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The Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Chicago, Illinois
Administrative Office: 312.908.5250
Patient Referrals: 866.LURIECC (587.4322)

www.cancer.northwestern.edu

Pediatric Oncology Services

Introduction

One June 9th, 2012, Children's Memorial Hospital became the Ann & Robert H. Lurie Children's Hospital of Chicago, and moved to the Northwestern University Medical Campus in downtown Chicago. The Center for Cancer and Blood Disorders is the pediatric arm of the Robert H. Lurie Comprehensive Cancer Center and is one of the nation's leading pediatric hospitals. This year, the Center for Cancer and Blood Disorders was ranked 9th nationally of pediatric cancer programs, and the hospital was ranked among the top 10 pediatric hospitals nationally. The center is approved by the American College of Surgeons, Commission on Cancer and offers a family-centered, multidisciplinary approach and provides the highest quality diagnostic and treatment services for children and adolescents with leukemia, tumors of the brain and spinal cord, and other solid tumors. The philosophy is to treat the “whole child” through a multidisciplinary approach involving caregivers from many related fields.  Our oncology specialists are recognized around the world for their knowledge and expertise. The Stem Cell Transplant program has attracted national and international leaders. The Brain Tumor Center at Children's Memorial is among the first institutions in the country to develop a cohesive, multidisciplinary program with support from specialists in more than 33 pediatric and surgical subspecialties.  Lurie Children's provides a warm and nurturing, educational, and recreational environment that allows “kids to be kids” as they undergo treatment.

The pediatric oncologists, faculty members of the Northwestern University Feinberg School of Medicine, have expertise in the management of all childhood cancers and are experts in the areas listed below:

Special Expertise

  • Brain Tumor
  • Leukemia
  • Liver Tumor
  • Wilms' Tumor
  • Lymphoma
  • Neuroblastoma
  • Radiation Oncology
  • Retinoblastoma
  • Soft Tissue Sarcoma
  • Long-Term Follow-up (Survivorship)
  • Stem Cell Transplantation
  • Graft Vs Host Disease

General Information

Ages Treated

The majority of our patients are 18 years of age and younger, but we do provide care for young adults with pediatric diagnosis and congenital disorders.

Pediatric Hot Line

800.KIDS.DOC (800.543.7362)

Lurie Children's pediatric nurses are available Monday through Friday from 8:30 AM to 4:30 PM to personally answer questions. When calling at other times, please press * to leave a message and Lurie Children's will call back.

Referring Physician Line

800.540.4131

E-mail

KIDSDOC@luriechildrens.org (All e-mails are answered within 72 hours.)

Location

Ann & Robert H. Lurie Children's Hospital of Chicago
225 E. Chicago
Chicago, IL 60611

The main telephone number is 312-227-4000. The Center for Cancer and Blood Disorders main line is 312-227-4090.

Physical Plant

The 24-bed unit is specially designed, staffed, and equipped to deliver the most sophisticated level of treatment to children of all ages. To assist with infection control, each private room and the entire unit maintains positive pressure.  With 18 ambulatory exams rooms, our teams are able to run simultaneous  multidisciplinary clinics in multiple specialties, offering ample appointment times designed to meet the needs of patients and their families.  Our 26 bed Ambulatory Infusion Center and Stem Cell Unit provides infusion therapies for children requiring specialized care and monitoring while undergoing chemotherapy treatments and stem cell transplant. Each room has intensive care monitoring capabilities. There is a playroom and parent lounge located on the inpatient and outpatient units.

Radiation Oncology is located just 2 blocks south of  Lurie Children's  at the main Northwestern campus.

Some patients may enjoy our Family Life Center, a respite area devoted to inpatients and their families. The colorful environment, amazing skyline and lake views, were designed to be a family-friendly distraction from hospital life. The center is equipped with a dedicate teen lounge, hair salon, Zen room, toys, games, and computers and is the focal point of many Child Life activities for patients.

Travel Assistance

Social work staff can provide assistance with travel needs and can, at times, coordinate transportation.  Social workers can also connect families with agencies and foundations that will provide reimbursement for travel expenses (including gas, parking, and airline fees).  Assistance is determined on a case-by-case basis.

Lodging

The Ronald McDonald House near Ann & Robert H. Lurie Children's Hospital of Chicago provides a temporary "home away from home" for families of children receiving treatment. The 90-bed facility is the newest Ronald McDonald House in the nation and is conveniently located 4 blocks from the hospital. The new House offers 14-stories of care & comfort for families of hospitalized children and includes 86 guest rooms, a rooftop healing deck and a kitchen filled with home-cooked meals and supportive conversation, and 2 dedicated transplant floors. An on-call shuttle is available for trips back and forth to the hospital. For more information, call the House at 312-888-2500.

Lurie Children's Admitting Department can help make arrangements for hotel accommodations within the area. The Admitting Department can be reached at 312-227-1220.

Social workers can also assist in making lodging arrangements for families.   Each patient is assigned a social worker upon diagnosis.

Social Support

Family Support Services, consisting of clinical social workers, child-life specialists, a chaplain, and Parentwise coordinator, addresses the psychosocial needs of pediatric cancer patients and their families and are a core part of the multidisciplinary team.

Social workers provide assistance in helping families cope with a child's illness hospitalization and treatment. Social workers also provide information and referrals to community agencies and other services focused on child and family well-being.

Certified child life specialists are trained professionals who promote effective coping through play, preparation, education, and self-expression activities. They provide emotional support for families, and encourage optimum development of children facing a broad range of challenging experiences, particularly those related to healthcare and hospitalization. Child life specialists utilize a family-centered care model that views the child's coping within the framework of a larger family system so there is also a focus on providing support and guidance to parents, siblings, and other family members. They also play a vital role in educating caregivers, administrators, and the general public about the needs of children under stress. Lurie Children's currently has two dedicated Child Life Specialists dedicated to serving Hematology/Oncology patients, providing services in both the inpatient and outpatient settings. On a daily basis, the Child Life Specialists can be seen providing preparation and distraction prior to painful procedures or engaging patients in age-appropriate teaching sessions and medical play opportunities to help a child understand and cope with a new diagnosis and the treatments that will occur. The same sessions are offered to siblings to clarify any misconceptions or fears that may exist, while also validating the unique aspects and emotions that go along with being the sibling of a pediatric patient. The Hematology/Oncology Child Life professionals facilitate therapeutic activities that promote an open expression of emotions, thoughts, or concerns relating to each individual's experience of chronic and life-threatening illness as well as introducing non-pharmacological techniques to help with pain management, implementing strategies to help with non-compliance/behavioral modification, and providing support to patients and siblings relating to end-of-life issues.

School services staff (including school teachers from both Chicago public and suburban school districts can provide educational instruction to a patient during inpatient hospitalizations and during extended outpatient treatment days. Tutoring and educational enrichment programs are also available.

Supportive services for the patient, parents, and family are also available through the following:

  • ParentWise
  • Palliative Care Program
  • Heartlight (Bereavement Program)

There are also a number of cancer wellness centers in the community which offer supportive and educational services to those impacted by cancer. Most, if not all, of their services are free of charge.

Financial Assistance

The need for financial assistance is evaluated on a case-by-case basis.

For more information, call 877-924-8200.

For questions about financial coverage while a child is in the hospital, call Monday through Friday, 7:00 AM to 6:00 PM; Saturday, 7:00 AM to 3:30 PM.

Home Health Care

The teams work closely with home health agencies experienced in pediatric oncology and stem cell transplantation.

Acceptance Criteria

Acceptance is based upon patient's specific clinical need and age.

Clinical and Research Information

Division Head, Pediatric Hematology and Stem Cell Transplantation

Morris Kletzel, MD

Multidisciplinary Teams

Lurie Children's uses a comprehensive, family-centered, multi-disciplinary approach to care. The primary care team approach is coordinated by clinicians, surgeons, scientists, nurses, nutritionists, dietitians, advanced practice nurses, and child and family support staff-all of whom are solely dedicated to the care of children. Core components of the multidisciplinary team are certified Child Life specialists, licensed clinical social workers, a trained chaplain, and Friends of the Family volunteer coordinator.

Cooperative Group Membership

  • Children's Oncology Group (COG) Phase 1
  • National Wilms' Tumor Study Group (NWTSG)
  • Pediatric Brain Tumor Consortium (PBTC) Phase I
  • Pediatric Blood & Marrow Transplant Consortium (PBMTC)
  • Therapeutic Advances in Childhood Leukemia (TACL) Phase I
  • Childhood Cancer Survivor Study (CCSS)
  • Collaborative Ependymoma Research Network
  • Childhood Cancer Research Network
  • Clinical Trials Network (CTN)

Cooperative Group Activities

Participation in COG committees include:

  • Bone Marrow/Stem Cell Transplant
  • Brain Tumor
  • Cancer Control
  • Clinical Research
  • Diagnostic Imaging
  • Hepatoblastoma
  • Hodgkin's Disease
  • Leukemias
  • Neuroblastoma and Other Embryonic Tumors
  • Neuroscience
  • Nursing
  • Pathology
  • Radiation Therapy
  • Sarcomas
  • Surgery
  • T-Cell Disease
  • Wilms' Tumor
  • Late Effects

Oncologists are principal investigators on numerous studies.

Average Number of Pediatric Clinical Trials

130 (oncology, neuro-oncology and stem cell transplant)

Pediatric Clinical Trial Coordinator

Yolanda Santiago, CCRP
312.227.4862

Research Efforts

The medical center is a hub of oncology/hematology research, leading efforts ranging from molecular genetic studies of certain childhood cancers, to the pioneering use of stem cell transplantation in treating and curing sickle cell disease, to the study of a multi-drug-resistant gene in cancerous brain tumors.

The faculty and nursing staff of Ann & Robert H. Lurie Children's Hospital of Chicago are involved with several significant research efforts, primarily in the areas of leukemia, sarcoma, bone marrow/stem cell transplantation, neuro-oncology, and neuroblastoma biology. Faculty members are actively involved in biologic research on neuroblastoma, as well as some early investigation into antiangiogenesis. Research is also being pursued relative to cell differentiation in the laboratory. In addition, the stem cell laboratory continues to make major advances in support of the clinical program in the areas related to stem cell procurement, transplantation, and engraftment. These include assessment of engraftment via molecular immuno-genetics, minimal residual disease testing for malignancies including leukemias and neuroblastoma, and the molecular HLA Typing Laboratory.

Children's Hospital of Chicago Research Center (CHOC) is an integral component of the Lurie Children's Medical Center. The research center has evolved as the Midwest's only institution devoted exclusively to pediatric medical research. The six core programs of the research center—cancer biology and chemotherapy, immunobiology, human and molecular genetics, neurobiology, developmental systems biology, and statistical sciences and epidemiology—represent an important direction in contemporary biological investigation in medicine.

Special Expertise

Brain Tumors

Ann & Robert H. Lurie Children's Hospital of Chicago treats more than 85 percent of the patients with pediatric brain tumors in the Chicagoland region. A large proportion of brain tumor patients are enrolled on clinical trials, including Phase I trials. In addition to brain tumors, Lurie Children's experts treat tumors of the spinal cord and the spine itself.

Members of the Division of Pediatric Neurosurgery are involved in basic research in cooperation with the Neurobiology and the Brain Tumor Research Program at Children's Hospital of Chicago Research Center.

The Brain Tumor Clinic provides a comprehensive, multi-disciplinary visit in which experts in pediatric neurosurgery, pediatric oncology, pediatric endocrinology, pediatric neurology, pediatric radiation oncology, and social services can examine youngsters. Representatives from physical therapy, audiology, and other pediatric subspecialties are also available to see patients in this clinic. Each patient's neuroradiographic studies are available for review on-site at this weekly clinic, making it easy for family members to ask all the questions they need to in order to fully understand their child's illness and make educated decisions regarding his or her care.

Lurie Children's uses a multidisciplinary approach that gives equal importance to tumor surveillance and neurological, neuroendocrine, and neuropsychiatric issues. Through this teamwork, Lurie Children's continues to make progress towards innovative therapies that maximize survival while minimizing the sequelae faced by these patients and their families.

Currently, Lurie Children's Brain Tumor Center treats over 120 new patients per year.

Leukemia

Children with leukemia comprise the largest single subgroup of patients with oncology diagnoses at Lurie Children's Hospital. Currently, the overall prognosis for children with leukemia is quite good with certain subgroups having outstanding survival while others are still suboptimal. Our faculty hold a special interest and expertise in the treatment of relapse leukemia. The majority of patients are treated on cooperative group protocols that are currently directed at both maximizing cure rates and minimizing toxicities.

For children with lymphocytic leukemia, a significant portion of the treatment can be administered in the clinic so children spend less time on the inpatient unit. For children with non-lymphocytic leukemia and certain high-risk subtypes of lymphocytic leukemia, the majority of the treatment occurs on the inpatient service. The efforts at Ann & Robert H. Lurie Children’s Hospital of Chicago are not only to refine treatment but to try to maintain, as much as possible, the normalcy of daily and family life.

A multidisciplinary approach to the wellbeing of the child, including psychosocial issues, long-term follow-up, and acute treatment issues, comprises the core of the efforts in this area.

Long-Term Follow-Up Clinic

Approximately 75 percent of children diagnosed with cancer become long-term survivors, and more than 1,300 children, adolescents, and young adults are treated through the STAR (Survivors Taking Action & Responsibility) Program at the Lurie Children's Long-Term Follow-Up Clinic.

The program follows patients beginning five years after diagnosis and extends until the patient is 21 years of age. At this time, survivors are transitioned to our adult health care partners at Northwestern Memorial Hospital for follow-up in their long-term follow-up program. A typical STAR visit focuses on the physiologic and psychological issues facing childhood cancer survivors, including evaluation of growth and development, blood work, physical exams, and cardiac and nutritional assessment. Interest is also given to the psychosocial and academic status of the patients, and new screening tools are being used to elicit information in these areas. Education is provided to patients and their families about their medical history; healthy living habits are promoted; and health maintenance is taught.

Liver Tumors

The distribution of childhood liver tumors diagnosed and treated at Ann & Robert H. Lurie Children's Hospital of Chicago include a wide variety of lesions. The most commonly encountered tumor is hepatoblastoma, and two thirds of these present with advanced disease (Stage III or IV). The majority of these children are placed on multi-agent treatment protocols of the Children's Oncology Group. The introduction of the liver transplant program at Lurie Children's in 1997 has provided a new dimension of treatment for these patients. Our hepatobiliary transplant surgeons have the ability now to resect many lesions previously considered “unresectable,” and if resection remains unobtainable, liver transplantation is sometimes an option for therapy.

Leukemia and Lymphoma

The majority of patients are treated on cooperative group protocols. Current prognoses for nearly every subgroup of patients with hematologic malignancies, including those with advanced disease, are quite good. Ann & Robert H. Lurie Children's Hospital of Chicago strives to improve the cure rates for certain high-risk groups by increasing and refining treatment intensity. Treatment is administered in both inpatient and outpatient settings. The multi-disciplinary faculty at Ann & Robert H. Lurie Children's Hospital of Chicago has a long-standing and significant interest in all aspects of blood cancers, including lymphomas that have a more unusual presentation or course and those lymphomas associated with the HIV infection.

Neuroblastoma

Innovative, research-based treatment protocols have been developed at Children's for patients with neuroblastoma. High-dose chemotherapy with autologous tandem stem cell rescue is performed on an outpatient basis. With this procedure, Children's has become the region's leading provider of care to children with neuroblastoma.

Ann & Robert H. Lurie Children's Hospital of Chicago has very active research efforts directed at both laboratory aspects of the biology of this disease and at clinical treatment. Many children with neuroblastoma are treated on cooperative group protocols. The current thrust of these protocols is to minimize therapy in early stage disease while attempting to increase the cure rate for patients with more advanced disease. Currently there is an open in-house study for the treatment of patients with advanced neuroblastoma that includes a multidisciplinary approach combining surgery, chemotherapy, radiation therapy, and biologic agents. The care of this subgroup of children is carefully coordinated between the oncologist, radiation therapist, surgeon, and the bone marrow/stem cell transplant team.

In addition, extensive laboratory research is directed at investigating biologic aspects of neuroblastoma.

Radiation Oncology

Ann & Robert H. Lurie Children's Hospital of Chicago patients receive their radiation oncology services at Northwestern Memorial Hospital. There are three radiation oncologists with a specialty in pediatric care. Our radiation oncology program employs state-of-the-art technology to maximize cure and minimize complications in the growing child. The technology currently includes fractionated stereotactic radiation, radiosurgery, 3-dimensional conformal treatment planning, total body irradiation, hyperthermia, and both low- and high-dose brachytherapy. Fractionated stereotactic radiotherapy allows delivery of the maximal doses required while sparing as much normal developing brain as possible. This capability has been pioneered at Lurie Children's and is one of the primary advances in pediatric radiation oncology.

Retinoblastoma

Ann & Robert H. Lurie Children's Hospital of Chicago is a leader in innovative multimodality therapies. The treatment of both sporadic and inheritable forms of retinoblastoma revolves around saving sight and minimizing long-term sequelae of past therapies, including secondary cancer. Presently, Ann & Robert H. Lurie Children's Hospital of Chicago employs a chemotherapy and local ophthalmologic control (cryotherapy, photocoagulation, etc.) in an attempt to preserve sight and avoid enucleation.

Soft Tissue Sarcomas

Children's approach to these patients is multidisciplinary, including surgery, radiation therapy, and chemotherapy. The treatment is adapted to the tumor type and stage of diagnosis, and each patient is carefully followed for response to therapy and appropriate timing of the various modalities of treatment. The majority of patients are initially treated on national intergroup protocols devised by multiple institutions across the country. Patients who do well are carefully followed in the Long-Term Follow-Up clinic for the management of late complications of their treatment.

A pediatric brachytherapy program has been established to obtain local control without amputation or other mutilating surgery in the treatment of pediatric sarcomas.

Stem Cell Transplantation

The program is a member of the Northwestern University Affiliated Transplant Center (NUATC), The Robert H. Lurie Comprehensive Cancer Center at Northwestern University, The Children's Oncology Group (COG), and the Pediatric Blood and Marrow Transplant Consortium (PBMTC). Each of these entities sponsors clinical trials in pediatric transplantation and correlates with activities in the laboratory.

Lurie Children's Stem Cell Transplant Program achieved initial accreditation from the Foundation for Accreditation of Cellular Therapy (FACT) in 1999. This program was the seventh institution nationwide and the first freestanding pediatric institution to achieve this milestone.  

An important feature of the program is a joint Cellular Therapy and Tissue Processing laboratory facility at Northwestern Memorial Hospital, at the cutting edge of stem cells processing, graft engineering,  and detecting tumor cell contamination of the graft, HLA typing, stem cell expansion, and detection of engraftment by molecular techniques. The program also conducts is own HLA research capable of the highest detection of alleles via molecular sequencing. Lab research is primarily in the areas of stem cell processing, stem cell expansion, detection of minimal residual disease, and characterization of mesenchymal cells.

The Stem Cell Transplant Program was started in 1992. In 1996, Ann & Robert H. Lurie Children's Hospital of Chicago became an approved National Marrow Donor Program and performs matched, unrelated, and umbilical cord blood stem cell transplants, as well as autologous transplants.

 

Statistics

Lurie Children's is a leader in the treatment of children in the Chicago area diagnosed with leukemia, solid tumors, and blood diseases.

As of August 31, 2011, a total of 985 stem cell transplants had been performed:

Transplant Type

Number Performed

Percent of No. Performed

Autologous

423

42.94%

PBSC

389

39.49%

BM

30

3.05%

BM+PBSC

2

0.20%

Cord

2

0.20%

Allogeneic

562

57.06%

PBSC

231

23.45%

BM

1

0.10%

Cord Blood

173

17.56%


Percent of children treated in each age range

Age Range

0-1

2-5

6-12

13+

Percent Treated

15.63%*

33.40%*

26.19%*

24.77%*

*Age Range Data for cases through August 2011

 

Pediatric Oncology Program Fiscal Year 2011 (Hematology/Oncology Only) (Move to new campus occurred June 2012.)

No. of Inpatient Beds

No. of Hematologist/Oncologists

No. of Admissions

Average Length of Stay (Days)

Total Outpatient Visits

No. of Stem Cell Transplants

22

23

1207

5.2

17,399

42