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eases,” he says. “We recruit absolutely the
best talent for patient care, clinical research
and basic scientific discovery, providing them
with outstanding resources that permit them
to do their best work.”
Research at St. Jude—the only pediatric
research hospital supported by a National
Cancer Institute cancer center support grant—
is unique. Rather than hiding discoveries from
competitors, St. Jude scientists are eager to
share them. “We know we can’t treat all the
sick children in the world,” Evans says. “But
we can train those who do, all over the world.”
The success of St. Jude occurred because
scientists there made the simple discovery
that cancer treatment for children is different
than for adults. “We often try to cure childhood
cancers with drugs developed for quite
different cancers in adults,” Evans says. “This
is one reason we are working to establish new
programs in chemical biology, human genetics
and cancer prevention. We must ensure
that our findings get translated into treatment
advances for children.”
Why is this St. Jude’s responsibility? It’s all
about the bottom line. Large pharmaceutical
companies have little interest in pediatric cancer
research, because there’s no real money in
it: After all, most cancers occur in adults.
In contrast to drug companies, which are
accountable to stockholders, St. Jude is
accountable only to its mission: For St. Jude
scientists and doctors, “finding cures, saving
children” is the bottom line.
Hope displayed in rainbow hues
The corridors of St. Jude are bright with
color. Murals of animals and people painted
from a child’s perspective. Storybook illustrations.
Each waiting area is outfitted like a
playroom, complete with toys, computer
games and books. Hanging in the airy atrium
are scores of flags—together representing the
countries of staff who left their homelands to
work here. At first, a guest might think he
had stumbled into Disneyland. Not so.
Enthrallment with the cheerful décor disintegrates
when the guide, nodding toward her
right, says, “And that’s our chemo lab.” All
that can be seen through a small glass panel
in the door is a stroller. A blue stroller with a
plaid sun cover.
The earth tilts on its axis. A baby stroller?
Here? This is definitely not Disneyland. This
is where desperate parents bring their desperately
sick children.
At its soul, St. Jude is not a complex of
buildings, a labyrinth of treatment rooms and
labs. It is people. Doctors, nurses, scientists,
technicians. Mainly, it is children—some still
in strollers.
Trailing clouds of glory…
As director of St. Jude, Evans not only
continues his own research in the Human
Genome Project, he also spends increasingly
more time securing support for the work of
the other scientists, including his wife, Dr.
Mary Relling, with whom he launched St.
Jude’s first pharmacogenomics research plan
20 years ago.
Today, Evans and Relling lead some of the
most promising pharmacogenomic studies in
children with acute lymphoblastic leukemia.
In the article, “Drugs by Design” in the
Autumn 2004 edition of “Promise,” the magazine
of St. Jude, Evans talks about pharmacogenomics,
by which a patient’s gene code
tells the doctor exactly which drug is likely to
work best. This requires studies of cancer
treatments in hundreds of children over
decades, but St. Jude is ahead of the game.
Over the years, it has collected more extensive
follow-up reports on children with cancer
than any hospital in the world.
One of those children is Cassidie Jackson,
who is profiled in “Promise.” Eight months
after her birth, her parents noticed the lymph
nodes in her neck felt like knots. St. Jude
doctors diagnosed acute lymphoblastic
leukemia, which depletes infection-fighting
white blood cells. Cassidie did well during
the first two rounds of chemo but, after the
third round, her white blood cell count fell
drastically and her stomach, liver and spleen
started to swell.
A genetic test revealed she had an inherited
defect for a specific enzyme. This defect
blocked metabolism of the anti-cancer drug,
causing her body to retain high levels of the
toxic drug. Thankfully, St. Jude studies also
proved that patients deficient in this enzyme
could benefit from a lower dose of the drug.
Cassidie started taking a fourth of the dosage
each time and, according to her mother, has
been fine ever since.
The enzyme mutations that plagued
Cassidie were discovered at St. Jude, as was
the genetic test now used routinely by hospitals
to screen children before administering
the drug. Cassidie is one of thousands of children
whose tales are chapters in the amazing
St. Jude Story.
And thanks to such dedicated scientists as
William Evans, more and more patients will
live to tell their own stories. Despite the best
research and treatment in the world, however,
some do not make it, but their deaths are not
the end. Their cancers, treatments and outcomes,
their stories—all become part of
research that, no doubt, will improve the odds
for other sick children.
The long hospital hallways are lined with
scores of photos of the children of St. Jude —
both the survivors and the little angels passing
through. Some say to stand before these
photos, to look into those eyes, is to catch a
fleeting glimpse of God.
Austin Peay/Fall 2005
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