Versiti Blood Research Institute Senior Investigator Richard H. Aster, MD, was part of the team that facilitated the first bone marrow transplant from an unrelated donor.
Matching a donor’s blood type with a recipient’s for red blood cell transfusion is usually quite straightforward. With blood platelet transfusion, however, the matching process can be more complicated because platelets carry HLA antigens that are likely to induce antibodies that impede the effectiveness of subsequent transfusions. In the 1970s, Versiti Blood Research Institute Senior Investigator Richard H. Aster, MD, was awarded a grant from the National Heart, Lung and Blood Institute (NHLBI) to characterize the complexity of platelet antigens and define rules for platelet matching that will improve transfusion effectiveness.
Throughout the late 1970s and 1980s, Dr. Aster and his team compiled a large panel of blood donors whose platelets were typed for the most important platelet antigens (also known as transplantation antigens), with the idea that these persons could be called upon to donate platelets when the need arose. At the same time, Versiti Diagnostic Labs developed the Histocompatibility and Immunogenetics Lab (H and I), which types patients and recipients across the country for organ and bone marrow transplants. “It was important to build up panels of matched donors because the antigen systems are complex, and it was kind of a numbers game to find a match for an individual patient,” Dr. Aster said.
Around this time, Versiti was consulted by Children’s Wisconsin about a child who had a condition called aplastic anemia and needed a bone marrow transplant to survive. Unfortunately, no one in this child’s family was a match—something that happens to more than 50% patients who need a bone marrow transplant. But because the H and I Lab had been typing donors to be called for platelet transfusions and the same sets of antigens are important in marrow transplantation, thousands of typed individuals were available who could be screened to see whether their bone marrow might be a match for this child.
Amazingly, a perfect match was identified, that individual consented to donate bone marrow, and the child was successfully transplanted, Dr. Aster said. This child was the first aplastic anemia patient in the world to be successfully transplanted with bone marrow from an unrelated individual.
Dr. Aster was also involved in establishing the National Marrow Donor Program, now known as Be The Match. The program’s first candidate for a transplant was a child in Seattle battling leukemia. At the time, Versiti had the largest number of typed donors—and one was a match. On the day of the donor’s bone marrow donation procedure, a huge snowstorm hit Milwaukee, closing the airport. But the bone marrow still had to get to Seattle or else the child would die, as he had already been given a lethal dose of chemotherapy to prepare him for the marrow transplant. Fortunately, the father of a woman in Versiti’s public relations department was the Milwaukee County Executive at the time. She called him, he called the airport, and one runway was cleared so that Flight For Life could take the marrow to Minneapolis, from where it shipped to Seattle. The National Marrow Donor Program has continued to thrive since that early beginning and an estimated 9 million donors worldwide are now typed as potential marrow donors.
In recent years, Dr. Aster and other investigators at Versiti Blood Research Institute (BRI) have focused their research on cancer and blood formation, learning more about how blood cells mature. This work could have future implications for someday making artificial blood—though Dr. Aster doesn’t think that will happen in our lifetime. “It’s a frontier that has lots of implications for cancer treatment, however,” he said.
According to the American Cancer Society, patients fighting cancer may need blood transfusions to treat a variety of symptoms, from anemia to side effects of radiation. But the research to find alternate treatments for these patients will take time and money before landmark discoveries are made. “It’s not often that you see a big breakthrough,” he said. “Most research progress is incremental.”
Dr. Aster credits Versiti’s Core Labs, supported by the Blood Research Institute Foundation, as a critical BRI resource. Each lab helps Versiti investigators perform their research in ways that wouldn’t otherwise be possible. “We couldn’t do what we do if we didn’t have this suite of helpful and sophisticated core labs,” he said. “That’s one of the real pluses of having an institution like this—all investigators can share the benefits of these wonderfully sophisticated central facilities.”
Richard H. Aster, MD, is a senior investigator at Versiti Blood Research Institute and a professor in the Departments of Medicine and Pathology at the Medical College of Wisconsin. In 2019, he was awarded the Wallace H. Coulter Award for Lifetime Achievement in Hematology from the American Society of Hematology.