Award for Professor Hartmut PH Neumann

Cross of Merit “on a Ribbon” of The Federal Republic of Germany to Professor Hartmut PH Neumann

University Medical Center, Freiburg, Germany

for his Lifetime Achievements on von Hippel-Lindau Disease

The "Bundesverdienstkreuz am Bande" is the Cross of Merit “on a Ribbon” of the Federal Republic of Germany (FDR), which is more officially termed the “Verdienstorden der Bundesrepublik Deutschland” (Order of Merit of the Federal Republic of Germany) for meritorious achievements on behalf of the public good. The Order is the only State decoration of the FDRand is conferred by The President of The Federal Republic of Germany, Sir Horst Köhler, who himself holds, ex officio, the Sonderstufe des Großkreuzes or the highest class of this same Order. The Cross of Merit has been in existence since September 7, 1951, and only several thousand have been awarded in the almost 60 years of its existence.

The Cross of Merit is conferred after nomination by one or more individuals or professional bodies to the President or the government of one of the German states. In the case of Professor Hartmut PH Neumann, the many patients with von Hippel-Lindau disease (VHL), whom he has served for over 2 decades, nominated him by sending a letter on behalf of the VHL self support group of Germany. Indeed, the two major nominators themselves both had pheochromocytoma. What launched Prof Neumann’s career interests, both medical and scientific, in VHL in the spring of 1983 was his first patient, who was also present at the recent Ceremony. This pheochromopcytoma patient was admitted to Neumann’s clinical service. The patient´s sister was operated for an hemangioblastoma one year before, and her son had been operated twice for pheochromocytoma. Astutely recognizing this, Dr Neumann was the first to give this patient and his family the diagnosis of von Hippel-Lindau disease.

Professor Neumann’s educational background is both unique and particularly suited for the study and service of VHL: he is Boarded in general medicine, pathology, internal medicine, nephrology and endocrinology. Now, fired by his the experience with his first patient with VHL, he visited this family and many pheochromocytoma patients and VHL families during his free evenings and during the weekends in the Freiburg – Blackforest area in order to set up a project on von Hippel-Lindau disease and pheochromocytoma.

He pioneered the meaning of a “living” population-based registry by creating a registry of about 700 patients with VHL and by forming a special team of physicians, study nurses and a laboratory in order to diagnose, treat and provide surveillence and prevention facililities at the University Medical Center of Freiburg, Germany. Professor Neumann has helped to establish the VHL Family Alliance in the USA in 1993 and the national German VHL Selfsupport Group in 1999. He served as a speaker in the VHL Patient/Provider Conferences in Kansas City, Burlington, Atlanta and Bethesda as well as in many of these meetings in Germany. In 1994, he invited all known physicians and researchers dealing with VHL to Freiburg. This was the start of the now well-estbalished biannual International VHL Symposium which subsequently took place in Hawaii, Paris, at the Mayo Clinic, in Padova, Koci/Japan, London/Ontario and Copenhagen. Professor Neumann has attended all these meetings and also serves on the Medical Advisary Board for the VHL Family Alliance from the very beginning. The same is true for the German VHL Self Support Group, fo which he also wrote the VHL German booklet for patients, relatives and physicians.

Scientifically, Professor Neumann collaborated with the Human Cancer Genetics Research group in Cambridge/UK where his additional families with MEN 2 were instrumental for the identification of the RET gene by Lois Mulligan, PhD and Charis Eng, MD, PhD then postdoctoral fellows in the laboratory of Professor Bruce Ponder. This also began his lifelong collaboration with Professor Eng. In 1993, Professor Neumann published in The New England Journal of Medicine the first and so far unique prospective trial, a comparison of various catecholamine metabolites and various radiological imaging methods regarding the diagnosis of pheochromocytoma after detection of this tumor in 36 of 79 subjects at familial risk with a total of 42 pheochromocytomas. Teaming up with co-PI’s, Andrej Januscewicz and Charis Eng, he created and established the worldwide largest registry of paraganglial tumors which represents all registrants with a blood DNA samples in his laboratory in Freiburg exceeding now 2000 subjects. Based on this registry and study group, he continued to work “at the edge of molecular genetics and practical consequences” on pheochromocytoma and published again a corner stone paper in The New England Journal of Medicine in 2002 (which has now garnered more than 300 citations) on the high frequency of 24% of germline mutations in the genes RET, VHL, SDHB and SDHD in nonsyndromic pheochromocytoma. His genotype-phenotype studies in patients with mutations of the SDHB, SDHC and SDHD genes have been presented in 2004 and 2005 in JAMA. Among other highlights are his medico-archeologico-clinical detective work on the classical description of pheochromocytoma by Felix Fraenkel, a physician in Freiburg, in 1886, again in The New England Journal of Medicine in 2007, and an in press paper in Cancer Research on nearly 600 patients with head and neck paragangliomas analyzing a strategy for reduction of escalating costs for molecular genetic testing of such patients. More recently, he was asked to author the Pheochromocytoma Chapter in the 2008 edition of Harrison´s Principles of Internal Medicine.

Professor Neumann has created a network of pheochromocytoma and pheochromocytoma associated disorders with many countries. His concepts for VHL clinics and pheochromocytoma centers have been instrumental for preventive care projects and centers in these countries. Being head of the Freiburg Preventive Medicine Unit, Professor Neumann is continuously engaged in practical surveillance of about 700 registered VHL patients and may additional patients with pheochromocytoma-associated syndromes. He feels honoured that patients come from across the globe, including Spain, Hungary, Turkey, Israel, Kuwait and Korea.

Because of his lifelong cutting edge work on VHL and neuroendocrine neoplasias, Professor Neumann has been awarded the classical German nephrology award, the Franz Volhard Prize, the Hufeland Prize for preventive medicine, the Semmelweis Medal of the University of Budapest, honorary membership of the Polish Society of Hypertension and is Visiting Professor at the University of Temesvar/Romania. One of Professor Neumann´s principles is to say that registries are only useful, if they are alive. In this sense, he is always grateful for the intensive collaborators, and eventually, friendship, with many colleagues from all continents. In terms of his numerous scientific contributions, he has cultured, for nearly two decades, a twin – like friendship with Charis Eng, now founding Chairwoman of Cleveland Clinic’s Genomic Medicine Institute and Director of the VHL Clinical Center of Excellence at the Cleveland Clinic.

With great aplomb and a ceremony that will be remembered for a lifetime, the Bundesverdienstkreuz am Bande was conferred on Professor Neumann on March 26, 2009 in the Grand Auditorium of the Medical Clinic of the Albert-Ludwigs University in Freiburg by The Minister for Science, Research and Art of the State of Baden-Württemberg, Prof. Dr. Peter Frankenberg.

The ceremony was opened by the Dean of the medical faculty, Prof. Dr. Christoph Peters, followed by the Leading Medical Director, Prof. Dr. Wolfgang Holzgreve. Subsequent to the opening remarks, the minister pinned the Order on Prof Neumann. The laudatio was given by the Head of the department of neurosurgery, Prof. Dr. Josef Zentner. Then the president of the VHL self support group of Germany, Gerhard Alsmeier, spoke on "Von Hippel-Lindau - not any more an unknown item". He himself is a VHL patient and spoke about his odyssey before coming to Freiburg, where all necessary investigations including MRI of the brain, the spinal cord and the abdomen as well as eye investigation and catecholamine measurement were performed on one day. Finally "The 1st VHL patient" of Professor Neumann, Karl Vogt, gave words of thanks and honor, surely a fitting laudation for Neumann. The ceremony was framed by what he so much cherishes, classical music: Dita Lammerse, a member of the Baden-Baden and Freiburg Broadcasting Symphony Orchestra played 5 movements of the Sonata in C (No. 3) for violoncello solo by Johann Sebastian Bach, surely a most touching and fitting finish to this event, since Professor Neumann is also an enthusiastic amateur violinist.

Hartmut Neumann contributed to VHL mightily, as a pioneer does. Equally importantly, he is a citizen of the world, family man, cutting edge scientist, caring clinician, loyal friend and mentor – there is a no more deserving recipient of Germany’s highest public services award than he. The VHL Family Alliance is proud to call Professor Neumann one of our own.