E. Donnall Thomas, M.D.

By Carol Milano





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.