Doctor tested research barriers as ‘father of modern leukemia therapy’
Dr. Emil Freireich, a maverick doctor who invented the first effective treatments for childhood leukemia, made strides that revolutionized cancer care and became a pillar of The University of Texas MD Anderson Cancer Center, died Monday. He was 93.
Defying the status quo throughout his career, Freireich was one of the first modern clinical cancer researchers in the world and spent 50 years at MD Anderson. The doctor’s early experiences with personal loss and his deep passion for saving lives drove him to innovate. He died in the care of the hospital where he spent his career and inspired countless students. The hospital and his family declined to disclose his cause of death.
“He was truly a great humanitarian,” said the doctor’s daughter, Debbie Freireich-Bier. “He had a firm belief in hope.”
That hope, to help children battling cancer, would lead to groundbreaking but controversial treatments that today have saved thousands of lives. Despite criticism and obstacles from the medical establishment at the time, Freireich made advances that proved for the first time that cancer could be cured.
The doctor came into medicine when the field of cancer research did not yet exist. He began his
work in 1955 at the fledgling National Cancer Institute in Bethesda, Md., the first of its kind in the world. He was assigned to work in the leukemia ward on his first day.
Before entering medicine, Freireich lost someone close to him to cancer; a girlfriend from his youth died of acute leukemia.
At that time, leukemia was a death sentence, Freireich said in previous interviews, and most children diagnosed with the disease died within four weeks.
“You cannot imagine how horrible it was,” Freireich told the Chronicle in 2015. “These were 3-, 4-, 5year-old kids bleeding to death, bleeding out of their ears, eyes, nose, skin and bowels, bleeding internally, vomiting blood. It was a parent’s greatest horror.”
The physician’s priority became to stop the continuous bleeding, a hallmark of leukemia. He correctly theorized it was caused by insufficient platelets, discs in blood that are necessary for clotting.
Freireich also realized that the blood children had been getting from blood banks was too old to contain the platelets needed to stop the bleeding.
The doctor invented and patented the first continuous-flow blood cell separating machine, which allowed platelets and white blood cells to be extracted from the blood of donors and then transfused to leukemia patients.
In the late 1950s Freireich and a team of researchers began investigating the idea of combination chemotherapy treatment for childhood leukemia patients. The method, which involves using a combination of drugs, had been successful in curing tuberculosis.
The team began a series of trials and eventually began administering four types of highly toxic drugs to patients in 1961.
“At the time people said what he was doing was ‘criminal’ and that those children should be left alone to die with dignity,” said Dr. Hagop Kantarjian, chair of the leukemia department at MD Anderson.
People were critical because what Freireich did was unlike anything that had been done before, said Dr. Jordan Gutterman, professor of leukemia at MD Anderson.
“Most new great ideas, when initially presented in medicine and science, commonly
are considered to be crazy because they are different,” said Gutterman.
Freireich didn’t care what other people thought of him and the criticism never gave him pause, Gutterman said.
“Because of Dr. Freireich’s vision and personality, he was able to push through and create new opportunities in cancer treatment,” said Kantarjian.
Despite backlash, the treatment trial worked, resulting in a 90 percent remission rate in the patients. Now, the survival rate for acute lymphocytic leukemia in children is still 90 percent overall, according to the American Cancer society.
In 1965, Freireich and his research partner Emil “Tom” Frei III were asked to launch a chemotherapy program at MD Anderson, which became the Department of Developmental Therapeutics. During that time, the department developed drug combinations to cure various kinds of cancer based on the combined chemotherapy research in leukemia patients.
The physicians and researchers who were recruited to the department became the first of a new generation of oncologists and hematologists who went on to develop more treatments for many types of cancer.
Freireich continued researching and teaching full time at MD Anderson until 2015. But even after he announced his retirement, the doctor never really stopped working in the medical center. He continued to teach part time until the pandemic made it too risky for Freireich to go into work. But even after that, Freireich would still sit in virtually on the center’s most important meetings, said Kantarjian.
Above all else, Freireich was committed to saving lives and never giving up
when options are limited.
“His whole issue was giving life and maintaining life,” said Gutterman. “He would get really upset if a doctor said they didn’t think there was anything more they could do for a patient. That was the worst thing you could say in front of him.”
Caring for patients with humanity was deeply important to Freireich, his daughter said.
“He spent hours and hours with patients and their families,” she said. “He cared about the comfort of the patient.”
In his work, the doctor witnessed a lot of death, suffering and trauma. But he always maintained hope, said Freireich-Bier.
“He believed that any contribution a patient made to helping discover something new was valuable,” she said. “When patients died, it wasn’t in vain. That life had meaning will possibly help save other lives.”
Freireich had learned to cope with loss at an early age. Born to Hungarian immigrants in 1927, he grew up poor in inner-city Chicago during the Great Depression. His father died, presumably by suicide after the 1929 stockmarket crash when Freireich was 2. He hardly saw his mother, who worked in a sweatshop 18 hours a day everyday to support the family. The boy considered an Irish maid who cared for him to be his surrogate mother.
At 16, Freireich was encouraged by a teacher to apply to the University of Illinois. The teen was accepted and paid for his education waiting tables and doing odd jobs. He received his medical degree from the university’s College of Medicine at 22.
Freireich interned and held residency at two Chicago hospitals before he accepted a fellowship in hematology
at Massachusetts Memorial Hospital in Boston. There, he published a study on anemia and met his wife, Haroldine Cunningham, who was a nurse at the hospital.
The researcher’s journey from poverty to becoming a world-renown celebrity in the cancer research community was chronicled by author Malcolm Gladwell, in the 2013 book “David and Goliath: Underdogs, Misfits, and the Art of Battling Giants.”
Freireich was the “David” in the story, an underdog who had the will to push himself to achieve what some thought was impossible.
Freireich contributed to more than 600 scientific papers and more than 100 books. He was recognized with many honors for his work, including the Albert Lasker Clinical Medical Research Award. MD Anderson created the Emil J. Freireich Award for Excellence
in Education in his honor, a nod to his work instituting teaching programs for graduate students to drive progress in research.
Freireich is survived by his wife, Haroldine, four children, six grandchildren and three great-grandchildren. Funeral services will be held virtually. In lieu of flowers, his family asks for donations to MD Anderson.