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Vanderbilt-Ingram Cancer Center
Nashville, Tennessee
800.811.8480
www.vicc.org

Pediatric Oncology Services

Introduction

The Vanderbilt Childhood Cancer Program is a collaboration of the Vanderbilt-Ingram Cancer Center and the Monroe Carell Jr. Children's Hospital at Vanderbilt, a free-standing children's hospital which opened in 2004. Its faculty are cancer center members and fully integrated in center programs and initiatives. Its director, James Whitlock, MD, and one of its physicians, John Kuttesch, PhD, MD, serve key roles in Vanderbilt-Ingram's clinical trials program as chairs of its Resource Allocation Committee and Scientific Review Committee.

Special Expertise

Highlight any special expertise physicians have at your institution, using bullets. Examples are as follows:

· Bone marrow transplantation

· Phase I clinical trials

· Musculoskeletal tumors including sarcoma

· Leukemias and lymphomas

· Brain tumors

  • Survivorship issues, including late effects
  • Cancer in adolescents and young adults
  • School re-entry

General Information

General Information

615.936.1762

www.vanderbiltchildrens.com/cancer

Referring Physician Line

615.288.5000

Location

Nashville, Tennessee

Physical Plant

Clinical care is delivered in the Monroe Carell Jr. Children's Hospital at Vanderbilt, a free-standing children's hospital opened in 2004 that includes a 12-unit self-contained HEPA-filtered wing that includes family gathering and patient play areas.

Lodging

Close relationship with the Ronald McDonald House, located just a few blocks from the hospital, and the American Cancer Society's Hope Lodge.

Social Support

Cancer patients and families have access to all of the support services of the Children's Hospital, including the Junior League Family Resource Center, Child Life Services, Hospital School Program, and a School Re-entry Program.

The psychosocial team is composed of 3 social workers, 2 child life specialists, 3 child psychologists and the Children's Hospital chaplain. The members of this team meet on a regular basis, together with the Pediatric Advanced Care Team (PACT), to discuss and review issues related to patient and family support. Specialized neuropsychological testing is also provided by the child psychology team in support of the brain tumor and survivorship programs

Home Health Care

Vanderbilt Children's Home Care Program offers a variety of home care services catering to the individual needs of patients; we provide both intermittent and private duty services.

The quality and level of care is in complete agreement with Children's Hospital standards, ensuring safe and effective treatment with all the benefits of home. As an affiliate of Vanderbilt University Medical Center, we offer family-centered care with a team approach to infants and children who require specialized services.

  • Children's Home Care Team-Our clinical staff is trained in the home care of pediatric patients and provides care underphysician order.
  • Nursing-Hands-on care in the home is provided by nurses who teach parents and children about care in the home, based on their individual needs.
  • Rehabilitation Services-Physical, speech and occupational therapists establish and carry out rehabilitation programs.
  • Medical Social Services-Services that enhance medical treatment and support, with goals to maximize the psychosocial functioning and adjustments of children and their parents at home.
  • Reimbursement Specialists-These specialists work closely with families and payers to minimize financial concerns.
  • Referral Process-One telephone call to Vanderbilt Home Care is all that is required to initiate service. Our intake staff will verify benefits and begin the process of admitting the patient for services.
  • Quality Improvement-Vanderbilt Home Care adheres to strict practice standards in providing pediatric home care services, enabling your patients to receive consistent quality care. Our internal quality improvement programs are based on standards set forth by state, federal and professional organizations.

Patient and Family Education-Pediatric home care nurses and rehabilitation therapists provide initial assessment, home care instruction and ongoing visit support. We assist our patients and families to overcome their fears and concerns about being at home. Working with the hospital staff, we aid the discharge process before the patient arrives home. All of these efforts are done with one goal in mind: a positive outcome for the patient and their family

Ages Treated

0-21

Clinical and Research Information

Director, Vanderbilt

Childhood Cancer

Program

James Whitlock, MD, Director of Pediatric Hematology-Oncology and Craig Weaver Professor of Pediatrics.

Multidisciplinary Teams

A multidisciplinary team of the following specialists addresses the complex needs of young patients and their families before, during, and after treatment:

· physicians;

· clinical nurse specialists;

· psychologists;

· pharmacists;

· clinical social workers;

· dietitians;

· physical, occupational, art, and recreation therapists;

· child life specialists;

· school reintegration coordinators; and

· case managers

Weekly tumor conferences are held.

Cooperative Group Membership

Children's Oncology Group (COG)

Pediatric Oncology Experimental Therapeutics Investigator Consortium (POETIC )

Pediatric Blood and Marrow Transplant Consortium

Sarcoma Alliance for Research through Collaboration

Activities in Cooperative Group

Leadership and participation in clinical trials

Average Number of Pediatric Clinical Trials

50

Research Efforts

Highlights of childhood cancer research faculty:

Dr. Whitlock's research interest include the biology and treatment of acute lymphocytic leukemia and acute nonlymphocytic leukemia, the biology and treatment of Langerhans cell histiocytosis and other forms of histiocytosis, and the development of new agents for the treatment of childhood cancers and blood diseases. He is actively involved in clinical research in these areas and has leadership roles in the Children's Oncology Group (COG), the Histiocyte Society, the Histiocytosis Association of America, and the Pediatric Oncology Experimental Therapeutics Investigators' Consortium (POETIC).

Haydar Frangoul, MD: evaluating alternative Stem Cell sources such as unrelated donors for Stem Cell transplant. The main focus of interest is the role of the growth factor stimulated Bone Marrow in related donor transplant setting.

Richard Ho, MD: identification and functional characterization of naturally occurring polymorphisms in drug transport proteins as they relate to drug disposition. To this extent, we focus on pharmacogenetics, the study of the role of inheritance in the individual variation in drug response. Even though individual differences in drug response can result from the effects of age, sex, disease, or drug interactions, genetic factors also influence both the efficacy of a drug and the likelihood of an adverse reaction. Transport proteins have an important role in regulating the absorption, distribution, and excretion of many medications as well as endogenous substances. Dr. Ho is currently studying several transport proteins important to the disposition of a number of chemotherapeutics agents and include such transporters as the multidrug resistance associated proteins (MRPs), the bile salt export pump (BSEP), and the breast cancer related protein (BCRP). Projects are primarily laboratory based and rely on background knowledge in the fields of molecular biology and pharmacology.

John F. Kuttesch Jr., PhD, MD: development and evaluation of new therapies for childhood brain tumors, including targeted molecular therapies to be used alone or in combination with other approaches.

Elizabeth Yang, MD, PhD: molecular mechanisms of apoptosis, or programmed cell death, an important regulatory pathway in cancer.

Anderson B. Collier, MD: determining genetic factors that affect cancer development in children and improving supportive care for children and adolescents receiving chemotherapy for cancer.

Jennifer A. Domm, MD: pediatric hemostasis and thrombosis

Michael Engel, MD, PhD: molecular mechanisms of hematopoiesis and leukemogenesis, cellular signal transduction, biochemistry and identification of novel therapeutic for myeloid and lymphoid leukemias.

Special Expertise

Pediatric Stem Cell Transplant Program

Led by Haydar Frangoul, MD and staffed by three attending physicians, a pediatric nurse practitioner, a nurse coordinator, and a clinical pharmacist, this program provides comprehensive transplantation services, including unrelated donor and cord blood transplants, for children and adolescents with malignant and non-malignant disorders. A 12-bed HEPA-filtered stem cell transplant unit is located within the Children's Hospital. The program is an active participant in the National Marrow Donor Program and the Pediatric Blood & Marrow Transplant Consortium. The Pediatric Stem Cell Transplant Program is approved by the National Marrow Donor Program, the Bone Marrow Transplant Committee of COG and the Foundation for the Accreditation of Cellular Therapy (FACT), and is recognized as a Center of Excellence by Blue Cross/Blue Shield of Tennessee.

Pediatric Cancer Experimental Therapies Program

Led by James Whitlock, MD, Vanderbilt participates in clinical trials of novel agents through POETIC (Pediatric Oncology Experimental Therapeutics Investigators' Consortium) which also includes childhood cancer programs at M.D. Anderson, Memorial Sloan-Kettering Cancer Center, the Sidney Kimmel Cancer Center at Johns Hopkins, Children's Healthcare of Atlanta at Egleston, the Children's Hospital at the University of Colorado the University of Florida, and the University of Arizona, and SARC. This program is funded in part by an infrastructure grant from the Alex's Lemonade Stand Foundation.

Pediatric Brain Tumor Program

Led by John Kuttesch, PhD, MD, this program provides multi-disciplinary care for children with tumors of the primary central nervous system. Treatment programs are developed in collaboration with other members of the Brain Tumor Center of the Vanderbilt-Ingram Cancer Center at a weekly Neuro-Oncology Tumor Board. Children with CNS tumors which do not respond to, or recur following, standard treatments are eligible for early phase clinical trials of novel therapies conducted through COG and POETIC.

Childhood Cancer Survivorship Program

This program provides a full range of follow-up care designed to meet the unique health care needs of each survivor. The program provides care based on recommendations from the Children's Oncology Group (www.survivorshipguidelines.org).The team consists of oncologists, pediatricians, internists, endocrinologists, psychologists, and a nurse coordinator. In addition to the evaluations provided by the survivorship clinic, referrals can be made for evaluations in other specialty clinics such as Pulmonology, Ophthalmology, or Cardiology. Our program is an invited member of the COG's Survivorship / Cancer Control Consortium.

Adolescent and Young Adult Cancer Program

Led by Anderson Collier, MD, the program is working with the Vanderbilt-Ingram Cancer Center, Vanderbilt Children's Hospital and the LIVESTRONG Young Adult Alliance to focus on the unique needs of this population of patients by enhancing access to appropriate clinical trials.

Statistics

Pediatric Oncology Program

No. of Inpatient Beds

No. of Admissions

Total Outpatient Visits

No. of Bone Marrow Transplants

No. of Oncologists

12-bed HEPA filtered myelosuppression unit plus 12 oncology beds

1050 in FY 2007

14,800 in FY 2007

29 in FY 2007

10

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