After 70 years of research and clinical trials, hematopoietic stem cell (HSC) transplantation has become a procedure that offers hope to many patients with cancer and other life-threatening diseases. In 2013 the Center for International Blood and Marrow Transplant Research reported 19,220 HSC transplants from United States (US) transplant centers. The number of HSC transplants performed in the US has increased every year since 1980, with a cumulative number of more than 200,000 autologous and 125,000 allogeneic transplants by 2014.
In the early 1950’s researchers studying the effects of ionizing radiation exposure discovered that animals and humans exposed to high doses of radiation, could be rescued by bone marrow grafts. Researchers also discovered that shielding the bone marrow allowed for repopulation of hematopoietic cells after exposure to high-dose radiation. Other studies showed the graft versus tumor effect that could be achieved by donor T cells attacking malignant cells in the transplant recipient.
These early studies led to the first transplants in humans in the late 50’s and early 60’s. Due to problems associated with HLA antigen compatibility and graft versus host disease (GVHD), most of these patients did not survive. In one study of 202 patients who received transplants, only three survived after six years. HSC transplants were discontinued in the mid 1960’s due to the high mortality rate of transplant recipients from GVHD and recurrence of their original cancer. A resurgence of transplants occurred in the late 60’s after new therapies to prevent graft rejection and chemotherapy agents that effectively destroyed malignant cells were developed.
In 1990, Dr. Edward Donnall Thomas and Dr. Joseph Murray shared the Nobel Prize for Medicine for their work in developing cell and organ transplantation. Dr. Thomas’ early work involved studying the effects of transplanting bone marrow into dogs that had been exposed to high doses of radiation. He discovered that transplants from littermates could replace the hematopoietic cells that had been destroyed by radiation. Dr. Thomas also developed a method to determine the tissue type of dogs that lead to development of similar methods to determine human HLA tissue typing. These research efforts created the knowledge for the first successful bone marrow transplants in humans in the late 60’s and early 70’s. In 1974 Dr. Thomas joined the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle and served as the Director of Medical Oncology and later was appointed Director of Clinical Research.
