Blood and lymph gland cancer

Including (haematological) including leukaemia, lymphoma and myeloma

Our service

Advice to patients diagnosed with blood cancer

Consultant Clinical Oncologist, Professor John Gribben, talks about the various treatment options for cancers of the blood, such as leukaemia. He outlines the innovative treatments and therapies available at Barts Cancer Centre and explains how to be referred here.

Barts Cancer Centre is at the forefront of pioneering new treatments for blood cancers and our specialists are internationally recognised for the treatment and care of patients with all types of blood cancer (lymphomas, chronic lymphocytic leukaemia and myeloma, acute and chronic myeloid leukaemias and myelodysplasia).

Our team has been instrumental in the design and execution of new and exciting treatment approaches, many of which are now used routinely.

We see approximately 350 new patients each year. Approximately 60 patients are referred to us each year with leukaemia and we perform over 100 stem cell transplants using some of the world’s most advanced techniques. To find out more about specialised treatments for blood cancer, please read on.

Type of treatments available

The treatments and equipment used at our centre are at the forefront of modern healthcare. As with all of our services at Barts Cancer Centre, treatments offered will depend on individual cases and the stage of cancer. This will be discussed in detail with every patient by one of our medical team once a diagnosis has been made.

Chemotherapy is the standard first-line treatment for many blood cancers including leukaemia and lymphoma. In addition to chemotherapy we also provide the following specialist treatments;

High dose chemotherapy and bone marrow transplant using patient’s own stem cells (autologous)

For some patients, high doses of chemotherapy are needed to kill malignant cells. Unfortunately this also kills normal bone marrow cells. To allow the patient to recover from this, we collect normal bone marrow stem cells from the patient before the high dose chemotherapy and freeze them. After the high dose therapy, these are thawed and given back and grow to regenerate the bone marrow. We have been perfecting these types of transplants using the patient’s own stem cells and this treatment can often be provided to patients on a day case basis (meaning that patients do not have to stay in hospital overnight).

Bone marrow transplant using donor stem cells (allogeneic)

In some circumstances it is appropriate to use stem cells obtained from a donor. The donor is either a matched family member or a matched unrelated donor from one of the donor registries. This type of transplant can be performed either with intensive chemotherapy and radiotherapy or with minimal amounts of chemotherapy (a ‘mini’ or reduced intensity transplant). The purpose of this type of transplant is that the donor cells can recognise and attack the cancer cells via a “graft versus leukaemia/tumour” effect.

We enjoy excellent results for stem cell transplants at Barts Cancer Centre and are constantly improving the way we perform them, which means better outcomes for our patients.

Some of our treatment approaches, such as stem cell transplantation are unsuitable for all patients but are the treatments of choice for selected patients based upon the actual disease, the availability of a suitable donor and the alternative treatments which are available in those specific circumstances.

For our patients, transplants are performed with the intention of curing those with otherwise incurable diseases.

Emergency treatment of hyperviscosity (blood thickening) and leucostasis

When the blood becomes too thick it may be necessary to remove cells or to replace the plasma. This is performed using an apheresis machine, which is operated by an experienced team of Clinical Nurse Specialists.

Research and clinical trials

Barts has been at the forefront of medical discovery since it was founded nearly 900 years ago and today, our research continues to be recognised for its originality, significance and rigour. The results of the work we do here means we are constantly improving the treatments and care we can offer patients.

Our research and published results have demonstrated excellent outcomes for stem cell transplants at Barts, which exceed the national rates. There is an active research program in the laboratory which aims to improve the way in which these procedures are performed and to improve the outcomes of our patients with these diseases. Barts is currently the highest recruiting centre in the UK for the national AML-17 clinical trial for patients with acute myeloid leukaemia (AML), (other than acute promyelocytic leukaemia) and high risk myelodysplasia and for adults with acute promyelocytic leukaemia (APL).

We have been carrying out studies to perfect the way we use a treatment called Reduced Intensity Transplant. This works by using a donor’s healthy stem cells, rather than a high dose of chemotherapy or radiotherapy, to eradicate the cancer cells. The donor’s healthy cells kill the cancer and as it does not involve toxic chemotherapy drugs, it can be offered to more patients and also be performed in the outpatient setting.

All the consultants in the team are actively involved in clinical, translational and basic medical science research and all hold joint appointments with the hospital and our partner medical school; Barts and The London School of Medicine and Dentistry, where Professor Lister and Professor Gribben have research laboratories.

We have an extensive portfolio of clinical trials currently open and laboratory research programmes in lymphoma, acute myeloid leukaemia, chronic lymphocytic leukaemia, allogeneic transplantation and myeloma.

Clinical trials are performed within the Experimental Cancer Medicine Centre, funded by The Department of Health and Cancer Research UK and led by Professor John Gribben and Dr Heather Oakervee.

Barts and The London is the only non-USA based hospital within the Chronic Lymphocytic Leukaemia Research Consortium, under the leadership of Professor John Gribben. This is an international collaboration in clinical and laboratory research into the causes and treatments of this disease funded by the National Institute of Health in the USA.

Our researchers have also developed a new technique to provide a faster and more accurate diagnosis for leukaemia which won Dr Samir Agrawal and his team the Department of Health’s national Health and Social Care Awards in 2007 and the top prize in the medical diagnostics and laboratory category at the NHS Innovator Awards 2006. The new test came about after he found that malignant cells could be detected by using antibodies to a protein that occurs in a certain type of leukaemia cell. The test enables medical staff to detect the most common form of leukaemia (chronic lymphocytic leukaemia) more rapidly and reliably than other methods. Since being introduced in 2002, the new approach has diagnosed the disorder in over 500 patients, and helped differentiate it from other malignant and non-malignant cells in the blood. No other laboratory in the world uses this diagnostic test.

For patients

Many of the treatments used for patients with blood cancers are associated with specific side effects which are often predictable and manageable. Our specialised care teams offer support for the side effects of chemotherapy and dietary support for patients who are not able to eat or drink well. For more details about our additional support services for patient, please click here.

Blood or platelet transfusions may be necessary for low blood counts. In addition, treatments are also available to encourage more rapid recovery of white cells or red cells in the bone marrow.

Find out about what our patients think of our services, by reading Emma's story and Lesley-Anne's story.

For clinicians

We consistently achieve national access targets for patients with suspected cancer and for treatment following diagnosis. Referral criteria and forms are all available on our website, please click here for referral forms.

For urgent clinical enquiries regarding existing patients please contact:

Monday – Friday 9am – 8pm : Bodley Scott Day Unit on tel: 020 346 55811/020 346 56780
Evenings and weekends: Ward 5A on tel: 020 3465 55566

The on-call Specialist Registrar will be contacted to give advice or admission can be arranged.

For new referral and other enquiries:

For lymphoma and acute lymphoblastic leukaemia patients, tel: 020 346 56070 or fax: 020 7796 3979
For myeloma, AML, MDS, CLL and allograft patients, tel: 020 346 55993 or fax: 020 346 55992