Professor Persis Amrolia, Institute of Child Health, London

01 December 2008

Improving immune response following bone marrow transplant for children with acute myeloid leukaemia (ALL).

Amount of grant: £348,791

Date of award: December 2008

Background

When a child is diagnosed with acute myeloid leukaemia (AML), doctors immediately start aggressive chemotherapy to kill the deadly leukaemic cells.

Unfortunately this isn’t enough to cure all children; some simply don’t respond to the chemotherapy, others may respond well initially only to relapse. The only hope for these children is a bone marrow transplant.

The child’s best hope lies in a transplant from a matched sibling. Many children, however, do not have a matched sibling and so are transplanted from either a matched unrelated donor or a half-matched donor (usually a parent).

In these cases, both the patient’s own immune cells and the immune cells in the donated bone marrow must be removed – to prevent the patient attacking the transplant, or the transplant attacking the patient.

This leaves the patient with very little immunity for many months after the transplant, placing them at enormous risk of life-threatening infections as well as leukaemic relapse.

The research project

This important work should improve the safety of bone marrow transplantation for children with AML

Professor Amrolia has found a way to improve the immunity of children receiving a transplant from a half-matched parent. The team has successfully removed from the graft the particular type of immune cell which can attack the patient, whilst preserving the ones that fight viruses and leukaemia.

The team is now applying this technique to children receiving transplants from unrelated donors. They also need to refine their methods for removing the harmful immune cells, to retain as many of the good cells as possible and give the patient the very best chance of fighting infections and leukaemic relapse.

This important work should improve the safety of bone marrow transplantation for children with AML by reducing the risk of both viral infections and leukaemic relapse post-transplant.

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Related Topics Institute of Child Health, Dr Persis Amrolia

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