World Blood Cancer Day (WBCD) takes place every year on the 28th May to raise awareness of blood cancer, and the active role you can take in helping fight blood cancers.
Blood cancer is an umbrella term for cancers that form due to defects in the blood forming (hematopoetic) system. Stem cells that reside in the bone marrow normally differentiate into three main blood cell types, red blood cells, white blood cells and platelets. Errors can occur in this developmental process that may lead to abnormal blood cells that grow uncontrollably and affect the blood from performing its normal functions, such as delivering oxygen around the body and fighting off infections. Blood cancers include leukaemias, myelomas and lymphomas. Every 35 seconds, someone, somewhere in the world, is diagnosed with blood cancer.
A key treatment option, and one that can be highly successful for some patients, especially those who have not responded to more conventional treatments e.g. chemotherapy, is haematopoietic stem cell (HSC) transplantation. If a matching donor is found, then the healthy stem cells from the donor can be used to replace those defective stem cells residing in the patients’ bone marrow. Unfortunately, finding a matching donor, i.e. a genetic twin, is not always easy. Only around one third of patients find a matching donor within their family, meaning that the majority of patients rely on the kindness of strangers, those who are registered as stem cell donors. Even though there are over 27 million people registered as stem cell donors, many still cannot find a matching donor. Therefore, a key aim of WBCD is to inform, educate and invite you to become a stem cell donor, expanding the available pool of donors and potentially saving a life.
For more information about blood cancer, world blood cancer day and how you can get involved in please visit: https://www.dkms.de/en/basic-information
Unfortunately, even though stem cell transplants can be highly successful in treating blood cancers, the therapy does not come without risk. Before transplantation, chemotherapy is used to destroy the immune and blood system of the patient, leaving them vulnerable to infection until the new stem cells have regenerated mature immune cells. Another major challenge is avoiding graft vs host disease (GvHD), which in extreme cases can be fatal. GvHD occurs when there are minor genetic mismatches between the transplanted HSCs and the patient, this is possible even when the donor and recipient have been highly matched. This can lead to the transplanted cells being rejected or attacking the patients’ tissues.
Fortunately, there are many novel advanced therapies in development to improve current treatments, for example use of iPSCs from umbilical cord blood that have been expanded in the laboratory, and to prevent unwanted side effects such as GvHD, for example administering T regulatory cells to blunt the detrimental immune response by the donor cells to recipient tissues. A more recent and very promising therapy is the use of chimeric antigen receptor (CAR) T cells. T cells are taken from the patients’ body and genetically engineered to produce a modified cell surface receptor (CAR) that can recognise tumour associated antigens and trigger the cells to kill the cancer cells harbouring the antigen on their surface. Two CAR T cell therapies have already obtained regulatory approval for use in a clinical setting (Tisagenlecleucel and Axicabtagene ciloleucel) for treatment of B cell lymphomas and acute lymphoblastic leukaemia. As a results of this initial success CAR T cell therapy is the focus of intense research. For more information about how CARs are evolving and improving please read this informative review:
The large- scale EU research initiative RESTORE supports the development of these above-mentioned advanced therapies, from their laboratory inception to their availability as a clinical therapy. The mission of RESTORE is to bring these life-changing and potentially curative treatments to all those in need.