# William M. Crist
**William M. Crist** is an American pediatric hematologist-oncologist whose research on childhood leukemias and solid tumors included work in the Intergroup Rhabdomyosarcoma Studies. He spent much of his career from the 1970s through the 1990s in [pediatric hematology and oncology](https://www.edgepedia.org/pediatric-hematology-and-oncology), first at the [University of Alabama at Birmingham](https://www.edgepedia.org/university-of-alabama-at-birmingham), then at the University of Tennessee College of Medicine at Memphis and [St. Jude Children's Research Hospital](https://www.edgepedia.org/st-jude-childrens-research-hospital) in Memphis.[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/) According to the Flinn Foundation, he is credited among the scientists who dramatically improved understanding of childhood leukemias and their treatments.[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/)
| Fact | Detail |
|---|---|
| Field | Pediatric hematology-oncology; childhood leukemia and solid-tumor clinical research |
| Medical degree | MD, University of Missouri, 1969[2](https://www.mizzou.com/) |
| Research career | University of Alabama at Birmingham, then University of Tennessee College of Medicine at Memphis and St. Jude Children's Research Hospital, 1970s–1990s[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/) |
| Signature work | NEJM 1991 study linking scheduled epipodophyllotoxin therapy to secondary acute myeloid leukemia in children[3](https://doi.org/10.1056/nejm199112123252402) |
| Rhabdomyosarcoma trials | Co-author of the 1990 report of Intergroup Rhabdomyosarcoma Studies I and II[4](https://doi.org/10.1200/jco.1990.8.3.443) |
| Later leadership | Chairman of pediatric and adolescent medicine at Mayo Medical Center; dean of the University of Missouri School of Medicine; University of Arizona vice president for health affairs[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/) |
## Education and career
Crist received his MD from the [University of Missouri](https://www.edgepedia.org/university-of-missouri) in 1969, and the Mizzou Alumni Association later honored him as a Faculty-Alumni Award winner.[2](https://www.mizzou.com/) His clinical research career then unfolded in pediatric hematology and oncology: the University of Alabama at Birmingham, the University of Tennessee College of Medicine at Memphis, and St. Jude Children's Research Hospital, from the 1970s through the 1990s.[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/) His St. Jude affiliation appears on his 1987 Postgraduate Medicine article and on the 1991 NEJM epipodophyllotoxin study.[5](https://doi.org/10.1080/00325481.1987.11699738) • [3](https://doi.org/10.1056/nejm199112123252402)
After Memphis he moved into academic medicine leadership. He became chairman of pediatric and adolescent medicine at Mayo Medical Center in [Rochester, Minnesota](https://www.edgepedia.org/rochester-minnesota).[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/) He then served as dean of the School of Medicine at the University of Missouri, and was named [University of Arizona](https://www.edgepedia.org/university-of-arizona) vice president for health affairs, beginning those duties on October 31.[1](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/)
## Representative work
In 1991 he published in the New England Journal of Medicine a study asking whether the epipodophyllotoxin drugs teniposide and etoposide, given to children with acute lymphoblastic leukemia (ALL), caused secondary acute myeloid leukemia (AML). In a cohort of 734 children, secondary AML was diagnosed in 21 patients, and prolonged administration twice weekly or weekly was independently associated with the complication (P<0.01 by Cox regression analysis).[3](https://doi.org/10.1056/nejm199112123252402) The six-year cumulative risk was 3.8 percent overall, but 12.3 percent in the twice-weekly and 12.4 percent in the weekly subgroups.[3](https://doi.org/10.1056/nejm199112123252402) After adjustment for treatment frequency, total cumulative dose showed no apparent relation to secondary AML, meaning the schedule of administration, not the amount of drug, drove the risk.[3](https://doi.org/10.1056/nejm199112123252402)
Also in 1991 he published the NEJM review "Common Solid Tumors of Childhood," according to the article itself.[6](https://doi.org/10.1056/nejm199102143240706) The review states that childhood cancer is the leading cause of death from disease in US children aged 1 to 15, with about 4,000 new malignant solid-tumor cases diagnosed each year.[6](https://doi.org/10.1056/nejm199102143240706) In 1987 he published "Predicting Outcome in Childhood Leukemia" in *Postgraduate Medicine*, which, according to the article itself, covered acute lymphoblastic leukemia risk assessment and survivors' quality of life.[5](https://doi.org/10.1080/00325481.1987.11699738)
## Intergroup Rhabdomyosarcoma Studies
Rhabdomyosarcoma has been treated through serial multi-institutional trials since 1972, run by the Intergroup Rhabdomyosarcoma Study Group (IRSG), now the Children's Oncology Group Soft-Tissue Sarcoma Committee.[7](https://pmc.ncbi.nlm.nih.gov/articles/PMC4008325/) According to the Journal of Clinical Oncology, Crist co-authored the group's 1990 analysis of Studies I and II.
The 1990 Journal of Clinical Oncology analysis covered all eligible patients enrolled in IRS-I (1972 to 1978, n = 686) and IRS-II (1978 to 1984, n = 1,002).[4](https://doi.org/10.1200/jco.1990.8.3.443) Estimated five-year survival was 56 percent in IRS-I and 62 percent in IRS-II (P = .006).[4](https://doi.org/10.1200/jco.1990.8.3.443) Clinical group, the extent of disease after initial surgery, was the most important patient characteristic related to survival.[4](https://doi.org/10.1200/jco.1990.8.3.443) The separate IRS-II report, published in Cancer in 1993, enrolled 999 previously untreated eligible patients and reported a five-year survival rate of 63 percent, an 8 percent increase over IRS-I (P < 0.001).[8](https://pubmed.ncbi.nlm.nih.gov/8448756/) [Central nervous system prophylaxis](https://www.edgepedia.org/central-nervous-system-prophylaxis) for group III patients with cranial parameningeal sarcoma raised survival to 67 percent from 45 percent in IRS-I (P < 0.001).[8](https://pubmed.ncbi.nlm.nih.gov/8448756/) The 1990 analysis gives IRS-II five-year survival as 62 percent; the 1993 IRS-II report gives 63 percent.[4](https://doi.org/10.1200/jco.1990.8.3.443) • [8](https://pubmed.ncbi.nlm.nih.gov/8448756/)
The IRSG retrospective covering 1972 to 1997, written as background for the IRS-V treatment protocols, described current IRSG-V protocols incorporating recommendations for risk-based management, with the agents topotecan and irinotecan under investigation for patients at intermediate or high risk of recurrence.[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC2395450/) A 2001 review in the Journal of Pediatric Hematology/Oncology summarized the four IRS studies conducted from 1972 through 1991.[10](https://doi.org/10.1097/00043426-200105000-00008) The IRS-V protocols it described reduced cyclophosphamide and radiation exposure for low-risk patients while adding topotecan or irinotecan to the standard vincristine, actinomycin D, and cyclophosphamide (VAC) plus radiotherapy backbone.[10](https://doi.org/10.1097/00043426-200105000-00008) Across the four consecutive IRSG trials, five-year survival for rhabdomyosarcoma rose from about 25 percent in the 1970s to about 70 percent in the 1990s.[11](https://ascopubs.org/doi/10.1200/JCO.2009.22.3768)
## Pediatric Oncology Group and the secondary-leukemia question
From 1984 to 2001 the Pediatric Oncology Group conducted seven studies for B-precursor ALL, two for T-cell ALL, and three for infant ALL, using risk-adapted therapy to limit toxicities and maximize cures.[12](https://rcastoragev2.blob.core.windows.net/8a21bb61560541acd7b11453d72a3eda/PMC4300959.pdf) Because of a high rate of secondary malignancies, subsequent POG studies focused on intensification with asparaginase and methotrexate.[12](https://rcastoragev2.blob.core.windows.net/8a21bb61560541acd7b11453d72a3eda/PMC4300959.pdf)
## References
1. [UA Vice President Dr. William Crist to lecture on childhood cancer (Flinn Foundation)](https://www.flinn.org/ua-vice-president-dr-william-crist-to-lecture-on-childhood-cancer/)
2. [Faculty-Alumni Award Winner William M. Crist, MD '69 (Mizzou Alumni Association)](https://www.mizzou.com/)
3. [Acute Myeloid Leukemia in Children Treated with Epipodophyllotoxins for Acute Lymphoblastic Leukemia (NEJM, 1991)](https://doi.org/10.1056/nejm199112123252402)
4. [Prognosis in children with rhabdomyosarcoma: a report of the Intergroup Rhabdomyosarcoma Studies I and II (Journal of Clinical Oncology, 1990)](https://doi.org/10.1200/jco.1990.8.3.443)
5. [Predicting Outcome in Childhood Leukemia (Postgraduate Medicine, 1987)](https://doi.org/10.1080/00325481.1987.11699738)
6. [Common Solid Tumors of Childhood (New England Journal of Medicine, 1991)](https://doi.org/10.1056/nejm199102143240706)
7. [Rhabdomyosarcoma: Review of the Children's Oncology Group Soft-Tissue Sarcoma Committee Experience](https://pmc.ncbi.nlm.nih.gov/articles/PMC4008325/)
8. [The Intergroup Rhabdomyosarcoma Study-II (Cancer, 1993)](https://pubmed.ncbi.nlm.nih.gov/8448756/)
9. [The Intergroup Rhabdomyosarcoma Study Group (IRSG): Major Lessons From the IRS-I Through IRS-IV Studies (Sarcoma)](https://pmc.ncbi.nlm.nih.gov/articles/PMC2395450/)
10. [Rhabdomyosarcoma and Undifferentiated Sarcoma in the First Two Decades of Life (Journal of Pediatric Hematology/Oncology, 2001)](https://doi.org/10.1097/00043426-200105000-00008)
11. [Vincristine, Actinomycin, and Cyclophosphamide Compared With VAC Alternating With VTC for Intermediate-Risk Rhabdomyosarcoma: COG Study D9803 (Journal of Clinical Oncology)](https://ascopubs.org/doi/10.1200/JCO.2009.22.3768)
12. [Long-term Results of the Pediatric Oncology Group Studies](https://rcastoragev2.blob.core.windows.net/8a21bb61560541acd7b11453d72a3eda/PMC4300959.pdf)
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*Topic: Encyclopedia › Life and health › Life and health scientists › Medical and health researchers › Hematology and blood disorder researchers › Leukemia and AML researchers*
*Initially written Sep 21, 2026 · Reviewed: Sep 25, 2026 · Edited: Sep 25, 2026 · Last review: Sep 25, 2026*
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License: Edgepedia Community License 1.0, https://www.edgepedia.org/edgepedia/license