I am interested in the use of high-dose chemoradiotherapy with bone marrow and/or stem cell transplantation in high-risk pediatric solid tumors. My nationwide transplant study using high-dose therapy with bone marrow transplant for relapsed pediatric solid tumors has been completed recently and the promising results are going to be published in the journal of Clinical Oncology. I have also been the Chairperson of a nationwide Childrens Cancer Group (CCG) protocol on neuroblastoma which utilizes a chimeric human/mouse anti-GO2 antibody (ch14.18) immediately post autologous bone marrow transplantation with granulocyte-macrophage colon, stimulating factor (GMCSF), an attempt to improve the outcome of children with advanced neuroblastoma.

The first part of this study is about to close, and the second part will test the addition of interleukin-2 (IL-2) to the above regimen. The preliminary results are encouraging, and the National Cancer Institute is planning to launch an intergroup protocol with CCG and Pediatric Oncology Group, which would include all patients with advanced neuroblastoma diagnosed in North America, to further test the efficacy of this approach.

I am also conducting a study on the use of sequential (tandem) high-dose chemotherapy with peripheral blood stem cell rescue in poor-risk pediatric solid tumors. I have also been part of the team at CCG who just concluded an allogeneic bone marrow transplantation protocol for the treatment of ultra-high risk acute Lymphoblastic leukemia patients in first remission. The encouraging results are being presented at national meetings and will be published soon. I have been interested in the Immortality enzyme called telomerase.

Every time a cell divides it sheds tiny pieces of DNA known as telomeres, which serves as protective caps on the ends of chromosomes. After approximately a hundred divisions, a cell's telomeres become so truncated that its chromosomes begin to fray, like shoelaces that have lost their plastic tips. Eventually such aged cells die, unless, like 'immortal' cancer cells, they produce telomerase. I have studied the telomere length and telormerase activity in collaboration with MSKCC in children with acute leukemias and solid tumors undergoing chemotherapy.

Every childhood cancer studied had increased levels of telomerase activity which returned to normal with treatment. The results will be published in Leukemia soon. The study continues, and I am interested to see if the use of chemotherapy in children may induce premature aging of the blood cells.

Currently, another interest of mine is to study the use of granulocyte colony stimulating factor (GCSF) - which helps the white cell count recover faster in children with cancer with fever and neutropenia. This will be another nationwide CCG protocol.

A child's smile.
A child's laugh.
A child's life.

They are priceless.

Presenting them in the face of cancer and life-threatening disorders is what I am dedicated to doing, and I try to do it with compassion, dedication and with a high degree of success. It is a responsibility and a challenge. A lot of progress has been made. A lot of work remains to be done.

Today, approximately 8000 children develop cancer every year, and the disease is the number one life threatening disease of children under the age of 14. Overall, the cure rate is close to 80%. While the cure rate for some childhood cancer has improved dramatically others continue to challenge the best efforts of researchers. I do my best to try to improve the outcome for the 20% who are not as lucky as the majority.

I am an eternal optimist

And there is every reason to be. Childhood cancer was almost 100% fatal only 25-30 years ago. If the current trend continues, the cure rate will be approximately 85% at the turn of this century. This remarkable success has occurred despite the fact that we have very little clue regarding the causes and mechanisms of cancer progression in children. Imagine what will happen when the whole human genome is mapped. Imagine what will happen when the gene therapy techniques are perfected. I am sure that the cancer treatments of the 21st century will have very little resemblance to our current protocols. However, I shall be proud and happy to have lived through this transition and have tried to be a miniscule part of It.