At the time the Hutchinson Center was founded in 1972, basic research that would lead to the treatment we now know as bone-marrow or stem-cell transplantation had been in process for nearly 40 years. Transplants between identical twins, because they have identical genetics, had been successful for more than 10 years. However, many difficult challenges remained and advances were slow in coming. Recurrent leukemia, problems of graft failure, failure to eradicate the disease, infection and graft-vs.-host disease (GVHD) meant that the treatment was still a highly experimental last resort for the dying. When the Center opened its new facility in 1975, the primary clinical focus was the pioneering work of Dr. E. Donnall Thomas in bone-marrow transplantation. Thomas' work, which was considered radical at the time, had attracted scientists from around the world. The Center became the recognized leader in the field of bone-marrow transplantation. Since that time, the work of the Center has lead to many advances in the field.
The first successful transplant was performed by Dr. Thomas in Cooperstown, N.Y., in the late 1950s. The transplant involved identical twins, one of whom had leukemia. Because identical twins share the same genetic make-up, transplants between twins avoid the problems associated with non-twin transplants, such as graft-vs.-host disease. GVHD occurs when the transplanted cells (the graft) attack the patient (the host) as they would a foreign object or infection. In 1975, Thomas moved his research to Fred Hutchinson Cancer Research Center, where much of the developmental work on bone-marrow and blood stem-cell transplantation has been done. He received the Nobel Prize in physiology or medicine in 1990, along with Dr. Joseph E. Murray, who pioneered kidney transplantation.
It wasn't until 1968, in Minnesota, that the first successful non-twin (allogeneic) transplant was performed. In this case, the donor was a sibling of the patient. By this time, it was known that a key to a successful transplant was a specific type of genetic matching (known as HLA) of the donor to the patient. Because siblings receive DNA from the same parents, a sibling is the most likely person to be a good match. Having a closely matched donor can help avoid graft-vs.-host disease. However, many people do not have a sibling who is HLA-matched. In this situation, an HLA-matched unrelated donor can be used.
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History of bone marrow transplant
The first successful unrelated donor transplant took place in 1973 in New York when a young boy with a genetic immunodeficiency disorder received multiple marrow transplants from a donor identified as a match through a blood bank in Denmark. The first successful unrelated donor transplant for a patient with leukemia took place in 1979 at the Hutchinson Center.
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In 1979, Laura Graves, a 10-year-old patient with leukemia, was referred to the Hutch. Laura did not have a matched donor in her family, so center staff searched through their database of platelet donors in an attempt to find a match. Luckily, one of the laboratory staff turned out to be a good match. Laura's transplant was successful, and she did not develop graft-vs.-host disease. Although Laura died two years later of recurrent leukemia, the Graves family continued to lead an effort to establish a national registry of people volunteering to be bone-marrow donors. The National Bone Marrow Donor Registry, as it was called initially, was federally funded in 1986, and in 1987 the first donor match was made. Today, the national registry is called the Be The Match Registry, operated by the National Marrow Donor Program/Be The Match, and it includes a network of donor centers, transplant centers and other registries in 41 countries. It is the world’s largest and most diverse donor registry with more than 11 million potential marrow donors and 193,000 cord blood units.