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Pediatric Oncology Services

Introduction

The University of Michigan (U-M) Comprehensive Cancer Center treats pediatric oncology outpatients at the Cancer Center facility that opened in May 1997. Pediatric oncology inpatients are admitted to the C.S. Mott Children's Hospital. U-M has the largest research effort in Pediatric Oncology in Michigan. The U-M program is one of the very few to hold an NCI training grant in Pediatric Hematology in the United States, which allows the program to train future academicians in clinical care and research involving childhood hematology/oncology disease. U-M researchers have contributed to the declining mortality rate for childhood cancers. U-M's Pediatric Hematology/Oncology Programs manage patients with pediatric solid tumors, including neuroblastomas, rhabdomyosarcomas, Wilms' tumors, and brain tumors, as well as patients with lymphomas, leukemias, and other childhood cancers.

U-M pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

Special Expertise

Blood and Marrow Transplant

Brain Tumors

Leukemia

Long-Term Follow-Up

Lymphomas

Neuroblastoma

Radiation Oncology

Retinoblastoma

Sarcomas

Wilms' Tumor

General Information

Ages Treated

Children of all ages are treated.

General Information Hot Line

800.865.1125, 9:00 AM to 4:30 PM EST, Monday through Friday.

Physician-to-Physician Communications

800.962.3555

Location

Ann Arbor, Michigan

Facility Description

The C.S. Mott Children's Hospital combines the most advanced medical technology with an inviting, very human setting and a full spectrum of amenities for patients and their families. The dcor is brightly colored and the equipment child-sized. Each hospital room at the Children's Hospital contains sleeping accommodations for overnight guests.

Travel Assistance

Social workers arrange transportation for patients. Chartered aircraft are available to transport patients throughout the United States and Canada. U-M participates with numerous not-for-profit organizations that provide free air transportation for cancer patients going to/from recognized cancer treatment centers on commercial, corporate, and private aircraft.

Lodging

Social workers assist in lodging arrangements for families. Families needing lodging and who cannot afford it can contact the Social Work Department at 734.764.3140 for information about assistance. The U-M has arrangements with local hotels and motels for discounted accommodations. The Guest Assistance Program can suggest a number of convenient, reasonably priced hotels, some with shuttle service to and from the Medical Center. For assistance, call 800.888.9825 or 734.764.6893.

A Ronald McDonald House is nearby. This temporary residence serves as an inexpensive "home away from home" for the parents and families of children being treated at the Medical Center. It offers more than 20 bedrooms, kitchen and laundry facilities, family rooms, and the support of other parents and hospital volunteers. For information, call 734.994.4442.

The "Med-Inn" is a hotel connected directly to the U-M Medical Center. This comfortable 90-room hotel, adjacent to the Cancer Center, offers double rooms, mini-suites, executive suites and barrier-free guest rooms. For information and rates, call 734.936.0100 or 800.544.8684. Also, U-M works with families in the community who offer rooms in their homes at no cost.

Social Support

All social workers are Master's level professionals with expertise in assisting those faced with health issues. Cancer Center social workers are specialists in the area of illness-related problems and are available for individual consultation. Social workers offer support and education groups to cancer patients and their families, including support groups for adolescents with cancer and parents of children with cancer. The Child Life Department operates an on-site school and offers tutoring. Child Life specialists help children understand feelings and medical interventions through medical play.

Financial Assistance

Social work assists families in obtaining financial assistance from Children's Special Health Services. CSHS will help pay health care costs for patients that need assistance. Social work also arranges transportation and meal support for patients when needed.

Home Health Care

U-M has a non-profit home health agency, "Home Med." The program actively participates in the development of outpatient protocols for the treatment of pediatric malignancies. In addition, the center works with other home care agencies in Michigan and adjacent states.

Clinical and Research Information

Director of Division Pediatric Hematology/Oncology

Steven Pipe, MD

Clinical Director of Bone Marrow Transplant

John Levine, MD

Director of Outpatient Pediatric Oncology Services

Ray Hutchinson, MD

Multidisciplinary Teams

U-M is a national leader in the multidisciplinary approach to cancer care. The multidisciplinary team includes highly trained physicians, four pediatric oncology nurse practitioners and pediatric bone marrow transplant nurses who provide ongoing care to patients. The specialists involved depend on the individual needs of each patient. The multidisciplinary clinic held for pediatric brain tumors permits patients and their families to consult with a group of medical specialists including neurologists, radiation oncologists, neurosurgeons, hematologist/ oncologists, and experts in rehabilitative medicine.

Cooperative Group Membership

Children's Oncology Group (COG)

Blood and Marrow Transplantation Clinical Trials Network (BMTCTN)

Cooperative Group Activities

The pediatric hematology/oncology faculty and nurse practitioners play an integral role in COG committees specifically for the development and implementation of treatment protocols and basic research studies in oncology. Staff participate in COG committees and strategy groups on the following diseases:

Acute lymphoblastic leukemia

Hodgkin's disease

Non-Hodgkin's lymphoma

Neuroblastoma

Brain tumors

In addition, BMT faculty serves in leadership positions in COG (Vice-chair Stem Cell Transplant Committee), NIH BMT Clinical Trials Network (Chair), and Pediatric Blood and Marrow Transplant Consortium (Executive Committee).

Average Number of Pediatric Clinical Trials

60

Pediatric Clinical Trial Coordinator

Margaret Barnich, CCRA, for Pediatric Hematology/Oncology
734.763.6345


Research Efforts

U-M has the largest research effort in Pediatric Oncology in Michigan. Studies are ongoing to better understand genetic mechanisms underlying neuroblastoma, acute leukemia, and brain tumors. The U-M program is one of only three centers in the U.S. to hold an HLBI training grant in Pediatric Hematology, which allows the program to train future academicians in clinical care and research involving childhood hematology/oncology disease.

The bone marrow transplant research portfolio is broad and includes:

Novel agents for the treatment and prevention of graft-vs.-host disease

Tumor lysate pulsed dendritic cell cancer vaccine for patients with high risk solid tumors

Treatment of refractory neuroblastoma with MIBG, chemotherapy, and autologous bone marrow transplantation

The oncology division has a research protocol for refractory neuroblastoma using Velcade

Special Expertise

Blood and Marrow Transplant

Since 1990, U-M has performed bone marrow transplantation for the treatment of leukemia and other hematological malignancies, solid tumors, and a variety of other cancer-related diseases. U-M performs autologous, related, unrelated, and cord blood allogenic transplants. A comprehensive strategy aims to improve outcomes by both decreasing transplant toxicities and reducing the risk of cancer recurrence. For example, to better treat the often lethal pulmonary related complication of idiopathic pneumonia syndrome, U-M researchers developed a TNF-inhibition treatment that has demonstrated a 67% reduction in mortality. Likewise, because relapse is the primary cause of treatment failure for patients with high-risk neuroblastoma, U-M researchers have developed trials that utilize pre-transplant MIBG therapy (a novel method for delivery of high-dose radiation to metastatic foci of neuroblastoma disease) or post-transplant immunotherapy with a tumor-lysate pulsed dendritic cell cancer vaccine. The bone marrow transplant program is accredited by FACHT and is approved by the National Marrow Donor Program.

Brain Tumors

Using a multidisciplinary approach, each patient is assigned a team consisting of a child neurologist trained in neuro-oncology, a pediatric neurosurgeon, radiation oncologists, nurse practitioners, and social workers. The division is actively involved in the evaluation of new drug protocols.

Leukemia

U-M researchers have contributed to the declining mortality rate for childhood cancers. For example, U-M led a national trial establishing the value of delayed intensification for the management of childhood ALL in the U.S.

Long-Term Follow-Up

This program is designed to meet the needs of adolescents and young adults diagnosed with cancer as children, who are now five years past all therapy. Staff members are involved in the Childhood Cancer Survivors Study Group to examine the long-term effects of treatment on childhood cancer survivors, in conjunction with the University of Minnesota.

Neuroblastoma

Faculty are national leaders in the generation of clinical guidelines and clinical research trials for the treatment of neuroblastoma.

Radiation Oncology

U-M has one of very few "racetrack microtrons" in the country. The microtron is able to focus radiation onto a treatment field that conforms more closely to the shape of the tumor, thus sparing adjacent normal tissue.

Statistics

Percent of children treated in each age range

Age Range

0-1

2-5

6-12

13+

Percent Treated

1%

18%

35%

45%

Pediatric Oncology Program-Fiscal Year 2007

No. of Inpatient Beds

No. of Oncologists

No. of Admissions

Average Length of Stay (days)

No. of New Outpatients

Total Outpatient Visits

16

1 17

1, 1,121

7. 7.01

4 433

5, 5,640

Pediatric Bone Marrow Transplant Program-Fiscal Year 2007

No. of Inpatient Beds

No. of Transplanters

Average Length of Stay (days)

Number of Bone Marrow Transplants

8

5

32.2

43