Could you explain a little bit about multiple myeloma?
Multiple myeloma is a cancer of the body's plasma cells. Healthy plasma cells are found in bone marrow and are key to a functioning immune system. Plasma cells work by making antibodies that protect the body from bacteria, viruses and fungi. But when plasma cells are cancerous, they make many cells just like themselves and cause damage to the body. The result is a weakening of the immune system as well as a slow destruction of the skeleton. The rogue plasma cells are like trillions of Pac-men chomping on the body's bones.
Multiple myeloma is devastating. Patients often struggle with bone fractures, kidney damage and anemia. About 25,000 new cases are reported each year in the United States. The good news is that therapy has come a long way and patients are living much longer than they did just a decade ago. Today, there are 100,000 people in the United States living with myeloma.
What drew you to UCSF?
I have a long history with UCSF. In the late 1970s, I was a fellow in hematology and oncology at UCSF. It was here that I took part in the university's first bone marrow transplant. Afterward, I left to work at a hospital with a larger transplant program.
In 2007, I returned to UCSF to help Dr. Thomas Martin build a comprehensive myeloma program that would span from basic science to clinical research to innovative treatments.
What brought you back?
Returning to UCSF gave me the chance to help unite world-class basic science with a superb clinical program with colleagues I respect, many of whom are the finest in the world. Since my return, we've done just what we set out to do. We've taken the topnotch basic science at UCSF and meshed it with our rigorous clinical research. Our goal is to develop new therapies, not just mix old drugs together but make new ones.
As part of our contribution, we developed an outstanding translational laboratory that takes new drugs from the bench and tests them in cells and mice. If the agent is promising, we partner with industry to develop it into a drug that we can then bring back to patients at UCSF. That means we can deliver promising new therapies faster. Eight years ago we had fewer than 100 patients. Now we have 1,200 active myeloma patients.
How did your patient Jimmy Fong come to your attention?
Jimmy was referred to us by his local oncologist because of UCSF's strong myeloma program. Jimmy agreed to participate in a study to look at the efficacy of bone marrow transplants for patients with multiple myeloma.
For the study, patients were randomized into two groups. One group got the transplant as part of their initial therapy. The others got the transplant later, if they relapsed. Jimmy was in the group that got a bone marrow transplant as part of the initial treatment, and he did extremely well.
What's Jimmy's prognosis now?
He is in complete remission. We're monitoring him with a new assay developed here in the Bay Area. This assay, a high-powered test, is capable of spotting a single cancer cell in a sample of a million bone marrow cells. In Jimmy, we looked at a million of his cells and didn't see a single one that was malignant. We hope that the therapy cured him of his cancer but, of course, it will be many more years before we know that for sure.
Jimmy wants to live long enough to watch his daughter grow up, go to college and get married, and I think that's a real possibility.