Understanding why some people with myeloma develop low white blood cell counts during treatment

Lenalidomide is a standard treatment for myeloma that helps many people live longer. However, it frequently causes a side effect where the number of white blood cells in the body becomes too low. White blood cells help our bodies to fight infection, so when levels drop people are more likely to become seriously ill. This can mean doctors have to reduce the dose of lenalidomide or pause treatment altogether, which can affect how well the drug works. At present, doctors cannot tell in advance which people are likely to develop this problem. Understanding why this happens in some people and not others is important, as it could help doctors personalise treatment and keep patients safer.

Dr Beer and Professor Kaiser have already found that some people inherit small differences in specific genes that appear to increase the risk of developing this side effect during lenalidomide treatment. This gene is known to play a role in controlling how blood cells develop, and they believe it may also influence how white blood cells are affected by the drug. In this project, they will study blood stem cells in the lab, looking at how this gene controls the way white blood cells grow and develop, and what happens to this process when lenalidomide is introduced. By understanding this, they hope to explain why some people's white blood cell counts drop so significantly during treatment.

If successful, this research could help doctors identify those who are most at risk of developing this side effect. This would allow those most at risk to be identified and monitored more closely or offered an adjusted treatment plan. In the longer term, this knowledge could also help in the development of safer treatments for myeloma that are less likely to cause this harmful side effect.