Professor Mark Drayson MBChB PhD FRCPath

• FRC Path - 2001
• MRC Path (Immunology) - 1993
• PhD (Immunology) - 1987 (Manchester University)
• MBChB - 1980 (Manchester University)
• BSc Hons First Class (Pathology) - 1978 (Manchester University)
• GMC No 2642983 (full registration August 1981) Specialist Registration Immunology 1994

Mark has a commitment to basic and translational research which started in his undergraduate years and PhD in Manchester where he studied the physiology of T and B lymphocyte responses in the secondary lymphoid organs of rodents and later humans. Mark graduated with a medical degree in 1980 and his general medical and haematology training continued in Manchester until he was recruited to the University of Birmingham in 1990 to become a Clinical Lecturer in Immunology. Mark was awarded Membership of the Royal College of Pathologists in 1993, became a Fellow in 2001 and was promoted to Professor in 2010. He has been an Honorary Consultant Immunologist in the NHS at University Hospitals Birmingham and Heart of England since 1997 and has directed the Clinical Immunology Service (CIS) at University of Birmingham since 2000.

The Clinical Immunology Service (CIS) provides a unique interface between the University's substantial scientific expertise in immunology and the clinical investigation and management of blood cancers, immunodeficiency and autoimmunity. Providing 600,000 immunodiagnostic tests per year for a population of five million, the CIS is a nidus for successful, productive (see references and teaching) interaction with clinical academics and basic research groups across the Birmingham Health Partners Campus. Mark is the lead for the laboratories in the Institute of Translational Medicine and with Mike Griffiths will integrate the new technologies of mass cytometry, metabolomics and single cell genomics into their blood cancer diagnostics, embodied in the Midlands Integrated Reporting Haemato Oncology (MIRHO) Service.

Since 1990 Mark has provided central laboratory analysis for phase 3 UK trials in myeloma (MRC 6th – 11th trials, MERIT and TEAMM), and he is Chief Investigator for two of these. The results have helped shape world opinion on investigation and management of the disease and supportive care. Mark is a member of national and international guidelines groups for diagnosis and management of both myeloma and MGUS, the MRC/NCRN Myeloma Working Groups and of the UK and UK/Nordic Myeloma Guidelines Group and MGUS Guidelines Group. He has played a key role in developing and demonstrating the utility of the first clinical test for serum immunoglobulin free light chains (FLC). This test was disseminated worldwide via a UoB spinout company Binding Site, and has been incorporated into the international guidelines for diagnosis and management of all plasma cell dyscrasias. Mark has developed a second generation of FLC tests based on monoclonal antibodies that provide improved laboratory and most importantly, point of care performance for management of myeloma, MGUS and related diseases. His basic research with colleagues on blood cancers has evolved into investigation of drug redeployment strategies as a route for development of novel therapies, an approach he is testing in clinical trials in the UK and Africa.

• 2nd Medicine and Surgery MBChB (350 students) Infection, Immunity and Haematology Module Coordinator (13 years)
• 3rd Medicine and Surgery MBChB Clinical Immunology (350 students)
• 2nd Medical Science BMedSc (75 students) 3rd BMedSci (20 students)

• MSc Blood Sciences Lead for Immunology Module
• MRes students
• PhD students
• MD Students
• Specialist Registrar training in Immunology

UK Myeloma trials

Mark joined these in 1990 with the 6^th trial, exploring and optimising combinations of cytotoxic chemotherapy agents and interferon (1^st to 6^th trials) and then intensification with high dose chemotherapy and autologous stem cell rescue (7^th trial). The value of drug redeployment and new biological therapies were tested and proven for thalidomide and proteasome inhibitors in the 9^th and 11^th trials. Myeloma 9^th trial recruited 1,970 patients the largest myeloma trial worldwide and along with myeloma 10 has generated 25 high impact papers since 2010, including in Blood, Leukaemia and Lancet with an average IF of 12.7. Myeloma 11 has recruited 4,247 patients in the last 4 years and is destined to have even greater impact on care of myeloma patients worldwide. Understanding the morbidities and causes of death in myeloma has informed supportive care studies that include proving the benefit of bisphosphonates for preventing skeletal disease (6^th and 9^th trials) and under investigation are the pros and cons of prophylactic antibiotics (TEAMM trial). FISH analysis for specific translocations provide strong indicators of survival as do early response and minimal residual disease studies post therapy (9^th trial) leading to trials testing the stratification of therapy by these prognostic markers.

Understanding the biology of plasma cell dyscrasias

This research has encompassed basic laboratory research to evaluation of clinical trials. It has identified biomarkers predictive of survival in myeloma and of progression from MGUS to myeloma. Comparison of disease between diagnosis and relapse and of response between treatment cycles reveals intraclonal heterogeneities. A bank of serial samples from diagnosis to death on over 5,000 patients allows application of new technologies to understand the biology of disease.

Developing new immunodiagnostics

The development of new immunodiagnostics is a major aim for the CIS. Mark has played a key role in developing and demonstrating the utility of the first clinical test for serum immunoglobulin free light chains (FLC). This test was disseminated worldwide via a UoB spinout company Binding Site, and has been incorporated into the international guidelines for diagnosis and management of all plasma cell dyscrasias. Mark has developed a second generation of FLC tests based on monoclonal antibodies that provide improved laboratory and most importantly, point of care performance for management of myeloma, MGUS and related diseases.

Drug redeployment strategies in blood cancers

Mark's basic research into blood cancers with Chris Bunce and Farhat Khanim strives to understand the biology of these diseases whilst the imperative for new therapies has led them into redeployment based drug screening to identify potential drugs, understanfd their mechanism of action and test them in clinical trials.

Immunity and Infection

Understanding the physiology of immune responses and the constitution of immunity is a continuing theme in my research and clinical work. The focus has been on antibody responses and the utility of these responses to assess immune competence and to assess effect of physical and mental stress on immunity which has generated a body of over forty papers.

• MRC Myeloma IX, X, XI and MERIT, OPTIMAL, TEAMM Clinical Trials committees. NCRN Myeloma Trials Committee (2002 - present)
• Guidelines working Group of the UK Myeloma Forum on behalf of the British Committee for Standards in Haematology (1999 - present)
• Director Serascience a University spin-out company for immunodiagnostics (2011 - present)
• Founder Member of Scientific and Medical Advisory Board, Abingdon Health (2015 - present)