Rainer Storb is giving us a brief outline of his keynote lecture for the upcoming EBMT Annual Meeting.
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Rainer Storb is giving us a brief outline of his keynote lecture for the upcoming EBMT Annual MeetingProfessor Rainer Storb in front of the chalk board that was originally in the office of his mentor, Don Thomas, when Rainer joined his lab as a senior research fellow in 1965. They planned all of their initial experiments on that board. The writing represents a series of (ultimately failed) experiments on producing bi-phenotypic antibodies to lymphocyte checkpoints including CD 28.
By 1965, clinical marrow transplantation was nearly dead. All reported human marrow grafts had failed. Patients had died from complications which included immune reactions that were not predicted from studies in inbred rodents. Nearly all investigators abandoned the field, which was considered a dead end. A handful of intrepid laboratories continued systematic studies of the biology of transplantation, to a large extent carried out in outbred, large animals, which set the stage for renewed, and ultimately successful, efforts to treat patients with otherwise fatal hematological diseases. The importance of matching for major tissue antigens was recognized. Methods were developed to mitigate or minimize immunologic graft-vs.-host reactions. Diagnostics and treatment of bacterial, fungal and viral infections evolved. The principle of allogeneic graft-vs.-tumor effects was established. These graft-vs.-tumor effects form the therapeutic basis of recently developed minimal-intensity conditioning protocols which have enabled extending hematopoietic cell transplantation to include older patients and those with medical comorbidities. This overview will show how, after 50 years of investigations into the use of hematopoietic cell transplantation for therapy of malignant and nonmalignant blood diseases, this procedure has progressed from one that was thought to be plagued with insurmountable complications to a standard treatment for many hematologic disorders. Transplantation has become a mainstay in medicine. Since 1969, more than 1 million transplants have been performed around the world. The observations describing the power of the immune system to eliminate cancer by graft-vs.-tumor effects are now bearing fruit in the modern field of cancer immunotherapy.