A Q&A with Dr. David Allan

As medical director stem cells at Canadian Blood Services, a scientist in the Sprott Centre for Stem Cell Research at The Ottawa Hospital and associate professor at the University of Ottawa, Dr. David Allan possesses a wealth of knowledge about clinical practice and research directions in blood- and bone marrow-based cellular therapies. He is also the current recipient of Canadian Blood Services’ Kenneth J. Fyke Award, which supports health services and policy research to promote the development of evidence-based Canadian practices and policies in transfusion, blood stem cell transplantation, and organ and tissue donation and transplantation for the benefit of Canadian patients.

Image

Dr. Allan recently shared his thoughts on the award, the project it will support and what he envisions in Canada’s health care future.

Q. Kenneth J. Fyke had a huge impact over four decades in public health, including the creation of a voluntary blood donor system in Canada. Why is receiving an award named after him important to you?

A. As the founding chair of the Board of Directors at Canadian Blood Services, Dr. Fyke’s vision and leadership remain central to the success of Canadian Blood Services in maintaining the public’s trust in the Canadian blood system. Throughout his distinguished career, he was able to build health care systems through his vision and bringing ideas together.

It is inspiring to pursue our vision of a system that will use umbilical cord blood for new areas of treatment, including regenerative therapy, with the support of a research award that bears his name. Our goal is to bring ideas together to develop policies that will bring Canadians one step further into the stem cell era.

Q. Describe the project that the award money is earmarked for.  

A. Our project will systematically summarize the evidence from clinical studies in support of cell therapy using umbilical cord blood cells for tissue regeneration or repair. We will also implement new technology that allows for continuous updating – so we will have a repository of clinical evidence that is always up-to-date.

In collaboration with Tim Caulfield’s team in health policy research at the University of Alberta, we will also summarize the perspective in the press and lay literature to evaluate the gap between what the evidence shows and where inflated expectations exist in the eyes of the public. This will help us address heightened expectations through public education efforts with our many partners within the Canadian stem cell and transplant community.

Our final goal is to develop a policy paper to ensure responsible use of banked cord blood for proven indications that can be used by blood establishments such as Canadian Blood Services to support the safe and optimal choice of treatments for Canadian patients.

Q. And what do you see this leading towards?

A. The goal is to provide a critical policy framework for cell-based regenerative therapy in Canada that ensures the responsible use of umbilical cord blood for effective treatments. Too often, patients who are desperate for a cure will travel out of country for a “stem cell” treatment that is unproven and suffer problems or complications that actually make them worse off. We want to change this trend and ensure Canadian patients have the tools to access treatments that are proven and to know which ones remain experimental or unproven.

Q. Can you elaborate a bit on “unproven” stem cell treatments, particularly those that use stem cells from blood, bone marrow and cord blood sources?

A. Blood stem cell therapy has become a standard treatment for blood-related disorders such as leukemia, but it remains in its infancy for the treatment of many other diseases. Similarly, while publications of regenerative therapy using umbilical cord blood are increasing quickly, it remains very early and we still do not know when it is helpful or not. We still need many more studies that are larger before we will fully understand which diseases will benefit from these treatments.

Q. You’re based in Ottawa and work for Canadian Blood Services, the Ottawa Hospital and the University of Ottawa. What does an affiliation with these organizations mean in terms of your ability to realize your goals?

A. Regenerative therapy using cells that come from cord blood involves expertise from many fields – biomedical lab research, clinical transplant medicine using blood stem cells, and the regulated biopharmaceutical perspective that exist in blood establishments such as Canadian Blood Services. By working at the interface between these three worlds, it allows me to see the strengths and limitations of each part as it applies to umbilical cord blood therapy.

Q. Over your career, what one thing has changed that has had the biggest impact on health?

A. The molecular and cellular era is arriving as we speak. There is a big shift occurring towards a deeper understanding of disease, more accurate diagnostics, personalized prognoses, and new treatments using molecular and cell-based methods. While this makes modern medicine more “intelligent”, it also makes it very costly and we are struggling more and more with the reality of how to ensure accessibility.

Q. How has this change affected your work with Canadian Blood Services?

A. The drive to develop cellular therapy in Canada has fueled enthusiasm over the past several years to build the public umbilical cord blood bank at Canadian Blood Services. Building a successful bank and having policies in place to expand the use of cord blood into regenerative therapy will make this investment a worthwhile venture for years to come.

Q. If you could make one more advance/change happen today, what would it be and how could this award help realize this?

A. It is a big question – and a big answer. I’d like to implement an improved and iterative learning process into our medical system that allows us to integrate new knowledge more efficiently and bring meaningful progress to the bedside earlier. In short, we are trying to ensure patients have access to the best care possible. This includes knowing when something is helpful and it also includes avoiding treatments that are not helpful.

Decision-making needs to be evidence based whenever possible, yet keeping the evidence up-to-date and in a form that can be used by patients and care providers is challenging. Our project hopes to improve this process for Canadian patients.

The Kenneth J. Fyke Award program supports health services and policy research in order to promote the development of evidence-based Canadian practices and policies in blood transfusion, blood stem cell transplantation, and organ and tissue transplantation for the benefit of Canadian patients. The 2016 Kenneth J. Fyke Award will support one project with up to $100,000 for a period of one year.

Next competition: Fall 2018

Canadian Blood Services – Driving world-class innovation

Through discovery, development and applied research, Canadian Blood Services drives world-class innovation in blood transfusion, cellular therapy and transplantation—bringing clarity and insight to an increasingly complex healthcare future. Our dedicated research team and extended network of partners engage in exploratory and applied research to create new knowledge, inform and enhance best practices, contribute to the development of new services and technologies, and build capacity through training and collaboration.

The opinions reflected in this post are those of the author(s) and do not necessarily reflect the opinions of Canadian Blood Services.