After reading last week’s coverage of Fred Appelbaum’s “Living Medicine: Don Thomas, Marrow Transplantation, and the Cell Therapy Revolution,” Jerome Yates, emeritus professor of oncology at Roswell Park Comprehensive Cancer, wrote a letter to the editor addressing the contributions of another leader in the field of bone marrow transplantation—George Santos.
A review of Appelbaum’s book was published in The Cancer Letter. The Cancer History Project also released an excerpt of the book and a podcast with Appelbaum.
As I read the recent issue of The Cancer Letter, I could not help but reflect on the environment around bone marrow transplantation in the early 1970s.
Don Thomas got much of the credit, but the other major leader in the field was George Santos—who was at Johns Hopkins. Don Thomas introduced the use of the radiation to ablate the leukemic bone marrow as the preparative regimen, but it was George Santos who introduced the use of high dose cyclophosphamide as a preparative regimen that did not require the two headed cobalt unit that Thomas had at the Mary Imogene Bassett hospital in Cooperstown.
I had them both to Roswell in about 1970 to critique our program—and both were pioneers. Thomas got the Nobel prize because of the volume and innovation, but in many ways, Santos did as much for the advancement of the therapeutic technique.
The other interesting thing about that time was that the chairman of Medicine at the University of Washington was an infectious disease guy (of FUO fame) by the name of Robert Petersdorf, who believed it was wrong to initiate antibiotic therapy, even in leukopenic patients, until you had the blood culture results back so that you could use targeted antibiotic treatment.
Don Thomas had a team of investigators, including a Master’s level microbiologist named Reginald Clift, and they all made rounds on their patients at Swedish Hospital in Seattle and did not subscribe to the infectious disease practices of Petersdorf.
Because we had platelet transfusions to manage bleeding in the leukemic patients, the aggressive management of infections was also a critical factor in facilitating the early success in the management of acute leukemia and transplantation.
Walter Hughes, who was an infectious disease specialist at St. Jude, Stephen Schimpff, who was at NCI at the time and subsequently became the dean of the medical school at the University of Maryland, and Gerald Bodey at NCI and subsequently at MD Anderson, were critical pioneers in the successful treatment of infections in leukopenic patients. The history project should include interviews with them if they are still alive. Certainly the fame of Don Thomas and his contributions should not obscure the contributions of George Santos.
