28 May 2024

Research Blog: The transformative impact of bone marrow transplants

In the realm of medical breakthroughs, few innovations have been as revolutionary and life changing as bone marrow transplants in the treatment of leukaemia. This ground-breaking procedure has not only offered hope but has also saved countless lives. Leukaemia, a cancer of the blood and bone marrow, has long been one of the most challenging diseases to treat. Conventional therapies such as chemotherapy and radiation, while effective to some extent, often come with debilitating side effects and limited long-term success.

Let’s delve into the transformative impact of bone marrow transplants and recognise some of the pioneers who have propelled this field forwards.

Understanding bone marrow transplantation

Bone marrow transplantation involves replacing diseased or damaged bone marrow with healthy stem cells, which can regenerate and produce healthy blood cells among other cells. This procedure holds immense promise for patients with leukaemia, as it offers the possibility of a cure by eradicating cancerous cells and restoring normal blood cell production.

A critical aspect of bone marrow transplants is finding a suitable donor whose tissue type closely matches that of the recipient, minimising the risk of rejection. This emphasises the importance of diversity among potential donors, and the need for extensive donor registries, where there really is power in numbers.

Over the years, the collection of stem cells has evolved, with peripheral blood stem cell collection (PBSC) emerging as a less invasive and less painful alternative to traditional bone marrow extraction. This method, used in 90% of donations, involves collecting blood stem cells directly from the bloodstream, making the donation process simpler and more accessible.

The role of the Anthony Nolan charity

Organisations like the Anthony Nolan Trust have been instrumental in facilitating bone marrow transplants by building and maintaining diverse registries of potential donors. Established in 1974, the Antony Nolan Bone Marrow Register has played a pivotal role in recruiting donors, facilitating matches, and supporting patients throughout the transplant process, now boasting about 22,000 donors (i). Through their relentless efforts, they have transformed the landscape of bone marrow transplantation and inspired similar initiatives worldwide.

However, there is still room to grow and becoming a donor is as easy as registering and taking a DNA swab.

Professor John Goldman

At the forefront of the bone marrow transplantation revolution stands Professor John Goldman, whose pioneering work reshaped the landscape of leukaemia treatment. Professor Goldman’s contributions to the field have been extraordinary, from his leadership in Europe’s early transplant initiatives to his ground-breaking research on Imatinib in the 1990s. Even after his passing, his dedication to leukaemia research continues to leave an enduring legacy, driving advancements in treatment globally.

Challenges and future directions

Despite the remarkable progress made in bone marrow transplantation, challenges persist, particularly regarding access to donor registries among underrepresented communities. Bone marrow transplants require a partial genetic match relating to an array of genes known as the HLA system – family members are the best chance of a match but failing that it’s likely a donor will have to be found from people with a similar ethnic background. This shows how important it is to have a diverse range of donors.

However, innovative approaches like haploidentical transplants – a type of stem cell transplant, using healthy blood forming cells from a half-matched donor – and cord blood transplantation – a transplant using stem cells from an umbilical cord or placenta of a newborn baby – offer promise in expanding the pool of potential donors and improving access to life-saving therapy.

Bone marrow transplants have revolutionised leukaemia treatment, offering new hope and potential cures for patients. However, complications like graft-versus-host disease, where donor cells attack the recipient, and transplant-related mortality highlight the need for ongoing research and innovation. By fostering collaboration between leaders and organisations, we can continue advancing medical innovations. Our commitment to diversity, research, and innovation ensures that every patient can access the life-saving treatment they need.

At Leukaemia UK, we demonstrate our dedication to improving leukaemia treatment not only by funding ground-breaking projects with innovative approaches but also by supporting partnerships like IMPACT, which has previously been jointly funded by Anthony Nolan, Leukaemia UK, and NHS Blood and Transplant. IMPACT is a collaboration of organisations dedicated to enhancing the outcomes of stem cell transplant patients through clinical trials across the UK.

With help from our incredible supporters, we hope to be able to fund even more innovative research that can give new hope and treatment options to those struggling with blood cancer.

References:

(i) – https://www.anthonynolan.org/what-we-do/anthony-nolans-50th-birthday