|Cancer and Blood Disorders |
The Center for Cancer and Blood Disorders
|Office Hours:||8 am until 4:30 pm Monday Through Friday|
Lolie Yu, MD, Director
Renee Gardner, MD
Maria Velez, MD
Jaime Morales, MD
Cori Morrison, MD
Pinki K. Prasad, MD
The Center for Cancer and Blood Disorders at Children's Hospital provides comprehensive care with a team approach. Faculty from LSU Health Sciences Center works with a team of specialized professionals including surgeons, pathologists, radiologists, radiation oncologists, nurses, pharmacists, psychologists, social workers and others to provide up-to-date, compassionate "total care" for the child and family. The hospital has dedicated areas for inpatient and outpatient care, providing treatment for children with cancer, sickle cell anemia, hemophilia, and other blood disorders.
The program is a part of the National Cancer Institute (NCI) approved LSUHSC/Children's Hospital Minority CCOP, and is a member of the Children's Oncology Group (COG) a nationwide Children's Cancer Study Group. The program is recognized by COG and Hematopoietic Stem Cell Transplant (HSCT) as well as the National Marrow Donor program and is affiliated with the CIBMTR and Louisiana's registries.
Pediatric surgery, orthopedic surgery, neurosurgery, pathology, radiation oncology, diagnostic radiology, and other pediatric subspecialists and laboratory facilities for studies of genetic disorders, bleeding disorders, and hemoglobinopathy are all available at the center. Radiation oncologists work closely with physicians at the center and work out of Touro Infirmary, which is near Children's Hospital.
Management expertise includes, but is not limited to:
- Leukemia, lymphoma, brain tumor, neuroblastoma, Wilms tumor, rhabdomyosarcoma and other childhood cancers
- Anemia, including sickle cell anemia
- Bleeding disorders, including ITP and hemophilia
- Hematopoietic stem cell transplant (related and unrelated donors)
In 2005, more than 846 patients received treatment at the Center for Cancer and Blood Disorders. The center followed 269 oncology patients and 575 hematology patients, including 245 with sickle cell disease.
In 1989, Children's Hospital was approved as a Pediatric Hospital Cancer Program by the American College of Surgeons. Our program is affiliated with the Louisiana State University's Minority Community Clinical Oncology Program (MCCOP), which is accredited by the National Cancer Institute. Children's Hospital is also a member of the Children's Oncology Group (COG), a national study group of premier research institutes in the United States and Canada. Our hospital has the only approved COG hematopoietic stem cell transplant program in Louisiana.
Though patient care is our primary focus, Children's Hospital is an active participant in clinical and basic research of childhood cancers and blood disorders.
Our physicians have access to the most modern therapies for treatment of malignancies and blood disorders in children.
The Center for Cancer and Blood Disorders is also a teaching facility for medical students, nursing students and those completing graduate and postgraduate training. Our program has the only approved, dedicated hematology/oncology fellowship training in the state of Louisiana. This program is part of the Louisiana State University Health Sciences Center (LSUHSC) Department of Pediatrics and the Stanley S. Scott Cancer Center of LSUHSC.
The Center for Cancer and Blood Disorders at Children's Hospital comprises the largest group in the Gulf South of hematology and oncology physicians and nurses dedicated exclusively to pediatrics. They are specially trained to care for the unique needs of children and work side by side with a medical staff of more than 200 pediatric specialists, including pathologists, radiologists, oncology surgeons and neurosurgeons.
Our pediatric experts realize that caring for children with malignancies and blood disorders commands a delicate balance of medical care and emotional support. Support for patients and their families is provided by child psychiatrists, psychologists and social workers. Other members of the multidisciplinary team include hematology/oncology hematopoietic stem cell transplant coordinators, pharmacists, dieticians, laboratory technologists, and physical, occupational, speech and hearing, music and recreation and child life therapists.
Lolie C. Yu, MD, Division Chief
Director, Bone Marrow Transplant Program, Children’s Hospital/LSUMC
Professor of Pediatrics, LSU Health Sciences Center
LSU CCOP/Children's Oncology Group (COG) Principal Investigator
University of Santo Tomas
University of Texas
LSU Health Sciences Center, New Orleans
Fred Hutchinson's Cancer Center, Seattle, WA
Masters in Public Health
Stem cell transplant, CD34 Stem Cell, Cord Blood, Veno-occlusive Disease, Nutrition and cancer, Neuroblastoma, Dendritic Cells
|Renee V. Gardner, MD|
Director, Sickle Cell Clinics
Professor of Pediatrics, LSU Health Sciences Center
Harvard Medical School
SUNY/Buffalo, Jackson Laboratory, NIDDK
Sickle cell anemia, Leukemia/lymphoma, Late effects in cancer survivors
In Area Since: 1993In Practice Since: 1975
Jaime Morales, MD
Pediatric oncologist, Children's Hospital
Assistant Professor of Pediatrics, LSU Health Sciences Center
Autonomous University of Guadalajare
Monmouth Medical Center, Longbranch, NJ
University of Texas, MD Anderson Cancer Center, Houston, TX
Miami Children's Hospital, Miami, FL
In Area Since: 2008
In Practice Since: 2000
Cori Morrison, MD
Pediatric oncologist, Children's Hospital
Louisiana State University School of Medicine
LSU Health Sciences Center, Pediatric Hematology / Oncology
|Maria C. Velez, MD|
Pediatric oncologist, Children's Hospital
Associate Professor of Pediatrics, Pediatric Hematology-Oncology Fellowship Program Director, LSU Health Sciences Center
University of Puerto Rico, School of Medicine and Health Sciences Campus, San Juan, Puerto Rico
Pediatric University Hospital, University of Puerto Rico SoM affiliated, San Juan, Puerto Rico
National Cancer Institute, National Institutes of Health, Bethesda, Maryland
Pediatric brain tumors, leukemias, thrombocytopenias, anemias
In Area Since: 1995
In Practice Since: 1995
Pinki K. Prasad, MD, MPH
Assistant Professor of Pediatrics
Pediatric Hematologist Oncologist
Director, Late Effects Center
University of Sint Eustasius School of Medicine, Netherlands
Pediactric Hematology/Oncology - Vanderbilt University, Nashville, TN
Master's in Public Health - Vanderbilt University, Nashville, TN
Pediatrics - Southern Illinois University, Carbondale, IL
Late effects; survivorship
In Area Since: 2009
In Practice Since: 2009
A full range of treatment options is available for children with acute or chronic lymphocytic and myelogenous leukemia, including chemotherapy, stem cell transplantation and radiation therapy. Oncology physicians and nurses offer and implement the treatment plan adequate for each child based on the type of leukemia and certain prognostic factors. Children with Hodgkin's disease and non-Hodgkin's lymphoma (NHL) are thoroughly evaluated and promptly treated according to the specific subtype and stage of the disease. They are supported by a team of psychologists, social workers and other specialized professionals who provide compassionate "total care" for the child and family.
SOFT TISSUE AND SOLID TUMORS
At Children's Hospital, pediatric experts treat a variety of tumors including neuroblastoma, tumors of the central nervous system (brain and spine), soft tissue sarcoma, bone sarcoma, retinoblastoma and Wilms tumor. The Center for Cancer and Blood Disorders is represented by the following medical and surgical disciplines: pediatric oncologic surgery, pediatric neurosurgery, pediatric neuro-oncology, genitourinary oncologic surgery, orthopedic oncologic surgery, pediatric ocular surgery, radiation oncology and pediatric pathology. Members of our medical team are highly skilled individuals dedicated to providing the latest innovative treatments to our young patients.
STEM CELL TRANSPLANT PROGRAM
Hematopoietic stem cell transplantation (HSCT) has become an alternative approach in the treatment of malignant diseases for many patients. For some diseases, the five-year survival rate surpasses that of chemotherapy alone. The list of diseases for which hematopoietic stem cell transplantation has been considered grows almost daily. Hematopoietic stem cell transplantation allows administration of cytoreductive therapy with curative intent, without regard for the lethal effects to the marrow of this treatment regimen. The sources of stem cells are bone marrow, peripheral blood stem cells mobilized by growth factors or chemotherapy, and cord blood.
The Children's Hospital hematopoietic stem cell transplant program began in January 1989. From January 1989 to December 2005, 185 transplants were performed. Of those performed, 126 were allogeneic and 59 were autologous. By far, the most common conditions for which HSCT has been carried out are hematologic malignancies, e.g., acute leukemia.
Diseases such as leukemia are treated here at Children's Hospital, New Orleans with the same protocols as those of the 240 Children's Oncology Group (COG) institutions (e.g. St. Jude, MD Anderson, Johns Hopkins) adopted throughout the nation. COG has recognized Children's Hospital as the only hematopoietic stem cell site in Louisiana for COG protocol studies.
A multidisciplinary team of physicians, nurses, social workers, nutritionists, pharmacists, physical therapists, psychologists and blood bank personnel is available, with experience and commitment to the clinical practice and basic science of hematopoietic stem cell transplantation.
In July 2000, Children's Hospital, led by Dr. Lolie Yu, became accredited by the National Marrow Donor Program® (NMDP) as a transplant center. Through the NMDP, Children's Hospital has access to the largest worldwide registry of hematopoietic stem cell donors. This affiliation provides patients with the best chance of finding a suitable donor for transplantation. Children's Hospital, in collaboration with LSUHSC, is also an approved COG hematopoietic stem cell transplant center with Dr. Yu as the principal investigator. Our HSOT program is also affiliated with the PBMTC and the BMT- CTN network.
For more information regarding the hematopoietic stem cell transplant center at Children's Hospital, please contact the Hematology/Oncology office or Dr. Lolie Yu at (504) 896-9740.
CHILDREN'S ONCOLOGY GROUP
The Children's Oncology Group (COG) is a National Cancer Institute (NCI) -sponsored cooperative group of individuals and institutions dedicated to treating cancer among children and adolescents. COG's purpose is to:
- improve the diagnosis and management of children and adolescents with cancer, with the aim of curing every newly diagnosed patient;
- investigate the etiology, pathology and pathophysiology of childhood cancer;
- assure that every child with cancer achieves the highest quality of life during and following treatment;
- expeditiously disseminate knowledge of these objectives in all appropriate media.
Children's Hospital and the LSUHSC/Stanley S. Scott Cancer Center have been members of COG for almost 20 years. This allows the Children's Hospital/LSUHSC Minority Community Clinical Oncology Program (MCCOP) to offer innovative and up-to-date clinical trials as part of the NCI-sponsored COG.
The hematology/oncology service treats a wide variety of hematologic disorders including sickle cell disease and other anemias, neutropenias, platelet and bleeding disorders. Our hematology service follows that largest group of sickle cell disease patients in the state of Louisiana.
More children with blood disorders come to Children's Hospital for treatment than to any other hospital in the state. They receive the highest level of care from a medical staff experienced in the latest treatments for a full spectrum of disorders.
HEMOPHILIA AND OTHER BLOOD DISORDERS
Patients with hemophilia, von Willebrand's disease, idiopathic thrombocytopenia purpura and other bleeding disorders are evaluated and treated with the most current therapies. Appropriate support for patients and parents is offered as needed. Nurse coordinators educate and coordinate the patient's care in clinic as well as at home.
Treatments that once required a child to be admitted are now often given on an outpatient basis. Patients visiting the hematology/oncology outpatient clinic at Children's Hospital are treated in an environment that places the comfort and care of the child and family first. In the hospital's Ambulatory Care Center, a separate patient suite with a private entrance and waiting area has been dedicated for patients with cancer or blood disorders. The location is convenient for families and provides the safest and protective conditions for immunocompromised patients.
Patients visiting our outpatient clinic are closely monitored by their pediatric hematologist/oncologists and nurses and receive a variety of treatments, including blood transfusions, platelet transfusions, gammaglobulin infusions, factor concentrates, and chemotherapy treatments.
In addition to eight private rooms, a large treatment room provides patients an opportunity to interact with other patients, watch TV, choose videos from a movie library, play games or simply relax while receiving treatments. With an average of 25 to 30 patient visits a day, the clinic is open Monday through Friday, 8 a.m. to 4:30 p.m.
If the need arises during a clinic visit, patients can be promptly admitted to the hospital's acute care unit, designated specifically for hematology/oncology patients.
SICKLE CELL ANEMIA
At Children's Hospital, the Sickle Cell Disease Clinic is held once a week and offers comprehensive treatment in pain management, transfusion and chelation therapy, as well as psychosocial support and counseling. Sickle cell clinics in collaboration with LSUHSC are also held in Baton Rouge, Lafayette and Lake Charles
Children's Hospital is also part of the STOP II trial, a NIH-sponsored study to evaluate and prevent strokes in patients with sickle cell disease. Because of this participation, Children's Hospital was one of the first facilities in the state of Louisiana to provide expertise in doing transcranial Doppler sonography (TCD) through our radiology department, headed by Dr. Ken Ward. This imaging study determines which sickle cell patient is at risk of stroke and which interventions are instituted to prevent this devastating complication.
Children's Hospital is also the site of a Novartis-sponsored study of the efficacy of the new oral chelator, Exjade, which has engendered considerable excitement in the Hematology field. It offers patients with hemoglobinopathies such as sickle cell disease and thalassemia (as well as other disorders requiring chronic transfusion [e.g., Diamond-Blackfan anemia or aplastic anemia]) the opportunity to prevent and lessen iron overload, which would otherwise lead to cumulative toxicity to the heart, lungs and liver. It promises to improve compliance, eliminating the tedious and painful Desferal injections, and by doing so, eventually improve quality of life and extend life expectancy. The hematology/oncology service is also involved in a trial of a novel agent manufactured by Celgene that is designed to prevent dehydration of sickle cells, a process that is implicated in the evolution of sickling. These and other trials are being conducted with the aim of finding means to prevent and treat more effectively the complications of sickle cell and its treatments.
Individuals interested in participating in or learning about these trials should contact Drs. Renée Gardner at (504) 896-9740.
The members of the Hematology/Oncology section of the Department of Pediatrics have maintained an interest in research, in the effort to improve care and expand knowledge regarding the various disease processes that are encountered by patients. One main venue for research has been the Children's Oncology Group, in which all members of the Division participate. Collaborations with other LSUHSC faculty and Research staff are continuously being sought out and conducted. They have included:
- Cellular responsiveness, the role of arginine in the production of cellular response to cancer cells and anergy. (Drs. Augusto Ochoa and Arnold Zea)
- The role of acetylated glycation end-products (AGEs) in the development of short- and long-term complications of sickle cell disease. (Dr. James Hempe)
- The use of counterimmunoelectropheresis in the diagnosis of hemoglobin variants. (Dr. James Hempe)
- The role of cells in improving immune function post HSCT. (Drs. Yu and Yan)
- Glucocorticord sensitivity in leukemia. (Drs. Wayne, Geng, Yu, Velez, Garner)
- The role of human- placental derived stem cells (HDPSC) in facilitating engraftment in cord blood transplantation. (Dr. Yu in collaboration BMT-CTN)
- Single vs. double cord blood transplant for pediatric patients with HR leukemia and MDS. (Dr. Yu in collaboration with BMT-CTN)
As noted, the division has been involved in a study on the new oral chelator, Exjade, and the study of an inhibitor of cellular dehydration, Icagen, in sickle cell disease. They also are members of the clinical trial of a novel molecular transcriptional inhibitor, produced by Biocryst, that has shown potential for the treatment of resistant or intransigent T-cell leukemia, and possibly resistant B cell malignancies. In addition, the division maintains a long-time interest in late-effects and a study of the reasons for their development. Clinical projects involving sickle cell disease, nutrition, alternative medicine, as well as studies entailing chart review, are currently in progress.
LANASA-GRECO CENTER FOR CANCER AND BLOOD DISORDERS
In November 2003, the LaNasa-Greco Center for Cancer and Blood Disorders opened its doors on the fourth floor of Children's Hospital. The inpatient unit boasts 18 private rooms with state-of-the-art environment and comfort for patients and families. Each room, as well as the entire unit, is equipped with high efficiency particle air (HEPA) filtration. The highly advanced air handling system allows hematopoietic stem cell transplants to be performed in any room and is essential to reducing the risk of infection. Located away from other inpatient areas and accessed through a positive pressure vestibule, the unit allows for the highest level of protection for patients.
The unit, overlooking Audubon Park, also includes a playroom stocked with games, toys, art supplies and computers, and an activity center, where music and recreation therapists can interact with small groups of children for organized play. A parent's lounge is available for those needing peace or respite.
When admission is indicated, pediatric oncologists, oncology nurses and other members of the multidisciplinary team devise an individual treatment plan for each patient. Patients and their families develop a special bond with the staff on the fourth floor, and the staff is committed to helping them cope both emotionally and physically with the side effects and complications associated with the disease and treatments.
For more information on the Treatment After Cancer & Late Effects Center, click here.