1 00:00:00,000 --> 00:00:03,000 So I am a pediatric cancer doctor 2 00:00:03,000 --> 00:00:07,000 and stem-cell researcher at Stanford University 3 00:00:07,000 --> 00:00:10,000 where my clinical focus has been bone marrow transplantation. 4 00:00:10,000 --> 00:00:12,000 Now, inspired by Jill Bolte Taylor last year, 5 00:00:12,000 --> 00:00:14,000 I didn't bring a human brain, 6 00:00:14,000 --> 00:00:17,000 but I did bring a liter of bone marrow. 7 00:00:17,000 --> 00:00:20,000 And bone marrow is actually what we use 8 00:00:20,000 --> 00:00:22,000 to save the lives of tens of thousands of patients, 9 00:00:22,000 --> 00:00:25,000 most of whom have advanced malignancies like leukemia and lymphoma 10 00:00:25,000 --> 00:00:27,000 and some other diseases. 11 00:00:27,000 --> 00:00:31,000 So, a few years ago, I'm doing my transplant fellowship at Stanford. 12 00:00:31,000 --> 00:00:33,000 I'm in the operating room. We have Bob here, 13 00:00:33,000 --> 00:00:35,000 who is a volunteer donor. 14 00:00:35,000 --> 00:00:37,000 We're sending his marrow across the country to save the life 15 00:00:37,000 --> 00:00:39,000 of a child with leukemia. 16 00:00:39,000 --> 00:00:41,000 So actually how do we harvest this bone marrow? 17 00:00:41,000 --> 00:00:45,000 Well we have a whole O.R. team, general anesthesia, nurses, 18 00:00:45,000 --> 00:00:47,000 and another doctor across from me. 19 00:00:47,000 --> 00:00:49,000 Bob's on the table, and we take this sort of small needle, 20 00:00:49,000 --> 00:00:51,000 you know, not too big. 21 00:00:51,000 --> 00:00:53,000 And the way we do this is we basically 22 00:00:53,000 --> 00:00:55,000 place this through the soft tissue, 23 00:00:55,000 --> 00:00:57,000 and kind of punch it into the hard bone, 24 00:00:57,000 --> 00:00:59,000 into the tuchus -- that's a technical term -- 25 00:00:59,000 --> 00:01:03,000 and aspirate about 10 mls of bone marrow out, 26 00:01:03,000 --> 00:01:05,000 each time, with a syringe. 27 00:01:05,000 --> 00:01:08,000 And hand it off to the nurse. She squirts it into a tin. 28 00:01:08,000 --> 00:01:11,000 Hands it back to me. And we do that again and again. 29 00:01:11,000 --> 00:01:13,000 About 200 times usually. 30 00:01:13,000 --> 00:01:15,000 And by the end of this my arm is sore, I've got a callus on my hand, 31 00:01:15,000 --> 00:01:17,000 let alone Bob, 32 00:01:17,000 --> 00:01:19,000 whose rear end looks something more like this, 33 00:01:19,000 --> 00:01:21,000 like Swiss cheese. 34 00:01:21,000 --> 00:01:25,000 So I'm thinking, you know, this procedure hasn't changed in about 40 years. 35 00:01:25,000 --> 00:01:27,000 And there is probably a better way to do this. 36 00:01:27,000 --> 00:01:30,000 So I thought of a minimally invasive approach, 37 00:01:30,000 --> 00:01:32,000 and a new device that we call the Marrow Miner. 38 00:01:32,000 --> 00:01:34,000 This is it. 39 00:01:34,000 --> 00:01:37,000 And the Marrow Miner, the way it works is shown here. 40 00:01:37,000 --> 00:01:39,000 Our standard see-through patient. 41 00:01:39,000 --> 00:01:41,000 Instead of entering the bone dozens of times, 42 00:01:41,000 --> 00:01:43,000 we enter just once, into the front of the hip or the back of the hip. 43 00:01:43,000 --> 00:01:46,000 And we have a flexible, powered catheter 44 00:01:46,000 --> 00:01:49,000 with a special wire loop tip that stays inside the crunchy part of the marrow 45 00:01:49,000 --> 00:01:52,000 and follows the contours of the hip, as it moves around. 46 00:01:52,000 --> 00:01:54,000 So it enables you to very rapidly aspirate, 47 00:01:54,000 --> 00:01:57,000 or suck out, rich bone marrow very quickly through one hole. 48 00:01:57,000 --> 00:01:59,000 We can do multiple passes through that same entry. 49 00:01:59,000 --> 00:02:01,000 No robots required. 50 00:02:01,000 --> 00:02:04,000 And, so, very quickly, Bob can just get one puncture, local anesthesia, 51 00:02:04,000 --> 00:02:08,000 and do this harvest as an outpatient. 52 00:02:08,000 --> 00:02:11,000 So I did a few prototypes. I got a small little grant at Stanford. 53 00:02:11,000 --> 00:02:13,000 And played around with this a little bit. 54 00:02:13,000 --> 00:02:15,000 And our team members developed this technology. 55 00:02:15,000 --> 00:02:19,000 And eventually we got two large animals, and pig studies. 56 00:02:19,000 --> 00:02:21,000 And we found, to our surprise, that we not only got bone marrow out, 57 00:02:21,000 --> 00:02:24,000 but we got 10 times the stem cell activity 58 00:02:24,000 --> 00:02:26,000 in the marrow from the Marrow Miner, compared to the normal device. 59 00:02:26,000 --> 00:02:29,000 This device was just FDA approved in the last year. 60 00:02:29,000 --> 00:02:32,000 Here is a live patient. You can see it following the flexible curves around. 61 00:02:32,000 --> 00:02:35,000 There will be two passes here, in the same patient, from the same hole. 62 00:02:35,000 --> 00:02:37,000 This was done under local anesthesia, as an outpatient. 63 00:02:37,000 --> 00:02:40,000 And we got, again, about three to six times more stem cells 64 00:02:40,000 --> 00:02:43,000 than the standard approach done on the same patient. 65 00:02:43,000 --> 00:02:46,000 So why should you care? Bone marrow is a very rich source of adult stem cells. 66 00:02:46,000 --> 00:02:48,000 You all know about embryonic stem cells. 67 00:02:48,000 --> 00:02:51,000 They've got great potential but haven't yet entered clinical trials. 68 00:02:51,000 --> 00:02:53,000 Adult stem cells are throughout our body, 69 00:02:53,000 --> 00:02:55,000 including the blood-forming stem cells in our bone marrow, 70 00:02:55,000 --> 00:02:57,000 which we've been using as a form of stem-cell therapy 71 00:02:57,000 --> 00:02:59,000 for over 40 years. 72 00:02:59,000 --> 00:03:02,000 In the last decade there's been an explosion of use 73 00:03:02,000 --> 00:03:05,000 of bone marrow stem cells to treat the patient's other diseases 74 00:03:05,000 --> 00:03:07,000 such as heart disease, vascular disease, 75 00:03:07,000 --> 00:03:09,000 orthopedics, tissue engineering, 76 00:03:09,000 --> 00:03:11,000 even in neurology to treat Parkinson's 77 00:03:11,000 --> 00:03:13,000 and diabetes. 78 00:03:13,000 --> 00:03:15,000 We've just come out, we're commercializing, this year, 79 00:03:15,000 --> 00:03:17,000 generation 2.0 of the Marrow Miner. 80 00:03:17,000 --> 00:03:19,000 The hope is that this gets more stem cells out, 81 00:03:19,000 --> 00:03:21,000 which translates to better outcomes. 82 00:03:21,000 --> 00:03:23,000 It may encourage more people to sign up to be 83 00:03:23,000 --> 00:03:25,000 potential live-saving bone marrow donors. 84 00:03:25,000 --> 00:03:27,000 It may even enable you to bank 85 00:03:27,000 --> 00:03:29,000 your own marrow stem cells, when you're younger and healthier, 86 00:03:29,000 --> 00:03:32,000 to use in the future should you need it. 87 00:03:32,000 --> 00:03:34,000 And ultimately -- and here's a picture of our 88 00:03:34,000 --> 00:03:36,000 bone marrow transplant survivors, 89 00:03:36,000 --> 00:03:38,000 who come together for a reunion each year at Stanford. 90 00:03:38,000 --> 00:03:40,000 Hopefully this technology will let us 91 00:03:40,000 --> 00:03:42,000 have more of these survivors in the future. 92 00:03:42,000 --> 00:03:44,000 Thanks. 93 00:03:44,000 --> 00:03:50,000 (Applause)