Hematology and Oncology | Clinical Activities
Clinical Phone Numbers
(314) 454-6018 (Voice)
(314) 454-2780 (Fax)
The division offers a full range of clinical services for pediatric patients
and draws from a population of more than 2 million in the greater St. Louis
area, with additional referrals from surrounding Missouri, Illinois and
throughout the Midwest. We care for more than 110 new oncology patients each
year and evaluate more than 200 new hematology patients per year resulting in
more than 600 children who are actively followed by the division. The
outpatient Hematology/Oncology unit meets regularly five days per week, and
generally 25 to 30 patients are seen per day (more than 6,000 outpatient visits
per year). Each clinic day is supervised by a senior attending
hematology/oncology physician. In addition, two clinical fellows, and three to
four pediatric advanced practice nurses participate in each outpatient clinic
session. History, physical examination and diagnostic procedures (including
bone marrow aspirate, biopsy and lumbar puncture) are performed. Therapy for
diseases in both hematology and oncology, complications thereof, and other
general medical problems, as well as social and psychological problems, are
addressed by the team of care providers (attending physicians, fellows, nurses,
social workers, psychologist, dieticians and others) providing comprehensive
pediatric care for the patients and their families. Our unit focuses on primary
care nursing, such that each child is identified with a primary outpatient and
inpatient nurse. Our nursing staff includes individuals with advanced training
and extensive experience in the management of cancer and hematology patients.
In addition, support services include an educational-liaison specialist and a
child life specialist.
We are a major member of the Children's Oncology Group and actively participate
in new clinical therapy evaluations, including the use of new drugs in the
fight against cancer. We also follow more than 400 patients with sickle cell
disease and are actively participating in national trials striving to improve
the treatment of this condition. Weekly clinical conferences include Tumor
Board, a hematology/oncology case discussion integrated with the adult
hematology/oncology service, as well as the Pediatric Research Seminar and
Pediatric Grand Rounds.
The inpatient service consists of a daily average of 15 patients hospitalized
for diagnostic evaluation, therapy, complications of therapy or pathological
processes. The inpatient service consists of a full-time attending physician in
hematology/oncology, one clinical fellow, four clinical nurse specialists, one
clinical psychologist, two social workers, two child life specialists and a
hospital chaplain.
All of the activities of the division are supported by expert
pediatric-dedicated clinical laboratories, hematology laboratories and a blood
bank located on site providing prompt diagnostic information for the patients,
thus optimizing their care.
The unit prides itself on the interactive environment and team approach to the
care of its patients. The nurse specialists, psychologists, social workers and
educational specialist function as integral members of the management team for
both acutely ill patients and patients undergoing long-term care. The
terminally ill child is one who deserves special and concentrated attention
provided by all members of the care team, as the unit also provides medical
support for the only pediatric hospice service in the region.
Our service aids in the diagnosis and management of
anemia. We offer consultation on the management of patients with congenital
anemias, including sickle cell disease, hereditary spherocytosis and
Diamond-Blackfan anemia. We are a leading NIH-funded center for clinical trials
on the natural history and management of pediatric sickle cell disease,
including novel therapies such as Hydroxyurea. Chronic transfusion therapy and
erythrocytopheresis are provided to select patients.
We evaluate and assist in the management of
congenital and acquired causes of neutropenia, including benign neutropenia of
childhood, congenital agranulocytosis and drug-induced neutropenia.
We evaluate and manage patients with ITP and other
causes of thrombocytopenia.
Our staff will diagnose and aid in the care of
patients with bleeding disorders, such as hemophilia and Von Willebrand's
disease. We also perform specialized evaluations of individuals predisposed to
thrombosis.
We will diagnose and manage patients with acute and
chronic leukemia, Hodgkin's disease and non-Hodgkin's lymphoma. We are active
participants in Pediatric Oncology Group (POG) protocols for treatment of these
malignancies.
We assist in the management of patients with brain
tumors, Wilms tumor, rhabdomyosarcoma, neuroblastoma, osteosarcoma and other
solid tumors. Members of the division work closely with neurosurgeons,
pediatric surgeons and pediatric radiation therapists at the School of Medicine
to provide optimal multimodality care for these patients. Our center also
participates in trials of new phase I chemotherapeutic agents in patients with
refractory malignancies.
The five-bed Pediatric Bone Marrow Transplant unit is conveniently
located adjacent to the The Hale Irwin Center for Pediatric
Hematology/Oncology. It is responsible for approximately 35 to 40 pediatric
transplant procedures each year. The program admitted its first patient in
September 1991, as the first children’s hospital to perform this procedure in
the state. It offers state-of-the-art care for the children of this region and
provides an environment conducive to clinical investigation with programs
developing innovative therapies for malignant and genetic diseases. Our
multidisciplinary team is designed to provide comprehensive, pediatric-specific
care to our patients and families to address not only medical, but also
emotional, social and spiritual needs. Our team of highly skilled nurses, nurse
practitioners, psychologists, social workers, child life, chaplain and school
liaison cover every aspect of the transplant experience. In addition, a group
of specially trained volunteers provides respite for parents and social
interaction for the children.
Patients eligible for transplantation include those
with relapsed ALL, AML, relapsed or refractory lymphoma, aplastic anemia,
myelodysplastic syndromes, SCIDS, solid tumors, sickle cell disease and
lysosomal storage diseases.
For more detailed information regarding the BMT program, please see the
relevant section
of the Saint Louis Children's Hospital web site or take a
virtual tour.
The International Simpson Golabi Behmel Registry, under the direction
of Drs. Michael R. DeBaun
and Scott Saunders, is aimed at understanding
more about children with Simpson-Golabi-Behmel Syndrome (SGBS) and their relatives.
Despite the mutations in glypican -3 gene being identified for SGBS, little
is known about it's role in congenital malformations and cancer.
In part this is because SGBS
is rare and the gene mutation has only recently been identified. This SGBS
registry is designed to collect information from patients with SGBS and
their relative so that we can begin to understand more about this syndrome.
Enrollment of participants in the Registry requires: a clinical diagnosis of
SGBS, male sex, and 2 of the 5 most common clinical features associated with
SGBS :
- birth weight and length greater than the 95th percentile;
- macroglossia (large tongue);
- skeletal abnormalities including polydactyly, syndactyly, vertebral abnormalities;
- extra nipples on chest;
- genito-urinary abnormality including cystic kidney's, hypospadias
(hole in the penis requiring surgery to fix), large kidneys (kidney
greater than the 95th percentile for age).
Participants need not to be patients of Washington University, St. Louis
Children's Hospital or pediatric patients. Participants may refer themselves
to the SGBS Registry. A questionnaire will be completed by the family to
obtain a detailed history of the patient with SGBS, clinical features associated
with SGBS, and family history of cancer. All information is confidential.
To request further information, please contact us via e-mail at
or telephone at
(314) 286-1169.
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SCHOOL OF MEDICINE
