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Allen Ray Sing Chen, MD PhD MHS

Director. Pediatric Bone Marrow Transplantation
Associate Professor of Oncology
Male
Appointment Phone

443-287-6997

Main Location

The Johns Hopkins Hospital

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Out of State Patients

Call 410-464-6641 (8a.m. to 6p.m., EST, Mon-Fri)

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International Patients

Call +1-410-502-0773 (7a.m. to 6p.m., EST, Mon-Fri)

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Titles

  • Director. Pediatric Bone Marrow Transplantation
  • Associate Professor of Oncology
  • Associate Professor of Pediatrics

Centers & Institutes

  • Pediatric Oncology
  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Expertise

Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia, Chronic Myeloid Leukemia, Leukemia, Leukemia/Lymphoma, Medical Oncology, Pediatric Bone Marrow Transplant, Pediatric Hematopoietic Cell Transplant, Pediatric Oncology

Research Interests

Pediatric Hematopoietic Cell Transplantation, Pediatric Bone Marrow Transplantation, Pediatric Oncology

Biography

Children with metastatic or recurrent malignancies have a poor prognosis despite initially chemoresponsive disease. There is a steep linear relationship between the dose of many cytotoxic agents and the log tumor cell kill. For agents whose major dose-limiting toxicity is myelosuppression, hematopoietic stem cell rescue may permit five to 10 times dose escalation, which would produce several times more cell killing. The Childrens Cancer Group has demonstrated in a prospective, randomized, controlled study in patients with high-risk neuroblastoma that purged autologous bone marrow transplantation (BMT) produces superior three-year event-free survival (EFS), compared with conventional dose-intensive chemotherapy as consolidation in first response. Although prospective randomized trials have yet to be completed for other pediatric solid tumors, autologous BMT appears to produce survival at least equivalent to longer courses of intensive conventional chemotherapy, and the major risk remains tumor progression. Therefore, additional agents and modalities that are not cross-resistant with current therapies are needed. Dr. Chen is investigating tandem transplantation and autologous GVHD as alternative approaches to provide improved control of pediatric solid tumors.

In allogeneic BMT, nonablative preparative regimens can produce engraftment with less preparative-regimen-related toxicity, but at a price of more graft versus.host disease. In fact, GVHD is a major limitation of the success of BMT for all indications, but its morbidity and mortality are offset in patients with hematologic malignancies by an improved graft-versus-leukemia effect. Therefore, for patients with nonmalignant diseases, such as inherited hematologic and metabolic diseases that present during childhood, preventing GVHD is particularly important. Rodent models indicate that cyclophosphamide administered at a critical interval after mismatched BMT can specifically destroy alloreactive T cell clones, and Dr. Leo Luzniks trial in adult patients undergoing haploidentical BMT for hematologic malignancies supports a role for cyclophosphamide treatment after graft infusion to produce tolerance. Dr. Chen will test whether cyclophosphamide administered after graft infusion will allow long-term engraftment without GVHD in immune-competent patients with hemoglobinopathies receiving nonmyeloablative BMT.

Languages

  • English

Clinical Trial Keywords

  • Pediatric Bone Marrow Transplantation, Pediatric Oncology
Additional Resources +
  • Education +

    Training

    • Johns Hopkins Bloomberg School of Public Health (Baltimore MD) (2002)
    • Duke University School of Medicine (Durham NC) (1986)
    • Duke University (Durham NC) (1985)

    Residencies

    • University of Washington Medical Center / Pediatrics (Seattle WA) (1989)

    Fellowships

    • University of Washington Medical Center / Pediatric Hematology & Oncology (Seattle WA) (1992)

    Certifications

    • Oncology, American Board of Pediatrics / Pediatric Hematology (2006)
  • Research & Publications +

    Selected Publications

    Journal Citations
    Chen, A. R. (2005). Bone marrow transplantation in acute myeloid leukemia in children. In Surgery of Infants and Children: Scientific Principles and Practices 2nd edit. (Kline, R. M. & Kline, K. M., eds.). Lippincott-Raven, Philadelphia, PA.

    Chen, A. R. (2006). Bone marrow transplant in acute myeloid leukemia in children. In Pediatric Bone Marrow Transplantation (Kline, R. M., ed.). Taylor and Francis, Philadelphia, PA.

    Chen, J. G., S. Y. Kuang, P. A. Egner, J. H. Lu, Y. R. Zhu, J. B. Wang, B. C. Zhang, T. Y. Chen, A. Munoz, T. W. Kensler, and J. D. Groopman. 2007. Acceleration to death from liver cancer in people with hepatitis B viral mutations detected in plasma by mass spectrometry. Cancer Epidemiol Biomarkers Prev 16:1213-8.

    Kim, G. R., Chen, A. R., Arceci, R. J., Mitchell, S. H., Kokoszka, K. M., Daniel, D. & Lehmann, C. U. (2006). Error reduction in pediatric chemotherapy: computerized order entry and failure modes and effects analysis. Arch Pediatr Adolesc Med 160, 495-8.

    Luznik, L., O''Donnell, P.V., Symons, H.J., Chen, A.R., Leffell, M.S., Zahurak, M., Gooley, T.A., Piantadosi, S., Kaup, M., Ambinder, R.F., Huff, C.A., Matsui, W., Bolanos-Meade, J., Borrello, I., Powell, J.D., Harrington, E., Warnock, S., Flowers, M., Brodsky, R.A., Sandmaier, B.M., Storb, R.F., Jones, R.J., and Fuchs, E.J. (2008). HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant 14, 641-650.

    Milstone, A. M., Balakrishnan, S. L., Foster, C. B. & Chen, A. (2006). Failure of intravenous pentamidine prophylaxis to prevent pneumocystis pneumonia in a pediatric hematopoietic stem cell transplant (HSCT) patient. Pediatr Blood Cancer 47, 859-60.

    Rubin, E., X. Wu, T. Zhu, J. C. Cheung, H. Chen, A. Lorincz, R. K. Pandita, G. G. Sharma, H. C. Ha, J. Gasson, L. A. Hanakahi, T. K. Pandita, and S. Sukumar. 2007. A role for the HOXB7 homeodomain protein in DNA repair. Cancer Res 67:1527-35.

    Simpson, L. A., Burwell, E. A., Thompson, K. A., Shahnaz, S., Chen, A. R. & Loeb, D. M. (2006). The antiapoptotic gene A1/BFL1 is a WT1 target gene that mediates granulocytic differentiation and resistance to chemotherapy. Blood 107, 4695-702.

    Williams, K.M., Higman, M.A., Chen, A.R., Schwartz, C.L., Wharam, M., Colombani, P., and Arceci, R.J. (2008). Successful treatment of a child with late-onset T-cell post-transplant lymphoproliferative disorder/lymphoma. Pediatr Blood Cancer 50, 667-670.

    Antin, J. H., Chen, A. R., Couriel, D. R., Ho, V. T., Nash, R. A., Weisdorf, D. 2004. Novel approaches to the therapy of steroid-resistant acute graft-versus-host disease. Biol. Blood Marrow Transplant 10:655-68.

    Brodsky, R. A., Chen, A. R., Brodsky, I., Jones, R. J. 2004. High-dose cyclophosphamide as salvage therapy for severe aplastic anemia. Exp. Hematol. 32:435-40.

    Higman, M., Vogelsang, G. B., Chen, A. 2004. Pentostatinpharmacology, immunology, and clinical effects in graft-versus-host disease. Expert Opin. Pharmacother. 5:2605-13.

    Iannone, R., Ohene-Frempong, K., Fuchs, E. J., Casella, J. F., Chen, A. R. 2005. Bone marrow transplantation for sickle cell anemia: Progress and prospects. Pediatric Blood Cancer. 44:436-440.
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  • Contact & Locations +

    Locations

    The Johns Hopkins Hospital
    600 N. Wolfe Street
    Hospital Main Entrance - Sheikh Zayed Tower
    Baltimore, MD 21287
    Appointment Phone: 443-287-6997
    Location Map

    Department/Division

    • Oncology

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