HemAware is conducting a series of interviews with recipients of the NHF-Shire Clinical Fellowship. It is funded through the generous support of Shire. The objective of this grant is to increase the number of skilled clinicians committed to providing comprehensive care for individuals with bleeding and clotting disorders and to prepare recipients for academic careers.
This interview was conducted with Michael Callaghan, MD, assistant professor of pediatrics, Children’s Hospital of Michigan in Detroit. The fellowship was funded from 2006 to 2008.
Why did you decide to study medicine?
The possibility of a medical career struck Callaghan while he was pursuing a chemistry degree as an undergraduate at Oakland University in Rochester, Michigan. “It seemed like a good application of science, and I liked the idea of helping people get better.” He then went to medical school at Wayne State University in Detroit.
What initially attracted you to hematology?
Although “hated” by his peers, a hematology course during Callaghan’s second year rotation in medical school planted the seed for his career specialty. After finding out from the pediatric hematologist who led his small group session what her specialty involved, Callaghan’s interest deepened. During his third year, Callaghan set up his elective in pediatric hematology, working on a research project with Jeanne Lusher, MD, then director of the hemophilia treatment center and coagulation laboratory at Children’s Hospital of Michigan, in Detroit. “She had five projects for me to choose from,” Callaghan says. “She was a great mentor.”
How did the training and mentorship you received as an NHF-Shire Clinical Fellow affect your decision to pursue clinical care and/or research in bleeding disorders?
“There are a lot of demands on fellows and junior faculty to do a lot of patient care in different areas,” says Callaghan. “Having the NHF-Shire Clinical Fellowship allowed me to focus more of my time and energy on research in hemophilia and on hemophilia care.” Plus, he was welcomed as part of the hemophilia team early on and received invaluable training, he says.
Callaghan worked in the lab of Randal J. Kaufman, PhD, at the University of Michigan in Ann Arbor on the “unfolded protein response.”
“That process is very important in inhibitor antibody development,” he says. “We did high-throughput drug screening to find what targeted that pathway.” Drug candidates were then tested on mice with hemophilia and inhibitors.
Are you still engaged in the clinical aspects of patient care or bleeding disorders research? What aspect of care are you most interested in?
Callaghan spends about 75% of his time in the lab, focusing on immune tolerance therapy to eradicate inhibitors. The rest of his time is devoted to patient care. “I like to see all comers—from people who are just being worked up for bleeding disorders, to hemophilia, von Willebrand disease, even platelet disorders and ITP (idiopathic thrombocytopenic purpura).” Although most of the patients are children, some are a bit older. “We do have several kind of big kids who stretch out into their 20s,” Callaghan says.
Did your NHF-Shire Clinical Fellowship assist in advancing your own position at your institution? Or did it serve as a building block to further your career in coagulation?
Receiving the grant helped Callaghan on both fronts. “Obtaining funding helps secure a position at your own institution and helps you get future funding,” he says. The time and resources it provided him were “very, very helpful.”
Where do you think bleeding disorders research and clinical care may be headed in the near future? In the next decade?
Callaghan says this is an exciting era for bleeding disorders research and drug development. After decades of research, clinical trials are now closer to yielding factor products with longer half-lives, for instance. “We expect that’s going to be integrated into clinical practice very soon,” he says.
Decades of research using gene therapy techniques are also advancing in clinical trials currently. “There’s been successful gene therapy in a few patients with hemophilia B,” says Callaghan. “That’s very exciting.”
A third area in which research is making headway is inhibitors, Callaghan says. “Hopefully, there’ll be some breakthroughs in new bypassing agents, with different mechanisms for inhibitor patients as well.”
When you are not working, how do you relax or “escape” from your work?
With three daughters ages 5, 6 and 8, Callaghan says work is his escape. “It is really kind of relaxing for me.” When he’s home, he is an active dad—biking or swimming with his girls, or perhaps attending an impromptu tea party.
A former competitive runner, Callaghan admits he doesn’t run as much as he’d like to, with so many demands on his time. “Now I just run to try not to get too fat,” he says with a laugh.