Chapter 09: Research Projects and the Future of Blood Banking
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Description
In this Chapter, Dr. Lichtiger first notes his collaborations with Dr. Emil J Freireich [Oral History Interview] in the Department of Developmental Therapeutics and the Adult Leukemia Research Program. He describes Dr. Freireich and explains that his work is part of Dr. Ronald DePinho’s Moon Shots initiative that involves the work on leukemia.
Dr. Lichtiger next evaluates Dr. DePinho’s plan to treat cancer by developing drugs that target the molecular structures of the different cancers. This “very imaginative” plan that moves toward personalized care, he says, will require a complete shift in thinking and practice at MD Anderson. He states that success in this plan will dramatically reduce the need for transfusion services, for example, but Dr. Lichtiger predicts that the patient need will not disappear, as most therapies have an impact on bone marrow and, thus, blood products. Transfusion Medicine will concentrate on generating better products and “shelf products” for patients. He predicts a major transformation in blood banking in the next ten years. He describes the exciting and promising example of harvesting stem cells from a patient, growing platelets, and then transfusing them back into the patient.
Dr. Lichtiger next sketches his own research, noting that he always worked collaboratively with others, providing equipment for blood banking, as well as sampling and processing services. He made a conscious decision not to aggressively pursue a research career, because he needed time to spend with his family and had watched as colleagues’ families broke up.
In the last portion of this Chapter, Dr. Lichtiger again talks about working with Fellows and the importance of mentoring.
Identifier
LichtigerB_02_20120612_C09
Publication Date
6-12-2012
City
Houston, Texas
Interview Session
Benjamin Lichtiger, MD , Oral History Interview, June 12, 2012
Topics Covered
The Interview Subject's Story - The ResearcherPortraits MD Anderson History Multi-disciplinary Approaches Growth and/or Change Understanding Cancer, the History of Science, Cancer Research The History of Health Care, Patient Care Patients Discovery and Success The Researcher Character, Values, Beliefs, Talents Personal Background
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD :
I didn’t ask you yesterday about whether there was a connection between your initiatives in the blood banking and blood products and Developmental Therapeutics—because I know that Development Therapeutics was pretty protective of what they were doing.
Benjamin Lichtiger, MD :
Oh, Dr. Clark protected them because they came in very aggressive and they created—therapeutic modalities were very successful. He gave them a lot of leeway, but they were not very much involved in the routine blood banking. They were mostly involved in the development of machinery, procedures—which, that’s fine. And then eventually it was closed down, and we absorbed everything.
Tacey Ann Rosolowski, PhD :
Right, so you didn’t collaborate with them.
Benjamin Lichtiger, MD :
We collaborated with them, of course. Tacey Ann Rosolowski, PhD What were some of the projects that you collaborated on?
Benjamin Lichtiger, MD :
Well, I collaborated in all their projects of providing the products, certain products, prepared them. I remember at that time we were washing blood, and at a certain time we were freezing blood all in coordination with them, and all these things are not done in a vacuum. It has to be done with demands and requirements, so that’s how we got involved with them but we were always very supportive. And Dr. Freireich—Dr. Freireich—today you see a very gentlemanly individual. Dr. Freireich used to come and pound on the table. He was very energetic and demanding and also very creative. Even today we are writing papers together, and the guy is unbelievable, but he could function under Clark.
Tacey Ann Rosolowski, PhD :
What are you working on with Dr. Freireich right now?
Benjamin Lichtiger, MD :
Right now we’re working on selecting patients—the best patients—to provide them with white cell transfusions, which is a section Dr. Freireich’s department created and went into oblivion, and now he came back because there are other processes that enhance the collection, and we’re using it, and we’re publishing a couple of papers now. That’s my area. My partners have other areas of research. This is what I’m working on with him and the whole leukemia department, and we’re also part of the leukemia department Moon Shot Project because we’ll have to participate in it, and we like to. We want to. That I think in a nutshell, more or less, summarizes from my perspective the contribution of each of these presidents.
Tacey Ann Rosolowski, PhD :
What do you foresee will be the contribution of Dr. DePinho?
Benjamin Lichtiger, MD :
I don’t know yet. Right now he’s—Dr. DePinho has got into a slump.
Tacey Ann Rosolowski, PhD :
Yeah, well, as we’re speaking right now there’s a—I’m saying this for the benefit of the recording. There’s a controversy about a CPRIT grant[Cancer Prevention and Research Institute of Texas grant].
Benjamin Lichtiger, MD :
I know, so there is a slump, but I think that his idea to move everything towards identifying elements and the individual elements in each cancer and make sure that we develop the drug that specifically acts at that level is tremendous. I think it could really change how we approach cancer.
Tacey Ann Rosolowski, PhD :
Really?
Benjamin Lichtiger, MD :
Yes, I think so, because they are going to look at certain cancers and see their molecular structure and see which of the molecules control the growth, the proliferation, and really apply medication or a drug that’s going to go and plug up that drain. That is highly imaginative, and I think with the technology right now it’s achievable. But that will require a change in mentality.
Tacey Ann Rosolowski, PhD :
Yeah, I was going to say, it sounds like a paradigm shift.
Benjamin Lichtiger, MD :
Oh, completely. It will require it completely because if that goes along— In ten years imagine if a person is dying of a certain tumor and they identify the molecular structure that’s really treating the tumor and they give the drug, and that is only specific for that molecule. Imagine turning it into chemotherapy, don’t need antibiotics. You won’t need blood. And I know he’s been successful, and I know he and his wife have companies outside that really produce some of those compounds, and I don’t know what level of the FDA they are. I have not followed that, but if that is the course, I mean, that’s a very, very visionary approach. It may change completely the way we are going to handle cancer because it really goes into the personalized care. In other words, in each individual the cancer is different. I can see now that—[Redacted] and I can see how they’re handling it here. The idea is already very—they are looking at that particular tumor—particular tests—and predict the value, and they are going to decide whether to give chemotherapy, radiotherapy, which is better? We are already going there.
Tacey Ann Rosolowski, PhD :
How do you foresee that that particular approach will change what happens in transfusion medicine?
Benjamin Lichtiger, MD :
If that is the case, for example, we’ll need blood for surgery. We’ll need some blood for the patients with leukemia, lymphoma, because regardless their bone marrow is affected, and one way or another the bone marrow—when they develop those compounds the diseased cells are in the bone marrow. It may diminish a little bit but not disappear, and we may be able to concentrate on better products.
Tacey Ann Rosolowski, PhD :
What do you mean by that, better products?
Benjamin Lichtiger, MD :
Better products—maybe select—for example, there are now some companies—something we’re looking into—that collect early elements in the bone marrow that eventually end up being white cells or end up being platelets, and we can extract those and expand them in the laboratory, then freeze them and store them. We can take—let’s say from one donor make ten bags of something, and we store it frozen.
Tacey Ann Rosolowski, PhD :
And then you can replenish that person’s supply.
Benjamin Lichtiger, MD :
Exactly, so we’re going more and more into areas that are going to change. There’s going to be a shelf product. I am glad I’ve lived so far. I just regret I’m not thirty years younger to really live through this transformation, but my card is up. But in the next ten years I foresee we’re going to see major, major transformation in blood banking. I always tell my children that people are going to say, “How could they take blood from one person and give it to another person? How could they do that?” Because the new blood center is working in getting blood, and they’re getting stem cells and producing red cells from the same patient, and they’re already able to produce bags and bags. But it will be expensive, but they are trying to shorten the steps so that it can be done in a week to have several bags, so everybody will have their own blood. Not the emergency, not the motorcycle accident, but if they’re currently patients. Imagine the patient with sickle cell that you can modify the bone marrow cells and then produce normal cells for them. This is going to happen.
Tacey Ann Rosolowski, PhD :
That blows the whole conversation about autologous blood. That’s old stuff.
Benjamin Lichtiger, MD :
Completely, completely so you will hear—and sometimes they will come out and say, “How could we do that? That’s terrible what we did.” Well, but like two centuries ago they used to take blood from sheep and transfuse it to people. How could they do that? Well, at that time it was a revolutionary thing and they did it in London in front of the British science—the medical society, whatever they have, and they showed it in front of everybody that it could be done. We’ll get there.
Tacey Ann Rosolowski, PhD :
That’s very exciting. That’s very exciting. I was hoping to go a little bit further into your own research path. Would you like to—?
Benjamin Lichtiger, MD :
Well, my research path was mostly collaborative research, although I got my PhD and applied to NIH. I was successful one or two times but then I couldn’t—but maybe the mistake I made is getting involved in the administrative business aspect of laboratory medicine, clinical pathology, and once one gets involved in that there’s no time for research. I decided early on to do collaborative—to be a collaborator and work and support, and I have collaborated on quite a few projects. That’s my CV that reveals it, but I did not conduct any independent research, no.
Tacey Ann Rosolowski, PhD :
What are some of the projects that you collaborated on that had particularly interesting or significant findings?
Benjamin Lichtiger, MD :
Drugs, introduce certain drugs, the penetration of new drugs. I remember they use a drug now that’s standard for CLL. We collaborated. We collaborated in pediatrics on the use of another drug. We collaborated in the development of some equipment for blood banking. We collaborated by facilitating sampling—specific sampling—so other collaborators could conduct research and obtain the samples and process the samples. But it was always collaborative. I did not follow up the line, and that was a conscious decision because I also made the decision that I wanted to enjoy my family life, my wife, my children, my grandchildren, in spite of the fact they still complain that many times I was not there, which is true. But still, I said somewhere, I need to make the cut. I used to see my colleagues spending day and night here and day and night here and having a family, and the family broke up. This is not for me. I don’t want to pay that price.
Tacey Ann Rosolowski, PhD :
It’s a very steep price.
Benjamin Lichtiger, MD :
Yes, and I said no. I’m not prepared to do that.
Tacey Ann Rosolowski, PhD :
What do you think—I mean, you have a fellowship program here, and we talked yesterday about how you are encouraging or even chastising some of the fellows who maybe aren’t showing the initiative, and I’m wondering, what’s the resolution to that problem? On the one hand you have fellows who aren’t showing the passion or the drive, and on the other hand where do you make the cut, or how can the administration or how can the institution support a developing researcher and scientist so that they can devote themselves in different areas?
Benjamin Lichtiger, MD :
You know, it’s like a fellow comes, and we show him what we have. We give him the opportunities. We even give him ideas. We give him projects that we have in mind. Some will grab it and run with it. Some you can throw it at them and you realize that nothing is going to happen, so one doesn’t seize. One continues to stimulate. You need to do this. You need name recognition. You need to—and then I tell them that sooner or later somebody will call us on the phone and say, “How is this guy? Would you hire him?” And you need to be able to answer that question, so where I think maybe I failed or my partners—it’s having the projectability. On paper they all look great. The references—and I don’t think people are very honest in the references they write too. They embellish it, so that’s why I always call and find out. We bring them in for an interview, and we talk to them. We try to get the feeling, but it’s all so subjective.
Tacey Ann Rosolowski, PhD :
What happens in the situation, though, when you have a fellow or you have a young faculty member and they do have the drive, and they want to do it all? How can the institution support that person so they—?
Benjamin Lichtiger, MD :
There are mechanisms in the institution, of course. There’s mentoring. We take them under our wing. We mentor them, and we show them things, how to do it. We try to smooth their rough edges and how to get things and be patient. We have fellows that had—they were wild horses. They are pulling us. They’re really unbelievable, and other ones you have to be pushing, pushing, pushing, and once you have them you cannot get rid of them. But I did let faculty go. I terminated faculty because they were not the ones that we were needing here, and one passed away about 2 years ago, but I was getting ready to let him go.
Recommended Citation
Lichtiger, Benjamin MD, PhD and Rosolowski, Tacey A. PhD, "Chapter 09: Research Projects and the Future of Blood Banking" (2012). Interview Chapters. 1464.
https://openworks.mdanderson.org/mchv_interviewchapters/1464
Conditions Governing Access
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