National Comprehensive Cancer Network

Through Seattle Cancer Care Alliance, pediatric patients have access to a broad range of oncology services offered by Fred Hutchinson Cancer Research Center, Seattle Children's, and UW Medicine.. These services include chemotherapy, radiation therapy, surgery, and bone marrow transplantation. The primary aims of the pediatric services are to provide optimal patient care for children with cancer and to engage in both clinical and basic research to develop and evaluate new approaches for the treatment of childhood neoplasia.

General information

Special Expertise

Bone Marrow and Stem Cell Transplant Program

Fred Hutchinson Cancer Research Center performs approximately 400 transplants a year, including 50-60 pediatric transplants. Transplantation is available for all types of hematologic malignancies and non-malignant hematologic disorders as well as a number of solid tumor, genetic disorders, and autoimmune diseases. Active protocols exist for transplantation with bone marrow, peripheral blood stem cells, and umbilical cord blood from related as well as unrelated donors. (UBC, normally discarded after the delivery of a newborn, is increasingly utilized as a stem cell source for transplantation. UCB has the advantageous quality of an immature immune system, which allows it to be used for transplant, even when not fully matched to the patient, without increased risk.
Therefore, even those patients who cannot identify a standard related or unrelated donor can still get a potentially life-saving transplant with UCB.)

Hutchinson Center performs all types of donor transplants: autologous-self donor, syngeneic-identical twin donor, allogeneic-related donor, allogeneic-unrelated donor, and allogeneic-"mismatched" donor. Also performed are myeloablative and non-myeloablative transplants. Children who require bone marrow transplantation receive their treatment at Seattle Children's.

Physicians from SCCA, Fred Hutchinson Cancer Research Center, and Seattle Children's take care of children with all types of leukemias, neuroblastoma, and lymphoma.

Continuing Care Chronic Graft vs. Host Disease (GVHD) Clinic

This special clinic is available to any pediatric patient at high risk to develop or who has developed clinical chronic GVHD. These pediatric patients are followed weekly at Hutchinson Center outpatient clinic and are treated according to Hutchinson Center chronic GVHD protocols or practice policies. This clinic is under the direction of Dr. Jean Sanders, who keeps in contact with the patient's primary care community physician regarding patient management issues.

Graft vs. Host Disease

Prevention of and treatment of acute and chronic GVHD continues to be a particular area of clinical and research interest of Hutchinson Center investigators. Pediatric patients are eligible for entry into all prevention and treatment trials with novel regimens and/or agents. All patients are evaluated at approximately day 80 post-transplant for presence of or risk of chronic GVHD.

Long-Term Follow-Up

Following patients long-term, determining the problems that they encounter, and carefully evaluating children with respect to the impact of the bone marrow or stem cell transplant process on their subsequent growth and development into productive adult citizens is a special area of interest and on-going clinical research. Dr. Jean Sanders directs the pediatric long-term follow-up program. Patients may return to Seattle for a comprehensive one-week evaluation annually or have the major portions of this evaluation performed at home. The goal is to discover specific abnormalities early in order to institute treatment.

Long-term follow up care is provided to cancer survivors through two programs. Seattle Children's ACCESS (After Cancer Care Ends Survivorship Starts) program is for hematology/oncology patients treated at Seattle Children's. All other transplant patients are seen through Fred Hutchinson Cancer Research Center's Long-Term Follow-up Program. Both programs are designed to meet the unique health-care needs of long-term survivors of cancer and their families. Both focus on health promotion and prevention. ACCESS addresses potential risks of developing complications secondary to childhood cancer and its treatments. A variety of long-term effects have been observed that may interfere with various organ systems, psychological well-being, and quality of life. For most survivors, these late effects are not serious, but are important to monitor. With education, intervention, and empowerment, survivors can take charge of their health and manage these problems.

Pediatric Surgeons

Pediatric surgeons from all major surgical specialties are on staff at Seattle Children's. Neurosurgery, transplant surgery, and limb-salvage orthopedic surgery represent a few of these specialties that are uniquely available at Seattle Children's. Pediatric General and Thoracic Surgeons use minimally invasive surgery whenever possible to diagnose and treat pediatric cancer. Pediatric experts in imaging, radiology, and surgery work with our pediatric pathologists to make accurate diagnoses from a minimum of tissue, reducing physical trauma and emotional distress.

Tumor resection by minimally invasive techniques such as thoracoscopy or laparoscopy is often made possible by neoadjuvant, or "up-front" chemotherapy, which can reduce tumor size. These approaches can decrease morbidity, shorten recovery, improve long-term survival, and improve the quality of life for survivors of childhood cancer.

Pediatric Bone and Soft-Tissue Sarcoma Program

The Pediatric Bone and Soft-Tissue Sarcoma Tumor Program brings high-quality care to children and adolescents with musculoskeletal tumors. Metabolic imaging methods, such as positron emission tomography (PET), have improved our ability to evaluate musculoskeletal malignancies, including their response to neoadjuvant chemotherapy. Our bone transplantation and skeletal reconstruction procedures leave patients with more function than older techniques did.

Pediatric Neuro-Oncology Program

The Pediatric Neuro-Oncology Program provides leading-edge technology to patients with brain or spinal cord tumors. A multidisciplinary pediatric cancer team provides a unified approach to cancer care in dedicated child-friendly inpatient and outpatient units. These physicians staff a weekly clinic for brain and spinal cord tumor patients. The pediatric team includes:

· Neuro-oncologists

· Pediatric neurosurgeons

· Radiation oncologists

· Pediatric anesthesiologists

· Advanced practice nurses

· Staff nurses with special training in the care of children with cancer

· Nutritionists and diet technicians

· Occupational, physical, and child life therapists

· Oncology pharmacists

· Social workers

· Educators

· Other disciplines as needed

Functional brain mapping and electrocorticography is used when a tumor is close to language or motor areas or is causing seizures. The program also uses state-of-the-art frameless stereotactic equipment as well as microscope and laser equipment.

Radiation Therapy

Radiation therapy is provided to our pediatric patients at University of Washington Medical Center, which offers state-of-the-art treatment technologies including: 3-D conformal treatment planning, Gamma knife stereotactic radiosurgery, and both permanent and temporary brachytherapy implants. A board-certified pediatric radiation oncologist participates in our Tumor Boards, providing continuity of care for our patients who receive radiation therapy here. I-131 radiolabeled antibody therapy is also available.

Statistics - Pediatrics

Percent of children treated in calendar year 2006