Own laboratory improved skills in the 1960s
Professor Gunnar Myllylä has held a number of expert and executive positions at the Blood Service over four decades. Here he talks about the highlights of his career.
"The 1960s was a time of hard work and achievements. The amount of blood collected and used grew significantly. The amount of blood drawn more than doubled from one hundred thousand bags in 1958 to 250,000 bags in 1968. The aim was a self-sufficient blood supply, and the use of blood in hospitals increased. Fresh blood was used for major bleeding and blood transfusions. This meant that we needed a 24-hour reserve of regular local donors. In addition, more and more plasma was required in the 1960s, which affected the entire structure of the operation.
From 1966–67, a crucial technical change shaped the entire blood service operation, as glass bottles were replaced by plastic bags. We were now able to produce modern blood cell products, which significantly improved the quality and safety of blood transfusions".
Lady Frida's coffee and active donors
"Finnish blood donors enabled us to grow. They often wanted no attention, they only wanted to carry out good, selfless acts. I always admired those active people in the workplace who often shared the same history: a friend who had been saved by a blood transfusion. The attitude of employers was also quite exceptional. They allowed people to donate blood during working hours.
The Blood Service's local offices were very special places. There was always something very local about the enthusiasm and the attitude, right down to the language. Many people were attracted by the great coffee that was served to donors. The coffee's reputation was mainly down to Agda Nordfors, the Blood Service's cafeteria lady who was also known as Lady Frida from a famous radio show hosted by Niilo Tarvajärvi. Frida's secret was a mixture of three or four different coffee brands".
"The blood was collected from volunteers around the country, but all possible operations were quickly concentrated. A laboratory was a natural choice. The establishment of our own laboratory in 1959 at Töölö Square was largely thanks to Harri Nevanlinna, the (then) director of the Blood Service. The director was pro-research and his motto was: "today's research is tomorrow's routine". Initially, the laboratory focused on donor research, but its operations soon expanded into general research and a service laboratory.
Research topics emerged directly out of clinical work with the results immediately available to hospitals. The Finnish Hematology Association was established and the Blood Service doctors participated in the further training it provided. We also attended events in other fields as members of the audience and as lecturers. We quickly gained expertise, and began to take a stand on ethical issues related to blood transfusion.
In the mid-1960s, it was discovered that children's Rh disease could be prevented with anti-D immunoglobulin. Harri Nevanlinna had started Rh blood group research as a student and, since 1948, had administered the first 200 blood transfusions to these patients. A national anti-D programme for expectant mothers was efficiently organised in the late 1960s and is still in use today".
"In my work, I concentrated on developing a product for treating haemophilia A, i.e. hereditary haemophilia. The idea was to separate from plasma the clotting factor the patients were missing and administer it to patients as a concentrate. I visited Sweden to learn about the new methods. I remember being at Odenplan when the tram driver announced that Kennedy had been shot.
The cryoprecipitation method was first described at a large haematology congress in Stockholm in 1964, where, as it happens, we tried teaching the other participants the traditional Finnish dance called "Letkajenkka". The method was so simple it was hard to believe. But there are many ways of processing blood and plasma before applying the method and the Cryo-AHG method used in Finland was different in many aspects from the methods used in other countries.
Haemophilia treatment was particularly successful because, thanks to Eero Ikkala's pioneering work, we had a unique, direct contact with patients. Every week, four boys with haemophilia visited the lab in Tehtaankatu to be administered with the new product. This made it easy to measure the practical effects immediately. Since then, treatment results have been clear: Over a period of 20 years, the life expectancy of patients with severe haemophilia has increased by 20 years.
Today, blood safety is largely based on accurate lab tests but, at the time, it was based on the careful selection of donors and production methods. Here we have another success story, as only two Finnish haemophilia patients contracted the HIV virus, which was an excellent result by international standards. These are two solid credits for Cryo-AHG although, by today's standards, it was a fairly rudimentary preparation".
"I have a funny anecdote from the midsummer of 1966. A Belgian professor of internal medicine had invited experts from different countries to discuss how they were getting on with the production of cryoprecipitate. As we were discussing freeze-drying the preparation, I mentioned that my result was 30% (the amount of the original coagulation factor left). This was met with disbelief, as the others experts' experiments had resulted in far smaller numbers.
Suddenly, Herman Krijnen, a six-foot Dutch physicist, stood up and said: "There are many ways of freeze-drying. Maybe we should learn how it was done in Helsinki". Krijnen subsequently consulted the implementation of the Blood Service freeze-dryer in 1969, and also later, when we began plasma fractionation.
The sixties was a decade of great progress. Technologies and methods were developed at a furious pace, and the approach to research was very pragmatic. We moved forward without hesitation".
Text: Minna Kalajoki / Mediafocus
Photos: Matti Rajala