Professor Ghulam Mufti, head of haemato-oncology at King's College Hospital in London, carried out King's first bone marrow transplant in 1986 and, with proud support from Leukaemia UK, his department has become an international centre for the diagnosis and treatment of blood cancers. Here, he discusses the transformation in blood cancer care he has seen during his time at King's

 "One of the reasons I came to King’s was that I was told there was a local charity – Leukaemia UK, as it is now known – which was absolutely committed to improving leukaemia treatment, through the generosity of a group of patients and their carers and research at King’s," says Professor Ghulam Mufti, who has been a pioneer in the research and treatment of blood cancers for more than 30 years.

The long-standing partnership between Professor Mufti’s department at King’s and Leukaemia UK has led to the creation of four specialist haematology wards – including the Derek Mitchell ward which was named after the charity’s founder – as well as the building of the Isobel Mitchell Laboratory. The department has grown to include 180 researchers, from which revolutionary advances in the treatment of blood cancer have been achieved.

Transforming inpatient facilities at King’s

"When I started at King's, this department had two beds, which was reluctantly increased to four," says Professor Mufti. "There were no specialist haematology wards. Today, it has 60 beds. The key seeds have come from Leukaemia UK in terms of patient facilities, outpatients and laboratories for research. Leukaemia UK has been integral to the evolution and the amazing success of this department."

Professor Mufti has overseen enormous changes in the treatment and diagnosis of blood cancer. From its first bone marrow transplant in 1986, the hospital now has the largest bone marrow transplant programme in the UK and performs more than 200 transplants a year.

Trailblazing science and research

One of the key breakthroughs for Professor Mufti's team was to develop the first immune gene therapy programme for leukaemia to be approved by the Gene Therapy Advisory Committee (GTAC). This was thanks to initial research funding from Leukaemia UK as well as advanced cellular products such as T-regulating and mesenchymal strong cells.

The department has an impressive GMP vector production set-up, which is nationally and internationally acclaimed, led by Professor Farzin Fazineh. King's now provides specialist haematology laboratory and clinics services that serve 3.6 million people across the south-east and parts of the south-west region and other parts of the country, and employs 13 people in its laboratory to keep up with demand.

The research team is currently developing the use of novel agents including chimeric antigen receptor T-cells for the treatment of a variety of blood cancers.

Ground-breaking outpatient care

Innovations continue to take place as the team at King's try to improve the experience of people who are receiving treatment for blood cancers. A few years ago, for example, the hospital opened the Leukaemia UK Ambulatory Care Unit which, for the first time, allows patients to receive stem cell transplants as outpatients.

"For me, it's amazing to see these advances from where we were to where we are today," says Professor Mufti. "The transformation in clinical care is breathtaking. The type of leukaemia Isobel Mitchell suffered from, for example, is now curable with a tablet."

Behind the scenes: lab-based molecular and diagnostic breakthroughs

In more than 30 years at King’s, Professor Mufti has overseen significant changes in the way cancer cells are detected and treated.

"The diagnosis of leukaemia has changed beyond recognition," he says. "We can know exactly the genetic make-up of individual leukaemic cells and what treatments they may or may not be susceptible to, therefore you can target the appropriate treatment. The provision of personalised medicine has become a reality."

He adds that there have been dramatic improvements in the diagnosis, treatment and life expectancy of myeloma, lymphoma and childhood leukaemia, as well as a big increase in the number of people who can now receive bone marrow transplants or be considered suitable donors.

It is almost routine to perform bone marrow transplant in patients over the age of 60, for example, whereas some years ago this was considered a contra-indication for this procedure. There are many other examples of this revolution in treatment.

"Myeloma was a crippling, painful disease, where patients lived a few months or maximum a few years. Now, we’ve reached a stage where people with that disease can live 13 to 15 years with an excellent quality of life," he says.

"Lymphoma, Hodgkin disease – this was a group of diseases where the death rate was still quite high and in many instances the cure rate was very low. We’re now at a stage where a high proportion of patients with those diseases are cured.

"Acute lymphoblastic leukaemia – childhood leukaemia – is now a curable disease in 80%-90% of children."

Pioneering the Leukaemia UK Mind & Body Team at King’s

Professor Mufti is a keen advocate of the importance of psychological as well as clinical support for people affected by leukaemia, myeloma, lymphoma and other blood disorders.

Leukaemia UK funded the first ever specialist haematology counsellor in the UK at King’s, a role that all hospitals now consider essential, and has recently launched the Leukaemia UK Mind & Body programme, which integrates research and clinical excellence in physical and mental wellbeing.

"If we are psychologically strong and positive we are better at facing something," he says. "We want to see if we can prolong the survival of patients because we are looking after them, not just physically but mentally, during the toughest period of their lives. If we don’t impact on their survival then have we impacted on their quality of life in terms of the experience these patients go through?

"There are a huge number of experiences that an individual goes through when they are diagnosed with a blood cancer. Being told you have to have chemotherapy, that it will change the way you look, that it’s a long-term treatment, that you may need to have a bone marrow transplant, and that despite this, there’s still a risk of the disease coming back – some of us are better at confronting those experiences, but this is a huge challenge both physically as well as psychologically."

Towards a Global Institute of Haematology

Professor Mufti is poised to realise a long-standing dream of bringing excellence in science, research and patient care together in one building – the Institute of Haematology – which he hopes will have a global influence.

He believes the research his team is carrying out will become even more important, as haematological disorders are set to increase as a result of our ageing population. His department has received a £20m grant to carry out a study of 6,000 people to examine changes in their blood as they age, in an attempt to understand more about this trend and to examine why blood cancers are more common and more resistant to treatment after the age of 60.

Professor Mufti is very proud of the department he has created.

"This department is unique because it looks after all haematological diseases, whether that is sickle cell disease, diseases of the coagulation system, such as haemophilia, or blood cancers and related diseases," he says.

"It is a complete department. We are beginning to benefit because the developed gene therapy for leukaemia is also applicable to haemophilia."

The Global Institute of Haematology will be an international hub for discovery science, clinical care, translational research and the Mind & Body Programme for all haematological disorders.

"I’m also very proud that we have trained a significant number of the world’s haematologists, particularly in the Middle East, Far East, south east Asia and Africa. We have a huge network of collaborations and teacher training programmes and we hope the training in all aspects of haematology at King's benefits the populations in those areas. That is absolutely phenomenal."

Partnership for the future

As Professor Mufti looks to the future at more groundbreaking work to improve patient care and treatment, Leukaemia UK is proud to support his life-changing ambitions. Professor Mufti also hopes the collaboration will continue.

"Leukaemia UK is a charity that is completely committed to the care of patients with blood diseases, particularly blood cancers, and it has been absolutely wonderful in terms of its commitment to the cause for a long period of time," he says.

"It is thanks to Leukaemia UK that we have this department which has saved lives and continues to do so. For me, it is a personal pleasure to work with this charity."

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