Professor David Galton
Pioneer in leukaemia treatment
Monday 12 February 2007
David Abraham Goitein Galton, physician and haematologist: born London 1 March 1922; Clinical Research Assistant, Chester Beatty Research Institute, Institute of Cancer Research, Royal Cancer Hospital (later Royal Marsden Hospital) 1947-57, Honorary Consultant in Chemotherapy 1957-65, Head of the Chemotherapy Unit 1963-65, Consultant Physician in Chemotherapy 1965-70; Director, MRC Leukaemia Unit, Hammersmith Hospital 1970-87; Professor of Haematological Oncology, London University 1976-87 (Emeritus); CBE 1986; married 1946 Pat Davenport (three sons); died Wiveton, Norfolk 28 November 2006.
David Galton was one of the early pioneers of effective chemotherapy for leukaemia and other cancers. As well as being a skilled scientific observer, he was a compassionate physician, able to consider both the welfare of his individual patients and the need to advance knowledge for the benefit of future patients. He was also an inspired and inspiring teacher.
Galton entered Trinity College, Cambridge, in 1939 at the age of 17 and completed his medical studies at University College London in 1942. Early in his career he took up a post at the Royal Cancer Hospital, later to become the Royal Marsden Hospital, as a Clinical Research Assistant to Dr (later Sir) Alexander Haddow, the head of the associated Chester Beatty Research Institute.
In 1947 a chance event led to a meeting between Galton and Professor (later Sir) John Dacie, another pioneer of British haematology. This meeting was to alter the course of Galton's career and the subsequent development of haematology in the UK and beyond. As with so much in his career, a patient was central to the story. Galton had been acting as a locum clinical pathologist at the Royal Surrey County Hospital and a patient, a previously fit professional gardener in his forties, presented with a sudden illness and in a week was dead.
The first blood test done by Galton indicated a diagnosis of acute leukaemia but a bone marrow examination showed an unexpected feature, the presence of unusual red blood cell precursors. Dacie, who was Head of the Haematology Department at the Postgraduate Medical School (PMS) at Hammersmith Hospital, had recently lectured on the subject of these abnormal cells and Galton took the bone marrow slides to the PMS to show to him. Careful observation and detailed discussion of this patient was the foundation of a professional association and friendship based on mutual respect that was to last half a century.
Later the same year, Galton was instrumental in the administration of aminopterin, an experimental anti-leukaemia drug newly synthesised in Boston, to a British patient, who was also the first adult to receive the drug. The drug had been supplied in small amounts to the Chester Beatty Institute and its administration (to a fully informed Scottish poet) was made possible by Dacie and Professor John McMichael, Professor of Medicine at the PMS. The patient achieved a remission of three months' duration, an unprecedented occurrence in the 1940s, which gave hope for greater therapeutic achievements in the future.
In the late 1940s, Alexander Haddow, Galton, Eric Boyland, Walter Ross and George Timmis started an ambitious programme to synthesise and study the potential of various chemicals in the treatment of cancer; urethane, busulphan, chlorambucil and melphalan were synthesised and used in patients. In 1953 Galton published, in The Lancet, a seminal paper on the use of busulphan in chronic myeloid leukaemia ("Myleran in Chronic Myeloid Leukaemia"). This drug remained the mainstay of treatment for this condition for several decades and is still in use today in patients being prepared for bone-marrow transplantation. Remarkably, chlorambucil and melphalan are also still in use.
In the next decade, with the encouragement of Haddow, Galton's association with Dacie and the PMS strengthened until he was working at the PMS for two days a week, treating patients with leukaemia, lymphoma and multiple myeloma.
In 1959 the Medical Research Council (MRC), acting on the recommendation of its Cancer Committee chaired by Lord Cohen of Birkenhead, invited Galton to become Secretary to its first Leukaemia Working Party. In the mid-Sixties the MRC decided to establish a Leukaemia Research Unit. Galton and Dacie put forward detailed proposals, which were accepted, and in 1969 the unit was established at the (now Royal) Postgraduate Medical School (RPMS).
Galton left the Royal Marsden Hospital to become full-time head of the new unit. Shortly afterwards he recruited John Goldman, Daniel Catovsky and Alexander Spiers to join him, all subsequently to become professors of haematology and to advance the treatment of patients with leukaemia to new levels.
One of Galton's major contributions to haematology was in the diagnosis and classification of cancers of the blood. He was a skilled morphologist who retained the microscopic slides on his patients and was able to remember the appearance of cells in individual patients. He diagnosed the first case of hairy cell leukaemia in the United Kingdom; when this condition was first described in the United States, under the name of leukaemic reticuloendotheliosis, Galton remembered a case in his files and on reviewing the slides confirmed that it was the same condition. He also described for the first time an uncommon leukaemia known as prolymphocytic leukaemia.
His most important contribution to diagnosis and classification was made as a founder member of the French-American-British (FAB) group. This group of seven haematologists published a series of papers, starting in 1976, which remained the basis of classification of leukaemias for nearly 30 years. A precursor paper, explaining some of the ideas on which the classification was based, had been published by Galton and Dacie in 1975.
The FAB classification provided a basic diagnostic framework for the many advances in leukaemia diagnosis that followed. In 1976, the year of publication of the first FAB paper, the title of Professor of Haematological Oncology was conferred on Galton, and he was appointed CBE in 1986.
David Galton will be remembered not only as a pioneer researcher but also as a man whose enquiring mind was coupled with great compassion for his fellow man. His interests were not confined to medicine but encompassed natural history (from birds to mushrooms and lichens) and music.
Galton left his body for the advancement of science. His last illness, metastatic cancer of the prostate first diagnosed 10 years before his death, was approached with unflinching honesty, although with sorrow at the leaving of a life that he still cherished.
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