King's College London has been awarded a £1 million grant to support its efforts in leading a multinational consortium focused on advancing treatment and understanding in a blood cancer called myelodysplastic neoplasms (MDS).
The grant, awarded by the Medical Research Council (MRC) will aid the activities of the International Integrative Innovative Immunology for MDS (i4MDS) consortium. Led by Professor Shahram Kordasti from King's, the i4MDS consortium aims to identify novel immune targets for the treatment and establish the international infrastructure needed to make immune profiling a routine part of the clinical diagnosis, prognosis and treatment of MDS.
The major challenge in MDS is its biological heterogeneity, which makes it difficult to use immune-modulating or immune-targeted therapies effectively, despite their success in other cancers. We believe this is partly because we do not yet know which patients have which type of immune dysregulation."
Shahram Kordasti, Professor of Systems Cancer Immunology, King's College London
He added: "This grant will help us identify novel and targetable immune pathways and immune-dysregulation subtypes in MDS, and develop standardised tools to stratify patients so they can be better matched to treatments most likely to benefit them."
Myelodysplastic neoplasms (previously known as myelodysplastic syndromes) are bone marrow cancers that occur most often in older people. They arise when blood stem cells gain genetic and epigenetic - when behaviours or environment cause changes to how the genes work - that impair blood production, causing anaemia, infections, bleeding and sometimes progression to acute leukaemia.
Around 4-5 people per 100,000 are diagnosed with MDS each year, rising to around 30 per 100,000 among those aged over 70. As MDS predominantly affects older people, the number of cases in the UK is expected to increase as the population ages. Prognosis is highly variable: some patients with low-risk disease live for many years, while those with high-risk forms may survive for less than two years.
It has become increasingly clear the immune system plays a central role in MDS. In some patients, overactive immunity drives inflammation and marrow damage, while in others, suppressed immunity allows malignant clones to expand unchecked. Due to the different forms of immune dysregulation, treatments do not work consistently across patients.
Doctors already categorise MDS using genetic profiling, which analyses gene mutations and other clinical features to estimate a patient's prognosis. However, immune profiling - measuring the types, numbers and activity of immune cells in the bone marrow or blood - is not standardised.
The i4MDS consortium aims to address this gap by bringing together 27 centres across 12 countries, along with a range of experts from these institutions - including Professor Mieke Van Hemelrijck from King's, who is co-investigator. It aims to create standardised methods for immune profiling so that immune information can be used alongside genetic information to guide patient care.
In doing so, it seeks to understand the different forms of immune dysregulation in MDS, develop routine clinical immune-monitoring tests and design new immune-targeted treatments for the benefit of patients worldwide.
