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1960s
The process of collecting platelets from volunteer donors has become more high-tech since this photo was taken, but these blood components remain critical for helping many cancer patients return to health.
The shortcomings of cancer chemotherapy at first seemed as powerful as its benefits. Leukemia not only causes a surge of immature white blood cells but also a sharp drop in platelets, cell fragments necessary for clotting. Patients who die of the disease usually do so as a result of bleeding or infection. Unfortunately, chemotherapy drugs that lower white blood cells counts also accelerate the loss of platelets.
In the 1950s and '60s, Sidney Farber and Isaac Djerassi, MD, who directed the Institute's blood bank, explored whether platelet transfusions could control leukemia patients' bleeding. The studies, in laboratory models and later in humans, showed the procedure was effective, and the pair devised ways to separate platelets from blood using simple centrifuge techniques and preserve them for later use.
"Finding compatible donors seemed unlikely. Fortunately, this system of donor selection worked exceedingly well for many patients."
The road to routine platelet transfusion wasn't yet open, though. It turned out that after patients received multiple transfusions, further ones didn't help as much. Why? The donated platelets were gradually destroyed by the immune system, which recognized that they came from a different body. At the National Cancer Institute, Ronald Yankee, MD, and his colleagues were studying the similar problem of tissue rejection in bone marrow transplantation. They found that rejection could be minimized or eliminated if tissue from donors and recipients had compatible "HLA factors," proteins on the surface of cells that showed their identity. Happily, the discovery also applied to platelet transfusions – meaning that as long as patients received platelets from a closely matched donor, often a family member, the transfusions would continue to be effective.
"There are so many types of antigens [identifying proteins] on platelets that finding compatible donors seemed unlikely," recalls Yankee, who became director of Dana-Farber's blood bank in 1973 and contributed to the development of automated platelet and stem cell collection systems. "Fortunately, this system of donor selection worked exceedingly well for many patients."
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