About 10,000 new patients are diagnosed with blood cancer each year in the UK. We aim to improve the clinical management of these disorders by supporting collaboration between our own team and other expert groups.

BLOOD CANCER AND ITS TREATMENT

Human tissue viewed through a microscope © arcyto/AdobeStock

STEM AND IMMUNE CELL TRANSPLANT AND CELL THERAPY

Transplanting stem cells and immune cells from a healthy donor is a well-established cellular therapy for numerous blood cancers and blood diseases. In the context of blood cancer, stem cells are harvested from the bone marrow or blood of the donor, and then infused into the patient after unhealthy bone marrow has been eliminated by chemotherapy or radiotherapy. Transplants work because the graft contains immune cells (called ‘T cells’) that can reject the blood cancer. However, T cells within the graft can cause significant side effects, for example graft-versus-host disease, a complication that can cause inflammation in normal parts of the body.

Our researchers are seeking to understand how to foster the anti-cancer effects of T cells, while avoiding damage to normal tissues, as well as understanding why some patients respond better than others to new T cell treatments such as chimeric antigen receptor T cells therapy (CAR-T).

Lymphoid disorders

Lymphoid disorders include a wide range of blood diseases that involve cells from the immune system, known as lymphocytes. Our research covers a number of lymphoid disorders including: Hodgkin Lymphoma, B and T-cell non-Hodgkin lymphoma, myeloma (and other plasma cell disorders), chronic lymphocytic leukaemia (CLL) and multiple myeloma.

Our researchers lead many trials of new treatments, particularly for B and T cell lymphomas and work closely with biotech partners, enabling them to bring some of their new treatments to patients with lymphoid cancers.

Acute Myeloid Leukaemia Research (AML)

Acute myeloid leukaemia (AML) is a cancer of the white blood cells which develops in the bone marrow. It originates in marrow stem cells that develop abnormalities deep in their instruction manual, the DNA. These cells then become elusive “leukaemic stem cells”. Current chemotherapy can efficiently kill leukaemia cells in the bone marrow, but generally do not get rid of the leukaemic stem cells- this means that after chemotherapy, the leukaemia can return. Our researchers work on methods to find these leukaemic stem cells and determine exactly how they have gone wrong to target them directly with new drugs.

Children with Down’s Syndrome are at increased risk of developing AML, which appears to be linked to mutations in a gene called GATA1. Our researchers work with clinicians to identify Down’s syndrome patients with GATA1 mutations. These patients are then followed-up with regular tests to see if the numbers of gene mutations are increasing. This can aid diagnosis and guide therapy.

Myeloproliferative Disease

Myeloproliferative neoplasms (MPN) are a group of chronic blood cancers that cause increased production of bone marrow and blood cells. Types of MPN include Chronic Myeloid Leukaemia, Polycythaemia Vera, Essential Thrombocythaemia, Myelofibrosis and other rare subtypes. In most cases these cancers develop and progress slowly. MPNs can cause significant symptoms and cancer-associated complications including blood clots. Researchers are focused on understanding why MPNs arise, and the mechanisms that drive progression from chronic to advanced stage disease.

Myelodysplasia (MDS)

Myelodysplasia (MDS) includes a diverse group of blood cell disorders, caused by abnormal bone marrow changes or ineffective blood cell production and development. These result in anaemia, infections and bleeding. MDS patients also have a high risk of developing acute myeloid leukaemia (AML). Our research focuses on rare MDS bone marrow cells, known as MDS stem cells, which are responsible for the disease. Past and current research is looking at how to identify these cells in different types of MDS, and how they differ from normal cells.

Myeloma

Myeloma is an incurable cancer of bone marrow-dwelling plasma cells, which interacts with its bone marrow microenvironment to cause immune suppression and bone destruction. In recent years various novel therapies have been developed that have improved survival significantly, but cure has remained elusive, and targeting these various new treatments to the patients and disease stage where they will be most effective remains a great challenge.