Pediatric Hematology-Oncology Fellowship Training Program

Pediatric Hematology-Oncology FellowshipTraining Program

St. Jude Children’s Research Hospital

Le Bonheur Children’s Medical Center

University of Tennessee, Memphis, College of Medicine

Contents

Our Mission .................................................................................................................. 2

The Hospital .................................................................................................................. 3

Memphis ....................................................................................................................... 4

Fellowship Program Goals and Objectives ................................................................... 5

Physician-Scientist Training Program ........................................................................... 5

Clinical Investigator Training Program ......................................................................... 6

Application Process and Selection of Fellows .............................................................. 6

The Subspecialty Training Experience ......................................................................... 7

Educational Meetings .................................................................................................. 11

Evaluations .................................................................................................................. 14

Research Programs ...................................................................................................... 15

Department of Hematology-Oncology Faculty .......................................................... 18

Program Director: Jeffrey E. Rubnitz, MD, PhD

Associate Director: Russell E. Ware, MD, PhD

Associate Director: Stephen X. Skapek, MD

Chair, Department of Hematology-Oncology: Michael B. Kastan, MD, PhD

Chair, Department of Pediatrics: Russell W. Chesney, MD

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Our Mission

To fi nd cures for children with catastrophic illnesses through research and treatment

St. Jude Children’s Research Hospital is dedicated to providing the highest quality

medical care to children with catastrophic illnesses—primarily pediatric cancer—and

to fi nding cures for those diseases. The institution is committed to research that seeks

to understand the molecular causes of disease, to improve diagnosis and treatment, and

to minimize the immediate and long-term side effects of therapy. Clinical and basic

science investigators work together in the same setting at which children benefi t from

their research. Clinicians work closely with laboratory-based researchers to translate

scientifi c discoveries into improved therapies.

We also recognize the devastating fi nancial, emotional, and psychological effects

of catastrophic disease on the family of a stricken child, and we are committed to

providing support services to the families of our children, regardless of their ability

to pay for treatment or services. Funds generated by the American Lebanese Syrian

Associated Charities (ALSAC) provide the vital foundation that buttresses ongoing

activities in patient care, research, and training within our hospital and, at the same

time, enable active partnerships with affi liates, both in the United States and through

our International Outreach Program.

The success of future biomedical research depends on the availability

of well-trained young investigators. St. Jude Children’s

Research Hospital is dedicated to nurturing and supporting

these clinicians and scientists. The education and training

programs at St. Jude Children’s Research Hospital refl ect

the institution’s commitment to excellence.

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The Hospital

St. Jude Children’s Research Hospital was founded by the late entertainer Danny

Thomas, a man of boundless energy and optimism, who was driven by the conviction

that “no child should die in the dawn of life.” He dreamed of a haven where sick children

could fi nd treatment, regardless of their race, religion, nationality, or ability to pay. He

envisioned a place where the top scientists in the world could

work together with superb clinicians to fi nd cures for

potentially fatal diseases of childhood. That dream

became a reality when this non-denominational

hospital, named for St. Jude Thaddeus—the

patron saint of hopeless causes—opened its

doors in 1962.

Since then, the institution has become an

international resource for the study and

treatment of catastrophic childhood diseases. St.

Jude Children’s Research Hospital is supported by

the only National Cancer Institute (NCI) Cancer Center

Support Grant directed solely toward pediatrics. It is the largest

hospital in the United States dedicated to pediatric cancer and hematologic diseases,

accepting approximately 350 new cancer patients each year. St. Jude Children’s

Research Hospital also has the largest pediatric bone marrow transplant program in the

world, currently performing nearly 200 transplants annually.

St. Jude Children’s Research Hospital offers a rich intellectual environment for

education and training. Fellows have the opportunity to work with world-renowned

senior faculty members, including Peter C. Doherty, PhD, winner of the 1996 Nobel

Prize for Physiology or Medicine and member of the National Academy of Sciences;

Robert G. Webster, PhD, member of the National Academy of Sciences; Charles J.

Sherr, MD, PhD, member of the National Academy of Sciences and recipient of the

Landon-AACR Prize for Cancer Research and the General Motors Cancer Research

Foundation Mott Prize; James N. Ihle, PhD, who, like Sherr, is a Howard Hughes

Medical Institute investigator; St. Jude Director William E. Evans, PharmD, recently

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elected to the Institute of Medicine; former St. Jude Director Arthur W. Nienhuis,

MD, member of the Institute of Medicine and the National Cancer Advisory Board;

Hematology-Oncology Chair Michael B. Kastan, MD, PhD, Board of Directors,

American Association of Cancer Research; Developmental Neurobiology Chair Tom

Curran, PhD, Former President of the American Association of Cancer Research;

Ching-Hon Pui, MD, American Cancer Society Clinical Research Professor; and

Pathology Chair James R. Downing, MD, member of the American Society of Clinical

Investigation.

At St. Jude, fellows are encouraged to attend regularly scheduled seminars, workshops,

journal clubs, and lectures given by faculty members and by internationally known

invited speakers. This rich academic environment is complemented by state-of-the-art

facilities, equipment, and research support services.

Memphis

Situated on a bluff overlooking the Mississippi River, Memphis, Tennessee, is the

metropolitan hub of a fi ve-state region known as the Mid-South. Home to nearly a

million residents, the greater Memphis area offers something for everyone. Memphians

enjoy a relatively low cost of living, a temperate climate, four distinct

seasons and good old-fashioned Southern hospitality. Memphis is

also home to one of the largest medical centers in the United

States.

The city is called the home of the blues, birthplace of

Rock’n’Roll, and is truly a music lover’s Mecca. From

the legendary Sun Studio where Elvis Presley, Ike Turner,

Carl Perkins, Rufus Thomas, Jerry Lee Lewis, and Johnny

Cash recorded, to the Stax Museum of American Soul

Music where Otis Redding, Booker T. and the MGs, and Isaac

Hayes made music history, to the pulsating night life of blues

clubs on historic Beale street, the Memphis beat never sleeps. Local

symphony orchestra, ballet, live theatre performances, several museums,

more than 150 diverse festivals, and special events are available to those seeking cultural

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activities. Nature lovers enjoy hiking, biking, hunting, fi shing and boating at a variety

of lakes, parks and nature preserves in and around the Memphis area. The city hosts

major sporting events, including the FedEx St. Jude Classic, the AutoZone Liberty

Bowl, the Kroger St. Jude Tennis Tournament, and the St. Jude Memphis Marathon.

Memphis is also the home of the Pacifi c Coast AAA Memphis Redbirds and the NBA

Memphis Grizzlies.

Fellowship Program Goals and Objectives

St. Jude Children’s Research Hospital provides a

comprehensive program for training subspecialty

fellows in Pediatric Hematology-Oncology. The

program is certifi ed by the Accreditation Council

for Graduate Medical Education (ACGME) and

leads to subspecialty certifi cation. The training

program is an integrated part of the University of

Tennessee, Memphis, Pediatric Residency Program

(Program 3274731034). The goal of the program is to

train the future leaders in academic pediatric hematology-

oncology in the United States. Upon successful completion of our training program,

fellows will have a comprehensive understanding of the pathophysiology of pediatric

hematologic and oncologic disorders, will be competent in the clinical diagnosis and

management of these disorders, will understand clinical trials methodology, and will

have competence in a selected research interest. Our program seeks to nurture and

develop laboratory researchers and clinical investigators.

Physician-Scientist Training Program

We have devoted special resources to a training program for physicians seeking

careers in laboratory-based academic pediatric hematology-oncology. As an

internationally recognized research center, St. Jude Children’s Research Hospital is in

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an ideal position to provide training in molecular medicine, particularly as it relates

to cancer and blood disorders. Our ultimate goal is to enable qualifi ed physicians to

become independent investigators at major academic institutions.

After completing a one-year clinical training period in hematology and oncology,

successful applicants for the laboratory research track will receive support for three

years of laboratory research training at St. Jude, the minimum time needed to prepare

researchers for productive careers in academic medicine. St. Jude is in a unique position

to offer special resources for laboratory training for the entire fellowship period and

for extended periods of laboratory research time if required. Because the training

period may exceed the three-year requirement for subspecialty board certifi cation

in pediatric hematology-oncology, St. Jude provides generous stipends to qualifi ed

applicants, depending on their prior training and experience. This program should

therefore provide the fi nancial security and protected time needed to develop superior

research skills and a comprehensive conceptual background in the molecular aspects

of hematology-oncology.

Clinical Investigator Training Program

In addition to the laboratory-based research track, we offer a clinical research track

for fellows interested in careers as clinical investigators. Formal training in clinical

research can be obtained through early involvement in several ongoing clinical trials

within the institution. Fellows may participate in the development of new institutional

protocols and may conduct retrospective hypothesis-driven studies. In addition, fellows

interested in pursing advanced degrees in clinical research or epidemiology can do so

through our partnership with the University of Tennessee Health Sciences Center

Application Process and Selection of Fellows

St. Jude participates in the National Residency Matching Program and accepts six

fellows each year for training in Pediatric Hematology-Oncology. Prospective fellows

are encouraged to apply early in their second year of pediatric residency. The Fellowship

7

Director, with the aid of the departmental Fellowship Committee, selects the applicants

who will be offered interviews. St. Jude Children’s Research Hospital pays the costs of

the interview, including lodging and travel.

The following criteria must be met for acceptance into the training program:

1. Successful completion of an ACGME-accredited pediatric residency program.

2. A commitment to pursue a career in academic pediatric hematology-oncology.

3. Excellence in the clinical care of children.

4. Proven research ability or the strong potential for success in clinical or laboratory

research.

Acceptance is granted on the basis of the applicant’s potential to become a successful

academic subspecialist.

The Subspecialty Training Experience

Overview of training

ACGME-accredited subspecialty training in pediatric hematology-oncology requires

a minimum of three years. The fi rst year of training provides comprehensive clinical

training in hematology, oncology, and stem cell transplantation, with initial

exposure to ongoing clinical investigations and research methods.

All inpatient rotations involve teams that include an attending

faculty member, one fi rst-year fellow, one or two pediatrics or

medicine-pediatrics residents, medical students, one or more

nurse practitioners or physician assistants, a social worker,

a pharmacist, and a nutritionist. All admitted patients are

treated by these care teams. The fellow learns to function

as a member of this multidisciplinary team and to call on

the skills and experience of team members. Two or more

subsequent years are devoted to active, direct involvement in

clinical or laboratory-based research.

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Clinical Rotations

Inpatient Leukemia-Lymphoma Service (2 months at St. Jude): In 2004, 139 new

patients with leukemia or lymphoma were seen at St. Jude. The fellow on service is

responsible for the supervision of all inpatients on the Leukemia-Lymphoma service

and becomes profi cient at diagnosing leukemia and lymphoma, enrolling patients on

treatment protocols, ordering chemotherapy, and providing supportive care. The fellow

learns how to manage complications of therapy, including infectious complications

in the immunocompromised host and complications of chemotherapy. He also

develops expertise at performing bone marrow aspirates and administering intrathecal

chemotherapy.

Inpatient Solid Tumor/Neuro-Oncology Service (2 months at St. Jude): In 2004, 131

patients with solid tumors other than brain tumors were seen at St. Jude. The fellow on

service is responsible for the supervision of all inpatients on the Solid Tumor service

and becomes profi cient at diagnosing malignant solid tumors, including neuroblastoma,

Wilms tumor, Ewing sarcoma, osteosarcoma, rhabdomyosarcoma and other soft tissue

sarcomas, hepatic tumors, retinoblastoma, germ cell tumors, colon cancer, melanoma,

and other tumors, enrolling patients on treatment protocols, ordering chemotherapy, and

providing supportive care. A major thrust of the clinical research is the development of

new agents. Fellows are thus exposed to the details of Phase I protocols, methodologies

and ethical considerations.

Inpatient Stem Cell Transplant Service (2 months at St. Jude):

Approximately 180 stem cell transplantation procedures are

performed each year (90 autologous and 90 allogeneic). Patients

are admitted to a specialized 14-bed BMT unit. During this

rotation, the fellow cares for children and adolescents who

are undergoing transplantation and gains experience with

hematopoietic and solid malignancies, bone marrow failure

syndromes, immunodefi ciency disorders, inherited metabolic

disorders, and complications of stem cell transplantation,

including graft failure, infectious complications, and graft-

versus-host disease.

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Hematology: 2 1/2 months at Le Bonheur Children’s Medical Center and St. Jude

Children’s Research Hospital. Care for all children and adolescents with nonmalignant

hematologic disorders is provided at both Le Bonheur and St. Jude. Patients with

hemoglobinopathies and bleeding disorders are admitted to

the inpatient hematology service at Le Bonheur, while

patients with bone marrow failure syndromes are

admitted to St. Jude. The fellow also participates

in an active Hematology Consultation service at

Le Bonheur and occasionally in the Newborn

Nursery. During the Hematology rotation, the

fellow attends the weekly outpatient hematology

clinics (half day on Mondays at St. Jude and a

full day on Thursdays at Le Bonheur) and the

comprehensive hemophilia and thrombosis clinics

(half day on Wednesdays), and a general hematology

clinic (half day on Tuesdays). Through these clinical

experiences, the fellow participates in the diagnosis and

treatment of the entire range of common and rare hematologic disorders in children,

including bone marrow failure syndromes, hemoglobinopathies, red cell membrane

and metabolism disorders, hemolytic and nutritional anemias, white cell disorders,

platelet and coagulation disorders, and immunodefi ciencies. The fellow presents

one hematology case of interest with didactic discussion each month at the St. Jude

Leukemia-Lymphoma-Hematology conference and one or two cases at the combined

pediatric and adult hematology conference held with the University of Tennessee every

other week.

After Completion of Therapy Clinic (two weeks at St. Jude): During this rotation, the

fellow gains experience with the long-term effects of treatment. Fellows participate in

ongoing studies of late effects of therapy on the skeleton; in evaluations of neurotoxic

and cardiotoxic effects of therapy; and in investigations of risk factors for second

malignancies.

Neuro-oncology (one month at St. Jude): In 2004, 137 patients with newly diagnosed

brain tumors were seen at St. Jude. This rotation provides education in the diagnosis

and management of CNS tumors. Fellows also attend the weekly multidisciplinary

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brain tumor clinical conference where new patients and consults are presented and

discussed.

Hematopathology (one month at St. Jude): During this rotation, the fellow develops

expertise in reading peripheral blood and bone marrow smears, and becomes familiar

with modern ancillary diagnostic techniques such as cytogenetics, fl ow cytometry,

and molecular diagnostics. In addition, the rotation offers exposure to

essential aspects of specimen handling in Surgical Pathology and in

Microbiology (the latter including conventional and molecular

methodology).

Electives (six weeks): Available electives include blood

banking, radiation oncology, coagulation disorders, general

hematology, sickle cell disease, infectious diseases, pediatric

oncologic surgery, and intensive care.

Continuity clinic (weekly at St. Jude): During the fi rst year,

fellows are assigned 25-30 new patients for whom they become

the primary caregivers. For one-half day per week throughout

the fellowship experience, fellows attend a continuity clinic at which

they provide direct patient care to these patients under the supervision of the

primary attending or clinic attending.

Scope of the inpatient experience: The fellows have direct supervisory responsibility

for care provided by residents, nurse practitioners, and physician assistants on all

inpatient rotations. They review patient assessments and management plans and are

responsible for assuring that protocol requirements are completed. They assume

primary care responsibility for a minority of patients on the Leukemia, Solid Tumor,

and Hematology services. They assume primary care responsibility for as many as

half of the patients on the Bone Marrow Transplant service. The inpatient attending

physician directly supervises the fellow on each rotation.

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Educational Meetings

The training program offers fellows a comprehensive series of didactic sessions and

teaching rounds, including the following:

Hodgkin’s staging conference: This working conference provides a weekly update of

all patients with Hodgkin’s disease who have undergone initial staging or re-staging.

The Hematology-Oncology, Surgery, Diagnostic Imaging, and Radiation Oncology

departments participate. Fellows are encouraged to attend

when their patients are discussed.

Hematology-Oncology Fellows Rounds: This

weekly meeting is organized by the fellows and

attended by fellows and faculty. Each fellow is

expected to present a topic or journal article

about two times per year.

Hematology conference: This is a combined

conference for pediatric and adult hematologists

at the University of Tennessee. At each meeting, one

pediatric and one adult hematology case is presented.

The St. Jude fellow on the Hematology service is expected to

give the case presentation and discussion.

Leukemia/Lymphoma/Hematology conference: This is a formal conference held each

week at St. Jude. Fellows are expected to present the case each week and may also

be asked to present the discussion. This conference is attended by faculty from the

Hematology-Oncology, Pathology, Diagnostic Imaging, and Infectious Diseases

Departments. Attendance is required for fi rst-year fellows and encouraged for all

others.

Pediatric Grand Rounds: This weekly conference on diverse topics in General Pediatrics

is organized by the Department of Pediatrics and is held at Le Bonheur Children’s

Medical Center. Attendance is optional.

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Solid tumor staging conference: At this weekly conference, management of specifi c

solid tumor patients is discussed by the Hematology-Oncology, Surgery, Diagnostic

Imaging, and Radiation Oncology faculty. Fellows are encouraged to attend when their

patients are discussed.

Solid Tumor, Leukemia, and BMT Division Rounds: In addition to daily ward rounds,

each division holds weekly rounds at which the inpatient team presents the current

inpatients to the entire division. The inpatient fellow is

required to attend.

St. Jude Grand Rounds: This is a weekly formal

presentation of a clinical or basic science topic

related to pediatric hematology-oncology.

Attendance is required for all fellows.

Tumor Board: This is a formal weekly conference

in which a solid tumor case is presented and

discussed. Attendance is required for fi rst-year

fellows and encouraged for other fellows. Fellows

are also expected to present several cases throughout the

year.

Danny Thomas Lecture Series: This series consists of weekly lectures presented to the

entire St. Jude community by distinguished visiting scientists and clinical researchers.

Cancer Biology Forum: This lecture series for postdoctoral fellows and graduate

students focuses on the major areas of cancer biology studied at St. Jude. It is held

every other week and is presented by faculty members of the institution.

Oncology-Biostatistics Journal Club: Held monthly, this is a combined journal club

attended by members of the Hematology-Oncology and Biostatistics Departments. At

each meeting, a Hematology-Oncology fellow presents a journal article and a member

of the Biostatistics Departments discusses the design and analysis of the study.

Hematology Journal Club: At this monthly meeting, fellows present recent articles

focusing on nonmalignant hematology.

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Psychosocial aspects of subspecialty care

Inpatient rounds on all services include members of the multidisciplinary team.

Therefore, patient care decisions that affect the allocation of resources or that have

social, cultural, and economic impact are routinely discussed and planned in the

context of appropriate psychosocial input. End-of-life decisions and allocation of

limited resources are reviewed with the primary physician and the inpatient attending

physician. St. Jude’s commitment to International Outreach assures the presence of a

signifi cant population of patients from other countries. This clinical exposure provides

a very wide spectrum of social, cultural, and economic considerations, which is not

available in many training programs.

Service Duties

The fi rst year fellow is required to make daily inpatient rounds during each inpatient

rotation and provide weekend coverage for rounds on an every other weekend schedule.

Thus, every other weekend (two of each fourteen day block) is free of all clinical care

responsibilities. During outpatient and elective rotations, the fi rst year fellow provides

coverage for weekend rounds on the alternate weekend not covered by the inpatient

fellow. Weekend coverage is provided primarily by the fi rst year fellows, although

fellows in subsequent years are asked to provide weekend coverage for 4-8 weekends

per year.

Although we do not require fellows to do in-house call, fellows at

all levels of training may choose to take optional in-hospital

night call, up to 6 nights per month. The institution

provides a generous stipend for fellows and junior

faculty to provide this coverage. Therefore, usual

demand for these night call slots is suffi ciently

high that no more that 4 nights per month are

available to any fellow. This in-hospital night

call (3 physicians assigned each night) provides

complete coverage for all inpatient care,

walk-ins, emergency admissions, and telephone

coverage for the hospital. Consequently, once the

inpatient fellow has signed out to the on-call team, his

inpatient clinical care responsibilities are suspended until

1414

the following morning, but he is required to be on call from home to provide backup

to the in-house physicians. All phone consultation from Le Bonheur for Hematology

patients is handled by the hematology inpatient fellow. Routine admissions to the

Hematology service are admitted by the on call resident team at Le Bonheur. Emergent

situations and critical changes in clinical status requiring presence of the Hematologist

are triaged to the Hematology fellow on call at home.

Since July 1, 2003, fellow work hours has been limited to 80 hours per week and no

more than 30 continuous hours of patient care. Fellows continue to have 2 weekends

free of all clinical duties every month.

Evaluations

Evaluation of fellows

Written yearly progress reports and written evaluations for all

clinical rotations are required. The inpatient attending

physician is responsible for completing the written

evaluation form at the end of each rotation on that

inpatient service. Evaluations should be discussed

with the fellow. Forms are reviewed by the

Fellowship Committee and become a permanent

part of the fellow’s fi le. The inpatient attending

physician is also responsible for assurance that

the fellow acquires necessary skills in performing

the procedures used by pediatric hematologists

and oncologists. If fellows encounter problems in

acquiring these skills, the inpatient attending physician

notifi es the Fellowship Directors. Additional supervised

training will then be made available to the fellow.

Supervision of the research training is the direct responsibility of the laboratory

research mentor. Written yearly progress reports, including descriptions of abstracts

and manuscripts, are required. The Fellowship Committee monitors progress during

the research portion of the training program.

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Evaluation of faculty members

At the end of each inpatient rotation, fellows are required to provide written evaluations

of the attending faculty members. These evaluations assess each attending physician’s

knowledge of pediatrics, pediatric hematology-oncology, and the literature relevant to

these areas; conduct of rounds; teaching ability; availability; encouragement of the

fellow; and overall performance. Signifi cant problems are discussed with the inpatient

attending physician. Teaching ability is one criterion established by the institution for

yearly evaluations of faculty members and for academic promotion.

Evaluation of program

Once each year, the fellows are required to provide written evaluations of the fellowship

program. These evaluations are reviewed by the Fellowship Committee and discussed

at the Hematology-Oncology faculty meetings as needed.

Research Program

St. Jude Children’s Research Hospital is the only

National Cancer Institute-designated Cancer

Center solely devoted to pediatrics (Cancer

Center Support Grant, P30 CA21765, Michael

B. Kastan, MD, PhD, Principal Investigator).

Dr. Kastan, Chair of Hematology-Oncology, is

also the Principal Investigator of the NCI training

grant (T32 CA70089) for laboratory training of

clinical oncologists. This grant provides support for

up to three years of research training beyond the fi rst year

of clinical training. To qualify for support on this grant, fellows

must be citizens or permanent residents of the United States.

Research at St. Jude is also supported by National Institutes of Health funding to

individual investigators and by several multi-project grants, including the Pediatric Brain

Tumor Consortium, UO1 CA081457, (James Boyett, PhD, Program Director), the Solid

Tumor Program Project, PO1 CA23099, (Studies of Childhood Solid Tumors, Peter J.

Houghton, PhD, Program Director), the Childhood Cancer Gene Program Project, PO1

1616

CA071907, (James R. Downing, MD, Program Director), the Gene Therapy for Sickle

Cell Disease Program Project, PO1 HL053749, (Arthur W. Nienhuis, MD, Program

Director), the Development of a Novel AIDS Vaccine Program Project, PO1 AI45142,

(Julia L. Hurwitz, PhD, Program Director), and the Brain Tumor Program Project,

PO1 CA096832, (Normal & Neoplastic Growth Regulation in the Brain, Thomas

Curran, PhD, Program Director). St. Jude researchers are active participants in the

Children’s Oncology Group (Institutional Principal Investigator, Wayne Furman, MD).

In addition, St. Jude is one of 10 comprehensive sickle cell centers to receive a grant

from the National Heart, Lung and Blood Institute, U54 HL070590, (The St. Jude

Comprehensive Sickle Cell Center, Winfred Wang , MD, Principal Investigator).

The Cancer Center has been supported by consecutive Cancer Center Support Grants

from the National Cancer Institute since 1977. Members of the center are committed

to laboratory-based research integrated with a broad program of clinical investigation,

currently supported by approximately $50 million in extramural funding. The center is

structured to emphasize interdisciplinary research programs with applicability to the

understanding, prevention, and treatment of childhood cancer. The 7 programs around

which the center is organized are targeted toward specifi c diseases (Hematological

Malignancies and Neurobiology & Brain Tumor), conceptual themes (Signal

Transduction, Molecular Oncology, and Infection & Host Defense), or novel therapeutic

approaches (Developmental Therapeutics for Solid Malignancies and Transplantation

& Gene Therapy). Each program supports cross-disciplinary, multi-departmental

collaborations that foster innovative translational research. The success

of such research is due in part to the use of crucial Cancer Center-

supported Shared Resources, which include the Hartwell Center

for Bioinformatics & Biotechnology.

The Cancer Center also includes the International Outreach

Program. Based on a humanitarian mission, the International

Outreach Program aims to improve the survival rates of

children with cancer worldwide by assisting partner countries

in establishing effective treatment protocols, facilities,

educational opportunities, and collaborative research projects.

Many research opportunities for fellows are available within the

International Outreach Program.

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The Cancer Center is currently expanding its Cancer Prevention & Control Program.

Dr. Les Robison, Principal Investigator of the Childhood Cancer Survivors Study, has

recently been recruited to St. Jude as the fi rst Chair of the Department of Epidemiology

and Cancer Control. He will also serve as Co-leader of the Cancer Prevention and Control

Program. Under Dr. Robison’s leadership, we anticipate that St. Jude will become the

leader in childhood cancer prevention and cancer control and the premier program for

the conduct of etiologic and outcomes-based research in childhood cancer.

Key areas of research in the Molecular Oncology Program include oncogenes and

tumor suppressors, cell cycle regulators, chimeric transcription factors, and molecules

governing stress responses, apoptosis, and checkpoint control. The program encourages

the application of emerging laboratory fi ndings in a practical clinical setting while

attempting to pinpoint clinical problems for which understanding and treatment

may be advanced through laboratory-based discovery. The Transplantation & Gene

Therapy Program is focused mainly on diseases that may be treated by manipulation

of hematopoietic stem cells and their progeny. A primary interest is the development

of haploidentical transplantation in which the parent serves as the stem cell donor for

his or her child. Additional research is devoted to the development of gene therapy for

hematopoietic disorders. The goals of this research are the effective transfer of genes

into repopulating stem cells, the selective growth of genetically modifi ed stem cells in

vivo, and the lineage-specifi c expression of a transgene at appropriate levels.

Fellows begin participation in the research activities of the

institution through patient care activities, by enrolling

patients on protocols, ensuring their eligibility

for protocol enrollment, following protocol

guidelines, and carefully documenting protocol

events. Preparation for important institutional

presentations often requires reviews of patient

materials, and these reviews occasionally lead

to publishable results. During the fi rst year, the

fellows learn about the research opportunities

available at the institution and select research

mentors. Research mentors may be selected from any

ongoing clinical or laboratory-based research program at

St. Jude. During their second and subsequent years of training,

1818

fellows are given generous resources and about 90% protected research time to allow

them to be productive and become fully prepared for careers as independent clinical,

translational, or basic science investigators.

Fellows interested in formal training in clinical investigation may enroll in the Master

of Science in Epidemiology Program at the University of Tennessee. Fellows on the

clinical investigator track have the opportunity to participate in the development of

clinical protocols in hematology, oncology, or stem cell transplant. Fellows are also

expected to participate in the analysis, interpretation, and publication of retrospective

studies. St. Jude has a substantial infrastructure dedicated to clinical research, including

data managers, research nurses, statisticians, and database developers. Fellows can

take advantage of these resources to develop their own ideas for studies and ask

original research questions. In summary, our fellowship program offers a wide variety

of research options that span all areas of pediatric hematology-oncology and that will

prepare fellows for careers as clinical or laboratory-based investigators.

A more complete coverage of research activities may be found in the St. Jude Children’s

Research Hospital Scientifi c Report and on our Web site (http://www.stjude.org).

Department of Hematology-Oncology Faculty

After Completion of Therapy DivisionMelissa M. Hudson, MDMemberDirector, After Completion of TherapyLate effects of cancer therapy; health education and promotion in childhood cancer survivors

Scott Howard, MDAssistant MemberDirector of Clinical Trials, International Outreach ProgramImproving treatment in countries with limited resources

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Experimental Hematology DivisionBrian P. Sorrentino, MDMemberDirector, Experimental Hematology DivisionCo-Director, Transplantation and Gene Therapy ProgramHematopoietic stem cell biology, gene therapy

John M. Cunningham, MDAssociate MemberMedical Director, Cell and Gene Therapy LaboratoriesStem cell biology

Edwin M. Horwitz, MD, PhDAssociate MemberStem cell biology

Carl W. Jackson, PhDMemberAssociate Director of Academic ProgramsPlatelet development and function, thrombopoietin

Arthur W. Nienhuis, MDMemberGene therapy

Derek Persons, MD, PhDAssistant MemberGene therapy for beta thalassemia and sickle cell anemia

Hematology DivisionRussell E. Ware, MD, PhDMemberDirector, Hematology DivisionSickle cell disease; genetic modifi ers of disease expression

John M. Cunningham, MDAssociate MemberMedical Director, Cell and Gene Therapy LaboratoriesDevelopmental erythropoiesis; fetal globin induction

Pedro A. De Alarcon, MDMemberDeputy Chief Medical Offi cerHemophilia, thrombophilia, thrombosis

Jane Hankins, MDAssistant MemberSickle cell disease

2020

Joseph Mirro, Jr., MDMemberChief Medical Offi cer/Physician in ChiefAML; stem cell transplantation

Ulrike M. Reiss, MDAssistant MemberNonmalignant hematology

Winfred C. Wang, MDMemberDirector, Pediatric Hematology Center of MemphisSickle cell disease; bone marrow failure

Leukemia/Lymphoma DivisionChing-Hon Pui, MDMemberVice-Chair, Hematology-OncologyDirector, Leukemia/Lymphoma DivisionProgram Director, Hematological MalignanciesFahad Nassar Al-Rashid Chair of Leukemia ResearchAmerican Cancer Society FM Kirby Clinical Research ProfessorBiology and treatment of childhood leukemia and lymphoma

Dario Campana, MD, PhDMemberMonitoring of minimal residual disease in leukemia and lymphoma; treatment of B-cell malignancies with receptor-modifi ed immune cells; identifi cation of factors that support leukemia cell growth

Nobuko Hijiya, MDAssistant MemberTreatment and biology of leukemia and lymphoma

Scott Howard, MDAssistant MemberHodgkin lymphoma, supportive care

Melissa M. Hudson, MDMemberHodgkin and non-Hodgkin lymphoma

Sima Jeha, MDAssociate MemberDirector, Leukemia/Lymphoma Developmental TherapeuticsDevelopmental therapeutics

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Monika Metzger, MDAssistant MemberHodgkin lymphoma

Bassem I. Razzouk, MDAssociate MemberMedical Director, Middle East and Telemedicine Programs, International Outreach ProgramBiology and treatment of AML; developmental therapeutics

Raul C. Ribeiro, MDMemberDirector, International Outreach ProgramBiology and treatment of AML; international pediatric oncology

Jeffrey E. Rubnitz, MD, PhDAssociate MemberDirector, Pediatric Hematology-Oncology Fellowship Training ProgramBiology and treatment of AML

John T. Sandlund, MDMemberBiology and therapy of NHL and ALL

Molecular Therapeutics DivisionMichael B. Kastan, MD, PhDMemberChair, Hematology-OncologyDirector, Molecular Therapeutics DivisionCo-Director, Molecular Oncology Program Cellular stress responses; molecular signaling pathways

Jeffrey Dome, MDAssociate MemberBiology and treatment of renal tumors; telomeres and telomerase

Stephen X. Skapek, MDAssociate MemberCell-cycle regulation and differentiation in skeletal muscle; sarcoma biology

Neuro-Oncology DivisionAmar Gajjar, MDMemberDirector, Neuro-Oncology DivisionBrain tumors; late effects

Alberto Broniscer, MDAssistant MemberNeuro-oncology; biology and therapy of gliomas

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Maryam Fouladi, MDAssistant MemberBrain tumors; developmental therapeutics; late effects

Richard J. Gilbertson, MD, PhDAssociate MemberErbB receptor signaling in brain tumors

Solid Tumor DivisionVictor M. Santana, MDMemberCharles B. Pratt Chair in Solid Tumor ResearchDirector, Solid Tumor DivisionCo-Leader, Solid Malignancies Program Biology and treatment of neuroblastoma; research ethics in children

Najat C. Daw, MDAssociate MemberOsteosarcoma; developmental therapeutics

Wayne L. Furman, MDMemberDevelopmental therapeutics

Lisa M. McGregor, MD, PhDAssistant MemberNeuroblastoma; developmental therapeutics

Fariba Navid, MDAssistant MemberBiology and therapy of sarcomas

Carlos Rodriguez-Galindo, MDAssociate MemberBiology and treatment of retinoblastoma, bone tumors, and histiocytoses

Sheri L. Spunt, MDAssociate MemberChildhood soft-tissue sarcomas

Stem Cell Transplantation DivisionRupert Handgretinger, MD, PhDMemberDirector, Stem Cell TransplantationCo-Director, Transplantation and Gene Therapy ProgramHaplo-identical stem cell transplantation; immunotherapy

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Raymond C. Barfi eld, MD, PhDAssistant MemberStem cell transplantation; immune reconstitution; immune therapy; bioethics

Gregory Hale, MDAssociate MemberClinical Director, Stem Cell TransplantationStem cell transplantation

Edwin M. Horwitz, MD, PhDAssociate MemberStem cell transplantation

Kimberly Kasow, DOAssistant MemberStem cell transplantation for nonmalignant disorders

Wing H. Leung, MD, PhDAssociate MemberStem cell transplantation; late effects of cancer treatment; molecular epidemiology; natural killer cells

Janice Riberdy, PhDAssistant MemberT cell development and regulation

Paul Woodard, MDAssistant MemberAllogeneic stem cell transplantation for non-malignant diseases, with emphasis on sickle cell disease, severe aplastic anemia, and inborn errors of metabolism

Usman Yusuf, MDAssistant MemberStem cell transplantation with emphasis on graft versus host disease

International Outreach ProgramRaul C. Ribeiro, MDDirector, International Outreach Program

Bassem I. Razzouk, MDMedical Director, Middle East and Telemedicine Programs, International Outreach Program

Judith A. Wilimas, MDMedical Director, Central America

Gaston K. Rivera, MDMedical Director, Chile

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For more information, contact:

Jeffrey E. Rubnitz, MD, PhDDepartment of Hematology-OncologySt. Jude Children’s Research HospitalMail Stop 260332 N. Lauderdale St.Memphis, TN 38105-2794t 901.495.2388 f 901.521.9005jeffrey.rubnitz@stjude.org

Photography credits: Seth Dixon, Lajar Hajar, and Ann-Margaret Hedges

Carlos Rodriguez-Galindo, MDMedical Director, Mexico

Scott Howard, MDDirector of Protocol Development and Clinical Trials

07/05—Biomedical Communications