Clinical Teams
The Department of Haematological Medicine provides leading clinical care. The department is recognised as a national leader in the management of bone marrow failure syndromes, sickle cell disease and the prevention and treatment of venous thromboembolism. The department also has the largest bone marrow transplant programme in the UK.
The department provides a secondary, tertiary and quaternary referral service for patients with myelodysplastic syndromes, acute myeloid leukaemia, and chronic myeloid leukaemia, high and low grade lymphoma, chronic lymphocytic leukaemia and myeloma. The department has an active research interest in the prenatal diagnosis of inherited disorders of the red cell with an active clinical research programme in sickle cell disease.
Bone Marrow Failure
Clinical Lead:Prof Ghulam Mufti
The department is a designated Centre of Excellence for the myelodysplastic syndromes and has an active basic science, clinical and translational research programme, with a large evolving portfolio of phase II and III clinical trials of novel agents for the myelodysplastic syndromes.
The recent appointments of consultants with specialist interests in Aplastic Anaemia (AA) complement our existing national and international reputation in the management of myelodysplastic syndromes (MDS) and other myeloid diseases. This has allowed us to establish a more comprehensive bone marrow failure (BMF) service. The service is provided by a team of 3 clinical nurse specialists together with Consultant Haematologists, Specialist Registrars and other senior nurses, establishing a patient centred service for a large cohort of patients with myeloid malignancies, MDS, AA and PNH to ensure local and national objectives are achieved.
AML/MDS Centre of Excellence
The department provides a secondary, tertiary and quaternary referral service for patients with myelodysplastic syndromes, acute myeloid leukaemia, and chronic myeloid leukaemia, and has a large bone marrow transplant programme.
The King's Haematological Malignancy Diagnostic Centre provides state-of-the-art diagnostic and prognostic testing for the myeloid malignancies, including morphology, flow cytometry, cytogenetics/FISH, and molecular testing for diagnostic translocations (e.g. t(15;17)) and prognostic mutations (e.g. N-RAS, NPM and FLT3).
Bone Marrow Transplant
Clinical Lead: Prof Antonio Pagliuca
The transplantation team encompasses a large support team of medical and surgical specialists for consultation. Radiology, anaesthetics, surgical, respiratory, renal, liver support, dermatological, microbiological, psychological and ITU facilities are all on site and immediately accessible. All laboratory services, which are on site, can provide rapid turnaround with none of the problems associated with offsite testing, i.e. delay in results and lost samples.
The core team meets weekly to discuss planned and possible transplant procedures. This ensures that all relevant information is shared amongst the team and provides the opportunity for open discussion about policy.
For bone marrow transplants the department accepts referrals from the SE England region and nationally for myeloid disease. The KCH transplant team is the largest provider within the London BMT consortium and undertakes the highest number of matched unrelated donor transplants nationally.
The department is an EBMT (European Group for Blood and Marrow Transplantation) and BSBMT (British Society for Blood and Marrow Transplantation) approved facility. During 2009 the service carried out 103 Allogeneic Transplants (27 Sibling, 76 MUD (Matched Unrelated Donor) and 63 Autologous Transplants. In addition, the service is accredited as a BBMR (British Bone Marrow Registry) and Anthony Nolan Trust harvest centre.
National Centre for PNH
Clinical Lead:Dr Austin Kulasekararaj
The Paroxysmal nocturnal hemoglobinuria (PNH) specialist service is a nationwide service funded centrally by NHS England under provision for rare diseases. It is divided between ourselves and St James Hospital in Leeds. We have approximately 130 patients 60 of which have been prescribed the monoclonal antibody eculizumab which they have at home on a fortnightly basis. We see all patients on a 3 monthly basis in our clinic although they are welcome to contact us at any time. The clincial team is formed by Dr Austin Kulasekararaj with Prof Judith Marsh and Spr Dr Shreyans Gandhi, as well as Ms Joanna Large (clinical nurse specialist) and a service coordinator. All patients have bloods, including their PNH clone taken on each scheduled visit and well as 6 monthly ultrasound of their liver and trans-thoracic echocardiogram if clinically indicated. We also run a well-attended support group for patients to come to and facilitate access to counselling and other adjunctive services available at King’s College Hospital.
Myeloma and Plasma Cell Dyscarsia
Clinical Lead:Dr Stephen Schey
The unit provides services for the management of plasma cell dyscrasias, including monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma, solitary plasmacytoma of bone, extramedullary plasmacytoma, Waldenström's macroglobulinemia (WM), primary amyloidosis, and heavy-chain disease. The unit has an active laboaratory and clinical research programme, and is involved in a number of clinical trials designed to evaluate the use of novel agents in early phase I and II clinical trials of patients with multiple myeloma at different stages of their disease with a large evolving portfolio of phase II and III clinical trials of novel agents for the myelodysplastic syndromes.
The service is provided by a team of one clinical nurse specialists together with Consultant Haematologists, Specialist Registrars and other senior nurses.