National Comprehensive Cancer Network

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The University of Texas MD Anderson Cancer Center
Houston, Texas
877.MDA.6789 (General Information)
800.392.1611 or 713.792.6161 (New Patient Referral Office)
www.mdanderson.org

Pediatric Oncology Services

Introduction

The Children's Cancer Hospital at The University of Texas MD Anderson Cancer Center offers comprehensive, family-centered care to children and adolescents with cancer within the environment of the No. 1-rated cancer hospital in the nation for cancer care. Pediatric cancer patients receive treatment at the Children's Cancer Hospital's inpatient facility (where caregivers can room with their children), outpatient clinic, day hospital, and the pediatric intensive care unit. Full supportive services are provided, including child and adolescent life, a pediatric supportive and palliative care team, psychological services, education and vocational guidance, music and art therapy, an in-hospital school with classrooms for grades 1 through 12, extracurricular programs including camps, an annual ski trip for visually and physically challenged patients, and a long-term follow-up clinic. Facilities in the Children's Cancer Hospital also include a designated "teen room" play space and an area for ages 15-30 years with pool, arcade games, movies, and more. Recreation therapy and language assistance also are offered. The Children's Cancer Hospital operates with family-centered cancer care in mind and is recognized worldwide for its expertise in treating children with cancer. Pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below:

General Information

Clinical and Research Information

Special Expertise

Cell Therapy (Bone Marrow Transplant)

MD Anderson is the largest BMT center in the United States, which includes the Children's Cancer Hospital's BMT Program. MD Anderson is FACT-accredited and designated by COG and the National Marrow Donor Program as a transplant center qualified to perform matched and unrelated donor transplants as well as autologous transplants. The unrelated transplantation program at the Children's Cancer Hospital uses umbilical cord transplant and is one of the few places in Texas that performs cord blood pediatric transplants. The program includes expertise in graft manipulation including T-cell depletion and investigational therapies based on selection of CD133. Active transplant protocols are underway for several types of malignancies: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), myelodysplasia, lymphoma, neuroblastoma, brain tumors, and other solid tumors of childhood. In addition to undertaking transplants, the program has an active translational research program developing new therapies based on infusion of T cells and NK cells.

Solid Tumors - including DSRCT, Sarcomas and Bone Tumor Cancers (Osteosarcoma, Ewing 's Sarcoma)

The Children's Cancer Hospital is an active treatment center for the many varieties of childhood solid tumors such as Wilms' tumor, hepatoblastoma, desmoplastic small round cell tumor, melanoma, neuroblastoma, retinoblastoma, tumors of the head and neck, and sarcomas - especially rhabdomyosarcoma, osteosarcoma, and Ewing's sarcoma. Patient evaluation results in an individualized approach that may or may not result in protocol therapy, depending on the specific circumstances of the patient and family. MD Anderson uses diagnostic imaging resources including PET-CT fusion imaging consultation to sort out important issues for not only best survival outcome, but also quality of life issues. Since most solid tumors require at least two and sometimes all three major modalities (e.g. surgery, chemotherapy, radiation), the coordination of care between experienced specialists for treatment of rare and/or difficult situations (e.g. metastatic or recurrent disease) is expected and routine. This group has pioneered and now routinely uses a number of innovative approaches in treatment of these cancers, including outpatient chemotherapy (e.g. high-dose methotrexate, ifosfamide, cisplatin, doxorubicin liposomes, dexrazoxane then doxorubicin, gemcitabine + docetaxel), radiation with concurrent outpatient chemotherapy, use of bone-seeking radiopharmaceuticals (samarium) for osteosarcoma, aerosol chemotherapy (L9NC, gemcitabine), and novel use of immune modulators (e.g. L-MTP-PE, MTher, aerosol cytokines including IL-2 and GM-CSF) in the treatment of bone tumors. For regional disease such as peritoneal spread of desmoplastic small round cell tumor (DSRCT), pleural lesions and disease in the mediastinum, coordinated care between surgical specialties, innovative chemotherapy, radiation oncology, and other services such as interventional radiology plastic surgery is common. Examples include improved enteral nutrition, surgery followed by continuous hyperthermic peritoneal perfusion of chemotherapy (CHPP) for DSRCT, intrapleural chemotherapy and/or chemotherapy for radio sensitization. Many treatment paradigms involve reduced likelihood of hospitalization.

Brain and Neural Tumors

The Pediatric Neural Tumor Section provides consultation, evaluation, and treatment for children with central nervous system tumors, and neurofibromatosis. For all common types of newly diagnosed brain tumors, therapeutic protocols form the basis for treatment with either institutional protocols or collaborative studies through the Children's Oncology Group. Phase I and II studies provide therapeutic options for children with recurrent tumors. MD Anderson pioneered an oral chemotherapy regimen for children with certain types of brain and spinal cord tumors, eliminating the need for radiation therapy and decreasing hospital stays. Oral chemotherapy treatments for these cancers have been found to be as effective as radiation.

Leukemias

The Pediatric Leukemia and Lymphoma Section has unique expertise in the care of patients with relapsed or refractory disease. This section works closely with our adult leukemia and lymphoma colleagues, sharing a protocol that treats children with acute promyelocytic leukemia without the use of traditional chemotherapy agents that appears quite promising. In addition, the section works with the Children's Oncology Group (COG) and the POETIC consortium to obtain new or innovative drugs or treatment approaches for patients whose original therapy has failed. The pediatric section was largely responsible for the only new drug, Clofarabine, to obtain FDA approval for childhood leukemia since 1990.

Neuropsychology

The neuropsychology team assesses patients for difficulties in language, memory, intellectual, visual perceptual, and attention skills. All children with brain tumors are evaluated as well as children undergoing bone marrow transplantation and others undergoing chemotherapy or radiation treatments to the brain. The neuropsychology team works closely with the education team to evaluate a child's strengths and weaknesses to ensure that they can attain their maximum academic potential, in spite of their cancer treatment. The Cognitive Training research program provides a 20-week course for patients who are at risk for cognitive difficulties associated with their treatment.

Statistics

Percent of children treated in each age range

Pediatric Oncology Program, 2008

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