December 14, 2023
“White Coats” is an AABB News series that interviews the experts who are transforming the fields of transfusion medicine and biotherapies. Join AABB today to read the rest of this month’s issue.
Zachary Thompson, MD, FCAP, CABP, is a board-certified anatomic and clinical pathologist with subspecialty training and certification in blood banking and transfusion medicine. He has further subspecialty training in conventional and novel cellular therapies. Thompson completed his pathology residency training at the Medical College of Georgia before seeking subspecialty training in transfusion medicine and cellular therapy at the Mayo Clinic in Rochester, Minn. He is the medical director of the Human Cell Therapy and Cell Pharmacy Laboratories at Mayo Clinic, as well as a senior associate consultant in transfusion medicine and an assistant professor of pathology in Mayo’s Department of Laboratory Medicine.
Thompson’s clinical focuses are on bone marrow transplantation and laboratory management of novel cellular therapy products. His research interests include subpopulation enumeration of cell types in conventional cell therapy grafts to improve time to engraftment and standardization of novel cell therapy collections of commercial and research drug products. Thompson spoke to AABB News about his clinical research interests, as well as his career path in biotherapies and novel cell therapy.
From my second year of medical school, I knew I was going to pursue a career in pathology. During my pathology elective in my third year, I discovered transfusion medicine, and more specifically apheresis, which allowed me to maintain my patient-facing passion while working in laboratory medicine. One thing that continued to bother me was the “black box” that existed between hematopoietic stem cell collection and transplant.
I sought a career in cell therapy to be a full-service physician from pretransplant preparation to post infusion care. One major driver of pursuing a career in biotherapies as it continues to grow, and more approved therapies come into the field, is promoting equal access for patients who might otherwise be unable to have access to these potentially curative treatments. I grew up in a household in which we chose to forego health insurance to make sure ends were met. Due to these financial concerns, my father delayed seeking care, leading to avoidable health issues. To honor his sacrifice, I aim to support those facing similar dilemmas in accessing novel biotherapies, whether through clinical trials or commercially available products.
I was told by a dear friend and colleague that “there is value in being a big fish in a small pond.” Much of my success has come from these 12 words. The value I have gained from learning within, and navigating through, practices with constrained resources has helped me to best identify pressure points within systems and to allocate staffing and capital to address these limitations. By choosing to practice or learn in a resource-constrained environment, I believe we can participate in “good struggle” where we can learn through hardship and setbacks to build resilience, innovation and independence.
Additionally, as I have grown into leadership and mentoring roles, this foundational experience keeps me grounded in teaching others to be aware of how our choices impact the system in which we work and our partners in the clinic, hospital and research.
I find the mentorship of my staff to be most rewarding. As many of us know, traditional medical technology and laboratory scientist programs are not embedded within biotherapy clerkships. It takes a leap of faith for these professionals to choose to leave conventional laboratory jobs to enter the research and development or clinical processing lab. As such, I strive to serve not only as medical and scientific director, but also as a mentor for these professionals. Being able to explain the reasoning behind our standard operating procedures, the value of our quality systems and the impact of our work in advancing the field in a way that promotes access and equity helps to demonstrate their great importance and responsibility to the field of biotherapies and the patients within. One piece of advice I give all my new staff is to “fight the urge for our processes to become routine.” Our patients have given their trust to us to protect the fidelity of their product, and with this knowledge, the importance of their role in this great process.
Standardization across biotherapies. It may come as a cheap response, but given the variability of collection material, processing, documentation and infusion requirements for the expanding list of clinical trials and commercial biotherapies, the burden of this risk falls on the cell collection and processing laboratories. I acknowledge that the development pipeline for these biotherapies is long, and that innovation is required to promote the best care for patients in need, but the lack of standardization forces many clinical sites to forgo onboarding new trials or products due to the lack of technical ability and staff to safely administer it. If more routine practices were generalized across emerging biotherapies, it would be easier to onboard these products to meet the needs of our local patients and researchers. It also becomes increasingly challenging to compare effectiveness of these therapies across sponsors and manufacturers given the differences in these procedures such that I struggle to advise my clinical counterparts when such questions arise.
Thompson: I want to standardize stability program practices across human cell therapy labs (HCTLs). Current regulations require participation of HCTLs in stability testing, but best practices within this requirement are not clear within our “fiefdoms.” Since we all freeze, store, thaw and test differently, it becomes challenging to determine which HCTLs are providing the highest quality product because of their process. We all collectively know that the “process is the product” but do not currently operate under the same or similar framework. By working to establish this dialogue and drive this improvement, I hope the field of biotherapies can improve and as a result, the outcomes for our patients.
WOW! This is a tough one to trim down to a singular moment. On arriving in Nashville, I almost immediately ran into my friend and mentor, Dr. Asa Bapat. She has been such a shining light and inspiration to me from afar during my formative years in cell therapy, and the fact that we were able to finally share a gravitational pull made the moment for me. To build on this, I was extremely touched by our keynote speaker, Simon T. Bailey, and his discussion of having a resilient circle. The collaboration and support from my resilient circle within the #blooducation and #AABBChamps groups have helped me grow as a person and professional.
My mentors have meant the world to me, both in their examples and the opportunities they have afforded me. From Greer Falls, MD, who assured me pathology wasn’t just hiding in the basement as a PGY1, to Gurmukh Singh, MD, who developed my passion for process improvement, quality, and assured me I could be dedicated to my family and my patients, to Justin Kreuter, MD, and Eapen Jacob, MD, who stressed introspection, reflection and humility as key qualities of leading and mentoring, every facet of my personal and professional development has been chiseled by mentors who invested in me and my success. I continue to lean on them for support and stress to everyone that mentors are not just books that get put up on a shelf collecting dust. Mentors are meant to be returned to, cherished and fostered.
Put aside your fears of imposter syndrome. This wonderful field is growing at an exponential rate and is ripe for your contributions to its advancement. We as individuals cannot wrap our arms around all that is biotherapy, but collectively, we can support each of our endeavors for the betterment of the whole. Find your passion in this field and share it with others openly. No contribution is too small to the patient and partner you benefit from the bench to the bedside.
When not serving as medical and scientific director of a cell pharmacy and cell processing lab, I chase my toddler (or let them chase me) around the house to give my wife some time off her feet while being 34 weeks pregnant with our second child. When the house quiets down, I enjoy being a home BBQ-pit master, beer and cider homebrewer, science fiction consumer and tabletop roleplaying game enthusiast. If you are looking for any recommendations, please send me a message; I promise you an overly long reply.
4550 Montgomery Avenue
Suite 700, North Tower
Bethesda, MD 20814
301.907.6977
