The Division of Pediatric Oncology offers state-of-the-art comprehensive care for children with cancer throughout the Intermountain West. Multidisciplinary teams manage care for each child treated at Primary Children's Medical Center through an individualized program that includes preventive care; crisis and emergent interventions; treatment plans for chemotherapy, radiation therapy, and surgical oncology; psychosocial services for the patient, family, local care providers, and involved community members; nutrition evaluation and support; pain management that includes pharmacologic and non-pharmacologic methods; long-term follow-up; home care and out-of-hospital care; hospice care; bereavement services; and education for staff, care providers, patients, and families.

Pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in providing care in the specialized areas listed below.

Special Expertise	� Acute lymphoblastic leukemia � Acute myeloid leukemia � Brain tumors � High-risk leukemias and lymphomas � High-risk solid tumors and sarcomas � Novel clinical therapeutic and Phase I clinical trials � Intensified therapies for high-risk patients using peripheral stem cell rescue or bone marrow transplantation � Long-term follow-up � Palliative care

General Information

Pediatric Hot Line	801.662.4700
General Information	801.662.4700
Referring Physician Hot Line	801.662.4700
Location	Salt Lake City, Utah
Physical Plant	Primary Children's Medical Center is a freestanding children's hospital physically connected to the University of Utah Hospital and Huntsman Cancer Institute.
Outreach Clinic	Outreach education programs and limited clinics are held throughout the Salt Lake Valley and the Intermountain West.
Financial Assistance	Financial counselors at Primary Children's Medical Center help families assess eligibility and apply for financial assistance. Limited funding resources are available to assist eligible patients from the Intermountain West.
Travel Assistance	Huntsman Cancer Institute's Cancer Learning Center has information about national programs that assist with travel. Transport teams can assist emergent and critical patients requiring special transport within the Intermountain West. 888.424.2100
Lodging	A Ronald McDonald House is located near Primary Children's Medical Center. Social worker referrals are required and available through Primary Children's Medical Center. Some local hotels offer special rates to families of children with cancer or with special needs.
Social Support	Educational resources are offered to staff, local care providers, families, patients, and local community members. Sibling sessions educate and troubleshoot issues with siblings of children with cancer. Age- and disease-specific group activities are also available, such as a summer camp for cancer patients and their siblings at a nearby facility, winter sports, and skiing programs. Pediatric oncology social workers exclusively treat children diagnosed with cancer or blood disorders. They offer preventive evaluation and care as well as crisis intervention. Initial evaluations, assistance programs, and ongoing services are available to all patients and their families. Social workers can refer patients to both national and local community resources.
Home Health Care	The Pediatric Oncology Comprehensive Care Team, in collaboration with local care providers, manages home care. With the exception of insurance-specific contracts, patients may choose from a variety of home care companies offering services in their geographic location.
Ages Treated	From birth to age 21 years.

Clinical and Research Information

Pediatric Oncology Director	Richard S. Lemons, MD, PhD Chief, Division of Pediatric Hematology/Oncology, University of Utah Primary Children's Medical Center 100 N. Medical Drive, Suite 1400 Salt Lake City, UT 84113 Phone: 801.588.2680 Fax: 801.588.2662 e-mail: Richard.Lemons@IHC.com
Operate Multidisciplinary Teams	Multidisciplinary teams and clinics are an integral part of the Pediatric Oncology Program. Huntsman Cancer Institute works in collaboration with Primary Children's Medical Center to offer specialty clinics for patients with brain tumors, high-risk sarcomas, and high-risk leukemias. These multidisciplinary clinics consist of specialists from areas involved in the patient's management, including the nurse practitioner, pediatric oncologist, oncology social worker, nurse specialist, dietician, pharmacist, and oncology nurses. Pediatric oncologists, radiation oncologists, neurosurgeons, neurologists, developmental neuropsychologists, nurse practitioners, oncology nurses, dieticians, child life specialists, and social workers attend each comprehensive brain tumor clinic.
Cooperative Group Membership	� Children's Oncology Group (COG) � Soft Tissue Sarcoma Group (formerly IRS) � National Wilms' Tumor Study Group (NWTSG)
Activities in Cooperative Group	Participation on COG committees: � Acute Lymphoblastic Leukemia Strategy Group and Steering Committee � Acute Myeloid Leukemia Strategy Group and Steering Committee � COG Executive Committee � COG Voting Body � Biology and Translational Research Program � Brain Tumor Committee � Discipline Committee � Publication Committee � Adolescent Cancer Committee Oncologists are principal investigators on numerous studies including the relapsed ALL committee.
Average Number of Pediatric Clinical Trials	80
Pediatric Clinical Trial Coordinator	Phillip Barnette, MD
Phase I Coordinator	Richard S. Lemons, MD, PhD 801.588.2680

Research Efforts

The physicians and support staff of the Pediatric Oncology Program and the Huntsman Cancer Institute Center for Children have an active basic clinical and translational research program. Four of the division members have extramurally funded basic laboratory research programs with the majority of their time spent in laboratory research activities. Areas of research include:

� Mechanism of DNA replication

� Gene mutation and repair

� DNA repair

� Chromosomal translocations in childhood cancers

� Circadian rhythm and cell cycle controls

� Hematopoietic stem cells and regulation of hematopoiesis

� Use of transgenic mice and transgenic zebrafish for study of gene expression and induction of childhood cancers

� Ewing's sarcoma-genetics, biology, and translational research studies

� Pediatric sarcomas

� RNAi's

Translational research projects focus on high-risk, relapsed, and resistant acute leukemias, brain tumors, and high-risk and metastatic sarcomas. These include studies of gene expression, apoptosis, and regulation of cellular differentiation. Clinical trials include local institutional, multi-institutional, and cooperative group trials with emphasis on novel clinical protocols in childhood brain tumors, relapsed or resistant acute leukemias, and relapsed sarcomas.

Special Expertise

1. Acute Lymphoblastic Leukemia (ALL)

Pediatric oncologists have developed and lead the Children's Cancer Group high-risk, relapsed, and resistant ALL treatment protocols. Oncologists participate in research projects to study the biology and genetics of high-risk ALL.

2. Acute Myeloid Leukemia (AML)

Oncologists study the biologic properties of specific types of AML to identify prognostic and risk factors. Treatment protocols using both related and unrelated donor bone marrow transplantation are available.

3. High Risk Leukemias and Lymphomas

This specially designed, high-risk clinic is staffed by a comprehensive team to identify, treat, and manage the care of high-risk leukemias and lymphomas, including relapsed, resistant, or high-risk patients.

4. Brain Tumors

Oncologists have developed novel treatment protocols for childhood brain tumors. Some of the treatment protocols are local institutional trials and others are limited institutional or collaborative group trials; all treatments incorporate biologic and genetic studies to improve understanding of the pathogenesis of brain tumors.

5. Solid Tumors and Sarcomas

Local institutional, multi-institutional, and cooperative group clinical trials are available for childhood sarcomas. Intensive therapeutic treatment plans are used for the treatment of metastatic or high-risk (metastatic, recurrent, or resistant) tumors including osteosarcoma, Ewing's sarcoma, rhabdomyosarcoma, neuroblastoma, primitive neuroectodermal tumors, undifferentiated, synovial, and other types of sarcomas.

6. New and Experimental Therapies

The Pediatric Oncology Program is an NCI-approved Phase I and II institution. Phase I and II therapies and chemotherapeutic agents are available to eligible patients.

7. Intensified Therapies for High-Risk Patients Utilizing Peripheral Stem Cell Rescue or Bone Marrow Transplantation

Treatment plans and biologic studies are used to treat high-risk patients with resistant, relapsed, or high-risk childhood cancers. Autologous, allogeneic, matched unrelated donor, and cord blood transplants are performed within the Pediatric Oncology Program. In addition, peripheral stem cell rescue is routinely available in conjunction with an increasing number of clinical protocols.

8. Long-Term Follow-Up
After completing therapy, patients undergo long-term follow-up that may include psychological, psychosocial, intellectual, behavioral, and physical evaluations.

Statistics

Percent of children treated in each age range

Age Range	0 - 1	2 - 5	6 - 12	13 +
Percent Treated	3%	30%	35%	32%

Pediatric Oncology Program, 2005

No. of Inpatient Beds	No. of Admissions	Average Length of Stay (days)	No. of New Outpatients	Total Outpatient Visits	No. of Bone Marrow Transplants	No. of Oncologists
232	700	5.0	350	7,300	28	9

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