National Comprehensive Cancer Network

The Robert H. Lurie Comprehensive Cancer Center is affiliated with Children's Memorial Hospital Center for Cancer and Blood Disorders, one of the nation's leading pediatric hospitals. The American College of Surgeons, Commission on Cancer Approved pediatric oncology program 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. Oncology specialists are recognized around the world for their knowledge and expertise. The Transplantation Center has attracted national and international medical and surgical leaders. The philosophy is to treat the "whole child" through a multidisciplinary approach involving caregivers from many related fields. 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. Children's Memorial provides a warm and nurturing, educational, and recreational environment that allows "kids to be kids" as they undergo treatment.

The 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

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 Children's Memorial Hospital are involved with several significant research efforts, primarily in the areas of bone marrow/stem cell transplantation, neuro-oncology, and neuroblastoma biology. Faculty 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 Memorial Research Center (CMRC) is an integral component of the Children's Memorial Medical Center. CMRC has evolved as the Midwest's only institution devoted exclusively to pediatric medical research. The six core programs of CMRC-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

Children's Memorial Hospital 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, include Phase I trials. In addition to brain tumors, 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 Memorial Research Center (CMRC).

The Brain Tumor Clinic provides a comprehensive, multi-disciplinary visit in which experts in pediatric neurosurgery, pediatric oncology, 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.

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

Currently, Children's Brain Tumor Center treats well over 150 new patients per year.

Leukemia

Children with leukemia comprise the largest single subgroup of patients with oncology diagnoses at Children's Memorial 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 Children's Memorial Hospital 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 Children's Memorial Hospital 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 Children's Memorial Hospital 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 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.

Lymphoma

The majority of patients are treated on cooperative group protocols. Current prognoses for nearly every subgroup of patients with lymphoma, including those with advanced disease, are quite good. Children's Memorial Hospital 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 Children's Memorial Hospital has a long-standing and significant interest in all aspects of lymphoma, 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.

Children's Memorial Hospital 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

Children's Memorial Hospital patients receive their radiation oncology services at Northwestern Memorial Hospital. There are two 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 Children's Memorial and is one of the primary advances in pediatric radiation oncology.

Retinoblastoma

Children's Memorial Hospital 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, Children's Memorial Hospital 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.

Children's Memorial 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 laboratory facility at the cutting edge of processing stem cells, graft engineering, detecting tumor cell contamination of the graft, HLA typing, stem cell expansion, and detection of engraftment by molecular techniques. The program also has its own state-of-the-art HLA laboratory 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 Ambulatory Stem Cell Unit (ASCU), consisting of four HEPA-filtered, positive-pressure rooms with state-of-the-art monitoring equipment, is devoted exclusively to stem cell transplant patients and their families. This allows Children's to conduct more innovative procedures and provides greater convenience and comfort to patients and families. The rooms are also equipped to provide patients and families the ability to connect to work and school via the Internet.

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

Statistics

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

As of August 31, 2009, a total of 896 stem cell transplants had been performed:

Percent of children treated in each age range

* Age Range Data available only on cases through August 2009.

Pediatric Oncology Program Fiscal Year 2009 (Hematology/Oncology Only)

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