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Future predictions for stem cell research

Shaun McCann is a man responsible for carrying out the first ever bone marrow transplant in Ireland, in 1984. We got to know Shaun in an interview and discussed his formative years, the risks involved in the early days of stem cell transplants, and the trials he has faced in over four decades of medicine. As the author of A History of Haematology: From Herodotus to HIV, he also told us about the specialty as a whole – defining discoveries, unsung heroes – and gave us his predictions for the future of stem cell research.

Can you tell us about your early years as a doctor?

I spent all of my adult life (after graduation from Medical School at University College, Dublin), working in haematology. The formative years of my training were at the University of Minnesota and the University of Washington. I learnt to be a stem cell (although it was bone marrow then) transplanter from the late E. Donnall Thomas (a Nobel Prize laureate for stem cell transplantation) at the Fred Hutchinson Cancer Centre in Seattle. The best decision I ever made in these ‘early years’ was to marry my wife – who was a fellow medical student.

What made you decide to specialise in Haematology?

It’s hard to remember what made me decide to specialise, but I think it was the combination of a strong scientific basis combined with clinical medicine. I like to remember that every time you take a blood sample, you are in fact, taking a biopsy of a mesenchymal organ called blood!

You carried out the first ever bone marrow transplant in Ireland, in 1984 – can you tell us more about this?

In the 1980s, stem cell transplantation was not available in Ireland. However, my boss at the time heard a lecture from E. Donnall Thomas – and suggested that it should be. He formed a charity with a patient, the late Eugene Murray. Alongside a number of business men, they raised the money to send me to Seattle, and to fund the Stem Cell Transplantation Programme. After that, bone marrow, now stem cell, transplantation took over my life.

Bone_marrow_biopsy
Image Credit: ‘A bone marrow harvest in progress’ from the Navy News Service (US Navy). Public Domain via Wikimedia Commons.

What were the risks associated with this new operation?

It was very stressful at first, as it involved persuading virtually all hospital departments to ‘come on board’. We were doing something against all medical rules – i.e. taking well patients and transplanting them because we thought their leukaemia would relapse. It was traumatic for staff and patients and unfortunately some patients died.

How was your work received at the time?

Because we were doing something new, and relatively un-tested, many people needed persuading. I did a lot of fundraising for a charity which supported all aspects of the transplant programme. This involved a lot of travel within Ireland and the consumption of many pints of Guinness. My outstanding memories are of raffling a heifer (a cow that has never had a calf) in a small Irish town, and sharing the singing stage with the late Liam Clancy of ‘The Clancy Brothers’ (a very famous folk singer in Waterford). The transplant programme was opposed by the Department of Health, and the hospital we were working at tried to stop the programme after the first two years because of the expense. The programme was saved after I launched a public campaign for its preservation.

Were there any difficult times in your career?

One of the most difficult (although also rewarding) periods of my life was when the Minister of Health asked me to run the National Blood Transfusion service in 1995 during the hepatitis C crisis. As the Minister said: ‘this was NOT a career move’ – but as my wife reminded me: ‘you can’t really say NO to a Government Minister!’ Seeing young patients dying from leukaemia, or as a result of complications from a stem cell transplant was always very difficult.

Your recent book details the longue durée of haematology studies. What discoveries have defined the specialty?

I would have to agree with Professor David Nathan of Harvard. I interviewed him for the European Hematology Association a few years ago, and he said that the invention of ‘automated cell counting’ by Wallace Coulter (an engineer), ‘combination chemotherapy,’ and the ‘genetic revolution’ are the three defining events in haematology. These in turn, allowed for greater precision, better treatment outcomes, and more productive research.

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Image Credit: ‘Odetta and Liam Clancy playing together for Clonmel Junction Festival, July 2006’, by Junction Festival, CC by SA 3.0, via Wikimedia Commons.

Can you tell us about any unsung heroes?

I have always been fascinated with the history of haematology, and I still wonder why some people have never made it into the canon and others have. For instance, two undeservedly overlooked figures are Norman Bethune (1890-1939) who was very influential in blood transfusion during the Spanish Civil War, and Ibn al-Nafis (1213-1288) who described the pulmonary circulation hundreds of years before Harvey’s account in 1628.

Moving to the present, did your work have an impact on stem cell research today?

Our success led the Department of Health to provide funding, and there is now a state of the art unit in St James’ Hospital. Research I was involved in also resulted in the development of a test to determine the percentage of donor and recipient cells following stem cell transplantation (Chimaerism). The test we developed was used internationally.

In a completely different vein (no pun intended) I was struck at this time, by what I thought was a sense of isolation from the outside world – for patients undergoing stem cell transplantation. I teamed up with an artist, Denis Roche, who came up with the idea of a virtual window in patients’ rooms. I received a competitive grant from the Irish Cancer Society and together with a great team, conducted a large prospective clinical trial to measure its effect (as far as I know this is the largest trial of this type to ever have been undertaken). The result was positive, with reduced anxiety and depression reported, and we published the study in 2011.

What are you working on at the moment?

I spent the last five years running the undergraduate School of Medicine at Trinity College Dublin, where I introduced a module on Medical Humanities – a topic I am still very interested in. This was a totally different role for me, but thoroughly enjoyable. Now I work for the European Haematology Association teaching and carrying out educational podcasts. I wrote a book about wine a few years ago, which I hope to enlarge and insert a number of vignettes about doctors who make wine. My wife and I have a small house in Tuscany, so we spend most summers there (we have a good internet connection so we both can write) – sometimes with our eldest son, his wife, and two children.

Finally, do you have any predictions for the future of stem cell research?

I think we will eventually be able to do away with ‘conditioning treatment’ (currently involving several different chemotherapy drugs) and hopefully have good treatment for ‘Graft versus Host Disease’ (which only occurs after stem cell transplantation). However, I am always struck by the words of Niels Bohr (a Danish physicist who won the Nobel Prize in 1922) who said: “Prediction is difficult, especially if it’s about the future!”

Featured Image Credit: ‘Stem Cell, Sphere’, by PublicDomainPictures, CC0 Public Domain, via Pixabay.

Recent Comments

  1. Finola Casey

    Great interview of a much respected man

  2. Prof Prem raj Pushpakaran

    Prof Prem raj Pushpakaran writes — 2020 marks the 100th birth year of Edward Donnall Thomas, who pioneered bone marrow transplantation !!!

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