A better way to harvest bone marrow
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0:00 - 0:03So I am a pediatric cancer doctor
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0:03 - 0:07and stem-cell researcher at Stanford University
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0:07 - 0:10where my clinical focus has been bone marrow transplantation.
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0:10 - 0:12Now, inspired by Jill Bolte Taylor last year,
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0:12 - 0:14I didn't bring a human brain,
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0:14 - 0:17but I did bring a liter of bone marrow.
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0:17 - 0:20And bone marrow is actually what we use
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0:20 - 0:22to save the lives of tens of thousands of patients,
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0:22 - 0:25most of whom have advanced malignancies like leukemia and lymphoma
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0:25 - 0:27and some other diseases.
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0:27 - 0:31So, a few years ago, I'm doing my transplant fellowship at Stanford.
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0:31 - 0:33I'm in the operating room. We have Bob here,
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0:33 - 0:35who is a volunteer donor.
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0:35 - 0:37We're sending his marrow across the country to save the life
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0:37 - 0:39of a child with leukemia.
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0:39 - 0:41So actually how do we harvest this bone marrow?
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0:41 - 0:45Well we have a whole O.R. team, general anesthesia, nurses,
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0:45 - 0:47and another doctor across from me.
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0:47 - 0:49Bob's on the table, and we take this sort of small needle,
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0:49 - 0:51you know, not too big.
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0:51 - 0:53And the way we do this is we basically
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0:53 - 0:55place this through the soft tissue,
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0:55 - 0:57and kind of punch it into the hard bone,
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0:57 - 0:59into the tuchus -- that's a technical term --
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0:59 - 1:03and aspirate about 10 mls of bone marrow out,
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1:03 - 1:05each time, with a syringe.
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1:05 - 1:08And hand it off to the nurse. She squirts it into a tin.
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1:08 - 1:11Hands it back to me. And we do that again and again.
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1:11 - 1:13About 200 times usually.
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1:13 - 1:15And by the end of this my arm is sore, I've got a callus on my hand,
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1:15 - 1:17let alone Bob,
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1:17 - 1:19whose rear end looks something more like this,
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1:19 - 1:21like Swiss cheese.
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1:21 - 1:25So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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1:25 - 1:27And there is probably a better way to do this.
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1:27 - 1:30So I thought of a minimally invasive approach,
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1:30 - 1:32and a new device that we call the Marrow Miner.
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1:32 - 1:34This is it.
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1:34 - 1:37And the Marrow Miner, the way it works is shown here.
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1:37 - 1:39Our standard see-through patient.
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1:39 - 1:41Instead of entering the bone dozens of times,
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1:41 - 1:43we enter just once, into the front of the hip or the back of the hip.
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1:43 - 1:46And we have a flexible, powered catheter
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1:46 - 1:49with a special wire loop tip that stays inside the crunchy part of the marrow
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1:49 - 1:52and follows the contours of the hip, as it moves around.
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1:52 - 1:54So it enables you to very rapidly aspirate,
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1:54 - 1:57or suck out, rich bone marrow very quickly through one hole.
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1:57 - 1:59We can do multiple passes through that same entry.
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1:59 - 2:01No robots required.
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2:01 - 2:04And, so, very quickly, Bob can just get one puncture, local anesthesia,
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2:04 - 2:08and do this harvest as an outpatient.
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2:08 - 2:11So I did a few prototypes. I got a small little grant at Stanford.
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2:11 - 2:13And played around with this a little bit.
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2:13 - 2:15And our team members developed this technology.
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2:15 - 2:19And eventually we got two large animals, and pig studies.
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2:19 - 2:21And we found, to our surprise, that we not only got bone marrow out,
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2:21 - 2:24but we got 10 times the stem cell activity
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2:24 - 2:26in the marrow from the Marrow Miner, compared to the normal device.
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2:26 - 2:29This device was just FDA approved in the last year.
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2:29 - 2:32Here is a live patient. You can see it following the flexible curves around.
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2:32 - 2:35There will be two passes here, in the same patient, from the same hole.
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2:35 - 2:37This was done under local anesthesia, as an outpatient.
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2:37 - 2:40And we got, again, about three to six times more stem cells
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2:40 - 2:43than the standard approach done on the same patient.
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2:43 - 2:46So why should you care? Bone marrow is a very rich source of adult stem cells.
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2:46 - 2:48You all know about embryonic stem cells.
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2:48 - 2:51They've got great potential but haven't yet entered clinical trials.
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2:51 - 2:53Adult stem cells are throughout our body,
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2:53 - 2:55including the blood-forming stem cells in our bone marrow,
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2:55 - 2:57which we've been using as a form of stem-cell therapy
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2:57 - 2:59for over 40 years.
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2:59 - 3:02In the last decade there's been an explosion of use
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3:02 - 3:05of bone marrow stem cells to treat the patient's other diseases
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3:05 - 3:07such as heart disease, vascular disease,
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3:07 - 3:09orthopedics, tissue engineering,
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3:09 - 3:11even in neurology to treat Parkinson's
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3:11 - 3:13and diabetes.
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3:13 - 3:15We've just come out, we're commercializing, this year,
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3:15 - 3:17generation 2.0 of the Marrow Miner.
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3:17 - 3:19The hope is that this gets more stem cells out,
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3:19 - 3:21which translates to better outcomes.
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3:21 - 3:23It may encourage more people to sign up to be
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3:23 - 3:25potential live-saving bone marrow donors.
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3:25 - 3:27It may even enable you to bank
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3:27 - 3:29your own marrow stem cells, when you're younger and healthier,
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3:29 - 3:32to use in the future should you need it.
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3:32 - 3:34And ultimately -- and here's a picture of our
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3:34 - 3:36bone marrow transplant survivors,
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3:36 - 3:38who come together for a reunion each year at Stanford.
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3:38 - 3:40Hopefully this technology will let us
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3:40 - 3:42have more of these survivors in the future.
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3:42 - 3:44Thanks.
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3:44 - 3:50(Applause)
- Title:
- A better way to harvest bone marrow
- Speaker:
- Daniel Kraft
- Description:
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Daniel Kraft demos his Marrow Miner -- a new device that quickly harvests life-saving bone marrow with minimal pain to the donor. He emphasizes that the adult stem cells found in bone marrow can be used to treat many terminal conditions, from Parkinson's to heart disease.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 03:51
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