[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.00,0:00:03.00,Default,,0000,0000,0000,,So I am a pediatric cancer doctor
Dialogue: 0,0:00:03.00,0:00:07.00,Default,,0000,0000,0000,,and stem-cell researcher at Stanford University
Dialogue: 0,0:00:07.00,0:00:10.00,Default,,0000,0000,0000,,where my clinical focus has been bone marrow transplantation.
Dialogue: 0,0:00:10.00,0:00:12.00,Default,,0000,0000,0000,,Now, inspired by Jill Bolte Taylor last year,
Dialogue: 0,0:00:12.00,0:00:14.00,Default,,0000,0000,0000,,I didn't bring a human brain,
Dialogue: 0,0:00:14.00,0:00:17.00,Default,,0000,0000,0000,,but I did bring a liter of bone marrow.
Dialogue: 0,0:00:17.00,0:00:20.00,Default,,0000,0000,0000,,And bone marrow is actually what we use
Dialogue: 0,0:00:20.00,0:00:22.00,Default,,0000,0000,0000,,to save the lives of tens of thousands of patients,
Dialogue: 0,0:00:22.00,0:00:25.00,Default,,0000,0000,0000,,most of whom have advanced malignancies like leukemia and lymphoma
Dialogue: 0,0:00:25.00,0:00:27.00,Default,,0000,0000,0000,,and some other diseases.
Dialogue: 0,0:00:27.00,0:00:31.00,Default,,0000,0000,0000,,So, a few years ago, I'm doing my transplant fellowship at Stanford.
Dialogue: 0,0:00:31.00,0:00:33.00,Default,,0000,0000,0000,,I'm in the operating room. We have Bob here,
Dialogue: 0,0:00:33.00,0:00:35.00,Default,,0000,0000,0000,,who is a volunteer donor.
Dialogue: 0,0:00:35.00,0:00:37.00,Default,,0000,0000,0000,,We're sending his marrow across the country to save the life
Dialogue: 0,0:00:37.00,0:00:39.00,Default,,0000,0000,0000,,of a child with leukemia.
Dialogue: 0,0:00:39.00,0:00:41.00,Default,,0000,0000,0000,,So actually how do we harvest this bone marrow?
Dialogue: 0,0:00:41.00,0:00:45.00,Default,,0000,0000,0000,,Well we have a whole O.R. team, general anesthesia, nurses,
Dialogue: 0,0:00:45.00,0:00:47.00,Default,,0000,0000,0000,,and another doctor across from me.
Dialogue: 0,0:00:47.00,0:00:49.00,Default,,0000,0000,0000,,Bob's on the table, and we take this sort of small needle,
Dialogue: 0,0:00:49.00,0:00:51.00,Default,,0000,0000,0000,,you know, not too big.
Dialogue: 0,0:00:51.00,0:00:53.00,Default,,0000,0000,0000,,And the way we do this is we basically
Dialogue: 0,0:00:53.00,0:00:55.00,Default,,0000,0000,0000,,place this through the soft tissue,
Dialogue: 0,0:00:55.00,0:00:57.00,Default,,0000,0000,0000,,and kind of punch it into the hard bone,
Dialogue: 0,0:00:57.00,0:00:59.00,Default,,0000,0000,0000,,into the tuchus -- that's a technical term --
Dialogue: 0,0:00:59.00,0:01:03.00,Default,,0000,0000,0000,,and aspirate about 10 mls of bone marrow out,
Dialogue: 0,0:01:03.00,0:01:05.00,Default,,0000,0000,0000,,each time, with a syringe.
Dialogue: 0,0:01:05.00,0:01:08.00,Default,,0000,0000,0000,,And hand it off to the nurse. She squirts it into a tin.
Dialogue: 0,0:01:08.00,0:01:11.00,Default,,0000,0000,0000,,Hands it back to me. And we do that again and again.
Dialogue: 0,0:01:11.00,0:01:13.00,Default,,0000,0000,0000,,About 200 times usually.
Dialogue: 0,0:01:13.00,0:01:15.00,Default,,0000,0000,0000,,And by the end of this my arm is sore, I've got a callus on my hand,
Dialogue: 0,0:01:15.00,0:01:17.00,Default,,0000,0000,0000,,let alone Bob,
Dialogue: 0,0:01:17.00,0:01:19.00,Default,,0000,0000,0000,,whose rear end looks something more like this,
Dialogue: 0,0:01:19.00,0:01:21.00,Default,,0000,0000,0000,,like Swiss cheese.
Dialogue: 0,0:01:21.00,0:01:25.00,Default,,0000,0000,0000,,So I'm thinking, you know, this procedure hasn't changed in about 40 years.
Dialogue: 0,0:01:25.00,0:01:27.00,Default,,0000,0000,0000,,And there is probably a better way to do this.
Dialogue: 0,0:01:27.00,0:01:30.00,Default,,0000,0000,0000,,So I thought of a minimally invasive approach,
Dialogue: 0,0:01:30.00,0:01:32.00,Default,,0000,0000,0000,,and a new device that we call the Marrow Miner.
Dialogue: 0,0:01:32.00,0:01:34.00,Default,,0000,0000,0000,,This is it.
Dialogue: 0,0:01:34.00,0:01:37.00,Default,,0000,0000,0000,,And the Marrow Miner, the way it works is shown here.
Dialogue: 0,0:01:37.00,0:01:39.00,Default,,0000,0000,0000,,Our standard see-through patient.
Dialogue: 0,0:01:39.00,0:01:41.00,Default,,0000,0000,0000,,Instead of entering the bone dozens of times,
Dialogue: 0,0:01:41.00,0:01:43.00,Default,,0000,0000,0000,,we enter just once, into the front of the hip or the back of the hip.
Dialogue: 0,0:01:43.00,0:01:46.00,Default,,0000,0000,0000,,And we have a flexible, powered catheter
Dialogue: 0,0:01:46.00,0:01:49.00,Default,,0000,0000,0000,,with a special wire loop tip that stays inside the crunchy part of the marrow
Dialogue: 0,0:01:49.00,0:01:52.00,Default,,0000,0000,0000,,and follows the contours of the hip, as it moves around.
Dialogue: 0,0:01:52.00,0:01:54.00,Default,,0000,0000,0000,,So it enables you to very rapidly aspirate,
Dialogue: 0,0:01:54.00,0:01:57.00,Default,,0000,0000,0000,,or suck out, rich bone marrow very quickly through one hole.
Dialogue: 0,0:01:57.00,0:01:59.00,Default,,0000,0000,0000,,We can do multiple passes through that same entry.
Dialogue: 0,0:01:59.00,0:02:01.00,Default,,0000,0000,0000,,No robots required.
Dialogue: 0,0:02:01.00,0:02:04.00,Default,,0000,0000,0000,,And, so, very quickly, Bob can just get one puncture, local anesthesia,
Dialogue: 0,0:02:04.00,0:02:08.00,Default,,0000,0000,0000,,and do this harvest as an outpatient.
Dialogue: 0,0:02:08.00,0:02:11.00,Default,,0000,0000,0000,,So I did a few prototypes. I got a small little grant at Stanford.
Dialogue: 0,0:02:11.00,0:02:13.00,Default,,0000,0000,0000,,And played around with this a little bit.
Dialogue: 0,0:02:13.00,0:02:15.00,Default,,0000,0000,0000,,And our team members developed this technology.
Dialogue: 0,0:02:15.00,0:02:19.00,Default,,0000,0000,0000,,And eventually we got two large animals, and pig studies.
Dialogue: 0,0:02:19.00,0:02:21.00,Default,,0000,0000,0000,,And we found, to our surprise, that we not only got bone marrow out,
Dialogue: 0,0:02:21.00,0:02:24.00,Default,,0000,0000,0000,,but we got 10 times the stem cell activity
Dialogue: 0,0:02:24.00,0:02:26.00,Default,,0000,0000,0000,,in the marrow from the Marrow Miner, compared to the normal device.
Dialogue: 0,0:02:26.00,0:02:29.00,Default,,0000,0000,0000,,This device was just FDA approved in the last year.
Dialogue: 0,0:02:29.00,0:02:32.00,Default,,0000,0000,0000,,Here is a live patient. You can see it following the flexible curves around.
Dialogue: 0,0:02:32.00,0:02:35.00,Default,,0000,0000,0000,,There will be two passes here, in the same patient, from the same hole.
Dialogue: 0,0:02:35.00,0:02:37.00,Default,,0000,0000,0000,,This was done under local anesthesia, as an outpatient.
Dialogue: 0,0:02:37.00,0:02:40.00,Default,,0000,0000,0000,,And we got, again, about three to six times more stem cells
Dialogue: 0,0:02:40.00,0:02:43.00,Default,,0000,0000,0000,,than the standard approach done on the same patient.
Dialogue: 0,0:02:43.00,0:02:46.00,Default,,0000,0000,0000,,So why should you care? Bone marrow is a very rich source of adult stem cells.
Dialogue: 0,0:02:46.00,0:02:48.00,Default,,0000,0000,0000,,You all know about embryonic stem cells.
Dialogue: 0,0:02:48.00,0:02:51.00,Default,,0000,0000,0000,,They've got great potential but haven't yet entered clinical trials.
Dialogue: 0,0:02:51.00,0:02:53.00,Default,,0000,0000,0000,,Adult stem cells are throughout our body,
Dialogue: 0,0:02:53.00,0:02:55.00,Default,,0000,0000,0000,,including the blood-forming stem cells in our bone marrow,
Dialogue: 0,0:02:55.00,0:02:57.00,Default,,0000,0000,0000,,which we've been using as a form of stem-cell therapy
Dialogue: 0,0:02:57.00,0:02:59.00,Default,,0000,0000,0000,,for over 40 years.
Dialogue: 0,0:02:59.00,0:03:02.00,Default,,0000,0000,0000,,In the last decade there's been an explosion of use
Dialogue: 0,0:03:02.00,0:03:05.00,Default,,0000,0000,0000,,of bone marrow stem cells to treat the patient's other diseases
Dialogue: 0,0:03:05.00,0:03:07.00,Default,,0000,0000,0000,,such as heart disease, vascular disease,
Dialogue: 0,0:03:07.00,0:03:09.00,Default,,0000,0000,0000,,orthopedics, tissue engineering,
Dialogue: 0,0:03:09.00,0:03:11.00,Default,,0000,0000,0000,,even in neurology to treat Parkinson's
Dialogue: 0,0:03:11.00,0:03:13.00,Default,,0000,0000,0000,,and diabetes.
Dialogue: 0,0:03:13.00,0:03:15.00,Default,,0000,0000,0000,,We've just come out, we're commercializing, this year,
Dialogue: 0,0:03:15.00,0:03:17.00,Default,,0000,0000,0000,,generation 2.0 of the Marrow Miner.
Dialogue: 0,0:03:17.00,0:03:19.00,Default,,0000,0000,0000,,The hope is that this gets more stem cells out,
Dialogue: 0,0:03:19.00,0:03:21.00,Default,,0000,0000,0000,,which translates to better outcomes.
Dialogue: 0,0:03:21.00,0:03:23.00,Default,,0000,0000,0000,,It may encourage more people to sign up to be
Dialogue: 0,0:03:23.00,0:03:25.00,Default,,0000,0000,0000,,potential live-saving bone marrow donors.
Dialogue: 0,0:03:25.00,0:03:27.00,Default,,0000,0000,0000,,It may even enable you to bank
Dialogue: 0,0:03:27.00,0:03:29.00,Default,,0000,0000,0000,,your own marrow stem cells, when you're younger and healthier,
Dialogue: 0,0:03:29.00,0:03:32.00,Default,,0000,0000,0000,,to use in the future should you need it.
Dialogue: 0,0:03:32.00,0:03:34.00,Default,,0000,0000,0000,,And ultimately -- and here's a picture of our
Dialogue: 0,0:03:34.00,0:03:36.00,Default,,0000,0000,0000,,bone marrow transplant survivors,
Dialogue: 0,0:03:36.00,0:03:38.00,Default,,0000,0000,0000,,who come together for a reunion each year at Stanford.
Dialogue: 0,0:03:38.00,0:03:40.00,Default,,0000,0000,0000,,Hopefully this technology will let us
Dialogue: 0,0:03:40.00,0:03:42.00,Default,,0000,0000,0000,,have more of these survivors in the future.
Dialogue: 0,0:03:42.00,0:03:44.00,Default,,0000,0000,0000,,Thanks.
Dialogue: 0,0:03:44.00,0:03:50.00,Default,,0000,0000,0000,,(Applause)