Blood cancers

Walking the tightrope: immunological control post-BMT

Challenge: can you describe of nature of your research in 10 words?

I use mouse models to examine the immunology underlying the complications of BMT and aim to translate this for improved clinical outcomes.

What have you discovered/achieved in this area so far?

My work has examined the role of cytokines (TNF and lymphotoxin largely) and antigen presentation in graft-versus-host disease (GVHD). More recently, I have reported that recipient dendritic cells (DC) actually induce the overstimulation of incoming alloreactive donor T cells and that this leads them down a pathway of exhaustion and apoptosis. This is counterintuitive, and means that perhaps we can harness recipient DC to delete alloreactive T cells in a very targeted way, that may spare the global T cell suppression that results from current approaches like calcineurin inhibition or post-transplant cyclophosphamide.

I have also developed an interest in molecular diagnostic approaches for blood stream infection, and have recently published a paper that reports a new method for rapid “Gram-typing” of possible causative organisms in febrile neutropenic patients.

What aspect of this research into GVHD excites you the most?

It’s exciting to work in a field where there are a lot of unanswered questions and a real clinical need to improve outcomes.

How long before your work impacts patient care?

We are currently in discussions regarding a clinical trial of the Flt-3L pre-treatment strategy (to expand recipient DC and delete the alloreactive donor T cells) that we’ve just published in the mouse system. It’s likely we’ll be able to commence that study within the next 12 months.

You’re heading to the US soon. What can you tell us about the new position?

I’m moving to New York for a fellowship at Memorial Sloan Kettering Cancer Center. It’s one of the largest transplant centers in the world and there I will be able to work in both mouse systems and with clinical samples to understand more about the role of the microbiome in transplant outcome, with a particular interest in infectious complications and GVHD.

What’s your Holy Grail – the one thing you’d like to achieve in your research career?

Ask and answer questions that are both interesting and important – and that can ultimately be translated for real clinical change.

What is your biggest research hurdle?

Time. Could there be more of it available please?

Who has inspired you (in work or life) and why?

I get inspired by people all the time – in the last few weeks I’ve seen a lot of cyclists out and about enjoying Brisbane summer and it’s reminding me to get back on my bike!

Describe your perfect day.

I was fortunate enough to meet geneticist Oliver Smithies in 2010, then aged 84, who told us over lunch that his perfect day still involved going to the lab in the morning, having lunch with his wife, and then flying his plane in the afternoon. Throw in getting a final acceptance email for a paper, make sure there’s a fancy drink at lunch, and replace the plane with a leisure activity I can actually do and that sounds pretty good to me.

Can you nominate a book that resonated with/influenced/changed you & why?

It was recommended to me a few years ago that I read Thinking, Fast and Slow by Daniel Kahneman, a psychologist who’s expertise is in judgement and decision making and who won the Nobel Prize in Economics in 2002. It’s a challenging read but well worth it!

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