Professor Sylvie Freeman MBChB MRCP DPhil FRCPath

Institute of Immunology and Immunotherapy
Professor of ImmunoHaematology, Honorary Consultant in Haematology

Contact details

Address
Clinical Immunology Service
Institute of Immunology and Immunotherapy
College of Medical and Dental Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Dr Sylvie Freeman is co-director of the Clinical Immunology Service, leading Immunophenotyping for the diagnosis and monitoring of haematological malignancies. The service provides a unique interface between the University's substantial scientific expertise in immunohaematology and the clinical investigation and management of blood cancers and immunodeficiency in the NHS and for trials.

Dr Freeman’s research is focussed on predicting treatment resistance in acute myeloid leukemia and myelodysplasia principally by monitoring residual disease (MRD). She leads flow cytometric MRD detection for the NCRI acute myeloid leukemia trials and is part of the TMG of these trials. Sylvie is a member of the UK NCRI AML Working Party and European LeukemiaNet AMLMRD Working Group 

Qualifications

  • Certificate of Completion of Specialist Training (Clinical Haematology) - 2003
  • FRCPath (Haematology) - 2002
  • DPhil, University of Oxford - 1996
  • MRCP (London) - 1990
  • MB ChB (Hons), University of Birmingham - 1987

Biography

Dr Sylvie Freeman’s clinical interests are in the management of acute myeloid leukaemia and myelodysplasia and diagnostics of haematological malignancies. This with her background in myeloid research led to her laboratory translation research focus on predicting treatment resistance in these myeloid malignancies.

During Dr Freeman's clinical specialist haematology training at Oxford, she completed a MRC funded DPhil followed by a MRC Clinician Scientist award. She had a clinical attachment at UCL and finished her clinical training in Bristol before being appointed in 2000 as a clinical academic at Birmingham University and honorary consultant at University Hospitals Birmingham NHS Foundation Trust. She is a longstanding member of the NCRI AML working party and more recently the European LeukemiaNet AMLMRD Working Group.

NCRI AML trials are in effect a national care plan for AML therapy within the NHS. Her laboratory work in the framework of a national NCRI clinical trials collaboration addresses a key question; whether relapse prediction in AML and myelodsyplasia could be improved by sensitive detection of leukemia-specific markers. She has developed and implemented immunophenotypic assays to evaluate and monitor AML during chemotherapy and allogeneic stem cell transplantation, recently extending this to novel assays tracking leukemic stem cell enriched populations with national /international collaborators. Under her leadership the Birmingham University Clinical Immunology Service has established an international reputation for flow cytometric AML monitoring, acting as the hub reference laboratory in the UK.  Sylvie has a part time role at the WHIMM in Oxford that will build on joint expertise for developing AML monitoring assays. Collaborations with the molecular expertise at KCL, Cambridge and international colleagues are critical to optimise ‘fit for purpose’ precision assays that will best inform treatment of AML including for novel therapies.   

 

Teaching

TEACHING PROGRAMMES

  • MBChB - Foundations of Medical and Science Practice 3 Immunology and Haematology course
  • BMedSci  
  • MPharm 

Research

The heterogeneity of AML in terms of both disease biology and patient-specific clinical factors necessitates advances in personalised risk stratification to improve outcomes with present and future therapies.   Although not a common malignancy, treatment of patients with AML is disproportionately expensive particularly if patients have treatment intensified by stem cell transplantation. There are therefore major economic as well clinical benefits to be gained by better selection of patient-appropriate targeted therapies.

Laboratory work in the framework of a national NCRI clinical trials collaboration addresses a key question; whether relapse prediction in AML and high risk myelodsyplasia could be improved by sensitive detection of leukemia-specific markers.

The first study of MRD in older AML patients (NCRI AML16, CRUK funded) generated data (Freeman et al JCO 2013) that underpins MRD-directed therapy in older patients (NCRI AML18 trial). The collaborative analysis of younger patients in AML17 (NIHR funded, Prof Grimwade King’s College, London)) has produced important data on the prognostic relevance of molecular MRD (Ivey et al NEJM 2016) as well as flow cytometric MRD (Freeman et al JCO in press) that are now being implemented for MRD directed therapy in the younger AML patients (NCRI AML19. In addition to flow cytometric MRD monitoring by standard leukemic-aberrant-immunophenotypes there is a collaborative focus on developing novel assays tracking leukemic-stem-cell-enriched populations, mass cytometry deep phenotyping and combining genetic profiling with flow cytometric data. In collaboration with Prof Craddock / Prof Vyas (Oxford), the potential of LSC tracking in parallel with conventional MFC MRD pre and post allogeneic transplantation was established (Bradbury et al, Leukemia 2015) and is part of a prospective randomised RIC-transplantation programme (FIGARO trial, BloodWise funded). The group are also testing a simple assay that might identify prior to treatment AML patients unlikely to respond to standard intensive chemotherapy by blood frequency of stem-cell-like blasts (BloodWise funded, collaboration with Prof Russell/Prof Hills for NCRI AML18) and evaluate expression of cell surface molecules that are targets for established and novel antibody directed AML therapy (Khan et al Leukemia 2017)

Collaborations:

  • National:  Prof Russell (Nottingham), Prof Grimwade (Guys), Prof Hills and Prof  Burnett (Cardiff), Prof Vyas (Oxford), Richard Dillon (KCL), Prof Huntly (Cambridge) plus other members of UK AML working group
  • International: Schuurhuis/ Ossenkopele (VU, HOVON group, Netherlands), plus European LeukemiaNet
  • Pappaemannuil Memorial Sloan Kettering Cancer Center
  • College/UHB: Prof C Craddock

Other activities

  • Member of the UK NCRI Acute Myeloid Leukaemia Working Party
  • Member of Trial Management Group of NCRI  AML Trials (AML18, AML19, FIGARO)
  • Member of the European LeukemiaNet Acute Myeloid Leukemia MRD  Working Group
  • Honorary Consultant University Hospitals Birmingham NHS Foundation Trust
  • Honorary contract WHIMM, Oxford University

Publications

Ivey A, Hills RK, Simpson MA, Jovanovic JV, Gilkes A, Grech A, Patel Y, Bhudia N, Farah H, Mason J, Wall K, Akiki S, Griffiths M, Solomon E, McCaughan F, Linch DC, Gale RE, Vyas P, Freeman SD, Russell N, Burnett AK, Grimwade D; UK National Cancer Research Institute AML Working Group (2016) Assessment of minimal residual disease in standard risk AML. New England Journal of Medicine 374(5):422-33 (IF 55.87)

Khan N, Freeman SD, Virgo P, Couzens S, Richardson P, Thomas I, Grech A, Vyas P, Grimwade D, Russell NH, Burnett AK and Hills RK (2015) An immunophenotypic pre‐treatment predictor for poor response to induction chemotherapy in older acute myeloid leukaemia patients: blood frequency of CD34+ CD38low blastsBritish Journal of Haematology 170(1):80-4 (IF 4.7)

Grimwade D and Freeman SD (2014) Defining minimal residual disease in acute myeloid leukemia: which platforms are ready for "Prime Time"? Blood 124(23):3345-55 Invited Review article (IF 10.45)

Bradbury C, Houlton AE, Akiki S, Gregg R, Rindl M, Khan J, Ward J, Khan N, Griffiths M, Nagra S, Hills R, Burnett A, Russell N, Vyas P, Grimwade D, Craddock C and Freeman SD (2015) Prognostic value of monitoring a candidate immunophenotypic leukemic stem/progenitor cell population in patients allografted for acute myeloid leukemia. Leukemia 29(4):988-91 (IF 10.43)

Freeman SD, Virgo P, Couzens S, Grimwade D, Russell N, Hills RK and Burnett AK (2013) Prognostic relevance of treatment response measured by flow cytometric residual disease detection in older patients with acute myeloid leukemia. J Clin Oncol 31(32):4123-31 (IF 18.428)

Craddock C, Quek L, Goardon N, Freeman S, Siddique S, Raghavan M, Aztberger A, Schuh A, Grimwade D, Ivey A, Virgo P, Hills R, McSkeane T, Arrazi J, Knapper S, Brookes C, Davies B, Price A, Wall K, Griffiths M, Cavenagh J, Majeti R, Weissman I, Burnett A and Vyas P (2013) Azacitidine fails to eradicate leukemic stem/progenitor cell populations in patients with acute myeloid leukemia and myelodysplasia. Leukemia 27(5):1028-36 (IF 10.43)

Burnett AK, Russell NH, Hills RK, Kell J, Freeman S, Kjeldsen L, Hunter AE, Yin J, Craddock CF, Dufva IH, Wheatley K and Milligan D (2012) Addition of Gemtuzumab Ozogamicin to Induction Chemotherapy Improves Survival in Older Patients with Acute Myeloid Leukaemia. J Clin Oncol 30(32):3924-31 (IF 18.428)

Cobbold M, De La Peña H, Norris A, Polefrone JM, Qian J, English AM, Cummings KL, Penny S, Turner JE, Cottine J, Abelin JG, Malaker SA, Zarling AL, Huang HW, Goodyear O, Freeman SD, Shabanowitz J, Pratt G, Craddock C, Williams ME, Hunt DF and Engelhard VH (2013) MHC class I-associated phosphopeptides are the targets of memory-like immunity in leukemia. Sci Transl Med 5(203):203ra125 (IF 15.843)