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My
father, Dr. Edward E. Thomas was born in 1870 and moved to Texas with
his family in a covered wagon in 1874. He grew up in frontier Texas and,
with almost no formal schooling went to the University of Louisville,
Kentucky, where he received his M. D. His 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. He was a solo general practitioner in our
small Texas village. Thus, together we span the time from horse and buggy
house calls to modern high-tech medicine.
My high school class consisted of about 15 people. I was not an outstanding
student even in this small group. I entered the University of Texas in
Austin in 1937. In my first semester I made only B grades, but as time
went on and the courses became more difficult and challenging I began
to enjoy the studies, mainly in chemistry and chemical engineering. I
received a B. A. in 1941 and an M. A. in 1943.
During my undergraduate
years at the end of the depression money was almost non-existent so I
worked at a number of odd jobs. One of the jobs was waiting tables at
a girls' dormitory. One January morning it snowed, a rare event in Texas.
As I emerged from the girls' dormitory, an attractive young woman hit
me in the face with a snow ball. I naturally had to catch her and avenge
the insult to my male ego. Thus, I meet Dorothy Martin, the Dottie who
has participated in all my endeavors up to the present time. We have 3
children, Don Jr. who practices internal medicine in Montana, Jeffrey
who is in business in Seattle and Elaine who is a Fellow in infectious
diseases at the University of Washington. We have eight grandchildren.
I entered Harvard Medical School in 1943. During medical school Dottie
abandoned her journalism work to enter training as a laboratory technician
while working to help support us. Her training in writing, laboratory
technology and library science has been invaluable in our work. I received
the M. D. in 1946.
There followed
an internship, a year of hematology training under my life-long friend
Dr. Clement Finch, two years in the army, a year of postdoctoral work
at Massachusetts Institute of Technology, two years of medical residency,
the last as the chief medical resident at the Peter Bent Brigham Hospital
in Boston. During that time Dr. Joseph Murray was a surgical resident
and we have been friends and colleagues over the years because of our
common interests in transplantation. I was on the wards of the Brigham
and helped care for his first kidney transplant patient.
During medical
school I became interested in the bone marrow and in leukemia. This interest
was intensified by my early association with Dr. Sydney Farber who gave
me my first laboratory in the new Jimmy Fund Building. I was fortunate
to see the first child with acute lymphoblastic leukemia (ALL) whose remission
was induced with an anti-folate drug. I became interested in factors that
stimulate marrow function in part due to Allan Erslev's attempt to demonstrate
erythropoietin. During my year at M.I.T. I worked under Dr. John Loofborrow
on stimulating factors released from irradiated yeast. I hoped to apply
this knowledge to marrow stimulating factors. Fortunately I left the field
of stimulating factors because it is only in recent years, with recombinant
technology, that great strides have been made in this area.
I had been intrigued by the studies of Dr. Leon Jacobsen et al. who demonstrated
that shielding the spleen would protect mice against otherwise lethal
irradiation and the subsequent demonstration by Egon Lorenz et al. that
a marrow infusion was also protective. These observations were initially
thought to be the result of stimulating factors. In 1955, Main and Prehn
published their paper showing that a mouse protected against lethal irradiation
by a marrow infusion would accept a skin graft from the marrow donor.
Their study and the demonstration by Ford et al. using cytogenetic technology
of donor chromosomes in such mice made it suddenly clear that the irradiation
protection effect was due to the survival of living bone marrow cells.
In 1955, at
the invitation of Dr. Joseph Ferrebee I went to the Mary Imogene Basset
Hospital in Cooperstown, N. Y., an affiliate of Columbia University. Immediately,
we began to work on marrow transplantation in human patients and in the
dog, as an outbred animal suitable for clinical care comparable to human
patients. Except for an occasional patient with an identical twin, we
quickly learned that allogeneic marrow transplants in man were going to
be very difficult. Joe Ferrebee and I and our young colleagues concentrated
on working with our dogs on many aspects of marrow transplantation. The
long cold winters, absence of commuting problems and opportunity for long
discussions were conducive to our work. Those years had a deep and abiding
influence on subsequent work since most of the basic concepts were laid
out during that time.
In 1963 I moved to Seattle at the invitation of Dr. Robert Williams, a
famous endocrinologist and first chairman of the Department of Medicine
at the University of Washington. Professor Williams recognized that our
School of Medicine was in its infancy and rather isolated in the Pacific
Northwest. He envisioned the affiliation of all the relevant institutions
in the area with the School of Medicine in order to create the critical
mass necessary for academic excellence. Within that concept I established
my program in the Seattle Public Health Hospital.
The rest of
the story seems short in retrospect. The recruitment of some brilliant
young co-workers who still work with me, studies of immunology and irradiation
biology in the dog, borrowing knowledge of human histocompatibility from
Amos, Payne and Dausset, the assembly and training of a critical care
team of nurses, and, finally, the demonstration that some patients with
advanced leukemia, aplastic anemia or genetic diseases could be cured
by marrow transplantation.
Our team of physicians and nurses proved to be stable and dedicated. We
did face problems that at times seemed almost insurmountable. In 1972,
the Seattle Public Health Hospital was faced with closure by the federal
government. After many conferences with the Dean of the School of Medicine,
it was apparent that we could not move to the University of Washington.
We found temporary space at Providence Hospital for a two year period.
In 1975 our team moved into the Fred Hutchinson Cancer Research Center
which provided superb facilities and the opportunity to expand the program
with the cooperation of the Swedish Hospital Medical Center. While continuing
laboratory and animal research, our team has now carried out more than
4,000 human marrow transplants.
It is always diffcult to identify the many threads that make up the fabric
of a life's work. I know that my philosophy and ideas have been heavily
influenced by more than 20 years of daily interaction with a small group
of colleagues, all of whom are now distinguished scientists in their own
right. Bob Epstein, Rainer Storb, Dean Buckner, Reg Clift, Paul Neiman
and Alex Fefer were with me at the start of the Seattle adventure, and
all except Bob are still my daily companions. Ted Graham moved with me
from Cooperstown and has played an essential role in our animal research.
Along the way we were joined by Joel Meyers, Fred Appelbaum, John Hansen
and many others who made major contributions to the achievements honored
by this award. From
Les Prix Nobel 1990.
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