There was a time when the cure for leukemia was almost as lethal as the disease. Before bone marrow transplants, patients were treated with arsenic or radiation — and the outlook was often considered hopeless.
Then a young doctor had a radical idea that would change the course of cancer treatment. Dr. E. Donnall “Don” Thomas was convinced that destroying abnormal bone marrow with radiation and replacing it with healthy marrow could significantly help patients.
Dr. Fred Appelbaum, deputy director of the Fred Hutchinson Cancer Research, worked with Thomas. He says it was a spectacular idea at the time, but almost nothing was known about how to do it.
“If you could do that, then you can cure all diseases of the bone marrow," Appelbaum said.
Bone marrow transplants initially worked on identical twins because their tissues matched. But for the vast majority of patients there were no options.
Thomas wanted to find a way, though the medical community largely agreed it was impossible.
“They thought it would never work,” Appelbaum said. “They thought he was out of his mind. Really, some of the things written weren’t very flattering.”
In the mid 1950’s, Thomas tried the procedure on patients who didn’t have identical twins. It failed due to two major challenges: the patient’s body rejecting the new bone marrow, and the bone marrow rejecting its new host. Thomas went back to the lab.
Then he got an invitation that would prove critical to his career. In 1963, he left Cooperstown, New York, to join the University of Washington’s fledgling med school. He was recruited to head its oncology division at a time when the Northwest was still relatively isolated for medical research.
Thomas continued his work on marrow transplantation at the UW, until a second major development forged a path for his work. President Richard Nixon signed the Cancer Act of 1971, creating cancer research centers around the country. One of those centers was the Fred Hutchinson Cancer Research Center in Seattle.
Thomas joined the Hutch in 1974. Four years later, he and his colleagues performed their first transplant from an unrelated donor. It was a success.
“It was for a young girl who had leukemia, and from then we helped build the first National Marrow Donor Registry,” Appelbaum said.
The procedure was still hard on patients, leaving them feeling nauseous, unable to eat, and susceptible to infections. But that success gave researchers insights that would lead to advances. Today, instead of spending weeks in the hospital, marrow transplants are an outpatient procedure.
Now, Thomas' unconventional idea is standard procedure for treating blood cancer. Luke Timmerman, found and editor of the Timmerman Report, says Seattle provided the right environment for that idea to grow.
"We've seen this in multiple industries — Boeing and Microsoft — these were founded by people who had rather strange ideas out of the mainstream," he said. "And Seattle, without a lot of people telling you, you can't do that, was fertile environment for people to test their quirky ideas."
In 1990, Thomas received the Nobel Prize for his work in bone marrow transplantation. But Appelbaum said Thomas was quick to deflect praise.
“He always mentioned the fact that the nurses were his secret weapon in his struggles,” he said. “And he was very thankful for the families and patients who had participated in all the research. He was a very gracious man.”
Thomas died in 2012, but his legacy lives on. What started as an idea is now used to treat an estimated 70,000 people worldwide each year.