, I started my medical training at the Cleveland Clinic Lerner College of Medicine. As part of its first graduating class, I found myself in an environment dedicated to training physician-scientists—people who cared for patients while asking difficult questions and developing the tools to answer them.

I arrived with a question that was impossible to separate from my own experience: What does it mean to be diagnosed with leukemia as a young adult?

As a medical student, I began working with researchers who shared my interest in that question. One of them was Justine Kahn, MD, now an associate professor and a pediatric oncologist here at Columbia. Under the mentorship of Archie Bleyer, MD, we studied outcomes among AYAs with leukemias and lymphomas.

What we found was troubling. AYAs were often too old for pediatric trials and too young for adult trials, leaving them underrepresented in the studies guiding treatment decisions. We called it the "AYA gap."

Our work helped draw attention to that problem and contributed to a growing movement focused on improving care for AYAs with cancer. Over time, eligibility criteria have expanded for many clinical trials, helping to ensure that patients ages 15-39 would no longer be excluded simply because they didn't fit neatly into traditional age categories. Dr. Kahn and I were later reunited when I came to Columbia, and her program continues to lead the charge for further optimization of care for these unique groups of patients.

This was a remarkable experience: seeing a question that began as a personal concern evolve into research that could help other patients.

Recently, I had another opportunity to contribute to that effort.

In 2023, the American Society of Hematology convened experts to develop consensus guidelines for AYAs with ALL. Participating in those discussions felt like coming full circle. Many of the questions we addressed were ones I had lived through myself—not only treatment decisions, but also issues involving education, fertility, career development, survivorship, and quality of life. In many ways, my own medical journey was woven into those recommendations.

One example remains especially meaningful.

When I was treated in 2003, I was enrolled in a clinical trial led by a physician I had never met—Nicole Lamanna, MD, who now leads our leukemia program at Columbia. One aspect of that trial involved a drug called L-asparaginase. Patients were randomized to receive it or not receive it (I did not receive it).

Today, we know that L-asparaginase is an important and effective therapy for many AYAs with ALL. That knowledge came from studies like the one I participated in. That knowledge is now part of the consensus guidelines for AYAs.

One decision from my treatment remains particularly significant. At the time, patients with leukemia involving the spinal fluid often received both intrathecal chemotherapy and cranial radiation. The radiation was effective but carried a substantial risk of long-term cognitive side effects.

My transplant oncologist consulted experts around the country to determine whether radiation could safely be avoided. Together, they decided to pursue a different path. Instead of whole-brain radiation, I received extended intrathecal chemotherapy through an Ommaya reservoir implanted beneath my scalp, allowing chemotherapy to be delivered directly into the fluid surrounding my brain.

For a full year after treatment, including during my first year of medical school, I left class once a month, went to the cancer center, received chemotherapy, and returned to my studies. At the time, the approach was not standard. Today, the evidence has caught up.

The consensus guidelines now recommend avoiding cranial radiation in many situations like mine because studies have shown it often adds toxicity without improving outcomes.

Being able to help write recommendations today that are supported by evidence that validated a decision made during my own treatment years ago is profoundly emotional.

At the time I was treated, relapsed ALL often felt like a death sentence. Fortunately, bone marrow transplantation was available to me then because scientists and physicians before me had asked difficult questions, conducted studies, and pushed the field forward. Today, patients have options that were unimaginable when I was diagnosed: Bispecific antibodies and antibody-drug conjugates have created new treatment possibilities. Targeted therapies continue to expand. And CAR-T cell therapy has transformed outcomes for many patients.

"Surviving cancer influences how I approach research today. My laboratory focuses on understanding how blood cancers develop and how we can design better treatments."

In some patients with specific genetic abnormalities, including the Philadelphia chromosome, we now have chemotherapy-free regimens that produce remarkable remission rates. The ability to preserve cognitive function and maintain fertility—allowing patients to pursue education, build careers, and raise families—matters deeply. Surviving cancer means more than being alive. It means having the opportunity to live the life you imagined for yourself.

Surviving cancer also influences how I approach research today. My laboratory focuses on understanding how blood cancers develop and how we can design better treatments. One area of interest is a gene called STAG2, which can carry a mutation that disrupts the development and maturation of blood cells from stem cells in the bone marrow. By understanding the mechanics of this disruption, we hope to identify therapies that restore proper cellular programming.

Cancer shaped my life in ways I never anticipated. It influenced the questions I ask, the research I pursue, and the perspective I bring into every clinic room and laboratory meeting. My experience as a patient informs that work. It gives it urgency, perspective, and meaning. But, ultimately, what matters most is whether that work helps others.

What gives me the greatest satisfaction today is not simply that I survived. It is becoming a father and watching my two beautiful children grow up. It is seeing patients benefit from advances that did not exist when I was diagnosed and watching treatments become safer and more effective.

Most of all, it is knowing that today's patients have more options, more hope, and brighter futures than ever before.

This as-told-to story is based on a conversation with Aaron Viny, MD, and has been edited for length and clarity.