Great Expectations
Much was surely expected of Jean-Luc Harousseau when he was born in Nantes, France seventy-five years ago. “My father was a doctor, my mother was a doctor, my grandfather was a doctor.” As we saw in the last article, he exceeded anything they might have envisioned in myeloma alone.
Harousseau received the seventh annual Robert A. Kyle Lifetime Achievement Award on May 15, 2009. Kyle was the inaugural recipient of the award named in his honor by the International Myeloma Foundation (IMF). The second one went to Bart Barlogie.
Prior to the ceremony which took place at a hematology event in Monaco, Kyle traveled to Nantes for an informal reception in the city’s imposing chateau. The site was chosen to recognize and celebrate the honor of being recognized as one of the most respected myeloma experts in the world together with his family, friends, and colleagues in his native city.
Although Harousseau and Kyle had known each other for almost twenty years, mostly from professional meetings, they learned more about common interests spending the afternoon together. Harousseau recalls showing Kyle around Nantes before the ceremony and being impressed by his knowledge of the Loire River, which flows through the city, being “filled with blood” after a battle in the French Revolution. It is doubtful Kyle fully appreciated the depth of the bond between the city and his host.
A young Harousseau excelled early in his education to qualify for the most elite French schools, called grande écoles. He stayed only a few months before deciding to leave and prepare to go to medical school, into the “family business.” Even then, as we saw, he trained in hematology in Paris with the intention of making a name for himself in Nantes. He never lost his connections to his home. He deepened them. The man driving Kyle that afternoon probably knew more about the sites than most of his neighbors.
In 2002, Harousseau was about as far away from Nantes as could be imagined, in the U.S. Virgin Islands at a retreat of myeloma experts hosted by the IMF. Summoned to the phone, he remembered thinking, “I don’t know how he could know I was in the Virgin Islands.” “He” in this case was François Fillon, the president of the regional council of Pays de la Loire, generally comparable with an American governor. Fillon had just been named as minister to newly elected French president Jacques Chirac. He was calling to find a replacement to serve out his term.
“He asked me, ‘Do you want to become president of the region?” stunning Harousseau, the setting making the question seem surreal. Gathering himself, he replied, “I cannot refuse. I became president of the region, and at the same time I remained head of my department.” He would figure it out as he went along.
“While I was president of my region, I had to deliver an educational program at ASH [the annual meeting of the American Society of Hematology]. So, at two levels,” Harrouseau said with a wry smile, “it was very interesting.” Very few ASH attendees had any inkling at all this giant of myeloma had another life. They were busy trying to manage one professional life. Two, they surely thought, was inconceivable.
Following the experience of the first myeloma patient Harousseau treated, by 1985, the university hospital had established a bone marrow transplantation (BMT) unit. Soon after, the unit performed its first autologous BMT. “At that time, very few centers were doing autologous BMT in France, the media” became aware and Harousseau joked, “I became very famous.” It did, however, bring him to the attention to many who didn’t know about him or his work.
After being invited by a colleague to participate in discussions about Nantes, Harousseau was recruited by the local branch of the conservative party to join a list of candidates for 1988 municipal elections. When a party veteran asked, “Who are you? I don’t know you, you are not involved in politics,” he became interested when reminded of the news story about the university and BMT. Harrousseau was named third to party’s list, which, as he expected, “eventually lost.”
He joined the opposition as an advisor, “and I started a political career then.” After regional elections in 1992, “I was elected, and in charge of research and education at the regional council.” By 1998, “I was head of the list in my area, and I became first vice president of the regional council.” And in 2002, a call was placed from France to the U.S. Virgin Islands.
President Harousseau was responsible for everything ranging from roads to trash pickup to public health with budgets totaling billions of Euros until the 2004 elections. He tended to official duties like ribbon-cuttings to highlight public works, attending meetings, scrutinizing budgets and reports, and all the other tasks that come with a state’s governmental responsibilities. As he was still leading the university hospital’s hematology department and a national research cooperative group.
Regardless of how seriously he took his duties, Harousseau was a conservative in traditional stronghold of France’s political left, like virtually every European industrialized harbor city. “We lost the election in 2004, then I was in the opposition, which was not very interesting.” He was used to losing elections; but now he was looking away from politics, “so then I stopped” in 2010.
He found another professional passion to occupy him two years earlier, something to look toward. And it was back to his roots: cancer research and treatment, but this time, expanding to influence all cancer types.
Harrousseau left the university department he founded in 2008 to become director of the local cancer center, the Centre René Gauducheau. He led the merging of Nantes cancer center with that of Angers (Ahn-zhay), a city on the Loire less than one hour to the east, putting two cancer centers under one umbrella to provide a greater range of expertise to more patients in the region in the newly named Institut de Cancérologie de l’Ouest (ICO, Cancer Institute of the West).
In 2011, Harousseau got another call from Fillon, this time on behalf of French President Nicolas Sarkozy, “asking me if I would accept the position of president of the HAS (Haute Autorité de santé), which evaluates drugs, medical devices, new strategies, and also looks at the quality of care in the 4,000 hospitals in France. It was an interesting job, but completely different.”
As a member state of the European Union, France abides by decisions of the Europeans Medicines Agency on matters of drug and therapy approvals. It is up to each nation to administer and implement those recommendations. The role HAS plays in French policy is immense.
Harousseau remained in the position into the next French administration after Sarkozy’s term ended in 2012, until 2016. “And then I was sixty-eight,” he said, reprising his wry smile, “and I got retired.” But that doesn’t mean he’s not busy. “I’m still working, back at the ICO as Director of Translational Research, in an advisory role.” And since 2018 – excepting the pandemic years – he has been mentoring myeloma physicians and researchers in Asia. He’s been a featured speaker and teacher at Asia Myeloma Network events in China, Thailand, Singapore, and is scheduled to take part in another program later this year in South Korea.
Had Harousseau chauffeured Kyle a few miles further west, they would have driven to Saint-Nazaire on the north side of the Loire River. Home to one of the largest shipyards in the world, a large number of today’s mega cruise ships were made here. In World War II, Germany used the occupied city as a base for many of its submarines and to direct Atlantic Ocean operations.
Further up the road from Saint-Nazaire, north along the Atlantic coastline, is La Baule, a small seaside resort town where Harousseau hosted Kyle and the International Myeloma Workshop in 1995. It is now his home. These days, he and his wife Florence split their time between there and Paris to visit with their children and grandchildren.
Although Harousseau’s professional and personal travels have taken him to virtually every part of the globe, being too far from Nantes too long would be unthinkable. It was his sanctuary, a community where his family provided stability and nurtured expectations.
Here a medical student’s bold dream about his hometown hospital became everyday realities for myeloma patients throughout the world. This continues.
Considering how much Harousseau accomplished – and still does – after being with him just a few minutes, it is clear he believes his greatest professional achievement, his living legacy, is the Intergroupe Francophone du Myélome (IFM), the national cooperative group he, Michel Attal, and Thierry Facon created.
In the last article, we learned about IFM 90 and another study leading to taking total body irradiation off the myeloma palette of treatment options. In the next, we’ll take a closer look at how the IFM further impacted clinical practice.
Housekeeping: As many of you may have noticed, I made an error in posting the last story, inadvertently posting an unedited version. The cleaned-up version is now in my Substack archive. The article below is intended to go with the last one. Please accept my apologies. Won’t make that mistake again!
If you’ve read this far and were thrown off by the last article, please give it another shot.
Photo courtesy of Jean-Luc Harousseau