Clara Bloomfield: Buck conventional wisdom always

ABSTRACT: Curing ‘incurable’ diseases fulfills her lifelong mission.

As a preschooler, Clara D. Bloomfield, MD, had visions of Florence Nightingale in her head. At the age of four, she informed her mother that she wanted to become a nurse. “My mother said, ‘Well dear, that’s very nice. But if you want to become a nurse, you might as well become a doctor’,” Dr. Bloomfield told Oncology News International.

Not only did Dr. Bloomfield become a doctor, she became one of the most prominent hematologists of her generation. For the past 35 years, Dr. Bloomfield has made it her mission to take so-called incurable diseases and make them curable.

“During my years of research, we’ve changed the treatment of adult leukemia and lymphoma. And that means patients who once would have died are now cured or enjoy prolonged survival and improved quality of life,” she said. Now a distinguished university professor of medicine at Ohio State University (OSU) Comprehensive Cancer Center, Dr. Bloomfield discussed how bucking conventional wisdom always served her well.

‘A woman’s priority’

Dr. Bloomfield grew up in Urbana- Champagne, Ill. While the town was dedicated to higher education, the fact that her mother encouraged Dr. Bloomfield to look beyond traditional women’s roles was unique.

“My mother was a feminist in her own right. I mean it was 1946, a woman’s priority was still raising kids, but my mother was also one of the first women to go to the University of Illinois law school. So when she encouraged me to become a doctor, I never looked back,” she said.

During high school, she excelled in science and took advanced courses at her hometown university. But Dr. Bloomfield then opted for a humanities program at the University of Wisconsin in Madison.

“I really thought that doctors were supposed to have compassion and take care of the public health. So I felt that it helped to have a good background in the humanities,” she said.

Encountering the glass ceiling

Married following her junior year at Wisconsin, Dr. Bloomfield accompanied her new husband to San Diego. While he completed a postdoc there, Dr. Bloomfield transferred to San Diego State College, where she graduated summa cum laude with a degree in biology.

“In my last year (at San Diego), a prominent faculty member was being treated for Hodgkin’s disease by Henry S. Kaplan, MD, whose work literally transformed the prognosis of that disease. Although the professor later died of acute sepsis, I became fascinated with the possibility of curing blood cancers,” she said.

Dr. Bloomfield ultimately returned to Illinois and received her MD from the University of Chicago in 1968.

Dr. Bloomfield focused her energies on research. She took an oncology fellowship at the University of Minnesota in Minneapolis.

“I looked at all the adult patients with acute myeloid leukemia (AML) who had been treated at the University of Minnesota Medical Center,” Dr. Bloomfield commented. “The longest survivor was a 17-year-old boy who lived for 31 months after his diagnosis.”

But her time in Minnesota was not without some hardship: The scientific world was still working through an entrenched gender bias.

“Throughout my career in academia, I’ve confronted issues of pay discrimination for women,” said Dr. Bloomfield. While at the university, she moved from assistant to associate professor in just three years and later became the university’s first female full professor of medicine.

Dr. Bloomfield recalled how her promotion unfolded. “My husband also worked at the university. When the head of medicine called me into his office, he said, ‘Congratulations on the promotion, Clara, but because your husband makes such a good salary, we’ve decided not to give you a raise.’ And he said it with a straight face!

“That was my first, but certainly not my last, exposure to the pay bias women face in the academic setting,” Dr. Bloomfield said.

Challenging the expert

It was an exciting era in cancer research when promising new drugs, such as daunorubicin, were just then being adopted in clinical use. Ironically, it was a doomsday editorial by William H. Crosby Jr., MD, a pioneering hematologist, that inspired Dr. Bloomfield. In his essay (Arch Intern Med 122:79-80, 1968), Dr. Crosby stated that without proven therapies, treating most kinds of AML was akin to malpractice because patients had no hope of significant benefit.

“After reading Dr. Crosby’s editorial, I decided that it would be a good project to attempt to find a cure for each of the diseases he said were not helped by treatment. And that’s what I set about to do,” Dr. Bloomfield said.

Dr. Bloomfield’s subsequent years of research helped reshape the clinical approach to hematologic malignancies. “We learned that leukemia and lymphoma are a heterogeneous group of genetic diseases,” she said.

Dr. Bloomfield and her research team were the first to identify the Philadelphia chromosome in acute lymphoblastic leukemia as well as the biological and genetic markers important in the diagnosis and treatment of AML.

Her work has translated into internationally accepted classification systems for blood disorders, including that of the World Health Organization, which incorporated genetics into its classification of AML. “We now cure 40% of adult patients between the age of 16 and 60 with primary (de novo) acute leukemia,” Dr. Bloomfield pointed out.

It’s a cure rate that would probably please even Dr. Crosby. Dr. Bloomfield stressed that sometimes the best way to achieve such success is to question the scientific dogma of the time. “Our young hem/onc academics (need) to challenge what the experts are saying, because it’s not always true,” she said.

Changing mindsets

In 1989, Dr. Bloomfield became chair of the department of medicine at Roswell Park Cancer Institute. She also became professor of medicine and chief of the oncology division at State University of New York, Buffalo.

In 1997, Dr. Bloomfield became the director of OSU comprehensive cancer center and deputy director of the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. She was only the third woman to direct an NCI-designated comprehensive cancer center. Under her guidance, cancer research funding at OSU tripled from $22 million to more than $74 million today.

She stepped down from the directorship in 2003 in order to return to leukemia research as the inaugural cancer scholar and senior advisor to the OSU cancer program.

“If you’re lucky, a few times in your career, you discover something new, and there is nothing like it. It’s happened to me a few times throughout my career, and the feeling is overwhelming,” Dr. Bloomfield said.

In addition to her research accomplishments, Dr. Bloomfield is a powerful advocate for women in academic medicine. She has mentored more than 20 women who currently hold senior leadership positions at universities around the country.

“I truly enjoy helping fellows and students learn how to do research and grow into capable, independent investigators,” she said. According to Dr. Bloomfield, free thinkers who question the status quo are essential to scientific advances.

“Unfortunately, clinical research has become so over-regulated that a lot of people are afraid to question authority. Changing that mindset is a worthy challenge,” she said.