In the summer after his first year of medical school, John Wagner had an experience that forever changed his life. It was his first day of clinical service at a cancer ward at Children’s Hospital in Philadelphia.
“A woman ran over and gave me a hug, exclaiming that it was a wonderful day,” he recalls. “Turned out she was a world-renowned childhood cancer doctor named Dr. Audrey Evans. A patient of hers had achieved a remission from a fatal disease. I stood in awe of someone who had seen so much, yet still so sincerely rejoiced at having one of her patients achieve a remission.”
His focus was further sharpened when a mentor at the Johns Hopkins Hospital, where he was doing his first rotation, took him aside and encouraged him to consider bone marrow transplantation as a career.
At that time (the mid-1980s), bone marrow transplantation was a young science It was discovered that it could be used to bring patients back from the brink of death after radiation and chemotherapy had been used to kill cancerous cells in their bodies.
It was Wagner who pioneered the use of umbilical cord blood for this same purpose. In 1990, he performed the world’s first cord-blood transplant for pediatric leukemia. In 1999, he and two colleagues developed the Minneapolis Regimen for treating adults with leukemia and lymphoma—now regarded as one of the most important medical advances in recent years.
“I thought we could use a cocktail of chemicals to expand the number of stem cells,” he explains. “But the problem was, how could I design a trial to prove that it worked and wasn’t harmful? We came up with the idea of doing a trial using two [partially matched] cord-blood units.”
But Wagner never got to do the experiment. When he tested the administration of the two units by themselves, they had a potent anti-leukemia effect.
“What was extraordinary was that not only did it make recovery more rapid, but it wasn’t the chemotherapy radiation that was killing off the tumor,” he says. “It’s the cord blood. It was unprecedented.”
Recently, Wagner completed the world’s first bone marrow transplant for a deadly childhood disease called Epidermolysis Bullosa (EB). Children with the disease lack a particular kind of collagen that anchors the skin.
The risky surgery took place in October 2007, to promising results. The stem cells in the bone marrow appear to have rebuilt the missing collagen in the patient. It is a stunning success.
“Nothing is without risk. But the question is whether you go down fighting, or simply go down. I am always trying to prove that something that was previously considered to be incurable is not really.”
