Daniel Kraft invents a better way to harvest bone marrow

28,932 views ใƒป 2009-07-15

TED


ืื ื ืœื—ืฅ ืคืขืžื™ื™ื ืขืœ ื”ื›ืชื•ื‘ื™ื•ืช ื‘ืื ื’ืœื™ืช ืœืžื˜ื” ื›ื“ื™ ืœื”ืคืขื™ืœ ืืช ื”ืกืจื˜ื•ืŸ.

ืžืชืจื’ื: Avihu Turzion ืžื‘ืงืจ: Shaike Katz
00:18
So I am a pediatric cancer doctor
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ืื– ืื ื™ ืจื•ืคื ื™ืœื“ื™ื ืœืกืจื˜ืŸ
00:21
and stem-cell researcher at Stanford University
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ื•ื—ื•ืงืจ ืชืื™-ื’ื–ืข ื‘ืื•ื ื™ื‘ืจืกื™ื˜ืช ืกื˜ื ืคื•ืจื“
00:25
where my clinical focus has been bone marrow transplantation.
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ืฉื ื”ืžื™ืงื•ื“ ื”ืงืœื™ื ื™ ืฉืœื™ ื”ื•ื ื”ืฉืชืœืช ืžื—-ืขืฆื.
00:28
Now, inspired by Jill Bolte Taylor last year,
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ืขื›ืฉื™ื•, ื‘ื”ืฉืจืืช ื”ืจืฆืืชื” ืฉืœ ื’'ื™ืœ ื‘ื•ืœื˜ื™ ื˜ื™ื™ืœืจ ืฉื ื” ืฉืขื‘ืจื”,
00:30
I didn't bring a human brain,
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ืœื ื”ื‘ืืชื™ ืžื•ื— ืื ื•ืฉื™,
00:32
but I did bring a liter of bone marrow.
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ืื‘ืœ ื”ื‘ืืชื™ ืœื™ื˜ืจ ืฉืœ ืžื—-ืขืฆื.
00:35
And bone marrow is actually what we use
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ื•ืžื—-ืขืฆื ื”ื•ื ืžื” ืฉืื ื• ืžืฉืชืžืฉื™ื ื‘ื•
00:38
to save the lives of tens of thousands of patients,
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ื›ื“ื™ ืœื”ืฆื™ืœ ืืช ื—ื™ื™ื”ื ืฉืœ ืจื‘ื‘ื•ืช ื—ื•ืœื™ื,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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ืฉืœืจื‘ื™ื ืžื”ื ื™ืฉ ืžื—ืœื•ืช ืžืžืื™ืจื•ืช ื›ืžื• ืœื•ืงืžื™ื” ื•ืœื™ืžืคื•ืžื”
00:43
and some other diseases.
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ื•ืžื—ืœื•ืช ืื—ืจื•ืช.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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ืื–, ืœืคื ื™ ื›ืžื” ืฉื ื™ื, ืขืฉื™ืชื™ ื”ืฉืชืœื” ื‘ืกื˜ื ืคื•ืจื“.
00:49
I'm in the operating room. We have Bob here,
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ืื ื™ ื‘ื—ื“ืจ ื”ื ื™ืชื•ื—. ื™ืฉ ืœื ื• ืืช ื‘ื•ื‘ ื›ืืŸ,
00:51
who is a volunteer donor.
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ืฉื”ื•ื ืžืชื ื“ื‘ ืœืชืจื•ื.
00:53
We're sending his marrow across the country to save the life
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ืื ื• ืฉื•ืœื—ื™ื ืืช ืžื—-ื”ืขืฆื ืฉืœื• ืœืฆื“ ื”ืฉื ื™ ืฉืœ ื”ืืจืฅ ื›ื“ื™ ืœื”ืฆื™ืœ ืืช ื—ื™ื™ื•
00:55
of a child with leukemia.
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ืฉืœ ื™ืœื“ ืฉืกื•ื‘ืœ ืžืœื•ืงืžื™ื”.
00:57
So actually how do we harvest this bone marrow?
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ืื– ืื™ืš ืื ื—ื ื• ืื•ืกืคื™ื ืžื—-ืขืฆื ื‘ืืžืช?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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ื™ืฉ ืœื ื• ืืช ื›ืœ ืฆื•ื•ืช ื”ื ื™ืชื•ื—, ื”ืจื“ืžื” ื›ืœืœื™ืช, ืื—ื™ื•ืช,
01:03
and another doctor across from me.
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ื•ืจื•ืคื ืื—ืจ ืžื•ืœื™.
01:05
Bob's on the table, and we take this sort of small needle,
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ื‘ื•ื‘ ืขืœ ื”ืฉื•ืœื—ืŸ, ื•ืื ื• ืœื•ืงื—ื™ื ืžืขื™ืŸ ืžื—ื˜ ืงื˜ื ื” ื›ื–ื•,
01:07
you know, not too big.
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ืืชื ื™ื•ื“ืขื™ื, ืœื ื’ื“ื•ืœื” ืžื“ื™.
01:09
And the way we do this is we basically
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ื•ืžื” ืฉืื ื• ืขื•ืฉื™ื ื”ื•ื
01:11
place this through the soft tissue,
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ืœื”ื—ื“ื™ืจ ืื•ืชื” ื“ืจืš ื”ืจืงืžื•ืช ื”ืจื›ื•ืช,
01:13
and kind of punch it into the hard bone,
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ื•ืœื ืงื‘ ืื™ืชื” ืืช ื”ืขืฆืžื•ืช ื”ืงืฉื•ืช,
01:15
into the tuchus -- that's a technical term --
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ืœืชื•ืš ื”ื˜ื•ื›ืขืก - ื–ื” ืžื•ื ื— ื˜ื›ื ื™ -
01:17
and aspirate about 10 mls of bone marrow out,
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ื•ืœืฉืื•ื‘ ื‘ืขืจืš 10 ืž"ืœ ืฉืœ ืžื—-ืขืฆื,
01:21
each time, with a syringe.
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ื‘ื›ืœ ืคืขื ืขื ืžื–ืจืง.
01:23
And hand it off to the nurse. She squirts it into a tin.
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ื•ืœืชืช ืืช ื–ื” ืœืื—ื•ืช. ื”ื™ื ืžืฉืคืจื™ืฆื” ืืช ื–ื” ืœืฆื ืฆื ืช.
01:26
Hands it back to me. And we do that again and again.
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ืžื—ื–ื™ืจื” ืœื™ ืืช ื–ื”. ื•ืื ื—ื ื• ืขื•ืฉื™ื ื–ืืช ืฉื•ื‘ ื•ืฉื•ื‘.
01:29
About 200 times usually.
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ื‘ืขืจืš 200 ืคืขื ื‘ื“"ื›.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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ื•ื‘ืกื•ืฃ ื”ื–ืจื•ืข ืฉืœื™ ื›ื•ืื‘ืช, ื™ืฉ ืœื™ ื™ื‘ืœื•ืช ืขืœ ื”ื™ื“.
01:33
let alone Bob,
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ืฉืœื ืœื“ื‘ืจ ืขืœ ื‘ื•ื‘,
01:35
whose rear end looks something more like this,
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ืฉื—ืœืงื• ื”ืื—ื•ืจื™ ื ืจืื” ื™ื•ืชืจ ื›ืžื•
01:37
like Swiss cheese.
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ื›ืžื• ื’ื‘ื™ื ื” ืฉื•ื•ื™ืฆืจื™ืช.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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ืื– ื—ืฉื‘ืชื™, ืืชื ื™ื•ื“ืขื™ื, ื”ืชื”ืœื™ืš ื”ื–ื” ืœื ื”ืฉืชื ื” ื›ื‘ืจ 40 ืฉื ื”.
01:43
And there is probably a better way to do this.
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ื•ืฆืจื™ื›ื” ืœื”ื™ื•ืช ื“ืจืš ื˜ื•ื‘ื” ื™ื•ืชืจ ืœืขืฉื•ืช ืืช ื–ื”.
01:45
So I thought of a minimally invasive approach,
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ืื– ื—ืฉื‘ืชื™ ืขืœ ื”ื’ื™ืฉื” ื”ื›ื™ ืคื—ื•ืช ืคื•ืœืฉื ื™ืช.
01:48
and a new device that we call the Marrow Miner.
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ื•ืžื›ืฉื™ืจ ื—ื“ืฉ ืฉื ืงืจื ื›ื•ืจื” ืžื—-ื”ืขืฆื.
01:50
This is it.
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ื–ื”ื• ื–ื”.
01:52
And the Marrow Miner, the way it works is shown here.
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ื•ื›ืืŸ ืจื•ืื™ื ืื™ืš ื›ื•ืจื” ืžื—-ื”ืขืฆื ืขื•ื‘ื“.
01:55
Our standard see-through patient.
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ื”ื—ื•ืœื” ื”ืฉืงื•ืฃ ื”ืกื˜ื ื“ืจื˜ื™ ืฉืœื ื•.
01:57
Instead of entering the bone dozens of times,
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ื‘ืžืงื•ื ืœื—ื“ื•ืจ ืœืขืฆื ืขืฉืจื•ืช ืคืขืžื™ื,
01:59
we enter just once, into the front of the hip or the back of the hip.
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ืื ื• ื—ื•ื“ืจื™ื ืคืขื ืื—ืช ืœื™ืจืš ืžืงื“ื™ืžื” ืื• ืžืื—ื•ืจื”.
02:01
And we have a flexible, powered catheter
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ื•ื™ืฉ ืœื ื• ืงืชื˜ืจ ื’ืžื™ืฉ ืžืžื•ื ืข
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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ืขื ืœื•ืœืื” ืžื™ื•ื—ื“ืช ื‘ืงืฆื” ืฉื ืฉืืจืช ื‘ืงืฆื” ื”ืคืจื™ืš ืฉืœ ืžื—-ื”ืขืฆื
02:07
and follows the contours of the hip, as it moves around.
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ื•ืขื•ืงื‘ืช ืื—ืจ ืงื•ื•ื™ ื”ืžืชืืจ ืฉืœ ื”ื™ืจืš ื‘ืชื ื•ืขืชื”.
02:10
So it enables you to very rapidly aspirate,
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ืื– ื–ื” ืžืืคืฉืจ ืœื”ื–ืจื™ืง ืžืื•ื“ ืžื”ืจ,
02:12
or suck out, rich bone marrow very quickly through one hole.
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ืื• ืœืฉืื•ื‘ ืžื—-ืขืฆื ืขืฉื™ืจ ืžื”ืจ ืžืื•ื“ ื“ืจืš ื—ื•ืจ ืื—ื“.
02:15
We can do multiple passes through that same entry.
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ืื ื• ื™ื›ื•ืœื™ื ืœืขื‘ื•ืจ ืžืกืคืจ ืคืขืžื™ื ื“ืจืš ืื•ืชื• ืคืชื—.
02:17
No robots required.
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ืœื ื“ืจื•ืฉื™ื ืจื•ื‘ื•ื˜ื™ื.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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ื•ื›ืš, ืžื”ืจ ืžืื•ื“, ื‘ืืžืฆืขื•ืช ื ื™ืงื•ื‘ ืื—ื“ ื•ื”ืจื“ืžื” ืžืงื•ืžื™ืช,
02:22
and do this harvest as an outpatient.
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ื‘ื•ื‘ ื™ื›ื•ืœ ืœืขืฉื•ืช ืืช ื”ืื™ืกื•ืฃ ื›ื—ื•ืœื” ื—ื™ืฆื•ื ื™.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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ืื– ืขืฉื™ืชื™ ืžืกืคืจ ืื‘ื•ืช-ื˜ื™ืคื•ืก. ืงื™ื‘ืœืชื™ ืžืœื’ื” ืงื˜ื ื” ื‘ืกื˜ื ืคื•ืจื“.
02:29
And played around with this a little bit.
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ื•ืฉื™ื—ืงืชื™ ืขื ื–ื” ืงืฆืช.
02:31
And our team members developed this technology.
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ื•ื—ื‘ืจื™ ื”ืฆื•ื•ืช ืฉืœื ื• ืคื™ืชื—ื• ืืช ื”ื˜ื›ื ื•ืœื•ื’ื™ื” ื”ื–ื•.
02:33
And eventually we got two large animals, and pig studies.
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ื•ืœื‘ืกื•ืฃ ืงื™ื‘ืœื ื• ืฉืชื™ ื—ื™ื•ืช ื’ื“ื•ืœื•ืช, ื•ืžื—ืงืจ ื—ื–ื™ืจื™ื.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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ื•ืžืฆืื ื•, ืœืžืจื‘ื” ื”ืคืชืขืชื ื•, ืฉืœื ืจืง ืงื™ื‘ืœื ื• ืžื—-ืขืฆื,
02:39
but we got 10 times the stem cell activity
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ืงื™ื‘ืœื ื• ืคื™ 10 ืคืขื™ืœื•ืช ืฉืœ ืชืื™-ื’ื–ืข
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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ื‘ืžื—-ื”ืขืฆื ืฉืœ ื”ื›ื•ืจื”, ื‘ื”ืฉื•ื•ืื” ืœืžื›ืฉื™ืจ ื”ืจื’ื™ืœ.
02:44
This device was just FDA approved in the last year.
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ื”ืžื›ืฉื™ืจ ืื•ืฉืจ ืข"ื™ ืžื ื”ืœ ื”ืชืจื•ืคื•ืช ื‘ืฉื ื” ื”ืื—ืจื•ื ื”.
02:47
Here is a live patient. You can see it following the flexible curves around.
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ื›ืืŸ ืจื•ืื™ื ื—ื•ืœื” ื—ื™. ื ื™ืชืŸ ืœืจืื•ืช ืื•ืชื• ืขื•ื‘ืจ ื‘ืคื ื™ื•ืช ื”ื’ืžื™ืฉื•ืช.
02:50
There will be two passes here, in the same patient, from the same hole.
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ื™ื”ื™ื• ืฉื ื™ ืžืขื‘ืจื™ื ื›ืืŸ, ื‘ืื•ืชื• ื—ื•ืœื”, ืžืื•ืชื• ื—ื•ืจ.
02:53
This was done under local anesthesia, as an outpatient.
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ื–ื” ื ืขืฉื” ื‘ื”ืจื“ืžื” ืžืงื•ืžื™ืช, ื‘ืืฉืคื•ื– ื™ื•ื.
02:55
And we got, again, about three to six times more stem cells
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ื•ืงื™ื‘ืœื ื•, ืฉื•ื‘, ืคื™ 6 ื™ื•ืชืจ ืชืื™ ื’ื–ืข
02:58
than the standard approach done on the same patient.
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ืžืืฉืจ ื”ื’ื™ืฉื” ื”ืจื’ื™ืœื” ืขืœ ืื•ืชื• ื—ื•ืœื”.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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ืื– ืœืžื” ืฉื™ื”ื™ื” ืœื ื• ืื™ื›ืคืช? ืžื—-ืขืฆื ื”ื•ื ืžืงื•ืจ ืขืฉื™ืจ ืžืื•ื“ ืœืชืื™-ื’ื–ืข ื‘ื•ื’ืจื™ื.
03:04
You all know about embryonic stem cells.
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ื›ื•ืœื›ื ื™ื•ื“ืขื™ื ืขืœ ืชืื™ ื’ื–ืข ืขื•ื‘ืจื™ื™ื.
03:06
They've got great potential but haven't yet entered clinical trials.
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ื™ืฉ ืœื”ื ืคื•ื˜ื ืฆื™ืืœ ืื“ื™ืจ, ืื‘ืœ ื”ื ืขื“ื™ื™ืŸ ืœื ื ื›ื ืกื• ืœื ื™ืกื•ื™ื™ื ืงืœื™ื ื™ื™ื.
03:09
Adult stem cells are throughout our body,
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ืชืื™-ื’ื–ืข ื‘ื•ื’ืจื™ื ื ืžืฆืื™ื ื‘ื›ืœ ื”ื’ื•ืฃ,
03:11
including the blood-forming stem cells in our bone marrow,
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ื›ื•ืœืœ ืชืื™-ื’ื–ืข ื™ื•ืฆืจื™ ื“ื ื‘ืžื—-ื”ืขืฆื ืฉืœื ื•.
03:13
which we've been using as a form of stem-cell therapy
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ืฉื”ืฉืชืžืฉื ื• ื‘ื”ื ื‘ืฉื‘ื™ืœ ืชืจืคื™ื™ืช ืชืื™-ื’ื–ืข
03:15
for over 40 years.
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ื‘ืžืฉืš 40 ืฉื ื”.
03:17
In the last decade there's been an explosion of use
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ื‘ืขืฉื•ืจ ื”ืื—ืจื•ืŸ ื—ืœื” ื”ืชืคื•ืฆืฆื•ืช ื‘ืฉื™ืžื•ืฉ
03:20
of bone marrow stem cells to treat the patient's other diseases
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ื‘ืชืื™-ื’ื–ืข ืžืžื—-ืขืฆื ื›ื“ื™ ืœื˜ืคืœ ื‘ืžื—ืœื•ืช ืื—ืจื•ืช ืฉืœ ื”ื—ื•ืœื”
03:23
such as heart disease, vascular disease,
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ื›ืžื• ืžื—ืœื•ืช ืœื‘, ืžื—ืœื•ืช ื›ืœื™-ื“ื,
03:25
orthopedics, tissue engineering,
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ืื•ืจืชื•ืคื“ื™ื•ืช, ื”ื ื“ืกืช ืจืงืžื•ืช,
03:27
even in neurology to treat Parkinson's
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ืืคื™ืœื• ื‘ื ื•ื™ืจื•ืœื’ื™ื” ืœื˜ื™ืคื•ืœ ื‘ืคืจืงื™ื ืกื•ืŸ,
03:29
and diabetes.
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ื•ืกื›ืจืช.
03:31
We've just come out, we're commercializing, this year,
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ื‘ื“ื™ื•ืง ื”ื•ืฆืื ื•, ืื ื• ืžื ืคื™ืงื™ื ื”ืฉื ื”,
03:33
generation 2.0 of the Marrow Miner.
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ืืช ื”ื“ื•ืจ ื”ืฉื ื™ ืฉืœ ื›ื•ืจื” ืžื—-ื”ืขืฆื.
03:35
The hope is that this gets more stem cells out,
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ื”ืชืงื•ื•ื” ื”ื™ื ืฉื”ื•ื ื™ื•ืฆื™ื ื™ื•ืชืจ ืชืื™ ื’ื–ืข.
03:37
which translates to better outcomes.
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ืžื” ืฉืžืชื•ืจื’ื ืœืชื•ืฆืื•ืช ื˜ื•ื‘ื•ืช ื™ื•ืชืจ.
03:39
It may encourage more people to sign up to be
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ื–ื” ืื•ืœื™ ืืฃ ื™ืขื•ื“ื“ ื™ื•ืชืจ ืื ืฉื™ื ืœื”ื™ืจืฉื ืœื”ื™ื•ืช
03:41
potential live-saving bone marrow donors.
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ืชื•ืจืžื™ื ืžืฆื™ืœื™ื-ื—ื™ื™ื ืืคืฉืจื™ื™ื ืœืžื—-ืขืฆื.
03:43
It may even enable you to bank
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ืื– ืื•ืœื™ ืืฃ ื™ืืคืฉืจ ืœืš ืœืื’ื•ืจ
03:45
your own marrow stem cells, when you're younger and healthier,
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ืืช ืชืื™-ื”ื’ื–ืข ืฉืœืš, ื›ืืฉืจ ืืชื” ืฆืขื™ืจ ื•ื‘ืจื™ื ื™ื•ืชืจ,
03:47
to use in the future should you need it.
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ืœืฉื™ืžื•ืฉ ื‘ืขืชื™ื“, ืื ืชื–ื“ืงืง ืœื•.
03:50
And ultimately -- and here's a picture of our
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ื•ืœื‘ืกื•ืฃ - ื”ื ื” ืชืžื•ื ื”
03:52
bone marrow transplant survivors,
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ืฉืœ ื”ืฉื•ืจื“ื™ื ืžื”ืฉืชืœืช ืžื—-ืขืฆื,
03:54
who come together for a reunion each year at Stanford.
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ืฉื‘ืื™ื ื›ืœ ืฉื ื” ืœืคื’ื™ืฉืช ืžื—ื–ื•ืจ ื‘ืกื˜ื ืคื•ืจื“.
03:56
Hopefully this technology will let us
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ื‘ืชืงื•ื•ื” ื”ื˜ื›ื ื•ืœื•ื’ื™ื” ื”ื–ื• ืชืืคืฉืจ ืœื ื•
03:58
have more of these survivors in the future.
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ืœืงื‘ืœ ื™ื•ืชืจ ืฉื•ืจื“ื™ื ื›ืืœื” ื‘ืขืชื™ื“.
04:00
Thanks.
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ืชื•ื“ื”.
04:02
(Applause)
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(ืžื—ื™ืื•ืช ื›ืคื™ื™ื)
ืขืœ ืืชืจ ื–ื”

ืืชืจ ื–ื” ื™ืฆื™ื’ ื‘ืคื ื™ื›ื ืกืจื˜ื•ื ื™ YouTube ื”ืžื•ืขื™ืœื™ื ืœืœื™ืžื•ื“ ืื ื’ืœื™ืช. ืชื•ื›ืœื• ืœืจืื•ืช ืฉื™ืขื•ืจื™ ืื ื’ืœื™ืช ื”ืžื•ืขื‘ืจื™ื ืขืœ ื™ื“ื™ ืžื•ืจื™ื ืžื”ืฉื•ืจื” ื”ืจืืฉื•ื ื” ืžืจื—ื‘ื™ ื”ืขื•ืœื. ืœื—ืฅ ืคืขืžื™ื™ื ืขืœ ื”ื›ืชื•ื‘ื™ื•ืช ื‘ืื ื’ืœื™ืช ื”ืžื•ืฆื’ื•ืช ื‘ื›ืœ ื“ืฃ ื•ื™ื“ืื• ื›ื“ื™ ืœื”ืคืขื™ืœ ืืช ื”ืกืจื˜ื•ืŸ ืžืฉื. ื”ื›ืชื•ื‘ื™ื•ืช ื’ื•ืœืœื•ืช ื‘ืกื ื›ืจื•ืŸ ืขื ื”ืคืขืœืช ื”ื•ื•ื™ื“ืื•. ืื ื™ืฉ ืœืš ื”ืขืจื•ืช ืื• ื‘ืงืฉื•ืช, ืื ื ืฆื•ืจ ืื™ืชื ื• ืงืฉืจ ื‘ืืžืฆืขื•ืช ื˜ื•ืคืก ื™ืฆื™ืจืช ืงืฉืจ ื–ื”.

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