Could a new blood test identify rare blood cancer sooner in people with kidney transplants?
How do rare blood cancers develop after transplant?
The immune system has an important role not only in helping fight infection, but also in protecting the body against cancer. However, in kidney transplant recipients the immune system functions less well owing to the treatments that are needed to prevent rejection of the donated kidney. This makes these patients more vulnerable to certain cancers, including a type of blood cancer called post-transplant lymphoproliferative disease (PTLD).
The most common cause of PTLD is Epstein-Barr virus. Epstein-Barr virus is common, and most people will be infected in their lifetime. After infection the virus remains in the body, where it is in a harmless, inactive state. In immunosuppressed patients their weakened immune system can mean the virus reactivates, unfortunately this can lead to cancer.
About PTLD
Around 50 transplant recipients a year in the UK develop PTLD. The small number of patients with PTLD makes research into outcomes challenging, but limited evidence from case studies of a variety of PTLD patients on different treatments has found survival rates to be around 40-60%. There is an urgent need for earlier diagnosis and treatments to improve outcomes for these patients.
Meet Dr Heather Long
Dr Heather Long is a researcher at the University of Birmingham looking at the relationship between the immune system, viruses and cancers. The Professor Michael Nicholson research project award of £230,000 will mean Heather can continue her work to identify markers of PTLD in the blood of kidney transplant patients and understand more about how the tumours in PTLD behave.
“PTLD is hard to identify, and therefore is often diagnosed late, meaning treatment is delayed and the outcomes for patients are not good. There is also an urgent need to develop new treatments for PTLD.
Studying a rare disease is difficult as it’s harder to get the samples and data needed for research. A clinical trial for PTLD led by Birmingham and Newcastle meant we finally had access to the samples needed and this catalysed the start of this research.” Dr Heather Long
Could a new blood test identify blood cancer development sooner after transplant?
Heather and her team previously collected samples of blood and tumours, alongside clinical data, from PTLD patients taking part in a UK-wide clinical trial. Using these blood samples, they were able to identify several markers found in PTLD patients.
Heather and her team will look at the levels of these markers in another group of kidney transplant patients with PTLD to confirm whether it is possible to detect PTLD from a blood sample.
Heather and the team will also use special technology to measure genes (sections of our inherited code, DNA) in the tumour cells of PTLD patients to study how the tumours prevent the entry of immune cells which helps them evade the immune system.
Looking for earlier diagnoses and treatments
“I am very grateful to Kidney Research UK and its supporters for helping fund the next stage of our research. We hope that identifying markers in the blood could lead to development of a new routine test for diagnosing PTLD earlier, meaning prompter treatments and better outcomes for patients. By studying the mechanisms by which PTLD tumours avoid the immune system we also hope to identify new treatment targets for more effective therapies in the future.” Dr Heather Long
"We are delighted to be funding Dr Heather Long’s important research at the University of Birmingham which builds on this work funded by Kidney Research UK. This project aligns closely with Rosetrees’ core aim of supporting high-quality medical research that can be translated into real patient benefit.
"By advancing earlier diagnosis and exploring new treatment strategies for post-transplant lymphoproliferative disease (PTLD), Dr Long’s work has the potential to significantly improve outcomes for transplant patients facing this life-threatening complication and may also open new avenues for treating other forms of lymphoma.
"By funding with Kidney Research UK into this disease area we aim to maximise the impact of this ongoing research to improve outcomes for transplant patients who develop this serious condition." Dr Vineeth Rajkumar. Head of Research, Rosetrees
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