Susan R. Rheingold, MD

Description of Research Expertise

Since my appointment as Assistant Professor, I have created clinical and translational research programs in childhood and adolescent ALL. These programs include clinical trials for newly diagnosed ALL, supportive care during ALL therapy, and experimental therapeutics for relapsed ALL. I am the institutional principal investigator (PI) for the majority of Children’s Oncology Group (COG), industry, and institutional ALL protocols available at CHOP. I am an active member of the COG Relapsed ALL Committee and am a member of the national study committees for the COG relapsed ALL trials ADVL04P2, AALL0433, and AALL07P1.

I am in my second year of a three year Leukemia Lymphoma Society Translational Research Grant introducing mTOR inhibitors into pediatric clinical trials. A protocol combining temsirolimus with intensive chemotherapy for relapsed ALL and Non-Hodgkin’s Lymphoma (NHL) will be run through the Children’s Oncology Group as a combined protocol between the developmental therapeutics, ALL, and NHL committees, with myself as the National PI. The Leukemia & Lymphoma Society Grant has also let me expand upon an institutional Phase I trial of sirolimus, an oral mTOR inhibitor. Based upon the preclinical work of my co-investigators, Stephen Grupp, MD, PhD and David Teachey, MD, which showed maintenance of complete remission of NOD/SCID mice with ALL using sirolimus and methotrexate, I am PI on an institutional Phase 2 efficacy trial of sirolimus combined with oral methotrexate for children and adolescents with relapsed and refractory ALL and NHL.

The industry sponsored Clofarabine trials, for which I was the local PI, successfully ended with the first new FDA approval for relapsed childhood ALL in over two decades. I have a manuscript in press on a novel combination of chemotherapeutic agents (nelarabine, etoposide, and cyclophosphamide) to treat relapsed T-cell ALL and NHL. Under Eric Kodish, MD (Cleveland Clinic), I am a co-investigator on a R01 funded investigation studying the informed consent process for Phase I pediatric cancer trials.
I also have research interests in oncologic emergencies, supportive care and nutrition/complementary and alternative medicine (CAM) for the pediatric oncology patient, especially as it relates to therapy for children with ALL. In the realm of supportive care and nutrition/CAM for I have collaborated on the following investigations: 1) CAM use in pediatric cancer patients; 2) antioxidant levels and chemotoxicity in ALL patients; 3) milk thistle therapy for hepatotoxicity induced by Maintenance therapy in ALL; 4) erythropoietin use on quality of life; and 5) a pilot study of enteral feeds for high risk pediatric patients. All of these studies have been funded by private foundation grants or industry and several of these studies have now been published. Further grant funding is being sought to run successor trials.

Description of Clinical Expertise

Acute lymphoblastic leukemia (ALL) is the most common type of childhood cancer. Although 80% of children and adolescents are cured with frontline therapy, 20% of patients relapse and have dismal outcomes. I actively participate in both clinical and translational research programs designed to improve outcomes for this population. I am the institutional principal investigator (PI) for the majority of Children’s Oncology Group (COG), industry, and institutional ALL protocols available at the Children’s Hospital of Philadelphia. I am an active member of the COG Relapsed ALL Strategy Group and am a member of the national study committees for several of the COG relapsed ALL trials.

I see the majority of second opinions referred to CHOP for newly diagnosed and relapsed ALL; as well as, communicate by email and phone with outside pediatric oncologists looking for advice on treatment in complex ALL cases. I oversee the care of all of our patients with ALL enrolled on COG trials as well as those not on study being treated with standard of care.