Bone Marrow Transplant Service
Research
Research is a continuing and integral part of our work, and is the only means by which treatments can be improved for future patients. The Westmead BMT Service is involved in research at a number of levels: basic laboratory scientific research, translational research, and clinical trials.
The basic laboratory and translational research programs are directed by Professor David Gottlieb. The main focus of the basic science program is to discover how to direct the immune system of normal donors to identify and kill acute myeloid leukemia (AML) cells in patients having BMT.
Prof. Gottlieb's team are developing an understanding of the proteins, or antigens, on AML cells that are recognized by the T lymphocytes (Immune cells) of normal donors, and working on harnessing these cells to eradicate any leukemia cells remaining in AML patients after BMT. Prof. Gottlieb is also investigating how the donor's immune cells can recognize and control various fungi and viruses that can infect patients after BMT. Some aspects of this basic science program have now entered the translational phase (lab bench to bedside) and are in early clinical trials at Westmead. The BMT Service has been conducting a clinical trial of giving BMT patients T lymphocytes from their donors, which have been grown in the laboratory after being exposed to proteins from the virus called Cytomegalovirus (CMV). This virus is common in the community, and is normally controlled by the immune system, but can cause illness in BMT patients, who have temporary severe deficiency of their immune system after BMT. Prof. Gottlieb's team have established a way of growing in the laboratory donor T cells, which recognize and attack CMV, and have given these cells to patients after BMT to restore their immunity to CMV. This breakthrough research will be extended to treating other viral and fungal infections affecting BMT patients.
The Westmead BMT Service is also conducting laboratory research into graft-versus-host disease (GVHD),one of the major complications of allogeneic BMT, in collaboration with Professor Derek Hart, a world authority on dendritic cell research at the Mater Medical Research Institute in Brisbane. Dendritic cells are crucial players in the immune response that regulate the action of T cells. Scientists at Westmead have shown that dendritic cells circulating in the blood of some patients early after BMT show signs of activation, and this is predictive of that patient later getting GVHD. The research team is now working on a novel antibody-based treatment to eliminate these activated cells as a way of preventing GVHD occurring.
The Westmead BMT Service is also very active in clinical trials research, including trials of new treatments for GVHD, new conditioning treatment protocols, and novel ways to diagnose and treat fungal and viral infections. These trials are being carried out as collaborations with other centres in Australia, or internationally, or through the Australasian Leukaemia and Lymphoma Group.
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Last updated: 10th July, 2007
