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Exceptional heart care.
Extraordinary results.

Seeking A Cure

Pediatric oncologist seeks childhood
leukemia causes using zebrafish.

Charles F.
Schwartz, MD,

FACS Chair
Cardiothoracic
Surgery

Introducing the
Structural Heart
Program

Shari S. Cohen
Special to the Jewish News

effrey Taub, M.D., has an
office bulletin board covered
with photos of children —
his young cancer patients at Children'
Hospital of Michigan. Many of them
were treated for leukemia, a cancer of
the blood cells that is the most common
form of childhood cancer.
Taub explained that about 85 percent
of children with acute lymphoblastic
leukemia (ALL) are cured with cur-
rently available treatments at CHM.
However, acute myeloid leukemia
(AML), which is completely different
biologically from ALL, has "a more
guarded prognosis and may require a
stem cell transplant:' he said.
When parents learn their child's
diagnosis, Taub says they immediately
ask him, "Why did my child get cancer?
Could it be prevented?" He has been
looking for answers in an unlikely place
— in genetically engineered zebrafish.
These tiny striped fish, often seen
in aquariums, are a good choice for
research because their organ and
blood development is similar to that of
humans. Also, zebrafish mature quickly
and require less space and cost to main-
tain than mice, which often are used in
medical research.
Taub knew from previous studies he
and other researchers published that
some newborns have pre-leukemic
cells. However, not all of these children
will develop leukemia. (Blood tests
of newborns are required to screen
for genetic and other diseases.) One
hypothesis is that leukemia develops in
a two-step process with the "first hit"
being a leukemic gene and the "second
hit" possibly the result of environmental
exposure.
His research with an interdisciplinary
team from Wayne State University is

j

When it comes to your heart, St. Joseph Mercy Oakland makes it
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level of care, we recently unveiled the Structural Heart Program
as a part of our comprehensive cardiovascular services. For
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delivers the most advanced medical technology and treatment
options available today.

Backed by a tradition of clinical excellence and patient
outcomes, St. Joseph Mercy Oakland's Structural Heart
Program features:

• A multi-disciplinary team consisting of interventional
cardiologists, cardiac surgeons, a dedicated cardiovascular
anesthesiologist and other clinical care team members

• Life-saving results for patients facing the most complex
heart conditions and treatments, including transaortic valve
replacement (TAVR), MitraClip, and other endovascular
procedures and minimally invasive heart valve surgery

• The St. Joe Structural Heart Team works hand-in-hand with your
primary care physician

"We provide personalized, highly advanced heart care at the
St. Joseph Mercy Oakland Heart Institute."

- Charles F. Schwartz, MD

For more information or to schedule a patient for an immediate evaluation at the
St. Joe's Oakland Structural Heart Clinic, call 248 75 VALVE or 248 758 2583.

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conducted in a lab with rows of special
tanks for the zebrafish. One group of
zebrafish embryos was injected with a
leukemic gene and 1 percent of them
developed leukemia. A second group
was also exposed to pesticides and
exhibited signs of delayed development.
Taub thinks these embryos may catch
up developmentally but then develop
leukemia later, much as some infants
with pre-leukemic blood cells seem
initially healthy but develop leukemia
within a year.
The researchers have acquired a
special form of zebrafish known as
casper, which lack pigment, that should
enhance their lab investigations.
"We are starting new studies with the
casper, which are transparent, like the
comic ghost character. This allows us
to visually look for signs of leukemia
developing in their organs before they
become 'sick: We are also going to study
genes in the zebrafish to determine if
there are other genetic factors that can
be early signals of leukemia developing:'
he explained.
Epidemiological studies have shown
an association between pesticides and
leukemia, but this doesrit prove a cause
and effect. However, some pesticides
can cross the placenta.
"I think that pregnant women should
try and potentially minimize exposure
to pesticides or use good food handling,
like washing fruits and vegetables thor-
oughly," he recommended.
He would like to study other potential
environmental or external factors in the
development of leukemia. Expanding
the screening of different factors is lim-
ited only by financial resources. These
environmental factors could include
chemicals from car exhaust, household
pesticides and exposure to certain
viruses or other infections. Funding
for the pilot research came from the
CHM Foundation and the Kids Without