Division of Pediatric Hematology and Oncology

Saint Louis University's Division of Hematology and Oncology provides a full range of clinical services to children and adolescents with blood disorders and cancer.

The division is committed to advancing the care of children through collaboration with basic science research as well as numerous clinical research programs. We are an active participant in the Children's Oncology Group, the Pediatric Blood and Marrow Transplant Consortium, and the Center for International Blood and Marrow Transplant Research, and are one of the founding institutions of the Neuroblastoma and Medulloblastoma Translational Research Consortium, which is actively investigating innovative approaches to the treatment of childhood cancer. We also  participate in several national and pharmaceutical company-sponsored studies in hemostasis and sickle cell disease.

Our referral area extends throughout Missouri and southern Illinois. Inpatient services include a four-patient hematopoietic stem cell transplantation unit. Outpatient services are provided within SSM Health Cardinal Glennon's Costas Center and include consultations for new patients, ongoing clinical care for patients with blood disorders or cancer, chemotherapy infusions and blood component transfusions.

Clinical Programs

There are currently seven clinical programs within the division. Our clinical programs include regular multidisciplinary clinics in neuro-oncology, hemostasis, sarcomas, and long-term follow-up; the latter also includes specific neuro-oncology, long-term follow-up and hematopoietic stem cell long-term follow-up clinics.

Hematopoietic Stem Cell Transplantation

Deepika Bhatla, M.D., serves as our lead transplant physician. The program is accredited by the Foundation for Accreditation of Cellular Therapy. It is a designated transplant center for the Children's Oncology Group and a participant in the Pediatric Blood and Marrow Transplant Consortium.

Neuro-Oncology Program

This multidisciplinary group encompasses all of the disciplines engaged in caring for these complex patients, including pediatric oncology, pediatric neurology, neurosurgery, and radiation oncology. It also includes a Neuro-Oncology Long-Term Follow-up Clinic, led by Thomas Geller, M.D. Pounima Navalkele, M.D., is director of the Neuro-Oncology Program.

Hemostasis Program

Ours was the first federally-designated pediatric Comprehensive Hemophilia Treatment Center in the St. Louis area. Christopher Hugge, M.D., is administrative director of this program; John Puetz, M.D., serves as the clinical director. 

Sickle Cell Anemia/Hemoglobinopathies Program

Dr. Dolatshahi is director of this program. SSM Health Cardinal Glennon Children’s Hospital is a designated sickle cell center for the State of Illinois.

Sarcoma Program

David Greenberg, M.D., (orthopedic oncology), William Ferguson, M.D., (pediatric oncology), and John Dombrowski, M.D., (radiation oncology) are the principal participants in this program, which provides state-of-the-art treatment for children with bone and soft tissue sarcomas.

Apheresis Program

Alex Babic, M.D., serves as the medical director of this program.

Long-term Follow-Up

John Puetz, M.D., is the physician director of this program.

Pediatric Hematology and Oncology Training

Members of the division take an active role in the education of residents and medical students, both by providing didactic lectures as well as serving as attending physician supervision for subspecialty and general pediatric patients and supervising residents and students doing electives in hematology-oncology. The Division's Pediatric Hematology and Oncology Fellowship, under the leadership of Dr. Hugge, has been approved and a fellow selected to begin in July 2017.

The division collaborates closely with the Saint Louis Cord Blood Bank, which has been a FDA-licensed manufacturer of umbilical cord blood units for transplantation since 2013 and remains one of only seven such programs. The bank continues to expand its basic science research program in the area of stem cell biology. The number of cord blood units donated for transplant has stabilized at approximately 40 percent of area births, and the bank continues to be one of the largest such programs in the country.

Research

Salem Akel, Ph.D.  

Salem Akel, Ph.D, directs basic science stem cell research activities at the SLCBB to advance our understanding of UCB biology by focusing on the development of methods to improve product engraftment and immune reconstitution. In addition, rapid expansion of the field of regenerative medicine is prompting the SLCBB to also develop its portfolio of allogeneic products for cellular therapy to include cell populations potentially suitable for tissue repair and immunomodulation. To this end we are focusing on characterization of Umbilical Cord tissue (UCT) and UCB as perinatal sources of mesenchymal stem cells (MSC).

Currently, Akel is involved in three studies of mesenchymal stromal stem cells isolated from the umbilical cord Wharton's jelly: 1. Method Validation for Isolation, Characterization and Freezing/thawing of Umbilical Cord Mesenchymal Stromal Cells (Principle investigator); 2. Decellularization of umbilical cord Wharton's Jelly for tissue regenerative applications and cancer-related research (Co-investigator with the University of Kansas Medical Center); and 3. Generation of NK cell from the UC blood (Co-investigator)

An additional focus of the basic research program is to develop and apply scientific sound plans to support HPC manufacturing and quality assurance studies.

The St. Louis Cord Blood Bank participates in NMDP/CIBMTR Protocol 10-CBA "A multicenter access and distribution protocol for unlicensed cryopreserved cord blood units (CBUs) for transplantation in pediatric and adult patients with hematologic malignancies and other indications." 

Aleksandar Babic, M.D.

The research interests of Aleksandar Babic, M.D., are focused on the evaluation of outcomes of umbilical cord blood (UCB) transplantation, with a particular focus on UCB units manufactured at St. Louis Cord Blood Bank. Beginning in March of 2013, Dr. Babic assumed the roles of Medical Director at St. Louis Cord Blood Bank and SSM Cardinal Glennon Children's Medical Center Cellular Therapy Laboratory. This position allows a unique perspective on the process of UCB collection, processing and export for transplantation. As the field of UCB transplantation moves from studying the suitability of UCB as a source of cells for transplantation to the area of improvement of outcomes of UCB transplantation, the outcome measures are becoming an invaluable tool in the assessment of UCB collection and processing methods. The goal of this research approach is to assess the impact of several UCB collection methods on safety and efficacy of the UCB transplantation with units manufactured at St. Louis Cord Blood Bank

Deepika Bhatla, M.D.

The research interests of Deepika Bhatla, M.D., include the treatment of acute leukemias and lymphomas (with particular reference to the influence of host polymorphisms on disease incidence and response to treatment) and stem cell transplantation with a special interest in umbilical cord blood transplantation. She serves as institutional co-principal investigator for the Primary Immune Deficiencies Treatment Consortium (PIDTC), including Protocol #6901 ("A Prospective Natural History Study of Diagnosis, Treatment and Outcomes of Children with SCID Disorders") and as institutional Principal Investigator for a Phase III trial for use of Defibrotide in Hepatic Veno-occlusive disease (VOD) and for the National Marrow Donor Program protocol 10-CBA ("A multicenter access and distribution protocol for unlicensed and cryopreserved cord blood units (CBUs) for transplantation in pediatric and adult patients with hematological malignancies and other indications"). She is also the institutional PI for the multicenter trial entitled "A Study of Hematopoietic Stem Cell Transplantation (HSCT) in Pediatric Non-Malignant Disease Using a Reduced-Intensity Preparatory Regimen."

Leili Dolatshahi, M.D.

 

Leili Dolatshahi, M.D.,'s major clinical research interests include participation in a clinical trial designed to improve the outcome of sickle cell disease. She is co-investigator for an ongoing clinical trial, "Adjuvant low dose rituximab for the patients with severe TTP."
William S. Ferguson, M.D.

William S. Ferguson, M.D.,'s research interests include participation in front-line Children's Oncology Group studies treating newly diagnosed osteosarcoma, Ewing sarcoma, and other soft tissue sarcomas; clinical trials evaluating new antineoplastic agents in the treatment of solid tumors, in particular neuroblastoma; personalized medicine utilizing new technologies for evaluating genetic profiles of tumors; and new drug therapies to prevent and treat complications of sickle cell disease. He is the institutional Principal Investigator for the Children's Oncology Group and the Neuroblastoma and Medulloblastoma Translational Research Consortium.

 

Christopher Hugge, M.D.

Major clinical research interests include continued participation in clinical trials designed to improve drug treatment of children with bleeding disorders and participation in clinical trials conducted through the Children's Oncology Group.

John Puetz, M.D.

Clinical research interests focus on treating and controlling complications of bleeding and thrombotic disorders in children, including participation in studies funded by the MCHB and CDC. Of particular interest is the development of novel agents to treat hemophilia, thrombosis, and the use of fresh frozen plasma in pediatric patients.

Shermini Saini, M.D.

Clinical research interests include stem cell transplantation and improving the utilization of palliative and end-of-life care in children with chronic, complex, and life-limiting illnesses. She is Medical Director for CGCH's palliative care program, Footprints.

Publications, Abstracts and Presentations

Publications
  •  Haynes, SE, Saini, S, Schowengerdt, KO. Post-transplant lymphoproliferative disease and other malignancies after pediatric cardiac transplantation: an evolving landscape. Curr Opin Organ Transplant, 20((5)), 562-9. (October (4th Quarter/Autumn) 2015).
  • Mitchell D, Bergendahl G, Ferguson W, Roberts W, Higgins T, Ashikaga T, DeSarno M, Kaplan J, Kraveka J, Eslin D, Werff AV, Hanna GK, Sholler GL. A Phase 1 Trial of TPI 287 as a Single Agent and in Combination With Temozolomide in Patients With Refractory or Recurrent Neuroblastoma or Medulloblastoma. Pediatr Blood Cancer. 2015; 63(1):39-46
  • Ferguson WS. Kids clot, too-just not like adult. J Pediatr. 2016 May;172:1-4.
  • Emnett RJ, Kaul, A, Babic A, Geiler V, Regan D, Gross G., Akel S. Evaluation of Tissue Homogenization to Support the Generation of GMP-compliant Mesenchymal stromal Cells from the Umbilical Cord. Stem Cells Int, 2016; 2016:1-9.
  • Pommert L, Friedman H, Saini S, Wathen D. Case 3: Acute Jaundice in a 16 year old boy. Pediatrics in Review 37 (12): 542-545. Dec 2016. PMID: 27909110.
Abstracts

 

  • Sholler G, Ferguson W, Bergandahl G, Bond J, Neville K, Eslin D, Roberts W, Wada R, Oesterheld J, Mitchell D, Foley J, Brown V, Parikh N, Ashun F, Zage P, Rawwas J, Sencer S, Pankiewicz D, Quinn M, Rich M, Junewick J, Wicha M, Kraveka J. DFMO maintains remission and increases overall survival in high risk neuroblastoma: results of a phase II prevention trial (#88). Advances in Neuroblastoma Research Congress 2016.
  • Platform presentation "Outcomes for Umbilical Cord Blood Transplantation in Severe Combined Immunodeficiency Disorders: Ten-Year Experience "C. Caruthers, J. Rodrigues, A. Shams, D. Bhatla, A. P. Knutsen. Presented at 2016 annual AAAAI meeting in Los Angeles, CA.
  • Platform presentation "Outcomes for Umbilical Cord Blood Transplantation in Severe Combined Immunodeficiency Disorders: Ten-Year Experience "C. Caruthers, J. Rodrigues, A. Shams, D. Bhatla, A. P. Knutsen. Presented at Pediatric Science Days at Saint Louis University, Saint Louis, MO.
Presentations

Deepika Bhatla, M.D.

  • "Outcomes for Umbilical Cord Blood Transplantation in Severe Combined Immunodeficiency Disorders: Ten-Year Experience "C. Caruthers, J. Rodrigues, A. Shams, D. Bhatla, A. P. Knutsen. Presented at 2016 annual AAAAI meeting in Los Angeles, CA.
  • "Outcomes for Umbilical Cord Blood Transplantation in Severe Combined Immunodeficiency Disorders: Ten-Year Experience "C. Caruthers, J. Rodrigues, A. Shams, D. Bhatla, A. P. Knutsen. Presented at Pediatric Science Days at Saint Louis University, Saint Louis, MO.
  • "All About Methotrexate", Cardinal Glennon Children's Hospital Nursing Education.

Leili Dolatshahi, M.D.

  • Family Medicine Grand Rounds at Saint Mary's Hospital
    Pediatric Resident Noon Conferences (Hemoglobinopathies, Anemia 1, Approach to Eosinophilia)

William Ferguson, M.D.

  • "Hemoglobin and Hemoglobinopathies", Saint Louis University School of Medicine 1st year Genetics course, August 2015.
  • "Consent, Research Ethics, and Clinical Trials" Combined BMT Program Advanced Practice Nurse curriculum, March 2016.

John Puetz, M.D.

  • "Update on Hemophilia", Department of Pediatrics Research Colloquium

Shermini Saini, M.D.

  • "Oncology Emergencies" - pediatric intern orientation series (7/22/15)
    SLU SOM Death and Dying Course, August 2015:
      • Course introduction and small group session (8/11/15)
      • Panel Discussion "Dying Children and Their Families" (8/20/15)
  • HPM fellow lecture: "Pediatric Palliative Care" part 1 (8/12/15) and part 2 (12/16/15)
  • "Sickle Cell Disease - Acute Complications and Inpatient Management" - pediatric intern orientation series (8/13/15)
  • Southern Illinois Perinatal Program regional conference, breakout session on "Difficult Conversations: Improving Communication and Strengthening Relationships with Families" (9/16/15)
  • "Overview of Pediatric Palliative Care and Footprints" (10/13/15)
  • "Improving Communication and Strengthening Relationships with Families", Pediatrics Grand Rounds: (11/4/15)