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Henrietta Lacks

Henrietta Lacks

Overview
Henrietta Lacks (sometimes erroneously called Henrietta Lakes, Helen Lane or Helen Larson) was an African-American
African American
African Americans are citizens or residents of the United States who have at least partial ancestry from any of the native populations of Sub-Saharan Africa and are the direct descendants of enslaved Africans within the boundaries of the present United States...

 woman who was the unwitting source of cells from her cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

ous tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...

, which were culture
Microbiological culture
A microbiological culture, or microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture media under controlled laboratory conditions. Microbial cultures are used to determine the type of organism, its abundance in the sample being tested,...

d by George Otto Gey
George Otto Gey
George Otto Gey was the scientist who propagated the HeLa cell line.-Biography:Gey was born in Pennsylvania, and both his parents were born in Germany. He received his undergraduate degree at the University of Pittsburgh in 1921 and then taught zoology there. Around 1926 he married Margaret K. ,...

 to create an immortal cell line for medical research. This is now known as the HeLa
HeLa
A HeLa cell is a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken on February 8, 1951 from Henrietta Lacks, a patient who eventually died of her cancer on October 4, 1951...

 cell line.

Henrietta Lacks, born Loretta Pleasant, on August 1, 1920 in Roanoke, Virginia
Roanoke, Virginia
Roanoke is an independent city in the Mid-Atlantic U.S. state of Virginia and is the tenth-largest city in the Commonwealth. It is located in the Roanoke Valley of the Roanoke Region of Virginia. The population within the city limits was 97,032 as of 2010...

, to Eliza (1886–1924) and John Randall Pleasant I (1881–1969).
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Encyclopedia
Henrietta Lacks (sometimes erroneously called Henrietta Lakes, Helen Lane or Helen Larson) was an African-American
African American
African Americans are citizens or residents of the United States who have at least partial ancestry from any of the native populations of Sub-Saharan Africa and are the direct descendants of enslaved Africans within the boundaries of the present United States...

 woman who was the unwitting source of cells from her cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

ous tumor
Tumor
A tumor or tumour is commonly used as a synonym for a neoplasm that appears enlarged in size. Tumor is not synonymous with cancer...

, which were culture
Microbiological culture
A microbiological culture, or microbial culture, is a method of multiplying microbial organisms by letting them reproduce in predetermined culture media under controlled laboratory conditions. Microbial cultures are used to determine the type of organism, its abundance in the sample being tested,...

d by George Otto Gey
George Otto Gey
George Otto Gey was the scientist who propagated the HeLa cell line.-Biography:Gey was born in Pennsylvania, and both his parents were born in Germany. He received his undergraduate degree at the University of Pittsburgh in 1921 and then taught zoology there. Around 1926 he married Margaret K. ,...

 to create an immortal cell line for medical research. This is now known as the HeLa
HeLa
A HeLa cell is a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken on February 8, 1951 from Henrietta Lacks, a patient who eventually died of her cancer on October 4, 1951...

 cell line.

Early life (1920–1940)


Henrietta Lacks, born Loretta Pleasant, on August 1, 1920 in Roanoke, Virginia
Roanoke, Virginia
Roanoke is an independent city in the Mid-Atlantic U.S. state of Virginia and is the tenth-largest city in the Commonwealth. It is located in the Roanoke Valley of the Roanoke Region of Virginia. The population within the city limits was 97,032 as of 2010...

, to Eliza (1886–1924) and John Randall Pleasant I (1881–1969). Her family is uncertain how her name changed from Loretta to Henrietta; with Hennie as a nickname. Eliza, her mother, died giving birth to her tenth child in 1924. Henrietta's father felt as if he couldn't handle the children, so he took them all to Clover, Virginia
Clover, Virginia
Clover is a census-designated place in Halifax County, Virginia, United States. The population as of the 2010 Census was 438. Clover was an incorporated town from 1895 until 1998, when it reverted to unincorporated status.Clover is located at ....

 and distributed the children between relatives. Henrietta ended up with her grandfather, Tommy Lacks.

Later life (1941–1950)


Pleasant married her first cousin, David "Day" Lacks (1915–2002), in Halifax County, Virginia. David had already been living with Henrietta's grandfather when she moved there at age 4. Their marriage on April 10, 1941, after their first two children were born (the first when Henrietta was just 14), surprised many in the family as they had been raised like brother and sister.

At the end of 1941, their cousin Fred Garret convinced the Lacks's to leave the tobacco farm and have Day work at Bethlehem Steel's Sparrow's Point steel mill. Soon, they moved—Day first, then Henrietta and the children—to Maryland. David bought a house for the family with the money Garret gave Day when he left to go overseas. Their house was on New Pittsburgh Avenue in Turners Station, now a part of Dundalk
Dundalk, Maryland
-Demographics:As of the census of 2000, there were 62,306 people, 24,772 households, and 16,968 families residing in the CDP. The population density was 4,689.5 people per square mile . There were 26,385 housing units at an average density of 1,985.9 per square mile...

, Baltimore County, Maryland
Maryland
Maryland is a U.S. state located in the Mid Atlantic region of the United States, bordering Virginia, West Virginia, and the District of Columbia to its south and west; Pennsylvania to its north; and Delaware to its east...

. This community was one of the largest and one of the youngest of the approximately forty African American
African American
African Americans are citizens or residents of the United States who have at least partial ancestry from any of the native populations of Sub-Saharan Africa and are the direct descendants of enslaved Africans within the boundaries of the present United States...

 communities in Baltimore County.

Day and Henrietta had five children together: Lawrence (b. 1935), Elsie (1939–1955), David "Sonny" Jr. (b. 1947), Deborah (1949–2009), and Joseph (b. 1950, later changed name to Zakariyya Bari Abdul Rahman). Joseph Lacks, Henrietta's last child, was born at Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

 in November 1950, just four and a half months before Henrietta was diagnosed with cancer. Elsie was described by the family as "different", "deaf and dumb" and in 1955 died in the Hospital for the Negro Insane (which was later renamed Crownsville Hospital Center
Crownsville Hospital Center
The Crownsville Hospital Center is a former psychiatric hospital located in Crownsville, Maryland. It was in operation from 1911 to 2004.-History:...

 and was also known as Crownsville State Hospital). Elsie had been placed there about 1950, around the same time Henrietta discovered that she had lumps and unusual bleeding.

Diagnosis and death (1951)


On January 29, 1951, Henrietta went to Johns Hopkins Hospital because she felt a lump inside her. It all started when she asked her cousins to feel her belly, asking if they felt the lump that she did. Her cousins assumed correctly that she was pregnant. But, after giving birth to her fifth child, Henrietta started bleeding, and it wasn't menstrual. She told Day, was then taken to the local doctor, tested for syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, which came back negative, and was then referred to Johns Hopkins.

Johns Hopkins was their only choice for a hospital, since it was the only one in a close proximity to them that treated black patients. Howard Jones, her new doctor, examined Henrietta and the lump in her cervix
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...

. It was nothing he had ever seen before. He cut off a small part of the tumor and sent it to the pathology lab. Soon after, Jones discovered she had a malignant epidermoid carcinoma of the cervix Stage 1 (cervical cancer).

Lacks was treated with radium tube inserts, which were sewn in place. After several days in place, the tubes were removed and she was released from Johns Hopkins with instructions to return for X-ray treatments as a follow up.

During her radiation treatments for the tumor, a small part of Henrietta's cervix was taken off—a healthy part and a cancerous part—without her permission . The cells from her cervix were given to Dr. George Otto Gey
George Otto Gey
George Otto Gey was the scientist who propagated the HeLa cell line.-Biography:Gey was born in Pennsylvania, and both his parents were born in Germany. He received his undergraduate degree at the University of Pittsburgh in 1921 and then taught zoology there. Around 1926 he married Margaret K. ,...

. These cells would eventually become the HeLa
HeLa
A HeLa cell is a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken on February 8, 1951 from Henrietta Lacks, a patient who eventually died of her cancer on October 4, 1951...

 immortal cell line, a commonly used cell line in biomedical research
Biomedical research
Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine...

.

Lacks returned for the X-ray treatments. However, her condition worsened and the Hopkins doctors treated her with antibiotics, thinking that her problem might be complicated by an underlying venereal disease (she had neurosyphilis
Neurosyphilis
Neurosyphilis is an infection of the brain or spinal cord caused by the bacterium Treponema pallidum. It usually occurs in people who have had untreated syphilis for many years, usually about 10 - 20 years after first infection.-Symptoms and signs:...

 and presented with acute gonorrhea
Gonorrhea
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain...

 at one point as well).

In significant pain and without improvement, Lacks returned to Hopkins on August 8th for a treatment session but asked to be admitted. She remained at the hospital until her death. Though she received treatment and blood transfusions, she died of uremic poisoning on October 4, 1951, at 12:30 A.M. at the age of thirty-one. A subsequent partial autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 showed that the cancer had metastasized throughout her body.

Henrietta Lacks was buried without a tombstone in a family cemetery in Lackstown, a part of Clover
Clover, Virginia
Clover is a census-designated place in Halifax County, Virginia, United States. The population as of the 2010 Census was 438. Clover was an incorporated town from 1895 until 1998, when it reverted to unincorporated status.Clover is located at ....

 in Halifax County, Virginia. Her exact burial location is not known, although the family believes it is within feet of her mother's gravesite. Lackstown is the name of the land that has been held by the (black) Lacks family since they received it from the (white) Lacks family, who had owned the ancestors of the black Lackses when slavery was legal. Many of the black Lacks family were also descendants from the white Lacks family. A row of boxwoods
Buxus
Buxus is a genus of about 70 species in the family Buxaceae. Common names include box or boxwood ....

 separates the graves of white ancestors from those of the black ancestors. For decades, Henrietta Lacks' mother has had the only tombstone of the five graves in the family cemetery in Lackstown.

In scientific research



The cells from Henrietta's tumor were given to researcher George Gey, who "discovered that [Henrietta's] cells did something they'd never seen before: They could be kept alive and grow." Before Henrietta, the cells would only survive for a few days. Scientists spent more time trying to keep the cells alive than performing actual research on the cells. Some cells in Lacks's tissue sample behaved differently than others. George Gey was able to isolate one specific cell, multiply it, and start a cell line. Gey named the sample "HeLa
HeLa
A HeLa cell is a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken on February 8, 1951 from Henrietta Lacks, a patient who eventually died of her cancer on October 4, 1951...

", after the initial letters of Henrietta Lacks' name, to protect her identity. As the first human cells grown in a lab that were "immortal" (did not die after a few cell divisions), they could then be used for conducting many experiments. This represented an enormous boon to medical and biological research.

As reporter Michael Rogers stated, the growth of HeLa by a researcher at the hospital helped answer the demands of the 10,000 who marched for a cure to polio just shortly before Lacks' death. By 1954, HeLa was being used by Jonas Salk
Jonas Salk
Jonas Edward Salk was an American medical researcher and virologist, best known for his discovery and development of the first safe and effective polio vaccine. He was born in New York City to parents from Ashkenazi Jewish Russian immigrant families...

 to develop a vaccine for polio
Polio vaccine
Two polio vaccines are used throughout the world to combat poliomyelitis . The first was developed by Jonas Salk and first tested in 1952. Announced to the world by Salk on April 12, 1955, it consists of an injected dose of inactivated poliovirus. An oral vaccine was developed by Albert Sabin...

. To test Salk's new vaccine, the cells were quickly put into mass production in the first-ever cell production factory.

Demand for the HeLa cells quickly grew. Since they were put into mass production, Henrietta's cells have been mailed to scientists around the globe for "research into cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

, AIDS
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

, the effects of radiation and toxic substances, gene mapping
Gene mapping
Gene mapping, also called genome mapping, is the creation of a genetic map assigning DNA fragments to chromosomes.When a genome is first investigated, this map is nonexistent. The map improves with the scientific progress and is perfect when the genomic DNA sequencing of the species has been...

, and countless other scientific pursuits". HeLa cells have been used to test human sensitivity to tape, glue, cosmetics, and many other products. Scientists have grown some 20 tons of her cells.

Doctors still have not discovered the reason for HeLa cells' unique vigor, but suspect that it is due to altered telomerase
Telomerase
Telomerase is an enzyme that adds DNA sequence repeats to the 3' end of DNA strands in the telomere regions, which are found at the ends of eukaryotic chromosomes. This region of repeated nucleotide called telomeres contains non-coding DNA material and prevents constant loss of important DNA from...

 function. There are almost 11,000 patents involving HeLa cells.

In the early 1970s, the family started getting calls from researchers who wanted blood samples from them to learn the family's genetics (eye colours, hair colours, and genetic connections). The family wondered why and this is when they learned about the removal of Henrietta's cells. No one else in the family had the traits that made her cells unique.

Recognition


In 1996, Morehouse School of Medicine
Morehouse School of Medicine
Morehouse School of Medicine is a medical school in Atlanta, Georgia, USA.-Establishment:Founded originally as a part of Morehouse College in 1975 during the tenure of college president Hugh M. Gloster, with Louis W. Sullivan, M.D. as dean, The School of Medicine at Morehouse College began as a two...

 in Atlanta, the state of Georgia
Georgia (U.S. state)
Georgia is a state located in the southeastern United States. It was established in 1732, the last of the original Thirteen Colonies. The state is named after King George II of Great Britain. Georgia was the fourth state to ratify the United States Constitution, on January 2, 1788...

 and the mayor of Atlanta recognized the late Henrietta Lacks' family for her posthumous contributions.

Her life was commemorated annually by Turners Station residents for a few years after Morehouse's commemoration. A congressional resolution in her honor was presented by Robert Ehrlich
Robert Ehrlich
Robert Leroy "Bob" Ehrlich, Jr. is an American politician who served as the 60th Governor of Maryland from 2003 to 2007. A Republican, he became governor after defeating Democratic opponent Kathleen Kennedy Townsend, a member of the Kennedy family, 51% to 48% in the 2002 elections...

 following soon after the first commemoration of her, her family, and her contributions to science in Turners Station.

Events in the Turners Station's community have also commemorated the contributions of others including Mary Kubicek, the laboratory assistant who discovered that HeLa cells lived outside the body, as well as Dr. Gey and his nurse wife, Margaret Gey, who together after over 20 years of attempts were eventually able to grow human cells outside of the body.

In 2011, Morgan State University
Morgan State University
Morgan State University, formerly Centenary Biblical Institute , Morgan College and Morgan State College , is a historically black college in Baltimore, Maryland, United States. Morgan is Maryland's designated public urban university and the largest HBCU in the state of Maryland...

 granted her a posthumous honorary degree.

On September 14, 2011 The Board of Directors of Washington ESD 114 Evergreen School District chose to name a new health and bioscience high school in her honor. The new school, scheduled to open in the fall of 2013, will be named Henrietta Lacks Health and Bioscience High School. "It is such an honor to name our new school after a person who so impacted the world of medicine and science," said school board member Victoria Bradford, who also served on the naming committee. "It is also a privilege to be the first organization to publicly memorialize Henrietta Lacks by naming this school building after her."

In media


In 1998, Modern Times: The Way of All Flesh, a one-hour BBC
BBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...

 documentary on Lacks and HeLa directed by Adam Curtis
Adam Curtis
Adam Curtis is a British BAFTA winning documentarian and a writer, television producer, director and narrator. He works for BBC Current Affairs.-Early life and education:Curtis was born in 1955...

, won the Best Science and Nature Documentary at the San Francisco International Film Festival
San Francisco International Film Festival
San Francisco International Film Festival is the oldest continuously running film festival in the Americas. Organized by the San Francisco Film Society, the International is held each spring for two weeks, presenting an average of 150 films from over 50 countries...

. Immediately following the film's airing in 1997, an article on HeLa cells, Lacks, and her family was published by reporter Jacques Kelly in The Baltimore Sun
The Baltimore Sun
The Baltimore Sun is the U.S. state of Maryland’s largest general circulation daily newspaper and provides coverage of local and regional news, events, issues, people, and industries....

. In the 1990s, the Dundalk Eagle published the first article on her in a newspaper in Baltimore City and Baltimore County, and it continues to announce upcoming local commemorative activities. The Lacks family was also honored at the Smithsonian Institution
Smithsonian Institution
The Smithsonian Institution is an educational and research institute and associated museum complex, administered and funded by the government of the United States and by funds from its endowment, contributions, and profits from its retail operations, concessions, licensing activities, and magazines...

. In 2001, it was announced that the National Foundation for Cancer Research
National Foundation for Cancer Research
The National Foundation for Cancer Research was founded in 1973 on the initiative of Albert Szent-Györgyi and Franklin Salisbury as a non-profit organization under U.S. tax code 501. Over the past 30 years, NFCR has provided more than $200 million in support of discovery-oriented basic science...

 would be honoring "the late Henrietta Lacks for the contributions made to cancer research and modern medicine" on September 14. Because of the events of September 11, 2001, the event was canceled.

In her 2010 book, The Immortal Life of Henrietta Lacks
The Immortal Life of Henrietta Lacks
The Immortal Life of Henrietta Lacks is a non-fiction book by American author Rebecca Skloot. It is about Henrietta Lacks and the immortal cell line, known as HeLa, that came from her cervical cancer cells in 1951. The book is notable for its accessible science writing and dealing with ethical...

, Rebecca Skloot
Rebecca Skloot
Rebecca L. Skloot is a freelance science writer who specializes in science and medicine. Her first book, The Immortal Life of Henrietta Lacks , was one of the best-selling new books of the year, staying on the New York Times Bestseller List for over 32 weeks and optioned to be made into a movie by...

 documents the histories of both the HeLa cell line and the Lacks family. Henrietta's husband, David Lacks, was told little following her death. Suspicions fueled by racial issues prevalent in the South were compounded by issues of class and education. For their part, members of the Lacks family were kept in the dark about the existence of the tissue line. When its existence was revealed in two articles written in March 1976 by Michael Rogers, one in the Detroit Free Press
Detroit Free Press
The Detroit Free Press is the largest daily newspaper in Detroit, Michigan, USA. The Sunday edition is entitled the Sunday Free Press. It is sometimes informally referred to as the "Freep"...

and one in Rolling Stone
Rolling Stone
Rolling Stone is a US-based magazine devoted to music, liberal politics, and popular culture that is published every two weeks. Rolling Stone was founded in San Francisco in 1967 by Jann Wenner and music critic Ralph J...

,
family members were confused about how Henrietta's cells could have been taken without consent and how they could still be alive 25 years after her death.

In May 2010, The Virginian-Pilot
The Virginian-Pilot
The Virginian-Pilot is a daily newspaper based in Norfolk, Virginia, and serving the Hampton Roads metropolitan area, southeastern Virginia, the Eastern Shore of Virginia, and northeastern North Carolina. The flagship property of Landmark Media Enterprises, The Pilot is Virginia's largest daily...

published two articles on Lacks, HeLa, and her family, which mentions that the Morehouse School of Medicine has donated the money for Henrietta's grave as well as her daughter Elsie, who died in 1955, to finally have headstones. Her grandchildren wrote her epitaph: "Henrietta Lacks In loving memory of a phenomenal woman, wife and mother who touched the lives of many. Here lies Henrietta Lacks (HeLa). Her immortal cells will continue to help mankind forever. Eternal Love and Admiration, From Your Family"

In May 2010, HBO announced that Oprah Winfrey
Oprah Winfrey
Oprah Winfrey is an American media proprietor, talk show host, actress, producer and philanthropist. Winfrey is best known for her self-titled, multi-award-winning talk show, which has become the highest-rated program of its kind in history and was nationally syndicated from 1986 to 2011...

 and Alan Ball
Alan Ball (screenwriter)
Alan E. Ball is an American writer, director, actor and producer for film, theatre and television.-Early life:Ball was born in Atlanta, Georgia, to Frank and Mary Ball, an aircraft inspector and a homemaker...

 would develop a film project based on Skloot's book.

On May 17, 2010, NBC ran a fictionalized version of Lacks' story on Law & Order
Law & Order
Law & Order is an American police procedural and legal drama television series, created by Dick Wolf and part of the Law & Order franchise. It aired on NBC, and in syndication on various cable networks. Law & Order premiered on September 13, 1990, and completed its 20th and final season on May 24,...

, titled "Immortal". An article in Slate
Slate (magazine)
Slate is a US-based English language online current affairs and culture magazine created in 1996 by former New Republic editor Michael Kinsley, initially under the ownership of Microsoft as part of MSN. On 21 December 2004 it was purchased by the Washington Post Company...

called the episode "shockingly close to the true story."

Further reading

  • Russell Brown and James H M Henderson, 1983, "The Mass Production and Distribution of HeLa Cells at Tuskegee Institute", 1953–1955. J Hist Med allied Sci 38(4):415–43
  • Michael Gold, A Conspiracy of Cells, 1986, State University of New York Press
    State University of New York Press
    The State University of New York Press , is a university press and a Center for Scholarly Communication. The Press is part of the State University of New York system and is located in Albany, New York.- History :...

  • Hannah Landecker
    Hannah Landecker
    Hannah Landecker is an author and Associate Professor of Sociology at UCLA. Her research interests are the social and historical study of biotechnology and life science, from 1900 to the present, the intersections of biology and technology, with a particular focus on cells, and the in vitro...

     2000 "Immortality, In Vitro. A History of the HeLa Cell Line". In Brodwin, Paul E., ed.: Biotechnology and Culture. Bodies, Anxieties, Ethics. Bloomington/Indianapolis, 53–72, ISBN 0253214289
  • Hannah Landecker, 1999, "Between Beneficence and Chattel: The Human Biological in Law and Science," Science in Context, 203–225.
  • Hannah Landecker, 2007, Culturing Life: How Cells Became Technologies. "HeLa
    HeLa
    A HeLa cell is a cell type in an immortal cell line used in scientific research. It is the oldest and most commonly used human cell line. The line was derived from cervical cancer cells taken on February 8, 1951 from Henrietta Lacks, a patient who eventually died of her cancer on October 4, 1951...

    " is the title of the fourth chapter.

External links