A few months before completing medical school in 2003, Lukas Wartman was diagnosed with acute lymphoblastic leukemia (ALL), a blood cancer that’s partic- ularly lethal when it strikes adults. So began a battle to stay alive that has involved more than 70 drugs, two rounds of cell transplants, and
a staggering series of twists and turns.
Wartman immediately received aggressive
chemotherapy, which drove the cancer into
remission and enabled him to graduate from
Washington University School of Medicine
(WUSM) in St. Louis in Missouri. He then
embarked on a career of clinical care and lab
research focusing on leukemia, the disease
that had almost killed him. But 5 years later,
Another round of chemotherapy again
knocked the cancer back to undetectable
levels. Doctors also used chemicals and ra-
diation to obliterate his bone marrow, the
source of all his blood cells—a crude but
effective strategy to destroy any cancerous
ones that survived chemotherapy. Then they
infused him with a bone marrow transplant
from his brother. Stem cells from his broth-
er’s marrow reconstituted his blood cells,
including immune system cells, and within
a year, Wartman was working full time and
running regularly. “I was almost back to
my baseline,” he says, as his runs gradually
lengthened and his speed improved. But in
2011, “all of a sudden I hit a wall.” Leukemia
had returned, and his prognosis was bleak.
“The outcomes with patients who relapse a
second time with ALL are abysmal,” he says.
Chemotherapy this time did nothing for
his leukemia and almost killed him. But then
a cutting-edge technique came to the rescue.
A genetic analysis performed at WUSM’s ge- PH
By Jon Cohen, in St. Louis, Missouri
SURVIVING THE CURE
Graft-versus-host disease dries Lukas Wartman’s
eyes, requiring drops every 20 minutes.
122 14 JULY 2017 • VOL 357 ISSUE 6347
A stem cell transplant helped beat back
a young doctor’s cancer. Now, it’s assaulting his body