National Comprehensive Cancer Network

NCCN Research & Business Resources

Pediatric Oncology Services

Introduction

Learning that a child has cancer is probably the most frightening news a parent can ever receive. Every day, City of Hope’s team of researchers aggressively studies the science behind childhood cancers. These studies mean that our scientific team and their partners bring new therapies to kids as fast and safely as possible.

An essential element in the care of all pediatric patients at City of Hope is the unique ability to integrate advanced research and treatment within a humanitarian environment that provides emotional and spiritual support to patients and their families. Whenever possible, treatment programs are developed that minimize hospitalization and maximize the time spent at home and in other normal childhood activities. The pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

Special Expertise	City of Hope’s Pediatric Cancers Program specializes in treatment for many childhood cancers and conditions, including: Brain tumors including neuroblastoma Hemophilia and sickle cell anemia Leukemias Acute lymphocytic leukemia (ALL) Acute myelogenous leukemia (AML) Lymphomas Hodgkin’s disease Non-Hodgkin’s lymphoma Musculoskeletal tumors including bone and soft tissue sarcomas

General Information

General Information	800.826.HOPE (4673)
Referring Physician Line	800.826.HOPE (4673)
Location	Duarte, California (Los Angeles)
Physical Plant	The Pediatric Family Center at City of Hope Helford Clinical Research Hospital provides special accommodations for children and teen patients, including a playroom, teen room, family lounge and a library. Rooms feature a comfortable sleeper chair for overnight visitors, video game systems and Internet access.
Travel Assistance	Assistance with patient travel to City of Hope is available through our social work office. Contact 626.256.HOPE (4673), ext. 62282 for more information. Transportation may be available on a case-by-case basis.
Lodging	In keeping with our mission to care for the whole person – physically and emotionally – City of Hope is one of the few cancer centers in the country to offer patients and their caregivers temporary, on-site housing in a comfortable, home-like setting. Each of the onsite 40 studio-style units in the Hope and Parson’s Village offers the following amenities: a fully equipped kitchen with refrigerator and stove or microwave two twin beds a full bath television, VCR and DVD emergency phones providing one-touch access to the operator and security trams staffed 24 hours a day to transport patients to and from therapy or infusion procedures a laundry room equipped with four washing machines and four dryers available to patients and their caregivers free of charge a lounge area for overnight visitors, featuring a complete kitchen with refrigerator, stove and shower a computer room, open seven days a week, with Internet and e-mail access the Cuervo Comedy Theatre featuring live entertainment, including musicians, comedians, movies and bingo In addition, an exclusive RV park containing six spaces equipped with full hookups to water, electricity and disposal is available to all families. Transplant patients staying in the Hope & Parson’s Village also have access to all of the facilities available on campus, such as the Sheri & Les Biller Patient and Family Resource Center, Supportive Care Resource Desk, Positive Image CenterSM, cafeteria, automated teller machine and Pastoral Care Services. For more information contact the Hope & Parson’s Village at 626.256.HOPE (4673), ext. 62380. Furthermore, close by and comfortable, many hotels and motels in neighboring communities offer special discounts to City of Hope patients and their families. Visit the “Patient and Visitor Guide” section of our Web site for a complete list.
Social Support	Professionals in psychology, social work, recreational therapy, music and art therapy, and school relations provide individual attention and group activities for patients and their families. They provide individual attention and therapy as well as group activities for families, siblings, teens and children.
Home Health Care	Home health is coordinated with home health nursing agencies, pharmacy agencies, and hospice services.
Ages Treated	The Pediatric Cancers Program’s focus extends to treating older adolescents and young adults, ensuring a continuum of care through the years for this special group of patients. We also emphasize successful survivorship – continued surveillance to monitor and proactively address long-term effects of childhood cancer.

Clinical and Research Information

Acting Chair of Pediatrics and Director of Pediatric Hematology/Oncology	Judith K. Sato, MD
Operate Multidisciplinary Teams	At City of Hope, our team of pediatric experts provides comprehensive care, offering both outstanding medical treatment and psychosocial support to young cancer patients and their family members. Pediatric oncologists, surgeons, radiation oncologists, pathologists, and other specialists work in concert to develop a targeted, effective treatment plan.
Cooperative Group Membership	Children’s Oncology Group (COG)
Activities in Cooperative Group	Participation in COG disease committees including: Developmental Therapeutics, Ewing’s Sarcoma, Osteosarcoma, Soft Tissue Sarcoma-Rhabdomyosarcoma, and Epidemiology and Late Effects. Physicians are principal investigators on numerous clinical trials.
Average Number of Pediatric Clinical Trials	25

Research Efforts

The Pediatric Neuro-oncology program at City of Hope is evaluating the potential of augmenting the antitumor response of T cells, a class of white blood cells that are part of the body’s immune defenses against infection or cancerous cells. Through a process called adoptive T cell therapy, T cells that can recognize and attack cancer cells are isolated from patients, their numbers significantly increased outside of the body and then reinfused back into the patients, delivering highly specific and potentially minimally toxic therapy.

Special Expertise

Hematopoietic Cell Transplantation

City of Hope’s Pediatric Hematopoietic Cell Transplantation (HCT) Program provides lifesaving treatment to patients from infancy to early adulthood. Numerous blood diseases, including leukemia, lymphoma, Fanconi anemia and acquired aplastic anemia are treated. Also, HCT after high dose chemotherapy is performed for solid tumors such as neuroblastoma and sarcoma. In addition, unique clinical research protocols are offered, ensuring innovative therapy is available to appropriate patients.

Musculoskeletal Tumors/Bone and Soft Tissue Sarcomas

Our comprehensive Musculoskeletal Tumor Program focuses on the diagnosis and treatment of pediatric cancers of the bone, muscle and cartilage. The multidisciplinary program is directing novel clinical studies investigating new therapies for children with these and other types of cancer, integrating precise surgical and reconstructive techniques thus optimizing their ability to be cured of their cancer while allowing them to continue to walk on their own limbs.

Hemophilia and Sickle Cell Disorders

The Pediatric Hemophilia and Sickle Cell Program provides care to children and young adults with inherited coagulation disorders such as hemophilia, and blood cell disorders such as sickle cell anemia. Current research focused on the accurate diagnosis and treatment of these diseases. Researchers are investigating risk factors leading to bleeding factor inhibitor development and immune tolerance induction regimens.

Immunotherapy

Immunotherapy, which stimulates or boosts the body’s immune system so it can fight cancer more effectively, offers hope as a therapy for cancers that are incurable or difficult to treat such as relapsing leukemia, neuroblastoma and brain tumors. In addition to killing cancer cells, immunotherapy stimulates the patient’s immune system to “watch out” for other cancer cells – known as immunosurveillance – and thus become part of the patient’s continuing defense against cancer.

Solid Tumors and Brain Tumors

Our pediatric oncologists focus on developing innovative strategies for the treatment of high risk, poor prognostic solid tumors, including brain tumors. Investigating pediatric neuro-oncologic disease in the laboratory and then applying these strategies to clinical patient care is a special focus of research at City of Hope. Immune-based therapies are developed in the laboratory and then used to treat malignancies including neuroblastoma, malignant tumors formed from embryonic nerve cells outside of the brain and spinal cord; and medulloblastomas and gliomas, cancers of the brain and spinal cord. Patients suffering from brain and spinal cord tumors are treated using advanced radiological techniques to tumors, which are then removed surgically. City of Hope was the first in the western U.S. to use the advanced radiological helical TomoTherapy system which couples three-dimensional imaging with innovative intensity-modulated radiation therapy, or IMRT, to target only the tumor while sparing the healthy tissues around it, thus reducing the risk of long-term cognitive problems. Prior to surgery, advanced technology called magnetic resonance spectroscopy is used to gather information on the cellular metabolism of the patient’s brain, which is then combined with anatomical images of the brain, resulting in optimal removal of cancerous tissue.

Survivorship and Late Effects

While almost 80 percent of all children with cancer are being cured of their diseases, the late effects of their treatment must be examined. City of Hope researchers have developed and continue to test their widely used quality-of-life survey in one of the largest cohorts of patients in the United States. Analysis of their results is critical to the development of future protocols. Extensive research, supported by the National Cancer Institute, the Leukemia and Lymphoma Society and the Lance Armstrong Foundation, is focusing on the health and well-being of the cancer survivor. Several studies are exploring the physical, psychological and neurocognitive health of our children treated for cancer. Furthermore, studies are under way to understand the contribution of genetic susceptibility and the environment in the development of late complications after successful treatment of childhood cancer.

Statistics

Percent of children treated in each age range

Age Range	0-1	2-5	6-12	13+
Percent Treated	6%	14%	32%	48%

Pediatric Oncology Program

No. of Inpatient Beds	18
No. of Admissions	432
Average Length of Stay (days)	9.84
No. of New Outpatients	804 (total OP)
Total Outpatient Visits	5,062
No. of Bone Marrow Transplants	47
No. of Oncologists	8

• Profile Overview
• Adult Oncology
• Genetic Testing
• Pediatric Oncology
• Find Clinical Trials