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Pratt, Guy
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Biography
Guy Pratt is Professor of Haematology (Haemato-Oncology) at the University of Birmingham and Deputy Director of the Cancer Research UK Clinical Trials Unit with responsibility for Haematology trials. He is secretary for the British Society for Haematology, on the exec committee for the UK Myeloma Society and trustee for the charity Cure Leukaemia. He is an Honorary Consultant Haematologist at University Hospitals Birmingham NHS Foundation Trust. He has been a Consultant Haematologist in Birmingham since 2001 with a clinical and research interest in Multiple Myeloma, Waldenstroms Macroglobulinaemia, plasma cell disorders such as amyloidosis and CLL. He trained at Cambridge University qualifying in 1989. Following junior doctor training in London he specialized as a specialist registrar in Haematology in Liverpool and Leeds. In Leeds he completed an MD thesis in Multiple Myeloma.
He was clinical lead for the 2016 NICE myeloma guidelines and had a number of previous positions nationally including BSH guideline lead for Haemato-Oncology, trustee for BSH, trustee for the charity WMUK, and chair of the BSH science and publication committee.
Over the years he has developed a large number of research collaborations with over 180 peer reviewed publications and including clinical trial involvement both locally and nationally on several trials as a co-investigator and is member of UK Myeloma trials group (UKMRA).
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Publication Search Results
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Publication Metadata only Advanced imaging for earlier diagnosis and morbidity prevention in multiple myeloma: a British Society of Haematology and UK Myeloma Society Good Practice Paper(Wiley-Blackwell, 2024-09-09) Kaiser, Martin; Goh, Vicky; Stern, Simon; Spencer, Nicholas; Rabin, Neil; Ramasamy, Karthik; Lawless, Sarah; Soutar, Richard; Ashcroft, John; Pratt, Guy; Messiou, Christina; Bygrave, Ceri; Pratt, Guy; Pratt, Guy; Haematology; Medical and Dental; Pratt, GuyThis Good Practice Paper provides recommendations for the use of advanced imaging for earlier diagnosis and morbidity prevention in multiple myeloma. It describes how advanced imaging contributes to optimal healthcare resource utilisation by in newly diagnosed and relapsed myeloma, and provides a perspective on future directions of myeloma imaging, including machine learning assisted reporting.Publication Metadata only Redefining nonmeasurable multiple myeloma using mass spectrometry(Elsevier, 2022-02-10) Giles, Hannah V; Cook, Mark A; Drayson, Mark Trehane; Cook, Gordon; Wright, Nicola Jane; North, Simon John; Harding, Stephen; Cairns, David A; Hockaday, Anna; Kaiser, Martin F; Moss, Paul; Davies, Faith E; Morgan, Gareth J; Jackson, Graham; Pratt, Guy; Pratt, Guy; Pratt, Guy; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Bristol Myers Squibb; St James's Institute of Oncology; University of Leeds; The Binding Site Ltd; Royal Marsden Hospital; Perlmutter Cancer Center; NYU Langone Health Care; Newcastle University; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Haematology; General Medicine; Admin and Clerical; Medical and Dental; Giles, Hannah; Moss, Paul; Pratt, GuyNo abstract availablePublication Metadata only Investigating the utility of saliva immunoglobulins for the detection of myeloma and using myeloma proteins to clarify partition between oral and systemic immunity.(Wiley, 2022-02-28) Heaney, Jennifer L J; Faustini, Sian; Evans, Lili; Rapson, Alec; Collman, Emily; Emery, Annabelle; Campbell, John P; Moore, Sally; Goodall, Margaret; Afzal, Zaheer; Chapple, Iain L; Pratt, Guy; Drayson, Mark T; Pratt, Guy; Pratt, Guy; Haematology; Medical and Dental; Pratt, GuyObjectives: Myeloma is characterised by the presence of monoclonal immunoglobulin (M-protein) and the free light chain (FLC) in blood. We investigated whether these M-proteins and FLC are detectable in myeloma patients' saliva to evaluate its utility for non-invasive screening and monitoring of haematological malignancies. Methods: A total of 57 patients with monoclonal gammopathy and 26 age-matched healthy participants provided paired serum and saliva samples for immunoglobulin characterisation and quantification. Results: Myeloma patients had IgG or IgA M-protein levels ranging up to five times and FLC levels up to a thousand times normal levels of polyclonal immunoglobulins. Despite these highly elevated levels, only two IgG and no IgA M-proteins or FLC could be detected in paired saliva samples. Most patients had reduced levels of serum polyclonal immunoglobulins, but all had normal levels of salivary IgA. Conclusions: Immunoglobulin transfer from blood is not determined by levels in the systemic circulation and more likely dictated by periodontal inflammation and the integrity of the oral epithelium. Immunoglobulins secreted by bone marrow plasma cells do not substantially enter saliva, which represents a poor medium for myeloma diagnosis. These findings, along with normal salivary IgA levels despite systemic immunoparesis, support a strong partitioning of oral from systemic humoral immunity.Publication Metadata only Delayed diagnosis resulting in increased disease burden in multiple myeloma: the legacy of the COVID-19 pandemic.(Nature Publishing Group, 2023-03-15) Carmichael, Jonathan; Seymour, Frances; McIlroy, Graham; Tayabali, Sarrah; Amerikanou, Rosie; Feyler, Sylvia; Popat, Rakesh; Pratt, Guy; Parrish, Christopher; Ashcroft, A John; Jackson, Graham H; Cook, Gordon; Pratt, Guy; Pratt, Guy; Haematology; Medical and Dental; McIlroy, GrahamThe COVID-19 pandemic has had global healthcare impacts, including high mortality from SARS-CoV-2 infection in cancer patients; individuals with multiple myeloma (MM) are especially susceptible to poor outcomes. However, even for MM patients who avoided severe infection, the ramifications of the pandemic have been considerable. The consequences of necessary socio-geographical behavior adaptation, including prolonged shielding and interruptions in delivery of non-pandemic medical services are yet to be fully understood. Using a real-world dataset of 323 consecutive newly diagnosed MM patients in England, we investigated the impact of the COVID-19 pandemic on routes to myeloma diagnosis, disease stage at presentation and relevant clinical outcomes. We demonstrate increasing MM presentations via emergency services and increased rates of bony and extra-medullary disease. Differences were seen in choice of induction therapy and the proportion of eligible patients undertaking autologous stem cell transplantation. Whilst survival was statistically inferior for emergency presentations, significant survival differences have yet to be demonstrated for the entire cohort diagnosed during the pandemic, making extended follow-up critical in this group. This dataset highlights wide-ranging issues facing MM patients consequent of the COVID-19 pandemic, with full impacts for clinicians and policy-makers yet to be elucidated.Publication Metadata only Improving the diagnostic pathway in patients presenting with acute kidney injury secondary to de novo multiple myeloma: a short report(BMJ Publishing Group, 2021-07) Rana, Ritika; Pratt, Guy; Cook, Mark; Drayson, Mark Trehane; Ramasamy, Karthik; Sadler, Ross; Zhu, Doreen; Connor, Thomas; Pinney, Jennifer Helen; Pratt, Guy; Pratt, Guy; Renal Medicine; Haematology; Medical and Dental; Rana, Ritika; Pratt, Guy; Pinney, JenniferNo abstract availablePublication Metadata only Impaired neutralisation of SARS-CoV-2 delta variant in vaccinated patients with B cell chronic lymphocytic leukaemia.(BMC, 2022-01-09) Parry, Helen; McIlroy, Graham; Bruton, Rachel; Damery, Sarah; Tyson, Grace; Logan, Nicola; Davis, Chris; Willett, Brian; Zuo, Jianmin; Ali, Myah; Kaur, Manjit; Stephens, Christine; Brant, Dawn; Otter, Ashley; McSkeane, Tina; Rolfe, Hayley; Faustini, Sian; Richter, Alex; Lee, Sophie; Wandroo, Farooq; Shafeek, Salim; Pratt, Guy; Paneesha, Shankara; Moss, Paul; Pratt, Guy; Pratt, Guy; University of Birmingham; University of Glasgow; UK Health Security Agency; Sandwell and West Birmingham NHS Trust; Haematology; Medical and Dental; Wandroo, Farooq; Pratt, Guy; Paneesha, ShankaraBackground: Immune suppression is a clinical feature of chronic lymphocytic leukaemia (CLL), and patients show increased vulnerability to SARS-CoV-2 infection and suboptimal antibody responses. Method: We studied antibody responses in 500 patients following dual COVID-19 vaccination to assess the magnitude, correlates of response, stability and functional activity of the spike-specific antibody response with two different vaccine platforms. Results: Spike-specific seroconversion post-vaccine was seen in 67% of patients compared to 100% of age-matched controls. Amongst responders, titres were 3.7 times lower than the control group. Antibody responses showed a 33% fall over the next 4 months. The use of an mRNA (n = 204) or adenovirus-based (n = 296) vaccine platform did not impact on antibody response. Male gender, BTKi therapy, prophylactic antibiotics use and low serum IgA/IgM were predictive of failure to respond. Antibody responses after CD20-targeted immunotherapy recovered 12 months post treatment. Post-vaccine sera from CLL patients with Spike-specific antibody response showed markedly reduced neutralisation of the SARS-CoV-2 delta variant compared to healthy controls. Patients with previous natural SARS-CoV-2 infection showed equivalent antibody levels and function as healthy donors after vaccination. Conclusions: These findings demonstrate impaired antibody responses following dual COVID-19 vaccination in patients with CLL and further define patient risk groups. Furthermore, humoural protection against the globally dominant delta variant is markedly impaired in CLL patients and indicates the need for further optimisation of immune protection in this patient cohort.Publication Metadata only How I Treat Light Chain Cast Nephropathy(Wolters Kluwer, 2023-12-18) Pratt, Guy; Pinney, Jennifer Helen; Cockwell, Paul; Pratt, Guy; Pratt, Guy; Pratt, Guy; University Hospitals Birmingham; Haematology; Renal Medicine; Medical and Dental; Pratt, Guy; Pinney, Jennifer; Cockwell, PaulNone availablePublication Metadata only Bortezomib, melphalan, dexamethasone: a new standard of care for AL amyloidosis?(American Society of Clinical Oncology, 2020-08-04) Pratt, Guy; Pratt, Guy; Pratt, Guy; University Hospitals Birmingham NHS Foundation Trust; Haematology; Medical and Dental; Pratt, GuyNo abstract availablePublication Metadata only National myeloma patient survey shows continuing inappropriate imaging and geographical inequalities.(Oxford University Press, 2024-08-01) Quinn, Sandra C M; Goh, Vicky; Westerland, Olwen A; Pratt, Guy; Pratt, Guy; Pratt, Guy; Haematology; Medical and Dental; Pratt, GuyObjective: To evaluate the provision of imaging at diagnosis of myeloma from the service user perspective with a specific focus on how the experiences of patients align with the National Institute for Health and Care Excellence (NICE) guidelines (NG35, 2016) on first-line imaging practice for myeloma in the United Kingdom. Methods: A national survey was performed to evaluate access to imaging from the patient's perspective. Patients with myeloma who received their diagnosis between 2017 and March 2022 were invited to participate. Data were collected using an online survey from 895 patients and carers between 4 and 14 March 2022. Results: Most patients had more than one imaging test. First-line MRI was used in 69.2% of respondents. First-line skeletal survey (SS, whole body X-rays) remained common (48.7% of respondents). 18F-fluorodexyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was used least often (23.1% of respondents). SS was used more often in East England (57.9%) and Scotland (61.2%) than in South East England (36.3%). Conclusions: Despite NICE recommendations, first-line MRI was not used in a third of patients surveyed, with geographical variation in imaging practice. Patients are still undergoing multiple imaging tests at diagnosis. Healthcare professionals should continue to emphasize the superiority of MRI compared to SS to drive for improvements in care. Advances in knowledge: Current recommendations on first-line imaging for myeloma are not provided consistently across the United Kingdom. There is a need to drive change and support healthcare professionals to deliver guidance-based recommendations to improve experience and outcomes for patients.Publication Metadata only The glutamate/aspartate transporter EAAT1 is crucial for T-cell acute lymphoblastic leukemia proliferation and survival.(Ferrata Storti Foundation, 2024-05-30) Stanulović, Vesna S; Al Omair, Shorog; Reed, Michelle A C; Roberts, Jennie; Potluri, Sandeep; Fulton-Ward, Taylor; Gudgeon, Nancy; Bishop, Emma L; Roels, Juliette; Perry, Tracey A; Sarkar, Sovan; Pratt, Guy; Taghon, Tom; Dimeloe, Sarah; Günther, Ulrich L; Ludwig, Christian; Hoogenkamp, Maarten; Pratt, Guy; Pratt, Guy; Honorary Consultant Haematologist; Medical and Dental; Pratt, GuyT-cell acute lymphoblastic leukemia (T-ALL) is a cancer of the immune system. Approximately 20% of paediatric and 50% of adult T-ALL patients have refractory disease or relapse and die from the disease. To improve patient outcome new therapeutics are needed. With the aim to identify new therapeutic targets, we combined the analysis of T-ALL gene expression and metabolism to identify the metabolic adaptations that T-ALL cells exhibit. We found that glutamine uptake is essential for T-ALL proliferation. Isotope tracing experiments showed that glutamine fuels aspartate synthesis through the TCA cycle and that glutamine and glutamine-derived aspartate together supply three nitrogen atoms in purines and all but one atom in pyrimidine rings. We show that the glutamate-aspartate transporter EAAT1 (SLC1A3), which is normally expressed in the central nervous system, is crucial for glutamine conversion to aspartate and nucleotides and that T-ALL cell proliferation depends on EAAT1 function. Through this work, we identify EAAT1 as a novel therapeutic target for T-ALL treatment.
