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Haematology/Oncology
Haematology/Oncology

Programs

AfterCare Program

The improved cure rates now achieved in many childhood cancers have resulted in a high likelihood of survival into adulthood for a majority of our patients. Unfortunately, some of the therapies needed to achieve these excellent results have unwanted organ toxicities (e.g. cardiorespiratory, endocrine) or impact learning and psychosocial outcomes. Recognition and management of these unwanted complications is paramount to maximizing the long-term health and quality-of-life of childhood cancer survivors. As a result, survivorship (or aftercare) is an integral and fast growing component of paediatric oncology. The AfterCare Program at SickKids is one of a network of five pediatric programs across Ontario that are run under the auspices of the Pediatric Oncology Group of Ontario (POGO).

Dr. Paul Nathan is Director of the Division's AfterCare Program. The clinic is also staffed by an oncologist (Dr. Mark Greenberg), a nurse practitioner, nurse, health psychologist, neuropsychologist, and a dietitian. Dr Stacey Urbach, an endocrinologist, provides care to children who have developed endocrine disorders as a result of their therapy. In addition to a weekly clinic for survivors of a range of childhood cancers, the AfterCare Program holds monthly specialized clinics for survivors of brain tumors (in collaboration with members of the neuro-oncology section) and stem cell transplant (in collaboration with members of the transplant section). Four times a year, the Program conducts transition clinics to facilitate the transfer of survivors who are turning 18 years the adult survivor program at the Princess Margaret Cancer Centre.

New Agents and Innovative Therapies (NAIT) Program

The New Agents and Innovative Therapies program (NAIT) provides access to promising new therapies for children with recurrent or refractory cancer. The NAIT program staff collaborates with members of the leukemia/lymphoma, solid tumour and neuro-oncology sections of the Division of Hematology/Oncology to conduct Phase I/II clinical trials, and works with referring physicians at other Canadian centres to facilitate access to early phase trials for children from across Canada with recurrent or refractory cancers. SickKids is the only Canadian member of the National and International consortia. In addition, clinicians and scientists in the Garron Family Cancer Centre at SickKids collaborate to translate scientific discoveries at SickKids into innovative early-phase paediatric cancer clinical trials.  SickKids also collaborates with other cancer centres in Canada and worldwide, as well as with industry partners.

Cancer Genetics Program

The cancer genetics program was established in under the leadership of David Malkin and Rosanna Weksberg (Division of Clinical Genetics). Members of the cancer genetics program include David Malkin, Rosanna Weksberg, Stephen Meyn (genetics), Maru Barrera (psychology), Amy Kaiser (psychology) and Harriet Druker (genetics councilor). The cancer genetics program receives approximately 80 referrals each year for SickKids (55 per cent), Canada and (30 per cent) around 40 countries from around the world The program acts as a teaching resource for Masters students enrolled in cancer genetics at the University of Toronto and there is currently one genetics fellow in the training program. The program is recognized nationally and internationally for its basic science/clinical research activities. Investigators in the program are recipients of approximately CDN$ 600,000 in operating grants and the program was awarded a $1.8 million grant from the Canadian Foundation for Innovation to assist with the development of a paediatric cancer tissue bank.

Marrow Failure and Myelodysplasia Program

The Marrow Failure and Myelodysplasia Program was established in 2002 under the leadership of Yigal Dror. The individual disorders with bone marrow failure and myelodysplasia are relatively rare; however, when combined together they constitute an important portion of the paediatric haematology/oncology practice. The aims of the Program are to provide the highest standards of care to patients with inherited and acquired marrow failure syndromes and myelodysplasia, as well as to maintain strong research and education activities. The Program team includes Yigal Dror, Dr. Melvin Freedman, Karen Charpentier (Haematology Nurse), Kim Yuille (Blood and Marrow Transplantation Nurse), Deborah Berlin (social worker) and Lisa Morgovsky (clinical research associate). As of July 2004 approximately 170 patients are being followed at the Haematology and Blood and Marrow Transplant clinics of the Program. The Program acts as a training resource for students and post-doctoral clinical and basic research fellows. It provides an excellent infrastructure for research in inherited marrow failure syndromes, through its Hematopoiesis Research Laboratory and its national collaborative network - the Canadian Inherited Marrow Failure registry under the direction of Yigal Dror. Reflecting the ongoing research and high quality of care in the pre-leukemic marrow failure syndromes and myelodysplasia in the Program, the Division of Haematology/Oncology was recognized as a Center of Excellencein research and treatment of myelodysplastic syndromes by the International MDS Foundation. Multiple laboratory-based and clinical research studies are conducted by investigators in the Program, and are funded by the Canadian Institute for Health Research, Shwachman-DiamondCanada, Fanconi Anemia Canada, Shwachman-Diamond syndrome International, and The Anemia Institute for Research and Education.