Saturday, December 24, 2005

Publication ethics

I e-mailed Lou Staudt when I saw his paper before it was published and asked him to come to England and talk about it. He seemed pleased to hear from me. We had not met previously but our work had suddenly become complimentary. The prognosis was so different between mutated and unmutated CLL that the question had to be asked whether they were both the same disease. Lou had developed his Lymphochip as a way of looking at which genes were switched and which switched off in a particular tissue. He had already explored the complexity of diffuse large cell lymphoma and it was an obvious move to look at CLL. His results clearly showed that CLL was a single disease very different from any other lymphoma and different also from most types of B cell.

What I didn’t understand was why it took so long to get published. We knew that it had been circulating around high impact journals and it was obviously a very important paper. We began to think that dark forces were preventing its publication.

Publication ethics is a can of worms. Referees are on their honor to say if they have a competing interest. Authors should reveal whether the paper has been published before in part or whole. Editors should not employ chicanery to raise their impact factor. All have sinned and fallen short of the glory of God.

When it was published it was brilliant. It identified a number of genes which separated the mutated and unmutated subset. Most important of these was ZAP-70. This could have been easily missed because it is always switched on in T cells, so unless the T cells had been depleted from the CLL specimens it would not have been found.

Lou couldn’t make the meeting, but Andreas Rosenwald (who is about 7ft tall) came instead and there began a useful collaboration. We began to develop tests for ZAP-70 and by 2002 we had a working flow cytometry test that remains our benchmark assay.

Emili Montserrat’s group in Barcelona developed a very similar test, again ready for the 2002 ASH meeting, and then last year Tom Kipps’ group working with the CLL Consortium developed a single step flow assay that can be used on whole blood.

Guess what? Concordance with VH genes isn’t perfect, and in fact with some assays it is hardly better than CD38.


Diane Ferguson said...

Dr. Hamblin, I check in with you each day to see what you have added to your blog. I may not make any comments but I am learning and I thank you so much for your time and the gift you are giving us by sharing your knowledge and experience.

Kurt Grayson said...

I'm not sure why you decided to share all this medical information with us, which is truly a gift and a prized present to most of us who are very interested. Also your personal thoughts which you share with us are amusing and fun although they do expose you for what you are. A brilliant medical expert and a very normal every day person. As compared to most of your medical posts on the digest your writing here is lighthearted and easy going. Of course your not posting on the digest to entertain are you.

I suppose on second thought that it depends upon a persons own definition of entertain. I can't remember when I was more interested and captured by the words I am reading when I am there reading your post on the digest, even more so than a best seller I am deeply immersed in. I suppose it's a need I have isn't it.

Perhaps thats what entertainment really is, a need at the center of a person's desire to be led down the path, to be tricked(how well depends upon the talent) into believing, into taking each new step, believing each new scene feeling each new song to see if it touch's deeply into your heart, seeing just how close it comes to being be entertained. As in going to the theatre or the ballet or a musical event or a lecture or reading the medical truth of our sickness A need. An Entertainment.

Here on the blog it's more relaxing, like being invited by you. On the digest your not inviting anyone, we are inviting you, imploring you to give us information that we worship. Information that we need. So It's much different there isn't it.

On the Digest one reads with the feeling that you are a doctor. A very stark atmosphere regardless of the many people and the attempts at humor and light hearted takes on things like Steve and Chis and David and some of the others provide. You are the doctor there and your words are few and far between unless your posting abstracts etc. Reading your posts there is a quick and intense sort of jolt of information. I didn't like it at first but then I realized that after I got used to it that I liked it better that way. No social
BS to weed thru, no diplomatic savy to brush aside. Just plain to the point very frank answers. I like that now very much.

Here though it's much more fun, because even though you are posting info for us to read that will help us and inrich our meager understanding of CLL and of the disease that eats us alive at this moment, here on your blog it's sort of like something you want to give to us. It's obvious that you are interested and involved and even delighted in doing this. It's special, so thanks, it's very much appreciated and very entertaining.

Merry Christmas Terry,

Kurt Grayson,
Sacramento, ca. 11:44 PM

Paul Garland said...

Dear Dr. Hamblin,

Wishing you a really fine Christmas.

Carol Witt said...

Dr. Hamblin,
I wanted to add my thanks for the countless things you have taught me about CLL. You have calmed me, encouraged me, sometimes frightened me a little, but always enlightened me with charm, warm humor, and grace. I'm very grateful for your willingness to give of your time and knowledge. You are a treasure to us.