b.19 August 1950 d.8 October 2006
MB ChB Birm(1973) DCH(1975) MRCP(1976) FRCP(1991)
Anthony ‘Tony’ Oakhill pioneered techniques of bone marrow transplantation that saved the lives of hundreds of children who would otherwise have died of leukaemia.
He was born in Leicester, the son of Harold Anthony Oakhill, a painter and decorator, and Elizabeth Mary Oakhill, a clerk. The boyhood home was a small terrace house, described by him as ‘two up and two down’. He was educated at City of Leicester Boy’s School and Birmingham University, where he qualified in 1973. He then trained in paediatric oncology, at the Birmingham Children’s Hospital, where he was a senior registrar from 1978 to 1980, and then in Philadelphia, on a two year fellowship at the Children’s Hospital.
Appointed to the Bristol Children’s Hospital in 1982 as consultant in charge of treatment of children with leukaemia, he had the vision, drive and leadership to put his department at the forefront of what were to become the two most important advances in the treatment of childhood leukaemia in the next 20 years. These were the widening of the use of bone marrow transplantation to enable patients to receive marrow from donors who were not members of their own family, and the refinement of techniques to detect the presence of residual leukaemia that can still be present in the patient after treatment but cannot be detected by conventional methods of looking with a microscope at the blood and bone marrow.
In the 1970s many children were being cured of leukaemia, but there remained considerable numbers who relapsed during chemotherapy or who had resistant forms of leukaemia that cannot be cured without intensive chemotherapy that has to be combined with bone marrow transplantation. Without the use of treatment regimes that involve bone marrow transplantation, these children died.
When bone marrow transplantation was first introduced in the treatment of leukaemia it could only be performed if the patient was lucky enough to have a close family member who had a marrow that matched that of the patient. Children who had no siblings had no chance of bone marrow transplantation, and the small family size which is the norm in the UK also reduced the chances of finding a compatible sibling. This severely limited the use of bone marrow transplants to a minority of those who needed it to survive.
Tony Oakhill had the foresight and courage to see that the way ahead was in the development of techniques to allow patients to receive bone marrow from donors who were not from their family and to prevent the rejection of this foreign bone marrow by newly developed drugs while the patient’s body learned to accept the new bone marrow. This work, for which he became the undisputed leader in the United Kingdom did not occur in isolation, but was strongly influenced by workers in other countries, most notably those in the internationally renowned bone marrow transplant unit in Seattle. These techniques in the hands of his department produced results that were as good, if not better than sibling bone marrow transplants, and meant that by using a large panel of volunteer bone marrow donors, more than 90 per cent of children who needed a bone marrow transplant for survival were able to receive one.
With meticulous attention to detail and a team that took an holistic approach to the care of their patients and parents, he built his department into the largest bone marrow transplant unit in the UK, with patients, including adults, referred from all over the country and from abroad.
The detection of leukaemia that is present in the body after chemotherapy but cannot be seen with the microscope (minimal residual disease) has been found to be important in predicting those children in whom the leukaemia is likely to come back after clinical remission. He was quick to see the importance of developing techniques to detect minimal residual disease and to use this knowledge to alter treatment regimes to prevent a relapse. Essentially a clinician who had the foresight to know the direction research should take; he attracted gifted young colleagues to his department to carry out the basic science which could be used for the benefit of patients.
He was pleased to be awarded his honorary professorial chair, a rare distinction in Bristol, on the basis of his impressive research output and his work was recognised by the College, which asked him to give the Lockyer lecture. Beyond this he had no wish to tread the corridors of power, disliked committee work and did not seek high office or an important position within the medical establishment. At work he was happiest and at his best with the families and children under his care. He had a magical way with children who were captivated by him and it was not unusual to see young children trying to follow him around the ward to remain close to him, wanting to play with him and to have more of his company. Oakhill was gifted with a remarkable memory, which included not just the medical details of the hundreds of patients under his care but the uniqueness of every one of them – what they liked at school, where they went on holiday, their pets, the games they liked playing, the football team they supported and even the score of the latest match.
Compassionate, honest, always giving his undivided attention when listening to parents and children, and with a gift for choosing the right words when talking to them, he remained personally involved throughout the treatment of his patients and this continued after treatment was completed. No less important, he remained in contact and supportive to the families of children who had died.
He enjoyed good wine and food, the theatre, travel, and read widely. As befits a son of Leicester he kept up to date with both rugby and soccer. He and his wife Christine cultivated a beautiful garden in the grounds of their cottage near Bath. He was passionate and quietly knowledgeable about art: it was not unknown for him to slip away from a session at an international conference and head for the nearest gallery. When he became ill and had to retire early, he made a complete break from paediatrics, resigned from the Royal College of Paediatrics and Child Health, and enrolled as a student of the history of art at Bristol University. He became, perhaps, the only person in the history of the university to be listed as a professor and at the same time an undergraduate. After gaining his degree, and with his cancer seemingly in remission, he was planning his doctorate on Alexander Pope when his illness relapsed.
He lost his first wife from illness and his second marriage was dissolved. He then married Christine Elliott, a widowed colleague with a young daughter. This marriage brought him great happiness and contentment. He leaves his third wife, a daughter, Ellen, from his second marriage, whose qualification as a doctor he lived to see, and a step daughter of whose academic achievements he was equally proud.
[Brit.med.J.,2007,334,48; The Daily Telegraph 31 October 2006]
(Volume XII, page web)
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