Did you ever wonder why our marrow is located inside of our *bones*, #MedTwitter? There’s no a priori anatomical reason it should be sited there. Blood cells could form in our spleens & livers, as they do during our fetal lives; or elsewhere, as in some animals. Let’s discuss! /1

After all, zebrafish get along just fine making blood cells in their “kidney marrow”, keeping @leonard_zon's lab running. Drosophila make blood-like cells in abdominal hubs, and frogs… frogs mix it up. Jeremiah Bullfrog & frog cousins make blood in kidneys, marrow, liver, etc./2

I was reviewing marrow failure history in preparation for an upcoming @aamdsif conference, and I’m completely awed by the observational skills of young physician Paul Strübing in Greifswald, Germany in 1882 describing the first clear case of paroxysmal nocturnal hemoglobinuria./1 This was the only photo I could find of Strübing, from over 20 years later (circa 1905). At the time of publication of his prescient 1882 paper, Strübing was 29 years old and had graduated from medical school 6 years earlier. /2

Today marks the end of an era: publication of the final philatelic vignette (authors.elsevier.com/a/1g-uM5qq8Xpp3) co-authored by Robert Kyle @MayoClinic. Bob turned 95 this year and decided to step down from helping prepare these. He published his first vignette @JAMA_current back in 1969!/1 This longstanding series focused on medical & scientific-themed postage stamps began in 1961. At the 109th Annual Meeting of @AmerMedicalAssn in the then-new convention center in Miami Beach, Florida in June 1960, John Mirt (1897-1968) discussed “Medical Pathfinders on Stamps”./2

@OpenAI #ChatGPT4 "hallucinations" remind me of a now-amusing event from way back in Grade 3 when I was 7, involving the last time I knowingly confabulated. I was assigned to write a report about airplanes.✈️ One thing I already knew about airplanes: they were expensive! (1/12) According to my parents, the high cost of airplane tickets was why our family always drove the tedious 800+ miles from our NYC suburban home to see relatives in Michigan at Christmas🎄If 4 airplane *tickets* were expensive, I reasoned an *entire airplane* must be hugely costly.

I’ve never posted a @tiktok_us link before, but this is a rare opportunity to observe one of the most poorly understood disorders in #hematology: Gardner-Diamond syndrome. This young woman's skin lesions first appear about 40 seconds in./1 #MedTwitter tiktok.com/@nancy.xoxx/vi… The syndrome was described by Drs. Frank Gardner (1919-2013) and Louis K. Diamond (1902-1999) in Boston in 1955, in @BloodJournal. They reported 4 cases, all women, who had a peculiar form of bruising on face or extremities but had no other bleeding & normal coagulation tests./2

Among the many things I am #thankful for: recent progress in hematologic malignancies. When I started my career - not that long ago! - standard therapy for myeloma was melphalan & prednisone or VMP, chlorambucil for CLL, CHOP (without R) for NHL, epoetin & transfusions for MDS./1 CML was treated with Hydrea, busulfan, or interferon & Ara-C,and the big debate was transplant timing. Most patients didn't have an allo transplant donor & the age cutoff was 50-55. Karyotyping was inconsistently done even in AML/MDS; FISH was new; single gene testing was rare./2

A medical textbook nostalgia thread! I dug up my @UChicagoMed transcript & recalled what books we used for each class. Buying books online was rare back then, so most came from the University bookstore at 58th & S Ellis, or the claustrophobic but amazing @SeminaryCoop on 57th./1 Year 1, Term 1 (Autumn): Netter’s Atlas of Human Anatomy (1989 edition), Wheater’s Functional Histology (1987), Moore’s Developing Human: Clinically Oriented Embryology (1988), Stryer’s Biochemistry (1990). (If you had another biochem text from undergrad, you could use that.)/2

K-562. It was the first human cell line I ever tried to grow in culture, during training @MayoClinic. It was also the first immortalized myeloid leukemia #cellline, published @BloodJournal way back in 1975. What does the K stand for? #HematologyTweetstory 37 is on cell lines./1 K-562s were derived from a the pleural effusion of a 53 year-old woman with #CML in blast crisis, so they have Ph+/BCR-ABL. She'd been treated with busulfan for 3 years & pipobroman for a year (limited & crummy Rx options back then), and died 9 days after cell collection./2

Stumbled across this today when looking for a different reference and did a double take - another David Steensma, and a Dr Papaemmanuil who is not ⁦@PapaemmanuilLab⁩, publishing on #ICUS which we have both published on - neither are especially common surnames 😮 I have to find this guy and publish with him and cause EndNote confusion forever after /2

It is often said that Marie Skłodowska-Curie died of "aplastic anemia." Try Googling it; you'll find many hits. But I am not so sure. She died on July 4th, 1934, at a sanatorium called Sancellemoz, in Passy, Haute-Savoie, France, after a long illness. #aplasticanemia #MDS /1

https://twitter.com/NobelPrize/status/1411703123501064194

The 1937 biography by her younger daughter Ève describes her final illness, including a consultation at Sancellemoz (postcard) by a "Professor Roch." That would have been Maurice Roch, Regent of @UNIGEnews & father of famous Alpinist André Roch who planned Aspen, Colorado./3

What is “Bloodburn”? In the @starwars Universe, this mysterious chronic hematologic condition led Greer Sonnel - Senator Leia Organa’s chief of staff - to quit spaceship racing. #HematologyTweetstory 36: hematologic changes from space travel, in fantasy & reality. Image:@NASA/1 First, some sci-fi fun. #StarWars fandom source “Wookipedia” (@WookOfficial, source of below image) tells us Bloodburn is a “rare, chronic, and often terminal illness of the blood that befell (often younger) starship pilots”. Symptoms include fevers... /2 starwars.fandom.com/wiki/Bloodburn

Aspirin continues to be the most widely used anti-platelet agent, 125 years after its synthesis. But where did it come from - and why do we give it in such weird doses (e.g. 81, 162 & 325 mg) – at least in the United States? #HematologyTweetstory 35 will answer these questions./1 Some lucky ancient person serendipitously discovered that willow bark & leaves relieved pain. Hippocrates used tea made from willow leaf to ease childbirth, while the Egyptian Ebers papyrus (~1500 BCE) mentions willow for aches and pains. (Images: Sermo/Pharmaceutical Journal)/2

#HematologyTweetstory 34: Vitamin K. This tale includes 2 larger-than-life characters, self experimentation, & bloody cows. Also, yours truly was once *so* dedicated to hematology history that he drove to rural Wisconsin to search local property records related to this story.😉/1 Melilotus: a genus of grassland plants originally from Eurasia, also known as “sweet clover” because of a vanilla-like scent (though the taste is bitter). Sweet clover was first brought to the US & Canada during the Colonial period, and became a useful farm animal feed./2

#HematologyTweetstory 33: hemoglobin variants, often said to be the most common single-gene genetic disorders in humans. “Disorders” is not entirely accurate, as many variants are clinically silent. We’ll focus on hemoglobinopathies; thalassemias are a story for another time./1 I got interested in this ~20 years ago & wrote a paper in 2001 @MayoProceedings about RBC disorders we'd incidentally noted in some of the many patients we saw @MayoClinic from the Middle East (esp. prior to 9/11). I then went to @MRC_WIMM in Oxford to a globin lab for 2 years./2

#HematologyTweetstory 32: lymph nodes with names. There’s also a major personal announcement in this thread. We each have lots of lymph nodes: an estimated 500-600 (Image: @MayoClinic). Like stars, they cluster. (Did you ever think of your axilla as a lymphatic “galaxy”?)🙂/1 One of the best known eponymous nodes is the “Sister Mary Joseph nodule”, named after the gifted woman born Julia Dempsey (1856-1939), who was Dr Will Mayo’s scrub nurse @MayoClinic and, as a Sister of Saint Francis, directed St Marys Hospital in Rochester, MN for 46 years./2

Here’s a thread about the #nucleus… no, Professor Ernest Rutherford, not the atomic nucleus that you discovered with your alpha particles back in 1911.😉 This is about *cell* nuclei and all their weird and wonderful forms, in blood cells and beyond. #HematologyTweetstory 31! /1 Cell nuclei were first drawn by Dutch microscopy pioneer Antonie van Leeuwenhoek circa 1719 (pictured), and discussed as distinct structures in 1804 by botanist Franz Bauer (below with green jacket), then clearly described in 1831 by botanist Robert Brown (below, with bowtie)./2

This is George Grenville (1712-1770): Whig Politician, once First Lord of the Admiralty, then Prime Minister of Great Britain from 1763-1765, and later Chancellor of the Exchequer. Probably also a myeloma patient! And…the subject of #HematologyTweetstory 30, about old bones.🙂/1 Over here in America, Grenville is best known for an ill-advised policy he championed in 1765 called the “Stamp Act”: a tax on colonial documents & newspapers, which could only be printed on special paper shipped from London. This notorious Act outraged the colonists./2

@Clotmaster @ASH_hematology It wasn't always that way! Hematology is older, and before medical oncology developed as an independent discipline in the 1960s pts w/ cancer were cared for by organ specialists (eg gastroenterologists for people w/ colon cancer, pulmonologists for those w/ lung cancer, etc.)/1 @Clotmaster @ASH_hematology Hematology emerged in 1800s with cell counters & stains, and "modern hematology" is often said to have begun in the 1920s w/ pernicious anemia Rx. The link between hematology and medical oncology in the US really emerged in the 1940s and later./2

The 1957 proto-ASH meeting included an eclectic mix of pediatric hematologists; clinical pathologists; radiologists; 50 internists (the largest group); basic scientists; and people from government agencies. Here's a humorous take on motivations for joining the new society:/18 There was discussion about whether “American” should include Central & South America. Blood had included "Latin American" board members from its inception in 1946. To their credit, proto-ASH leaders decided that, like Blood, ASH would be open to hematologists from *anywhere*./19

In December 2020, the 62nd Annual Meeting of @ASH_hematology #ASH20 will be “virtual” – a huge change from the previous 61 meetings. The first ASH annual meeting was in Atlantic City, New Jersey, April 1958. #HematologyTweetstory 29: how did ASH & the annual meeting come about?/1 @BloodJournal came first! In 1941, Henry M. Stratton (1901-1984), a Jewish med student who immigrated to the US from Vienna via Havana in 1938, set up a publishing company called Grune & Stratton with a businessman named Ludwig H. Grunebaum. ("Grune" wasn’t involved for long)./2

A hematology-related book suggestion, with some context. Back in 2014, I heard #LawrenceHill speaking on the radio one morning on my way to clinic, about his @CBC #MasseyLectures @UofT on blood's rich symbolism. Mr. Hill grew up as the child of "mixed race" parents in Toronto./1 His parents met in Washington, DC, and moved to Canada in 1955 because at the time it was illegal for them to be married in the Commonwealth of Virginia - prior to the Supreme Court decision on Loving v Virginia in 1967 (real couple below R), the topic of 2016's @lovingthefilm./2