Dr. Adi Tzoref-Lorenz's life changed after seeing one particular patient. She was an internal medicine physician, specializing in hematology, with no particular ambitions towards research, when a patient with chronic lymphocytic cancer came to her clinic.
"This is supposed to be a 'good' disease that allows for continued functioning and a reasonable life expectancy," she says. "But one day she came with hemophagocytic lymphohistiocytosis (HLH), a side effect of blood cancer, in which the immune system overreacts. We treated her for a very intensive month and a half, I would read articles at night and we tried everything. There were moments of hope, and then, boom, she went."
Tzoref-Lorenz couldn't let go of the questions. Why did HLH appear in that patient in particular? And what could be done anyway? "I brought up the idea of conducting research in the field to my department director, and he quickly connected me with the world's leading center of excellence for HLH, at Cincinnati Children's Hospital."
So she set out on a new path. "I had to shorten my residency and obtain funding." Here, a circle closes: "The patient's son helped finance the trip."
She arrived at the HLH center already prepared, with data and ideas for research on HLH in adults, in contrast to the clinic's specialization, which at the time was only in children. "The phenomenon suddenly went from being esoteric to a very hot topic, when it turned out that it was a possible side effect of cancer immunotherapy treatments (drugs that activate the immune system, which have changed the treatment of the disease in the past 15 years – GW)."
She developed an index called OHI, which for the first time allows the diagnosis of the disease based on two blood tests. "Today it is used all over the world," she says. The test found that even without immunotherapy, 3%-5% of leukemia patients have high-level HLH, and 20%-30% have low-level. "We discovered that even the low level leads to a shortened life expectancy in cancer patients. The test can already be used today to plan treatment."
Have you registered a patent for the tests?
"The tests are part of my research and we gave it to the world. The adoption of the OHI around the world has greatly advanced and facilitated research in the field."
However, after a year, funding for the research ran out. "It was during the Covid pandemic, and up until the last minute we didn't know if I would receive additional funding, because at that time I didn't yet have results. In the end, I gave up and decided to return to Israel, with my husband and three children." In the end she did receive the funding.
After three fruitful years in Cincinnati, Tzoref-Lorenz returned to Tel Aviv University for a doctorate, where she identified opportunities for treating HLH using drugs that are already on the market. Unlike with the test, she says, "We might build a company around this solution." After completing her doctorate, she joined Meir Hospital in Kfar Saba and set up a laboratory there to study the over-activity of the immune system in cancer. This laboratory is already well-funded, among other things, through the "Beria" program for physician researchers.
"We are examining whether the phenomenon occurs in other types of cancer, and trying to understand why it occurs in certain people. Meanwhile, we find it in a variety of blood cancers and are examining it in other tumors." At the same time, she has founded a multidisciplinary unit at the hospital to examine HLH in conditions other than cancer.
A spur-of-the-moment decision to study medicine
Tzoref-Lorenz grew up in Herzliya to parents who were accountants. In her youth, she had no particular academic ambitions. "I was a bit rebellious over my parents' achievements," she says. In the army, she took a training course as a guide at Sde Boker, which included geology, zoology, astronomy and Israeli history, and this stimulated a thirst for knowledge. She says she enrolled in medical studies on a spur of the moment decision, but on second thoughts she says: "As a child, I got injured a lot. My mother says this is my fix."
She met her husband Lior in the army. "He was a in the navy and came to train in preparation for the (Gaza) disengagement. It's unpleasant to say that thanks to the disengagement, a difficult event for many people, I got to know him. He is very significant in my success because he is very supportive and inspiring, and together we like to dream and push boundaries. He is an educator and is establishing a new school in Pardesiya."
Is it easier for you to deal with the death of patients today?
"Not really. We have very young patients, and you can't remain indifferent. But if I'm doing research, I'm basically saying that I don't accept that I don't have an answer. I will learn, understand and apply it to the next patient."
This article is part of the annual "Globes" "40 Under 40" young leadership in Israel project.
Published by Globes, Israel business news – en.globes.co.il – on April 4, 2025.
© Copyright of Globes Publisher Itonut (1983) Ltd., 2025.
