The Asco Post

From Small-town House Calls to Bone Marrow Transplants, Nobel Laureate Continues Father’s Legacy

By Ronald Piana
June 15, 2012, Volume 3, Issue 9, Supplement 2

Figures:

“I echo the sentiments of many previous Nobel laureates when I say that the success we celebrate today was made possible by the work of many others in this and in related fields.”

So ended the Nobel Lecture by E. Donnall Thomas, MD, the famed investigator and 1990 Nobel Laureate in Physiology or Medicine who pioneered bone marrow transplantation, marking a new era in the treatment of leukemia and other blood malignancies.

Humble Beginnings

Dr. Thomas was born in the sun-scorched farming town of Mart, Texas. He remembers his father—a general practitioner—as a kind and tireless family doctor who spent long hours driving country roads to see patients during the smallpox epidemic. “My father took me on house calls, and I decided to go into medicine when I was about 5,” Dr. Thomas remarked.

Mart was a dot on the vast rural landscape and Dr. Thomas attended grade school in Prairie Hill in a one-room structure with about 20 classmates, most of whom were children from nearby farms and ranches. “The school didn’t have highfalutin trappings, but we got a sturdy education in all the basics,” Dr. Thomas said.

In 1933, his family moved to Coolidge where he went to high school. In 1937, Dr. Thomas went to the University of Texas in Austin as a chemistry major. “During my second year, my father was returning from a nighttime house call when he crashed into a farm truck that was stalled on the dark road. He was killed instantly. Along with the grief of losing such a good father, his death left us without any viable support. I thought I’d have to quit college, but fortunately I was able to pick up work waiting tables in the girl’s dormitory,” Dr. Thomas said, noting that at the time, the nation was still in the grip of the Great Depression and jobs were scarce.

Despite the emotional and financial hardships, good fortune came like a change in the weather. “A young student named Dorothy Martin appealed to me greatly and we hit it off, literally. During a freak snowstorm in Austin, I was leaving my shift at the dorm dining room and pow! a snowball smacked me in the head. I turned and there was Dottie, smiling. We married 2 years later,” Dr. Thomas said, adding that Dottie would work with him in the lab throughout his career.

The Road to Medical School

Dr. Thomas received a BA in chemistry in 1941 and an MA in chemical engineering in 1943. It was time to consider medical school, an almost untenable proposition for the young couple. After the United States’ entry into World War II in 1941, the U.S. military needed to increase the number of doctors in their ranks and thus launched the Army Specialized Training Program. “I had an army reserve commission, so it seemed natural to stay in the service and go to medical school and, thanks to Uncle Sam, finally stop worrying about money,” Dr. Thomas said.

“Dottie and I decided that as long as the Army was paying for my education, why not try for a more famous school. I applied to Johns Hopkins and Harvard. Lo and behold, two weeks later a telegram from Harvard said that I’d been accepted—but the first class started in 10 days. So Dottie and I sold our few possessions and took the train to Boston, arriving in 8 inches of snow wearing sneakers,” Dr. Thomas said. Years later, he remembered how Worth Hale, MD, the Dean of Admissions at Harvard Medical School, quipped, “The main reason we accepted you was so we could get a look at this Texas guy who had the nerve to apply to Harvard 10 days before the start of the first semester.”

After graduating from Harvard Medical School in 1946, Dr. Thomas did a hematology internship with Clement Finch, MD, at the Brigham Hospital. “Dr. Finch was a first-class mentor and he stimulated my interest in all aspects of clinical medicine, not just hematology. We also became lifelong friends. At the time, I had several patients with acute leukemia and I became very interested in things that stimulate bone marrow,” he said, pausing. “As for pivotal things that steered my career path, well, I really just followed my nose. There’s a certain amount of luck that goes with a success,” Dr. Thomas commented with characteristic humility.

Pioneer in Bone Marrow Transplant

A dizzyingly busy period in Dr. Thomas’s life ensued. He spent a year completing his army medical service requirements in postwar Germany, a year of postdoctoral work at Massachusetts Institute of Technology, and 2 years of medical residency (the last as the Chief Medical Resident at the Peter Bent Brigham Hospital in Boston). In 1955, he was Physician-in-Chief at the Columbia University branch in Cooperstown, New York. “We immediately began to work on marrow transplantation first in dogs, as outbred animals suitable for clinical care comparable to human patients, and later in human patients. Except for an occasional patient with an identical twin, we quickly learned that allogeneic marrow transplants in humans were going to be very difficult,” Dr. Thomas said.

Then, in 1963, the famous endocrinologist Robert Williams, MD, invited Dr. Thomas to join the faculty of the University of Washington School of Medicine. “Dottie and I packed up and moved to the Pacific Northwest. Dr. Williams understood that the school was in its infancy and initiated an affiliation of all the relevant institutions in the area. It was within that framework that I established my research program in the Seattle Public Health Hospital,” Dr. Thomas explained.

He said that after establishing the  Seattle program, he was fortunate to recruit a host of brilliant young coworkers. “The rest of the story—demonstrating that some patients with advanced leukemia, aplastic anemia, or genetic diseases could be cured with bone marrow transplant—seems a bit short in retrospect. That said, I do acknowledge that my work and philosophy have been heavily influenced by a wonderful group of dedicated colleagues,” Dr. Thomas said.

A Father’s Legacy

Dr. Thomas noted that his father moved to frontier Texas with his family in a covered wagon in 1874. With almost no formal schooling he went to the University of Louisville, Kentucky, where he received his MD. “My father’s first wife died of tuberculosis, and I was the only child of his second wife. He was 50 years old when I was born on March 15, 1920. So in the course of one generation, my father and I journeyed from horse-and-buggy house calls to high-tech scientific procedures such as bone marrow transplants,” said Dr. Thomas, whose scientific contribution ranks among the most significant medical advances of the 20th century. ■

Disclosure: Dr. Thomas has no potential conflicts of interest to disclose.

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