Since 1989, Dr Walker has worked with haematologists to provide expert care to patients with thalassaemia and sickle cell anaemia. By establishing a special clinic devoted to patients with these disorders, clinical care and research has advanced. A collaborative project, between UCH and the Brompton Hospital, led to the development of the now accepted methodology of measuring myocardial iron content using magnetic resonance imaging (the cMR T2* parameter); many other projects, including the first randomised placebo controlled treatment trial in thalassaemia have been undertaken by this collaboration with Professor Dudley Pennell.
The increased ability to detect pre-clinical disease using T2*, has been credited with helping to change the outlook for these patients, with a recorded large fall in mortality (>70%) for patients with thalassaemia in the decade following the introduction of this non-invasive method of measuring tissue iron overload.
Dr Walker serves as a Scientific Adviser for the international association Thalassaemia International Federation (TIF), which is supported by the World Health Organisation (WHO) and has a very active programme of support, education and intensive political lobbying to improve the outlook for the hundreds of thousands of patients with the inherited condition of thalassaemia, 80% of whom live in the poorer nations of the world.
Malcolm has provided pro-bono clinical services to the India Thalassaemic Society, by undertaking clinics in India on an annual basis. These clinics also serve as a launching point for setting locally appropriate standards of cardiovascular investigation and care.
In 2013, Dr Walker was asked to join an expert panel of the American Heart Association to prepare a consensus document defining the standards of clinical cardiology care for thalassaemia major; this work was published in Circulation, the world’s premier scientific journal for cardiovascular disease.
Malcolm worked with Professor John Wood, of the University of Southern California, to produce the updated cardiology guidelines, published by TIF.
You can view a video of Dr Walker talking about his work with inherited blood disorders here: