Leukemia research pioneer Sallan named Culver’s Graduate of the Year

 

Dr. Stephen Sallan ’59 has had a number of “aha moments” and major miracles that led to him becoming one of the world’s foremost experts on childhood leukemia.

He has been a pioneer in the treatments of acute lymphoblastic leukemia (ALL), curing cancer in children for more than 50 years. That is why he was named this year’s Graduate of the Year at Culver Academies at his 65th Reunion.

“It came as a total surprise, out of nowhere,” said Sallan, chief of staff emeritus at the Dana-Farber Cancer Institute in Boston. “I’m thrilled to be so honored. It is not one of the things I expected to happen to me – ever.”

He shouldn’t have been so surprised.

He’s had numerous breakthroughs in leukemia research. When he started as a doctor, children diagnosed with ALL, the most common childhood leukemia, had less than a 20 percent chance of surviving back then. Today, a child with the same diagnosis being treated at Dana-Farber has about a 90 percent chance of survival, in large part because of research by Sallan and his team.

He has published hundreds of peer-reviewed journal articles and developed treatments for malignant kidney tumors and ways to reduce illness associated with some cancer treatments.

“What you learn when you’re doing this is, you think you are focused on your own disease of interest, but you’re really working with the biology in cancer medicine at large,” he said.

He also has mentored hundreds of doctors who have gone on to become leading investigators in hematology and oncology.

“We know that one’s mentees carry the torch of current knowledge, passing it along to the next generation,” he said. “For me, in many ways, mentoring mirrors the joy of parenting.”

He was named Graduate of the Year at Wayne State University School of Medicine Distinguished Alumni in 1997. He also was awarded the James Carreras Prize for International Pediatrician of the Year in 1998, named to Castle Connolly America’s Top Doctors in 2006 and Castle Connolly America’s Top Doctors for Cancer in 2009. He became Dana-Farber’s chief of staff emeritus in 2012.

 

 

So being named Graduate of the Year at Culver, the first in his class to receive this honor, seemed like an obvious choice. Especially because his journey to becoming a pioneer in leukemia research began with a biology class taught by Maj. Jim Miracle at Culver Military Academy when Sallan was a junior. He said he had been a “lackadaisical student” until that time and “science averse.”

“I credit Maj. Miracle for planting the seed of my lifelong career,” he said.

Sallan said he was able to share his story with Miracle at his 50th Reunion 15 years ago.

Culver was a time of tremendous growth for Sallan, and not just in the classroom. He grew 14 inches, gained 100 pounds and went from being “an undifferentiated barely adolescent so-so student and gradually evolved into a university-bound pre-med student,” he said. “Literally and figuratively, my half-century medical career began as a miracle at Culver. An actual miracle.”

No one in his family had ever worked in medicine. Sallan planned to follow in his father’s and grandfather’s footsteps of running the family jewelry business, with stores in metropolitan Detroit and throughout Michigan and Ohio, until he took that biology class.

“Never for a moment considered medicine until that time,” Sallan said. “And then, never considered anything else.”

Sallan said that was his first “aha moment.”

“Culver prepared me in a way that I was totally, totally surprised by,” Sallan said.

He said he had another “aha moment” that led him to a career in pediatric hematology (study of blood diseases) and oncology (study of cancer), ultimately becoming chief of staff at the prestigious Dana-Farber Cancer Institute in Boston and a professor of pediatrics at the Harvard Medical School.

Sallan said he couldn’t make up his mind what field to specialize in all the way through Wayne State University School of Medicine in Detroit, although he thought he wanted to be a general pediatrician.

“Then in my residency I liked every specialty I saw,” he said.

He completed residencies in pediatrics at Boston Floating Hospital (1968), Children’s Hospital of Philadelphia (1969) and the Hospital for Sick Children in London, England (1970).

 

 

He enlisted into the Navy during the Vietnam War while he was still in medical school. In the middle of his Navy service, while he was a submarine medical officer, he signed up for a gastrointestinal fellowship. But just before going on patrol, he worked with the Navy neuropsychiatric research unit and got interested in psychiatry.

So when he came home from that first patrol, he gave up his GI fellowship and became a child psychiatry resident after he was discharged from the Navy. Two months in, though, he realized that psychiatry wasn’t for him.

They made him the liaison psychiatrist to the Boston Children’s Hospital  oncology unit.

“That was another of my early ‘aha moments,’ ” Sallan said.

When he decided to focus on childhood cancer, he chose leukemia because it was so deadly. He served as a fellow in pediatric oncology at Boston Children's Hospital and Dana-Farber from 1973 to 1975.

Sallan and Dr. Emil Frei III started in 1973 the first in an ongoing series of clinical trials for children diagnosed with ALL. He joined the Dana-Farber staff in 1975.

A key early discovery for Sallan was an anti-leukemia antibody that allowed doctors to clean the child’s own bone marrow of low levels of leukemia cells and reinfuse it, so they didn’t have to depend on a suitable donor.

“It worked for a few children, but better things came along and more children had other opportunities,” Sallan said.

But he said a protein that they found on leukemia cells and for which they produced an antibody is used now as a routine diagnostic tool.

“It’s a team effort. There are a lot of people involved in these sorts of things,” he said.

 

 

He had other breakthroughs, such as immunologic cell surface markers, molecular measures of leukemia, targeted therapies and immunotherapies.

Among the breakthroughs he’s most proud of is discovering the impact of a therapeutic enzyme called asparaginase to treat leukemia, as well as using a group of drugs called anthracyclines against leukemia, and also discovering a way to protect the heart while using those drugs.

Those breakthroughs involved him as the principal investigator in a group that involved basic scientists, translational scientists, clinical trial specialists, computational biologists, immunologists, working together on a project that included zebra fish labs and fruit fly labs.

“The outcomes were amazing, with one trial after another getting better than the last success, basically using the entire Dana-Farber Cancer Institute,” he said.

He said the treatment of cancer has changed remarkably in recent years. Instead of focusing on the site of the cancer, such as breast cancer or lung cancer, doctors are focused on the mutated genes that drive the cancers.

He said Dana-Farber has a chip with a hundred of the most common mutated genes. It’s what he turned to when he saw a 5-year-old boy who had an inoperable cancer growing on the back of his hand that was not responsive to drugs or radiation. It might have led to amputation in years past.

“Today we do something that was unimaginable to me only a decade ago. We take a piece of the tumor, put it in the “gene machine,” if you will, and we get a readout of which gene or genes are driving his cancer,” Sallan said.

He said it turned out the boy had a gene that is most often associated with lung cancer. He said there are half a dozen good gene specific drugs that attack lung cancers. They put him on a medication once a week with no side effects.

At first all they noticed was that the tumor wasn’t growing. Then they observed the tumor was getting softer.

“Then a week or two later, ‘Oh no, it not only is definitely softer, it’s smaller,’ ” Sallan said. “Then at the end of four or five months, it was gone.”

He said no one knows if the growth is gone forever. But it is gone for now. That is becoming a more common practice in treating cancers.

Looking back, Sallan said it wasn’t until he began caring for children with cancer and becoming immersed in cancer research that the “deeply engrained Culver values” he had learned emerged.

 

 

 

“Leadership, integrity, character, those Culver values re-emerged and became increasingly apparent in my day-to-day responsibilities – especially leadership,” he said.

He said he is certain those Culver values formed the glue that held his research team together and allowed it to create so many major miracles.

Sarah Sallan said her father is big believer in not worrying about who gets credit for an accomplishment. Sallan describes himself as “mission-focused,” saying “you have to be when you’re on a team of 100 scientists working together.”

“It’s all integral, like parts of a watch,” Stephen Sallan said. “You need every single one. You can’t do it without everyone, and frankly no one can do it on their own. We’ve very much focused on our outcomes. We celebrate together. We mourn together when we’re not successful. We recognize we all need one another.”

Sallan said he’s loved working with his daughter at Dana-Farber. Initially she graduated from college as a sociology major and didn’t know what she wanted to do. She subsequently  went to the University of Pennsylvania and became a pediatric nurse practitioner, and then went into oncology and joined Dana-Farber right before the pandemic hit. Today, she and her father work together.

“She’s become an incredible caretaker and being in the clinic with her and seeing how she models for her patients and their families and the other nurse practitioners, and really, for all of us, has been an absolute joy,” he said.

His daughter said she knew she had her father’s support no matter what field she went into. But she knew he was happy when she chose to pursue a career in medicine. She said it was a bit awkward working with her father at first, but they quickly got used to it.

“I think what I am most proud of to be working with him and by him is that people just think he’s a good human. People go to him as a sounding board for career advice or patient advice or just someone who they trust,” she said. “I also think the people who work with us would want him to care for their patients. So there's all these things about him as a doctor, of course, but also just as a good human being that makes me proud to work beside him and with him.”

Stephen Sallan said his goal is never to be the smartest in the room or the best.

“My goal is to be so good that while there may be many as good, I know there are none better. That does it for me,” he said. “I’m very happy to have everybody at a high level. I don’t have to be higher. But I like to set the bar high.”

Being a cancer researcher comes with the rewards of saving young lives, but also the devastating losses when a cure is impossible.

“You learn to accept your losses,” he said. “You also learn if you can’t accept them, if you can’t deal with this part of the field, there’s no way you’re going to make a mark in it. You have to stay the course. … Those of us in cancer medicine know that accepting loss is part of the field. It comes with the territory.”

He said those in the business develop coping mechanisms that those who don’t have to deal with death might not understand.

He takes great pride in knowing that Dana-Farber excels in caring for patients. He tries to lead in that area, saying the doctor-patient relationship nourishes the soul.

“There’s no question that leaders set the tone and establish the culture,” he said.

It’s a lesson he learned at Culver.

“Focus on leadership carries forward in your whole life.  And leaders set the tone. Leaders create the culture. And leaders not only lead but they model leadership and they model the way to do it. When one is in that position you show your mentees and the young and your trainees at all levels how to care for people and how to listen to what people have to say. Listening is probably one of the most important tools of a physician,” he said.

He says at age 82, some mornings when he wakes up he asks himself why he hasn’t retired yet, joking that is especially true “in a nation already abuzz about whether someone my age is cognitively fit enough.” But he says he keeps going because he’s able to make a difference and because he’s enabled by colleagues who let him set his work hours.

“I think staying engaged with other people, especially with the young, and staying engaged with the teaching and training, has been hugely stimulating as I’ve aged,” he said.

He’s still having “aha moments” and taking part in major miracles.

“It’s been a great ride. One that started right here on the shores of Lake Maxinkuckee,” he said.