Dr. Donald Pinkel

Donald Pinkel

Dr. Donald Pinkel served as the first director and CEO of St. Jude Children’s Research Hospital from 1962 to 1973 focusing on ALL, the most frequent cancer in young children, he and his colleagues identified four major obstacles to its cure: drug resistance, drug toxicity, meningeal relapse and most important, pessimism.

Dr. Donald Pinkel has received numerous recognitions for his contributions to the cure of childhood leukemia and other forms of pediatric cancer. These include international awards: the Lasker Award for Medical Research, the Kettering Prize for Cancer Research and the Pollin Prize for Pediatric Research. The American Cancer Society gave him their Annual Award for Clinical Research and the Leukemia-Lymphoma Society of America the Return of the Child award. In Germany he received the Zimmerman Prize for Cancer Research and in the United Kingdom the Leukemia Society Annual Lectureship and the Royal College of Pediatrics and Child Health biennial Windermere Lectureship.

Dr Pinkel and his colleagues at St Jude, the patron of the hopeless, instituted a treatment program aimed at permanent cure of ALL. Called “Total Therapy”, it was based on all the available relevant laboratory and clinical research and experience. There were four phases: remission induction, remission consolidation or intensification, specific pre-emptive meningeal treatment and continuation chemotherapy for 3 years. Both radiotherapy and instillation of drug directly into spinal fluid were used for meningeal treatment. Eventually a 50% cure rate was achieved in the 1967-68 study V; this cure rate continues for the children in this study 40 years later. This was the first significant cure rate for generalized cancer and for primarily drug treatment of cancer.

This four-phase treatment plan is still used in 2008 with numerous modifications. Increases in resources and trained physicians and nurses, better infection control, safer blood transfusion and newer drugs and drug schedules have increased the reported cure rates to 75-85 % of treated children with ALL in developed countries. Better use of drugs both systemically and by instillation into the spinal fluid have replaced the need for radiation therapy to pre-empt meningeal relapse in most children with ALL.