We maintain a large clinical data base on our patients with brain and spinal cord tumors which facilitates the study of the natural history of uncommon childhood tumors.
We also conduct institutional and cooperative group clinical trials to identify more effective and safer ways of controlling both malignant and slower growing primary brain and spinal cord tumors. We are also interested in identifying and remedying some of the late effects of therapy such as cognitive impairments and neuro-endocrine deficiencies.
We have initiated collaborations with basic scientists both at NYU and elsewhere to explore more precise molecular methods of categorizing childhood brain tumors, identifying new and recognized tumor oncogenes and what molecular events may predispose a tumor to infiltrate normal brain and metastasize.
Lastly, we maintain a large Tumor Bank which collects stores and distributes aliquots of tumor tissue to our research collaborators.
My major research interest has been focused on the development of novel treatments for relapsed childhood leukemia given the poor outcome of children treated with conventional approaches including stem cell transplant.
My particular area of interest is identifying and defining the epigenetic landscape of relapsed leukemia by performing chromatin immunoprecipitation sequencing in matched diagnosis-relapse paired clinical samples.
Our laboratory is focused on two major challenges facing children with acute lymphoblastic leukemia (ALL).
First, in spite of dramatic improvements in outcome one in four children will suffer a relapse and their prognosis is poor.
Second, the "cost" of therapy for those who are cured is high with short and long term side effects. Therefore our laboratory seeks to understand mechanisms of drug resistance and to identify pathways unique to the cancer cell that can serve as targets for more effective, less toxic therapeutic approaches.
In addition we are using genomic and proteomic approaches to predict prognosis better so that therapy can be tailored to the individual patient thereby maximizing chances for cure while minimizing side effects.
We have identified gene expression profiles that predict response to therapy and are validating these signatures in an independent cohort of children currently undergoing therapy for ALL.
In addition similar efforts using expression profiling to characterize blasts at relapse has led to the provisional identification of a number of drug resistance mechanisms in ALL.
We are now using siRNA approaches to validate the functional significance of these pathways and our long term goal is to use relevant pathways as targets for therapy.
Finally we have had a long term interest in defining cell death pathways that operate in vivo and have discovered that leukemic blasts use a variety of pathways to execute apoptosis.
We hypothesize that the route of cell death correlates with response to therapy and such pathways can be modulated to favor cancer cell death thereby maximizing the therapeutic potential of conventional agents.
Our laboratory encompasses the full spectrum of investigation involving basic "bench" research, highly translational efforts using samples from patients and clinical trials in children with ALL.
My specific interests include the treatment of children with malignant brain tumors and the use of high dose chemotherapy with autologous stem cell rescue in children with a variety of malignancies.
As the Director of the Pediatric Stem Cell Transplant Program I oversee all of the hematopoietic stem cell transplants performed in pediatric patients at NYU. My primary research interests include therapy for patients with malignant brain tumors.
I have focused on the use of high dose chemotherapy in order to reduce and in some cases eliminate the use of radiation therapy particularly in very young children newly diagnosed with brain tumors and older patients with recurrent brain tumors for whom irradiation is not a curative option.
I have written many of these studies which were initially piloted as limited institution studies and subsequently became national cooperative group trials.
In addition to clinical trials in patients with brain tumors, I am also involved in high dose chemotherapy trials in patients with recurrent Hodgkin's Disease and Ewings' sarcoma.
I am currently a member of the supportive care committee of the Pediatric Blood and Marrow Transplant Consortium. Through this committee, I am actively involved in decreasing the toxicity associated with high dose chemotherapy through early detection of potential complications as well as through the development of therapies to decrease the side effects often associated with this treatment.
I am currently leading a study in the consortium involving the use of enteral feeds during high dose chemotherapy in order to decrease the toxicity associated with parenteral nutrition.
As a member of the Children's Oncology Group Transplant Steering Committee I am involved with developing policies and procedures for performing hematopoietic transplants in children across the country as well as developing new clinical trials.
My basic science research, conducted in collaboration with Simon Karpatkin, M.D., has centered on the study of platelet immunohematology, specifically investigating the mechanism of HIV-1-related immunologic thrombocytopenia, the mechanism of complement-independent antibody-induced platelet fragmentation through NADPH oxidation of reactive oxygen species and the role of molecular mimicry to HIV-1 peptides in HIV-1 infection.
Additionally, in my capacity as Supervisor of the Special Hematology laboratory at Bellevue Hospital Center I also conduct clinical laboratory research.
My particular areas of interest are improving and simplifying the identification of hemoglobinopathies and thalassemias by HPLC technology and the development of more accurate algorithms and methodologies for the detection of lupus anticoagulants.
My major research interests include translational laboratory studies centering upon apoptotic protein expression and gene expression profiling studies in childhood acute lymphoblastic leukemia and non-Hodgkin's lymphoma.
My clinical research interests focus on treatment strategies for recurrent leukemia and lymphoma with the incorporation of new agents.
As a member of the Children's Oncology Group (COG), I serve as institutional Principal Investigator for all COG studies at NYU School of Medicine.
I am also a member of the Non-Hodgkin lymphoma disease committee in the COG, and I currently chair three COG clinical trials for childhood acute lymphoblastic leukemia.