Remembering hematologist Zhou Jianfeng: Iron Man, Bridge and Man Who Brought Light

"Man is great because he is a bridge." - Nietzsche

Recalling Zhou Jianfeng seemed easy.

Because he is a typical good person and a good doctor, he is a famous hematology expert in China and a leader in the field of CAR-T treatment in China. He is elegant and humble, so that everyone feels looked down upon and respected.

But it's also difficult to remember him at times.

It all came so suddenly, at the age of 56, the golden age of a medical expert.

On March 27, at noon on an ordinary Sunday, Zhou Jianfeng died suddenly.

According to the custom, Zhou Jianfeng will generally use the weekend time to conduct academic exchanges with domestic counterparts.

In the morning, as the vice chairman of the China Anti-Leukemia Alliance, he made an appointment with Ma Jun, chairman of the alliance and director of the Harbin Institute of Blood Research, to discuss the CAR-T guidelines online.

At 9:55, the line suddenly broke. Zhou Jianfeng's relatives told Ma Jun that he was unconscious in his study. Rushed to the hospital 20 minutes later, Zhou Jianfeng's coronary artery dissection ruptured, and the rescue was ineffective and died.

Ma Jun couldn't believe it.

"For the blood doctor, Zhou Jianfeng is in the golden age."

The development of Blood Disease in China has gone through 107 years, after 5 generations of clinicians, Ma Jun is the third generation, and Zhou Jianfeng, who is more than 10 years younger than him, is the mainstay of the fourth and fifth generations.

At 11:30 the night before the accident, Zhou Jianfeng was still talking to Ma Jun on the phone to discuss how to reduce the toxic side effects of CAR-T and how to standardize treatment.

The guide was originally scheduled to be published on April 1.

The two have known each other for more than 20 years. In 2001, after Zhou Jianfeng returned from further study in the United States, he talked with Ma Jun, and the two sides reached a consensus: first, Clinicians in China lack basic research; second, doctors of modern blood diseases should apply basic research and translational medicine to the clinic.

In the following years, Ma Jun and Zhou Jianfeng worked closely together and studied together, witnessing his gradual growth into a leader in domestic CAR-T treatment, "He raised China's CAR-T treatment to an international height." ”

As soon as the news of Zhou Jianfeng's death came out, the domestic and foreign blood disease academia, patient groups, and CAR-T industry fell into shock.

Everyone who knew him was confused. We found Zhou Jianfeng's peers in the field of blood, his colleagues and students, his patients, and entrepreneurs in the CAR-T industry, who often couldn't help crying, pausing, and needing some time to calm down and continue.

This makes the process of recalling Zhou Jianfeng like collecting pieces of broken fragments.

When we recall Zhou Jianfeng, we feel that he is such a bridge, a connector who "drags manufacturers, drags patients, and pushes technology forward".

At first, we were surprised that Zhou Jianfeng's death caused three groups in a field — academia, patient groups, and industry — to shake and grieve en masse.

In this consortium, there are "desperate blood disease patients who regard him as the last hope", companies that hope to develop domestic CAR-T drugs, and junior doctors who regard him as a beacon.

After Zhou Jianfeng suddenly left, what was left was a patient with a blood disease who was registered, a new CAR-T drug that was still in the second phase of the clinic, patients still being treated in the ward, several patient groups, his colleagues, and his family. Some people are worried: without him, what will happen next?

Technology and salvation

When a pragmatic idealist discovers a seed with potential, then while he is ready for the soil, he must also be ready for the ideal.

After returning to China, Zhou Jianfeng, in more than ten years, cultivated a humble small blood department that he had taken root in into a two-hundred-person department that could undertake the most difficult coefficient of cell and gene therapy operations at that time.

"Many years ago, we had an idea that our language should be internationalized, and our examinations and patient data should be in line with international standards, so since then, we have established various diagnostic systems including molecular, pathological, genetic, immune... In the future, we can also lead the world and become the leader of the world view concept," he said in an interview with Xinhua News Agency in 2017, "In my generation, it may be difficult for us to do this, but the young people behind us, they may be able to do it, as long as everyone is clear and keeps working hard, it can be done."

When many people mention Zhou Jianfeng, they use a definition: clinical scientist.

"He can do both clinical and technical research, and this requirement is very high." As one of Zhou Jianfeng's assistants, Huang Liang, deputy chief physician of the Department of Hematology of Tongji Hospital, has the impression that almost all of Zhou Jianfeng's time is soaked with patients, he gets up at 5 o'clock all year round, arrives at the hospital early, and will reply to emails and messages at 11 o'clock at night.

Zhou Jianfeng was very concerned about the students. Xiaowen (pseudonym), an eight-year student at Tongji Medical College, told Eight Points Jianwen, "He was afraid that we were not in good spirits, so he equipped us with a coffee machine, and the coffee beans were all sent by him." ”

On March 21, Xiaowen also went to the office to find him and signed a two-way selection form for mentors as an eight-year doctoral supervisor. Zhou Jianfeng was in a meeting at the time, but after signing the letter, he did not forget to encourage future students.

A cell therapy practitioner who has known Zhou Jianfeng for 12 years told Eight Points Kenwen, "Before the advent of CAR-T therapy, Professor Zhou was already a front-line expert in the field of hematological tumors, especially in the treatment of lymphoma, and the emergence of CAR-T around 17 or 18 years made Professor Zhou really stand out and go to the center of the stage."

"He relies on doing practical research, turning technology into products, making patients use them, and really curing patients." The practitioner said, "It can even be said that embracing the emergence of new technologies has made Professor Zhou stand out from the front-line experts to become a top expert."

Undoubtedly, the new technology of CAR-T is of epoch-making pioneering significance for the treatment of lymphoma.

For the vast majority of patients with relapsed refractory hematologic malignancies, after the failure of chemotherapy and molecularly targeted drug therapy, they will eventually die because there is no drug available. But CAR-T is a lifesaver for them.

Tongji Hospital began to carry out CAR-T treatment at the end of 2015, when there were few hospitals in the country that could carry out this technology, the team led by Zhou Jianfeng was a pioneer in China, and in order to establish the entire system, from laboratories, clinics to pharmaceutical partners, he would be deeply involved.

At that time, fosun Kate joint venture company had not yet been established, China's first listed CART product - Agilun Sai had not yet started the technology transfer plan to China, and then Wang Liqun, who was the CEO of Fosun Kate, was still doing CAR-T in Sibiman, but at that time he had heard of Professor Zhou Jianfeng's clinical research, and Professor Zhou Jianfeng's team had provided CAR-T therapy for more than 20 patients. To date, Zhou Jifeng's team has performed CAR-T treatment for more than 1,000 patients, which is one of the few in the country.

At that time, CAR-T treatment for patients was a very risky behavior. "In the early days, it was difficult to deal with cytokine storms and complications," Pan Jing, a student of Zhou Jianfeng and director of the Department of Hematology at Beijing Boren Hospital of Gaobo Medical Group, told Eight Point Jianwen, "When I first started doing it, there was a lot of pressure, and the patient's condition was very serious, how to deal with it, without any experience."

So far, such attempts have not stopped. Professor Zhou Jianfeng's group of doctors and deputy chief physician of the Department of Hematology of Tongji Hospital, Zhou Xiaoxi, told Eight Point Jianwen, "Taking diffuse large B-cell lymphoma as an example, the existing technology can only solve 70% of the patient's problems, and the remaining 30% of the patients have no available solution, but you always have to find new ways for these patients to continue their lives."

When desperate patients come and Zhou Jianfeng hardly refuses, every patient and every complex situation will design a new plan with a serious and responsible attitude.

Whether it is in the eyes of Ma Jun, director of the Harbin Blood Research Institute, or entrepreneurs in the industry, Zhou Jianfeng is an uncompromising and dedicated academic expert.

He chose the lymphoma sub-specialty more than a decade ago, and he always has the courage and ability to sharply grasp the cutting-edge progress of the industry and have the courage and ability to translate the research results into products for patients. Everything, "not just for the clinic, but for the future of the entire discipline".

Almost everyone we spoke to was impressed by the clinical expert's "approachability" and felt treated and respected as equals. Fellow countryman and Reindeer Medical CEO Wang Wen described, "like a camel, carrying a heavy load, no aggression."

As a pharmaceutical company, dealing with clinicians is always more like "Party B", most clinical experts will actively participate, but most of the time it is the company that serves the clinic. But working with Zhou Jianfeng, "he is completely communicating with the company on a channel." ”

In Wang Liqun's memory, Zhou Jianfeng has never been on top, "He is for patients, so he is willing to use science to promote clinical practice, pay attention to the production and preparation quality of enterprises, and give enterprises a lot of pertinent suggestions." ”

A bridge

Zhou Jianfeng is a person who firmly believes that technology subverts the treatment of diseases.

He can provide clinical needs for cooperative companies, and he is willing to provide guidance for the entire industry, even the WeChat signature reads "innovation for development".

At a symposium held by the Food and Drug Administration, Zhou Jianfeng was the only clinician present. Industry insiders here were worried that clinicians were not on the same channel as companies. But Zhou Jianfeng's speech gave the company a lot of leading advice, "He knows how to transform research results into industries, apply them to the clinic, what should be done, and how important it is for patients."

A person who once worked at WuXi Juno explained to us more bluntly: "He knows what the real needs of patients are in the clinic, and then tells us about this need, repeatedly bringing the relationship between supply and demand closer." ”

"He is most qualified to say that CAR-T is the whole process of management, because from every link in the clinic to the design of the product, he is involved in the whole process." Wang Liqun said that this is something that can only be done by a clinician who is interested in science and has the ability to do it.

Before the Wei Zexi incident, he called for cell therapy to be regulated as a drug, "he insisted on promoting cell therapy as a drug, controlling quality, and requiring enterprises."

In the view of Wang Liqun, chairman of Xingyi Ang Biology, "Zhou Jianfeng is an industrial, scientific research and clinical binder. ”

"He believes in science and is willing to use science drive clinically, to drive the production and preparation quality of enterprises, because he believes, we also believe, which is why we have a common desire to be together."

When more and more people in the CAR-T field turn their fiery eyes to Zhou Jianfeng, people hope that he can give more guidance.

After an international blood tumor exchange meeting, Professor Zhou Jianfeng once mentioned the future of CAR-T to Wang Wen, "He said that the listing of CAR-T terminal blood tumors is only the first step in the long march, and in the next ten years, it will most likely be pushed to the front line and become the pillar therapy of blood tumors." However, sometimes in the process of clinical communication, Wang Wen can feel that "he has a very full schedule, very stressful, and sometimes very anxious."

It's like building a bridge between patients, clinics, and industries.

On the patient side, it is not easy to use new technologies to help patients solve problems. Even for the most authoritative experts in this field, the new technology is an "unknown field", "even if he is not in the hospital, he pays attention to the changes in clinical indicators of all patients 24 hours a day." Zhou Xiaoxi said.

On the enterprise side, the overall preparation of CAR-T treatment requires cooperation with pharmaceutical companies. From CAR-T scientific research, to how to improve the overall design, make suggestions for the preparation process, and control quality, Zhou Jianfeng almost participated in the whole process.

Since 2015, every Wednesday at noon, the Department of Hematology has held a meeting on the progress of CAR-T patients enrolled in the ward office of the Optics Valley Branch of Tongji Hospital. The participants were not only clinical doctors, but also researchers and biomedical scientists from companies.

The communication meeting usually lasts 1-2 hours, and everyone discusses the progress of the disease and the stability of the patient in detail for the patients who have been enrolled, and for the patients who are about to enroll, the disease analysis, risk assessment, plan preparation, etc. of CAR-T treatment are carried out, one patient after another.

All the clinical results of CAR-T, the first feedback, improvement, and application here, the progression of the patients who have been enrolled, the analysis of the ungrouped patients, and the rules of planning preparation are all discussed in an orderly manner.

It's been more than 7 years.

Zhou Jianfeng is a clinical scientist recognized in the field of blood as a "low-key, practical" scientist.

He's not just a bridge, he's a Stark trailblazer. Six or seven years ago, he was keenly aware that a profound change in the field of blood was taking place, and he began to put CAR-T on the market. Just like he is extremely adventurous and innovative, he led the tongji hematology department, which was unknown more than a decade ago, to rush to the forefront of the country.

Industry insiders see it as a flag. The application of cell and gene technology is An opportunity for China to be the closest to the world's leading level, and CAR-T is a non-traditional cutting-edge drug with a high degree of customization and high risk in China and even the world, "Now many companies can keep up because early clinicians dare to take risks and break this road out, otherwise it will waste a lot of time." Wang Liqun said.

Ma Jun lamented the departure of this industry leader, "If he were alive, he would make more contributions to the research and clinical practice of blood diseases in China and even the world."

The one who brings the light

The patient's family member Lin Ping came from abroad, originally hung up zhou Jianfeng's outpatient clinic on Monday afternoon, March 28, but received a text message at noon the day before to inform "cancellation for special reasons", unexpectedly, it was suspended forever.

The news of Professor Zhou Jianfeng's death has spread among the patients. Many patients arrived in Wuhan early and waited for Professor Zhou to give treatment suggestions. Now, they are overwhelmed.

The webpage of the "House of Lymphoma" became black and white, and patients posted mourning posts to record the bits and pieces of getting along with Zhou Jianfeng. The unshared joy of the results of the examination, the unfulfilled rendezvous and drinking convention, all the emotions turned into grief and mourning at that moment.

The wreaths downstairs of the community were piled up in piles, and every patient he had "rescued from the hands of the god of death" desperately wanted the professor to see his presence. Although, the professor is no longer there.

Student Xiaowen told us that all professor Zhou's students in Wuhan had gone to help. She was unable to rush back, but asked her classmates to help write down her name as a final goodbye to the teacher.

The patients who cried bitterly said that the professor had treated many patients with terminal and recurrent blood tumors that had nowhere to go, and was the "light of life" for nearly a thousand blood tumor patients.

In the eyes of patients, Zhou Jianfeng is a doctor, a scientist, and an idealist who loves food and loves life. In the patient groups "Happy Island" and "Snow World", he will encourage patients to live well and enjoy the fireworks in the world.

Many details often make people forget that he is a "big coffee" in the system.

He published his mobile phone number to the patient group during the Epidemic in Wuhan, his team left the contact information to the patients to answer questions, he bought a high-speed rail business seat for patients who had developed disease progression, and bought Chinese medicine for the patients throughout the city at three o'clock in the middle of the night. I met a "Maxima" who interviewed in the morning and let the family go to work in the afternoon. He will carefully prepare every meeting he attends, and his WeChat can be added by CRA/CRC at will.......

He often @ a certain patient he is worried about in the group chat: "How are you doing lately?" "It's like thinking about relatives and friends who haven't been seen for some days." Xiao Zheng (pseudonym), a family member of a patient with sleeve cell lymphoma, looked through the chat records with Professor Zhou since June 2021, and there were 26 WeChat phone calls alone, many of which he took the initiative to call.

Xiaozheng also helped us piece together "Zhou Jianfeng's Day".

At eight o'clock in the morning, carrying a simple breakfast from the office on the 6th floor to the ward on the 7th floor, the large rounds of Wuyangyang always listened to the patient's feelings first, and then listened to the opinions of the doctor in charge, "everything is subject to the patient's feelings."

The afternoon clinic was full, and the southerners' meticulous calculations were vividly formulated in the treatment plan, and until 7 p.m., there were sporadic patients waiting for consultation in the clinic.

At night, it can be a sleepless night, and the patient with cell proliferation reaction, improper diet into the ICU, and neurotoxic nonsense needs him to turn back to the bed again.

Until his death, Zhou Jianfeng had to travel to and from the 3 branches of Tongji Hospital every week, visiting outpatients 4 times a week to grasp the situation of general inpatients in detail.

"Zhou Jianfeng is too desperate."

When Qiu Lugui, director of the Lymphoma Diagnosis and Treatment Center of the Blood Disease Hospital of the Chinese Academy of Medical Sciences, said this sentence, he was stuck several times before he decided to use this word.

It is hard to imagine that a doctor who is a national discipline leader should interrogate patients one by one. "They all advised him to fight less, but when the patient found him on the head, he didn't care much about himself."

Zhou Jianfeng's WeChat nickname is "Iron Man".

Iron Man's heroic practice seems destined to illuminate others only by "burning oneself" and "burning oneself" can one illuminate others. The humble and low-key Zhou Jianfeng may not want to be called heroic, but through the restoration of the memory fragments of many narrators, he and Iron Man, who is also a leader in technology, have experienced a short life with the theme of technology and salvation.

Zhou Jianfeng fell in the golden age of the hematologist. Unfortunately, there are no transistors in reality that can make the heart beat again.

Yu Huanhuan, Li Lin, Yan Shengnan | writing

Chen Xin | responsible editor

This article was first published on the WeChat public account "Eight Points Health" (ID: HealthInsight)

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