Dr Neema Mayor, Anthony Nolan’s head of immunogenetics research, has worked for the blood cancer charity for 20 years in different roles. “I came straight here from university into the post of research assistant and from day one I’ve been fascinated by matching stem-cell donors to patients,” she says.
“As a student I had investigated being a stem-cell donor and I was thrilled that my first job involved helping people in such an important way. I’ve been in my current role for nearly four years and I lead the Patient/Donor project, an ongoing study which started in 1996 and aims to identify genetic and clinical factors that impact on stem cell transplant success.
“There have been many milestones at the Anthony Nolan Research Institute already. For instance, the research that proved that donors under 30 provide better outcomes for patients. Discovering that stem cells taken from umbilical cords can be used in transplant with a greater degree of flexibility, because these cells can tolerate a higher degree of genetic mismatch and also using new technology to ‘type’ saliva and blood samples to the highest quality yet, allowing us to obtain very high-quality information about a patient and donor’s tissue types by analysing an entire gene in one go, enabling them to make the best possible matches. But we know there are so many more milestones to achieve.”
Dr Mayor manages a team of lab-based scientists and students looking at ways to improve the success of stem-cell transplants to treat blood cancer and blood disorders all over the world. This groundbreaking study of how genetic factors affect transplant outcome has transformed patient care through several significant findings over the years, shaping Anthony Nolan’s stem-cell donor recruitment and selection strategies as a result and helping to save lives.
The current research looks at how matching donors and patients using a new method in Anthony Nolan’s clinical laboratories impacts on the outcome of the stem-cell transplant, as well as seeking new genetic markers that may be associated with better survival prognoses. “Looking at positive change based on your research is an amazing feeling,” says Dr Mayor. “We talk about the perfect match a lot, and the more we learn the better we can tailor the treatment for each patient. My ultimate aim would be to do myself out of a job – when we’ve reached a point where there’s a perfect donor for everyone needing one.”
The Patient/Donor team collects blood samples from blood cancer patients and their donors in the UK, examines how genetically similar they are and how this affects the outcome of their transplant. Its successes include confirming that donors under 30 provide a better chance of survival for patients – which is reflected in Anthony Nolan’s policy of recruiting 16-30 year olds to the stem-cell register.
The team has also demonstrated the importance of matching for an additional gene HLA-DPB1, which was historically not considered to have any impact on transplant prognoses, and Anthony Nolan now routinely types all new donors for this gene. “There is always something new in research for us to apply to patient care,” says Dr Mayor. “We recently made a fascinating discovery where we’ve been able to confirm that if we have to pick a donor that isn’t a perfect match (for a blood cancer patient), not all mismatches are equal. Certain mismatches in a gene called HLA-DPB1, for example, give better outcomes than others. This understanding could potentially help us minimise complications and save more lives in the future.”
Although she doesn’t have direct contact with patients, it is clear that they are at the heart of everything Dr Mayor does. “They are our constant motivation. Experiments in research not working well is par for the course, but I feel frustrated for patients when that happens,” she says. “The hardest part of my job is when I hear that a patient has passed away without a match, or a transplant hasn’t worked. That affects all of us because everyone involved with Anthony Nolan is so passionate about what we do, and that collaborative spirit is reflected in how we feel about the patients. Everyone matters.
“Recent months have also made other people aware of this unique group of individuals and the challenges they face, where shielding is an everyday occurrence for them. As a result, we’ve seen incredible support, where people have taken Anthony Nolan to their hearts and recognise just how much their life-saving support means.”
Just as her hardest moments at work are based around patients, so too are Dr Mayor’s proudest times. “I couldn’t pinpoint one particular day as my proudest moment with Anthony Nolan. Every time I hear or see that our studies are changing practices in the UK and internationally, and patients are benefiting as a result, I know I’m in the right job. I’ll never lose my passion for what we do here and the lives we transform.”
Without your support, there is no cure
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