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He was "Little Doc" to his boyhood neighbors in Prairie Hill,
Texas, where his father, a general practitioner, was the town's only physician.
"I'd go along on house calls and help in the office. I admired him
very much and always wanted to be a doctor," recalls E. Donnall Thomas,
MD.
During the Depression, medical school looked unaffordable, so he earned
BS and MS degrees in chemical engineering at the University of Texas,
where he met his future wife, Dottie, a journalism major. He says that
when he was able to enter Harvard Medical School, "It quickly became
apparent that we wouldn't see each other much, so [Dottie] went to Deaconess
Hospital in Boston and became a medical technologist."
Drawn to research, he completed an internship in hematology with Clement
Finch, MD, followed by two years of Army medical service in Europe, during
Germany's rebuilding. Before becoming a hematologist at Brigham Hospital
in Boston, he worked at Massachusetts Institute of Technology, studying
stimulants for yeast growth. "I was very interested in things that
stimulate bone marrow," Dr. Thomas comments.
In 1955, he was Physician in Chief at a Columbia University branch in
Cooperstown, New York, at a time when, he says, "Some crucial experiments
in mice indicated that bone marrow could be transplanted. For 15 years,
with healthy dogs as models to bridge the gap between mice and humans,
we worked out the basic problems of bone marrow transplants," he
explains. While some transplants were autologous, the greater challenge
was allogeneic transplants-those transplants from another dog. A few studies
were on dogs with leukemia or lymphoma.
He moved to the University of Washington in 1963 to work with Dr. Finch,
who had relocated there. Dr. Thomas was based at the Public Health Hospital,
but the radiation facilities were in an underground bunker in West Seattle,
where his team irradiated dogs. "Human subjects, with advanced leukemia
and all existing treatments exhausted, had to come to the same facility.
Our only successes were with identical twins."
Beginning allogeneic transplants in 1969, Dr. Thomas' team was greatly
encouraged when 13 of the first 100 patients became long-term survivors.
"This [result] made it possible, eventually, to do transplants earlier
in the progress of the disease. It was a dangerous procedure, which we
couldn't ethically do if another treatment was possible," he notes.
Investigators at Johns Hopkins University, the University of California
at Los Angeles, and the University of Minnesota soon began to study earlier
bone marrow transplants, which grew more widely available.
"For certain diseases and certain stages, It's now the accepted form
of treatment. For other diseases, its role is still being worked on, as
with so much of oncology," Dr. Thomas reflects. "We hope that
10 years from now, there will be many better therapies, so we can forget
about transplantation."
"A very interesting development has been the use of nonmyeloablative
transplants, without chemotherapy doses high enough to destroy bone marrow,"
he continues. "A fair number are now done on an out-patient basis.
Patients used to spend 60 days in the hospital," he marvels. For
about half of the transplants at Fred Hutchinson Cancer Research Center,
patients do not have to be admitted to the hospital unless complications
occur
"We give a low dose of radiation, accompanied by several immunosuppressive
drugs so the patient's immune system can accept the transplant. This was
implemented first at Hutchinson and at M.D. Anderson Cancer Center. It's
a great thing to see," Dr. Thomas admits. Most patients had chemotherapy
before becoming eligible for transplant. "We see the ones who weren't
cured. Depending on the type of leukemia, the cure rate ranges from 20%
to 80%."
Dr. Thomas was the first head of the University of Washington's Medical
Oncology division, from 1966 until 1985, as the department grew rapidly.
"In 1975, we moved into the new Fred Hutchinson Cancer Research Center,
where we had much better facilities," Recently retired, he participates
in Hutchinson conferences and fundralsing activities, and, "most
importantly, spends a good deal of time with young investigators here."
He has an office in the Thomas Building, opened in 1998, and he travels
a bit.
He and his wife celebrated their 60th anniversary in December. "At
every opportunity,
we've worked together. When we couldn't afford to hire technicians on
weekends, she did blood counts on patients," says Dr. Thomas. Thanks
to her journalism background, Dottie has helped her prolific spouse with
all his writing: about 1,000 published papers and the textbook, Marrow
Transplantation, now in its second edition. They joke about raising their
three children at Hutchinson; two became physicians.
Involved in ASCO since its early days, Dr. Thomas was nominated for ASCO
President in the mid-1980s, and he quips, "My oncology friends say
becoming President of the American Society of Hematology in 1988 was my
consolation prize." The Society honored him with David A. Karnofsky
Memorial Award in 1983, and he delivered his lecture, "Marrow Transplantation
for Malignant Diseases." He received the ASCO Distinguished Service
Award For Scientific Achievement in 1997.
Proud of his 1990 Nobel Prize in Medicine for his pioneering work in bone
marrow transplantation as a leukemia treatment (shared with Joseph Murray,
MD, HMS), Dr. Thomas considers his greatest thrill "seeing people
who were my patients back in the 1970s or 1980s. It's very gratifying."
"Don Thomas is equally admired for his pioneering scientific contributions
and the way in which he achieved his success," says Frederick Appelbaum,
MD, Director of Hutchinson's Clinical Research Division. "It is difficult
to think of many other fields of modern medicine that are so much the
result of a single man's work. His vision and dedication have changed
the lives of literally hundreds of thousands of patients."
Many of these articles
appear on the publication's website, which are often password-protected
or members-only. For your convenience, I've gathered them on my own
website. |
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