Haematology

The Department of Haematological Medicine specialises myelodysplastic syndromes, CAR T cells, myeloma, leukaemia, lymphoma, sickle cell disease and the prenatal diagnosis of inherited red cell disorders.

King's College Hospital was the first centre in the UK to deliver CAR T cells to patients with lymphoma through the NHS and has performed the largest number of cases nationwide.

The department’s anticoagulation and clinical thrombosis services are national leaders in managing venous thromboembolism and thrombophilia.

We also have close links with the Department of Child Health and jointly manage the paediatric haematology disorders with an active clinical research programme in sickle cell disease.

Meet the team

Haematology

The unit has the largest bone marrow transplant programme in the UK and performs more than 160 autologous, allogeneic and unrelated transplants a year, with outcomes equal to international standards. We have the first Gene Therapy Advisory Committee (GTAC) approved immune gene therapy programme for leukaemia and are a centre of excellence for myelodysplastic syndromes.

Chimeric antigen receptor (CAR) T cell therapy is an approach that uses the bodies own immune cells to fight cancer. It is showing great promise particularly in leukaemia and lymphoma and is offered here at King’s Private.

King’s Private is one of a handful of CAR T cell centres in the UK that are approved to give both the licenced autologous CD19 CAR T cell products, Yescarta and Kymriah under specific indications:

  • Axicabtogene ciloleucel (Yescarta) for patients with relapsed (lymphoma has returned) or refractory (lymphoma did not respond) diffuse large B cell lymphoma (DLBCL), primary mediastinal B-cell lymphoma (PMBCL) or transformed follicular lymphoma, who have had two or more previous courses of treatment.
  • Tisagenlecleucel (Kymriah) for patients with DLBCL or transformed follicular lymphoma who have had two or more previous courses of treatment.
  • Tisagenlecleucel (Kymriah) for young adults aged 18-25 with acute lymphoblastic leukaemia whose cancer has come back two or more times or has come back after stem cell transplantation.

Our NHS partner King’s College Hospital was the first hospital in the UK to infuse CAR T cells to a patient with lymphoma in January 2019 and has rapidly become the largest CAR T cell centre in the UK. At King’s Private, our consultants are linked with our specialist haematology multi-disciplinary teams to ensure you are given the best advice for your treatment.

We will also have access to state of the art clinical trials in CAR T cells in other disease not currently covered by the licenced indications in acute lymphoblastic leukaemia, myeloma, acute myeloid leukaemia and follicular lymphoma.

CAR T cell therapy is a complex treatment and can only be provided at a very small number of hospitals in the UK that have JACIE accreditation and perform stem cell transplantation. King’s private will delivery CAR T cell therapy on a ward with specific CAR T expertise, with access to a variety of specialists that have had input into the management of the largest number of CAR T cell treated patients in the UK. We also have large level 3 intensive care unit facilities within the same building at King’s College Hospital with expertise in dealing with the potential side effects.

For further information please contact:

Kch-tr.KingsCAR@nhs.net

We provide specialist diagnostic investigations and treatment for a wide range of blood, bone marrow and spleen disorders.

We treat all types of anaemia, platelet disorders, polycythaemia (high red cell count), iron metabolism disorders such as haemochromatosis (iron overload) and abnormal white cell counts.

Our service also offers specialist transfusion advice for pregnant women, patients with special requirements and patients who refuse blood products.

King’s is a leading national and international centre for the diagnosis and treatment of blood cancers.

We are home to the centralised bone marrow transplant (BMT) service for King’s and Guy's and St Thomas's NHS Foundation Trusts. This has the largest BMT programme in the UK and performs more than 160 transplants a year.

We are also an international centre for research into and the treatment of myeloid leukaemias, lymphomas and myeloma, and have the first immune gene therapy programme for leukaemia approved by the Gene Therapy Advisory Committee (GTAC).

As a Centre of Excellence for myelodysplasia we have expertise in matched and unrelated transplants for the treatment of myelodysplastic syndrome (MDS)

Twenty years ago we began conducting autologous transplants (where a patient is treated with their own cells) and we now run the UK’s largest programme of complex transplants, including non-related adult and parent-to-child bone marrow transplants and cord blood cell transplants. We have a large unit with experts in every disease type which is internationally recognised.

King’s is one of the world’s leading centres for the treatment of leukaemias and is the only centre in Europe to have clinical and research expertise in all the main disease areas, including:

  • myelodysplastic syndromes (MDS),
  • acute myleoid leukaemia (AML),
  • aplastic anaemia (AA) and
  • paroxysmal nocturnal haemoglobinuria (PNH).

The outlook for leukaemia patients aged over 50 is often very poor, as traditional chemotherapy treatments are not well tolerated by older people. King’s introduced the concept of non-related bone marrow transplants for patients over 50, using minimal chemotherapy to suppress the patient’s immunity and replace it with a new immune system which then kills the leukaemia cells. This technique is now widely used, especially for myeloid leukaemias, where King’s is an international centre of excellence.

We investigate and treat children with general blood problems such as anaemia, or abnormal bruising or bleeding. We also support children who attend King's Paediatric Liver Unit and those on the Neonatal and Paediatric Neurosurgical units who may have blood problems.

In addition, we treat children with sickle cell anaemia and other haemoglobin (red blood cell) disorders and those being treated for cancer and leukaemia (blood cancer).

Sickle cell disease (SCD) is the most prevalent inherited blood condition worldwide. In the UK and northern Europe SCD numbers are growing faster than any other serious genetic disease.

SCD causes the red blood cells to behave abnormally, meaning they become hard and sticky and shaped like sickles (crescents). These red blood cells die prematurely, causing symptoms of anaemia like tiredness and breathlessness. The sickle-shaped cells can also clog blood vessels, leading to acute spells of pain called crises that often require hospital admission. These crises begin suddenly and can last from several minutes to several weeks, with the average crisis lasting for seven days. The pain can be excruciating and can affect any body part, often involving the bones and joints, chest and abdomen. Some crises lead onto stroke and acute chest syndrome, complications that can be fatal if not treated in time.

Recurrent crises and severe anaemia starve tissues in organs and bones of oxygen, leading to failure of organs like the kidneys, heart and chest, which causes early death. The average life expectancy of an SCD sufferer is about 50 years old.

The King's research team discovered two of the three major genetic controls of foetal haemoglobin (HbF), which is one the major factors influencing the severity of SCD. Patients with high levels of HbF have a milder disease with fewer complications. This discovery contributed to the increased use of a chemotherapy drug called hydroxyurea that increases HbF levels, which can lead to improved quality of life and fewer hospitalisations for patients.

Adult Sickle Cell & Thalassaemia

We run one of the largest services in the UK for the diagnosis and treatment of haemoglobin conditions (haemoglobinopathies) such as sickle cell disease and thalassaemia.

We provide:

  • Multidisciplinary management of sickle cell disease, thalassaemia and other haemoglobin conditions incuding sickle antenatal, orthopaedic, renal and cardiology conditions.
  • Prenatal diagnosis for sickle cell disease and thalassaemia.
  • Investigation and management of other red cell disorders including anaemias and enzyme function conditions (enzymopathies).
  • Management of porphyrias.

Paediatric Sickle Cell & Thalassaemia

We provide care and treatment for children with sickle cell disease and thalassaemia. We have the longest-established clinic in the UK which is run by paediatric (children), haematology (blood), nursing and clinical psychology specialists.

Our service works closely with the paediatric surgeons and colleagues in the intensive care wards. We monitor children regularly using blood and urine tests and transcranial doppler scans, to pick up those who are at risk of stroke.

We can also help children with emotional problems or psychological difficulties.  

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