Awards

Adding immune T cells to the mix—giving bone marrow transplant patients a fighting chance

Photo supplied by: University of Sydney

David Gottlieb

Patient tailored immunity transplant for the prevention of viral infections post haemopoietic stem cell transplantation

University of Sydney | 2011 | Project Grant | $567,968

Team Members: Dr Emily Blyth, Dr Kenneth Micklethwaite and Dr Leighton Clancy

Professor David Gottlieb was determined to reduce the high risk of infection for his patients after watching them suffer from the debilitating chemotherapy administered prior to bone marrow (stem cell) transplantation. His team at the University of Sydney have added specific immune T cells to treatment to help the body rapidly rebuild an effective immune response to reduce the risk of infection.

‘Over 2,000 stem cell transplants are performed in Australia each year. For many patients, infections after transplant result in suffering and poor quality of life even if their original disease is cure1

Most patients undergoing a stem cell transplant for malignant blood cancer receive powerful chemotherapy before their transplant is given. This chemotherapy causes severe damage to the immune system and this in turn results in patients being very prone to developing serious infections after the transplant. Standard treatment is to wait for the immune system to recover though this can take up to and sometimes beyond a year, during which patients may have serious, even fatal infections.

Professor David Gottlieb and his team have thought outside the standard approaches—such as antibiotics, oxygen and blood transfusions—to deal with this ongoing problem. They’ve grown specific immune T-cells in their lab to assist their patients undergoing stem cell transplant to fight off infections. This allows them the best chance of survival. 

‘My research has identified and promoted the concept of immune reconstitution as a key plank in dealing with infection in stem cell transplant and other immunocompromised patients,’ Professor Gottlieb explained.

‘Using responsive T-cells to speed up immune recovery after stem cell transplant offers an alternative and sometimes lifesaving option to patients in whom standard treatment has failed. Without this treatment many of these patients would have spent long periods in hospital, and some would have died from their infections.’

‘I have established a clinical adoptive immunotherapy program in the setting of one of Australia’s largest stem cell transplant units. The program has run a number of important clinical trials demonstrating the benefits of administering virus and fungus specific T-cells to transplant recipients,’ he said.

‘In the future, new products being developed will target not only infections but also the patient’s own blood cancer to further increase the likelihood of a cancer cure with lower impact on patients’ lives.’

Next steps:

Professor Gottlieb and his team will test specific adoptive immunotherapy strategies that target individual opportunistic pathogens and cancers. From there they hope to identify how these can best be combined to minimise infections and cancer recurrence after stem cell transplant or chemotherapy.


1 Australasian Bone Marrow Transplant Recipient Registry, 2015,  Annual Data Summary