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Get to Know: Mignon Loh, Pediatric Hematologist-Oncologist

Mignon Loh, MD, joined the UW School of Medicine’s Department of Pediatrics as division chief of Pediatric Hematology, Oncology, Bone Marrow Transplant and Cellular Therapy on Dec. 1, 2021.

In this role, she will also provide clinical leadership at Seattle Children’s Cancer and Blood Disorders Center and research leadership as the director of the Ben Towne Center for Childhood Cancer Research (BTCCCR) at Seattle Children’s Research Institute. Loh will also serve as professor in the Department of Pediatrics at the UW School of Medicine, as well as head of the Section of Pediatric Oncology at Fred Hutchinson Cancer Research Center.

She’s been at University of California San Francisco (UCSF) for 22 years as a pediatric hematologist-oncologist focusing on conducting translational studies in childhood leukemia, specifically acute lymphoblastic leukemia and juvenile myelomonocytic leukemia. At UCSF, she served as division chief of Pediatric Hematology Oncology for eight years.

Get to know her:

What inspired you to go into medicine and pediatric oncology?

My interest in medicine and pediatric oncology stems from my desire to integrate scientific discoveries in cancer research with a patient population that ranges from newborns to adults. In so many ways, pediatrics is a challenging but exciting specialty because of the unique make up of children at every stage of development. Balancing how we treat our population with serious illness at the beginning of life until they reach adulthood raises unique opportunities that have always motivated me.

Pediatric oncology is multidisciplinary and multifaceted, ranging from basic science discoveries to innovative clinical trials to caring for patients and their families during very stressful times in their lives. When caring for these complex patients, I really enjoy interacting with many different subspecialist colleagues and putting the pieces of this complicated puzzle together. The research I do is translational — it stems from what we learn from patients, brought to the lab, and then back to the patients’ bedside. Pediatric oncology is the pinnacle of how you can take science to patients relatively rapidly and it’s exciting how it’s changing the landscape of care.

You’re moving from California. What are your looking forward to living in the Seattle area?

I spent November 1990 in Seattle when I was a fourth-year medical student, and it rained every day! But I am looking forward to exploring the Pacific Northwest, particularly during the summer. I love California, and I’ll be commuting for this year while my husband and daughter (a senior in high school) live in San Francisco. My son is a senior in college. During the recruiting process, it felt like it was a good time for our family to consider something new.

I am really excited about this job. It’s a great division already and I want to make it that much better. I’m excited about the opportunity to further expand on the BTCCCR by recruiting new investigators to Building Cure and bringing together UW Medicine, Seattle Children’s and Fred Hutch to significantly accelerate our growth as a world-class program for pediatric patient care and research.

During the pandemic, I think everyone took a step back to evaluate, and for me it was the same. This opportunity offered me something that I’ve always wanted, which is to build something, and I’m really excited to do that.

What are your clinical interests?

For my clinical interests, I focus on childhood leukemias: acute lymphoblastic leukemia and rare juvenile myelomonocytic leukemia.

As for research, I run a lab at UCSF and contribute new knowledge to both diseases. I study how the genetics in both diseases can inform our current therapies and discover new therapies. I’ve been fortunate to be part of many collaborations in better understanding the pathogenesis of these conditions through unravelling their genetics. I’m interested in hereditary predisposition to cancer, and there are a number of genetic variations predisposing to solid tumors that I have an interest in as well.

I also chair the Acute Lymphoblastic Leukemia Committee for the Children’s Oncology Group (COG) and am responsible for supervising the design and execution of the clinical trial portfolio for newly diagnosed and relapsed patients who are treated in more than 210 COG centers in North America, Australia and New Zealand.

What are you most looking forward to working on?

The remarkable opportunity to build a center. There are two floors in Building Cure that are being built out for our center, with 60,000 square feet. There is room for 20 principal investigators and a couple hundred people that work for them. I get to guide the vision of how we want to put ourselves on the map for investigating some of the most vexing problems in childhood cancer. This type of opportunity does not come along very often.

My goal is to build a great center and to engage current faculty and recruit new faculty in a programmatic, themed way that will add expertise and build collaboration. Starting out, we will be thinking about what directions to move in and what are the roles we want to fill and programs we want to build. I have some ideas and it will be really exciting to get going.

What’s new or exciting in pediatric cancer therapy?

In my opinion, I think there are a few things that are really new and exciting.

In terms of immunotherapy, you can take someone’s own T cells, an arm of your immunity, and engineer those cells in a lab to recognize cancer cells. Seattle is already doing a lot in that area. There’s a lot to learn from patients in immunotherapy trials: Some patients do respond to the treatment and some don’t, and we’re working on finding out why that is.

It’s exciting because many pediatric tumors aren’t super complicated on a genomic level. Adult tumors have 40 to 60 mutations, while there are relatively few in pediatric cancers. Genomics is important in pediatric cancer and we want to do more of integrating genomic tests with therapies. We also want to deeply study how genes are silenced or activated using epigenetic modification, and we will be investing in the technology and in investigators to study the genome and epigenome as a start.

Importantly, as we have gotten more successful in treating populations with childhood cancer, there’s a growing population of patients that went through cancer as a kid and are living with the consequences of surviving. We have a top tier program that studies both the physical effects of survivorship as well as what it takes emotionally to survive childhood cancer. Measuring resilience during therapy is important for cancer therapy as well as in other diseases, in this way, research done in our division benefits children with other diseases who are treated at Seattle Children’s.

Lastly, we are not always successful when treating childhood cancers. It’s important to help improve the patients’ lives and their families’ lives at end of the journey and we’re working to better understand how people cope and can be cared for. Even if the treatments are not successful, the end-of-life care is really important.

What do you find most challenging and rewarding about your job?

Experiments don’t always work the way you want them too. I also find the regulatory and bureaucratic hoops that we interact with challenging. On a personal level, I am always motivated by seeing a patient with relapsed disease and think “we must do better.”

On the flipside, it’s rewarding when we make progress or a discovery in a research experiment or when I see a patient that I treated 10 years ago and they look great. Or, when someone is at the end of life and our team is able to help them have a peaceful death surrounded by their family without pain, that’s incredibly rewarding.

What would you like your colleagues to know about you?

I like to be transparent in how I approach my job. I am driven and competitive, but I’m also inclusive and that goes along with transparency.

On a personal level, I love the outdoors and I’m excited to explore Seattle. I like to eat and try new foods (I’m a foodie!) but I like to cook for people even more. I also like to read and listen to music.

Do you have a favorite book, podcast or TV show?

I’m late to “Ted Lasso,” but I’m just finishing the show and that’s been really fun and inspirational for me as a leader.

As for books, I’m in the middle of reading “The Overstory” by Richard Powers (it’s about trees), and recently for book club I read “Klara and the Sun” by Kazuo Ishiguro.

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