TRAILBLAZERS AND LIFESAVERS

The past 50 years have seen the rise of one of the most remarkable medical achievements of all time; stem cell transplantation.

Not so long ago, the science behind this lifesaving treatment hadn't even been dreamt of. But thanks to the work of dedicated researchers, groundbreaking thinkers, and courageous activists, more than one million stem cell or bone marrow transplants have now been performed worldwide.

In this timeline, we tell the stories of the people who made stem cell transplants a reality, while looking at the place of Anthony Nolan (the world’s first bone marrow donor register) in transplant history.

1908

Alexander Maximow, a scientist and doctor working in St Petersburg, Russia, develops the theory that all blood cells are created from the same 'builder cell', which can evolve into different varieties of blood cell. He invents a new name for these builder cells – stem cells.

After the massive social upheaval of the Russian Revolution, Maximow leaves his homeland behind, continuing his research at the University of Chicago.

1945

In the final stages of the Second World War, the United States drops atomic bombs on the cities of Hiroshima and Nagasaki.

The ensuing devastation kills more than 120,000 people. Survivors are often affected by radiation sickness in the long-term; medical scientists note a sharp increase in leukaemia cases among the victims.

In the years to come, researchers from across the world will study the possibility of a cure for this new condition.

By transplanting unaffected stem cells (taken from bone marrow) into a radiation victim, they theorise, it should be possible for the patient's body to begin creating new, healthy blood cells once more.

1957

'The leukemic patient who needs radiation and bone marrow, and the uremic patient who needs a spare kidney, are people who deserve immediate consideration.'

Edward Donnall Thomas, a Texan doctor and researcher, is one of these pioneers, carrying out research into stem cell transplantation with funding from the Atomic Energy Commission.

In 1959, he carries out the first human bone marrow transplant, taking healthy stem cells from one identical twin in the hopes of curing their sibling's leukaemia.

The transplant is a success at first – but just a few months later, the patient’s blood cancer returns.

1958

'These structures are, in fact, the identity card of the entire organism.'

Meanwhile, two scientists, Jean Dausset and Jon van Rood, separately make a startling find; a certain protein that appears on most of the body’s cells.

These ‘HLA-proteins’ are used by the body’s immune system to identify which cells belong there, and which cells are intruders to be fought off (if they’re virus cells, for example).

So for a bone marrow transplant to be a long-term success, the donor and the patient would need to have matching HLA-proteins, to ‘trick’ the patient’s body into accepting the new stem cells.

1963

'The only thing we know is that we have a given time to life; let's be happy and help others to be happy too.'

In 1959, after a nuclear reactor accident in Yugoslavia, four physicists are left dangerously sick from radiation poisoning. Another French scientist and Resistance veteran, Georges Mathé, conducts a successful bone marrow transplant to save their lives.

Four years later, he shocks the medical world by announcing the successful use of a transplant to cure a patient’s leukaemia.

Once again, however, the patient dies after 20 months – apparently from infection, but another setback in the pioneers’ progress.

All four men will spend the rest of their lives dedicated to the cause of transplantation; both Thomas and Dausset will eventually receive a Nobel Prize in Medicine for their achievements.

1973

'We were still in the Jurassic period...it was pioneering stuff.'

The doctors’ failure to keep bone marrow transplant patients alive in the longer term could easily have become an insurmountable obstacle.

But a decade later, a 21-month-old boy called Simon Bostic receives a transplant from a stranger to treat his chronic granulomatous disease (a rare genetic disorder that affects the immune system) – the first procedure of its kind in the UK, and the first successful unrelated bone marrow transplant in the world.

Over 40 years later, Simon is still alive – thanks to decades of groundbreaking research and a donor who was only found after a highly-publicised worldwide search.

1974

'Anthony was a symbol of hope. If his tragic death is to have any meaning, I implore everyone to help ensure that we give life to others.'

One of the people who sees Simon’s story from across the globe is Shirley Nolan in Australia, whose newborn son Anthony has a rare immune system deficiency.

Travelling to London, Shirley begins fighting to find a donor for Anthony – however, none can be found with a matching HLA type. With time running out, she lobbies the medical establishment to form the world’s first bone marrow donor register.

Men and women from across the UK give a blood sample, and their HLA types are stored on a national database in case they’re ever a match for a patient in desperate need.

More than four decades on, Anthony Nolan has over 550,000 potential donors on its register.

1979

In the USA, a ten-year-old girl called Laura Graves needs a bone marrow donor to treat her acute leukaemia. Remarkably, one is found at the Fred Hutchinson Cancer Research Centre in Seattle.

Laura relapses two years later, but her family campaigns for the creation of a national donor registry like the one already established in the UK.

However, pending new laws passed by Congress, it isn't until 1986 that the United States forms the National Bone Marrow Donor Registry – later known as Be The Match.

1982

Despite a growing number of volunteer stem cell donors on registries worldwide, a match still cannot be found for many patients – particularly those from mixed-race or minority backgrounds, who have a smaller chance of locating the right HLA type.

A researcher in Indiana, Hal Broxmeyer, suggests that immature (and therefore unformed) stem cells in umbilical cord blood can be used in transplants for patients who would otherwise be left without a chance of life.

In 1988, Broxmeyer's colleague Eliane Gluckman performs the first cord blood transplant to help a five-year-old boy with aplastic anaemia in France; the procedure, happily, is a complete success.

At Anthony Nolan, we now have a cord blood bank and four cord collection centres in the UK, and over 4,000 cords banked.

1983

An Australian team of researchers led by Donald Metcalf discover 'granulocyte-colony stimulating factor' (GCSF) – the protein which stimulates bone marrow to release stem cells into the bloodstream.

Further research finds an ingenious use for this protein. If doctors give a donor a large dose of GCSF, millions of stem cells will enter their bloodstream – enough to be extracted directly, as if the donor was giving blood.

Simpler, more convenient, and less painful than taking stem cells from the bone marrow, this process will make the experience far easier for the vast majority of donors.

1988

Three major figures of stem cell transplantation come together to form a united global organisation: Edward Donnall Thomas (representing the USA), John Goldman (Anthony Nolan's medical director, representing the UK), and Jon van Rood (representing the Netherlands).

The World Marrow Donor Association (WMDA), as it comes to be called, will grow rapidly over the next two decades, sharing donor information and vital research between different countries, and establishing legal and ethical guidelines for the field.

1990s

The days of the stem cell pioneers may be over – but a united, worldwide community of researchers, doctors, nurses and charities continues to work towards a better future.

From the 1990s, patients who relapse after their transplant can be given an infusion of lymphocytes (a particular kind of white blood cell in the immune system) to attack cancer cells, hopefully removing the need for a second transplant.

2013

'It's quite shocking to think I’m the youngest ever. You’re never the first to do anything nowadays.’

2013 sees two incredible milestones in the UK, signalling just how far stem cell transplantation has come.

At 75 years old, ex-Olympian athlete Alf Meakin becomes the oldest person in the country to receive a transplant (just a quarter-century before, even a 50-year-old was considered dangerously old).

And at 17 years old, Victoria Rathmill becomes the youngest person in the world to donate her stem cells and give a stranger a second chance of life.

2015+

'But our work is not done.'

By 2015, there are 25 million potential stem cell donors in 53 nations across the face of the planet.

A movement that began in the fires of global conflict has become a powerful expression of global collaboration; nearly half of all transplants now involve a patient and a donor from different countries.

As patients across the world continue to search for a match (over 225,000 searches in 2014 alone) our scientists work harder than ever to reach the next lifesaving phase of stem cell transplantation.

The future awaits.