Distinguished Researcher Changed the Face of Hematologic Malignancies

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Don’t be afraid to challenge authority, even if it’s the biggest name in the field. Look at what’s in front of you and trust your own analysis. That’s the way breakthroughs happen.

— Clara D. Bloomfield, MD

Clara D. Bloomfield, MD, grew up in a steadfastly academic environment that spurned typical children’s entertainment such as comic books or television. Born in New York City during World War II, she moved to Washington, DC, with her family while her father, an expert on labor and industrial relations, served on the War Labor Board. “After the war, my father took a professor’s position at the University of Illinois. Many of his students were foreign and he often invited them for dinner. It wasn’t uncommon for me to be seated next to a student from Ethiopia or Chile. Our meals were filled with engaging, intellectual conversation,” said Dr. Bloomfield.

Path Set from an Early Age

Looking back, Dr. Bloomfield said that growing up in an academically-focused family helped prepare her at a young age for her own career path into academic medicine. Having an independent and self-motivated mother also helped mold Dr. Bloomfield’s mettle and career drive. She recalls her mother as a feminist in her own right; she was one of the first women to attend the law school at the University of Illinois.

“My mother began law school when I was in first grade and she received her law degree when I graduated high school,” said Dr. Bloomfield, adding, “When I was 9 my mother announced that she wasn’t spending enough time with the family so she decided to quit law school. My younger brother and I started crying and screaming that we couldn’t have a mother who wasn’t going to law school,” laughed Dr. Bloomfield. She recalled that the state actually had to pass a law allowing her mother to obtain her law degree since her staggered schooling had passed the statute of limitations governing the time it takes to complete law school.

While attending the University of Illinois Laboratory High School, a mother-daughter conversation sealed the deal in Dr. Bloomfield’s mind about her desire to pursue a medical career. She even penned a 90-page paper about the history of women in medicine. “I had classmates who developed leukemia and, because of limited options in the early 1950s, they were sent to the National Cancer Institute for treatment. Then they’d return with steroid-bloated faces and soon die,” said Dr. Bloomfield.

She continued, “I remember thinking to myself, how cool it would be to develop a medicine that could save kids from dying of childhood leukemia. I’d already decided to become a doctor, so seeing the real-life effects of cancer certainly helped shape my early desire to become an oncologist.”

Juggling Academic Careers

Dr. Bloomfield entered the University of Wisconsin in 1959 with a depression-era sense of self-sufficiency and fiscal responsibility. “I grew up having to earn each nickel of my allowance doing chores around the house. So I was not keen on saddling my parents with a huge bill. The University of Wisconsin offered a couple of scholarship programs, which helped out. While doing my premed, I became very interested in genetics. I actually did my honors research on radiation therapy’s effect on fruit fly eggs,” said Dr. Bloomfield.

Dr. Bloomfield married a chemist during her junior year at the University of Wisconsin. He wanted to do his postdoctoral work in a renowned research institute in La Jolla, California, so off they went to the West Coast. “I finished my last year of college at San Diego State College, and then I was faced with the challenge many women in academia face: how to coordinate two academic careers,” said Dr. Bloomfield. Coordinating careers resulted in a commuter marriage: Dr. Bloomfield’s husband accepted a chemistry professorship offer at the University of Illinois and she decided to go to medical school at the University of Chicago.

In the year prior to entering medical school, Dr. Bloomfield worked in a biochemistry lab at the prestigious Scripps Research Institute, which was at the cutting edge of scientific exploration. “At that time, a very prominent faculty member working where my husband was had Hodgkin disease and he was traveling back and forth to Stanford to see renowned Hodgkin specialist Dr. Henry Kaplan. My mindset, from my grade school days seeing classmates die of leukemia, was that cancer was a death sentence—I was simply blown away by how well my husband’s professor colleague was responding. That experience had a significant effect on my decision to study hematologic malignancies,” said Dr. Bloomfield.

Grand Rounds with Dr. Kaplan

At the University of Chicago, Dr. Bloomfield met and worked with Dr. Henry Rappaport, best known for his “Rappaport Classification,” in lymphoma. “The structure at the University was geared toward an academic career, which fit in to how I’d been brought up,” said Dr. Bloomfield.

Between her junior and senior year, Dr. Bloomfield did a subinternship at the University of California at San Francisco (UCSF). “After a month or so, I saw this patient with Hodgkin disease who was not being treated with curative intent. I told them, this is terrible, you’re not giving this patient modern therapy,” said Dr. Bloomfield. To that, her attending replied, “Well, if you’re so smart, we’ll have you do grand rounds on how to treat Hodgkin disease.”

Not one to back down from a challenge, but also wanting to be well armed, Dr. Bloomfield called Stanford, and asked the famous Dr. Kaplan for advice. “Henry was really nice; he said he’d be thrilled to come and help me do grand rounds,” said Dr. Bloomfield. To the surprise of the attending at UCSF, Dr. Bloomfield, a medical student, conducted grand rounds with her friend from Stanford, Dr. Henry Kaplan.

Practice-changing Research

In 1971, Dr. Bloomfield started her medical oncology fellowship at the University of Minnesota, where she became one of the institution’s first female Chief Residents. Her supervisor wanted Dr. Bloomfield to get an American Cancer Society junior clinical faculty fellowship. For that, she had to interview with external reviewers, one of which was Dr. Ed Henderson, an eminent leukemia expert. “Dr. Henderson asked what the focus of my research was. I panicked because I hadn’t thought about it. But I recovered and said,  ‘I’ve been looking at the biologic features of leukemia and lymphoma to help predict outcome and select therapy,’” said Dr. Bloomfield. “He was impressed, and I got the fellowship. Interestingly, that line of inquiry, with certain variations, has essentially been the basis of my life’s research.”

Dr. Bloomfield ended up running the acute leukemia and lymphoma service at the University of Minnesota, seeing every patient herself. She also conducted a study looking at all adult patients with acute leukemia seen at her institution over the past 10 years. “The majority had acute myeloid leukemia (AML). Our longest survivor was a 17 year old who lived for 33 months. Given the success we were beginning to see in childhood leukemia, I saw a real opportunity in adult disease. We stratified the patients by age and as a result I found that the older adult patients did just as well as the younger ones,” said Dr. Bloomfield.

“I published a paper in JAMA with my results, showing that older patients responded just as well to treatment as their younger counterparts. At the time, the major hematologists contended that treating AML patients over 50 years of age was tantamount to malpractice. So you can imagine the stir I caused,” noted Dr. Bloomfield. “It was an important lesson,” she continued, “one that resulted in my telling my Fellows, don’t be afraid to challenge authority, even if it’s the biggest name in the field. Look at what’s in front of you and trust your own analysis. That’s the way breakthroughs happen.”

Distinguished Career

Dr. Bloomfield left Minnesota in 1989, taking a position at Roswell Park Cancer Institute, serving as Roswell’s Chair of the Department of Medicine. In 1997 a career turn took her to The Ohio State University (OSU) where she served as Director of the Division of Hematology and Oncology and Director of the OSU Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Solove Research Institute (OSUCCC–James) until 2003. She is currently a Distinguished University Professor and William G. Pace III Professor of Cancer Research at OSUCCC–James.

Dr. Bloomfield, whose work has been described in more than 950 publications, is the recipient of oncology’s most prestigious awards. She has also chaired and served on boards in estimable organizations such as ASCO, AACR, NCCN, NCI, and WHO. But it is her translational work, especially in the field of genetics, that has changed the face of blood malignancies and is the hallmark of her career. She has discovered many genetic abnormalities that have changed how we classify and treat leukemia and lymphoma. Dr. Bloomfield’s work also showed for the first time that elderly patients with acute leukemia could be cured with chemotherapy. On the global scale, her work has changed the way we think about leukemia and the way we treat individual patients.

Dr. Bloomfield is now married to Dr. Albert de la Chapelle, a geneticist and Professor in the Department of Molecular Virology, Immunology, and Medical Genetics at OSU and who, among many things, is the discoverer of XX male syndrome. “We’ve been married for 29 years, but as we have different names and are prominent in separate fields, lots of people don’t know we’re a couple,” said Dr. Bloomfield.

Asked about the future, Dr. Bloomfield remarked, “I’ll be turning 71 this year. Besides my work at OSU, I’m very active on international leukemia projects. During the past 7 weeks, I traveled to six different meetings, two of which were in Europe. So there’s not much time for anything but work.” ■