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Pediatric Oncology Services

Introduction

The Comprehensive Cancer Center at The Ohio State University provides pediatric oncology services at Nationwide Children's Hospital and at the James Cancer Hospital and Solove Research Institute. Nationwide Children's Hospital is one of the nation's recognized pediatric leaders. The program conducts both basic and clinical investigations, and the leadership of the Comprehensive Cancer Center focuses primarily on developing and applying new knowledge by bringing groundbreaking laboratory research directly to the patient's bedside. This focus translates solid tumor research into clinical studies that result in improved therapy and quality of life for children with cancer. The pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

General Information

Special Expertise

Blood and Marrow Transplantation

Brain Tumors

Bone Tumors

Leukemias

Lymphomas

Soft Tissue Sarcoma

Neuroblastoma

Pediatric Solid Tumors

Long-term Follow-up of Childhood and Adolescent Cancer

Psychology/Neuropsychology for Children and Adolescents

In collaboration with the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute (OSUCCC-James) unique capabilities exist in:

Intra-operative radiotherapy (IORT)

High-dose-rate brachytherapy

Gamma knife

Intensity modulated radiation therapy (IMRT)

Pediatric Referral and Information

General Hematology Oncology
Phone: 614.722.3250
Fax: 614.722.3271

Blood and Marrow Transplantation
Phone: 614.722.3558
Fax: 614.722.3699

Weekends, Holidays, and Weekdays after 5PM

Phone: 614.722.2000

General Information

Nationwide Children's Hospital Operator
Phone: 614.722.2000
www.nationwidechildrens.org

Referring Physician

General Hematology Oncology
Phone: 614.722.3250
Fax: 614.722.3271

Location

Columbus, Ohio

Pediatric Oncology services at the OSU Comprehensive Cancer Center-James Cancer Hospital and Solove Research (OSUCCC-James) reside at Nationwide Children's Hospital.

Physical Plant

The new Hematology/Oncology Unit at Nationwide Children's Hospital opened in 2002. The 31-bed, HEPA-filtered unit has eight rooms dedicated for Blood and Marrow Transplant patients. The unit contains a four-bed apheresis facility, a Day Hospital, an outpatient clinic for Blood and Marrow Transplant patients, and a dedicated hospice room. It is served by a dedicated pharmacy staffed from
7:30 AM-6:00 PM. There are laundry facilities, parent showers, a family kitchen, and family lounge areas on the inpatient unit.

The outpatient clinic is in the Outpatient Care Center and includes an infusion area for chemotherapy, fluids, and blood products, and a dedicated pharmacy. Radiation oncology services are provided at the OSUCCC-James Cancer Hospital and Solove Research Institute.

Travel Assistance

Nationwide Children's Hospital social workers coordinate transportation for patients as needed.

Lodging

A new Ronald McDonald House opened in place of the former one in 2005 on the hospital campus. There are four dedicated suites for immune-compromised patients and their families. The Clinical Services and Care Coordination department assists with lodging and can be reached at 614.722.6300.

Social Support

Psychology, Nutrition, Dental, Child Life, Physical Therapy, Occupational Therapy, and Recreational Therapy specialists work as members of the interdisciplinary team to support the psychosocial, developmental, and emotional needs of patients and their families. An educational specialist is available as a liaison to the child's school. Tutoring and a school re-entry program are available. There is a sibling support group and a "Clubhouse" for siblings of children in the hospital. Nationwide Children's Hospital runs an annual weekend camp for children with hematologic and cancer diagnoses. Visitation for parents is 24 hours a day.

Home Health Care/Hospice

Nationwide Children's Hospital offers many services to meet the needs of children at home throughout central Ohio either through Children's Homecare or working through other community-based agencies. To contact Children's Homecare, call
614.461.2727 or 800.466.2727.

Children's also offers hospice services for pediatric oncology patients. This service is JCAHO-accredited and certified by Medicare/Medicaid. It is the only pediatric hospice program in central Ohio. It provides homecare services to meet the physical, emotional, and spiritual needs of terminally ill children and their families. To contact Nationwide Children's Hospice program, call 614.722.3556.

Ages Treated

Children of all ages, from birth to age 20, are treated at Nationwide Children's Hospital, including young adults with pediatric disease diagnoses.

Clinical and Research Information

Pediatric Oncology Director

Thomas G. Gross, MD, PhD

Phone: 614.722.3552
Fax: 614.722.3699

Director, Pediatric Blood and Marrow Transplant Program

Amanda M. Termuhlen, MD
Phone: 614.722.3552
Fax: 614.722.3699
e-mail: amanda.termuhlen@nationwidechildrens.org

Multidisciplinary Teams

All children and adolescents diagnosed with cancer are treated by a multidisciplinary team consisting of a pediatric oncologist, nurse practitioner, nurses, psychologists, social workers, child life specialists, education specialists, pharmacists, and therapists. There are formal teams that care for patients with brain or bone tumors, long-term survivors, and those undergoing blood or marrow transplantation.

Cooperative Group Membership

Children's Oncology Group (COG)

Childhood Cancer Survivor Study (CCS)

Pediatric Blood and Marrow Transplant Consortium

International Bone Marrow Transplant Registry (research member)

National Bone Marrow Donor Program

Cooperative Group Activities

The Pediatric Blood and Cancer Program at Children's Hospital is one of the largest and most active members of the Children's Oncology Group. The Division Chief, Tom Gross, MD, PhD, is the chair of the Non-Hodgkin's Lymphoma Strategy Group and chairs a protocol for the treatment of post-transplant lymphoproliferative disease.

The associate chief, Amanda Termuhlen, MD, is chair of a Rare and Cutaneous Non-Hodgkin Lymphoma Registry, vice-chair of the treatment protocol for all newly diagnosed lymphoblastic lymphomas, and a member of the protocol committee running a trial for relapsed B-cell lymphomas. She is on the Voting Body, Adolescent and Young Adult Committee, and is a member of both the Hematology/Oncology and the Stem Cell Transplant discipline.

Fred Ruymann, MD, former principal investigator in the Children's Cancer Oncology Group and active in the Intergroup Rhabdomyosarcoma committees, chairs the Children's Oncology Group Membership Committee. Several advanced practice nurses and clinical research associates serve on Children's Oncology Group committees, including late effects and the treatment of neuroblastoma, nasopharyngeal carcinomas, and Hodgkin's disease.

Clinical research is supported by a staff of Clinical Research Associates and managed by Barb Pugh, RN, MS, CCRP. The clinical research office can be contacted at 614.722.3568.

Average Number of Trials

100

Research Efforts

In 2004, the Center for Childhood Cancer was established as a new Center of Emphasis in The Research Institute at Nationwide Children's Hospital. The Center for Childhood Cancer strives to expand understanding of the pathogenesis of childhood cancer through basic and translational research. The goal is to improve diagnosis, refine prognosis, and advance treatment, with the ultimate goal of increasing cure rates and decreasing side effects and outcomes of therapy. Specific research programs focus on mechanisms of cellular growth and proliferation, the tumor microenvironment, and the role of the immune system in cancer control and treatment. Studies on the pathogenesis of childhood sarcomas are also an emphasis and a distinguishing strength of the Center.

An important component of the Center for Childhood Cancer is the Biopathology Center, led by Nilsa Ramirez, MD. The Biopathology Center serves as the only pediatric repository for pediatric solid tumor samples and is one of only two repositories for leukemia samples in the United States, Canada, and Australia. More than 80,000 samples have been characterized and distributed to 250 pediatric cancer researchers throughout the world in the past five years. Because of the Biopathology Center, The Research Institute at Nationwide Children's Hospital receives more grant funds from COG than any other national program.

Scientists in the Center for Childhood Cancer are listed below:

Research Scientist

Expertise

Tom Gross, MD, PhD

Transplant and Tumor Immunology

Long-Sheng Chang, PhD

Retinoblastoma, Neurofibromatosis

Mary Beth Ross, MD, PhD

Leukemia; Genome profiling

Dawn Chandler, PhD

Pre-mRNA splicing; Rhabdomyosarcoma

Julie Gastier-Foster, PhD

Molecular genetic testing

Jayah Lin, PhD

Jak/Stat signaling and cancer

Christopher Pierson, MD, PhD

Brain Tumors and Neuromuscular Diseases

Corey Raffel, MD, PhD

Neurosurgery

Nilsa Ramirez, MD

BioPathology

Special Expertise Descriptions

Blood and Marrow Transplantation

The Nationwide Children's Hospital Pediatric Blood and Marrow Transplantation (BMT) Program works in collaboration with the adult BMT Program at the OSUCCC-James Cancer Hospital and Solove Research Institute. Bone marrow processing, HLA typing, and cytogenetics are shared between the two institutions. The Pediatric Blood and Marrow Transplant program is accredited by the Federation for Accreditation of Cellular Therapies (FACT), is an independent National Marrow Donor Program Center, and is a Children's Oncology Group BMT Center. Types of transplants offered include:

Autologous (one's own bone marrow or peripheral blood stem cell)

Allogeneic (a donor's marrow-related or unrelated)

Umbilical cord blood

The Pediatric Blood and Marrow Transplant Program patients are cared for at Nationwide Children's Hospital with a full complement of multidisciplinary team members and pediatric sub-specialists. Nationwide Children's Hospital has a Pediatric Intensive Care Unit with four designated HEPA-filtered Bone Marrow Transplant beds that offer 24-hour in-house pediatric intensivist coverage. The BMT physician team is sub-specialized into those caring for patients with leukemia, solid tumors, non-malignant disorders, and genetic/metabolic or immune deficiency disorders. There are dedicated multidisciplinary clinics for chronic graft-vs.-host disease patients and long-term survivors of BMT. The BMT program works closely with two immunologists, and the program conducts clinical research in oncology as well as brain tumors, non-cancer conditions, and graft-vs.-host disease. The program is supported by four full-time nurse practitioners who provide outpatient clinic coverage and 24-hour house coverage of BMT patients Monday through Friday. There are two BMT coordinators to facilitate referral and pre-transplant evaluations of patients. For a BMT referral, call 614.722.3558.

Brain Tumors

Randal Olshefski, MD, directs the Pediatric Neuro-oncology Program and provides extensive expertise in the treatment of children and adolescents with all varieties of brain tumors. Edward Kosnik, MD, director of neurosurgery at Nationwide Children's Hospital, utilizes a variety of new surgical techniques to completely resect brain tumors. The Neuro-oncology Care Team consists of Drs. Oshefski, Kosnik, or his pediatric neurosurgery colleagues; a dedicated pediatric nurse practitioner; RN staff; psychologists; an educational specialist; and a social worker. The Pediatric Neuro-oncology Program has a Long-Term Follow-Up Clinic dedicated to meeting the needs of brain tumor survivors.

Bone Tumors

Nick Yeager, MD, oncologist, and Joel Mayerson, MD, orthopedic oncologist, along with a dedicated bone tumor pediatric nurse practitioner, staff a comprehensive bone tumor clinic. They jointly meet with new patients and collaborate on medical and surgical management. Mayerson is a national expert on limb-salvage procedures using cutting-edge surgical techniques and innovative pediatric prosthetics.

Behavioral Research

The Nationwide Children's Hospital Blood and Cancer Program works very closely with two research psychologists who are studying pediatric cancer patients. Ongoing research includes:

A study of communication between parent and child about cancer diagnosis and prognosis

Grief in the family that has lost a child to pediatric cancer

Obesity/bone problems in children finishing chemotherapy for leukemia

The late neuropsychological effects of brain tumor therapy

The efficacy of massage and humor therapy during bone marrow transplantation