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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 Metadata only NGS-based targeted sequencing guides risk-adapted and molecularly targeted therapy decisions in multiple myeloma(Wiley-Blackwell, 2025-08-26) Agarwal, Gaurav; Kazeroun, Mohammad; Salazar, Mirian; McBean, Khrystal; Kannan, Ananya; Larham, Jemma; Varghese, Sherin; Balik, Berrin; Browning, Joseph; Caulier, Alexis; Chan, Y L Tracey; Giles, Hannah; Jenner, Matthew; Kishore, Bhuvan; Pratt, Guy; Rabin, Neil; Robinson, Rebecca; Talbot, Alexis; van de Wyngaert, Zoé; Xu, Ke; Moore, Sally; Boyle, Eileen; Ansari-Pour, Naser; Ramasamy, Karthik; Hamblin, Angela; Thakurta, Anjan; Gooding, Sarah; Boston Children's Hospital; Harvard Medical School; University of Oxford; Oxford University Hospitals NHS Foundation Trust; University Hospitals Birmingham NHS Trust; University of Birmingham; University Hospital Southampton NHS Foundation Trust; University College London Hospitals NHS Foundation Trust; Assistance Publique des Hopitaux de Paris; Université Paris Cité; Sorbonne Université; University Hospitals Bristol and Weston NHS Foundation Trust; Haematology; Oncology; Medical and Dental; Chan, Tracey; Giles, Hannah; Kishore, Bhuvan; Pratt, Guy; Robinson, RebeccaNo abstract availablePublication Metadata only Evaluating the real-world value of Daratumumab addition to multiple myeloma induction therapy by real-world minimal residual disease assessment and extended genetic profiling.(Elsevier, 2025-11-10) Bertuglia, Giuseppe; Seneca, Elisa; Corbett, Timothy; Croft, James; Kaczmarek, Pawel; Ellis, Lauren; Neoh, Chin; Renaudon-Smith, Edward; Vanhinsbergh, Lewis; Lindsay, Jindriska; Bonetto, Stefania; Kristinsson, Sigurdur Y; Spence, Dingle; Pratt, Guy; Jackson, Graham; Ethell, Mark; Nicholson, Emma; Messiou, Christina; Brown, Tommy; Conneely, Leonora; Thornton, Tracy; Fuller, Lynnsay; Petrizan, Mikel Valganon; Dunlop, Alan; Smith, Katy; Gay, Francesca; Pawlyn, Charlotte; Boyd, Kevin D; Kaiser, Martin F; Haematology; Medical and Dental; Pratt, GuyBackground: Daratumumab, bortezomib, thalidomide, and dexamethasone (Dara-VTd) is the current standard of care in Europe based on the CASSIOPEIA study, which demonstrated improved depth of response and progression-free survival when daratumumab is added to VTd. Patients and methods: We conducted a retrospective analysis of patients treated with VTd or Dara-VTd at the Royal Marsden Hospital (RMH). Post-transplant response was assessed by biochemical response and minimal residual disease (MRD) using flow cytometry (sensitivity 10⁻⁵), with additional stratification by cytogenetic risk. Results: A total of 173 patients (103 Dara-VTd, 70 VTd) with balanced baseline characteristics were included; 150 patients (87%) had a full cytogenetic panel. Median follow-up was 18.6 months. Post-transplant overall response rate was higher with Dara-VTd than VTd (97.1% vs. 87.1%), as was MRD negativity (78.6% vs. 55.7%). While Dara-VTd consistently outperformed VTd, the benefit decreased in patients with multiple high-risk cytogenetic abnormalities. Twenty-four-month progression-free survival was 97.3%, 94.1%, and 63.9% for patients with 0, 1, and ≥ 2 abnormalities treated with Dara-VTd, compared with 82.6%, 61.9%, and 55.6% for VTd, respectively. Conclusion: Adding daratumumab to VTd improves post-transplant response and MRD negativity in real-world practice. The magnitude of benefit diminishes with increasing numbers of high-risk cytogenetic abnormalities, supporting the value of risk-adapted strategies and real-world MRD assessment in treatment evaluation.Publication Metadata only Monoclonal immunoglobulin measurement by mass spectrometry in patients with multiple myeloma and kidney failure: Analysis from the EuLITE trial(Wiley-Blackwell, 2025-05-25) McIlroy, Graham; Giles, Hannah V; Rollins, Amy; Malin, Gemma; Jones, Libby; Wright, Nicola J; Berlanga, Oscar; North, Simon; Cook, Mark; Hutchison, Colin; Heyne, Nils; Weisel, Katja; Pinney, Jennifer; Harding, Stephen; Cockwell, Paul; Pratt, Guy; University of Birmingham; University Hospitals Birmingham; Thermo Fisher Scientific; Bristol Myers Squibb; Hawke's Bay District Health Board; Universität Tübingen; Universitätsklinikum Hamburg-Eppendorf; Haematology; Renal Medicine; Medical and Dental; McIlroy, Graham; Giles, Hannah; Pinney, Jennifer; Cockwell, Paul; Pratt, GuyNo abstract availablePublication Metadata only mTOR activity and metabolic reprogramming of CD8+ T cells is impaired under hypoxia and within the multiple myeloma bone marrow.(American Society of Hematology, 2025-09-12) Fulton-Ward, Taylor; Gudgeon, Nancy; Thirlwell, Isaac; Bishop, Emma Louise; Marzullo, Bryan; Giles, Hannah Victoria; McIlroy, Graham; Ferguson, Paul; Kishore, Bhuvan; Rogers, Kate; Alfasi, Nuri Nuri; Wong, Timothy; Aytain, Satnam; Tennant, Daniel A; Pratt, Guy; Dimeloe, Sarah; University Hospitals Birmingham NHS Foundation Trust, Birmingham; University of Birmingham, Birmingham, United Kingdom; Haematology; Nursing; Medical and Dental; Nursing and Midwifery Registered; Additional Clinical Services; Giles, Hannah; Kishore, Bhuvan; Rogers, Kate; Alfasi, Nuri; Wong, Timothy; Aytain, SatnamNovel therapies for multiple myeloma aim to engage anti-tumour functions of T cells. However, evidence indicates these functions are limited within the bone marrow environment. This is relatively hypoxic in health and studies indicate widespread hypoxia in multiple myeloma. In this study, CD8+ T cell responses to stimulation were assessed under hypoxia, which identified that activation, proliferation and interferon-gamma (IFN-γ) secretion were profoundly suppressed, whilst cytotoxicity and tumour necrosis factor-alpha (TNF-α) expression were unaffected. These changes occurred alongside decreased mTOR activity and expression of c-Myc, which drives T cell metabolic reprogramming upon stimulation. Consistently, hypoxic CD8+ T cells demonstrated decreased activation-induced glycolysis and mitochondrial glutamine oxidation. Mechanistically, this was linked to elevated BNIP3 expression under hypoxia and reciprocally decreased abundance of its interaction partner, Rheb, an important mTOR activator. Assessment of BCMAxCD3 bispecific antibody activity confirmed impaired capacity to elicit CD8+ T cell activation, IFN-γ expression, proliferation and altered memory differentiation under hypoxia, although initial target cell killing was unaffected. Finally, assessment of bone marrow CD8+ T cells from multiple myeloma patients identified decreased proliferation, c-Myc and Rheb expression compared to peripheral blood cells, alongside elevated BNIP3, confirming mechanistic features of hypoxic exposure in this environment. Taken together, the findings indicate potential for bone marrow hypoxia to influence efficacy of T cell-directed therapies for multiple myeloma.Publication Metadata only Paraprotein-induced spurious hypercalcaemia: diagnostic pitfalls in two cases.(Oxford University Press, 2025-07-31) Lorde, Nathan; Pratt, Guy; Geberhiwot, Tarekegn; Ayuk, John; Gittoes, Neil; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Endocrinology; Pathology; Haematology; Medical and Dental; Additional Professional Scientific and Technical Field; Lorde, Nathan; Pratt, Guy; Geberhiwot, Tarekegn; Ayuk, John; Gittoes, NeilThis brief report describes 2 cases in which paraprotein caused spurious biochemistry results. In both cases standard laboratory measurements of calcium indicated the patients were hypercalcaemic and had significantly raised Vitamin D concentrations in serum. However, use of alternative measurements of calcium and vitamin D showed that these results were spurious. Clinicians looking after patients with significant paraprotein concentrations or other significant protein abnormalities should be aware of the possibility of assay interference when reviewing their biochemistry results. This awareness can be vital in avoiding unnecessary investigations or treatments, thus not only saving resources but also protecting patients from harm that may be caused by inappropriate therapies.Publication Metadata only An open-source repository-based tool for quality control of imaging protocol compliance: demonstration in a multicentre MRI study(British institute of radiology, 2025-08-01) Keaveney, Sam; McHugh, Damien J; Rata, Mihaela; Dragan, Alina; Winfield, Jessica M; Doran, Simon J; Blackledge, Matthew D; Scurr, Erica; Koh, Dow-Mu; Berks, Michael; Gill, Andrew B; Birchall, Jonathan R; O'Connor, James P B; King, Alexander; Rennie, Winston J; Gaba, Suchi; Suresh, Priya; Malcolm, Paul; Davis, Amy; Nilak, Anjumara; Shah, Aarti; Gandhi, Sanjay; Albrizio, Mauro; Pratt, Guy; Cook, Gordon; Hall, Andrew; Roberts, Sadie; Jenner, Matthew; Brown, Sarah; Kaiser, Martin; Hubbard Cristinacce, Penny L; Messiou, Christina; Haematology; Medical and Dental; Pratt, GuyClinical translation of advanced MRI techniques can be hindered by the challenges of performing standardized multicentre imaging trials. This work aims to develop and demonstrate an automated tool for monitoring imaging protocol deviations, enabling corrective action to be taken. Methods: A Python-based tool, integrated into the imaging repository XNAT, was developed to compare DICOM series with an agreed imaging protocol, highlighting missing series and parameter deviations. This was demonstrated through retrospective analysis of a prospectively acquired dataset from a ten-site whole-body (WB) MRI study of patients with multiple myeloma. The acquired data were compared to the relevant radiological guidelines and to the site-specific imaging protocols agreed for the study. Results: The rate of technical software failure was 0% across 174 examinations from 10 sites. The clinical guidelines were followed in 87.9% of examinations and compliance with the site-specific imaging protocol was greater than 75.0% for all parameters. Common deviations included number of averages for diffusion-weighted imaging (DWI) and repetition time for DWI and Dixon: 85.2%, 81.7%, and 75.1%, respectively. There was a statistically significant correlation between protocol compliance and overall exam radiological image quality. Conclusions: Repository-integrated software is presented for automated monitoring of imaging protocol compliance to support standardization in multicentre studies and clinical translation. Advances in knowledge: This study presents a novel open-source repository-integrated software tool for automatically monitoring compliance with the expected imaging protocol. Standardized acquisition protocols are crucial in multicentre imaging studies and this tool has the potential to enhance research outcomes and support clinical translation.Publication Metadata only Examining the effect of intermittent cycling throughout a 3-h period on peripheral blood concentrations of haemopoietic stem and progenitor cells and cytolytic natural killer cells(BioMed Central, 2025-03-28) Cox, Phoebe A; Pradana, Fendi; Noble, Ella; Lucas, Samuel J E; Pratt, Guy; Drayson, Mark T; Amin, Kevin; Kinsella, Francesca A M; Wadley, Alex J; University of Birmingham; Tadulako University; University Hospitals Birmingham NHS Foundation Trust; Haematology; Medical and Dental; Pratt, Guy; Kinsella, FrancescaBackground: Peripheral blood stem cell (PBSC) donation is the primary procedure used to collect haemopoietic stem and progenitor cells (HSPCs) for haemopoietic stem cell transplants (HSCT), however there is a clinical need to reduce collection times and achieve sufficient HSPC doses for successful engraftment. Short bouts of interval cycling transiently enrich peripheral blood with HSPCs and cytolytic natural killer (CD56dim NK) cells, which predict engraftment success and prevent post-transplant complications respectively. Despite this, feasible protocols for use during PBSC collections (≈ 3 h) have yet to be evaluated. Methods: In a randomised crossover design, 18 adults (9 young: 22.7 ± 3.2 years, 9 older: 65.2 ± 12.9 years) completed 3 × 3-h trials: high-intensity interval exercise (HIIE, 9 × 2-min cycling at 80-85% heart rate (HR)max/9 × 18 min rest), moderate-intensity interval exercise (MIIE, 9 × 4-min cycling at 65-70% HRmax/9 × 16 min rest) and REST (180 min). Immune cell subsets, including HSPCs and CD56dim NK concentrations (cells/µL) were determined across 18 timepoints and area under the curve (AUC, cells/µL x minutes) and total cell dose (cells/kg) were estimated. Results: By design, MIIE elicited lower average and peak HR and rating of perceived exertion than HIIE and was reported as more enjoyable. All cell subset concentrations increased following each interval of MIIE and HIIE. Across all participants, the estimated cell dose of total lymphocytes, monocytes, T cells, CD56bright and CD56dim NK was greater in MIIE and HIIE versus REST (p < 0.03), but there were no differences between MIIE and HIIE. The magnitude of change versus REST was greatest for CD56dim NK versus all cell subsets, and AUC was significantly greater in HIIE versus REST for this cell type only (p < 0.0001). There were no statistically significant differences in HSPC AUC (p = 0.77) or cell dose (p = 0.0732) in MIIE and HIIE versus REST. Age did not predict any changes across trials or timepoints for any cell type. Conclusion: Persistent mobilisation of peripheral blood immune cells throughout 3 h of MIIE and HIIE evoked sustained numbers of CD56dim NK cells, but there was no reliable difference in HSPCs compared to a time-matched period of rest.Publication Metadata only PHF6 interacts with the LMO2 complex in T-cell acute lymphoblastic leukemia(Ferrata storti foundation, 2025-07-10) Stanulović, Vesna S; Binhassan, Sarah; Jaber, Budoor A; Alazmi, Shimaa; Saleman, Fatma M B; Potluri, Sandeep; Pratt, Guy; Ludwig, Christian; Ward, Douglas G; Hoogenkamp, Maarten; Haematology; Medical and Dental; Pratt, GuyThe transcriptional mediator LIM domain only 2 (LMO2) forms a large multi-protein complex together with TAL1/LYL1, HEB/E2A, LDB1 and GATA. This complex regulates transcription from the onset of hematopoietic development and during differentiation. Chromosomal rearrangements involving LMO2 and TAL1 are causative for T-cell lymphoblastic leukemia (TALL). We have identified Plant Homeodomain (PHD)-like Finger 6 (PHF6) as a new LMO2 interacting factor. Somatic mutations in PHF6 have been found to occur in several types of leukemia. We show that PHF6 interacts with LMO2 as a part of the TAL1, GATA2, LDB1 complex in T-ALL and binds to the DNA. These findings show that PHF6 associates with the TAL1/LMO2/LDB1/GATA2 complex and regulates genes that have a major role in blood development, such as SPI1 (PU.1).Publication Open Access Extending the reach of expert amyloidosis care : a feasibility study exploring the staged implementation of a UK amyloidosis network(Elsevier, 2024-01-19) Choy, Chern Hsiang; Steeds, Richard; Pinney, Jennifer; Baig, Shanat; Turvey-Haigh, Lauren; Wahid, Yasmin; Cox, Helen; Zaphirou, Alex; Srinivasan, Venkataramanan; Wilson, David; Fryearson, John; Ahamed, Mubarak; Lim, Sern; Chue, Colin; Pratt, Guy; Fontana, Marianna; Gillmore, Julian D.; Moody, William E.; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; Worcestershire Royal Hospital; South Warwickshire University NHS Foundation Trust; University College London;; Cardiology; Renal Medicine; Research & Development; Neurology; Haematology; Medical and Dental; Nursing and Midwifery; Additional Professional, Scientific and Technical; Fryearson, John; Steeds, Richard; Pinney, Jennifer; Baig, Shanat; Wahid, Yasmin; Cox, Helen; Zaphirou, Alex; Srinivasan, Venkataramanan; Lim, Sern; Chue, Colin; Pratt, Guy; Moody, William E.There has been an exponential increase in the diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CA). In response, the Midlands Amyloidosis Service was launched with the aim of providing patients with a timely diagnosis, remote expertise from the National Amyloidosis Centre and access to emerging transthyretin (TTR)-directed therapies. This was a descriptive study of a pilot hub-and-spoke model of delivering specialist amyloidosis care. Patients with suspected amyloidosis were referred from the wider Midlands region, and seen in a consultant-led multidisciplinary clinic. The diagnosis of ATTR-CA was established according to either the validated non-biopsy criteria or histological confirmation of ATTR deposits with imaging evidence of amyloid. Study endpoints were the volume of service provision and the time to diagnosis from the receipt of referral. Patients (n=173, age 75±2 years; male 72 %) were referred between 2019 and 2021. Eighty patients (46 %) were found to have cardiac amyloidosis, of whom 68 (85 %) had ATTR-CA. The median time from referral to diagnosis was 43 days. By removing the need for patients to travel to London, an average of 187 patient-miles was saved. Fifteen (9 %) patients with wild-type ATTR-CA received tafamidis under the Early Access to Medicine scheme; 10 (6 %) were enrolled into phase 3 clinical trials of RNA interference or antisense oligonucleotide therapies. Our results suggest that implementing a UK amyloidosis network appears feasible and would enhance equity of access to specialised amyloidosis healthcare for the increasing numbers of older patients found to have ATTR-CA. Keywords: Amyloidosis; Screening; Transthyretin amyloid cardiomyopathy.Publication Metadata only Excluding myeloma diagnosis using revised thresholds for serum free light chain ratios and M-protein levels.(Ferrata Storti Foundation, 2019-08-08) Heaney, Jennifer L J; Richter, Alex; Bowcock, Stella; Pratt, Guy; Child, J Anthony; Jackson, Graham; Morgan, Gareth; Turesson, Ingemar; Drayson, Mark T; Pratt, Guy; Pratt, Guy; Haematology; Medical and Dental; Pratt, GuyNo abstract available
