Daniel Kraft invents a better way to harvest bone marrow

Translator: Morten Kelder Skouboe Reviewer: Anders Finn Jørgensen

So I am a pediatric cancer doctor

Jeg er speciallæge i børnecancer

and stem-cell researcher at Stanford University

og forsker i stamceller på Stanford Universitet,

where my clinical focus has been bone marrow transplantation.

hvor mit kliniske fokus har været knoglemarvstransplantation.

Now, inspired by Jill Bolte Taylor last year,

Inspireret af Jill Bolte Taylor sidste år

I didn't bring a human brain,

tog jeg ikke en hjerne med,

but I did bring a liter of bone marrow.

men jeg tog en liter knoglemarv.

And bone marrow is actually what we use

Og knoglemarv bruger vi faktisk

to save the lives of tens of thousands of patients,

til at redde titusindvis af patienters liv,

most of whom have advanced malignancies like leukemia and lymphoma

hvoraf de fleste har fremskredne lidelser som leukæmi og lymfoma

and some other diseases.

og andre sygdomme.

So, a few years ago, I'm doing my transplant fellowship at Stanford.

For et par år siden er jeg transplantations-fellow på Stanford.

I'm in the operating room. We have Bob here,

Jeg er på operationsstuen. Her har vi Bob,

who is a volunteer donor.

der er frivillig donor.

We're sending his marrow across the country to save the life

Vi sender hans marv på tværs af landet for at redde

of a child with leukemia.

et leukæmiramt barn.

So actually how do we harvest this bone marrow?

Hvordan høster vi knoglemarv?

Well we have a whole O.R. team, general anesthesia, nurses,

Vi har et operationshold, anæstesi, sygeplejersker

and another doctor across from me.

og en anden læge foran mig.

Bob's on the table, and we take this sort of small needle,

Bob er på bordet, og vi tager denne lille nål,

you know, not too big.

ikke særlig stor.

And the way we do this is we basically

Og grundlæggende placerer vi

place this through the soft tissue,

den gennem det bløde væv

and kind of punch it into the hard bone,

og presser den ind i den hårde knogle

into the tuchus -- that's a technical term --

ind i tuchus -- det er et fagord --

and aspirate about 10 mls of bone marrow out,

og suger omkring 10 ml knoglemarv ud

each time, with a syringe.

hver gang med en kanyle.

And hand it off to the nurse. She squirts it into a tin.

Og giver det til sygeplejersken. Hun sprøjter det i en dåse.

Hands it back to me. And we do that again and again.

Giver mig den. Og vi gør det igen og igen.

About 200 times usually.

Omkring 200 gange.

And by the end of this my arm is sore, I've got a callus on my hand,

Og til sidst er min arm øm, jeg får hård hud på hånden,

let alone Bob,

for ikke at tale om Bob,

whose rear end looks something more like this,

hvis bagdel mere ligner dette,

like Swiss cheese.

Schweizisk ost.

So I'm thinking, you know, this procedure hasn't changed in about 40 years.

Så jeg tænker, denne procedure har været uforandret i 40 år.

And there is probably a better way to do this.

Der er nok en bedre fremgangsmåde.

So I thought of a minimally invasive approach,

Jeg kom på en minimalt invasiv metode

and a new device that we call the Marrow Miner.

og et nyt apparat, vi kalder Marvgraveren.

This is it.

Her er den.

And the Marrow Miner, the way it works is shown here.

Her kan I se hvordan Marvgraveren virker.

Our standard see-through patient.

Vores standard gennemsigtige patient.

Instead of entering the bone dozens of times,

Frem for at trænge ind i knoglen dusinvis af gange,

we enter just once, into the front of the hip or the back of the hip.

kan vi trænge ind én gang, ind i hoften forfra eller bagfra.

And we have a flexible, powered catheter

Og vi har et fleksibelt, eldrevet kateter

with a special wire loop tip that stays inside the crunchy part of the marrow

med en speciel rund ledningsspids, der bliver i marvens knasende del

and follows the contours of the hip, as it moves around.

og følger hoftens konturer, mens den bevæger sig rundt.

So it enables you to very rapidly aspirate,

Den muliggør hurtigt at opsuge

or suck out, rich bone marrow very quickly through one hole.

eller udsuge rig knoglemarv hurtigt gennem ét hul.

We can do multiple passes through that same entry.

Vi kan tage flere runder gennem den ene indgang.

No robots required.

Uden robotter.

And, so, very quickly, Bob can just get one puncture, local anesthesia,

Derfor kan Bob nøjes med ét hul, lokalbedøvelse

and do this harvest as an outpatient.

og blive høstet som ambulant patient.

So I did a few prototypes. I got a small little grant at Stanford.

Jeg lavede nogle prototyper. Jeg fik et lille stipendium fra Stanford.

And played around with this a little bit.

Og legede lidt med denne.

And our team members developed this technology.

Vores hold udviklede teknologien.

And eventually we got two large animals, and pig studies.

Endelig fik vi to store dyr og forsøg med grise.

And we found, to our surprise, that we not only got bone marrow out,

Vi fandt, at vi ikke kun fik knoglemarv ud

but we got 10 times the stem cell activity

men vi fik 10 gange højere stamcelleaktivitet

in the marrow from the Marrow Miner, compared to the normal device.

i marven fra Marvgraveren, i forhold til det normale apparat.

This device was just FDA approved in the last year.

Apparatet her blev godkendt sidste år.

Here is a live patient. You can see it following the flexible curves around.

Her er en levende patient. I kan se, det følger kurverne.

There will be two passes here, in the same patient, from the same hole.

Her er to runder fra samme patient, samme hul.

This was done under local anesthesia, as an outpatient.

Dette blev gjort under lokalbedøvelse som ambulant patient.

And we got, again, about three to six times more stem cells

Igen fik vi omkring tre til seks gange flere stamceller

than the standard approach done on the same patient.

end standardfremgangsmåden på samme patient.

So why should you care? Bone marrow is a very rich source of adult stem cells.

Hvorfor skulle I kere jer? Knoglemarv er en rig kilde til voksenstamceller.

You all know about embryonic stem cells.

I kender alle embryoniske stamceller.

They've got great potential but haven't yet entered clinical trials.

De har stort potentiale, men er endnu ikke i kliniske forsøg.

Adult stem cells are throughout our body,

Voksenstamceller er i hele kroppen,

including the blood-forming stem cells in our bone marrow,

også bloddannende stamceller er i vores knoglemarv,

which we've been using as a form of stem-cell therapy

som vi har benyttet som en art stamcelleterapi

for over 40 years.

i over 40 år.

In the last decade there's been an explosion of use

I det seneste årti har der været en eksplosion i brugen

of bone marrow stem cells to treat the patient's other diseases

af knoglemarvsstamceller for at behandle patientens andre sygdomme

such as heart disease, vascular disease,

som hjerte-kar-sygdomme,

orthopedics, tissue engineering,

ortopædi, vævsmanipulation,

even in neurology to treat Parkinson's

selv i neurologi til at behandle Parkinsons

and diabetes.

og diabetes.

We've just come out, we're commercializing, this year,

Vi er lige udkommet, vi kommercialiserer i år

generation 2.0 of the Marrow Miner.

generation 2,0 af Marvgraveren.

The hope is that this gets more stem cells out,

Håbet er, at dette får flere stamceller ud,

which translates to better outcomes.

hvilket viser sig i bedre udfald.

It may encourage more people to sign up to be

Det kan opfordre flere til at skrive sig op til at være

potential live-saving bone marrow donors.

potentielt livreddende knoglemarvsdonorer.

It may even enable you to bank

Det muliggør måske at sætte

your own marrow stem cells, when you're younger and healthier,

sin marvstamceller i banken, mens man er yngre og raskere

to use in the future should you need it.

til brug i fremtiden, skulle det blive nødvendigt.

And ultimately -- and here's a picture of our

Og ultimativt -- her er et billede af vores

bone marrow transplant survivors,

knoglemarvstransplantations-overlevende,

who come together for a reunion each year at Stanford.

som kommer sammen til en genforening hvert år på Stanford.

Hopefully this technology will let us

Forhåbentlig vil denne teknologi lade os

have more of these survivors in the future.

have flere af disse overlevende i fremtiden.

Thanks.

Tak.

(Applause)

(Bifald)