Chronic Myeloid Leukaemia
Understanding the biology and improving the management of chronic myeloid leukaemia (CML) has been a major focus of the group for the past three decades. Professor Jane Apperley, Dr David Marin and Dr Dragana Milojkovic co-ordinate the largest clinical practice in CML in Europe. Together with the previous Chairman of the Department, and current Emeritus Professor, John Goldman, they have contributed to the development of the tyrosine kinase inhibitors (TKI) for clinical use, participating in numerous pivotal trials. Professor Goldman has a world-wide reputation in the biology and treatment of chronic myeloid leukaemia and his legacy is the continuing strength of the department in this disease. The use of TKI has replaced the previous front line therapy of allogeneic stem cell transplantation (SCT) but the department remains the busiest centre in Europe for SCT in CML, as we maintain a national and international referral service for patients failing TKI. We have a comprehensive clinical database of transplant outcome, co-ordinated by our in-house biostatistician, Dr Richard Szydlo, and have contributed extensively to improvements in clinical management and outcome.
Our clinical programme is complemented by our Clinical Trials Department, directed by Dr David Marin, where the combination of expertise in trial design, biostatistical modelling, research nursing, database management and ethical and regulatory affairs, allow us to instigate academic led studies and participate in national and international academic and commercial trials. This work actively links with and supports the achievements of the CML Working Group of the European LeukemiaNet (ELN). The value of our clinical data is enhanced by the presence of a CML biobank for both in-house and national use. Current academic led studies focus on the role of patient compliance in determining disease response and the enhancement of tumour induced immune responses via peptide and DNA vaccination of leukaemic antigens (trial led by Dr Katy Rezvani)
Modern management of CML, either by TKI or SCT, requires rigorous attention to monitoring or minimal residual disease (MDR). Our molecular diagnostic and MRD laboratory, headed by Professor Letizia Foroni, is internationally acclaimed for accuracy and quality, such that we support the molecular monitoring of global commercial and national academic studies. Professor Foroni also heads a more basic research laboratory and together with Professor Junia Melo, has a particular interest in the identification of biomarkers for response to therapy and disease progression by gene expression profiling and genome wide sequencing. This work is further developed in our cytogenetics laboratory, headed by Dr Alistair Reid, whose interests lie in the use of modern techniques to identify copy number abnormalities and variation as an alternative technology for the recognition of biomarkers. Professor Myrtle Gordon (now Emeritus) has a long standing interest in the identification of links between molecular defects and cell kinetics in CML and the cellular basis for therapy in CML.
