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St. Jude Children's Research Hospital is known worldwide for its expertise in the diagnosis and treatment of pediatric cancers. The institution is dedicated to saving children’s lives by finding the causes of catastrophic diseases, improving treatment, and developing cures. St. Jude is internationally known for its treatment of all pediatric cancers, but is particularly esteemed for its treatment of brain tumors, leukemia, neuroblastoma, and retinoblastoma. St. Jude oncologists are also experts in gene therapy and pediatric stem cell transplantation.

• Research efforts at St. Jude focus on understanding the molecular and genetic bases of catastrophic diseases in children, identifying cures for such diseases, and promoting their prevention. St. Jude researchers actively participate in the Children’s Oncology Group and serve as protocol coordinators and chairs for various discipline or disease committees. The current basic and clinical research at St. Jude includes work in gene therapy, chemotherapy, the molecular control of normal and cancerous cells, radiation treatment, blood diseases, resistance to therapy, viruses, hereditary diseases, influenza, pediatric AIDS, and the psychological effects of catastrophic illnesses. St. Jude also conducts long-term biostatistical investigations on its patients and is the only pediatric research hospital supported by a National Cancer Institute Cancer Center Support Grant.
• St. Jude’s Hartwell Center for Bioinformatics and Biotechnology is one of the leading facilities of its kind in the world. The center features extensive capabilities in high-throughput DNA sequencing and genotyping, macromolecular synthesis, cDNA and Affymetrix microarray analysis, proteomics and mass spectrometry, molecular interaction analysis, and a complete bioinformatics infrastructure to support the entire system. The center’s mission is to be the best in applying modern bioinformatics and biotechnology to the study and treatment of pediatric catastrophic diseases.
• St. Jude is the world’s only pediatric cancer research center to have an on-site Good Manufacturing Practices (GMP) facility. The 64,000-square-foot GMP has a core unit dedicated to producing highly specialized medicines and vaccines under government-approved Good Manufacturing Practices guidelines. The GMP is equipped to make vaccines, drugs, proteins, gene-based molecules, and other biological products. The facility also has Biological Safety Level (BSL) 3 laboratories that will accommodate work with microorganisms that must be specially contained.
• Among the projects underway are an avian flu seed vaccine, parainfluenza vaccine, and monoclonal antibody to treat neuroblastoma
• As of January 1, 2006, St. Jude has leased some of the space in this facility to the Children's GMP, LLC. St. Jude will continue product development activities in the facility while transferring the responsibilities for the actual production of clinical products to this new company. The company will only produce clinical materials for St. Jude and collaborating centers.
• The late entertainer Danny Thomas founded both St. Jude and ALSAC®, the hospital's fund-raising organization. No child who is eligible for enrollment on an institutional research protocol is ever turned away from St. Jude because of an inability to pay. ALSAC assumes all patient treatment expenses not covered by third-party insurers and all expenses when insurance is not available.

About 4,700 patients visit St. Jude yearly, most of who are treated on a continuing outpatient basis as part of ongoing research programs. The hospital is licensed for 62 inpatient beds.

St. Jude Children's Research Hospital is the only institution designated as a childhood cancer center by the National Cancer Institute. St. Jude has treated children from across the United States and around the world.

University of Tennessee Cancer Institute, located in Memphis, Tennessee, is the adult cancer partner of St. Jude Children’s Research Hospital. UTCI is a unique partnership between the UT Health Science Center and Boston Baskin Cancer Group that includes collaboration with Methodist Healthcare and other major healthcare and research institutions in the Mid-South. This association combines the research and teaching capabilities of a leading institution with one of the Mid-South’s largest cancer physicians group. At the University of Tennessee Cancer Center Institute a multidisciplinary team approach is taken for common malignancies. 

St. Jude Children’s Research Hospital
Pediatric Oncology Services

Introduction

St. Jude Children’s Research Hospital is recognized as one of the world’s leading centers for the research and treatment of catastrophic diseases in children, primarily pediatric cancers. It is the largest childhood cancer research and treatment center in the world. Through its clinical studies, the hospital’s medical staff has developed fundamental insights into the treatment of leukemia and other childhood diseases.

The hospital has built an exceptional medical staff of physicians and scientists who have received extensive training in clinical care, basic biomedical sciences, and clinical research at St. Jude and from many other premiere institutions throughout the world. St. Jude physicians have expertise in the management of all childhood cancers.

General Information

Clinical and Research Information

Research Efforts

Current basic and clinical research at St. Jude Children’s Research Hospital includes work in gene therapy, chemotherapy, the biochemistry of normal and cancer cells, radiation treatment, blood diseases, resistance to therapy, viruses, hereditary diseases, influenza, pediatric AIDS, and psychological effects of catastrophic diseases.

The developmental neurobiology department has focused on the role of specific genes in the development and function of the nervous system. Scientists in this program are striving to unravel the brain’s complexity and to understand the molecular principles behind its organization and function.

The molecular diagnostics lab at St. Jude was set up to enhance the transfer of technology from the research laboratory to the clinic and vice versa. When researchers identify gene alterations that contribute to malignancies, the molecular diagnostics team designs tests to screen patients for those changes. This team discovered that a shift from one chromosome to another is the most common translocation in pediatric acute lymphoblastic leukemia (ALL). The translocation was once thought to be rare, but this discovery predicts an excellent outcome for all patients with this type of ALL.

Pharmacogenomics/Gene Array Studies

St. Jude is a leading center for pharmacogenomics research, a technology for studying how populations of specific genes control an individual’s response to drug therapy. Such studies are identifying genetic variations that contribute to the success or failure of therapy.  Gene expression profiles obtained with DNA arrays provide clinicians and researchers with a genetic snapshot of each patient’s potential response to drug therapy before treatment begins. These profiles identify patients likely to benefit from treatment or suffer a toxic reaction. This work has the potential to differentiate among patients with ALL who can be treated with moderate doses of chemotherapy from those who should be treated aggressively. Mary Relling, Pharm.D., chair of the Department of Pharmaceutical Sciences, is leading a major NIH-funded program to identify the major pharmacogenetic determinants of treatment response in children with ALL. She and her colleagues are world leaders in extending these studies to other catastrophic diseases in children.

 Molecular Targeted Therapy Studies

St. Jude research includes studies aimed at determining the expression and activity of molecular targets in patient tissues and the evaluation of drugs that target these molecules. Ongoing projects include testing treatment strategies using gene therapy or small molecule therapy for catastrophic diseases; producing candidate therapeutic agents that can be tested in preclinical studies of catastrophic pediatric diseases; identifying growth signals and cell cycle checkpoint functions essential for survival of malignant cells; and defining new targets for drug therapy to modulate cellular responses to drugs currently used as anticancer agents. The Molecular Clinical Trials Core facility at St. Jude assists faculty in the design, conduct, and interpretation of molecular assays of drug target expression and activity in clinical trials.

Special Expertise

Stem Cell Transplant

The Stem Cell Transplantation Program at St. Jude is one of the largest pediatric programs in the world, having performed more than 1,000 transplants, including about 150 transplants in the last year. The hospital treats newborns, infants, children, adolescents, and young adults who have malignant or nonmalignant life-threatening disorders that are treatable with hematopoietic stem cell/bone marrow transplants using autologous or allogeneic cells. The hospital has a designated 14-bed unit in its Patient Care Center for the care of patients undergoing hematopoietic stem cell transplantation. Because many patients do not have matched related or unrelated donors available when transplants are needed, investigators at St. Jude are studying ways to decrease the risks of graft-versus-host disease so that mismatched related donors can be used. New purging techniques, novel conditioning regimens, and post-transplant immunomodulation strategies are being investigated in patients undergoing autologous hematopoietic stem cell transplantation.

Brain Tumors

Developing innovative treatments for brain tumors with very poor prognoses, such as high-grade gliomas, has been the focus of St. Jude’s brain tumor program. To support the brain tumor program, the hospital established a department of developmental neurobiology. Studies underway will contribute to the knowledge of brain growth and response to injury. Also, clinical researchers are trying to delay or eliminate the amount of radiation therapy by using chemotherapy as the initial postoperative treatment for central nervous system tumors, thereby minimizing or avoiding the adverse neurophysiologic and neuroendocrine effects of radiation therapy.

Leukemia

St. Jude has more expertise and experience in treating patients with ALL than any other facility and has helped bring the overall survival rate for ALL to 90 percent. Current research aims to improve treatment outcome for all types of leukemia by optimizing dosage and scheduling of antileukemic agents based on an individual patient’s genetic and pharmacologic characteristics. Additionally, the hospital is extensively using molecular studies to identify patients at high-risk for relapse.

Late effects

After successful treatment, all St. Jude patients are examined one or more times yearly for 10 years in the After Completion of Therapy (ACT) Clinic. Survivors are screened for any residual disease effects or treatment sequelae, including physical, psychological, and social problems. The ACT Clinic emphasizes educating survivors about the importance of maintaining a healthy lifestyle and remaining alert for possible late effects and secondary cancers. Also, the growing population of childhood cancer survivors enables the clinic to gather unique epidemiologic and treatment follow-up data. These findings have enabled physicians to improve therapeutic protocols at St. Jude and to advance pediatric cancer care in the larger community.

Neuroblastoma

Scientists at St. Jude continue to investigate what factors cause neuroblastoma cells to form in the first place. Current studies include testing of tumor vaccines against neuroblastoma and the use of a new class of anticancer drugs (camptothecins) predicted to be highly effective in this disease.

Statistics

Percent of children treated in each age range

Pediatric Oncology Program Fiscal Year 2005

University of Tennessee Cancer Institute
Adult Oncology Services

Introduction

At the University of Tennessee Cancer Institute, basic science research and clinical trials, as well as the best-known care for patients, occur seamlessly and in one place. For patients, it is a one-stop clinic. For physicians, it’s an opportunity to work closely with specialists to give patients the utmost care and to find new treatments. University of Tennessee Cancer Institute has seven full-service clinics throughout the Mid-South in order to better serve this region’s adult cancer patients.

University of Tennessee Cancer Institute is a member of the Southwest Oncology Group (SWOG). This membership allows physicians at UTCI participate in and develop research studies for all types of cancers.

General Information

Clinical and Research Information

Special Expertise

Blood and Marrow Transplant Center

The UT Blood and Marrow Transplant Center offers patients state-of-the-art facilities for cell therapies in the treatment of cancer and blood or bone marrow disorders in adults.

Patient care and education is provided by a multi-disciplinary team that includes not only the specially trained physicians but also dedicated transplant coordinators, a financial counselor, nurse practitioners, social workers, dieticians, an apheresis nurse, and clinical pharmacists. Spiritual support and a translation service are also available.

Acute outpatient care is provided at the Blood and Marrow Transplant Clinic at Methodist University Hospital adjacent to the University of Tennessee Cancer Institute. The program currently emphasizes outpatient care whenever possible. For those who live out of town, guest rooms are available adjacent to the outpatient clinic.

Inpatient care is provided in the Oncology Special Care Unit, a specially-designed ward in the cancer center at Methodist University Hospital, with staff trained to care for the transplant patients.

Head and Neck Multidisciplinary Clinic

The Head and Neck Multidisciplinary Clinic allows for patients with these cancers to receive a comprehensive evaluation. A group of surgeons, medical oncologists, radiation oncologists, nurses, speech therapists, and other professionals who specialize in taking care of these patients are present in the clinic for the patients’ appointments. UT Cancer Institute utilizes this multidisciplinary team approach to determine and execute the best treatment options for head and neck cancer patients.

Statistics

Percent of adults treated in each age range:

Fiscal Year 2005

Last updated: 2/11/2008