The Division of Hematology offers expertise in the diagnosis and treatment of a broad spectrum of blood disorders. Hematology faculty participate in specialized patient care and research programs in the areas of hematologic malignancies, thrombosis, bleeding disorders, sickle cell anemia, and bone marrow transplantation. Specialized interdisciplinary hematology clinics and conferences are held weekly in the areas of benign and malignant hematology, in association with other members of the UNC Blood Research Center, nationally recognized in the areas of Hemostasis and Thrombosis, Hemophilia, and the UNC Lineberger Comprehensive Cancer Center, one of the foremost cancer research centers in the country. The UNC Blood Research Center, UNC Lineberger, and the UNC Sickle Cell Program, are central to implementing the patient care and research missions of the Division.
Research by the benign hematology group is highly recognized internationally. According to Expertscape.com, and based on publications since 2011, expertise in hemostasis at UNC is ranked #4 worldwide (#2 in the United States), #22 in thrombosis (#14 in the USA), and #16 in sickle cell anemia (#12 in the USA).
The thrombosis program at UNC is focused on innovative clinical practice models. In 2021, the newly developed rapid follow-up DVT clinic provided care to 130 patients from across the state, improving access to urgent specialized care in thrombosis. Dr. Stephan Moll’s multidisciplinary Athlete Thrombosis Program. The “UNC Athletes and Blood Clots Program” offers state-of-the art multispecialty medical care (Hematology plus Sports Medicine) to high level athletes who have had a deep vein thrombosis (DVT or pulmonary embolism (PE).
The UNC Sickle Cell Clinical Program is a founding member of the GRNDaD registry for people with sickle cell disease, which is prospective and multi-site. We communicate regularly with state educators, and we are working diligently to care for our patients who are many miles away, often down the coast, for whom regular care is difficult. We participate in UNC-originated and multi-site research studies, working to find new ways to manage and treat sickle cell disease.
The UNC Bone Marrow Transplant and Cellular Therapy (BMTCT) Program cares for both adults and children with hematologic malignancies and solid tumors at the NC Cancer Hospital.The program has a long history of basic and translational research with 4 NIH/CDC funded investigators, as well as clinical trials and investigations. Areas of focus for the program include:
Basic and translational research:
Health optimization and patient reported outcomes research
Management of post-transplant complications
Disease relapse as well as infections and graft versus host disease remain the leading causes of post-transplant mortality. Multiple investigators are involved in clinical research aimed at addressing these issues.
Learn more on the Bone Marrow Transplant and Cellular Therapy website.
The Leukemia Program has a robust clinical research program focused on investigating novel therapies for patients with acute leukemia, myelodysplastic syndromes, myeloproliferative neoplasms and chronic leukemia’s. Highlights of our research group include:
- Frontline Treatment Approaches
- Joshua Zeidner, MD is leading several innovative clinical trials exploring new ways to treat newly diagnosed AML. He is leading a multi-institutional randomized phase 2 clinical trial of CPX-351 versus CPX-351 + pomalidomide (NCI-10434; NCT04802161) in newly diagnosed AML with myelodysplasia-related changes (AML-MRC), a high-risk subset of AML patients with suboptimal clinical outcomes.
- Dr. Zeidner is also leading a multi-institutional phase 2 clinical trial exploring Tagraxofusp (Antibody-drug conjugate to CD123) in newly diagnosed secondary AML patients (NCT05442216). This innovative clinical trial is the first to investigate novel treatment options for AML patients with previous treatment with hypomethylating agents.
- University of North Carolina is an active site on the Beat AML initiative (NCT03013998), a multi-institutional precision-medicine based clinical trial sponsored by the Leukemia and Lymphoma Society. Beat AML conducts a comprehensive centralized genomic profile of a patient’s AML. Investigational treatment regimens are thereby selected based on each individual unique genomic profile.
- We are participating in clinical trials targeting specific genomic subpopulations of AML that do not respond favorably to conventional chemotherapy regimens. For example, Dr. Zeidner is the Principal Investigator of a randomized phase 3 study of azacitidine plus magrolimab (anti-CD47) versus physician choice in newly diagnosed AML with TP53 mutations (ENHANCE-2: NCT04778397) Relapsed/Refractory AML
- Relapsed/Refractory AML
- We have a multitude of novel clinical trial options for patients with relapsed/refractory AML including targeted therapies and investigational strategies for unique subgroups of AML
- Treatment Outcome Preferences
- Daniel Richardson, MD’s research focuses on developing and advancing methods to assess patient values, goals, and preferences to improve treatment decision-making. His group has developed several instruments to quantify the treatment outcome preferences of patients with blood cancers and has several trials evaluating the clinical implementation of these instruments to better align treatment decisions to what matters most to patients.
- We are interested in exploring novel treatment approaches for patients with low and high-risk MDS. Dr. Zeidner is the Principal Investigator of an industry-sponsored randomized phase 3 study investigating the combination of azacitidine plus magrolimab (CD47 antibody) versus azacitidine plus placebo for newly diagnosed high-risk MDS (ENHANCE: NCT04313881)
- University of North Carolina is a national leader in innovative immunotherapy approaches in ALL. Matthew Foster, MD is the lead investigator of a novel Chimeric Antigen Receptor (CAR) T cell therapy approach with an inducible caspase-9 safety switch for patients with relapsed/refractory ALL. This novel clinical trial is the first study to explore the use of an inducible caspase 9 safety switch for CAR T cell therapy in ALL.
- Brandi Reeves, MD leads the MPN Program and serves as Co-PI for the UNC Lineberger MDS Foundation Center of Excellence. Her research focuses on understanding mechanisms of thrombosis in MPN’s and utilizes a bench-to-bedside approach wherein observations gleaned from the clinic are taken to the laboratory with the ultimate goal of translating back to the clinic to improve patient care.
- We have a multitude of cutting-edge clinical trial options for patients with newly diagnosed and relapsed/refractory CLL.
The lymphoma group has been very active in treating rare and underserved lymphoma subtypes. Highlights of our group include:
1. Lymphoma in elderly or frail patients.
- The lymphoma group has focused on several projects that specifically target effective treatment approaches in elderly or frail patients. Anne Beaven, MD is leading a study (S1918) evaluating oral azacitidine with R-miniCHOP for the treatment of DLBCL in patients over the age of 75. Christopher Dittus, DO, MPH, is collaborating with Levine Cancer Center to study the effectiveness of nivolumab consolidation in primary CNS lymphoma patients over the age of 65 who are not candidates for stem cell transplant or radiation.
- Additionally, Dr. Christopher Dittus, has an investigator-initiated trial (IIT) evaluating the targeted BTK inhibitor, acalabrutinib for the treatment of relapsed primary and secondary CNS lymphoma (LCCC1841). This study targets patients who are not eligible for more intensive chemotherapy options.
2. Virally-mediated lymphomas.
- Christopher Dittus, DO, MPH is leading a multicenter IIT evaluating the antibody-drug conjugate brentuximab vedotin for the treatment of the rare adult T-cell leukemia/lymphoma (LCCC1637).
- UNC is the only active AIDS Malignancy Consortium (AMC) site in North Carolina. We currently have several prospective studies open.
3. CAR-T cell therapy
- Most of the clinical CAR-T research has been led by Natalie Grover, MD in the lymphoma group. Areas of specific focus in lymphoma have been the CD30 CAR-T program, kappa CAR-T clinical trial for kappa expressing lymphomas, and the CD19 CAR-T trial using the inducible caspase 9 safety switch (LCCC1813) which has accrued CD19+ patients including Waldenstrom’s Macroglobulinemia.
- CD30 Program: This has led to a publication in JCO. This product has also received FDA RMAT (regenerative medicine advanced therapy) designation. We now have trials open in Hodgkin lymphoma and peripheral T cell lymphoma and are planning to open a trial in germ cell tumors as well.
- Inducible caspase 9 safety switch: We have CAR-T clinical trials using the inducible caspase 9 safety switch to mitigate life-threatening toxicities. We have a recent publication describing using the safety switch in one of our clinical trials.
- Solid Tumors: We are opening new trials with novel targets and approaches in solid tumors including a trial in GBM, lung cancer and head and neck cancers.
Sascha Tuchman, MD MHS, is the primary investigator of LCCC 1603. This is a first-in-human, ongoing clinical study testing a novel chimeric antigen receptor T-cell (CAR-T) that targets CD138 in relapsed and refractory multiple myeloma. This first of its kind CAR-T represents a true “bench to bedside” effort; it was developed by UNC faculty Drs. Barbara Savoldo and Gianpietro Dotti, and it is now being investigated in patients by the UNC multiple myeloma clinical studies team.
Shakira Grant, MBBS was awarded a 2-year (R03) grant from the National Institute of Aging totaling $200,000. This grant will support older adults’ longitudinal PaCE-MM (Patient and Care Partner Experiences living with Multiple Myeloma) study. The study aims to characterize individual social stressors, functional trajectories, and quality of life for patients and their care partners living with multiple myeloma. https://www.med.unc.edu/aging/multiple-myeloma-study/
Shakira Grant, MBBS and Sascha Tuchman, MD MHS, were awarded a one-year, $75,000 grant from the Jimmy V foundation. This mixed-methods research study aims to understand from both the patient and provider perspectives the barriers and facilitators that contribute to effective communication and decision-making about cancer research study participation among Black persons living with multiple myeloma.
Christopher Jensen, MD was awarded an American Society of Clinical Oncology / Conquer Cancer Foundation Young Investigator Award. This one-year, $50,000 grant supports his ongoing study of supportive care for older adults with multiple myeloma. The aim of this research is to test better ways of incorporating supportive interventions to address non-myeloma-related health issues while older adults are undergoing treatment for myeloma.