News

Australian and NZ Myeloma and Related Diseases Registry reaches 4000 patients

Congratulations to Wellington Hospital, who recruited the 4000th patient on 30th September 2020, and to the whole MRDR team. This is a wonderful achievement, representing the contributions of patients and staff at 48 sites across Australia and New Zealand, the bi-national steering committee chaired by Professor Andrew Spencer, our funders and supporters, and the MRDR operations team at Monash University. Well done everyone!

International haemovigilance at the China Blood Safety Symposium

Professor Erica Wood joined the Chinese Academy of Medical Sciences, Peking Union Medical College and National Center for Disease Control and Prevention on 19 September 2020 for the First China Blood Safety Symposium, to discuss “International haemovigilance: Status and challenges”.

A/Prof Zoe McQuilten and Dr Allison Mo speak at Transfusion United conference

At the online conference, supported by Lifeblood, ANZSBT, RCPA and HOW, Zoe provided an overview of hospital transfusion services’ responses to COVID-19 which featured in a Vox Sanguinis International Forum. Allison presented data on the changing transfusion needs of patients with myelodysplastic syndromes as part of an analysis of longitudinal data from the Victorian Admitted Episodes Dataset, which forms part of her PhD studies.

Dr Lucy Fox presents at the Maddie’s Vision Patient and Family Forum on Bone Marrow Failure Syndromes

Lucy shared an update on the Aplastic Anaemia and Other Bone Marrow Failure Syndromes Registry and the DIAAMOND trial as part of the event on 28th August 2020, which brought together over 200 patients, families, clinicians and scientists.

The full recording of the event is available on YouTube
(with Lucy’s presentation commencing at 3:26:25)

Professor Erica Wood presents at the NIH/Versiti Red Cell Genotyping Symposium 2020

Hosted by the National Institutes of Health, Versiti Blood Centers and the US Department of Health and Human Services, the 10th annual red cell genotyping symposium was held online on 9 September 2020. Erica delivered the opening lecture “Red cell genotyping for improving patient care and clinical outcomes.”

Australian and NZ Myeloma and Related Diseases Registry holds its annual investigator meeting online

The MRDR was delighted to welcome a large group to its 2020 investigator meeting, this year held online on September 5 as part of the National Myeloma Workshop, with thanks to Myeloma Australia.

Special thanks to guest speakers A/Prof Dennis Petrie from the Centre for Health Economics, speaking about the MRFF-funded myeloma epidemiological modelling study, and Dr Cecily Forsyth from Gosford speaking about participating in the MRDR from private practice. Prof Andrew Spencer delivered the annual update on MRDR activities, and Dr Kim Huynh provided an update on progress with the Asia-Pacific Myeloma Registry (more info at apacmrdr.org).

Dr Karina Brady joins TRU as Blood Synergy Program Manager

TRU welcomes Karina as the new Program Manager for the Blood Synergy Program – an NHMRC-funded program addressing Australia’s national transfusion research priorities. She coordinates Blood Synergy activities and provides leadership, project and strategic support to the Synergy grant investigators team. Karina has a background in scientific and clinical research, and a PhD in neurophysiology. Prior to joining TRU, she was a Laboratory Head/Senior Research Fellow at the University of Melbourne, and Project Lead at the HEARing Cooperative Research Centre. She has experience in a broad range of preclinical, multidisciplinary and clinical studies, with particular focus on neuroscience, hearing loss and cochlear implant technology.

Recent publications from the Transfusion Research Unit

  1. Hervig TA, Doughty HA, Cardigan RA, Apelseth TO, Hess JR, Noorman F, Bohoněk M, Yazer MH, Lu J, Wendel S, Sparrow RL; Biomedical Excellence for Safer Transfusion Collaborative. Re-introducing whole blood for transfusion: considerations for blood providers. Vox Sang 30 September 2020. doi: 10.1111/vox.12998.
  2. Sanderson B, Coiera E, Asrianti L, Field J, Estcourt LJ, Wood EM. How well does your massive transfusion protocol perform? A scoping review of quality indicators. Blood Transfus 18 September 2020. doi: 10.2450/2020.0082-20.
  3. Eisen DP, Leder K, Woods RL, Lockery JE, McGuinness SL, Wolfe R, Pilcher D, Moore EM, Shastry A, Nelson MR, Reid CM, McNeil JJ, McBryde ES. Effect of aspirin on deaths associated with sepsis in healthy older people (ANTISEPSIS): a randomised, double-blind, placebo-controlled primary prevention trial. Lancet Respir Med. 17 September 2020. doi: 10.1016/S2213-2600(20)30411-2.
  4. Wolfe R, Wetmore JB, Woods RL, McNeil JJ, Gallagher H, Roderick P, Walker R, Nelson MR, Reid CM, Shah RC, Ernst ME, Lockery JE, Tonkin AM, Abhayaratna WP, Gibbs P, Wood EM, Mahady SE, Williamson JD, Donnan GA, Cloud GC, Murray AM, Polkinghorne KR; ASPREE Investigator Group: Subgroup analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) randomized clinical trial suggests aspirin did not improve outcomes in older adults with chronic kidney disease. Kidney International 10 Sep 2020:S0085-2538(20)30973-X. doi: 10.1016/j.kint.2020.08.011.
  5. Cheok KPL, Chhetri R, Wee LYA, Salvi A, McRae S, Bardy P, Singhal D, Roxby DJ, Wood EM and Hiwase DK: The burden of immune-mediated refractoriness to platelet transfusions in myelodysplastic syndromes. Transfusion 9 September 2020. doi:10.1111/trf.16029
  6. Kiely P, Seed CR, Hoad VC, Gambhir M, Cheng AC, McQuilten ZK, Wood EM: Modelling the West Nile virus transfusion-transmission risk in a non-outbreak country associated with travelling donors. Transfusion 31 August 2020. doi: 10.1111/trf.16060.
  7. Ket SN, Sparrow RL, McQuilten ZK, Gibson PR, Brown GJ, Wood EM: Critical peptic ulcer bleeding requiring massive blood transfusion: outcomes of 270 cases. Internal Medicine Journal 12 August 2020; doi: 10.1111/imj.15009.
  8. Fox LC, Wood EM, Ritchie DS, Blombery P. Diagnostic evaluation and considerations in hypocellular bone marrow failure-A focus on genomics. Int J Lab Hematol. 2020;42 Suppl 1:82-89. doi: 10.1111/ijlh.13179.

Convalescent plasma trials for COVID-19 open to recruitment in Australia

Convalescent plasma to treat SARS-CoV-2 (COVID-19) infection is now being used as part of the Australasian COVID-19 Trial (ASCOT) and the international Randomised, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) trial.

The Australian Convalescent Plasma Study, led A/Prof Zoe McQuilten and supported by the Medical Research Future Fund, is a collaboration between the Monash University Transfusion Research Unit/Blood Synergy investigators, Australian and New Zealand Intensive Care Research Centre, REMAP-CAP and ASCOT investigators, and Australian Red Cross Lifeblood.

A big ‘thank-you’ to the blood donors and the hard-working teams who have made these trials a reality.

More information is available at: abc.net.au/news/2020-08-06/coronavirus-treatments-and-covid19-cure-research/12527034 and doherty.edu.au/news-events/news/convalescent-plasma-treatment-for-covid-19-introduced-to-ascot-and-remap-cap-trials

Recent publications from the Transfusion Research Unit

Flint AWJ, McQuilten ZK, Bailey M, Smith JA, Wood EM, Reade MC. Preoperative identification of cardiac surgery patients at risk of platelet transfusion: the Australian Cardiac Surgery Platelet Transfusion (ACSePT) risk prediction tool. Transfusion (online 5 August 2020). doi.org/10.1111/trf.15990.

Mahady SE, Margolis KL, Chan AT, Polekhina G, Woods RL, Wolfe R, Nelson MM, Lockery J, Wood EM, Reid CM, Ernst ME, Murray AM, Le LTP, McNeil JJ: Major gastrointestinal bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial. Gut 2020;0:1–8. doi:10.1136/gutjnl-2020-321585 (online 3 August).

Piechotta V, Chai KL, Valk SJ, Doree C, Monsef I, Wood EM, Lamikanra A, Kimber C, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2020 Jul 10;7:CD013600. doi: 10.1002/14651858.CD013600.pub2.PMID: 32648959.

Alves D, Curvello R, Henderson E, Kesarwani V, Walker JA, Leguizamon SC, McLiesh H, Raghuwanshi VS, Samadian H, Wood EM, McQuilten ZK, Graham M, Wieringa M, Korman TM, Scott TS, Banaszak Holl MM, Garnier G, Corrie SR: Rapid gel-card agglutination assays for serological analysis following SARS-CoV-2 infection in humans. ACS Sensors Jul 16. doi: 10.1021/acssensors.0c01050.

Al-Riyami AZ, Schäfer R, van der Berg K, Bloch EM, Estcourt EJ, Goel R, Hindawi S, Josephson C,  Land K, McQuilten ZK,  Spitalnik S, Wood EM, Devine DV  and So-Osman C: Clinical use of convalescent plasma in the COVID-19 pandemic; a transfusion-focussed gap analysis with recommendations for future research priorities. Vox Sanguinis 15 Jun 2020. doi: 10.1111/vox.12973.

Ashby M, Attwood L, Graham M, Wood E: Challenges for pathology laboratories during the COVID-19 pandemic: the view from Australia. Bulletin of the Royal College of Pathologists (UK), 2020;191;151-152. Available at: rcpath.org/profession/publications/college-bulletin/july-2020/covid-19-challenges-for-pathology-laboratories-during-the-covid-19-pandemic-the-view-from-australia.html.

Yazer MH, Jackson B, Pagano M, Rahimi-Levene N, Peer V, Bueno JL, Jackson RP, Shan H, Amorim-Filho L, Lopes ME, Boquimpani C, Sprogøe U, Bruun MT, Titlestad K, Rushford K, Wood EM, McQuilten ZK, de Angelis V, Delle Donne M, Murphy M, Staves J, Cho D, Nakamura F, Hangaishi A, Callum J, Lin Y, Mogaddam M, Gharehbaghian A, Lozano M. Vox Sanguinis International Forum on transfusion services about response to COVID-19. Vox Sanguinis 2020 May 8. doi: 10.1111/vox.12943.

A new, rapid test for COVID-19 antibody detection

In collaboration with Monash BioPRIA and Chemical Engineering, TRU researchers have contributed to development of a new assay for SARS-CoV-2 antibodies. The world-first research was published on 17 July 2020 in the prestigious journal ACS Sensors. The test incubates patient plasma or serum with reagent red blood cells previously coated with short peptides representing pieces of the SARS-CoV-2 virus, and uses red cell agglutination to determine a positive or negative result. The new assay, using column agglutination cards and automated readers already widely available in pathology laboratories, gives results in 20 minutes and could be used for high-throughput screening. “We found that by producing bioconjugates of anti-D-IgG and peptides from SARS-CoV-2 spike protein, and immobilising these to RRBCs, selective agglutination in gel cards was observed in the plasma collected from patients recently infected with SARS-CoV-2 in comparison to healthy plasma and negative controls,” said Professor Gil Garnier, Director of BioPRIA.

For more information:
monash.edu/news/articles/breakthrough-blood-test-detects-positive-covid-19-result-in-20-minutes

To download a copy of the research, please visit doi.org/10.1021/acssensors.0c01050

To watch a video of this research in action, please visit youtu.be/9WBQUC43u9Q

Haemoglobinopathy Registry

The Australian Haemoglobinpathy Registry (HbR) reached an important milestone recently, with more than 500 participants now contributing from 9 hospitals across Australia.

The goal of the HbR is to better understand the picture of haemoglobinopathies in Australia, with the aim to improve outcomes for patients, families and the community. Approximately half the HbR participants to date have beta thalassaemia major, and about one-third have a sickling disorder. Additional hospitals have ethics approval to participate and are anticipated to commence recruitment during 2020.

The HbR is currently conducting a study of diagnoses, management and outcomes for Australian adults with sickle cell disease, and this will be extended to paediatric patients during 2020.

Thank you to all the participants, staff and investigators around Australia contributing to the HbR! If your hospital is interested in joining the registry, or you have questions about the HbR please contact the Monash team at:
monash.edu/medicine/sphpm/registries/hbr

Prof Erica Wood becomes president of the International Society of Blood Transfusion

Congratulations to Professor Erica Wood who took up her role as president of the International Society of Blood Transfusion on 9 June 2020, for a two-year term. Due to the COVID-19 pandemic, the first time, the ISBT General Assembly was held by webinar – a first for the Society. For more information: isbtweb.org/about-isbt/board-of-directors

Monash researchers awarded MRFF funding for epidemiological modelling study of myeloma treatments

Congratulations to A/Prof Zoe McQuilten and the team of researchers from SHPHPM (Dr Elizabeth Moore, Dr Cameron Wellard, Prof Erica Wood), Alfred Health (Prof Andrew Spencer) and the Monash Centre for Health Economics (Prof Tony Harris, A/Prof Dennis Petrie and Dr Laura Fanning) who were awarded funding from the MRFF through the call for Targeted Health System and Community Organisation Research. The group will use data from the Australian and New Zealand Myeloma and Related Diseases Registry (MRDR), in combination with national population level data on myeloma incidence, to model estimated transplant-eligible and ineligible myeloma patient populations at different treatment stages and according to performance status. The models will be validated with external, international datasets and input from a national and international network of clinical experts.

TREATT trial update

The TREATT trial is reopened to recruitment after a COVID-related hiatus affecting all participating Australian and UK hospitals. In a briefing for Australian investigators on 9 June, trial coordinator Amber Degelia updated the group on recent activities. Well done to the team at Monash Medical Centre who recruited the first post-COVID participant. Only 57 more patients are needed to reach the goal of 616 total participants – the finish line is in sight! Thank you to all the patients and staff working on TREATT across the country.

Convalescent plasma study for COVID-19 funded by the MRFF

Congratulations to A/Prof Zoe McQuilten and colleagues, whose SARS-CoV-2 Australian Convalescent Plasma Study has been awarded support from the Medical Research Future Fund (Antiviral Development for COVID-19 Funding). The study is a collaboration between the Australian and New Zealand Intensive Care Research Centre, the Randomised, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) investigators, the Australasian COVID-19 Trial (ASCOT) investigators, the Monash University Transfusion Research Unit/Blood Synergy investigators, and the Australian Red Cross Lifeblood.

Myeloma and lymphoma registries highlighted at the National Oncology Alliance/Rare Cancers Australia workshop

Professor Andrew Spencer, chair of the Myeloma and Related Diseases Registry steering committee, and Professor Stephen Opat, chair of the Lymphoma and Related Diseases Registry steering committee, shared their experiences of collecting and analysis of ‘real world’ data using registries for blood cancers at the NOA Vision 20-30 workshop. They emphasised the value of these data for patients, clinicians, governments and industry, and how registry data complement the information provided by clinical trials. More information on these registries is available at: www.mrdr.net.au and www.lardr.org

TRU contributes to Cochrane rapid review of convalescent plasma or hyperimmune immunoglobulin for COVID-19, and to guidelines for managing haematology/ oncology patients during the COVID-19 pandemic

Haematologist and TRU PhD student Dr Khaili Chai and colleagues contributed to a Cochrane rapid review of convalescent plasma or hyperimmune immunoglobulins for COVID-19. The study was published on 14th May 2020. The work will be updated as a living review, as more data on the safety and efficacy of these therapies become available.

Valk SJ, Piechotta V, Chai KL, Doree C, Monsef I, Wood EM, Lamikanra A, Kimber C, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19: a rapid review. Cochrane Database of Systematic Reviews 2020, Issue 5. Art. No.: CD013600. DOI: 10.1002/14651858.CD013600.

A/Prof Zoe McQuilten and colleagues developed guidance for clinicians managing haematology patients during the pandemic. The recommendations were endorsed by a large number of professional organisations across Australia and New Zealand.

Weinkove R, McQuilten ZK, Adler J, Agar MR, Blyth E, Cheng AC, Conyers R, Haeusler GM, Hardie C, Jackson C, Lane SW, Middlemiss T, Mollee P, Mulligan SP, Ritchie D, Ruka M, Solomon B, Szer J, Thursky KA, Wood EM, Worth LJ, Yong MK, Slavin MA, Teh BW. Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance. Med J Aust. 2020 Jun;212(10):481-489.

NHMRC Investigator Grant for A/Prof Zoe McQuilten

Well done, Zoe! A/Prof Zoe McQuilten has been awarded an NHMRC Investigator Grant for her research: “Improving patient outcomes through better use of blood products”. The highly competitive award will support Zoe’s research for 5 years from 2021.

My-PROMPT study results published

Congratulations to Dr Elizabeth Moore and colleagues on publication of the MY-PROMPT study results. This pilot randomized controlled trial showed that it was feasible to collect patient-reported outcomes on quality-of-life issues important to patients with myeloma, and provide real-time feedback of these results to clinicians. The study’s findings will help inform a future study in this area.

Moore EM, King TA, Wood EM, Ruseckaite R, Klarica D, Spencer A, Ho PJ, Quach H, Prince HM, McQuilten ZK. Patient-reported outcome measures in multiple myeloma: real-time reporting to improve care (My-PROMPT) - a pilot randomized controlled trial. Am J Hematol 2020 Apr 3. doi: 10.1002/ajh.25815.

Fiona Stanley Prize for NHMRC Synergy Grant

Professor Erica Wood was delighted to receive the inaugural Fiona Stanley Prize for the top-ranked 2019 Synergy grant: “Addressing Australia’s national transfusion research priorities”. It was extra-special that Professor Stanley herself presented the award at the NHMRC Research Excellence Awards dinner, held in Canberra in March 2020.

Victorian Cancer Agency Clinical Research Fellowship for A/Prof Zoe McQuilten

Congratulations to A/Prof Zoe McQuilten who has been awarded a 5-year Victorian Cancer Agency Clinical Research Fellowship. This funding will support her work on the IMPACT program: Immunoglobulin replacement versus Prophylactic Antibiotics to prevent infections in patients with hypogammaglobulinaemia due to blood Cancers Trials.

Immunoglobulin products made from donated plasma are routinely used to supplement antibody levels to prevent infections for patients with blood cancers such as myeloma and lymphoma. However, treatment of these disorders has changed dramatically since the original studies on immunoglobulin replacement were conducted, and there is little up-to-date evidence on optimal use of these blood products or alternative therapies. Zoe will continue and expand the TRU clinical trials program to identify which patients are most likely to benefit from immunoglobulin and whether alternatives, such as antibiotics, could also be effective, aiming to improve patient outcomes, reduce risks and costs, and improve stewardship of these precious community resources.

NHMRC Synergy Grant kicks off with planning day

The investigators of the successful NHMRC Synergy grant met for the first time on 21st February to get underway with the 5-year program of work: “Addressing Australia’s national transfusion research priorities.” Main themes of the research include major haemorrhage and massive transfusion, prevention and management of bleeding and anaemia in patients with blood cancers, bleeding and platelet transfusions in patients with critical illness, and efficient and effective use of immunoglobulins.

Pictured left: Investigators and guests

Absent: Prof Jamie Cooper, A/Prof Craig French, Prof Enrico Coiera, Prof Simon Stanworth

Recent publications from the Australian and New Zealand Massive Transfusion Registry

Congratulations to the ANZ-MTR team on two recent publications:

“Haematological features, transfusion management and outcomes of massive obstetric haemorrhage: findings from the Australian and New Zealand Massive Transfusion Registry” was published in the British Journal of Haematology in February 2020, led by Dr Masa Lasica and A/Prof Rosemary Sparrow.

“Clinical coding data algorithm to categorize type of gastrointestinal bleeding as a primary reason for massive transfusion: results from the Australian and New Zealand Massive Transfusion Registry”, was published online in Vox Sanguinis in November 2019, led by Dr Shara Ket and A/Prof Rosemary Sparrow.

TRU welcomes new staff and students for 2020

TRU welcomes Sabine Albold who joins the Myeloma and Related Diseases Registry (MRDR) team as a Research Officer, and Natthida Khajornjiraphan and Rosalyn Cao who are working with us on 6-month projects using the MRDR for their Master of Clinical Research studies. We also welcome our new PhD student Dr Khaili Chai, haematologist, who will be studying immunoglobulin use in patients with blood cancers. Kamal Al-Helou joins us for a professional placement year as part of the RMIT Pharmaceutical Sciences program – the fourth year TRU has hosted a student. Dr Mike Shipton from Peter MacCallum Cancer Centre and Dr Adi Tedjaseputra from Monash Health, both training in haematology, are working on projects using the Lymphoma and Related Diseases Registry (LaRDR).

Prof Erica Wood participates in the APEC Life Science Innovation Forum on Blood Screening and Processing Centralisation through development of Centres of Excellence

Erica was an invited speaker at the APEC meeting held in Yogyakarta, Indonesia on 4-5 February 2020, which brought together experts in blood safety from a number of APEC countries. She gave four presentations at the forum and its associated ‘basic-advanced course in transfusion’ for clinicians, covering special considerations for female blood donors, international haemovigilance, engaging with clinicians, and patient blood management.

Transfusion Research Unit NHMRC Synergy Grant success

Congratulations to all investigators and supporters on the award of a $5 million NHMRC Synergy Grant: “Addressing Australia’s national transfusion research priorities”.

The research focusses on two major themes:

  1. Evidence gaps in patient blood management, both in critical bleeding and for support of patients with blood cancers
  2. Evidence gaps in immunoglobulin use

The research will include observational studies and interventional trials of new approaches and new blood products.

The Chief Investigators are: Prof Erica Wood, A/Prof Zoe McQuilten, Prof Peter Cameron, Prof D Jamie Cooper, Prof Michael Reade, Ms Alisa Higgins, Prof Judith Trotman, Prof Simon Stanworth and Ms Linley Bielby. The Associate Investigators are: Prof Enrico Coiera, Dr Andrew Flint, A/Prof Craig French, Prof Anthony Harris, Dr Allison Mo, A/Prof John Reynolds, Dr Brenton Sanderson, and Dr Rosemary Sparrow.

Prof Erica Wood attends meeting of World Health Organization anaemia guideline development group

WHO has convened a new guideline development group on the use and interpretation of haemoglobin concentrations for assessing anaemia in both individuals and populations. The multi-disciplinary group met for the first time in Barcelona in November 2019 to identify available evidence and priorities for research and implementation to address these important issues.