JAN. 15, 2013

Karl Blume, founder of Stanford's blood and marrow transplantation program, dies at 75

BY KRISTA CONGER

Karl Blume

(click on the photo for a high-resolution version)

Karl Blume, MD, an emeritus professor of medicine at the Stanford University School of Medicine who started its blood and marrow transplantation program and spearheaded its effort to attain Cancer Center designation from the National Cancer Institute, died unexpectedly at his home in Palo Alto on Jan. 9. He was 75.

Blume is remembered as a meticulous and organized visionary who excelled at team building and enjoyed literature and music and avidly supported Stanford athletics. Although he is considered the founding father of the Stanford blood and marrow transplantation program, he was always most proud of the patients he treated during his career.

"Dr. Blume reminded us that, although the profession of a physician-scientist encompasses many duties, including research, teaching and patient care, in the end it is always the patient who is most important," said Lloyd Minor, MD, dean of the School of Medicine. "He was a remarkable individual who will be sorely missed in the Stanford community. He leaves behind an enduring legacy of a robust, successful blood and marrow transplant program, and also of the hundreds of patients whose lives he touched."

Blume was recruited to Stanford in 1987 from the City of Hope, a biomedical research, treatment and education institution in Southern California. He served as the director of Stanford's then-newly created Division of Bone Marrow Transplantation from 1987 until 2000, and as the associate chair for research in the Department of Medicine from 2000 until 2002. During that time he mentored many young physicians and researchers, some of whom went on to direct transplantation programs at other medical centers around the country. In 2003 he assumed emeritus status, after which he served as senior cancer research program advisor for the Stanford Cancer Institute until his death.

"Dr. Blume was beloved, deeply valued and truly unforgettable," said former medical school dean Philip Pizzo, MD. "Committed to excellence, unwavering in his support for patients, rigorous in his value for research and education, he built one of the world's most successful stem cell transplant programs, laid the critical foundation for the Stanford Cancer Institute, mentored and guided countless students, trainees and faculty, and deeply loved his family and Stanford. I value my friendship with Dr. Blume exceedingly and will miss him tremendously. He leaves an indelible mark on all of us."

Blume not only built the bone marrow transplantation program at Stanford from the ground up, but he also shepherded it through a multitude of clinical advances and changes. During his tenure, the process of transplantation evolved from a reliance on whole bone marrow, often from a patient or a patient's relative, to the use of blood stem cells that can be harvested from the plasma of an unrelated, matched donor. The program grew from about 40 transplants during its first year in 1987 to more than 300 transplants during 2012.

"We've seen an incredible evolution of this treatment over time," said Robert Negrin, MD, current chief of the blood and marrow transplant program. "Karl always brought a sense of commitment to the patients and their experience. He also encouraged discipline in the design of clinical trials, which enabled the field to move forward with rigor and clarity. He excelled in his ability to relate to many different kinds of people and personalities and to bring them together to work toward a common goal in a very effective way."

In 2003, Blume dedicated himself to achieving National Cancer Institute-designated Cancer Center status for the Stanford Cancer Institute, which would afford greater access to NCI resources, funding and clinical trials. The designation was awarded by the NCI in 2007 after a three-year grant application process.

"The entire Stanford Cancer Institute is saddened by the news of Karl Blume's passing," said Beverly Mitchell, MD, director of the institute. "Karl served as a trusted advisor on almost every issue of importance during the initial planning of the cancer institute. His dedication and commitment were extraordinary. We could always count on Karl for thoughtful and objective advice on virtually any subject, and his compassion, steadiness, work ethic and sense of fairness set the standard for collaborative work. He was an inspiration to all of us, and we will miss him greatly."

In addition to his clinical and administrative duties at Stanford, in 1994 Blume was a driving force in founding the American Society for Blood and Marrow Transplantation — an international organization of physicians and researchers committed to serving patients with a variety of blood diseases and cancers. He was also a leader in the American Society of Hematology and for many years was in charge of that organization's career development program.

Blume earned a medical degree in 1963 from the University of Freiburg, Germany. He came to the United States as a research fellow in hematology at the City of Hope in 1971, and became the head of its Department of Bone Marrow Transplantation in 1975. While there, he formed what was to be a lifelong friendship with his mentor, the hematologist Ernest Beutler, MD, then the chair of medicine at City of Hope.

"At City of Hope, Karl showed that it was possible to do successful transplants outside of the Fred Hutchison Cancer Research Center in Seattle, where the technique was invented," said Nelson Chao, MD, a former Stanford physician and Blume mentee who now heads the Division of Hematologic Malignancies and Cellular Therapy at Duke University. "This was a great contribution to the field. And although he could be quite demanding — you had to do your share — he also loved life and helping people."

"Karl was a real gentleman, very respectful," said Negrin. "He gave me a great sense that our major role is to mentor people and promote their careers. I was a great beneficiary of that, and I've tried to model my own career around this idea. The thing that Karl always had was time. I would go to him often and he would sit and listen and hear all the details before giving his advice."

"Karl was thinking about his patients all the time," said Stanley Schrier, MD, emeritus professor of medicine. "At the same time, he was an incredibly good mentor who took care of his young people. He coached them and helped them with their career choices. He was also committed and absolutely loyal to Stanford. He cheered for all the sports teams, and never missed an opportunity to promote Stanford and to work to make it the best he could."

"In many ways, he was a very joyful man," said Negrin. "When he'd travel to Germany, which he did regularly, he'd call to check in, and I'd start telling him about the latest clinical trial results or other aspects of the program. He'd listen, but he'd always take time to ask about the latest Stanford basketball or football recruits. We would promise one another that when Stanford made it to the national finals, we'd be there together. I'll always regret that that never happened."

When, in 1987, Stanford wanted to start its own bone marrow transplantation program, Blume was one of several candidates under consideration. Schrier recalled: "I was the chair of the recruiting committee, and Ron Levy, who was also on the committee, and I were flying to City of Hope to interview Karl. We sat together during the flight, and discussed what we wanted to ask him, and how best to describe the type of program we wanted at Stanford. When we got there, Karl being Karl, he took control of the interview immediately and told us exactly what he wanted to do and how he would do it. And he did so in a thoughtful, sensible manner. His priorities matched ours, and it was clear at that point that he was absolutely the right person for the job."

Pizzo, the former dean, said: "Dr. Blume set the bar of excellence extraordinarily high for everyone, including himself. He thought about issues deeply and made choices based on a hard and critical look at the data — something that he did quite uniquely in his own personal decisions about life and death."

Most recently, Blume had to decide whether to undergo a lung transplant to treat a progressively worsening lung disease with which he had struggled for years. According to Negrin, Blume approached the process with his typical thoughtfulness: "Karl struggled with the decision to go through with the transplant. He consulted with various experts in the field as to whether it was the right thing to do at his age, or if the organs should instead go to someone younger. In the end he decided to go forward, and he was doing well in the weeks following the surgery."

Blume recovered enough to resume his normal duties at Stanford, and was working on campus in the days before his death.

"It's hard to explain how influential Karl was," said Negrin. "He inspired people in a very positive way. He brought people together and made them feel good about being part of his team. He had a remarkable way of making each person feel special."

Blume is survived by his wife, Vera; his daughter, Caroline Mirtich; his son, Philipp Blume; and five grandchildren.

A memorial service is planned for March 23 at 4 p.m. at the Frances C. Arrillaga Alumni Center. Memorial contributions may be made to the Stanford Cancer Institute Discovery Fund in memory of Karl G. Blume, MD. Send contributions to Medical Center Development, 3172 Porter Drive, Suite 210, Palo Alto, CA, 94304.

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