Myeloproliferative neoplasms (MPN) and chronic myeloid leukaemia (CML)

We have a particular specialism in caring for myeloproliferative neoplasms (MPN) and chronic myeloid leukaemia (CML).

Myeloproliferative neoplasms (MPN)

Myeloproliferative neoplasms (MPN) are types of blood cancer that are caused when the bone marrow produces either too many or not enough blood cells. Although they are officially classed as blood cancers, many people feel well and their disease is stable or progresses very slowly.

There are many different types of MPN but the classical MPNs fall into three main categories:

  • Polycythaemia vera (PV) – too many red blood cells
  • Essential thrombocythaemia (ET ) – too many platelets
  • Myelofibrosis (MF) – too many fibroblasts, which cause scar tissue & fibrous tissue in the bone marrow and stop it from producing enough blood cells

There are also several atypical or non-classical MPNs.

Causes

MPNs are caused by gene mutations in stem cells. We don’t know why these mutations happen in some people. Research is taking place to find out why and to look at which gene mutations are most common in different MPNs.

Symptoms

Symptoms vary depending on the type of MPN. Many people have no symptoms at all. People who do have symptoms may experience:

  • frequent headaches
  • tiredness (fatigue)
  • bruising or unusual bleeding
  • blurred vision or other eye problems
  • tinnitus (ringing in your ears)
  • frequent infections

Chronic myeloid leukaemia (CML)

Chronic myeloid leukaemia (CML) usually develops very slowly and, for many people, it can be well controlled. Around 750 people are diagnosed each year in the UK. They can be any age although it is more common as you get older.

Causes

CML develops when the spongy material inside some bones (bone marrow) produces too many myeloid cells – immature white blood cells that are not fully developed and do not work properly. Scientists don't yet know why this happens. It doesn't seem to run in families or be linked to smoking, diet, chemicals or infections. It's more common over the age of 60 and slightly more common in men.

Symptoms

Many people have no symptoms in the early stages. CML is sometimes discovered when people are having blood tests for something else. If undiagnosed, it may progress and symptoms may include:

  • tiredness
  • weight loss
  • night sweats
  • tenderness and swelling in the left side of your tummy
  • feeling full after small meals
  • pale skin and shortness of breath
  • a high temperature
  • bruising and bleeding easily
  • frequent infections
  • bone pain

Diagnosis & treatment at The Clatterbridge Cancer Centre

At The Clatterbridge Cancer Centre, we diagnose and treat CML and all types of MPN. Dr Nauman Butt, our lead MPN clinician, is one of the very small number of UK specialists with a particular interest in atypical MPNs such as systemic mastocytosis and hypereosinophilic syndromes.

We accept referrals for diagnosis as well as treatment and can make laboratory diagnosis from tissue samples which include blood and bone marrow. Dr Rachel Wells is Liquid Lead for haemato-oncology diagnostics.

We treat:

  • Chronic myeloid leukaemia (CML)
  • Classical MPNs including PV, ET and MF
  • Atypical MPNs including systemic mastocytosis and hypereosinophilic syndromes

Treatments are all offered in line with NICE guidelines. We also have an active clinical trials portfolio for MPN and CML.

We have our own on-site stem cell transplant unit for patients with complex disease.

Our MPN & CML team

We have a dedicated team of specialists in myeloproliferative neoplasms (MPN) and chronic myeloid leukaemia (CML).

Consultants

Dr Nauman Butt, Consultant Haemato-Oncologist and Lead Clinician for MPN & CML

Nauman has a special interest in MPN and CML. He is one of only a few specialists nationally with an interest in systemic mastocytosis and hypereosinophilic syndromes. He has an active clinical trials portfolio and is a member of the NCRI's MPN Clinical Trials Subgroup. Nauman has contributed to several of the British Society for Haematology guidelines, including leading on the guidelines for the investigation and management of eosinophilia. [Read Nauman's consultant profile.]



Dr Rachel Wells, Consultant Haemato-Oncologist

Rachel has a special interest in diagnosis and treatment of MPN and CML. She trained and worked in Newcastle-upon-Tyne up until 2018 when she was given the opportunity to come and work at The Clatterbridge Cancer Centre as part of the MPN team. She is also Liquid Lead for the Haemato-Oncology Diagnostic Service in Liverpool (LCL), responsible for reporting tissue samples which include blood and bone marrow biopsies. [Read Rachel's consultant profile.}

Advanced Nurse Practitioner

  • Carolyn Parry

Clinical Nurse Specialists

  • Lauren Mercer
  • Katy Knight

Team members

  • Aileen McCaughey, Advanced Haematology Pharmacist
  • Lauren Quilty, Research Specialist Nurse
  • Laura Connolly, Clinical Trials Data Coordinator
  • Tracey Wellman, Clinical Trials Data Coordinator
  • Dr Lihui Wang, Clinical Scientist
  • Linda Boyne, Haematology counsellor

Our MPN & CML team also work closely with colleagues across The Clatterbridge Cancer Centre including the leukaemia team, the stem cell transplant team, clinical psychology and the palliative and enhanced supportive care team.

For more information & support

  • Your clinical team will be happy to answer any questions you have and can signpost you to information, guidance & support that you may find useful.
  • We also have a Cancer Information & Support team in each of our hospitals for guidance on anything related to living with cancer and life after cancer. Just drop into their offices or contact them on: ccf-tr.informationcentre@nhs.net
  • Liverpool Haematology Support Group. Contact Linda Boyne, Support Group Leader/Haematology Counsellor. Email: marylinda.boyne@nhs.net Mobile: 07341 869875
  • MPN Voice is an organisation dedicated to supporting people with MPN and raising awareness of MPN. Their website has lots of useful information & support. https://www.mpnvoice.org.uk/
  • Blood Cancer UK also have lots of useful information about MPN on their website. https://bloodcancer.org.uk/
  • Macmillan have information about all different cancers including MPN and lots of useful information, guidance and support for people with cancer and their loved ones. https://www.macmillan.org.uk/