In this section, you’ll find testimonials from recipients of BSH grants. These testimonials show how our grants have helped them achieve goals, create networks and further their research.
Scroll down and click on the headline to expand and read the full testimonial.
Have you received a BSH grant and want to share your experience in a text or video format? Please email [email protected].
Our ASM will be held at the The ACC, Liverpool from 28-30 April 2024.
We will be offering Abstract Scholarships, Travel Scholarships and Nursing Bursaries.
We have selected some reports from our ASM grant ambassadors who told us about their experience and learning at the 2023 Annual Scientific Meeting in Birmingham and previous ASMs.
Tracey Small, Haematology Clinical Nurse Specialist, Chesterfield Royal Hospital
It was my first time attending the BSH Annual Scientific Meeting, and I found it incredibly informative and educational.
The sessions I found most beneficial were the myeloproliferative neoplasm (MPN) and the myeloma ones.
The MPN in relation to myelofibrosis was of particular interest. My knowledge increased in the management of patients on ruxolitinib, and it was very good to hear about further treatments for this group of patients.
The session on myeloma was very informative and was particularly interesting in regard to the MYpos score. This led me to look into other palliative scores that can be implemented when caring for all of our patients on supportive care.
All in all, it was a very positive experience and will benefit my nursing practice.
Gemma Whitehead, Haematology Clinical Nurse Specialist, Chesterfield Royal Hospital.
The BSH Annual Scientific Meeting Travel Scholarship allowed me and my clinical nurse specialist (CNS) colleagues to attend the ASM in Birmingham.
In 2022, I was invited to talk at the Early Careers Forum, where I presented my career in haematology nursing to date, my ambitions to stoke haematology interest in ward nursing staff and improve training and, therefore, retention in the speciality.
I was very interested to see what is happening nationally in supporting the careers of haemato-oncology nurses. I found the session on developing nurses, particularly the Aspirant Cancer Career and Education Development (ACCEND) programme, very helpful.
I plan to use this knowledge to work with the ward educator to assess the current training provided to newly qualified staff and see where this fits onto the ACCEND pathway. I feel that if we can formalise the training pathway for nursing staff, we will help nurture their interest and give them a feeling of organised development for specialisation within their careers.
It is often easy as a nurse to feel that you don’t necessarily belong in the world of research and conferences. The BSH really supports the aspiration of nurses to learn and progress within the speciality, and I want to pay that support forward to the future nursing workforce.
Sherif Badawy, Haematology Specialist, Lurie Children's Hospital of Chicago
I am very grateful to the BSH for supporting me with the 2023 Annual Scientific Meeting (ASM) Abstract Scholarship.
This grant allowed me to attend the conference and actively participate in different sessions by covering my travel and accommodation costs. It also allowed me the opportunity to network with many practising haematologists and oncologists in the UK and Europe.
This experience gave me a chance to reflect on differences and similarities related to how we practise medicine, and haematology, in the United States. Networking and being at the ASM opened doors for several potential collaborations for clinical research projects and clinical management or guidelines development informed by evidence.
One session worth mentioning, which gave me a lot to think about, focused on teenagers and young adults (TYA), which we call adolescents and young adults in the United States (AYA).
I was impressed with the transformation created by the establishment of a dedicated TYA cancer unit in an adult hospital: not only improving clinical outcomes with better responses and lower risk of relapse but also the positive impact on TYA quality of life, including mental and psychosocial wellbeing.
That made me go back to my home institution and re-evaluate what we currently do for our TYA or AYA. And ask if (or should) we do better by learning from the UK model or experience in that context.
I wouldn’t have started this inquiry if it wasn’t for the BSH and the travel award I received to attend the ASM in Birmingham, UK. Thank you again to the BSH. Their help is much appreciated!
Maryam Owais Subhan, Haematology Registrar (ST6), University College London Hospitals NHS Foundation Trust
I am grateful to the BSH committee for awarding me a scholarship for my oral abstract, Comparison of ADAMTS13 activity testing platforms for diagnosis and monitoring of thrombotic thrombocytopenic purpura. The grant supported my attendance at the Annual Scientific Meeting in Birmingham by covering my travel and accommodation costs.
During the conference, I particularly enjoyed the session on autoimmune haematology. Professor Siobhan Burns’ talk on primary immunodeficiency causing autoimmune haematological disease was enlightening and made me consider some cases I have managed in a different light. I aim to incorporate her guidance into my approach towards autoimmune cases in the future.
Secondly, Professor Matthieu Mahevas’ talk, How immune modulation is changing in autoimmune haematological diseases - can we direct treatment?, was also very interesting, as it highlighted anti-BAFF-directed therapy in rituximab-resistant immune thrombocytopenia (ITP), an option I had not been aware of. His research into antigen-specific B-cells in ITP was useful knowledge I could relay to interested colleagues in our research lab.
In addition to all the excellent talks, attending the meeting was a great opportunity to engage and interact with other trainees and clinicians with similar subspecialty interests.
I came away inspired by what we can achieve by collaborating and eager to play my part in it.
Henry Wood, Specialty Registrar, King's College Hospital
I would like to thank the BSH for this grant, which supported my attendance at the Annual Scientific Meeting in Birmingham.
I was very pleased to present an oral abstract, Venetoclax-based non-intensive combinations for relapsed/refractory acute myeloid leukaemia – real-world data from a UK-wide programme. This work was the result of a collaborative effort under the aegis of the National Cancer Research Institute Acute Myeloid Lymphoma (NCRI AML) relapse subgroup, coordinated by Dr Pramila Krishnamurthy.
I also co-chaired the education session at the meeting, which focused on improving the training experience and planning for the future workforce.
The BSH and American Society of Hematology (ASH) session on Machine learning in hematology and the BSH and European Hematology Association (EHA) session on Diversity in haematology both provided a great deal of food for thought.
Professor Claire Harrison’s BSH Medal Lecture on the changing face of the myeloproliferative neoplasm treatment landscape was excellent.
I was very interested to hear about Dr Robert Weinkove’s work developing TLR2-costimulated third-generation anti-CD19 CAR T-cells for relapsed/refractory B non-Hodgkin lymphomas. The low toxicity rates in the phase 1 trial were notable, and it was great to see the use of this innovation to develop a CAR T-cell programme for New Zealand.
The annual Pitfalls Day remains a fantastic learning opportunity with a host of brilliant speakers. This year the focus was on diagnostics across the spectrum of haematology and included a very valuable session from Surabhi Chaturvedi and Elli Wellving on communicating diagnoses with patients.
In addition to the high-quality content within the sessions, the chance to meet colleagues from across the UK haematology community and beyond is a huge advantage of the ASM.
I would strongly urge all trainees to try to attend the ASM and benefit from the excellent educational and networking opportunities, as well as to develop presentation skills through oral and poster abstracts.
Dr Saidu Yusuf Yakubu, PhD Student of Clinical Haematology and Blood Transfusion/Consultant Anaesthetist, Ahmadu Bello University Teaching Hospital, Nigeria
Please, permit me to start by thanking the British Society for Haematology for giving me the great opportunity to attend the 2023 Annual Scientific Meeting in Birmingham.
Attendance at the meeting has allowed me to make friends, share ideas with colleagues, listen to top-notch presentations and lectures and acquire research ideas. As an anaesthetist with an interest in haematology and blood transfusion, I really felt at home, and my expectations were met through sessions relevant to my practice.
I was able to stroll in London and Birmingham, where I had a taste of the great food the two cities offer.
I arrived in Birmingham on Saturday, 22 April and registered for the conference. That evening, I was privileged to attend the welcome and network reception, where I met Lee from Malaysia and Lydia from the UK. Both were medical officers interested in specialising in haematology. I was so impressed with their passion and enthusiasm towards the speciality. It was great sharing ideas with them while having drinks and snacks.
Sunday was a busy day for me, with so much networking at the exhibition stands during breaks. The various companies exhibiting were awesome, with products ranging from drugs, equipment, education and gifts/souvenirs for participants.
I visited the BSH stand, where I was given an international delegate pin. I also visited the Sickle Cell Society stand and learnt about their various activities. My country, Nigeria, has a large number of sickle cell anaemia patients.
The coffee/cappuccino, food and drinks served during the entire conference were very good.
The welcome, and MacFarlane-Biggs plenary lecture, were excellent. I learnt a lot during the sessions on anticoagulation and thrombosis and the use of technology to improve health care (machine learning in haematology).
In addition, I attended the lunch with experts on paediatric sickle cell disease (SCD) and the industry session on the unmet need and multiple burdens of SCD. I also joined the Blood Cancer UK workshop on teenage and young adults.
Highlights of the Monday for me were sessions on new initiatives in transfusion research, obstetrics haematology (iron deficiency anaemia, and coagulopathy following postpartum haemorrhage) and the BSH medal and presidential session.
I was very impressed with the Crucible Prize session on What haematology can learn from history, where young haematologists presented on things that have happened, or are happening, in the Society and related to the practice of haematology.
The poster walk in the evening was educative. I learnt what others are doing from different parts of the world and made friends.
On the last day of the conference, I enjoyed top abstracts on laboratory haematology and transfusion.
Aimee Armstrong, Biomedical Scientist – Haematology and Blood Transfusion, NHS Greater Glasgow and Clyde
I would like to thank the BSH for awarding me a travel grant to attend their Annual Scientific Meeting in Birmingham in 2023.
As a biomedical scientist who has recently begun specialisation within the haematology field, I found the event incredibly insightful and educational. It was great to listen to and understand how nurses, doctors, physician associates and scientists interact to manage and advance patient care – we all have the same end goal of providing the best standard of care for patients.
I attended the Haematology Essentials day, which preceded the BSH conference on the Saturday. As a new professional in the field, I found this day incredibly beneficial to the development of my career.
It was great to hear from experienced medical staff on the interpretation and principles of the basic haematology tests – full blood count, C/S, myeloma screening/staging - and also the main differences between different types of leukaemia.
I thoroughly enjoyed hearing about the research and development of the Haem-Match programme, which has started trialling in England, though not yet in Scotland. I had not previously come across the concept. It was fascinating to hear about the principles and thought processes, how it will work and the end goal from the people at the heart of designing and implementing it.
I would love to see the programme developed across the UK, as it will be massively beneficial to patients who are regularly transfused. It would also help laboratory staff responsible for typing and cross-matching blood components.
I massively enjoyed the Blood Stories lecture, presented directly by patients with sickle cell disease, type 3 Von Willebrand Disease and amyloidosis. As a biomedical scientist, I have very little direct interaction with patients. I found it invaluable to listen to their stories, understand how these haematological conditions affect them, and how they have found the process of interacting with all healthcare professionals in their journey. It really emphasised the principle of understanding the whole story when dealing with patient samples in the laboratory.
It was also great to hear speakers, particularly BSH chairman Josh Wright, speak about the difficulties the NHS workforce is facing. The reality of the current condition of the NHS was not missed, and I find that incredibly important and applaud the BSH for including it; it is something that every healthcare professional is dealing with on a daily basis.
Finally, the performance from B Positive Choir before the presidential lecture was fantastic. A thoroughly enjoyable to lift the spirits of all attending and to break up the day.
Joshua Bray, Intercalated PhD Student, University of Leicester
I am incredibly grateful for the BSH Travel Scholarship, which enabled me to attend their Annual Scientific Meeting (ASM) this year in Birmingham.
It was my first time attending the conference, which, as a medical student and PhD student, I found really engaging from both clinical and scientific perspectives. I was amazed by the huge breadth of clinical haematology, covering malignant and non-malignant conditions.
I have developed a strong appreciation of the constantly evolving clinical landscape of haematology and how the latest research shapes the care and treatments our patients receive.
My particular research interests lie in lymphoma and immunotherapy. I was excited by the updates from the TRANSFORM and EPCORE NHL-1 trials, which shared very encouraging clinical data for Liso-cel (a CD19 CAR-T) and Epcoritamab (a CD3xCD20 bispecific antibody), respectively.
It was also fascinating to hear from Dr Maria Themeli about allogeneic sources of CAR-T cells, in particular her work in developing CAR-T products from induced pluripotent stem cells.
I presented a poster at the conference entitled Development of a functional assay to assess activation and proliferation in peripheral blood T Cells. It was a great opportunity to share my work with others. It initiated some very interesting discussions.
It was wonderful to be surrounded by professionals from a variety of disciplines (clinicians, nurses, allied health professionals and scientists), all with a shared passion for haematology.
I found it particularly useful talking to clinical trainees who shared their experiences of applying for and undertaking haematology training. They gave some really useful tips for building a strong haematology portfolio which I will take on board for the future.
Overall, I had an excellent time at the BSH ASM 2023. I very much look forward to attending in future years.
Eman Hassan, Haematology Speciality Registrar in the West Midlands, University Hospitals Birmingham
I was so grateful to be awarded the scholarship grant to present my oral abstract The diagnostic utility of the R90 bleeding and platelet disorder panel: the West Midlands experience.
The BSH Annual Scientific Meeting is my favourite event. I have been keen to attend since I started training in haematology because the scientific material is invaluable.
My favourite sub-speciality is haemostasis and thrombosis and the meeting this year was full of fantastic sessions in these areas. The session about the impact of anticoagulation on menstrual bleeding was particularly innovative. It highlighted the poor quality of life in this group of patients and their unmet needs, which open the field for further research.
I also found the session about pitfalls in managing haemostasis cases very interesting and practical.
Thank you to the BSH for giving me the opportunity to attend and present my work.
1. Jignesh P. Patel, Ovianuju Nzelu, Lara N. Roberts, Jemma Johns, Jackie Ross How do anticoagulants impact menstrual bleeding and quality of life? - The PERIOD study. Res Pract Thromb Haemost. 2023 Feb 4;7(2):100072.
Dr Michael Norton, Senior Lecturer, University of Buckingham
This was my first BSH Annual Scientific Meeting (ASM) and my first medical conference as a doctor. Currently, I am teaching haematology, and I had hoped that attending this event would add to my knowledge and increase my confidence as a lecturer.
The ASM was well-organised.
The venue was appropriate and located in a fascinating city. The convention centre was clean, well-staffed, and with good facilities and signage. The IT seemed to go perfectly in all the sessions I attended.
My current post meant I needed to listen to presentations on educational and employment matters. There were no surprises in the information given in the session on Developing the professional role of haematology nursing. But the speakers and those who asked questions spoke with passion, and everything was very understandable.
More significant were the speakers in the Early Career Forum who explained the work of a PA and nurse specialist. I think those who attended this were enlightened. One speaker was absent.
It was good to meet a few of the key people in haematology.
Despite being upset that I could not tour the whole museum, I was able to speak with a few important members at the dinner and was given details of someone near me who may be able to help with my need for resources.
Ruth Evans was great, and Fiona Miall shared that her students were having similar problems to mine due to lockdown and online teaching.
In terms of science updates, for me, the most useful was the session on haemoglobinopathies.
Dr Potter was impressive with some interesting transplant news, and John James was someone I would like to meet again. I will elevate the status of sickle cell in my course curriculum.
I am very grateful that I received this funding, for it allowed me to attend this worthwhile event.
I got the most out of the resources I picked up at the small charity booths.
The photo shows me receiving a surprise prize at the Leukaemia Care stand.
I intend to attend the next event in Birmingham, and I am seriously considering working in haematology when I return to clinical practice.
Thank you to the BSH.
Agnerys López Sacerio, Haematologist, Arnaldo Milián University Hospital, Santa Clara, Cuba
This travel scholarship was a great opportunity to participate in the BSH Annual Scientific Meeting 2022.
This important meeting was a valuable experience to improve and update my knowledge as a haematologist and clinical researcher, especially in haematological malignancies and cancer-associated thrombosis.
It also allowed me to establish a scientific and academic exchange with colleagues from the UK and other parts of the world and present the results of our research.
All the above will allow us to improve the care of patients with haematological diseases we treat.
I am currently working on my PhD in venous thromboembolism (VTE) in haematological malignancies. This event helped me to learn about other research in this area. Because of my teaching role, my update will enhance the preparation of our hospital's residents-in-training.
Emily McMullen, Foundation Year 1 Doctor, Kingston Hospital
I would like to say a huge thank you for awarding me the abstract scholarship, as this allowed me to attend the ASM and present my audit. It will most certainly be one of the more impressive additions to my CV and portfolio. I am extremely grateful for the opportunity to present. If not for the abstract scholarship, I would not have been able to afford to attend the event.
I have been considering a career in haematology since finding it especially interesting in my undergraduate biomedical science degree, and it has continued throughout my medical training and clinical practice.
I appreciate that having presented at the ASM will no doubt put me in good stead if I do indeed decide to embark on a career in haematology.
I am also grateful for the experience of presenting an oral presentation. I found I rather enjoyed it, and it has built my confidence in public speaking.
I found the presentations I listened to very interesting and enjoyed the variety.
I learnt of rare disorders I had never heard of before, for example, Kabuki syndrome, and now appreciate how difficult it can be to research these conditions. There was very limited UK data on this syndrome, and data had to be extrapolated from elsewhere.
There was also the added problem that, often, Kabuki syndrome is not regarded as a separate entity from immune thrombocytopaenia generally. That must present a significant barrier to understanding Kabuki syndrome and, therefore, the information we, as clinicians, can provide to these patients and their families. I can only imagine how worrying it must be to be a parent to a child with a rare haematological disorder.
I also learnt how convoluted the clinical trials system can be in haematology, with exclusion criteria for studies often not published and a lack of continuity between researchers/government trials and the haematology trials body. I developed a new admiration for this body, as they direct patients towards clinical trials that could be appropriate, and this is something I cannot envisage ever having the time to stay up to date with whilst working as a doctor in the NHS.
Aside from this, I enjoyed reading the scientific posters on multiple myeloma. We often screen for this in some of our hospital inpatients as part of a routine workup for certain presentations/symptoms, but I rarely have time to appreciate the academic side of it.
Sion Williams, ST6 in infectious diseases and GIM, University Hospitals Birmingham
Thank you so much to the British Society for Haematology for awarding me this travel scholarship to attend the ASM.
I am a trainee in infectious diseases. My reason for attending the conference was mainly to make links with my colleagues in haematology and to see how we might strengthen our working relationship looking after haematology patients with infection.
As a trainee in infectious diseases, I have found delegates from the field of haematology to be incredibly welcoming and receptive.
I am presenting a poster on the use of AmBisome prophylaxis in high risk haematology patients. During the poster walk, I had numerous interesting and fruitful discussions with other delegates about the real challenges of keeping these vulnerable patients safe, whilst at the same time acting judiciously with our use of anti-microbials. I feel we bridged important ground between the aim of reducing the development of drug resistance, and safeguarding our patients from the potentially toxic side effects of powerful drugs.
One piece of original research I found particularly interesting was an original science project presented as a poster by James Boncan from Queen's University Belfast. The research looked at using a novel molecule purified from snake venom as a potential candidate for the treatment of acute lymphoblastic leukaemia (ALL), Purified phospholipase A2 from Pseudechis australis snake venom - A novel anticancer agent for the treatment of precursor-B acute lymphoblastic leukaemia. It was an exciting "proof of concept" piece of work showcasing how we might look to discover potential drugs in the future.
I come away from the conference feeling more than ever that haematology and the infection specialities are interlinked and that patient care will be best served by developing deeper working relationships.
In a scientific and professional environment where we are ever more specialised, there is a natural tendency for specialists to limit their sphere of concern to their own field. However, what patients need are the various diverse specialists caring for them to work more closely together, and to take an interest in each other's work and also each other's perspectives, to be more collegiate and understanding and less adversarial.
Attending this conference has greatly helped me work towards that ideal, and I'm sure more fruitful working with my colleagues in haematology will ensue, both with projects and with patient care.
Wei Yee Chan, Haematology Registrar (ST6), University College London Hospitals NHS Foundation Trust
I am thankful and honoured by the BSH's decision to award me an ASM abstract scholarship for my oral abstract on Antibody responses to SARS-CoV-2 vaccination in patients with acute leukaemia and high-risk MDS on active anti-cancer therapies, which I presented at the Top AML abstracts session on 4 April 2022.
The travel bursary covered my cost for attendance and travel to Manchester, and I had the opportunity to attend the ASM in person after two years of virtual conferences, an unfortunate result of the SARS-CoV-2 pandemic.
The merits of virtual conferences have been thoroughly explored during the pandemic. However, the benefits of ASM attendance in person really came to light this year. The engagement and social interactions (missed in virtual conference attendance) were far more exciting for me as a trainee. The ability to learn and listen to live speakers really brought innovation and practice recommendations to life with improved interaction from a live audience.
After taking an interest in antibody responses to SARS-CoV-2 vaccination in haematological malignancies, I was thrilled to hear Dr Sean Lim's presidential lecture talk discussing her findings from leading the UK PROSECO study on the immune responses to two and three SARS-CoV-2 vaccine doses in a large cohort of lymphoma patients.
She highlighted the poor responses generally in a cohort of lymphoma patients. She also highlighted the effects of systemic anti-cancer therapy and dysfunction in T-cell and humoral responses in these patients.
It is exciting to see such a large clinical study, with such important data to guide our practice moving forward in the pandemic, come to fruition in such a short period. I applaud and am in awe of what has been achieved in the publication of these results.
I would like to thank the BSH again for recognising my work and for the opportunity to present it at the ASM. I thoroughly enjoyed the ASM this year and have been brought up to date over the four days of attendance in various aspects of haematology.
But most importantly, I've been inspired by the ongoing work to improve our ability to deliver care to haematology patients in the United Kingdom. It is especially fascinating how some of this work can also influence care delivered internationally.
The ASM highlighted the UK's strong ability to recruit to academic clinical trials and deliver meaningful results, which truly influence how we practice.
1. Lim, S. H., Stuart, B., Joseph-Pietras, D. et al. Immune responses against SARS-CoV-2 variants after two and three doses of vaccine in B-cell malignancies: UK PROSECO study. Nat Cancer (2022). https://doi.org/10.1038/s43018-022-00364-3
Omolade Dada, Medical student, University of Nottingham
Attending the BSH Annual Scientific Meeting 2022 was a great pleasure!
The scholarship I received funded my travel, accommodation, food and general expenses for the three days.
I was inspired to see so many healthcare professionals sharing knowledge on their research with the primary aim of improving healthcare.
It was also fascinating to see the innovative products companies had created to improve the delivery of care. I was particularly interested in the biopharmaceutical company Global Blood Therapeutics, which raised awareness of sickle cell disease and their newly introduced drug that targets one of the primary causes of red blood cell sickling.
I also attended a scientific talk by Dr Carolyn Millar, Update on diagnosis and management of von Willebrand Disease: what are the current controversies?
I was encouraged by the fact that management strategies are constantly being revised as the body of knowledge within the scientific community improves.
It was also interesting to consider the impact of a diagnosis on the patient, such as the impact on their medical insurance, which Dr Millar briefly touched on.
Regarding my poster presentation, it was a huge encouragement to me to discuss my findings with those senior to me and answer their questions whilst discussing potential future research. One of my highlights was discussing my research with the members of Haemochromatosis UK.
Considering that my research was focused on this iron overload disease, meeting people diagnosed with haemochromatosis who also participate in research and work closely with those whose treatment was affected by Covid-19 really put my research into perspective and added great value. I perceived the potential impact of my research findings from this encounter.
The conference was a great opportunity to network. I made new friends and found potential partners to collaborate with on future research, and the ASM scholarship made it possible for me to attend. Thank you to the BSH!
Paul McLaughlin, Clinical Specialist Physiotherapist in Haemophilia and NIHR/HEE Clinical Doctoral Research Fellow, Royal Free London NHS Foundation Trust
I would like to express my thanks to the BSH for awarding me a travel scholarship to attend the 2022 Annual Scientific Meeting in Manchester.
I applied and received this scholarship as I was privileged to have been an awardee for the BSH/NIHR AHP Researcher of the Year. It gave me the opportunity to travel to Manchester for the Presidential session on Sunday, 3 April, to receive my award.
I wanted to attend in person as I felt it was a great platform and chance to make the role of allied health professionals in haematology more visible. I hope that doing so will encourage others to be more confident in sharing their research activities.
Katarina Flatman, IMT2 ACF, University of Leicester/University Hospitals Leicester NHS Trust
The ASM travel scholarship allowed me to attend the meeting in person, which I was very excited about, given the lack of such opportunities during the pandemic.
Attending in person has given me educational and networking opportunities that would not have been so well provided by online attendance.
It has enabled me to meet other IMT doctors who are planning to specialise in haematology, and it has been exciting to discuss our plans and to think that we might be meeting at similar events in years to come!
I have also been able to meet with registrars and consultants from around the country and hear about their exciting careers and ongoing enthusiasm for their speciality.
It has helped me understand the breadth of haematology as a speciality. Particularly by attending sessions about non-malignant haematology, to which I have had less exposure.
In terms of the conference content, I was fascinated to hear about the work of haematologists in characterising vaccine-induced thrombosis and thrombocytopenia (VITT) in such a timely manner during the pandemic. It was amazing to think of how quickly the international community were aware of this new phenomenon and the rapidity of response. It is a reminder of the importance of communication between centres in identifying these rare cases and formulating a rapid response to such a potentially devastating condition.
As a junior doctor, I particularly enjoyed the patient stories session; it was a format I hadn't previously experienced at a conference. It was brilliant that individuals with such different experiences were willing to be open about their experiences as patients. It gave me an opportunity to think about the impact of living with not just haematological diagnoses but also other long-term conditions and how all of us can strive to provide the best possible patient-centred care.
I am grateful to the BSH for giving me the opportunity to attend this conference, and I feel it has been very helpful in my understanding of haematology as a career.
Nicola Cecchi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan
The BSH abstract scholarship allowed me to get closer to the British medical reality. Different countries can have different views about managing patients.
This scholarship took me into a stimulating environment where I could show my work and how my team and I take care of the patients and, at the same time, compare our results with someone else's results.
Claudette Hewitt, SHO Doctor, Ealing Hospital, London North West Thames Healthcare Trust
The scholarship I received from the BSH enabled me to attend their Annual Scientific Meeting (ASM) in Manchester from 3-5 April 2022.
I am a junior doctor about to start internal medicine training (IMT) and am interested in a career in haematology. Attending the ASM provided the opportunity to get an insight into the world of haematology.
What struck me most is how new research and clinical trials constantly inform clinical practice. The conference made me appreciate how dynamic haematology is as a speciality, with many opportunities to expand our knowledge and refine our treatment options.
I particularly enjoyed the lectures on chimeric antigen receptor (CAR) T-cell therapy in lymphoma. I have been interested in CAR T-cells since I wrote an essay about their potential future therapeutic uses while at university.
Now, the National Institute for Health and Care Excellence (NICE) has licensed CAR T-cells for acute lymphoblastic leukaemia (ALL), diffuse large B-cell lymphoma (DLBCL), and mantle cell lymphoma (MCL) under certain conditions. CAR T-cell centres are being set up across the country.
However, the lectures demonstrated that even though we have progressed past clinical trials into clinical practice, our understanding of CAR T-cell therapy continues to be developed. The CAR T-cell centres have collected a wealth of data, which has been used to evolve the knowledge of the efficacy and toxicities of the therapy.
In particular, the risk of CAR T-cell toxicity can be estimated based on patient-specific factors such as their performance status, the lactate dehydrogenase (LDH) level on day 0 of infusion and whether their disease has progressed through bridging therapy. Therefore, toxicity prevention and management can be individualised based on the specific risk factors of the patient at hand.
After two years of Zoom meetings, I really enjoyed attending the conference in person. One of the best parts was meeting haematology registrars and other IMT doctors who are in the process of applying to haematology training. Hearing about their experiences and getting their advice was very valuable.
I came away from the conference inspired and motivated to pursue my interest in haematology!
4. Sanderson et al. ASH 2021 (abstract 531; oral)
Martin Gonzo, Biomedical Scientist and Senior Lecturer in Biomedical Science, University of Greenwich
I am very grateful to the British Society for Haematology for supporting me with a travel scholarship to attend their Annual Scientific Meeting in Manchester, UK, this year.
The 62nd ASM was my first time attending a BSH-organised event, and I must say, it will be one of many.
The ASM was a three-day meeting which was well organised and packed with opportunities to learn, network, and share professional practices in haematology.
The programme afforded me the opportunity to listen to experts in haematology.
The session on Developing the professional role of haematology nursing was very useful for me. This session took place on the 3rd of April and allowed me to appreciate the value of well-informed career guidance. It is an important aspect of my job as an academic and a personal tutor to undergraduate students.
Together with the early career forum on the 4th of April, they were important sessions that will impact how I support my tutees in decision-making beyond graduation.
Biomedical science graduates often wonder what else they can do with their first degree. The presentation by a clinical scientist and a haematology nurse gave me ideas on other career options to suggest for my students.
Another session I particularly enjoyed was the sponsored symposium titled Sickle cell disease: Shifting to a long-term view on patient care. This session, together with others on erythrocyte disorders, has improved and updated my knowledge of disease management from the patient's perspective.
Patients with sickle cell disease (SCD) are usually transfusion-dependent. As such, transfusion practices directly affect this patient group. A poster on Home transfusions: Balancing safety with individualised care was also a befitting presentation as it presented findings from 20 cases of home transfusions.
I had the opportunity to go through the posters displayed during the three days I was at the conference. Having spent several years studying for a Doctor of Health and researching in the area of erythrocyte disorders, it was refreshing to be reminded of the many advances still taking place in this and other areas of haematology.
The poster by Narayan et al. on Under or delayed transfusion: Risk factors leading to patient deaths certainly helped me to come up with a concept paper on transfusion practice in under-resourced settings. It has given me new ideas to research in blood transfusion practice in general.
Finally, this event could not have been a success without the networking events that punctuated the conference. The annual meeting has given me the opportunity to meet with experts in different fields of haematology.
The discussions will certainly inform my teaching, and I will be incorporating some of the case studies into my learning material. It helps me maintain currency as I teach and facilitate the learning of undergraduate biomedical science students.
1. Jennifer Davies. Home transfusions: Balancing safety with individualised care. Poster presented at the British Society for Haematology 62nd ASM; 03-05 April 2022; Manchester.
Lara Howells, ST4 Haematology Registrar, University College London Hospital NHS Foundation Trust
I would like to extend my thanks to the BSH committee for awarding me a scholarship to attend the Annual Scientific Meeting in Manchester from 3-5 April 2022.
As an ST4 haematology registrar, the conference – a hybrid event – provided the perfect opportunity to immerse myself in the world of haematology, meeting other trainees and colleagues from across the UK and abroad.
The conference kicked off in an unexpected but undoubtedly powerful way, with a stunning performance from grime artist A Star, who rapped about his first-hand experience of living with sickle cell disease. He spoke of how his challenges have spurred him to work with youth groups in East London, spreading education and awareness of sickle cell disease. I know that this is not the last we will see of A-star, as he continues to use his position of influence to drive change and ongoing engagement with both his local and the haematological community.
The popular BSH ’Pitfalls’ day preceded the conference on Saturday, 2 April. Here, we were delivered a schedule of quality lectures from experts across the UK.
Dr Joe Shariff delivered an engaging talk on lifelong care for patients with sickle cell disease, during which he illustrated a particularly gripping case presentation of protracted hyperhaemolysis. Another memorable session was delivered by Dr Cheryl Fitzgerald, highlighting the challenges in fertility preservation in young women with haematological disease.
Satisfyingly, I found that my newly ascertained knowledge from these sessions was translated directly back to the wards upon return to work when faced with similar complex cases.
A personal highlight was being provided with the opportunity to give an oral presentation on Covid-19 antibody responses in patients with myeloma who undergo autologous stem cell transplant, inviting questions from an engaged audience.
The topic of immune responses to Covid-19 vaccination in patients with haematological disease featured heavily throughout the ASM programme, highlighting our shared interest in doing all we can to mitigate our patients from Covid-19. Both in terms of the effects of the disease itself and the associated delays in treatment that occur as a result.
This was succeeded by a presentation from Dr Rakesh Popat, who summarised the results from two early phase trials in myeloma, resulting in a palpable level of anticipation and excitement amongst myeloma doctors in the room.
During the BSH Presidential Session and Medal Lecture, we were treated to a talk from Professor Marie Scully, MBE, on vaccine-induced thrombocytopenia and thrombosis (VITT). Here, the rapid identification of a new syndrome and formulation of a management strategy was particularly impressive and undoubtedly saved many lives.
In the face of such challenging and fast-paced circumstances, it was the level of collaboration between centres, sharing experience, knowledge and expertise around the UK and Europe, which I found to be enormously inspiring.
Being awarded this scholarship allowed me to fully embrace the conference experience.
I would like to thank Professor Adele Fielding and the BSH committee for providing this invaluable opportunity to attend at an early stage of training. I look forward to seeing many familiar faces at conferences over the years to come.
Lastly, this brief highlight reel would be incomplete without marking my colleagues on the dancing skills exhibited in the Manchester Museum of Science and Industry in true Craig Revel Horwood style – 10/10.
1. Pavord S., Scully M., Hunt B.J. et al. Clinical features of vaccine-induced immune thrombocytopenia and thrombosis. N Engl J Med. 2021 Oct 28:385(18):1680-1689
2. Craven B., Lester W.A., Boyce S. et al. Natural history of PF4 antibodies in vaccine-induced immune thrombocytopenia and thrombosis. Blood. 2022 Mar 9: blood.2021014684.
Stephen Hibbs, Haematology Registrar, Barts Health NHS Trust
I'm grateful to the BSH for the scholarship to pay for my funding for train fares and hotel accommodation for the ASM.
For the ASM, I contributed in the following ways:
- Co-organised and co-chaired the Blood stories session.
- Co-organised and co-chaired two virtual sessions: Blood stories part 2 and Haematology at the extremes.
- I played the piano for the Faculty dinner.
- I was a co-presenter of an ePoster.
In addition to the sessions I helped to lead, some of the highlights for me were:
a) The Meet the Expert (MtE) sessions. I attended four (haemostasis, global haematology, haemophagocytic lymphohistiocytosis (HLH) and marginal zone lymphoma). These were excellent and engaging discussions. A new project has emerged from the global haematology MtE session, in which I hope to be involved.
b) Discussions with some of the industry and charity stalls. For example, a discussion of a new bone marrow training project with BD and around finding foreign language patient information with Myeloma UK.
c) I found the opening performance of Hidden Pain by Alidor Gaspar (A Star) very moving and a fitting way to move forward with the tone of the meeting.
Louise Wallis, Haematology Specialist Nurse, Royal Bournemouth Hospital
Thank you for awarding me this scholarship and allowing me to attend the Annual Scientific Meeting to share my piece of work with the attendees as a speaker.
I found the meeting itself stimulating, and I felt it was important to attend in person, following the isolation of the Covid-19 pandemic.
Highlights for me fell into three categories.
Updates in MPNs and CML
I gained insight into the specifics of young myeloproliferative neoplasms (MPN) patients and difficult scenarios in MPNs from lectures. The posters enabled me to easily see a large quantity of information in a relaxed environment. Relevant to my practice were posters about pegylated interferon (UCL) and nurse-led telephone clinics (Manchester).
Interesting and thought-provoking lectures
A highlight of the entire meeting was listening to the entries for the Crucible prize. These were all interesting, were presented enthusiastically by the authors, and engaged the audience. The subjects were ones I had not previously really thought about and made me think more deeply about the future of haematology. Attending this type of session broadened my view of issues in haematology, which can be narrowed to my local area.
Resources for my patients
I will return to my workplace with an armoury of resources to directly benefit patients. These include different ways of recording quality of life to ensure this information is used in shared decision-making. I was made aware of two support programmes available to patients via apps and an advice line offered by Blood Cancer UK, specifically relating to clinical trials.
Attending the conference enabled me to leave my normal place of work and participate in the high-quality, varied programme without everyday interruptions and distractions.
It was a great opportunity to learn about new evidence and different ways of building services as well as practical resources that can be signposted to patients and directly enhance their care.
Karen Desay, Biomedical Scientist, NHS Blood and Transplant
I was very grateful to receive an abstract scholarship from the BSH to attend the 2019 ASM in Glasgow. It gave me a platform to present my research in front of and be questioned by world-renowned experts in the field. I came away with new ideas, a sharpened focus, and a renewed vigour to continue research on genotyping haemoglobinopathy patients to reduce rates of alloimmunisation.
As a biomedical scientist, I don't have any patient contact. This conference expanded my horizons beyond the lab and gave me a greater appreciation of the clinical aspects of disease and the applications of our work. It has informed all of my subsequent writing and teaching on my topics of interest.
I particularly enjoyed the informal nature of the Meet the Expert sessions. They provided stimulating discussion and a fantastic opportunity to ask questions you might not usually ask in a large auditorium.
The conference also highlighted the cutting edge of clinical science. Dr Alexis A. Thompson, Head of Hematology at Lurie Children's Hospital of Chicago and Professor of Pediatrics at the Northwestern University Feinberg School of Medicine, presented the latest results from clinical trials on gene therapy in haemoglobinopathy patients. It represents a really exciting advancement which could transform treatment of these patients.
I also enjoyed the Novartis Sponsored Symposia entitled Artificial intelligence to reimagine haematology treatment.
It's always best to keep abreast of upcoming changes – the future could look very different!
I'd really recommend the BSH ASM to all scientists and clinicians alike, and I look forward to seeing what is in store next year.
Tricia Tay, Medical Student, University of Manchester
When I saw Dr A.V. Hoffbrand well up in tears on receiving his lifetime achievement award, I too welled up in tears to receive this invaluable opportunity of being awarded this scholarship to attend the BSH's 59th Annual Scientific Meeting.
I am grateful for the opportunity to present on behalf of my team on the treatment of natural killer/T-cell lymphoma in Singapore. As a medical student, it was a sheer delight to attend and present a poster at my first haematology conference.
With this scholarship, I have received invaluable feedback on our study and areas of improvement for our future projects. Observing how other presenters shared their presentations and subsequently presenting at this conference has improved my presentation skills.
It has improved my confidence in presenting, and stepping out of my comfort zone to seek constructive feedback on the poster and study design. It has also been pivotal in shaping the future of our study as we begin writing the article for publication.
In addition, this meeting has enhanced my understanding of the wider field of haematology and lymphoma. The session on Making sense of haematology for senior medical students and other professionals was a great session to build a strong foundation in the basics of haematology before the conference started.
We covered a range of topics that foundation doctors should be competent in: from reading full blood counts to dealing with haematological emergencies.
Interprofessional working was at the heart of the small group teaching as we applied our experience and knowledge to answer the questions with highly supportive tutors.
Many participants felt they were not sufficiently prepared for haematology in most of their curricula. We brainstormed how to tackle the stigma and improve the knowledge of our peers because haematology is vital in every speciality.
I am interested in education and research in haematology. The session, How to future-proof yourself in haematology, improved my understanding of how trainees can participate in research and education.
At the end of the day, patients value the clinician in front of them more than the research ongoing in the laboratory or in front of the computer, and it is the clinician's role to bridge the gap from bench to bedside.
This conference has also provided the opportunity to meet supportive mentors keen to teach and inspire the next generation of haematologists.
Attending the ASM felt like I was standing on a cliff – we are at the edge of change in haematology and healthcare in the United Kingdom and the world. I would highly recommend anyone to attend this conference.
I would also like to thank Dr Richard Byers, Haem-pathologist at the Manchester Royal Infirmary, for the initial inspiration in haematology and Dr Tiffany Tang, Haem-Oncologist at the National Cancer Centre Singapore, for the opportunity to conduct this study and present on behalf of the team in Singapore.
Dr Amelia Fisher, ST4 Haematology Registrar; NIHR Academic Clinical Fellow in Genomics, Leeds Teaching Hospitals NHS Trust, University of Leeds
The British Society of Haematology Abstract Scholarship enabled me to attend the BSH Annual Scientific Meeting 2019 to present the poster, Reducing inappropriate blood testing in haematology inpatients: A multicentre quality improvement project.
During a very enjoyable day in which I was also a speaker for the Crucible Prize session, I attended the National Institute of Health Research (NIHR): Better blood research session.
As an NIHR academic clinical fellow trainee, it was brilliant to hear how all grades of haematologists are being engaged by NIHR to bring haematology research and audit not just to teaching hospitals but to any hospital with willing participants.
This idea has been embraced by HaemSTAR, as highlighted in the Trainees propelling blood research talk by David Tucker. I have been fortunate to be a member of HaemSTAR, and David gave an excellent summary of how we are encouraging trainee participation in audit and research across the country.
One speaker I found particularly inspirational was Dr Charlotte Bradbury. She spoke about being a Young consultant initiating blood research, a position I hope to find myself in in future.
From my experience as a Haematology Registrar in Leeds and a member of HaemSTAR, I was aware of the FLIGHT trial that Dr Bradbury has led. To hear about the challenges of setting up this trial, from finding the right research question to ask, ethics, funding (especially when developing research involving a generic drug), and collaboration, was fascinating. Her experiences also demonstrated how hard work pays off – this was a good example of resilience in science!
Before this session, I had not given much thought to the fact patients could consent to two optional blood tests for translational research during the trial. As someone with a keen interest in genomics, I can see why Dr Bradbury chose to include this as part of the trial because there is a limited amount of genomic data available for ITP patients. The development of translational research to find the underlying mechanisms for disease could prove invaluable for developing more effective therapeutics.
At the evening poster moderation session, it was a pleasure to present my poster to moderators and be involved in discussion with them with regards to some of the challenges involved in quality improvement.
Challenges can include continuity of care, adapting a protocol for use at centres with different patient requirements and techniques to encourage the sustainability of changes.
I was pleased to receive feedback that the project was interesting, and the moderators agreed that it is important to rationalise the blood testing we do in haematology. This feedback has encouraged me to go ahead and write up the study results for submission for publication.
1. Pell J., Greenwood R., Ingram J., Wale K., Thomas I., Kandiyali R., Mumford A., Dick A., Bagot C., 7 Nichola Cooper, Hill Q., Bradbury C.A., Trial protocol: a multicentre randomised trial of first-line treatment pathways for newly diagnosed immune thrombocytopenia: standard steroid treatment versus combined steroid and mycophenolate. The FLIGHT trial, BMJ Open: first published as 10.1136/bmjopen-2018-024427 on 18 October 2018.
Dr Shasha Khairullah, Haematology Trainee, University of Malaya
This year was my first BSH Annual Scientific Meeting, and hopefully, it will not be my last. I gained a lot in terms of the most recent advances in clinical and laboratory haematology.
This year's focus was more on benign haematology, which I appreciated, as I find this section of haematology more difficult to comprehend in comparison to malignant haematology.
The Pitfalls Day was a comprehensive overview of what is required of a trainee, and I benefited a lot from it.
I have a special interest in thalassaemia and, therefore, was pleased to hear lectures from Dr Alexis Thompson and Professor John Porter on the success of gene therapy in sickle cell disease and β-thalassaemia. It is definitely a big step towards finding a cure for these debilitating chronic conditions.
I thought the best session was the MacFarlane-Biggs lecture by Professor Mark Crowther from McMaster University on antiphospholipid antibody syndrome (APLS) and the reversal of anticoagulants. He was brilliant at pointing out that a definitive diagnosis of APLS remains elusive and confirmed my prior learning on the management of this potentially devastating condition. It is, in fact, remarkable that so little progress has been made in APLS management, despite the advances in other haematological conditions.
The chimeric antigen receptor (CAR) T-cell lectures were inspiring, bringing hope for refractory conditions, although, of course, the costs preclude us from adopting this therapy widely in Malaysia at present.
The speakers, on the whole, were very knowledgeable and were fantastic at delivering their topics. There was adequate breadth and depth of the topics covered.
I would like to thank the BSH for the opportunity to present two posters on thalassaemia at the meeting. One on biomarkers of ineffective erythropoiesis in non-transfusion dependent b-thalassaemia; and one unique case report of moyamoya in a-thalassaemia.
I was very privileged to meet several well-known researchers in this field during the poster session.
I enjoyed my stint at the Glasgow BSH in April 2019 and my brief exposure to Scottish culture and hospitality. I would like to thank the committee for making this trip possible.
1. Thompson A.A., Walters M.C., Kwiatkowski J., Rasko J.E.J., Ribeil J.A., Hongeng S. et al. Gene therapy in patients with transfusion-dependent beta-thalassemia. N Engl J Med. 2018;378(16):1479-93.
Dr James Adam Austin, Postdoctoral Research Associate, University of Liverpool
Firstly, it was rewarding that my research was recognised to merit a travel scholarship that enabled me to partake in the BSH conference and join the showcase of excellent research occurring within and outside the UK.
It was my second consecutive year of attending the BSH conference and another great opportunity to promote and absorb current trends in haematological research.
As a post-doctoral researcher at the University of Liverpool, my expertise is in myeloid leukaemia and the malignant properties of the oncoprotein CIP2A. CIP2A is overexpressed in many cancers and is almost always associated with poor clinical outcomes.
Through attending the BSH meet, I was able to seek out works of interest to help develop my research ideas. The abstracts chosen by the BSH catered for a wide variety of research genres, and the quality of the presentations enabled a concise dissection of the key messages. It provided an efficient overview of haematology themes and enhanced the context of my research within the field.
Throughout the conference, I was in close proximity with experts in the field, which provided a great opportunity for in-depth discussion and a feel of current opinion within haematology.
It also provided assurance of the future direction of my research. This year I was impressed by the top-scoring abstract talks in the first 'Acute leukaemia' session, which touched on the hot topic of cancer metabolism. Reprogramming of energy metabolism in cancer is emerging as a means of survival in many leukaemias, including myeloid and lymphoblastic leukaemias[2–5]).
The presentation entitled Targeting metabolic vulnerabilities and aberrant signal transduction pathways in paediatric T-cell acute lymphoblastic leukaemia (T-ALL), presented by Laura Anselmi, was of particular interest, linking commonly mutated genes in T-ALL to metabolic alterations. Many of these changes rewired cellular metabolism towards glycolysis and involved many well-established cell signalling pathways, including AKT and mTORC1 signalling. These metabolic changes were relied upon by these cells and therefore present new vulnerabilities to treating residual disease. The data presented was easy to follow and had clear implications for the future treatment of these diseases.
Attending the BSH conference, I gained a wealth of additional information and contacts from which to strengthen future research. As such, I will aim to regularly attend the meeting in the future.
1. Lucas, C. M., Harris, R. J., Giannoudis, A., Copland, M., Slupsky, J. R. and Clark, R. E. (2011) Cancerous inhibitor of PP2A (CIP2A) at diagnosis of chronic myeloid leukemia is a critical determinant of disease progression. Blood 117, 6660–6668.
2. Chen, W.-L., Wang, J.-H., Zhao, A.-H., Xu, X., Wang, Y.-H., Chen, T.-L., Li, J.-M., Mi, J.-Q., Zhu, Y.-M., Liu, Y.-F. et al. (2014) A distinct glucose metabolism signature of acute myeloid leukemia with prognostic value. Blood 124, 1645–1654.
3. Kuntz, E. M., Baquero, P., Michie, A. M., Dunn, K., Tardito, S., Holyoake, T. L., Helgason, G. V. and Gottlieb, E. (2017) Targeting mitochondrial oxidative phosphorylation eradicates therapy-resistant chronic myeloid leukemia stem cells. Nat. Med. 23, 1234–1240.
4. Galicia-Vázquez, G. and Aloyz, R. (2019) Metabolic rewiring beyond Warburg in chronic lymphocytic leukemia: How much do we actually know? Crit. Rev. Oncol. Hematol. 134, 65–70.
5. Knoechel, B. and Aster, J. C. (2015) Metabolic mechanisms of drug resistance in leukemia. Cell Metab. 22, 759–760.
Early-Stage Research Start-up Grants
Early-Stage Research Start-Up Grants are available from 7 November annually.
The reports below may have had information redacted to ensure the confidentiality of sensitive research information or grant applications. The complete reports will be available once the sensitive content has been published.
Dr Christina Pina, Lecturer in Biomedical Sciences, Brunel University London
The funding received was critical for my installation as a new Lecturer in Biomedical Sciences at Brunel University London, College of Health, Medicine and Life Sciences.
It bridged my previous fellowship work at the University of Cambridge into my first established academic position. It also allowed me to recruit a talented MPhil (Res) student, Ralph Samarista, to undertake laboratory work whilst I got settled into the combined teaching, research and administrative commitments of my new post.
This student's recruitment was particularly critical during the Covid-19 pandemic, which placed a strong onus on teaching responsibilities with adaptation to remote and, later, hybrid teaching and extensive undergraduate student support.
Furthermore, charity-based funding opportunities that have historically supported work in the haematology and leukaemia fields were significantly reduced and, in many cases, suspended during the last two years, and the BSH funding was critical to sustain my research activity.
At an institutional level, my early establishment as an externally-funded researcher in the leukaemia field supported my nomination as the Cancer Cluster Lead in the newly-established Centre for Genome Engineering and Maintenance. It prompted a college-level financial commitment to upgrade the existing Novocyte flow cytometer analyser from 5 to 15 channels to enable my research.
More recently, my sustained research activity proved critical to a successful college matched-funded application to the Wolfson Foundation for the acquisition of a cell sorter.
Scientifically, the funding allowed me to analyse individual and combined contributions of epigenetic methylations and the unfolded protein response (UPR) in acute myeloid leukaemia (AML) and to explore the therapeutic potential of combined DNA demethylating agents and UPR modulators.
I had previously identified these two pathways as the main candidate mediators of AML dependency on the MAT2A enzyme, which catalyses the synthesis of S-adenosyl-methionine, the main methyl donor in the cell.
I have now shown that combined targeting of DNA methylation and activation of the pro-apoptotic arm of the UPR can cooperate in eliminating AML cells from different genetic backgrounds, both cultured AML cell lines and patient samples.
I will now aim to extend these results in vivo to confirm their translational therapeutic potential.
Dr Henry Wood, Clinical Fellow, King's College London
The grant was critical to enabling me to develop a novel mass cytometry panel to study human monocyte/macrophage populations in acute myeloid leukaemia (AML).
The funds paid for the purchase of antibodies and reagents used in the panel, custom metal conjugation of antibodies, and acquisition of data from stained samples on the Helios mass cytometer at the NIHR Biomedical Research Centre Flow Core at Guy's Hospital.
The mass cytometry panel was developed successfully through multiple optimisation steps using a range of frozen, fresh, cultured and stimulated samples from different haematopoietic tissues to assess the efficacy of the antibodies and titrate them appropriately.
Once optimised, the panel was used to assess paired blood and bone marrow samples from 5 normal donors and 20 AML patient samples (10 recorded as FAB M0-2 and 10 FAB M4-5) alongside umbilical cord blood controls.
The resulting data demonstrate biologically relevant monocyte/macrophage and immature haematopoietic cell populations with a high degree of consistency within normal samples, although preserving the expected differences between peripheral blood, bone marrow and umbilical cord blood.
The data revealed significant variation in the monocytic populations present in different AML samples, which were not always consistent with the previously assigned FAB classification.
The samples can be broadly categorised into primitive, monocytic, mixed (primitive and monocytic) or intermediate 'monoblastic' phenotypes. These categories provide a basis on which to explore the behaviour of AML samples when challenged with chimeric antigen receptor (CAR) T-cells and may be predictive of the severity of the inflammatory response.
Dr Richard Burt, Senior Clinical Research Fellow, University College London
The BSH grant has been enormously helpful in my career development as a clinician-scientist.
Following the completion of my PhD on the acute lymphoblastic leukaemia (ALL) microenvironment in Professor Fielding's lab, I was very keen to continue research in this area. However, before obtaining the BSH grant, I was not in a position to apply for an intermediate fellowship as I required evidence of output from my PhD, preliminary data for the intermediate fellowship and evidence of obtaining grants independently.
The BSH Early Stage Research Grant enabled me to complete the benchwork required for a high-impact publication in Blood from my PhD, produce the preliminary data required for the intermediate fellowship application and show evidence of obtaining a competitive independent grant.
Without the BSH grant, it would have been much more challenging to have the time and budget for consumables to complete the required work to get to the next stage of my career as an early clinician-scientist.
The overarching hypothesis of the work was that surviving cells post-chemotherapy in B-cell acute lymphoblastic leukaemia (B-ALL) reside in a protective niche, which alters their metabolic state and favours chemotherapy resistance.
The objectives of the work are to:
- Determine whether B-ALL cells are rescued from chemotherapy-induced oxidative stress via transfer of mitochondria in in vivo models.
- Establish patient-derived xenograft (PDX) models of B-ALL for use in intravital imaging.
- Compare niche formation in a B-ALL PDX model using intravital imaging across different genetic sub-types both before and after chemotherapy.
Using a B-ALL xenograft murine model, I confirmed my in vitro findings that B-ALL cells are rescued from oxidative stress induced by chemotherapy by residing in a protective bone marrow niche.
I was able to show that part of the protective mechanism within the niche is the transfer of mitochondria from bone marrow stromal cells to B-ALL cells, as demonstrated by the presence of murine mitochondrial DNA in human B-ALL cells.
The transfer of mitochondria to B-ALL cells enables them to resist oxidative stress induced by DNA damaging chemotherapy agents (e.g. Daunorubicin, Cytarabine). Importantly, this protective mechanism can be inhibited by microtubule damaging agents (e.g. Vincristine, Nocodazole) as the transfer occurs between cells via microtubule containing tunnelling nanotubes. This provides a strong scientific rationale for giving microtubule damaging agents with or prior to DNA damaging agents in B-ALL treatment.
The work was published in Blood, and there are plans to test the approach in a randomised fashion in the proposed UKALL15 trial.
Dr Rhys Morgan, Research Fellow, University of Bristol, School of Cellular and Molecular Medicine
Wnt/b-catenin signalling is an evolutionary conserved signalling pathway critical for normal development and heavily implicated in human cancer. The central mediator, b-catenin, is frequently overexpressed in acute myeloid leukaemia (AML), where its expression is linked with inferior patient survival. Furthermore, well-characterised experimental models of AML development have demonstrated b-catenin to play a pivotal role in leukaemogenesis, rendering the protein an ideal therapeutic target.
The stability, subcellular localisation and transcriptional activity of the central mediator b-catenin is dictated heavily by proteins interactions. To date, much of its molecular characterisation has been performed in epithelial cells. However, b-catenin's haematopoietic interactome is likely to vary from its epithelial interaction network given its less prominent cell adhesion role (adherens junctions) in blood cells and the relative scarcity of activating Wnt mutations (APC, Axin and b-catenin), which are frequent in solid tumours but rare in haematological malignancy.
Pertinent to the molecular targeting of b-catenin to disrupt its pathological role in AML is the prior characterisation of its interacting partners in leukaemia cells.
My BSH early-stage research start-up grant has allowed me to assess the feasibility of performing b-catenin interactome studies in leukaemia cells for the first time. Specifically, we have trialled the process of co-immunoprecipitating (co-IP) b-catenin protein from both leukaemia cell lines and primary AML patient blast samples, followed by mass spectrometry analysis.
Obtaining research funds from major grant funding bodies would have been a considerable challenge, given the perceived level of risk associated with our experimental approach. As a junior research scientist, I would have also struggled in more competitive funding schemes, given my relative inexperience in comparison with more senior co-applicants in the field.
However, our now optimised experimental strategy has proved successful. And the BSH grant has provided me with the novel and interesting data I require to build a more substantial and long-term research bid.
Dr Holger Auner, Clinical Senior Lecturer and Honorary Consultant in Haematology, Imperial College London
This BSH award contributed to the successful application for a Cancer Research UK (CRUK) Small Molecule Drug Discovery Award that will be activated in 2019 and will focus on validating a potential new therapeutic target to overcome proteasome inhibitor resistance.
My research group works on aspects of intracellular protein homeostasis (proteostasis) in cancer cells and non-transformed cells, with a particular interest in multiple myeloma. The ultimate goal of our work is to find ways to disrupt proteostasis in malignant cells while largely sparing non-cancerous cells.
This aim builds on the proposition that cancer cells and, in particular, myeloma cells are highly dependent on the mechanisms that coordinate protein degradation and synthesis. This notion is supported by the clinical success of inhibitors of the proteasome, the main effector of intracellular protein degradation.
The BSH grant allowed us to complete a set of experiments that formed a key part of a project that has now been completed, with a manuscript under review (May 2018).
The grant also enabled us to conduct a set of preliminary experiments that supported a successful grant application with an industry partner and another grant application submitted to a UK organisation.
While the experiments funded by the BSH grant formed part of a larger work programme, the results of these experiments became important components of both the submitted manuscript and the grant applications, providing critical support for our conclusions and hypotheses.
Global Haematology Scholarships
Four Global Haematology Scholarships are available each year. Two to travel to the UK from a low to middle-income country (LMIC) and two from an LMIC to the UK. They are available from 1 July each year.
LMIC to UK
The paper flower I hold in the photograph is a precious gift I got from an eight-year-old girl, “T.A."
We performed the matched sibling donor transplant for aplastic anaemia on her, using the knowledge and confidence I gained from the training at Great North Children’s Hospital, Newcastle upon Tyne. This is the most valuable gift I can give to the BSH for giving me an opportunity to train at one of the best institutions in Europe, if not the world.
I am from Sri Lanka and work for the one and only government-funded paediatric transplant centre in the island. The centre is new, and our expertise in transplantation is limited. We have a long waiting list of patients who cannot afford a transplant in India or more locally, particularly in the private sector.
In conclusion, this was a great experience, and I will be using it to broaden the horizons of my career and uplift the haematopoietic stem-cell transplantation services in Sri Lanka. I can assure you that there will be many patients like "T.A.” who will benefit from the experience given to me by the BSH. THANK YOU!!!
Student Elective Scholarships
I used the BSH grant to fund my elective, and I went on elective in India. I went to a part of India called Kerala, which is where my parents are from. I've been to Kerala a few times but never experienced the healthcare system, and I was particularly interested in how cancers were treated - in particular, blood cancers - in that part of the world.
I was looking for funding for my elective, and I happened to do an internet search for funding, and I found it on... I think it was a website called money for medical students, and I found BSH, and the requirements were very, very few.
So I just applied for it, and they wanted a report or some evidence of academic standing and what extra-curricular activities I participate in. And they accepted my request.
The BSH grant has opened a lot of doors for me. It has allowed me to go and see things in my chosen country that I probably wouldn't have had the opportunity to see, such as lab experience.
I am able to pay more money into seeing things such as FISH and SKY procedures that are done in the laboratories, which are probably not accessible to see in the UK unless you get special permission. So that's really helped me a lot.
The highlight of my elective was going to an outpatient clinic on my first day and being given a stack of notes, and being asked to clock in patients in a totally different language. That was a great experience.
The BSH grant has changed my experience of haematology. Being able to see various presentations on haematology, things I had never seen in the UK. And it allowed me to see things that I'll probably never see again in my lifetime. And I'm very grateful to the British Society for Haematology for that.
I am grateful to the British Society for Haematology for awarding me a Student Elective Scholarship. This funded a placement at the renowned Aga Khan University Hospital AKUH(N) in my home town, Nairobi. I had long admired the hospital for its commitment to patient care and innovative research.
I had not had any clinical experience in Nairobi and was looking forward to seeing the Kenyan healthcare system. During the elective, I had the privilege of working alongside esteemed medical professionals within the Departments of Haematology & Oncology and Pathology.
I attended ward rounds where I observed patients undergoing treatment for various haematological malignancies. These included acute myeloid leukaemia (AML), acute lymphoblastic lymphoma (ALL), non-Hodgkin lymphoma (NHL), multiple myeloma and myeloproliferative neoplasms (MPN). I also saw non-malignant conditions such as sickle cell disease and venous thromboembolism. I actively contributed to discussions about diagnoses, treatment plans, and patient management.
In the out-patient clinics, patients often presented late, with various clinical signs and symptoms. This enabled me to practise my history and clinical examination skills and appreciate findings such as splenomegaly and lymphadenopathy.
I attended didactic morphology sessions and bone marrow reporting sessions. I shadowed the laboratory technicians as they processed blood films and reviewed these along with the resident doctors in Clinical Pathology.
I attended interactive case-based learning sessions and lectures with postgraduate residents in the AKUH(N) programme. I also attended governance sessions such as haematology multidisciplinary meetings and mortality and morbidity meetings, which gave me insight into how clinical quality is maintained.
One of the profound impacts of the scholarship was the chance to interact with patients benefiting from healthcare subsidies and welfare programs.
The Haem-Onc Department at AKUH(N) recently launched a subsidised acute myeloid leukaemia induction chemotherapy package. This package has made treatment more accessible and affordable for patients from disadvantaged economic backgrounds and increased the number of patients getting high quality and life-changing treatment.
Interacting with these patients fostered an increased sensitivity to the unique challenges that patients face, and it reinforced the importance of delivering equitable and patient-centred care.
Lastly, the grant facilitated my participation in a clinical audit, which will influence future patient care and may form the basis of a hypothesis for future study. This project further cemented my interest in clinical research.
As I reflect on the transformative journey made possible by the scholarship, I am immensely grateful for the opportunity to take this significant step forward in my medical career.
I want to thank my supervisor Dr. Anne Mwirigi for her support, and the entire department for a memorable learning experience. I am inspired to pay this support forward by committing myself to excellence in patient care, continuous learning, and contributing meaningfully to the field of medicine.
I would like to thank the British Society for Haematology for awarding me a Student Elective Scholarship. I spent my medical elective at the University of Benin Teaching Hospital (UBTH) in Nigeria. This was an interesting experience as I got to visit my parents' country of origin.
I was intrigued to learn more about the Nigerian healthcare system and culture. I moved between different rotations including paediatrics, internal medicine, obstetrics and gynaecology, with an overlap of haematology in each rotation. I also explored Benin City.
I gained a lot of valuable communicative and hands-on experience. I saw how the doctors conducted morning reviews of their patients, on top of ward rounds and providing emergency services.
I was exposed to a wide variety of clinical presentations prevalent in Nigeria, such as malaria and sickle cell anaemia.
I will be carrying forward these positive experiences into my clinical practice. This experience allowed me to witness the positive aspects and the current challenges facing Nigeria.
Thanks to the British Society for Haematology’s Student Elective Scholarship, I was able to complete a haematology-based elective in Sri Lanka. I spent the elective in Elpitiya Base Government Hospital, with weekly Ayurveda clinics in the local village.
My hospital placement was spent in paediatrics, obstetrics & gynaecology. It allowed me to see a vast range of haematological conditions, along with their presentation and management.
I have a personal interest in obstetric haematology and my current university research project is in this field. I was especially keen to see how post-partum haemorrhages were managed.
I was surprised to find NICE guidelines and BSL algorithms peppered throughout the wards. The similarities to UK hospitals extended to how ward round notes were written. These similarities make sense, given the history of British rule in Sri Lanka. Of course, there were differences, eg the recommended use of a sandbag as an alternative to bimanual compression of the uterus during a postpartum haemorrhage.
I particularly enjoyed attending the Ayurveda clinics. This traditional practice of medicine is very popular in Sri Lanka. It focuses on the mind, body and soul and their interactions and imbalances within diseases.
The clinics were run by a female doctor every week and were attended by many locals. Most patients were given a form of oil for their symptoms. Although I was sceptical at first, it was undeniable that many patients returned for more herbal medicine due to the relief of their symptoms.
I particularly enjoyed the practice of pulse-reading diagnosis, which split people into vata, pitta or kapha pulses. As intrigued medical students, many of us had our pulses read and were shocked at their medical accuracy.
The whole experience of these clinics reminded me of the importance of treating a patient holistically, suggesting non-pharmacological interventions such as meditation and breath-work, and believing in the power of something that is not fully understood.
This medical elective has been the trip of a lifetime. I extend my deepest gratitude for the opportunity provided by the British Society for Haematology.
The British Society for Haematology Student Elective Scholarship has been a great benefit as it gave me the opportunity to carry out my medical elective in Bangkok, Thailand. I have learnt a great deal from the one month I spent attending placement at King Chulalongkorn Memorial Hospital on my haematology rotation.
One of the biggest differences I noted in Bangkok compared to the UK was that which was expected of the medical students.
In the UK, we have skills and competencies we are expected to complete, but this is all under supervision. Medical students are limited in what they are permitted to do. At Chulalongkorn, the medical students were encouraged to run their own clinics and perform minor procedures.
My day began with a debrief among the haematology doctors in the microscope room, which involved an hour of studying slides down a microscope and discussing what the specimens showed. I had never been given the chance to use a microscope before, and it was an enlightening experience to learn what each of the dials did, how to focus on an image, etc.
I had only ever seen cells on a computer screen before and it was interesting to learn how to diagnose different blood cancers using a microscope.
The doctors were all very kind, taking me under their wing during the ward rounds and happy to explain anything I was confused about.
Many of the patients we visited on ward rounds were critically unwell, having been moved to the intensive care unit (ICU). This meant that I didn’t get the opportunity to speak to many of them. Regardless, my placements in the UK hadn’t given me much chance to attend the ICU and my elective allowed me to familiarise myself with this crucial part of the hospital.
To conclude, this elective was a truly exciting and novel opportunity to experience healthcare in a country with a different culture and customs. I am extremely grateful to the BSH for providing me with the funding to carry out this medical elective abroad.
With the help of the British Society for Haematology's Student Elective Scholarship I was able to carry out an elective in haematology at the Mater Misericordiae University Hospital (the Mater) in Dublin, Ireland.
I was interested in experiencing a different country’s healthcare system, while exploring a speciality I had an interest in, but little experience of.
My elective consisted of a variety of interesting clinical activities in which I took part directly. I was an involved member of the team in daily ward rounds. I assisted in carrying out bone marrow trephines and sat in on specialist haematology clinics. These events greatly expanded my clinical knowledge.
The most memorable experience of my elective was during my time in the hospital's haematology lab. I was able to view slides created from the bone marrow trephines of patients I had seen. From this I could see the physical diagnosis, which the patients would ultimately receive.
The haematology registrar was also very kind in taking me through interesting cases he had collected. I was allowed to explore the slides to enhance my use of the microscope, as well as working on differentiating between normal and abnormal variants of haematological disease from Neutropenia to Diffuse Large B-cell lymphoma (DLBCL).
The team I was with in the Mater were very accommodating and fantastic to work with and learn from. I received teaching at all times and during every aspect of daily clinical life, from all levels of medical staff.
Alongside my clinical experience, this scholarship allowed me to experience a different city. Dublin is a very vibrant and busy city. I spent time exploring local parks, pubs and tourist attractions. Special highlights were taking walks down the Grand Canal on sunny days and eating New York style pizza from Bambino.
I would like to again thank the staff of the haematology department at the Mater for their time and effort in accommodating me. I would also like the thank the British Society for Haematology for awarding me this scholarship.
Due to the support of the British Society for Haematology, I was able to expand my horizons about haematology and the challenges haematologists face.
I joined the Newcastle haematology team at the Freeman Hospital and the Royal Victoria Infirmary for four weeks. These have a strong focus on stem cell transplants. It was very interesting to see the wide range of patients and new trials taking place.
Newcastle is a larger centre than where I am based. I was able to see more than eight allogeneic transplant patients, with conditions such as sickle cell disease. I was also introduced to CAR T-cell therapy.
By speaking to current F1s and F2s I realised that haematology is something not many medical students experience. I think this has set me up perfectly to appreciate how to manage complex patients. Hearing about patients' struggles in dealing with their chronic diseases highlighted to me the importance of holistic care.
As part of the team, I joined ward rounds and clinics. I saw patients with lymphoma and myeloproliferative disorders, as well as pre and post-stem cell transplant cases. I discovered how varied the job can be as it includes apheresis, lab work, bone marrow biopsies and matched unrelated donor meetings.
One thing that stands out was accompanying a registrar to do a bone marrow biopsy on a patient and then taking this straight to the lab for diagnosis.
The satisfaction of being able to do a lot of the processes was really appealing. I had the opportunity to undertake a QI project alongside a peer, exploring senior house officers' confidence in managing CAR-T/bone marrow transplant (BMT) patients.
I was also privileged to attend some paediatric clinics and ward rounds; this is something few medical students get to do, especially as there are only 11 paediatric stem cell transplant centres in the UK. This opened my eyes to other areas of haematology.
It was interesting to see the similarities and differences in the stem cell transplant clinics between adults and paediatrics. Not only the different chemotherapies and immunosuppressant medications but also how different patients cope and their management strategies.
One consultation that stood out to me was a six-month post-transplant young boy. He was desperate to go back to school but was unable to do so due to graft-versus-host disease, requiring an increase in his immunosuppressant medication.
Following a ward round, a consultant said that if you don’t have a breakdown as a registrar on inpatient haematology then you probably aren’t right for the job. It shows me the responsibility and the hardships that I might face in the future but also the privilege of playing a role in our patients’ lives.
I am extremely grateful to the BSH for the opportunity given to me by the grant. I'm also grateful to the haematology teams at the Freeman Hospital and Royal Victoria Infirmary as this is an experience I will never forget.
I’m so grateful for the grant from the British Society for Haematology, which enabled me to have a career-shaping four weeks at Great Ormond Street Hospital (GOSH).
One of the places I saw haematology at play was in transplant medicine. It was amazing to see ventricle assist devices in use as the bridge between severe heart failure and transplant.
I saw the seriousness of needing accurate anticoagulation and haematology input when parents were counselled about the risk of clot formation and the potential for subsequent embolic events whilst waiting for a transplant.
Furthermore, I got to think about ABO and human leukocyte antigen compatibility when the clinical nurse specialists made decisions about accepting each organ offer. Interestingly, recent research done at GOSH has shown that ABO matching may be less crucial for children under two, depending on their concentration of ABO antibodies.
I enjoyed sitting in on benign haematological clinics and seeing conditions I’ve not seen before such as haemophilia. I also enjoyed seeing scientific advancements in haematology such as CAR T-cell therapy making such a difference to patients.
It was fascinating to see bone marrow biopsies being performed and then going into the lab to see the cells under the microscope.
I was privileged to be able to hear the stories of patients with acute lymphoblastic leukaemia (ALL) and how they coped with the highs and lows of the journey.
When I saw ALL diagnoses being given it was a reminder of how foreign most of the language we use in medicine is to people. It struck me that not only are we doing that for the adults in the room but also for the child. Part of delivering diagnoses is explaining some of our jargon to parents and relating this to their children.
If not planned, timed and executed well, the first understanding of leukaemia and cancer a child can have is from observing the understandably emotional reaction of their parents. I can’t imagine how scary that must be for the child, something worth considering when I may deliver bad news in the future.
The most poignant takeaway I have from this placement is how powerful hope is. Medicine, or rather treatment for illness, offers a sometimes imperfect and incomplete version of hope but it is one of the best parts of being a doctor.
Being able to tell a family that there is treatment, or even better that treatment has worked, is the biggest privilege of the job. I loved seeing patients who had been treated in their early childhood and who were now 16/17 and going to university.
On the contrary, when you have to deliver the worst news and remove all sense of hope it is beyond devastating, especially with children. I feel fortunate to have had these experiences so early on in my career to see medicine in its entirety.
I would again like to thank the BSH for enabling this elective experience!
I would like to thank the British Society for Haematology for their generous scholarship that enabled me to spend four weeks with the Haematology and Haemato-oncology department at the Mater Dei Hospital in Malta.
This is the largest tertiary teaching hospital on the island, with the most extensive haematology ward. The Sir Anthony Mamo Centre sees the vast majority of routine referrals as well as emergency presentations for general haematology and haemato-oncology.
The placement has given me extensive outpatient clinic exposure, providing an insight into both the acute and chronic presentations in haematology and their management in the inpatient and outpatient settings.
With its unique demographics, Malta has a comparatively high proportion of patients with thalassaemias (especially beta-thalassaemia).
Malta has also been of great interest to immunologists, with, interestingly, one of the highest incidences of leucocyte adhesion deficiency in the world. I was given the opportunity to attend the annual immunology clinic and witness how closely haematologists and immunologists work together in managing complex cases of primary immunodeficiency.
It was an incredible opportunity to learn more about conditions such as common variable immunodeficiency, the secondary complications that arise and rare causes of agammaglobulinemia. I also observed discussions about navigating the care of patients with potentially novel variants (American College of Medical Genetics class variants of unspecified significance) in immunologically significant loci.
The Maltese healthcare system works in close association with the NHS. Much of the genetic profiling and sequencing of haematological malignancies is conducted at Great Ormond Street Hospital, and bone marrow transplants often take place at the Royal Marsden Hospital.
One of the key learning points I have taken away from this placement is the expanding role of genetics and genomics in informing treatment and predicting prognosis. Indeed, haematology as a speciality has always been in the vanguard.
The discovery of the t(9;22)(q34;q11) BCR-ABL proto-oncogene translocation in chronic myeloid leukaemia in 1982 paved the way for the use of Imatinib (and now second and third-generation tyrosine kinase inhibitors). This dramatically increased the overall survival of BCR-ABL positive chronic myeloid leukaemia and acute lymphoblastic leukaemia.
With advances in exome and genome sequencing, it is possible to sequence malignancies in a clinically useful timeframe, allowing its use as a diagnostic profiling test. It also provides important information about the cancer genetics that can inform responsiveness to chemotherapy or biological therapy regimens.
I am grateful for this placement, for introducing me to the expanding role of genetics and genomics in haematology and the wider speciality of oncology.
To further this interest, I have become involved in a project with the Clinical Genetics Team at Great Ormond Street Hospital. I am in the process of conducting a review bringing together the haematology and genetics exposure I have seen during my elective placement.
It has been a privilege to be welcomed by the fantastic Haematology department at the Mater Dei Hospital, I am forever grateful for their guidance and support.
I would like to thank the British Society for Haematology for this grant, which allowed me to undertake a six-week elective.
During my elective, I worked alongside Dr Busuttil and the haematology team at Mater Dei Hospital in Malta. It is the main hospital for the island, so I saw the full range of haematological care, from informing patients of falsely reported normal full blood count results to seeing lymphoma patients undergo palliative chemotherapy.
While I spent most of my time on the intensive haematology ward or in general haematology clinics, I gained exposure to two new areas of haematology.
Firstly, I sat in bone marrow transplant clinics with Dr Ethell from the Royal Marsden.
Malta does not provide transplants locally but has an agreement for their patients to be treated for free in the UK. This created some practical problems for these patients, who would often arrive at appointments with a long list of questions.
Consultations often involved much more than explaining the process of a bone marrow transplant. Questions included: issues with passports and planes; who, when and how their families could visit; and even differences in laws and Covid-19 restrictions.
Secondly, I had the opportunity to undertake bone marrow biopsies and lumbar punctures for intrathecal chemotherapy administration. These are skills I had rarely seen during my studies but had the chance to focus on during this extended placement.
I would like to thank my supervisor Dr Busuttil for his support and the rest of the haematology team at Mater Dei Hospital for making my elective period one to remember.
I was fortunate enough to be supported by the British Society for Haematology for an elective in haematology at King’s College Hospital (KCH), London.
The Haematology department at KCH is large and varied. It is a national centre for haemophilia and thrombosis, the largest UK centre for sickle cell disease and bone marrow transplants, and one of the largest CAR-T centres in Europe.
This elective offered me an invaluable experience, at the start of my career, to learn more about the working life of haematologists and their patients.
I spent time with each of the main haematology teams at KCH (myeloid, lymphoid, CAR-T and transplant). I visited the wards as well as attending clinics. The long placement time allowed me to follow patients through their stay and treatments.
I enjoyed seeing in-person treatments I had only read about. It was quite amazing to observe a patient receive their 68ml of CAR-T cells that had travelled the world after a ~£150,000 production process.
I also visited some of the diagnostic and research labs, as I wanted to experience the laboratory as well as the clinical aspects of work as a haematologist.
Visually diagnosing myeloid disorders or confirming remission through a microscope was a satisfying process. It allows haematologists to maintain expertise over the whole patient journey. It also benefits patients through improved continuity of care, another strength of haematology I observed through years of consultants treating the same patients.
I felt privileged to observe clinics led by world experts in their specialities, with patients travelling from all over the UK to hear their advice.
I saw some wonderful aspects of the job, including long-term relationships with patients, the breadth and depth of the staff's medical knowledge and research-led practice. I also experienced a few challenges, most notably breaking bad news – particularly when treatments fail and few options remain.
Seeing the consequences of potentially lifesaving treatments was eye-opening, particularly regarding the neurotoxicity of CAR-T that left several patients in the intensive care unit for weeks.
The need for improved treatments with fewer side effects and further options after disease recurrence was evident. Equally evident was the commitment of the department to research, with a highly active clinical trials unit and staff keen to recruit patients to trials where they might benefit.
In a year where many medical students’ elective plans were scuppered, I was very grateful to have been hosted by this excellent department and supported by the BSH. This experience has greatly benefitted my understanding of haematology as a speciality and career. It remains my plan for the future.
This grant supported me in carrying out an eight-week medical elective with the Haematology department at the Aberdeen Royal Infirmary in Scotland.
The scholarship provided me with an excellent opportunity to build upon the pre-existing knowledge I gained in my pre-clinical years. I gained experience in the many nuances of haematology, a speciality I have long been interested in but have had limited exposure to during my time as a medical student.
I was able to attend several ward rounds on the haematology ward. Not only did this provide an insight into the many acute ways that patients can become haematologically unwell, but it facilitated my growth as a medical student as I was encouraged to talk to and examine patients with clinically interesting histories and signs, respectively.
I also attended many haematology outpatient clinics with a variety of consultants dealing with general haematology, malignant haematology and haemostasis. It expanded my knowledge of haematology immensely and provided me with much greater insight into the different conditions that haematologists contend with.
In addition, I was also able to attend the local blood transfusion service centre for a morning. Here I met a patient undergoing a peripheral stem cell collection. I was given a tour of the centre and received some teaching from the haematology consultant there.
I also spent time in the haematology lab, on two separate occasions, with a consultant and a registrar. It gave me a new appreciation of the processes of analysing blood films.
These activities are not something I would have been able to gain exposure to during any other part of my medical school journey, so it was a real bonus having the opportunity to do so during my elective.
My elective was not exclusively clinical. I carried out a project focusing on the outcomes of smouldering myeloma patients. It enabled me to become much more proficient in concepts such as progression-free survival, overall survival and Kaplan-Meier graphs. Not only did it help me grow as a holistic clinician and allow me to become more comfortable with these concepts routinely utilised in haematology, but it also allowed me to give something back to the department by helping them carry out that research.
Unfortunately, a summary is not enough to do this elective justice as I also attended registrar teaching, ward teaching, pathology meetings, multi-disciplinary team meetings, shadowed the on-call registrar and even spent an afternoon in the Royal Aberdeen Children’s Hospital speaking to some acute lymphoblastic leukaemia patients there.
Nevertheless, I have immensely enjoyed and benefited from having carried out this haematology elective. I am extremely grateful for the support the BSH provided. It has encouraged me to view haematology in a completely new light, and I eagerly await my next opportunity to partake in haematology again.
Due to the generous contribution of the British Society for Haematology, I was able to compare the work of haematologists in the highly-specialised department of Oxford Healthcare Trust with the relatively resource-poor and politically-complicated setting of the Augusta Victoria and Makassed hospitals, Jerusalem, two hospitals serving the Palestinian community of the West Bank.
In Oxford, I worked with Dr Ramasamy's team on a project looking at bone health in myeloma. It gave me insight into how the multidisciplinary team work together to produce research and inform evidence-based medicine.
They spent time to enable me to understand the different processes involved in data collection, clinical practice and writing. I saw how haematology treatments are developing (particularly for multiple myeloma) so that disease is increasingly controlled, and long term management of symptoms is required.
The Augusta Victoria, I suspect, provided a truly unique experience as it is a specialist oncology and haematology centre serving a community fraught with political complications. Whilst it has many resources not available in truly developing countries, monetary restrictions limit the care available.
The patients travel from all over Palestine. However, movement is restricted by the borders and checkpoints separating their land from Israel.
The week before I arrived, no patients had been allowed to travel from Gaza due to the recent bombings. When they reached the hospital, their situation had progressed, and often, the given diagnosis was incorrect.
Patients in need of bone marrow transplants required transfer to the local Israeli hospital, Hadassah. However, this is also barred by the government, so two patients who had been worked up and prepared for bone marrow transplant had to have their expectations managed and treatment altered to fit the limitations of the medications available in the Augusta Victoria.
The doctors and nurses do an excellent job managing the situation presented to them daily, dealing with relative shortages in staffing, facilities and medication.
Further, what made it so unique was the excellent tuition of Doctor Morabito, an Italian haematologist heading the department for a year. He is helping develop the haematology service and will hopefully get a bone marrow transplant service in place by the end of 2019.
He tutored me in diagnostic techniques, the interpretation of blood films, spectroscopy, and much, much more! So whilst I learnt huge amounts about their life and medical practice from the friendly staff welcoming me wherever I went, I also saw haematology in practice.
Makassed is a general medical hospital and more representative of the facilities available to the Palestinian population. Whereas the Augusta Victoria manages to provide a clean, quiet and generally effective hospital service, Makassed is busy, often dirty, and frantic. The staff did not hold back in telling me about problems they face.
Again, the staff were friendly, and spending a day in endocrine, rheumatology and neurology clinics allowed me to see a massive range of disease presentations.
It was an informative and rewarding elective which allowed me to explore a beautiful country, learn about the political situation and explore many aspects of medicine.
I feel committed to helping medical services in Palestine in the future and have enrolled in Arabic lessons.
Firstly, I would like to thank the British Society for Haematology for generously funding my elective.
I spent my elective period at UCL Cancer Institute under the supervision of Dr Marc Mansour and Dr Simon Richardson. The Mansour laboratory has extensively studied the mechanisms of leukaemogenesis. And novel therapies in T-cell acute lymphoblastic leukaemia and acute myeloid leukaemia.
I was involved in a project investigating PRDM16 as a putative oncogenic driver of normal karyotype acute myeloid leukaemia (NK-AML). Cytogenetic analyses are currently used to stratify AML patients into different prognostic groups. However, in 40-50% of AML cases, no chromosomal abnormality is visible by conventional karyotyping.
Molecular analyses have recently identified several recurrent, distinct mutations in NK-AML patients. These include activating mutations such as internal tandem duplications of the receptor tyrosine kinase FLT3 gene (FLT3-ITD), point mutations of the RAS protooncogenes, mutations altering genes encoding transcription factors (AML1, CEBPA), and mutations interfering with tumour suppressor pathways such as NPM1.
Identification of these mutations can provide insight into the mechanisms that promote and maintain NK-AML. And not only aids risk stratification in this cytogenetically heterogenous group but also guides therapeutic decisions.
PRDM16 is a zinc finger transcription factor and also encodes for histone methyltransferases that maintain heterochromatin integrity. It plays a critical role in the regulation of hematopoietic stem cells and is, therefore, a prime candidate for leukaemogenesis.
High PRDM16 expression is a significant predictive marker for poor prognosis in paediatric and adult AML patients and correlates with other known mutations in adult AML. Furthermore, it is preferentially overexpressed in NK-AML.
I completed an ongoing screening of NK-AML patient samples for PRDM16 expression as part of the project. It involved preparing RNA from the biobank, making cDNA libraries, and performing quantitative PCRs, which allowed for the identification of monoallelic cases and differentiation between short and long isoform expression. This work allowed us to investigate the correlation between PRDM16 expression and clinical outcomes, particularly disease relapse.
In addition, to elucidate the mechanism of PRDM16, I helped to characterise 2 AML cell lines – 1 PRDM16+ NPM1 WT and 1 NPM1+ – by performing Western blot analysis for PRDM16 on nuclear, cytoplasmic, and whole-cell extracts. I also performed shRNA knock-down experiments in both cell lines and assessed PRDM16 expression and cell viability. Finally, I was able to commence making an NPM1 knock-in cell line using CRISPR-Cas9 genome editing techniques.
This elective gave me the opportunity to spend time with both clinicians and scientists, allowing me to gain insight into the current challenges and questions asked in malignant haematology and the molecular biology strategies available to answer them.
Furthermore, I was able to build on skills from my PhD in an entirely new field. Overall, my elective most certainly did meet and exceed expectations.
I would like to express my sincere gratitude to Dr Marc Mansour and Dr Simon Richardson for their supervision and support and to the rest of the Mansour lab for allowing my elective period to be thoroughly enjoyable and memorable.
Firstly, I would like to thank the British Society for Haematology for the scholarship they have awarded me. It allowed me to visit the country of Sri Lanka and meet patients suffering from serious diseases and their families. This experience will certainly change the way I practise medicine in the future.
Had it not been for this bursary, I would not have had the opportunity to study in Sri Lanka, and therefore I could not be more grateful. I studied in the southern state of Sri Lanka, in Galle, splitting my time between Karapitiya teaching hospital and various community clinics and medical facilities, allowing me to fully experience a completely different healthcare system.
I chose to do this report on haematological malignancies in Sri Lanka. After some initial research, I found that after accidental death, haematological malignancy is the second most common cause of death in the entire country, making it an important public health concern for Sri Lanka.
Furthermore, although Sri Lanka has some public funding for healthcare, there are limited resources, which makes charity assistance a necessity, particularly with regard to patient support. However, in the southern province of the island, there is very little charity support for paediatric patients suffering from leukaemia. The northern province has its own charity, so I was intrigued to speak to patients and their families and find out their personal experiences.
I first spent two weeks with paediatric hospital inpatients, going on the oncological specialist ward rounds that visited the unit and then speaking to the families of the patients on the ward.
It struck me how much of a role the parents play in the wards here. It is essential for there to be a family member with every patient, and they are much more intricately involved in the patient care than we see in Great Britain. The parents would be with the child all day during their stay on the wards. Ensuring their needs were met and acting as the responsible adult for each child.
A lot of the treatment for leukaemia is carried out as a hospital inpatient in Sri Lanka. Therefore, the child will spend a great deal of time in hospital. As mentioned, the parents are vital in the child's care and, therefore, it is a great difficulty for the whole family to be caring for the child whilst in hospital.
I learned that there is a large paediatric haematological malignancy unit in the country's capital of Colombo. That means that for patients who live outside of one of the large cities, families may need to travel to one such facility and spend a long time there caring for the child, with relatively little charitable support compared with what we experience in Great Britain.
Furthermore, the time spent on the wards really helped develop my scientific understanding of haematological malignancies, and their chemotherapeutic treatments, in the paediatric population, which is something I have never had much experience with before. It was invaluable for my learning. I now understand what these patients truly go through on a day-to-day basis which is so important to see first-hand to fully appreciate the immensity of it.
I spent the following two weeks on community medicine posts, which focused on serious paediatric conditions, prioritising haematological malignancies. Here, my focus was much more on the family experience of the disease and the treatment and care they received. The thing that struck me most about this period of study was the difficulty experienced by parents if they are worried that their child may be showing signs of illness.
There are no publicly-funded GPs. Instead, children receive basic health checks whilst at school. Doctors visit larger schools at grades 1, 4, 7 and 11, giving the children vaccinations and an overview health check.
However, even in these situations, it would be difficult to pick up signs of a haematological malignancy unless the child verbally discussed any complaints themselves.
Other than the school checks, the only ways a parent can get their child seen would be to pay for a private general practitioner - which many patients do not have access to. Or to queue up at the hospital from the early hours and hope to see a general paediatrician who can examine the child thoroughly.
However, it can take hours to be seen by a doctor in this way. Arriving at the hospital at 9 am, the corridors would already be filled with patients and families hoping to be seen by a doctor. Other than the access to care, most families reported feeling incredibly lucky to be treated at such an amazing facility and had nothing but praise for the care they had received.
This elective has truly changed my future in medicine.
It has taught me not only a great deal about the scientific and medical intricacies of treating haematological malignancies in paediatrics. But it has also truly opened my eyes to a healthcare system that has such a core role for the patient's family. And I feel very lucky to have witnessed this first hand.
Thank you to the BSH for giving me this opportunity and helping to shape my future career.
Firstly, I would like to say a tremendous thank you to the British Society for Haematology for awarding me a Student Elective Scholarship, without which my elective would not have been possible.
For my elective, I travelled to Seoul National University Hospital (SNUH) in South Korea to undertake a placement in paediatric haematology, a speciality in which I have been interested throughout my time at medical school.
As one of South Korea's leading tertiary hospitals with a 300-bed children's hospital, SNUH was an attractive location for me to gain a breadth of experience in both specialist and core haematology.
During my placement, I was supervised by Professor Kang Hyoung Jin, who has a specialist interest in the development of novel treatments for refractory leukaemia. I integrated into his team and attended handover, ward rounds and clinics, weekly radiology meetings, pathology meetings and journal clubs.
I was also given the opportunity to attend clinics for benign haematology. I was able to learn about the clinical trials they were undertaking and the process that this entails, both administratively and clinically.
During my elective, I completed two literature review projects that I presented at departmental meetings. The first review was centred on the key genetic mutations in acute myeloid leukaemia, their effect on prognosis and potential for targeted therapies. The second review concentrated on key haematological tumour antigens and related immunotherapies. It was a very useful opportunity for me to read about certain areas of malignant haematology in depth, allowing me to gain a good overview of promising future directions in these fields.
With South Korea being so culturally and socially different from the UK, I had to adapt to difficult communication and differing patient expectations.
The approach to offering investigations and discussing disease with patients was also very different from my previous experiences, with a focus on explaining pathology in detail. It was interesting to see how this changed patient experience of healthcare.
I was able to appreciate the remarkable work ethic and time management skills of the clinical team, from attending to over fifty patients in a single ward round to seeing patients in clinic with a turnover of five minutes.
I experienced challenging and educational medicine while learning how to holistically manage complex and very unwell paediatric patients.
Paediatric oncology with interest in haematology at the Royal Hospital for Children in Glasgow was a four-week venture into the Schiehallion ward.
Under the supervision of Dr Ronghe, I was able to diversify my learning between the three specialities that share the ward: oncology, haematology and transplant medicine.
Partaking in ward rounds and clinics of these three specialities and visits to the lab and apheresis unit at Gartnaval Hospital, I was able to see a vast amount in four weeks.
In addition, I completed two projects: the first was an audit of paediatric neuroblastoma patients. To complement this, a spreadsheet program to provide dates for a treatment plan for paediatric patients with neuroblastoma.
The core outcomes of my elective were to learn how paediatric medicine differs from adult medicine and contribute to the field by completing an audit. During completion of these educational outcomes, I would learn through exposure to different scenarios how a paediatric doctor fulfils his duty of care to his patients. Observing the interplay of various health professionals would, in turn, add to my growing understanding of what it means to be a health professional.
My supervisor, paediatric consultant Dr Ronghe, listened to my goals and ensured I could access the right people and facilities to achieve them.
He introduced me to consultant haematologist, Dr Kenneth Douglas, who explained the challenges of treating paediatric neuroblastoma. It became my audit subject.
Treatment is guided by the SIOPEN trial, which dictates whether the patient receives the N7 or COJEC chemotherapy. Peripheral blood stem cell (PBSC) transplant is a critical component in the treatment of neuroblastoma patients, as this ensures adequate populations of progenitor blood stem cells remain in the patient's bone marrow.
These cells are collected after chemotherapy once the bone marrow has had a chance to recover. However, the limited success of PBSC collections is thought to be contributed to by the design of the trial. My audit, therefore, centred on gathering data on which mobilising chemotherapy achieved the most successful PBSC collections.
In addition to my audit project, another doctor provided me with a brief on a second project. He stated a need for a program that effectively planned each stage of the treatment protocol for the SIOPEN trial. What resulted was a program that required one date for starting chemotherapy.
The code was such that an alteration in any of the dates - for example, a delayed chemotherapy treatment due to line sepsis - would result in the rescheduling of all other dates to the new timetable. In this way, a plan was available to both the healthcare team and the patient's parents.
I was proud of the final product, as when I took on the project, I was not confident in using Excel to this end. I used my initiative and, at the same time, gained an understanding of trial design that will benefit me in interpreting the complex details of some trials.
Delving into this audit, I developed my understanding of a new area of oncology. Neuroblastoma is an example of the malignancy of embryonic stem cells. I understand now why blastoma type cancers are prevalent in children and how they are treated differently. This linked to the necessity of PBSC transplants in the treatment protocol.
Learning about PBSC transplants provided a link between oncology and haematology, my special interest. Autologous transplants are different to allogeneic transplants as the aim is to encourage regrowth of the patient's native immune cells, in contrast to using the graft vs host effect to attack cancer cells.
Transplant and oncology specialities work together efficiently, and communication is aided by sharing the same ward. MDTs are held daily, and care is highly-coordinated. I noted, in particular, how tightly care was coordinated. And how this translated into benefit for the patient and their family. Parents were kept so well informed; in essence, the doctor-parent relationship was the basis for a greater trust placed on the doctor than I had seen before.
The weight of responsibility on the doctors was intense. Occasionally, the doctors' room was a place for consolation following conversations on dolorous topics with parents. The doctor must inform the patient's carers in such a way as to allow them to make decisions that may result in the death of their child. The parent places trust in the doctor's knowledge, their opinion, and in the speciality as a whole.
It was humbling to have even a minor role in the care of any patient. The privilege of treating any sick patient is an understanding I never want to lose hold of in my career. Taking responsibility for the care of a human in the most vulnerable period of their life is a humbling experience.
The weight of the responsibility can be shared among the team members. Everyone in a team has a different background and views, but in Schiehallion, I saw them brought together by their duty of care for their patients. The strength of a team comes from the safety they feel in their job. The confidence to make decisions does not come entirely from knowledge and experience but from the assurance received from being part of a dependable and cohesive team.
Ideally, I would have liked to have completed my paediatric block before my elective. It would have given me a greater appreciation of just how different a paediatric speciality is, compared to adult medicine.
I feel the most enjoyable aspect of an elective is the freedom to explore the areas you are passionate about without the restrictions placed on you to complete cases and coursework.
I am a student who works best with minimal guidance, and the audit work and Excel program I designed were examples of my best work. I had a task and a deadline. I planned as best as I could and got the job done.
The confidence I have gained from looking back at my work and seeing that I have made a difference - seeing what I can do when I grasp opportunities - will be something I wholeheartedly take forward in my fast-approaching professional life.
As part of my PhD, I focused on the role of a subset of natural killer (NK) cells - CD56bright NK cells - following IL-2 therapy. The elective period was principally spent learning new techniques and applying them in the context of a new scientific area of interest - the role of NK cell exhaustion in melanoma - in a collaborative laboratory environment.
It enabled me to explore further a field of interest (cancer immunotherapy) whilst also giving me more laboratory experience in a different system and a greater understanding of the translation of therapies from bench to bedside.
The Bhardwaj Research Laboratory has extensively studied the tumour microenvironment in melanoma to understand whether the cellular dysfunction seen in T cells is also present in natural killer (NK) cells.
In particular, these studies have focused on the immunoregulatory protein T cell immunoglobulin and mucin-domain containing molecule 3 (Tim3), a mediator of exhaustion in T cells, understanding its role in NK cells and whether exhaustion of this cell subset contributes to disease progression. These cells reduce their cytokine secretion in the context of melanoma, and this project was to further investigate the profile of such putatively exhausted cells.
I also had the opportunity to spend time with clinicians and others in the translational pathway to more fully understand how these treatments were moving from bench to bedside and to observe their effects on patients.
The sheer speed of development of new therapeutics and the very impressive remission rates using such drugs is remarkable. The effects on patients are extremely dramatic, both in terms of life-lengthening and quality of life.
In addition, I was able to spend time becoming familiar with new forms of personalised medicine, for example, the use of tissue biopsy. And humanised mouse models of tumour growth to characterise the genetics and test therapies or particular drugs in the context of their specific disease.
At present, the model is not fast enough to impact directly upon the individual patient's care, but in the future, the use of such techniques may revolutionise cancer care.
This elective gave me a fantastic opportunity to develop my PhD skills and knowledge in a new area.
Already having some skills developed in those years helped enormously, as I was able to immediately perform a number of experiments and pick up other techniques quickly. Working in a different environment from my PhD was also helpful to really understand how various laboratories engage with the science, and the different research regulatory and academic environment was interesting to experience.
Overall, my elective most certainly did meet and exceed expectations. I am delighted to have gained a poster from the research period. I was made extremely welcome in the laboratory, and overall, it must be said, that New York City is a great place for both academic and social collaboration.
I would like to express my sincere gratitude to the British Society for Haematology; the University of Cambridge Clinical School (Hawkins Award); Queens' College, Cambridge; the Royal College of Physicians; the British Medical and Dental Students' Trust and the Gilchrist Trust for funding this amazing opportunity. And to Elena Gonzalez-Gugel and Nina Bhardwaj for their supervision, support, and for making this possible.
Firstly, I would like to thank the British Society for Haematology for sponsoring this period of elective study.
I carried out my elective in the state of Kerala, tucked away in the southwestern corner of India. I chose Kerala as my elective location as it is the place of my parents' origin, and from previous visits to India, it is somewhere I can identify with culturally.
I was intrigued by the 'Kerala model' of development, which has seen the state achieve the best living conditions in India. With only 3% of India's population, this diminutive state excels in indicators of social development such as low levels of infant mortality and population growth; the highest levels of literacy in the country, particularly among females; and higher life expectancy relative to the whole Indian population.
These statistics are even more impressive considering such indicators are comparable to many developed countries despite Kerala's per capita income being much lower. I wanted to explore the basis for the state's impressive health standards and compare it to the UK's National Health Service.
Unfortunately, Kerala is reported to have the highest number of cancer patients in the country. I wanted to study whether cancer care was proficient in Kerala, so I decided to visit the Regional Cancer Centre (RCC) in the state capital, Thiruvananthapuram.
The RCC is an autonomous scientific institution sponsored jointly by the government of Kerala and the government of India, which prides itself on being an internationally recognised centre providing state-of-the-art care.
I also had a specific interest in haematological malignancies and was allocated to observation in the Medical Oncology department. I was expected to attend the morning ward round, where the majority of patients were diagnosed with acute myeloid leukaemia (AML), acute lymphoblastic leukaemia (ALL) or non-Hodgkin lymphoma. Just as in the UK, all three are present in the top twenty types of cancer.
The ward looked barren, the only cooling was from ceiling fans, and there were no curtains between patients' beds.
The ward round consisted of a senior resident and a nurse working in a pair, reviewing the female and male bays, during which time each of the three consultants would pop in at various periods to check on their patients.
The senior resident would check any outstanding blood results, palpate for any new lymphadenopathy, look inside the mouth for fungal infection, and auscultate the chest for signs of respiratory disease.
Once the rounds were completed, I was afforded the opportunity to observe patients receiving lumbar punctures and administration of intrathecal methotrexate as part of their chemotherapy regimen. The residents were amicable and keen to explain the intricacies of the various chemotherapy protocols.
I was briefed about routine investigations such as blood tests and what important parameters to look out for. I was able to observe how diagnostic methods were being employed in the laboratory. Bone marrow studies helped identify possible chromosomal translocations, and flow cytometry classified various cell populations that were used to identify types of leukaemia.
I was also shown newer techniques required in the identification of the Philadelphia chromosome, such as fluorescence in situ hybridisation (FISH) and spectral karyotyping (SKY).
During the afternoons, I was expected to attend outpatient clinics. These were undoubtedly the highlight of my trip. The outpatients' department consisted of two consulting rooms with a room dedicated to procedures adjacent to them.
The rooms were swelteringly hot, and there were no facilities for cooling. Each room was smaller than a standard NHS consulting room, and personnel were split, with consultants being in one room seeing follow-up patients and junior doctors in the other clerking in new patients. There would always be three doctors in each tiny room working simultaneously and up to 10 people in a room, including patients, nurses and relatives.
I was overwhelmed by the turnover of patients within the department; one could argue it is up to three times as efficient as an NHS outpatient clinic despite a complete disregard for patient confidentiality.
On my first day, I was handed a pile of new patient notes and asked to call in patients to be clerked while being supervised by one of the postgraduate doctors. I found it extremely challenging to clerk patients in my native language, Malayalam. Even though I was reasonably fluent in conversing with the local population, asking questions or explaining complicated medical concepts was a struggle. Fortunately, my supervisors often came to my rescue.
There are vast differences in practice between the UK and India regarding communication from caregivers. I was present when bad news was broken to a patient about a cancer diagnosis in what seemed like an insensitive manner, without the classical 'warning shot' we are taught at medical school. The patient felt understandably devastated and, being the breadwinner from a modest farming family, was fearful about the cost of treatment. Fortunately, at RCC, cancer treatment is subsidised by the Indian government, with more funding available for those on a lower income.
There has been much discussion over the role of Ayurveda in cancer treatment. It is an ancient Indian system of medicine involving therapies based on complex herbal compounds, prayer, meditation and nutritional supplements as a means of healing from cancer.
According to Cancer Research UK, there is no scientific evidence to prove Ayurveda can treat cancer. Experts at RCC I spoke to corroborated this conclusion and further went on to mention how some patients try alternative treatments first due to their perception of the financial burden a cancer diagnosis may create, which then fail, resulting in patients presenting late, at a stage when their disease cannot be cured.
Overall, I have enjoyed my trip to Kerala. The weather was fantastic, the people were a joy to work with, and the food was delicious and cheap!
I was exposed to a wide variety of clinical presentations, and I was able to gain a lot of valuable hands-on experience.
Being thrown into the deep end by being asked to communicate in a different language, and diagnose and work out appropriate treatment strategies, proved to be an important character-building experience. I will definitely be carrying forward these positive experiences into my clinical practice.
Trainee Educational Bursaries
I was fortunate enough to receive a Trainee Educational Bursary to attend the Paediatric Special Interest Group meeting in London. This coincided with my paediatric rotation.
It is not always possible to attend these sorts of meetings due to the cost of travel, but it was made possible by this grant. The teaching on the day helped cement some of the knowledge learnt on the rotation and gave a fascinating view into up-to-date developments in the field.
I really enjoyed the day and appreciate the funding that helped me attend this meeting.
I found the new acute myeloid leukaemia therapies -cord transplant and granulocytes - very interesting. The advantage of cord transplant is ease of stem cell collection, which is less likely to cause graft versus host disease.
I am an adult haematology trainee in the East Midlands deanery. I would like to thank the British Society for Haematology for funding me to attend the BSH Paediatric Haematology Study Day held in January 2023.
Adult haematology trainees get little exposure to paediatric haematology in our routine training. This study day was extremely useful in understanding current practice and advances.
It was great to hear about the UK studies. I was particularly interested in CAR-T in acute lymphoblastic leukaemia (ALL). The speaker spoke about CAR-T in relapsed settings. It is currently licenced in the UK to treat patients up to 25 years old with refractory B cell ALL, in relapse post-transplant or in second or later relapse.
Another interesting topic was anticoagulation in paediatrics, which has been a challenge for many years due to a lack of randomised control trials for the use of direct oral anticoagulants (DOAC)s.
Dr Rob Wynn presented a brilliant lecture on cord blood transplants, and the protocols and advantages of using it. It is rarely done nowadays. Dr Wynn presented his centre's data, which was very promising.
The talks on whole genome sequencing and its importance were discussed in great detail.
The latest advances in sickle cell disease treatment were excellently explained by Dr Subarna Chakravorty.
I gained insights from ASH 2022, including updates and exciting evidence of gene therapy.
I would like to thank the BSH for awarding me a Trainee Educational Bursary.
I enjoyed my experience attending the ST3 Induction Day at the University of London on 1 July. It was a well organised induction program for new haematology ST3 trainees.
During the day, I had the opportunity to meet many new haematology trainees and consultants from different hospitals across the UK. We were able to exchange our experiences and share our knowledge and thoughts.
Many different haematologists delivered interesting topics on the induction day. I really enjoyed the morphology session, which gave me hands-on experience of operating a microscope. I also got the chance to review many blood films.
I personally feel that transfusion and haemostasis are difficult subspecialities in haematology. I am pleased that the lectures broadened my knowledge and reminded me of the importance of transfusion and haemostasis in our daily clinical practice.
Furthermore, the Essential Survival Skills lecture opened my eyes and gave me a broader knowledge of handling issues during the on-calls.
In conclusion, this was a focused and helpful induction for the new haematology trainee, with many interesting lectures and practical sessions. Once again, I am very grateful to the BSH for giving me the opportunity to attend the induction day.
Deadline for general travel scholarships: 31 January and 31 July.
ASH and EHA Travel Scholarship deadlines vary by year.
I would like to thank the British Society for Haematology for their support of a Travel Scholarship. The grant allowed me to present at and attend the International Society for Experimental Hematology’s (ISEH) Annual Scientific Meeting in New York City.
ISEH attracts internationally renowned scientists, working across basic and translational research on haematopoiesis and malignant haematology, to their Annual Scientific Meeting. Alongside a well-organised and varied scientific programme there was an emphasis on trainee support and mentoring, making it an ideal meeting for early-stage researchers.
I was able to present work from my PhD entitled Understanding immunotherapy failure in CNS leukaemia, insights from a murine model of infant ALL at one of the meeting’s poster sessions. I also took part in a pre-meeting new investigator workshop, where I gained valuable, individual feedback on the work I presented from a panel of experts. We discussed ways to develop the project further. The broad range of perspectives I gained on this work was extremely motivating and has allowed me to refine a research proposal I hope to gain funding for.
There were excellent networking events for junior researchers to discuss scientific careers and collaborations, which included a meet-the-experts session using a ‘speed dating’ concept. The opportunities to gain career perspectives and advice from highly successful researchers in haematology, from a wide range of backgrounds, are rare, which made this one of the standout events of the meeting.
One scientific highlight was a presentation by Daniel Tavakol from Columbia University, who discussed applying bioengineering approaches and ‘organ-on-a-chip’ platforms to generate patient-specific bone marrow models, using induced pluripotent stem cells and a decellularised bone scaffold. This type of model system has the potential to be a very useful tool, especially for those studying the contribution of the microenvironment to normal haematopoiesis, malignant transformation, and therapy resistance.
Overall, this experience, which was facilitated through the generosity of a BSH Travel Scholarship, allowed me to develop my ongoing research projects, gain thoughtful career advice and immerse myself in cutting-edge research.
I am extremely grateful to the British Society for Haematology for supporting my attendance at the International Society for Thrombosis and Hemostasis Conference in Montreal.
I had the privilege of presenting two posters that showcased research conducted at Imperial College, London.
The first poster presented the results of a retrospective study on the use of therapeutic subcutaneous unfractionated heparin for the treatment of venous thromboembolism in patients with renal failure. This work has now been published in Seminars in Thrombosis and Hemostasis.
The second poster focused on acquired von Willebrand disorder (vWD) in patients with myeloproliferative disorders (MPN) and thrombocytosis. Data was collected from a cohort at Hammersmith Hospital, London and provided insights into clinical and laboratory features of patients with extreme thrombocytosis. These individuals are at risk of developing thrombosis and bleeding due to acquired vWD.
This is a fascinating pathology. It is not completely understood and is often difficult to manage and, therefore, of great clinical and scientific interest.
I attended several lectures and particularly enjoyed the sessions on gene therapy (the focus of my PhD) and women’s health, a topic I am passionate about.
Here are some standout moments from the lectures I attended:
- In the haemophilia basic science sessions, the University of Bonn's German team delved into captivating research on intracellular trafficking of full-length FVIII versus B-domain deleted FVIII.
- The haemophilia gene therapy sessions for haemophilia A provided updates from the GENEr8-1 and SPK-8011 trials. There was also a comprehensive overview of the World Federation of Hemophilia gene therapy registry by Professor Barbara Konkle.
- The SSC women's health session, particularly Dr Rohan D'Souza's lecture, offered keen insights into understanding the decision-making process for anticoagulation choices in pregnant patients with mechanical heart valves.
In between lectures, I had the opportunity to network with clinicians and scientists from across the globe. One standout moment was connecting with the Hemostasis and Thrombosis Research Society, a North American scientific community committed to advancing research, mentoring, networking, and medical education in haemostasis and thrombosis.
I am eagerly looking forward to converting these connections into enduring scientific collaborations.
As a clinician and an early career researcher, this experience expanded my knowledge, forged valuable connections and ignited fresh inspiration for my future endeavours.
1. Al-Rifai, R. et al. B-Domain - Deleted Factor VIII shows clear differences in intracellular processing and cellular responses when compared to full length Factor VIII. International Society for Thrombosis and Hemostasis; Montreal, Canada 2023.
2. Bhatia, K., Shehata, N., D'Souza, R. - Anaesthetic considerations and anticoagulation in pregnant patients with mechanical heart valves. BJA Educ. 2022;22(7):273-81.
3. George, L. A., Monahan, P. E., Eyster, M. E., Sullivan, S. K., Ragni, M. V., Croteau, S. E. et al. Multiyear Factor VIII Expression after AAV Gene Transfer for Hemophilia A. New England Journal of Medicine. 2021; 385(21): 1961-73.
4. Ozelo, M. C., Mahlangu, J., Pasi, K. J., Giermasz, A., Leavitt, A. D., Laffan, M. et al. Valoctocogene Roxaparvovec Gene Therapy for Hemophilia A. New England Journal of Medicine, 2022;386(11):1013-25.
I am very grateful to the British Society for Haematology for awarding me a Travel Scholarship to attend the annual Wnt signalling meeting in Awaji, Japan.
Participation at this meeting allowed me, and my group members, to showcase our very latest research relating to Wnt/β-catenin signalling and acute myeloid leukaemia (AML).
During the poster sessions, PhD students Okan Sevim and Samuel Olaitan presented their work entitled Investigating the role of β-catenin in post-transcriptional regulation in acute myeloid leukaemia and Mining the Wnt signalling Responsive Surfaceome for Novel Drug Targets in Acute Myeloid Leukaemia.
Furthermore, in the Wnt signalling in Cancer session, the group’s research fellow Dr Megan Wagstaff presented her PhD study Crosstalk between β-catenin and WT1 activity in AML.
Both sessions allowed the group to receive critical feedback on our research, whilst also obtaining invaluable advice from world-leading Wnt researchers on how to develop and progress our findings.
As a relatively junior investigator in the field of Wnt signalling, I enjoyed the unparalleled opportunity to exchange conceptual and experimental advice from established leaders in the field. I also received many offers of reagents, techniques, and guidance on experiments we should undertake.
In particular, I learned about a new technique called ‘CUT&RUN’ from Dr Claudio Cantù of Linköping University, Sweden, which we now intend to deploy for investigating shared gene targets of WT1 and β-catenin in normal haematopoietic stem cells and AML stem cells.
It was also very useful to speak with Professor Tobias Madl following his talk on the structural studies of Wnt signalling about intrinsically disordered regions (IDR) in peptides and how this might affect molecular interactions in the cell. We are keen to try some experimental approaches for β-catenin which contains IDRs and examine how this affects binding to its molecular partners in leukaemia cells.
In summary, the BSH travel scholarship has been essential in allowing me to attend the Wnt 2022 meeting. I and the wider group have returned with renewed motivation and conceptual/experimental ideas to progress our existing research projects.
The new collaborations and resources acquired will benefit help our research which aims to understand disease mechanisms in AML and how they may be therapeutically targeted.
1. Gianluca Zambanini, Anna Nordin, Mattias Jonasson, Pierfrancesco Pagella, Claudio Cantù - A New CUT&RUN Low Volume-Urea (LoV-U) protocol uncovers Wnt/β-catenin tissue-specific genomic targets. BioRxiv 2022. doi https://doi.org/10.1101/2022.07.06.498999.
2. Spreitzer E, Alderson T. R, Bourgeois B, Eggenreich L, Habacher H, Brahmersdorfer G, Pritišanac I, Sánchez-Murcia PA, Madl T. - FOXO transcription factors differ in their dynamics and intra/intermolecular interactions. Curr Res Struct Biol. 2022 Apr 27;4:118-133. doi 10.1016/j.crstbi.2022.04.001. eCollection 2022.
I was grateful to receive the British Society for Haematology's Travel Scholarship to travel to the Gordon Research Conference on Megakaryocytes and Platelets in Galveston, Texas, USA.
I am an MB/PhD student currently studying for a PhD in the lab of Dr Cedric Ghevaert at the Department of Haematology, University of Cambridge, and the lab works on generating platelets in vitro for transfusions without the need for blood donors.
My project, in particular, focuses on developing engineered platelets as a targeted drug delivery system by loading the granules of platelets with drugs so that they can activate and secrete these drugs where they need to go, without systemic side effects.
Thanks to the help of the BSH, I was able to present my work at this international meeting, where I was able to meet the authors of all the major papers in the field of platelet biology!
I had the opportunity to discuss and receive valuable feedback on my work from many different perspectives, which would have been impossible otherwise.
I also had the chance to see my research in the context of the other fascinating advances taking place in the field.
The conference was very well organised, with several sessions with different themes. Each session started with short introductory slides presented by session chairs, followed by several presentations.
I was also able to talk to my contemporaries working globally on the similar issues we face and the big names in the field. I felt I was able to learn from both and made lots of new friends!
One of the reasons for attending the conference was to find out more about the tools that other labs use to ask similar kinds of questions that we are. One of the more fascinating talks was about some of these tools from the Hahn lab at the University of North Carolina at Chapel Hill.
They had developed biosensors to detect signalling GTPases spatiotemporally and to study how the dynamics of signalling take place in much more depth than can be shown by any western blot. They have developed computational techniques to analyse these videos and even engineered optogenetically activatable GTPases, using them to demonstrate how to activate Rac61 precisely and reversibly using blue lasers.
Rac61 is thought to control cell motility, and they were able to show how localised Rac activity was enough to mobilise cells to follow around the laser pointer, much like a cat.
From this, I learnt a lot about the frontiers of what was possible with protein engineering and new techniques for studying these signalling cascades in a way I had not considered before and certainly plan to use going forward.
Overall, I would like to thank the BSH for this opportunity to be able to travel, present my work, discover more about the work of others and the challenges we are facing together, and foster potential collaborations in the future that will hopefully benefit us all.
1. Wu, Y. I. et al. A genetically encoded photoactivatable Rac controls the motility of living cells. Nature 461, 104 (2009).
Souradip Mookerjee's Twitter: @souramoo
I am very grateful to the British Society for Haematology for supporting me with a travel scholarship to attend the Fondazione Italiana Linfomi (Italian Lymphoma Foundation) Cantera in Lecce, Italy.
Cantera, literally meaning 'quarry' in Spanish, is a term used to refer to Spanish sporting academies. Taking its inspiration from this training model, the FIL Cantera is an annual three-day course that aims to bring together a small number of trainees from across Europe and beyond to receive instruction from a leading expert in the field of lymphoma.
The brainchild of Professor Massimo Federico of the University of Modena and Reggio Emilia, Modena, Italy, the course has been co-sponsored by the European Haematology Association Lymphoma Group since 2018.
In previous years, course experts have included Bruce Cheson (2013), Richard Fisher (2014), Randy Gascoyne (2015), Andrew Zelenetz (2016), Steven Rosen and John Chan (2017) and Stephen Ansell (2018).
Professor Anas Younes of Memorial Sloan Kettering Cancer Center, New York, led this year's course. A highly respected international expert, Professor Younes works in the development of novel targeted therapies and the identification of biomarkers for lymphoma. He has been the principal investigator in numerous clinical trials, including some of the pivotal studies of Nivolumab and Brentuximab vedotin in Hodgkin's lymphoma.
Designed with an emphasis on interactivity, each session involved a presentation by Professor Younes, with generous amounts of time allocated to discussion, giving ample opportunity to ask questions and share and reflect on each other's experiences and opinions.
This year's theme was Precision medicine in lymphoma. Sessions were delivered on the current standards of care in lymphoma, drug development, clinical trial design, circulating tumour DNA, immune therapy, combination strategies, trial endpoints and target populations.
On the final day, the trainees pitched a clinical trial proposal that they had developed in groups to a panel of experts comprising Professors Younes and Federico, joined by Professors Antonino Carbone and Martin Dreyling. The most popular proposals received promises of support from the panel to help develop them in future.
The course venue was Lecce, a beautiful town in Salento, Italy. With evenings spent dining together in some very nice restaurants, the course was also a great opportunity to network with like-minded individuals and to lay the foundations for future collaborative relationships.
It was a tremendously valuable educational experience that I would highly recommend to anyone wishing to develop an interest in lymphoma.
I have thoroughly enjoyed my experience attending the 60th American Society of Hematology Annual Meeting & Exposition in San Diego for numerous reasons.
I greatly benefited from the extensive and well-planned programme and was struck by how much effort is placed into educational sessions geared towards haematology trainees.
I have definitely improved and updated my knowledge of the pathophysiology, diagnostic and management process of various haematological diseases.
One session I found particularly interesting was entitled Low iron promotes megakaryocytic commitment of megakaryocytic-erythroid progenitors in human and mice, which showed the pathophysiological process behind why iron deficiency anaemia is often accompanied by thrombocytosis. A question asked many times during my medical student teaching sessions that I am unable to answer.
Secondly, I had the opportunity to present a poster entitled Long-term safety and efficacy of autologous or allogeneic donor stem cell transplantation in patients with Behçet's syndrome. Another abstract I co-authored entitled Randomized trials of autologous hematopoietic stem cell transplantation for diffuse cutaneous systemic sclerosis: Systematic review and meta-analysis with trial sequential analysis of overall mortality was presented as an oral poster.
Being given this opportunity has definitely further developed my interest in research and has motivated me to continue to be involved in research at a local and national level whenever the opportunity arises.
Thirdly, this annual meeting has given me the opportunity to interact with haematologists from all around the globe. We were able to exchange experiences, and I was able to see how haematological conditions are being managed differently in other developed or developing countries. This experience has opened my eyes and given me a broader perspective of the overall issues surrounding haematology.
In conclusion, these three reasons have not only given me motivation in my career as a haematologist to further expand my knowledge and deliver the best care to my patients, but they have also contributed to my development as a well-rounded haematologist.
1. Low iron promotes megakaryocytic commitment of megakaryocytic-erythroid progenitors in human and mice. Juliana Xavier-Ferrucio, Xiuqi Li, Vanessa Scanlon, Ping-Xia Zhang, Nadia Ayala-Lopez, Toma Tebaldi, Stephanie Halene, Karin E. Finberg and Diane S. Krause. Blood 2018 132:2; doi: https://doi.org/10.1182/blood-2018-99-115214
This year's American Society of Haematology (ASH) conference was held in sunny San Diego, California. Celebrating its 60th anniversary, it lived up to my expectations.
As a clinician, albeit one who has recently started a PhD in megakaryocyte biology, the conference provided an opportunity to get updates about the latest trials and evidence.
One of the big talking points of the conference was the presentation of data from genome-wide association studies (GWAS) on the heritability of de novo AML, which indicated that up to 20% of patients might have an inherited genetic disposition for developing the condition.
Other notable highlights were the results from trials looking at the utility of direct oral anticoagulants (DOACs) in malignancy-related VTE.
Sickle cell disease also featured highly with some fascinating educational sessions reporting on the progress in gene-editing of the beta haemoglobin gene, which may present a potential 'cure' for the condition without the need for a bone marrow transplant.
The conference included several superb educational scientific talks within the area of haematopoiesis, the focus of my PhD. These included Stress and haematopoiesis, Thrombopoiesis and the lung, and How to make a red cell. The talks summarised key discoveries in the field and gave some insights into where the field seems to be going in the future.
The conference was also an opportunity to present my own work and discuss my findings and approaches with other scientists and clinicians. My poster, entitled Bayesian analysis of TPO in immune thrombocytopenia, is part of a larger body of work that aims to understand how the immune system affects the normal functioning and regulation of megakaryocytes in both autoimmunity and inflammation more generally.
Using novel mathematical approaches and computer simulations, I generated a model of TPO production in immune thrombocytopenia. The work attracted a great deal of interest and inspired lively discussion both about the research itself and about possible future directions the work could take.
I am very grateful to the BSH for sponsoring my attendance at the conference.
It has been a wonderful experience and a great opportunity for me, especially at this early stage in my scientific training.
The 10th International Workshop on Waldenström's Macroglobulinemia (IWWM) conference was held in New York City, USA, in a historic area near Wall Street and the 9/11 Memorial Museum.
The conference was an extremely well-organised three-day event with presentations covering a range of topics relating to WM. There were sessions on the genomic landscape of WM, diagnosis and management of the disease, clinical trial updates and resistance mechanisms.
Without the support of the British Society for Haematology and the travel scholarship, I would not have been able to attend this exciting event and present our group's research.
Our abstract, entitled Sequential analysis of TP53 variation using targeted next generation sequencing (NGS) in patients with Waldenström macroglobulinaemia, was selected as a poster presentation and shown at the poster viewing reception on Friday 12 October.
Our research showed that TP53 variation could develop over the course of the disease in WM patients. It implies that TP53 testing should be performed both at presentation and prior to any therapy initiation during the time course of the disease in order to accurately appraise therapy choices.
One of the most interesting topics for me was a talk by Irene Ghobrial from the Dana-Farber Cancer Institute on whether cell-free DNA (cfDNA) could be used to assess mutation status in WM. Her group found almost 99% concordance between somatic mutations found in liquid and tumour biopsies. The application of this technique is extremely sensitive, with batch sampling proving cost-effective.
The idea was most appealing to me for use in the sequential sampling of the patient over time, enabling minimally invasive procedures and avoiding the use of repeat bone marrow aspiration. Despite the bulk of disease occurring in the bone marrow, this group have shown that cfDNA from peripheral blood can better reflect the tumour heterogeneity.
One of the keynote speakers, Dan Landau, also discussed this method of testing as a useful way to study the evolutional landscape of Ibrutinib resistance, with his expertise based on studies in chronic lymphocytic leukaemia (Landau et al 2017).
That was another key theme of the conference, with Ibrutinib resistance becoming more common with increased use of BTK inhibition in this patient cohort. The outcome of these discussions led to the opinion that combination therapy rather than single-agent therapy is the key to overcoming clonal evolution of resistant clones.
I would like to thank the BSH committee for their generous travel scholarship award of £1,000, which enabled me to travel to New York, USA, for this conference.
The experience has been invaluable, and I hope it will impact my research work both now and in the future.
1. Landau, D. A., Sun, C., Rosebrock, D., Herman, S. E. M., Fein, J., Sivina, M., Underbayev, C., Liu, D., Hoellenriegel, J., Ravichandran, S., Farooqui, M. Z. H., Zhang, W., Cibulskis, C., Zviran, A., Neuberg, D. S., Livitz, D., Bozic, I., Leshchiner, I., Getz, G., Burger, J. A., Wiestner, A. & Wu, C. J. (2017) The evolutionary landscape of chronic lymphocytic leukemia treated with ibrutinib targeted therapy. Nat Commun, 8, 2185.
I would like to take this opportunity to thank the BSH for supporting me in attending the Sixth International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma (NHL) in Rotterdam, the Netherlands. This four-day symposium focused on translational research and clinical trials in paediatric and young adult NHL.
During the symposium, I had the opportunity to present our work entitled Investigation of FOXO1 mutations in paediatric endemic and sporadic Burkitt lymphoma, which was selected as an oral presentation in the poster discussion session. This study described the high frequency of FOXO1 mutations in Burkitt lymphoma (BL) and the oncogenic role of FOXO1 in BL that makes it a potential therapeutic target.
I also had the chance to engage with senior researchers from around the world who gave suggestions and criticism that helped us put this work together into a manuscript after the symposium and submit it for publication.
This conference broadened my knowledge of recent progress in paediatric and young adult NHL, such as current molecular and bioinformatics research, ongoing clinical trials, global clinical experience (especially in developing countries), stem cell transplantation, patient stratification and recent improvement in treatments.
One particularly interesting research field was chimeric antigen receptor (CAR) T-cells. Gardner et al demonstrated the efficacy of anti-CD19+ CAR T-cells in paediatric relapsed or refractory NHL with well-tolerated toxicities in a phase II trial. Ryotaro Nakamura improved in vivo expansion of CAR T-cells by developing CMV-CD19 bi-specific T-cells with CMV vaccine stimulation, which has progressed to phase II clinical trial (British Journal of Haematology, 182, (Suppl. 1), 5–109). These studies offered hope to paediatric NHL patients who failed front-line therapies and stem cell transplantation.
Overall, this was a focused and informative conference that kept me updated on recent NHL research and clinical trials, provided the opportunity to network with researchers from other countries and led to the establishment of potential collaborations.
Once again, I am very grateful to the BSH for granting me funding to attend this symposium.
Without this, I would not have had the chance to present my data to experts in NHL or get valuable feedback.
Thanks to the generous support of the BSH, I was able to travel to Atlanta to attend the 59th Annual Meeting and Exhibition of the American Society of Haematology (ASH).
I presented my group's work entitled Histone acetyl-transferase Kat2a regulates transcriptional heterogeneity and impacts self-renewal of acute myeloid leukemia cells in a disease-specific manner at the conference and enjoyed multiple opportunities for discussion.
Critically, I initiated two collaborations only possible due to my attendance at the meeting.
The ASH meeting is an intense yet highly-rewarding experience that articulates clinical with basic science perspectives and audiences. The unpublished or recently-published nature of the work presented provides investigators with very clear and live notions of the directions the field is taking.
It assists young principal investigators such as myself in making strategic decisions at project bifurcations. Moreover, the quantity and diversity of the sessions on display inevitably sheds new light on the interpretation of one's own data.
This year, from a basic research perspective into myeloid malignancies, there were very clear focuses on the role of metabolism, particularly mitochondrial metabolism, in influencing leukaemia progression.
A more recent but equally timely area of research was the articulation between epigenetic regulation and alternative splicing, a novel theme for which there is a strong body of emergent evidence, whilst precise mechanistic connections are still being defined. The idea that epigenetic dysregulation inherent to myeloid malignancies may perturb not only the quantity but also the quality of gene expression is remarkably interesting to me.
I focus my research on the contribution of transcriptional heterogeneity to fate transitions in acute myeloid leukaemia (AML) and employ manipulation of individual epigenetic regulators to promote differentiation or death of AML cells with therapeutic intent.
I had previously viewed epigenetic regulators as sensors and translators of metabolic cell status into initiation, processivity and/or suppression of gene expression. The association with alternative splicing suggests that metabolic status and availability of intermediate metabolites can additionally modify the protein diversity of the cell with the generation of variability in and complex rewiring of regulatory networks. I had encountered tentative associations between metabolic status, splicing and protein synthesis in my data, which now take shape in light of substantive unpublished data presented at the conference.
My travel to ASH, much like everybody else's, was complicated by the extremely cold weather conditions in the southern states, and I eventually arrived in Atlanta a day later than expected, and by taxi rather than plane.
Despite the bumpy start, ASH proved to be the enriching experience I had anticipated. It generated numerous ideas that already bear fruit in my group's research.
I thank the British Society for Haematology and my own Fellowship funding body, the Kay Kendall Leukaemia Fund, for making this trip possible.
The BSH travel scholarship enabled me to travel to ASH in Atlanta this year.
My abstract, entitled High-throughput sequencing in patients with inherited bleeding and platelet disorders: novel gene discovery and robust diagnosis, was selected as one of the top six abstracts (out of more than 6,000) for presentation in the ASH plenary scientific session.
It was a wonderful opportunity for me personally and professionally. The work I presented is the culmination of several years of collaborative work from an international team of clinicians, geneticists, and laboratory and computational scientists and has been the focus of my PhD research.
Showcasing my work on this platform at ASH enabled me to bring our research to a wider audience. To show how high-throughput sequencing using whole genome sequencing and a targeted gene panel is transforming diagnosis for patients with rare coagulation, thrombotic and platelet disorders.
Since my talk, I have been approached by clinicians from around the world with interest in our study, and I have been able to bring haematologists and scientists working on specific diseases together.
I have also had interest in sequencing more patients on our gene panel, and it is great to have been able to spread the word and get more people using this resource.
Giving a presentation like this was a great privilege. I learned a lot about preparing for and talking to a large, diverse audience.
It was my first trip to ASH, and I also appreciated the diverse quality of presentations across the field of haematology. It was refreshing to be reminded of the many advances in other areas of haematology, having spent the last few years doing a PhD in rare bleeding and platelet disorders. And how interesting it is being a haematologist!
I also attended some education sessions, which were really useful for my clinical practice.
Finally, giving a presentation at ASH was an ideal way to meet haematologists and scientists interested in my area of research from across the world. And to meet up and maintain links with colleagues across haematology.
I am enthused to carry on and make the most of this opportunity. It was an invaluable experience and many thanks to the BSH for their support in making it possible.
I'm very grateful to the BSH for the travel scholarship to support my attendance at the International Workshop on Chronic Lymphocytic Leukaemia (CLL) in May 2017.
The workshop is a four-day meeting with a blend of clinical/translation studies and basic biology with the aim of advancing the understanding and treatment of CLL (and associated malignancies).
The workshop opened with sessions focused on the factors leading to the development of CLL, including a description of familial CLL. Tait Shanafelt described how 10% of patients have first degree relatives with CLL. Monoclonal B-cell lymphocytosis (MBL) may also contribute to the development of CLL. And genome-wide studies have identified nine loci associated with an increased risk for CLL. Richard Houlston explained how single nucleotide polymorphisms (SNPs) conferring risk for CLL map to areas of open chromatin where they may be involved in regulation of gene expression.
At the meeting, I also had the opportunity to present a poster entitled Activation of p53 by the MDM2 antagonist RG7388 in CLL cells ex vivo triggers cell death via a pro-apoptotic gene signature. The poster describes part of our recent work from the Cancer Research UK Drug Discovery Newcastle team working in alliance with Astex Pharmaceuticals.
We are investigating how MDM2 antagonists may be used in CLL, particularly as this represents a non-genotoxic therapy with minimal effect on normal cells.
The poster was well received and gave me the opportunity to engage with others in the field and consider possible combination therapies using MDM2 antagonists.
Finally, these relatively small workshops facilitate interaction. I was able to meet with two collaborators to discuss recent data and progress future directions with novel small molecule inhibitors that are of mutual interest.
Many thanks to the BSH for this award, which was much appreciated.
The deadline for the Visiting Fellow grant is 30 June.
Please allow sufficient time for your application to be reviewed, usually 6-8 weeks after the deadline.
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Sickle cell disease and β-thalassemia are common monogenic disorders that cause significant morbidity and mortality globally. Currently, the only curative treatment is allogeneic hematopoietic stem cell transplantation. It is unavailable to many patients due to a lack of matched donors and carries risks, including graft-versus-host disease.
Genome editing therapies targeting the BCL11A erythroid enhancer or the HBG promoter are already demonstrating success in reinducing fetal haemoglobin. However, where a single locus is targeted, reliably achieving levels high enough to deliver an effective cure remains a challenge.
We investigated the application of a CRISPR/Cas9 multiplex genome editing approach, in which both the BCL11A erythroid enhancer and HBG promoter are disrupted within human hematopoietic stem cells.
We demonstrate superior fetal haemoglobin reinduction with this dual editing approach without compromising the engraftment or lineage differentiation potential of edited cells post-xenotransplantation.
However, multiplex editing consistently resulted in the generation of chromosomal rearrangement events that persisted in vivo following transplantation into immunodeficient mice. Therefore, the risk of oncogenic events resulting from such translocations currently prohibits its clinical translation. But it is anticipated that, in the future, alternative editing platforms will help alleviate this risk.