Bone marrow transplantation: Dottie Thomas, primary sources, and controversies

Dottie Thomas, deemed the “mother of bone marrow transplantation,” died Jan. 9, 2015 at her home near Seattle. She was 92. 

Thomas was also the wife and research partner to 1990 Nobel laureate E. Donnall Thomas

The Thomases formed the core of a team that proved bone marrow transplantation could cure leukemias and other blood cancers, work that spanned several decades.

“Dottie’s life had a profound impact, not just on those who knew her personally, but also countless patients,” said Fred Hutch President and Director Gary Gilliland, who became friends with the Thomases when he and Don served on the advisory board of the José Carreras Leukaemia Foundation.

Dottie Thomas may have gotten the name from the late George Santos, a bone marrow transplantation expert at Johns Hopkins University and a professional colleague. “If Dr. Thomas is the father of bone-marrow transplantation, then Dottie Thomas is the mother,” he once said

Dottie was a journalism major in college when, in March 1943, Don was admitted to Harvard University Medical School under a U.S. Army program. Dottie got a job as a secretary with the Navy while Don attended medical school.

“Dottie and I talked it over, and we decided that if we were going to spend time together, which it turned out we liked to do, that she probably ought to change her profession,” Don told The Seattle Times. “She’d taken a lot of science in her time in school, much more than most journalists. She liked science.”

Robert W. Carlson: Those of us on the breast cancer panel, being more disease-related experts rather than modality experts, were concerned that the appearance of superiority of transplantation in the non-randomized trials was based upon unconscious, [and] sometimes probably conscious, evaluation by the treating physicians, that they were essentially selecting a healthy cohort, that someone who looked like they could handle a therapy as strong or as aggressive as transplantation was a healthy cohort patient, and we should expect them to do better.

And so, it became a discussion on are these results the result of selection bias and using historical controls that were not selected in the same way? Or was this really a difference in the effectiveness of the therapies? It was a spirited, let’s say, discussion, with substantial disagreement; sometimes got heated.

At one point in time, I looked at the person who was leading the transplant presentation, and just looked at him and said, “If that’s really what you think, then we’re done. We’re done.”

And I collected my stuff and headed for the door. And Rodger, bless his little soul, ran over to the door, literally locked the door, and turned around and said, “You can’t leave, Bob. You’ve got to stay.”

It digressed into a non-scientific discussion, and if we’re going to do this based upon opinion, then that’s not the way you get on our breast cancer guideline.

Every three minutes, someone in the United States is diagnosed with a blood cancer. These cancers, which include leukemia, lymphoma, multiple myeloma, and many others, account for nearly 10% of all new cancer cases, according to the Leukemia Research Foundation. 

The Leukemia and Lymphoma Society estimates that 1.3 million Americans are living with, or are in remission from, leukemia, lymphoma, or myeloma.

“Every week our staff sits down together and offers the best to our patients, whether it’s chemotherapy, radiation, immunotherapy, stem cell transplant, bone marrow transplant, cellular therapy, or a combination of all of them,” said Henry Chi Hang Fung, MD, FACP, FRCPE, chair of the Department of Bone Marrow Transplant (BMT) and Cellular Therapies at Fox Chase. Fung has more than 30 years’ experience working with thousands of patients undergoing transplants. Among many other honors, he is consistently listed by Castle Connolly and Philadelphia magazine as a top doctor in hematology and cancer.

The department, which was recently formed from the Fox Chase-Temple University Hospital Bone Marrow Transplant Program, treats patients with different types of blood cancers. It also provides bone marrow and stem cell transplantation and cellular therapies to patients with blood disorders and other life-threatening diseases with the goal of improving their long-term outcomes.

City of Hope’s bone marrow transplant program recently performed the procedure on its 15,000th patient, a remarkable milestone considering that the initiative started with just two physicians, three beds and guarded expectations in 1976.

Forty-three years ago, a young college student from Indiana was admitted as a patient and became the hospital’s first successful bone marrow transplant.

In October of that year, the student, then 27, received the devastating news from his physician that he had acute myeloid leukemia (AML). In those days, an AML diagnosis was grim. Bone marrow transplantation (BMT) as a cancer treatment was still primitive and not in wide practice. At the time, City of Hope was one of only six medical centers in the United States offering it.

The student’s doctor advised the young man to get his affairs in order, and he broke the devastating news to his family. It was a cousin, a doctor living in Los Angeles, who told him she knew of a cancer treatment center in nearby Duarte that had just launched a program for BMT.