Advertisement
Mayo Clinic Proceedings Home

Robert A. Kyle, MD: Lessons From a Legend

      In this issue of Mayo Clinic Proceedings, there are 2 articles authored by a living legend in medicine: Robert A. Kyle, MD.
      • Kyle R.A.
      • Larson D.R.
      • Kurtin P.J.
      • et al.
      Incidence of AL amyloidosis in Olmsted County, Minnesota, 1990 through 2015.
      • Muchtar E.
      • Gertz M.A.
      • Kyle R.A.
      • et al.
      A modern primer on light chain amyloidosis in 592 patients with mass spectrometry-verified typing.
      The scientific contributions of Dr Kyle over a remarkable 60-year career in medicine have no parallel. From his first publication in 1959
      • Kyle R.A.
      • Kiely J.M.
      • Stickney J.M.
      Acquired hemolytic anemia in chronic lymphocytic leukemia and the lymphomas: survival and response to therapy in twenty-seven cases.
      to his latest articles in this issue of the Proceedings, Dr Kyle has defined and redefined the epidemiology, diagnosis, risk stratification, prognosis, and management of the entire spectrum of plasma cell disorders. From monoclonal gammopathy of undetermined significance (MGUS) to multiple myeloma,
      • Kyle R.A.
      • Therneau T.M.
      • Rajkumar S.V.
      • et al.
      Prevalence of monoclonal gammopathy of undetermined significance.
      • Kyle R.A.
      • Remstein E.D.
      • Therneau T.M.
      • et al.
      Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma.
      • Kyle R.A.
      • Gertz M.A.
      • Witzig T.E.
      • et al.
      Review of 1027 patients with newly diagnosed multiple myeloma.
      his academic legacy is unmatched. It will be futile to try and list his countless scientific contributions. What I can and wish to highlight are aspects of Dr Kyle that go beyond his formidable bibliography: 4 lessons I learned watching and working with him for the past 25 years.
      Attention to detail: Quite possibly the first lesson I learned from Dr Kyle is attention to detail. Witnessing him check and double check and triple check every decimal to ensure that everything he publishes is accurate has left an indelible impression on me. It is the stuff of legend, but indeed true that he personally verified the medical records of each and every one of the 1384 patients with MGUS described in his landmark study describing the natural history of the disease.
      • Kyle R.A.
      • Therneau T.M.
      • Rajkumar S.V.
      • et al.
      A long-term study of prognosis of monoclonal gammopathy of undetermined significance.
      If he was going to declare that the risk of progression in MGUS was persistent regardless of the duration of the disease, he knew it was of paramount importance to accurately classify each patient in the original inception cohort. Of course, he did not stop with this. Dr Kyle took this to a whole new level by following the cohort for an additional 15 years to be sure that the risk of progression was truly lifelong, resulting in another seminal article.
      • Kyle R.A.
      • Larson D.R.
      • Therneau T.M.
      • et al.
      Long-term follow-up of monoclonal gammopathy of undetermined significance.
      Scientific accuracy requires attention to detail.
      Vision: Leadership is all about vision. More than any other lesson, this is one that I have personally benefited from. Dr Kyle has always had a clear vision of what he wanted to accomplish: to define the natural history and improve the outcome of myeloma and related disorders. It was vision that led him to form the Mayo Clinic Dysproteinemia Biobank decades ago, when few investigators were investing in such efforts. This biobank at Mayo Clinic today has more than 250,000 samples available for the study of myeloma and related disorders. I have witnessed him stay laser focused on this aspirational goal. I have also been the recipient of 1-on-1 “lectures” from him on the importance of being able to quickly distinguish legitimate hobbies that add value from distractions that promise fame but at the expense of taking time away from fulfilling the vision. Dr Kyle’s productivity and enduring contributions to the field are directly related to his remarkable ability to stay focused on his vision. Meaningful academic success needs vision and a commitment to stay true to the vision.
      Mentorship: Dr Kyle has been and is instrumental in the success of a generation of leaders in the field of plasma cell disorders worldwide. At Mayo Clinic, there are more than 25 faculty dedicated to the study of plasma cell disorders, including more than 10 at the professor level. Although it is uncommon to have even 2 or 3 major leaders in a disease concentrated at any one institution, having so many develop and work collaboratively in one center is a reflection of Dr Kyle’s mentorship. More importantly, it is a testament to his generosity in giving credit. It is this critical aspect of mentorship that allowed so many to succeed. He reveled in our success. He considered our success as the best metric of his success as a leader. For this to happen, he identified our individual strengths and helped us amplify them. With Dr Kyle as a role model for mentorship, a generation of leaders in the myeloma field has grown to display similar attributes. It is no surprise that the International Myeloma Working Group and the collective myeloma academic community are often cited as great examples of collegiality and mentorship in oncology. Mentorship has enduring rewards.
      Integrity: Clearly, the singular most identifiable and universally revered aspect of Dr Kyle is his integrity. When he speaks, people listen. Physicians and scholars in medicine look up to him. Integrity is not a virtue that one can readily lay claim to. It is an innate virtue. It is genuine. It is natural. With Dr Kyle it is unquestioned and unconditional, something that all his peers and mentees recognize and marvel at. Of all the lessons I have learned, this is the most aspirational and the most difficult. It is the one that requires a lifetime of staying true.
      Many of us in the field of plasma cell disorders are fortunate to have a great role model in Dr Kyle. He continues to serve the myeloma community through his research and leadership. As the chairman of the Scientific Advisory Board and a member of the Board of Directors of the International Myeloma Foundation, he has committed himself for decades to education and advocacy. For decades, Dr Kyle has also contributed to the history of medicine through hundreds of vignettes on stamps associated with medicine. These were published in the Journal of the American Medical Association and subsequently in Mayo Clinic Proceedings and bound into 3 volumes called Medicine and Stamps. He has received the David A. Karnofsky Memorial Award and Lecture from the American Society of Clinical Oncology and the Wallace H. Coulter Award for Lifetime Achievement in Hematology from the American Society of Hematology—both of which represent the highest honors bestowed by these organizations, and he is the only one ever to receive them both. The International Myeloma Foundation has established the Robert A. Kyle Lifetime Achievement Award to “honor the physician who most exemplifies a singular dedication to and compassion for myeloma patients and treatment of their disease.” His hobbies include travel, sports, and stamp collecting. He is a national treasure in medicine, a living legend, a man revered by his colleagues for his countless contributions to patient care, medical education, research, and mentorship.

      References

        • Kyle R.A.
        • Larson D.R.
        • Kurtin P.J.
        • et al.
        Incidence of AL amyloidosis in Olmsted County, Minnesota, 1990 through 2015.
        Mayo Clin Proc. 2019; 94: 465-471
        • Muchtar E.
        • Gertz M.A.
        • Kyle R.A.
        • et al.
        A modern primer on light chain amyloidosis in 592 patients with mass spectrometry-verified typing.
        Mayo Clin Proc. 2019; 94: 472-483
        • Kyle R.A.
        • Kiely J.M.
        • Stickney J.M.
        Acquired hemolytic anemia in chronic lymphocytic leukemia and the lymphomas: survival and response to therapy in twenty-seven cases.
        AMA Arch Intern Med. 1959; 104: 61-67
        • Kyle R.A.
        • Therneau T.M.
        • Rajkumar S.V.
        • et al.
        Prevalence of monoclonal gammopathy of undetermined significance.
        N Engl J Med. 2006; 354: 1362-1369
        • Kyle R.A.
        • Remstein E.D.
        • Therneau T.M.
        • et al.
        Clinical course and prognosis of smoldering (asymptomatic) multiple myeloma.
        N Engl J Med. 2007; 356: 2582-2590
        • Kyle R.A.
        • Gertz M.A.
        • Witzig T.E.
        • et al.
        Review of 1027 patients with newly diagnosed multiple myeloma.
        Mayo Clin Proc. 2003; 78: 21-33
        • Kyle R.A.
        • Therneau T.M.
        • Rajkumar S.V.
        • et al.
        A long-term study of prognosis of monoclonal gammopathy of undetermined significance.
        N Engl J Med. 2002; 346: 564-569
        • Kyle R.A.
        • Larson D.R.
        • Therneau T.M.
        • et al.
        Long-term follow-up of monoclonal gammopathy of undetermined significance.
        N Engl J Med. 2018; 378: 241-249

      Linked Article