Donald Paul Pinkel

Abstract

Paediatric oncologist specialising in leukaemia. He was born on Sept 7, 1926 in Buffalo, NY, USA, and died on March 9, 2022 in San Luis Obispo, CA, USA, aged 95 years. What should be done about a life threatening illness for which available therapies are individually inadequate and toxic? This dilemma faced paediatricians in the early 1960s when treating patients with acute lymphoblastic leukaemia (ALL). Paediatric oncologist Professor Donald Pinkel of St Jude Children's Research Hospital in Memphis, TN, USA, opted for an innovative approach: administer all the treatments simultaneously. At the time, many other oncologists thought this regimen was reckless, dangerous, and unethical. “Don was stubborn”, says virologist Robert Webster, an emeritus member of the Infectious Diseases Department at St Jude. “He was undeterred by criticism.” Pinkel's persistence paid off. “He was the man responsible for introducing the word ‘cure’ to the cancer conversation”, says James Downing, President and Chief Executive Officer of St Jude and holder of its Donald Pinkel Chair of Childhood Cancer Treatment. Pinkel himself was no stranger to severe illness. After his 1951 medical degree from what is now the Jacobs School of Medicine and Biomedical Sciences in Buffalo, NY, USA, and then a fellowship at the Children's Hospital in Boston, MA, USA, he joined the US Army Medical Corps. But he contracted polio and spent months in a state of paralysis. Discharged from the military, and gradually rehabilitating himself, he returned to Boston to work briefly for the renowned pathologist Sidney Farber who had succeeded in using a folate antagonist to achieve brief remissions in children with ALL. In 1956, Pinkel was appointed head of paediatrics at Buffalo's Roswell Park Comprehensive Cancer Center, and it was here that he set his sights on what seemed to colleagues a hopelessly ambitious target: a cure for ALL. Wearied by the effect on his health of Buffalo's cold and damp winter climate, Pinkel decided to move to a warmer part of the country. Around the same time, he learned that the popular entertainer Danny Thomas was about to open a new hospital, St Jude Children's Research Hospital, for which he had been fund raising. The hospital was looking for a paediatrician to work on leukaemia and having some difficulty. As Pinkel later recalled, “Memphis was such a sad place medically, highly [racially] segregated and not much going on there scientifically.” But after talking to Thomas and to his supportive hospital board, Pinkel believed that St Jude was the place to develop and test his ideas. He joined the hospital as Director and Chief Executive Officer in 1962, at the same time becoming Professor of Pediatrics and Preventive Medicine at the University of Tennessee. “He came here with the idea of using drugs in combination”, says Webster, “and never doubted that it would work”. The five drugs he chose for what he called his “total therapy” had all been used in ALL, but with patchy results. “The individual drugs would always quickly spawn resistance”, says Sir Mel Greaves, Professor of Cell Biology at the Institute of Cancer Research in London, UK. “Used in combination the effect of any emergent resistance among one or two of them would be minimised.” By 1970, with ALL survival rates having already risen from 4% to more than 50% with the total therapy approach, professional scorn had given way to imitation. Pinkel's ambitions extended beyond curative medicine. He backed and furthered his hospital's desegregation policies, and saw health care in a broader context. “When he started treating kids he noticed that those from the lower socioeconomic areas of Memphis weren't doing as well”, says Downing. “He realised it was nutrition, and so set up a programme in the city to provide them with free food.” Pinkel continued to improve his total therapy. In 1972 he was a co-winner of the Albert Lasker Clinical Medical Research Award for combination chemotherapy for lymphoma and acute leukaemia. But seeing himself as a man who liked to start new things, he left St Jude in 1973 for appointments as professor or chair at universities and hospitals in Milwaukee, WI, Duarte, CA, and Philadelphia, PA. He moved to the University of Texas MD Anderson Cancer Center in Houston, TX, in 1985, where he influenced the development of clinical trials. In 2001, he retired as Professor Emeritus at MD Anderson. He finished his career by teaching a basic biology course at his local state polytechnic. “A man of great integrity, and very little ego considering his fame”, says Greaves. “And very likeable”. Pinkel is survived by eight children from his first marriage to Marita Donovan, his wife Cathryn Howarth and their son, a sister, Ellen, and his grandchildren.