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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.


Focus Areas

Each of our Division’s subspecialty research groups are recognized as leading programs of national and regional distinction. Click below to learn more about particular focus areas.

Benign Hematology Program

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.

 

Learn more on the UNC Blood Research Center website.

Bone Marrow Transplant Program

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:

Jonathan Serody, MD has a long-standing interest in the basic immunologic mechanisms behind graft versus host disease and is developing research protocols investigating the use of ILC-2 cells for the treatment of steroid refractory GVHD of the gut.
Benjamin Vincent, MD and Paul Armistead, MD, PhD have basic and translational research efforts aimed at developing both cellular and vaccine-based therapeutics to target myeloid malignancies post-transplant.
Health optimization and patient reported outcomes research
William Wood, MD has developed the HealthScore program, which is intended to use digital technologies and personalized health coaching to improve quality of life and health outcomes in patients undergoing stem cell transplantation
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.

Because disease relapse remains the leading cause of post-transplant mortality, UNC has expanded its research interests in this area. Katarzyna Jamieson, MD is the UNC lead investigator for the VIALE Trial investigating the use of venetoclax and azacitidine as post-transplant maintenance therapy for patients with high-risk AML. Jay Coghill, MD and Dr. Armistead are opening studies investigating tagraxofusp (anti-CD123 immunoconjugate) and MT-401 (anti-tumor specific T cells) as maintenance therapy and treatment for relapsed myeloid malignancies.
Graft versus host disease remains the leading cause of post-transplant non-relapse mortality, and Dr. Jamieson is the UNC lead investigator for the EQUATOR Trial investigating Itolizumab (anti-CD6 antibody) in combination with corticosteroids as first line treatment for acute GVHD.
As HLA-mismatched stem cell grafts have become more widely used, increasingly immunosuppressive GVHD prophylaxis regiments (such as post-transplant cyclophosphamide) have become common. However, this approach has led to increased risks of opportunistic infections. Dr. Coghill is the UNC lead investigator for the ALVR-106 study investigating the use of off-the-shelf, anti-viral specific T cells to treat severe respiratory viral infections. Dr. Jamieson is the lead investigator for the EAP-901 expanded access study using third-party, anti-EBV specific T cells to treat post-transplant lymphoproliferative disease. In addition, the BMTCT program has been heavily involved in the CTN 2101 trial investigating COVID vaccine responses in post-transplant patients.

 

Learn more on the Bone Marrow Transplant and Cellular Therapy website.

Leukemia and Myeloproliferative Neoplasms Program

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:

1) Acute Myeloid Leukemia (AML)
  •  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.
2) Myelodysplastic Syndromes (MDS)
  • 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)
3) Acute Lymphoblastic Leukemia (ALL)
  • University of North Carolina is a national leader in innovative immunotherapy approaches in ALL. 
4) Myeloproliferative Neoplasms (MPN)
  • 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.
5) Chronic Lymphocytic Leukemia (CLL)
  • We have a multitude of cutting-edge clinical trial options for patients with newly diagnosed and relapsed/refractory CLL.
Lymphoma Program

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.
Myeloma Program

Multiple Myeloma and Amyloidosis Program

 

The UNC Lineberger Multiple Myeloma and Amyloidosis Program is a highly active clinical entity serving patients across NC and surrounding states with plasma cell disorders.  The program also hosts a robust research effort aimed at improving therapies for patients with these disorders worldwide by devising cutting edge new medications, optimizing existing ones, and otherwise studying methods for improving care for patients.

 

The program is primarily based at the UNC Hillsborough Medical Office Building. This geography affords our patients the best of both worlds – all the advances of a subspecialty academic medical center, with the comfort and convenience of a small clinic.

 

Broadly speaking in terms of research, the program has a number of scientific initiatives. A few examples follow.

 

Clinically developing new agents and optimizing existing agents for treating plasma cell disorders:

 

UNC Lineberger physicians lead national efforts advancing the treatment of these conditions.  Sam Rubinstein, MD MSCI is chairing an NC-wide study (LCCC2323) of daratumumab, lenalidomide, bortezomib and dexamethasone in patients with newly diagnosed myeloma, testing a novel “real world” schedule for administering these medications that is likely more tolerable and convenient than standard approaches.  The study is one of the first of its kind in the US to utilize a “decentralized model,” which broadens its availability statewide, in recognition of the desire of many patients to be treated close to home and not repeatedly travel to UNC for their myeloma care.  Eben Lichtman, MD is leading a national study (LCCC2119) of isatuximab, pomalidomide and dexamethasone in older and frail adults with relapsed and refractory multiple myeloma.  The standard dosing for this regimen can be difficult on patients who are vulnerable to side effects, and this study is testing a reduced-dosing strategy geared toward preserving the regimen’s effectiveness in controlling myeloma while reducing side effect burden.  Sascha Tuchman, MD MHS is the chair for a nationwide study (A062102) in patients with relapsed and refractory myeloma who have been treated with idecabtagene vicleucel (“Abecma”) CAR-T, and then receive either a new medication called iberdomide or standard observation.  The study’s goal is to assess the safety of iberdomide in these patients, as well as the drug’s ability to enhance CAR-T’s ability to keep myeloma in remission for a longer period of time. Separately, Dr. Tuchman also leads the LCCC1603 study of a new CD138-directed chimeric antigen receptor T-cell (CAR-T) for the treatment of advanced myeloma.  This is a truly bench-to-bedside UNC creation: it was designed in the lab by UNC faculty Drs. Barbara Savoldo and Gianpietro Dotti, it is manufactured for patients at clinical-grade (“GMP”) UNC facilities, and it is being studied in a first-in-human clinical trial for patients in the UNC clinical program who need newer approaches.  UNC Lineberger is one of very few centers worldwide that has the ability to take something like this from discovery all the way to patients.

 

Laboratory-based efforts to deepen our understanding of disease biology and develop entirely new approaches for therapy:

 

Eben Lichtman, MD created the LCCC1849 (PERMIT) study in collaboration with UNC infectious disease physician Tessa Andermann, MD, to examine both immune system function and the gut microbiome (bacteria and other organisms that naturally live in the intestines) in patients with plasma cell disorders.  1) In patients with myeloma precursor conditions (monoclonal gammopathy of uncertain significance or smoldering myeloma), they aim to identify immune or microbiome predictors of development of multiple myeloma.  2) For patients with smoldering myeloma or active multiple myeloma on treatment, they seek to explore the same domains to find predictors of response to therapy and longer duration of remission.  Better understanding these areas will hopefully lead to the development of concepts regarding how to intervene in these areas in ways that improve clinical outcomes for patients.

 

The entire program is collaborating with UNC Lineberger physician scientist Dr. Chad Pecot, who is an internationally renowned expert in RNA therapeutics.  The group is working with Dr. Pecot and his lab to create first-ever types of new RNA-based approaches for suppressing the synthesis of key proteins in myeloma development, with the aim of devising chemotherapy-free approaches to treating these disorders. Once appropriate candidates are identified, they will be moved forward into the UNC clinics where they will be offered as part of research studies to patients needing new approaches.

 

Clinical correlatives to better understand the impact of plasma cell disorders and treatment on patients:

 

The entire program collaborates to run the LCCC1728 study and the separate but connected UNC plasma cell disease quality database.  These efforts conducted among patients being treated at UNC for any plasma cell disorder collect data from patients in such areas as quality of life, physical function, cognitive function, response to therapy and financial impact of treatment. The goal of this now 300+ patient and 5+ year effort is two-fold: 1) to provide objective data that ensures that the quality of clinical care for patients with plasma cell disorders at UNC is outstanding, and 2) to provide research data that enables the program to learn from our patients’ experience.  Multiple manuscripts have been published in the scientific literature using these data, which means that people worldwide with multiple myeloma and related conditions are learning from our patients and our work.