Anthony Oakhill, consultant paediatric oncologist and haematologist 1982-2003, professor of childhood leukaemia and bone marrow transplantation Royal Hospital for Sick Children, Bristol, 1996-2003 (b 1956; q Birmingham 1973; MRCP, DCH), d 8 October 2006.
Pioneer of unrelated bone marrow transplantation for childhood leukaemia
In a brilliant career cut short by cancer, Tony Oakhill built the team that developed the most important recent advance in the treatment of childhood leukaemia: bone marrow transplantation using unrelated donors. The technique is now standard and has saved hundreds of lives. His team also developed a method of detecting minimal residual disease.
In the 1980s many children were being cured of leukaemia, but around a quarter had a relapse after chemotherapy. High dose chemotherapy and bone marrow transplantation saved many, but this was possible only when there was a close family match. The idea of using unrelated donors was heresy.
Tony Oakhill and the team he built widened the use of transplantation to enable children to receive, safely, partially matched bone marrow from unrelated donors. The technique they used Campath antibodies to kill the T cells that caused graft versus host disease. Now, most children who need bone marrow transplantation can be treated successfully, and their outcome is as good as with transplants from siblings. Patients receiving transplants can discard cyclosporine after a few months, by which time the donor cells will have engrafted and their white blood cells will be those of the donor.
Oakhill was an outstanding scientist with a talent for choosing his team. He built up the largest bone marrow transplant unit in Britain, with many patients—including adults—referred from the rest of the United Kingdom and overseas. His team's results were based on good science and meticulous attention to detail.
Minimal numbers of residual leukaemic cells cannot be detected by microscopy as they resemble ordinary blast cells. By making patient specific gene probes, Oakhill's team developed a method for detecting leukaemia cells at a concentration of 1 in 105 normal cells, which is now provided nationally as a networked service coordinated from Bristol. The information this gives is used to alter treatment regimens to prevent relapse, and studies are under way to see if this is effective.
Oakhill was awarded an honorary chair (a rare distinction at Bristol) in recognition of his research, and the Royal College of Physicians invited him to give its 1994 Lockyer lecture. He published 150 papers and a book on the supportive care of the child with cancer (K Wright Bristol 1988), and gave invited lectures around the world. He disliked committee work, and had no interest in high office within the medical establishment.
He was happiest and at his best with the families and children under his care. He was brilliant with children, overcoming his natural gravitas and shyness to clown about, and he could make them laugh before he had spoken a word to them. He was followed on his ward rounds, like a pied piper, by a string of children who were so captivated by him that they didn't want him to leave their bedside. He was interested in his patients and remembered every one of them, what they liked at school, their pets, where they went on holiday, and the football teams they supported. He knew more bad Skoda jokes than anyone could have thought possible. He remained involved throughout and after the treatment of every patient, and he remained in contact with bereaved families and supported them.
Anthony Oakhill was born on 19 August 1950 in Leicester, the son of a painter and decorator. He was educated at the City of Leicester Boys' School and Birmingham University. He trained in paediatric oncology in Birmingham and Philadelphia before his appointment in Bristol. He did most of his postgraduate training at the Birmingham Children's Hospital, where he was senior registrar from 1978 to 1980. He followed this with a two year fellowship in paediatric oncology at the Children's Hospital of Philadelphia before taking up his appointment in Bristol.
Oakhill was a cultured man with wide interests. He was prodigiously well read and knowledgeable about theatre and travel, rugby and soccer. He was extraordinarily knowledgeable about art. He and his wife cultivated a large and beautiful garden. He kept pet ornamental snakes.
He died of a leiomyosarcoma that originated in a lung blood vessel. It took over a year to get the correct diagnosis. His illness meant that he had to retire in 2003, whereupon he took a complete break from paediatrics, resigned from the Royal College of Paediatrics and Child Health, and took a degree course in art history in his own university. In remission after the removal of a lung, he was planning a doctoral thesis on the portraits of Alexander Pope when he had a relapse.
Tony Oakhill's first wife died of an unknown cause at an early age. He was divorced from his second wife, Sue; they have a daughter. He married Dr Chris Elliot, a widow who was also a paediatric oncologist, in 1996. He is survived by his mother, his wife, his daughter, and his stepdaughter.