Funded by The Little Princess Trust and administered by CCLG
Lead investigator: Dr Robert Wynn, University of Manchester
Award: £86,108
Awarded July 2021
Bone marrow transplant (BMT) often cures children with leukaemia where chemotherapy has failed. The donor bone marrow makes both normal blood and a new immune system in the patient. This new immune system may attack the body of the patient because it is different from the donor. This attack is known as Graft versus Host disease (GVHD). Part of GVHD is a rejection of any leukaemia, where the new immune system attacks the leukaemia cells, as they also are recognised as different. This is how transplant cures leukaemia. GVHD however may make children very sick and can be fatal.
When we do BMT then we may use bone marrow harvested from a donor under anaesthetic, or we may use an umbilical cord blood donation, taken from the placenta of a new-born baby. Both bone marrow and cord blood will make new blood cells and a new immune system in the patient. There is scientific evidence that cord blood is better than bone marrow at eradicating leukaemia and also less likely to cause GVHD.
We have shown that if white cells are given during a cord blood transplant, then cord blood immune cells, known as T-cells, are increased (more T-cells) very early after transplant (in the first several weeks). The white cell transfusions appear to stimulate cord blood T-cells. These T-cells are primed to attack the patient's leukaemia, and yet they are increased only transiently, and there is no increase in GVHD.
We are opening a transplant trial in children with leukaemia using cord blood and using white cell transfusions to stimulate the cord T-cells. Here we will study these cord blood T-cells to understand how they are different from a bone marrow T-cells, how they kill cancer and whether they might similarly target other children's cancer cells.