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Cherraqi A, El Mandour J, Dghoughi B, Tbouda M, El Kababri M, Hessissen L, El Haddad S, Allali N, Chat L. A rare case of Ewing's sarcoma of the maxillary sinus. Radiol Case Rep 2023; 18:4248-4252. [PMID: 37766835 PMCID: PMC10520663 DOI: 10.1016/j.radcr.2023.08.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Ewing's sarcoma is generally an aggressive, poorly differentiated bone and soft tissue tumor affecting children and young adults, it accounts for 4%-6% of all primary bone tumors and primary facial locations occur in only 1%-4% of all cases, primarily in the mandible and calvaria. Involvement of the paranasal sinuses is rare. Here we report the case of an 11-year-old girl with no medical, surgical, or traumatic history, who presented for 1 month and progressive evolution of swelling of the left cheek, associated with pain, nasal obstruction, rhinorrhea, and a slight weight loss not quantified. A craniofacial computed tomography (CT) scan showed a mixed lytic and condensing lesional tissue process centered on the left maxillary sinus, heterogeneously enhanced after contrast injection, lysing the walls of the sinus extended to the homolateral nasal cavity and slightly infiltrating the adjacent soft tissues. An incisional biopsy was performed and the pathological study proved that it was Ewing's sarcoma. She was put on neoadjuvant chemotherapy using 6 courses of vincristine, doxorubicin, ifosfamide, etoposide which resulted in a partial regression of the tumor size by 50%. Then the patient was put on combined chemotherapy and radiotherapy. A follow-up CT scan after 6 courses of vincristine, actinomycin, cyclophosphamide, and 17 sessions of radiotherapy showed lesion stability. Maxillary Ewing's sarcoma is a rare and aggressive tumor. Therefore, early diagnosis, combination therapy, and long-term follow-up are suggested in such cases to improve the survival rate.
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Affiliation(s)
- Amine Cherraqi
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
| | - Jihane El Mandour
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
| | - Basma Dghoughi
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
| | - Mohammed Tbouda
- Anatomical Pathology Department, Mohammed Vth military hospital, Rabat, Morocco
| | - Maria El Kababri
- Pediatric Oncology Department, Mother and Child Unit, CHU Ibn Sina Rabat, Morocco
| | - Laila Hessissen
- Pediatric Oncology Department, Mother and Child Unit, CHU Ibn Sina Rabat, Morocco
| | - Siham El Haddad
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
| | - Nazik Allali
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
| | - Latifa Chat
- Radiology Department Mother and Child Hospital Ibn Sina, Rabat, Morocco
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Laasri K, Bahlouli N, Chait F, Isfaoun Z, Hessissen L, Rouas L, Lamalmi N, Allali N, El haddad S, Chat L. A rare case of renal tumor in children: Clear cell sarcoma with an unusual presentation. Radiol Case Rep 2023; 18:3865-3871. [PMID: 37670910 PMCID: PMC10475403 DOI: 10.1016/j.radcr.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023] Open
Abstract
Clear cell sarcoma of the kidney is the most frequently misdiagnosed renal tumor in children. We report the case of a 6-year-old boy with clear cell sarcoma of the kidney with an unusual presentation, including a primary tumor of the left kidney with metastasis in the homolateral psoas muscle. The renal tumor was revealed by abdominal mass without hematuria. In a review of the literature. Clear cell sarcoma of the kidney is most commonly associated with bone and lung metastases. Muscular metastasis at initial diagnosis has not previously been reported. This case represents an unusual metastatic pattern of clear cell sarcoma of the kidney. This also illustrates clear cell sarcoma of the kidney's ability to metastasize to other sites including the muscular. These tumors present a diagnostic challenge for the radiologist who should be aware of this entity to differentiate it from other renal tumors which are more frequent at this age. We aim to report the clinical, radiological features, and pathological presentation of this entity.
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Affiliation(s)
- Khadija Laasri
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Nourrelhouda Bahlouli
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Fatima Chait
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Zineb Isfaoun
- Pediatric Oncology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Laila Hessissen
- Pediatric Oncology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Lamiae Rouas
- Anatomo-Pathology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Najat Lamalmi
- Anatomo-Pathology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Nazik Allali
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Siham El haddad
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
| | - Latifa Chat
- Pediatric Radiology Department, Rabat Children's Hospital, Ibn Sina Hospital, Mohamed V University, Rabat, Morocco
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Ouadghiri S, El Morabit K, Elansari N, Atouf O, Elkababri M, Hessissen L, Essakalli M. Human leukocyte antigen immunization in transfusion-dependent Moroccan patients with beta-thalassemia major: prevalence and risk factors. Hematol Transfus Cell Ther 2023:S2531-1379(23)00086-X. [PMID: 37244818 DOI: 10.1016/j.htct.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/22/2022] [Accepted: 03/30/2023] [Indexed: 05/29/2023] Open
Abstract
INTRODUCTION Beta-thalassemia major patients need a regular blood transfusion to have an initial normal growth. However, these patients have an increased risk of developing alloantibodies. Our main goal was to study HLA alloimmunization in Moroccan Beta-thalassemia patients by confronting it with transfusion and demographic criteria, exploring the involvement of HLA typing profile in the development of HLA antibodies and in turn determining risk factors for their development. METHODS The study consisted of 53 Moroccan pediatric patients with Beta-thalassemia major. Screening for HLA alloantibodies was performed using Luminex technology Whereas HLA genotyping was done with sequence-specific primers (PCR-SSP). RESULTS In this study, 50.9% of patients have been identified as positive for HLA antibodies, with 59.3% having both HLA Class I and Class II antibodies. A significant increase frequency of DRB1*11 allele was revealed in non-immunized patients (34.6% vs. 0%, p = 0.001). Our results also revealed that the majority of our HLA immunized patients were women (72.4% vs. 27.6%, p = 0.001), and transfused with more than 300 units of RBC units (66.7% vs. 33.3%, p = 0.02). There were statistically significant differences when comparing these frequencies. CONCLUSIONS This paper revealed that the transfusion dependent Beta-thalassemia major patients are exposed to risk of developing HLA antibodies following transfusions with leukoreduced RBC units. The HLA DRB1*11 was a protective factor against HLA alloimmunization in our beta-thalassemia major patients.
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Affiliation(s)
- Sanae Ouadghiri
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco.
| | | | - Naoual Elansari
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco
| | - Ouafae Atouf
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Maria Elkababri
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Laila Hessissen
- Pediatric Oncology center of the children's Hospital, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Malika Essakalli
- Blood Transfusion, Ibn Sina University Hospital, Rabat, Morocco; Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
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Isfaoun Z, Laasri K, Jidal M, Cherradi N, Melhaoui A, Chat L, Haddad SE, Kababri ME, Khorassani ME, Kili A, Ansari NE, Hessissen L. A rare presentation of a spinal diffuse midline glioma in a child: a case report. Pan Afr Med J 2023; 44:183. [PMID: 37484594 PMCID: PMC10362656 DOI: 10.11604/pamj.2023.44.183.39885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 07/25/2023] Open
Abstract
Our patient had an extremely rare type of pediatric Diffuse Midline Glioma (DMG) with modified H3 K27 that occurred in the cervical spinal cord. Due to its location in the spinal cord, slow clinical presentation with torticollis for 7 months, and the non-specific radiological appearance of this tumour, it was initially considered to be a low-grade glioma. Based on imaging findings, the neurosurgery team performed a complete surgical resection, but the pathological features were consistent with a high-grade, diffuse midline glioma. Therefore, we are reporting a case of an altered high-grade DMG H3K27 glioma, which is difficult to diagnose due to its slow clinical symptoms which caused a delay in diagnosis, non-specific imaging, and with difficulty in accessing histopathological markers in low and middle income countries (LMIC).
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Affiliation(s)
- Zineb Isfaoun
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Khadija Laasri
- Mohammed V University, Radiology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Manal Jidal
- Mohammed V University, Radiology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Nadia Cherradi
- Mohammed V University, Pathology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Adil Melhaoui
- Mohammed V University, Neurosurgery Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Latifa Chat
- Mohammed V University, Radiology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Siham El Haddad
- Mohammed V University, Radiology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Maria El Kababri
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Mohamed El Khorassani
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Amina Kili
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Naoual El Ansari
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
| | - Laila Hessissen
- Mohammed V University, Pediatric Hematology and Oncology Department, Children’s Hospital in Rabat, Rabat, Morocco
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van Heerden J, Lisa Christine I, Downing J, Davidson A, Hessissen L, Schoeman J, Ladas EJ, Abdelhafeez H, Georgia Odongo Arao S, Fentie AM, Kamal S, Parkes J, Naiker T, Ludick A, Balagadde-Kambugu J, Geel J. Current status of African pediatric oncology education efforts aligned with the Global Initiative for Childhood Cancer. Pediatr Hematol Oncol 2023; 40:224-241. [PMID: 36083006 DOI: 10.1080/08880018.2022.2117882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/01/2022] [Accepted: 08/20/2022] [Indexed: 10/14/2022]
Abstract
Education of the pediatric oncology workforce is an important pillar of the World Health Organization CureAll technical package. This is not only limited to healthcare workers, but all stakeholders in the childhood cancer management process. It includes governmental structures, academic institutions, parents and communities. This review evaluated the current educational and advocacy training resources available to the childhood cancer community, the contribution of SIOP Africa in the continental educational needs and evaluated future needs to improve the management of pediatric malignancies in reaching the Global Initiative for Childhood Cancer goals. Childhood cancer, unlike adult cancers, has not been prioritized in African cancer control plans nor the teaching and advocacy surrounding pediatric oncology. The availability of formal training programs for pediatric oncologists, pediatric surgeons and radiotherapy specialists are limited to particular countries. In pharmacy and nutritional services, the exposure to pediatric oncology is limited while training in advocacy doesn't exist. Many nonacademic stakeholders are creating the opportunities in Africa to gain experience and train in these various fields, but formal training programs should still be advocated for. LEARNING POINTSThe African continent has various resources to increase the capacity of childhood cancer care stakeholders to increase their knowledge.African pediatric oncology teams rely on a multitude of international sources for training while developing their own.There is a greater need for formal, standardized cancer training especially for pediatric surgeons, radio-oncologists and nurses.Greater inclusion of pathologists, pediatric oncology pharmacists and dieticians into multidisciplinary care and childhood cancer training should be facilitated and resourced.Successful advocacy programs and tool kits exist in parts of Africa, but the training in advocacy is still underdeveloped.
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Affiliation(s)
- Jaques van Heerden
- Pediatric Hematology and Oncology, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- Pediatric Hematology and Oncology, Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Irumba Lisa Christine
- Advocacy and Research Officer, Palliative Care Association of Uganda, Kampala, Uganda
| | - Julia Downing
- International Children's Palliative Care Network, Bristol, UK
- Palliative care Education and Research Consortium, Kampala, Uganda
| | - Alan Davidson
- Pediatric Hematology-Oncology Service, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Laila Hessissen
- Pediatric Oncology Department, Children's Hospital, University Mohammed V, Rabat, Morocco
| | - Judy Schoeman
- Department of Pediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - Elena J Ladas
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Columbia University Irving Medical Center, New York, New York, USA
| | - Hafeez Abdelhafeez
- Department of Surgery, St. Jude Children Research Hospital, Memphis, Tennessee, USA
| | | | - Atalay Mulu Fentie
- Tikur Anbessa Specialized Hospital, School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sherif Kamal
- Pharmacy Manager, Children's Hospital, Cairo, Egypt
| | - Jeannette Parkes
- Department of Radiation Oncology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Thurandrie Naiker
- Department of Radiation Oncology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Adri Ludick
- Program Development Manager, Childhood Cancer Foundation South Africa (CHOC) National Office, Johannesburg, South Africa
| | | | - Jennifer Geel
- University of the Witwatersrand, Division of Pediatric Hematology-Oncology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
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Cherraqi A, El Haddad S, Messaoud O, Andour H, Tbouda M, El Ansari N, KILI A, Hessissen L, Allali N, Chat L. Saphenous Nerve Schwannoma: A Rare Differential Diagnosis of Knee Pain in Children. Glob Pediatr Health 2023; 10:2333794X231156047. [PMID: 36814534 PMCID: PMC9940164 DOI: 10.1177/2333794x231156047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/20/2023] [Indexed: 02/19/2023] Open
Abstract
Schwannomas are uncommon benign tumors of the peripheral nerves with a low risk of malignant transformation. They rarely affect children, can affect any part of the body but rarely occur in the lower extremity and typically present with a palpable mass, pain or neurological signs. Imaging helps to orient the diagnosis and anatomopathological examination helps to confirm it. We report a case of a 12-year-old girl who presented with left knee pain with subcutaneous mass overlying the tibial tuberosity medially. Clinical examination revealed a positive Tinel's sign. Magnetic resonance imaging (MRI) of the knee was performed, which revealed an encapsulated subcutaneous soft tissue mass overlying the tibial tuberosity medially, eccentric to the course of the infrapatellar branch of the saphenous nerve. The patient was operated with total intracapsular excision of the lesion and the anatomopathological study of the surgical specimen came back in favor of a schwannoma. Postoperatively, the patient showed a good recovery with disappearance of pain and swelling.
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Affiliation(s)
- Amine Cherraqi
- Mother and Child Hospital IBN SINA, Rabat, Morocco,Amine Cherraqi, Ibn Sina University Hospital Center, Rabat 10000, Morocco.
| | | | - Ola Messaoud
- Mother and Child Hospital IBN SINA, Rabat, Morocco
| | - Hajar Andour
- Mother and Child Hospital IBN SINA, Rabat, Morocco
| | | | | | | | | | - Nazik Allali
- Mother and Child Hospital IBN SINA, Rabat, Morocco
| | - Latifa Chat
- Mother and Child Hospital IBN SINA, Rabat, Morocco
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van Heerden J, Balagadde-Kambugu J, Angom R, Lusobya RC, Chantada G, Desjardins L, Fabian ID, Israels T, Paintsil V, Hessissen L, Diouf MN, Elayadi M, Turner SD, Kouya F, Geel JA. Evaluating the baseline survival outcomes of the "six Global Initiative for Childhood Cancer index cancers" in Africa. Pediatr Hematol Oncol 2022; 40:203-223. [PMID: 36369884 DOI: 10.1080/08880018.2022.2140860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Limited survival data for the six Global Initiative for Childhood Cancer (GICC) priority cancers are available in Africa. Management of pediatric malignancies in Africa is challenging due to lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment. Reporting of outcome data is problematic due to the lack of registries. With the aim of evaluating the feasibility of baseline outcomes for the six index cancers, we present a descriptive analysis of respective survival rates in Africa. The survival rates were between 18% (lower middle-income countries) to 82.3% (upper middle-income countries) for acute lymphoblastic leukemia, between 26.9% (low-income countries) to 77.9% (upper middle-income countries) for nephroblastoma, between 23% (low-income countries) to 100% (upper middle-income countries), for retinoblastoma, 45% (low-income countries) to 95% (upper middle-income countries) for Hodgkin lymphoma and 28% (low-income countries) to 76% (upper middle-income countries) for Burkitt lymphoma. Solutions to improve survival rates and reported outcomes include establishing and funding sustainable registries, training and to actively include all countries in consortia from different African regions.HighlightsContinental differences in childhood cancer management such lack of resources, setting-specific comorbidities, high rates of late presentation and treatment abandonment, present challenges to the achievement of Global Initiative for Childhood Cancer goals.The available data registries do not adequately inform on the true incidences and outcomes of childhood cancers in Africa.The pathophysiology of some childhood cancers in Africa are associated with high-risk prognostic factors.Outcomes can be improved by greater regional collaboration to manage childhood cancer based on local resources and tumor characteristics.Some individual countries have reached the Global Initiative for Childhood Cancer goals for single cancers and it should be possible for more African countries to follow suit.
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Affiliation(s)
- Jaques van Heerden
- Pediatric Hematology and Oncology, Department of Pediatrics, Antwerp University Hospital, Antwerp, Belgium.,Pediatric hematology and Oncology, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | | | - Racheal Angom
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Rebecca Claire Lusobya
- Department of Ophthalmology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Guillermo Chantada
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | - Ido Didi Fabian
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.,International Center for Eye Health London School of Hygiene and Tropical Medicine, London, UK
| | - Trijn Israels
- Department of Pediatrics, Queen Elizabeth Central Hospital, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Vivian Paintsil
- Department of Child Health, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Laila Hessissen
- Pediatric Hematology and Oncology Center, University Mohammed V Rabat, Rabat, Morocco
| | | | - Moatasem Elayadi
- Department of Pediatric Oncology, National Cancer Institute, Egypt & Children Cancer Hospital of Egypt (CCHE-57357), Cairo University, Giza, Egypt
| | | | - Francine Kouya
- Department of Pediatric Oncology, Cameroon Baptist Convention Hospitals in Mutengene, Mbingo and Banso, Mutengene, Cameroon
| | - Jennifer A Geel
- Division of Pediatric Hematology-Oncology, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Witwatersrand, South Africa
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Mechita NB, Cherkaoui S, Abousselham L, Benmiloud S, Kili A, Kababri ME, Maani K, Houdzi JE, Benajiba N, Madani A, Bennani M, Belakhel L, Bouffet E, Patte C, Harif M, Youbi M, Hessissen L. Implementing the WHO Global Initiative for Childhood Cancer in Morocco: Survival study for the six indexed childhood cancers. Pediatr Blood Cancer 2022; 69:e29788. [PMID: 35796382 DOI: 10.1002/pbc.29788] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/06/2022] [Accepted: 03/21/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND In 2018, the World Health Organization (WHO) launched the Global Initiative for Childhood Cancer (GICC). The goal is to achieve a global survival rate of at least 60% for all children with cancer by 2030. Morocco was designated as a pilot country for this initiative. PROCEDURE This retrospective study included a cohort of children aged 0-15 years, with one of the six indexed cancers (acute lymphoblastic leukemia [ALL], Burkitt lymphoma [BL], Hodgkin lymphoma, retinoblastoma [RB], Wilms tumor or nephroblastoma, low-grade glioma), diagnosed between January 1, 2017 and December 31, 2019 at the six Moroccan Pediatric Hematology and Oncology units. Patients were followed-up until August 31, 2020. The Kaplan-Meier method was used to estimate survival rates, the log-rank test for comparing survival curves, and the Cox model for identifying prognostic factors. RESULTS Data on 878 patients were included in the study. The most frequently reported cancer type was ALL (n = 383, 43.6%), followed by Wilms tumor (n = 139, 15.8%) and BL (n = 133, 15%). Most patients were less than 5 years of age (n = 446, 50.9%) and the male/female ratio was 1.46. The 1, 2, and 3-year overall survival rates were 80.1%, 73.6%, and 68.2%, respectively. In a multivariable Cox regression model, care center, cancer type, age group, and distance to the care center were statistically significantly associated to survival. Patients aged 10 years and older and patients living more than 100 km from the care center were more likely to die (respectively, HR = 1.39, p = .045 and HR = 1.44, p = .010). CONCLUSION The reported results represent the baseline for measuring the impact of GICC implementation in Morocco.
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Affiliation(s)
| | - Siham Cherkaoui
- Pediatric Hematology and Oncology Unit, 2O August Hospital Casablanca, Moroccan Society of Pediatric Hematology and Oncology, Casablanca, Morocco
| | | | - Sarra Benmiloud
- Pediatric Hematology and Oncology Unit of Fès, Moroccan Society of Pediatric Hematology and Oncology, Fès, Morocco
| | - Amina Kili
- Pediatric Hematology and Oncology Department of Rabat, Moroccan Society of Pediatric Hematology and Oncology, Rabat, Morocco
| | - Maria El Kababri
- Pediatric Hematology and Oncology Department of Rabat, Moroccan Society of Pediatric Hematology and Oncology, Rabat, Morocco
| | - Khadija Maani
- Pediatric Hematology and Oncology Unit at Abderrahim El Harouchi Hospital Casablanca, Moroccan Society of Pediatric Hematology and Oncology, Casablanca, Morocco
| | - Jamila El Houdzi
- Pediatric Hematology and Oncology Department of Marrakech, Moroccan Society of Pediatric Hematology and Oncology, Marrakech, Morocco
| | - Noufissa Benajiba
- Pediatric Hematology and Oncology Department of Oujda, Moroccan Society of Pediatric Hematology and Oncology, Oujda, Morocco
| | - Abdellah Madani
- Pediatric Hematology and Oncology Unit, 2O August Hospital Casablanca, Moroccan Society of Pediatric Hematology and Oncology, Casablanca, Morocco
| | - Maria Bennani
- Lalla Salma Foundation - Cancer Prevention and Treatment, Rabat, Morocco
| | - Latefa Belakhel
- Directorate of Epidemiology and Disease Control, Rabat, Morocco
| | - Eric Bouffet
- The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Catherine Patte
- Francophone African Group of Pediatric Oncology, Gustave Roussy Institut, Villejuif, France
| | - Mhamed Harif
- University Hospital Center of Tangier, Tangier, Morocco
| | - Mohammed Youbi
- Directorate of Epidemiology and Disease Control, Rabat, Morocco
| | - Laila Hessissen
- Pediatric Hematology and Oncology Department of Rabat, Moroccan Society of Pediatric Hematology and Oncology, Rabat, Morocco
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Balagadde-Kambugu J, Davidson A, Hessissen L, Afungchwi GM, Parkes J, van Heerden J, Geel J. Toward 2030: SIOP Africa adopts the Global Initiative for Childhood Cancer. Pediatr Hematol Oncol 2022; 40:197-202. [PMID: 36062960 DOI: 10.1080/08880018.2022.2117883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | | | | | | | | | | | - Jennifer Geel
- SIOP Africa Secretary-General, Johannesburg, South Africa
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Abdulrahaman AA, Abouelnaga S, Ademola-Popoola DS, Adio A, Afifi MA, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Akinsete A, Al Harby L, Al Mesfer S, Al Ani MH, Alarcón Portabella S, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad CE, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amankwaa-Frempong D, Amiruddin PO, Armytasari I, Astbury NJ, Atalay HT, Ataseven E, Atchaneeyasakul LO, Atsiaya R, Autrata R, Balaguer J, Balayeva R, Barranco H, Bartoszek P, Bartuma K, Bascaran C, Bechrakis NE, Beck Popovic M, Begimkulova AS, Benmiloud S, Berete RC, Berry JL, Bhaduri A, Bhat S, Bhattacharyya A, Biewald EM, Binkley E, Blum S, Bobrova N, Boldt H, Bonanomi MTBC, Bouda GC, Bouguila H, Brennan RC, Brichard BG, Buaboonnam J, Budiongo A, Burton MJ, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Caspi S, Cassoux N, Castela G, Castillo L, Català-Mora J, Cavieres I, Chandramohan A, Chantada GL, Chaudhry S, Chawla B, Chen W, Chiwanga FS, Chuluunbat T, Cieslik K, Clark A, Cockcroft RL, Comsa C, Correa Llano MG, Corson TW, Couitchere L, Cowan-Lyn KE, Csóka M, Dangboon W, Das A, Das P, Das S, Davanzo JM, Davidson A, De Francesco S, De Potter P, Quintero D K, Demirci H, Desjardins L, Díaz Coronado RY, Dimaras H, Dodgshun AJ, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Du Plessis J, Dudeja G, Eerme K, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elhaddad AM, Elhassan MMA, Elzembely MM, Ericksen C, Essuman VA, Evina TGA, Ezegwui IR, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Garcia JL, García Aldana D, Garcia Pacheco HN, Geel JA, Ghassemi F, Girón AV, Goenz MA, Gold AS, Goldberg H, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Gorfine M, Graells J, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Gupta V, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Muhammad H, Hassan S, Hassan S, Hautz W, Haydar H, Hederova S, Hessissen L, Hongeng S, Hordofa DF, Hubbard GB, Hummelen M, Husakova K, Hussein Al-Janabi AN, Ibanga A, Ida R, Ilic VR, Islamov Z, Jairaj V, Janjua T, Jeeva I, Ji X, Jo DH, Jones MM, Kabesha Amani TB, Kabore RL, Kaliki S, Kalinaki A, Kamsang P, Kantar M, Kapelushnik N, Kardava T, Kebudi R, Keomisy J, Kepak T, Ketteler P, Khan ZJ, Khaqan HA, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivela TT, Klett A, Koç I, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lam GC, Larson SA, Latinović S, Laurenti KD, Lavy Y, Lavric Groznik A, Leverant AA, Li C, Li K, Limbu B, Liu CH, Quah B, López JP, Lukamba RM, Luna-Fineman S, Lutfi D, Lysytsia L, Madgar S, Magrath GN, Mahajan A, Maitra P, Maka E, Makimbetov EK, Maktabi A, Maldonado C, Mallipatna A, Manudhane R, Manzhuova L, Martín-Begue N, Masud S, Matende IO, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Mehrvar A, Mengesha AA, Menon V, Mercado GJV, Mets MB, Midena E, Miller A, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KIM, Munier FL, Murray TG, Musa KO, Mushtaq A, Musika AA, Mustak H, Mustapha T, Muyen OM, Myezo KH, Naidu G, Naidu N, Nair AG, Natarajan S, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ng Y, Nikitovic M, Nkanga ED, Nkumbe HE, Numbi MN, Nummi K, Nuruddin M, Nyaywa M, Nyirenda C, Obono-Obiang G, Oliver SCN, Oporto J, Ortega-Hernández M, Oscar AH, Ossandon D, Pagarra H, Paintsil V, Paiva L, Palanivelu MS, Papyan R, Parrozzani R, Pascual Morales CR, Paton KE, Pe'er J, Peralta Calvo J, Perić S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov V, Ponce J, Qadir AO, Qayyum S, Qian J, Refaeli D, Rahman A, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Randhawa JK, Randrianarisoa HL, Raobela L, Rashid R, Reddy M, Renner LA, Reynders D, Ribadu D, Ritter-Sovinz P, Rogowska A, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sanchez Orozco AJ, Sayalith P, Scanlan TA, Schlüter S, Schwab C, Sedaghat A, Seth R, Sgroi M, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shields CL, Sia D, Siddiqui SN, Sidi cheikh S, Silva S, Singh AD, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Steinberg DM, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tang J, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Teh KH, Tehuteru ES, Teixeira LF, Tekavcic Pompe M, Thawaba ADM, Theophile T, Toledano H, Trang DL, Traoré F, Tripathy D, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, Valente P, van Hoefen Wijsard M, Vasquez Anchaya JK, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Villegas VM, Vishnevskia-Dai V, Waddell K, Wali AH, Wang YZ, Wangtiraumnuay N, Wetter J, Widiarti W, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wong ES, Wongwai P, Wu SQ, Xiang D, Xiao Y, Xu B, Xue K, Yaghy A, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yee RI, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang Y, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries. The Lancet Global Health 2022; 10:e1128-e1140. [PMID: 35839812 PMCID: PMC9397647 DOI: 10.1016/s2214-109x(22)00250-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Funding Queen Elizabeth Diamond Jubilee Trust.
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van Heerden J, Irumba LC, Assani K, Downing J, Davidson A, Hessissen L, Schoeman J, Israels T, Cox S, Abdelhafeez H, Arao SO, Parkes J, Balagadde-Kambugu J, Geel J. Conference report on the 14th International Society of Paediatric Oncology African Continental Meeting, 16–18 March 2022, Kampala, Uganda. Ecancermedicalscience 2022; 16:1423. [PMID: 36158982 PMCID: PMC9458268 DOI: 10.3332/ecancer.2022.1423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Indexed: 11/16/2022] Open
Abstract
Together with the Africa Continental Branch of the International Society of Paediatric Oncology (SIOP Africa), the Uganda Cancer Institute, a tertiary governmental institution for specialised cancer care services, research and training, hosted the 14th continental meeting of SIOP Africa from the 16–18 March 2022. Under the conference theme, ‘Innovate for Africa’, the hybrid conference brought together close to 400 international delegates to discuss innovations and experiences, as well as share the latest research in the field of paediatric oncology. The World Health Organisation 2030 Global Initiative for Childhood Cancer provided the main starting point for the conference with a comprehensive pre-conference workshop programme, from multiple stakeholders and organisations and the themes for the plenaries towards improving survival to the main breakout sessions. Delegates discussed various ways of improving outcomes in Africa, despite the challenges faced individually and collectively ranging from education, management systems and treatment guidelines to future governmental and NGO involvement in African cancer care. The main achievements of the conference were various commitments for collaboration, investing in junior investigators, development of registries and systems for improved childhood care on the African continent, while working towards greater access to advanced management options such as targeted therapies and bone marrow transplant services.
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Affiliation(s)
- Jaques van Heerden
- Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Antwerp 2650, Belgium
- Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town 7530, South Africa
- Department of Paediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | | | - Karim Assani
- International Children’s Palliative Care Network, Bristol BS1 2NT, United Kingdom
| | - Julia Downing
- International Children’s Palliative Care Network, Bristol BS1 2NT, United Kingdom
- Palliative care Education and Research Consortium, Kampala, Uganda
| | - Alan Davidson
- Paediatric Haematology-Oncology Service, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town 7701, South Africa
| | - Laila Hessissen
- Paediatric Oncology Department, Children’s Hospital, University Mohamed V Rabat, 6533, Morocco
| | - Judy Schoeman
- Paediatric Haematology and Oncology, Department of Paediatrics University of Pretoria, Steve Biko Academic Hospital, Pretoria 0001, South Africa
| | - Trijn Israels
- Queen Elizabeth Central Hospital, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Sharon Cox
- Division of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town 7701, South Africa
| | - Hafeez Abdelhafeez
- Department of Surgery, St Jude Children Research Hospital, Memphis, TN 38105, USA
| | - Shauna Odongo Arao
- Department of Paediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Jeannette Parkes
- Department of Radiation Oncology, Groote Schuur Hospital and the University of Cape Town, 7701, South Africa
| | | | - Jennifer Geel
- University of the Witwatersrand, Division of Paediatric Haematology-Oncology, Charlotte Maxeke Johannesburg Academic Hospital, 2000, South Africa
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Lam CG, Alcasabas AP, Antillon F, Calderon P, Dolendo M, Fu L, Gamboa Y, Gassant P, Gomez-Garcia W, Gunasekera S, Khaing AA, Kizyma R, Hessissen L, Mulindwa J, Nogovitsyna Y, Pascal C, Quintero K, Renner L, Soto G, Vasquez L, Vasquez R, Metzger M. Defining availability of 100 essential diagnostic items for children with cancer and gaps in implementing WHO recommendations: Global CEDx Working Group survey. Lancet Oncol 2022. [DOI: 10.1016/s1470-2045(22)00428-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Pritchard-Jones K, Challinor JM, Hunger SP, Sung L, Davidson A, Morrissey LK, Khan MS, Dalvi RB, Sullivan MJ, Hessissen L, Chantada GL, Kearns P, Frazier AL, Wollaert S, Laub T. SIOP Strategy 2021-2025: Cure for more, care for all. Pediatr Blood Cancer 2022; 69:e29577. [PMID: 35166434 DOI: 10.1002/pbc.29577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Kathy Pritchard-Jones
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | | | | | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | | | | | - Rashmi B Dalvi
- Bombay Hospital Institute of Medical Sciences SRCC Children's Hospital, Mumbai, India
| | - Michael J Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | | | | | - Pamela Kearns
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, United Kingdom
| | | | - Susanne Wollaert
- Executive Director, International Society of Paediatric Oncology, Meierskappel, Switzerland
| | - Tzvetomira Laub
- Executive Director for Programmes and Strategy, International Society of Paediatric Oncology, Meierskappel, Switzerland
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14
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Ngwa W, Addai BW, Adewole I, Ainsworth V, Alaro J, Alatise OI, Ali Z, Anderson BO, Anorlu R, Avery S, Barango P, Bih N, Booth CM, Brawley OW, Dangou JM, Denny L, Dent J, Elmore SNC, Elzawawy A, Gashumba D, Geel J, Graef K, Gupta S, Gueye SM, Hammad N, Hessissen L, Ilbawi AM, Kambugu J, Kozlakidis Z, Manga S, Maree L, Mohammed SI, Msadabwe S, Mutebi M, Nakaganda A, Ndlovu N, Ndoh K, Ndumbalo J, Ngoma M, Ngoma T, Ntizimira C, Rebbeck TR, Renner L, Romanoff A, Rubagumya F, Sayed S, Sud S, Simonds H, Sullivan R, Swanson W, Vanderpuye V, Wiafe B, Kerr D. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. Lancet Oncol 2022; 23:e251-e312. [PMID: 35550267 PMCID: PMC9393090 DOI: 10.1016/s1470-2045(21)00720-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 01/13/2023]
Abstract
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality. Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about 1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive, and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial investment is needed in developing cancer registries and cancer diagnostics for core cancer tests. We show that investments in, and increased adoption of, some approaches used during the COVID-19 pandemic, such as hypofractionated radiotherapy and telehealth, can substantially increase access to cancer care in Africa, accelerate cancer prevention and control efforts, increase survival, and save billions of US dollars over the next decade. The involvement of African First Ladies in cancer prevention efforts represents one practical approach that should be amplified across SSA. Moreover, investments in workforce training are crucial to prevent millions of avoidable deaths by 2030. We present a framework that can be used to strategically plan cancer research enhancement in SSA, with investments in research that can produce a return on investment and help drive policy and effective collaborations. Expansion of universal health coverage to incorporate cancer into essential benefits packages is also vital. Implementation of the recommended actions in this Commission will be crucial for reducing the growing cancer crises in SSA and achieving political commitments to the UN Sustainable Development Goals to reduce premature mortality from non-communicable diseases by a third by 2030.
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Affiliation(s)
- Wilfred Ngwa
- Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Information and Sciences, ICT University, Yaoundé, Cameroon.
| | - Beatrice W Addai
- Breast Care International, Peace and Love Hospital, Kumasi, Ghana
| | - Isaac Adewole
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Victoria Ainsworth
- Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, USA
| | - James Alaro
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | | | - Zipporah Ali
- Kenya Hospices and Palliative Care Association, Nairobi, Kenya
| | - Benjamin O Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Rose Anorlu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Stephen Avery
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Prebo Barango
- WHO, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Noella Bih
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Otis W Brawley
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Lynette Denny
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa; South African Medical Research Council, Gynaecological Cancer Research Centre, Tygerberg, South Africa
| | | | - Shekinah N C Elmore
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Ahmed Elzawawy
- Department of Clinical Oncology, Suez Canal University, Ismailia, Egypt
| | | | - Jennifer Geel
- Division of Paediatric Haematology and Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Katy Graef
- BIO Ventures for Global Health, Seattle, WA, USA
| | - Sumit Gupta
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Laila Hessissen
- Pediatric Oncology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Andre M Ilbawi
- Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Joyce Kambugu
- Department of Pediatrics, Uganda Cancer Institute, Kampala, Uganda
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, WHO, Lyon, France
| | - Simon Manga
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Lize Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Sulma I Mohammed
- Department of Comparative Pathobiology, Center for Cancer Research, Purdue University, West Lafayette, IN, USA
| | - Susan Msadabwe
- Department of Radiation Therapy, Cancer Diseases Hospital, Lusaka, Zambia
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | | | - Ntokozo Ndlovu
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kingsley Ndoh
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Timothy R Rebbeck
- Dana-Farber Cancer Institute, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Lorna Renner
- Department of Paediatrics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
| | - Anya Romanoff
- Department of Health System Design and Global Health, Icahn School of Medicine, The Mount Sinai Hospital, New York, NY, USA
| | - Fidel Rubagumya
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda; University of Global Health Equity, Kigali, Rwanda
| | - Shahin Sayed
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | - Shivani Sud
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Simonds
- Division of Radiation Oncology, Tygerberg Hospital and University of Stellenbosch, Stellenbosch, South Africa
| | | | - William Swanson
- Department of Physics and Applied Physics, Dana-Farber Cancer Institute, University of Massachusetts Lowell, Lowell, MA, USA
| | - Verna Vanderpuye
- National Centre for Radiotherapy, Oncology, and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - David Kerr
- Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
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Bouyadmar M, Khorassani ME, Kababri ME, Kili A, Hessissen L. The prevalence of anti-factor VIII and anti-factor IX antibodies among patients with hemophilia in Rabat, Morocco: a single center experience. Pan Afr Med J 2022; 41:126. [PMID: 35480405 PMCID: PMC9011910 DOI: 10.11604/pamj.2022.41.126.29571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 01/08/2022] [Indexed: 11/25/2022] Open
Abstract
The emergence of anti-factor VIII and anti-factor IX antibodies in hemophilia A or B is the most serious complication of hemophilia. We aim to expose through a series of patient's data, collected between 02/2009 and 02/2016 in the pediatric service of university hospital of Rabat, Morocco, the epidemiological and clinical characteristics of these patients, and to highlight the therapeutic difficulties encountered during their treatment. Out of 120 hemophiliac patients, we included 22 hemophiliac patients (18.33%, p<0.004) who developed an antibody, 21 patients with hemophilia A. Among the patients, 54.5% (n=12) exhibited moderate hemophilia, while 45.5% (n=10) had major hemophilia. The average age at diagnosis is estimated to 12±6.6 years. The circumstances of diagnosis were dominated by therapeutic inefficiency (63.64% (n=14)), then came dental extraction (9.09% (n=2)), preoperative assessment 22.73% (n=5) and hemophiliac arthropathy in a single case. The titration of antibodies in a 12-person sample ranged from 0.6 UB to 84 UB, of which (41.67% (n=5)) were low responders. The therapeutic treatment was based on fresh frozen plasma (54.55% (n=7)), recombinant activated factor VII (18.2% (n=4)), recombinant activated factor VII and PFC (18.2% (n=4)), and induction of immune tolerance. The occurrence of an inhibitory antibody represents the major residual complication of replacement therapy.
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Affiliation(s)
- Meryem Bouyadmar
- Department of Pediatrics, Cheikh Khalifa Ibn Zayed International University Hospital, Casablanca, Morocco.,Hemophilia Treatment Center and Bleeding Disorders, Hematology-Oncology Unit, Children's Hospital Rabat, Mohamed V University, Rabat, Morocco
| | - Mohamed El Khorassani
- Hemophilia Treatment Center and Bleeding Disorders, Hematology-Oncology Unit, Children's Hospital Rabat, Mohamed V University, Rabat, Morocco
| | - Maria El Kababri
- Hemophilia Treatment Center and Bleeding Disorders, Hematology-Oncology Unit, Children's Hospital Rabat, Mohamed V University, Rabat, Morocco
| | - Amina Kili
- Hemophilia Treatment Center and Bleeding Disorders, Hematology-Oncology Unit, Children's Hospital Rabat, Mohamed V University, Rabat, Morocco
| | - Laila Hessissen
- Hemophilia Treatment Center and Bleeding Disorders, Hematology-Oncology Unit, Children's Hospital Rabat, Mohamed V University, Rabat, Morocco
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Major A, Palese M, Ermis E, James A, Villarroel M, Klussmann FA, Hessissen L, Geel J, Khan MS, Dalvi R, Sullivan M, Kearns P, Frazier AL, Pritchard-Jones K, Nakagawara A, Rodriguez-Galindo C, Volchenboum SL. Mapping Pediatric Oncology Clinical Trial Collaborative Groups on the Global Stage. JCO Glob Oncol 2022; 8:e2100266. [PMID: 35157510 PMCID: PMC8853619 DOI: 10.1200/go.21.00266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The global pediatric oncology clinical research landscape, particularly in Central and South America, Africa, and Asia, which bear the highest burden of global childhood cancer cases, is less characterized in the literature. Review of how existing pediatric cancer clinical trial groups internationally have been formed and how their research goals have been pursued is critical for building global collaborative research and data-sharing efforts, in line with the WHO Global Initiative for Childhood Cancer. Local stakeholder engagement is necessary to collaborate with global pediatric cancer trial groups.![]()
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Affiliation(s)
- Ajay Major
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Monica Palese
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Ebru Ermis
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Anthony James
- Department of Pediatrics, University of Chicago, Chicago, IL
| | - Milena Villarroel
- Grupo de América Latina de Oncología Pediátrica (GALOP), Hospital Luis Calvo Mackenna, National Pediatric Cancer Program (PINDA), Santiago, Chile
| | - Federico Antillon Klussmann
- National Unit of Pediatric Oncology, Francisco Marroquin University School of Medicine, Guatemala City, Guatemala
| | - Laila Hessissen
- Pediatric Hematology and Oncology, Mohammed V University of Rabat, Rabat, Morocco
| | - Jennifer Geel
- Faculty of Health Sciences, Division of Pediatric Haematology and Oncology, Department of Pediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Muhammad Saghir Khan
- Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Al Madinah, Saudi Arabia
| | - Rashmi Dalvi
- Bombay Hospital Institute of Medical Sciences and SRCC Children's Hospital, Mumbai, India
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | - Pamela Kearns
- Cancer Research UK Clinical Trials Unit, National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Institute of Cancer and Genomic Sciences, Birmingham, United Kingdom
| | | | - Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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17
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Sniderman ER, Graetz DE, Agulnik A, Ranadive R, Vedaraju Y, Chen Y, Devidas M, Chantada GL, Hessissen L, Dalvi R, Pritchard‐Jones K, Rodriguez‐Galindo C, Moreira DC, Bolous NS, Haidar CE, Bihannic L, Sa da Bandeira D, Wang JX, Li D, Graca F, Vasilyeva A, Lesmana H. Impact of the COVID‐19 pandemic on pediatric oncology providers globally: A mixed‐methods study. Cancer 2022; 128:1493-1502. [PMID: 35067925 PMCID: PMC9015299 DOI: 10.1002/cncr.34090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 12/19/2022]
Abstract
Background Coronavirus disease 2019 (COVID‐19) disrupted pediatric oncology care globally, increasing demands on health care providers (HCPs) who adapted to continue care. This study sought to characterize the pandemic's impact on pediatric oncology HCPs worldwide. Methods A 60‐item survey focused on changes to clinical care, resources, and effects on clinicians. A diverse subgroup of institutions was purposefully selected for focus groups that explored teamwork, communication, and changes to care delivery. Results The survey included 311 responses from 213 institutions representing 79 countries. Sixteen institutions participated in 19 multidisciplinary focus groups in 8 languages. Decreased clinical staff availability was cited by 51% of institutions as a major impact. Staffing modifications included decreased provider availability (66% of institutions), roles or responsibility changes, and transfer outside the specialty. Physical effects included frequent COVID‐19 illness; 8% of respondents reported HCP deaths. Fifty percent of providers did not have the necessary personal protective equipment. HCPs also experienced psychological distress and financial concerns. Findings indicated more frequent impact on nurses than other providers. Impacts were described across all hospital resource levels, with staffing modifications more frequent in countries with higher COVID‐19 incidence (P < .001) and mortality rate (P = .004). Focus groups revealed negative impacts were stabilized by increased teamwork, communication, contributions outside usual roles, policies aimed at optimizing safety, and feeling that they were contributing. Conclusions COVID‐19 had a profound impact on the pediatric oncology workforce, creating challenging modifications to staffing and resulting in physical, psychological, and financial distress. Despite these challenges, HCPs caring for children with cancer came together to continue to provide high‐quality care. This mixed‐methods study reveals the impact that the coronavirus disease 2019 (COVID‐19) pandemic has had on pediatric oncology providers globally, and it highlights the importance of implementing strategies to protect the health care workforce during challenging situations.
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Affiliation(s)
- Elizabeth R. Sniderman
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Dylan E. Graetz
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Asya Agulnik
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Radhikesh Ranadive
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Yuvanesh Vedaraju
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Yichen Chen
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
| | - Guillermo L. Chantada
- Department of Pediatric Hematology and Oncology Fundacion Perez Scremini‐Hospital Pereira Rossell Montevideo Uruguay
- Department of Pediatric Hematology and Oncology Hospital Sant Joan de Deu Barcelona Spain
| | - Laila Hessissen
- Department of Pediatric Hematology and Oncology Mohammed V University Rabat Morocco
| | - Rashmi Dalvi
- Department of Pediatrics Bombay Hospital Institute of Medical Sciences Bombay India
| | - Kathy Pritchard‐Jones
- Great Ormond Street Institute of Child Health University College London London England
| | | | - Daniel C. Moreira
- Department of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee
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18
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Derqaoui S, Boujida I, Marbouh O, Rouas L, Hessissen L, Lamalmi N. Non Hodgkin Lymphoma Among Children: Pathological Aspects and Diagnostic Challenges. Clin Pathol 2022; 15:2632010X221090156. [PMID: 35465133 PMCID: PMC9019377 DOI: 10.1177/2632010x221090156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
Non-Hodgkin lymphoma (NHL) are common malignancies in children. Available data on clinico-pathological aspects of pediatric NHL in developping countries are limited and diagnostic approach appears more delicate with absence of molecular studies. The objectives of our study are: analyzing the pathological spectrum of NHL among children and highlighting challenges in the diagnosis including: limited biopsic material; unususal subtyptes, age group, or localization. We retrospectively analyzed clinico pathological characteristics of 101 NHL’s cases among children diagnosed in the Pediatric’s pathology unit over a period of 4 years There were 78 (77.2%) male and 23 (22.8%) female. The median age was 7.2 years. The most common histologic subtypes of NHL were Burkitt lymphoma in 65 patients (64.4% ); followed by lymphoblastic lymphoma in 22 patients, large B-cell lymphoma in 9 patients ( 8.9%); anaplastic T cell lymphoma in 3 patients; NOS mature T cell lymphoma and pediatric type follicular lympoma in 1 patient each. In conclusion, this study Morocco illustrates the pattern of distribution of NHL and emphasizes challenges in the diagnosis of these neoplasms.
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Affiliation(s)
- Sabrine Derqaoui
- Department of Pathology, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco
| | - Ismail Boujida
- Department of Pathology, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco
| | - Oussama Marbouh
- Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco.,Department of Pediatric Surgery A, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco
| | - Lamiaa Rouas
- Department of Pathology, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco
| | - Laila Hessissen
- Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco.,Center of Pediatric Hematology and Oncology, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco
| | - Najat Lamalmi
- Department of Pathology, Children's Hospital Ibn Sina University Hospital, Rabat, Morocco.,Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco
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19
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Geel JA, Ranasinghe N, Myezo KH, Davidson A, Howard SC, Hessissen L, Bouffet E, Challinor J. Pediatric cancer care in Africa: SIOP Global Mapping process. Pediatr Blood Cancer 2021; 68:e29315. [PMID: 34455693 DOI: 10.1002/pbc.29315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/24/2021] [Accepted: 08/16/2021] [Indexed: 11/06/2022]
Abstract
In November 2018, theInternational Society of Paediatric Oncology (SIOP) launched a project to map African facilities providing pediatric oncology treatment. A 55-item digital survey was created in English, piloted in India, translated to French and Portuguese, and distributed by email, social media, or personal contacts. December 2019, 48/54 African countries responded (72% surveys completed and analyzed). Issues included incomplete responses, multiple entries for one facility with conflicting data for key services, and repeated entries with varied answers by the same respondent. The facility mapping project, now on-going program will serve as a global registry of global pediatric cancer centers.
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Affiliation(s)
- Jennifer Ann Geel
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil Ranasinghe
- SIOP PODC Education and Training Working Group, Refinitiv, London, UK
| | - Khumo Hope Myezo
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Alan Davidson
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Scott C Howard
- Department of Acute and Tertiary Care, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Resonance, Arlington, Tennessee, USA
| | - Laila Hessissen
- Paediatric Hematology and Oncology Unit of Rabat, Mohamed V University, Rabat, Morocco
| | - Eric Bouffet
- Garron Chair in Childhood Cancer Research, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, California, USA
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20
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Geel JA, Challinor J, Ranasinghe N, Myezo KH, Eyal KC, Aderounmu W, Davidson A, Pritchard-Jones K, Howard SC, Bouffet E, Hessissen L. Pediatric cancer care in Africa: SIOP Global Mapping Program report on economic and population indicators. Pediatr Blood Cancer 2021; 68:e29345. [PMID: 34519435 DOI: 10.1002/pbc.29345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 07/13/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Inalignment with the World Health Organization (WHO) Global Initiative for Childhood Cancer (GICC), the International Society of Pediatric Oncology initiated a program to map global pediatric oncology services. As survival rates in Africa are low and data are scant, this continent was mapped first to identify areas with greatest need. METHODS Beginning November 2018, an electronic survey was sent to all known stakeholders, followed by email communications and internet searches to verify data. Availability of pediatric oncologists, chemotherapy, surgical expertise, and radiotherapy was correlated with geographic region, World Bank income status, Universal Health Coverage, population < 15 and < 24 years, percentage of gross domestic product spent on healthcare, and Human Development Index (HDI). RESULTS Responses were received from 48/54 African countries. All three treatment modalities were reportedly available in 9/48 countries, whereas seven countries reported no pediatric oncology services. Negative correlations were detected between provision of all three services and geographic region (P = 0.01), younger median population age (P = 0.002), low-income country status (P = 0.045), and lower HDI (P < 0.001). CONCLUSION This study provides a comprehensive overview of pediatric oncology care in Africa, emphasizing marked disparities between countries: some have highly specialized services, whereas others have no services. A long-term strategy to eliminate disparities in African pediatric cancer care should be aligned with the WHO GICC aims and facilitated by SIOP Africa. MEETING ABSTRACTS SIOP maps pediatric oncology services in Africa to address inequalities in childhood cancer services. Geel J, Ranasinghe N, Davidson A, Challinor J, Howard S, Wollaert S, Myezo K, Renner L, Hessissen L, Bouffet E. 51st Annual Congress of the International Society of Paediatric Oncology (SIOP), Lyon, France, October 2019. Pediatric Blood and Cancer Vol 66 S219-S219. Pediatric cancer care in Africa: SIOP Global Mapping Program report on economic and population indicators.
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Affiliation(s)
- Jennifer Ann Geel
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Neil Ranasinghe
- SIOP PODC Education and Training Working Group, Refinitiv, UK
| | - Khumo Hope Myezo
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Wuraole Aderounmu
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alan Davidson
- Division of Paediatric Haematology/Oncology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Scott C Howard
- Department of Acute and Tertiary Care, University of Tennessee Health Science Center, Memphis, USA.,Resonance, Arlington, USA
| | - Eric Bouffet
- Garron Chair in Childhood Cancer Research, University of Toronto, Hospital for Sick Children, Toronto, Canada
| | - Laila Hessissen
- Paediatric Hematology and Oncology Unit of Rabat, Mohamed V University, Rabat, Morocco
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21
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Mukkada S, Bhakta N, Chantada GL, Chen Y, Vedaraju Y, Faughnan L, Homsi MR, Muniz-Talavera H, Ranadive R, Metzger M, Friedrich P, Agulnik A, Jeha S, Lam C, Dalvi R, Hessissen L, Moreira DC, Santana VM, Sullivan M, Bouffet E, Caniza MA, Devidas M, Pritchard-Jones K, Rodriguez-Galindo C. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): a cohort study. Lancet Oncol 2021; 22:1416-1426. [PMID: 34454651 PMCID: PMC8389979 DOI: 10.1016/s1470-2045(21)00454-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies have shown that children and adolescents with COVID-19 generally have mild disease. Children and adolescents with cancer, however, can have severe disease when infected with respiratory viruses. In this study, we aimed to understand the clinical course and outcomes of SARS-CoV-2 infection in children and adolescents with cancer. METHODS We did a cohort study with data from 131 institutions in 45 countries. We created the Global Registry of COVID-19 in Childhood Cancer to capture de-identified data pertaining to laboratory-confirmed SARS-CoV-2 infections in children and adolescents (<19 years) with cancer or having received a haematopoietic stem-cell transplantation. There were no centre-specific exclusion criteria. The registry was disseminated through professional networks through email and conferences and health-care providers were invited to submit all qualifying cases. Data for demographics, oncological diagnosis, clinical course, and cancer therapy details were collected. Primary outcomes were disease severity and modification to cancer-directed therapy. The registry remains open to data collection. FINDINGS Of 1520 submitted episodes, 1500 patients were included in the study between April 15, 2020, and Feb 1, 2021. 1319 patients had complete 30-day follow-up. 259 (19·9%) of 1301 patients had a severe or critical infection, and 50 (3·8%) of 1319 died with the cause attributed to COVID-19 infection. Modifications to cancer-directed therapy occurred in 609 (55·8%) of 1092 patients receiving active oncological treatment. Multivariable analysis revealed several factors associated with severe or critical illness, including World Bank low-income or lower-middle-income (odds ratio [OR] 5·8 [95% CI 3·8-8·8]; p<0·0001) and upper-middle-income (1·6 [1·2-2·2]; p=0·0024) country status; age 15-18 years (1·6 [1·1-2·2]; p=0·013); absolute lymphocyte count of 300 or less cells per mm3 (2·5 [1·8-3·4]; p<0·0001), absolute neutrophil count of 500 or less cells per mm3 (1·8 [1·3-2·4]; p=0·0001), and intensive treatment (1·8 [1·3-2·3]; p=0·0005). Factors associated with treatment modification included upper-middle-income country status (OR 0·5 [95% CI 0·3-0·7]; p=0·0004), primary diagnosis of other haematological malignancies (0·5 [0·3-0·8]; p=0·0088), the presence of one of more COVID-19 symptoms at the time of presentation (1·8 [1·3-2·4]; p=0·0002), and the presence of one or more comorbidities (1·6 [1·1-2·3]; p=0·020). INTERPRETATION In this global cohort of children and adolescents with cancer and COVID-19, severe and critical illness occurred in one fifth of patients and deaths occurred in a higher proportion than is reported in the literature in the general paediatric population. Additionally, we found that variables associated with treatment modification were not the same as those associated with greater disease severity. These data could inform clinical practice guidelines and raise awareness globally that children and adolescents with cancer are at high-risk of developing severe COVID-19 illness. FUNDING American Lebanese Syrian Associated Charities and the National Cancer Institute.
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Affiliation(s)
- Sheena Mukkada
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA.
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Guillermo L Chantada
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Yichen Chen
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Yuvanesh Vedaraju
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lane Faughnan
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Maysam R Homsi
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Hilmarie Muniz-Talavera
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Radhikesh Ranadive
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Monika Metzger
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Paola Friedrich
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Sima Jeha
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Catherine Lam
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Rashmi Dalvi
- Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Laila Hessissen
- Department of Pediatric Hematology and Oncology, Mohammed V University, Rabat, Morocco
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Victor M Santana
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Eric Bouffet
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada
| | - Miguela A Caniza
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
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22
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Harif M, Mallon B, Patte C, Bey P, Chalvon-Demersay C, Omer-Decugis L, Hessissen L. Improving Care for Children With Cancer in Africa: Two Decades of Experience of the French African Pediatric Oncology Group. JCO Glob Oncol 2021; 7:1509-1512. [PMID: 34678073 PMCID: PMC8547926 DOI: 10.1200/go.21.00239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/26/2021] [Accepted: 09/20/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Mhamed Harif
- Groupe Franco-Africain d’Oncologie Pédiatrique, Centre Hospitalier Universitaire Tanger, Faculté de médecine et de pharmacie, Casablanca, Morocco
| | - Brenda Mallon
- Groupe Franco-Africain d’Oncologie Pédiatrique, Villejuif, France
| | - Catherine Patte
- Groupe Franco-Africain d’Oncologie Pédiatrique, Villejuif, France
| | - Pierre Bey
- Groupe Franco-Africain d’Oncologie Pédiatrique, Villejuif, France
| | | | | | - Laila Hessissen
- Groupe Franco-Africain d’Oncologie Pédiatrifque, Centre Hospitalier Ibn Sina, Faculté de Médecine et de pharmacie, Rabat, Morocco
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23
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Doubaj Y, Zrhidri A, Elalaoui SC, Lyahyai J, El Kadiri Y, Elkassimi N, Sbiti A, El Kababri M, Hessissen L, Sefiani A. Clinical, cytogenetic and molecular findings in nine Moroccan patients with Fanconi anemia. Pan Afr Med J 2021; 39:72. [PMID: 34422195 PMCID: PMC8363957 DOI: 10.11604/pamj.2021.39.72.27220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 05/12/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Fanconi anemia (FA) is a rare inherited hematological disease due to a defect in the DNA repair pathway resulting in congenital abnormalities and high susceptibility to develop cancers. The cytogenetic analysis using alkylating agents is still a reference test to establish the diagnosis. Despite the genetic heterogeneity, the identification of the causal mutation is actually performed especially after the development of next generation sequencing (NGS). Methods we report here nine Moroccan patients referred to the department of Medical Genetics for suspicion of FA. We realized a genetic consultation to establish a clinical record with biological data before carrying out the genetic analysis. Karyotyping with mitomycin was performed for all the probands before elaborating molecular study. We used massively parallel sequencing to analyse the three most frequent mutated genes FANCA, FANCC, and FANCG, representing 84% of all genes involved in FA. Results all the patients showed hematological signs associated with at least one extra-hematological congenital anomaly. The chromosomal breaks were significantly higher for the nine patients, compared to the controls. The molecular diagnosis was confirmed in 8 of the 9 families tested (88.8%) with 4 novel mutations. The next generation based sequencing identified 9 variations: 6 in the FANCA gene (66.6%), 3 in the FANCG gene (33.3%) and no FANCC variation was found. Of those, 7 were homozygous and 2 were compounds heterozygous. Conclusion to the best of our knowledge, this is the first molecular report of Moroccan patients with FA suggesting the predominance of two genes without any recurrent mutation. The molecular analysis of FANCA and FANCG genes should be offered first for all patients in Morocco.
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Affiliation(s)
- Yassamine Doubaj
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc.,Département de Génétique Médicale, Institut National d'Hygiène, Rabat, Maroc
| | - Abdelali Zrhidri
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc
| | - Siham Chafai Elalaoui
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc.,Département de Génétique Médicale, Institut National d'Hygiène, Rabat, Maroc
| | - Jaber Lyahyai
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc
| | - Youssef El Kadiri
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc
| | - Nadia Elkassimi
- Département de Génétique Médicale, Institut National d'Hygiène, Rabat, Maroc
| | - Aziza Sbiti
- Département de Génétique Médicale, Institut National d'Hygiène, Rabat, Maroc
| | - Maria El Kababri
- Centre d´Hématologie et Oncologie Pédiatrique, Hôpital d´Enfants, Rabat, Maroc
| | - Laila Hessissen
- Centre d´Hématologie et Oncologie Pédiatrique, Hôpital d´Enfants, Rabat, Maroc
| | - Abdelaziz Sefiani
- Centre de Recherche en Génomique et Pathologies Humaines (Centre GENOPATH), Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc.,Département de Génétique Médicale, Institut National d'Hygiène, Rabat, Maroc
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24
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Chitsike I, Paintsil V, Sung L, Njuguna F, Mavinkurve-Groothuis A, Kouya F, Hesseling P, Kaspers G, Afungchwi GM, Ilbawi A, Renner L, Pritchard-Jones K, Hessissen L, Molyneux E, Chagaluka G, Israels T. Working Together to Build a Better Future for Children With Cancer in Africa. JCO Glob Oncol 2021; 6:1076-1078. [PMID: 32673078 PMCID: PMC7392779 DOI: 10.1200/go.20.00170] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Inam Chitsike
- Department of Pediatrics, College of Health Sciences, Harare, Zimbabwe
| | - Vivian Paintsil
- Directorate of Child Health, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Lillian Sung
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Festus Njuguna
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Francine Kouya
- Department of Pediatric Oncology, Mbingo Baptist Convention Hospital, Mbingo, Cameroon
| | - Peter Hesseling
- Department of Pediatrics and Child Health, Stellenbosch University, South Africa
| | - Gertjan Kaspers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, Amsterdam, the Netherlands
| | - Glenn M Afungchwi
- Department of Pediatric Oncology, Mbingo Baptist Convention Hospital, Mbingo, Cameroon
| | - Andre Ilbawi
- Global Initiative for Childhood Cancer, WHO, Geneva, Switzerland
| | - Lorna Renner
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohamed V University, Rabat, Morocco
| | | | | | - Trijn Israels
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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25
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van Heerden J, Zaghloul M, Neven A, de Rojas T, Geel J, Patte C, Balagadde-Kambugu J, Hesseling P, Tchintseme F, Bouffet E, Hessissen L. Pediatric Oncology Clinical Trials and Collaborative Research in Africa: Current Landscape and Future Perspectives. JCO Glob Oncol 2021; 6:1264-1275. [PMID: 32762563 PMCID: PMC7456323 DOI: 10.1200/go.20.00159] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Adequate clinical services have yet to be established in the majority of African countries, where childhood cancer survival rates vary from 8.1% to 30.3%. The aim of this review is to describe the landscape of pediatric oncology trials in Africa, identify challenges, and offer future opportunities for research collaborations. METHODS The study includes data from the International Pediatric Oncology Society (SIOP) global mapping survey, meta-research identifying trials in Africa in ClinicalTrials.gov, and a literature overview of publications on the subject of pediatric oncology clinical research supported by expert opinions on the current situation and challenges. RESULTS The SIOP global mapping survey received responses from 47 of 54 African countries, of which 23 have active clinical research programs. A preliminary search of ClinicalTrials.gov showed that only 105 (12.1%) of 868 African oncology studies included children and adolescents. Of these, 53 (50.5%) were interventional trials according to the registry’s classification. The small number of African trials for children and adolescents included palliative care and leukemia trials. In African oncology journals and international pediatric oncology journals, < 1% of the pediatric oncology publications come from Africa. Services and research were strengthened by international collaboration. National studies focused on clinical needs, local challenges, or interventional priorities. Both the literature review and the expert opinions highlight the need to expand clinical research in Africa, despite ongoing regional instability and lack of resources. CONCLUSION While a low number of pediatric clinical treatment trials are open to African children and adolescents, clinical research of high quality is being done in Africa. Several initiatives are stimulating the development of the research capacity across the continent, which should increase the publication output.
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Affiliation(s)
- Jaques van Heerden
- Department of Pediatric Haematology and Oncology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Mohamed Zaghloul
- Radiation Oncology Department, National Cancer Institute, Cairo University and Children's Cancer Hospital, Cairo, Egypt
| | - Anouk Neven
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda.,Statistics Department, European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | - Teresa de Rojas
- Department of Pediatric Oncology, Uganda Cancer Institute, Kampala, Uganda.,Pediatric OncoGenomics Unit, Pediatric Oncology-Hematology Department, Children's University Hospital Niño Jesús, Madrid, Spain
| | - Jennifer Geel
- Faculty of Health Sciences, Division of Pediatric Haematology and Oncology, Department of Pediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Catherine Patte
- Franco-African Pediatric Oncology Group and Gustave Roussy Institute, Villejuif, France
| | | | - Peter Hesseling
- Department of Pediatrics and Child Health, Tygerberg Childrens' Hospital, University of Stellenbosch, Stellenbosch, South Africa
| | | | - Eric Bouffet
- Pediatric Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Laila Hessissen
- Pediatric Haematology and Oncology Center, University Mohamed V. Rabat, Rabat, Morocco
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26
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Fabian ID, Khetan V, Stacey AW, Allen Foster, Ademola-Popoola DS, Berry JL, Cassoux N, Chantada GL, Hessissen L, Kaliki S, Kivelä TT, Luna-Fineman S, Munier FL, Reddy MA, Rojanaporn D, Blum S, Sherief ST, Staffieri SE, Theophile T, Waddell K, Ji X, Astbury NJ, Bascaran C, Burton M, Zondervan M, Bowman R. Sex, gender, and retinoblastoma: analysis of 4351 patients from 153 countries. Eye (Lond) 2021; 36:1571-1577. [PMID: 34272514 PMCID: PMC9307655 DOI: 10.1038/s41433-021-01675-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/14/2021] [Accepted: 06/25/2021] [Indexed: 01/26/2023] Open
Abstract
Objective To investigate in a large global sample of patients with retinoblastoma whether sex predilection exists for this childhood eye cancer. Methods A cross-sectional analysis including 4351 treatment-naive retinoblastoma patients from 153 countries who presented to 278 treatment centers across the world in 2017. The sex ratio (male/female) in the sample was compared to the sex ratio at birth by means of a two-sided proportions test at global level, country economic grouping, continent, and for selected countries. Results For the entire sample, the mean retinoblastoma sex ratio, 1.20, was higher than the weighted global sex ratio at birth, 1.07 (p < 0.001). Analysis at economic grouping, continent, and country-level demonstrated differences in the sex ratio in the sample compared to the ratio at birth in lower-middle-income countries (n = 1940), 1.23 vs. 1.07 (p = 0.019); Asia (n = 2276), 1.28 vs. 1.06 (p < 0.001); and India (n = 558), 1.52 vs. 1.11 (p = 0.008). Sensitivity analysis, excluding data from India, showed that differences remained significant for the remaining sample (χ2 = 6.925, corrected p = 0.025) and for Asia (χ2 = 5.084, corrected p = 0.036). Excluding data from Asia, differences for the remaining sample were nonsignificant (χ2 = 2.205, p = 0.14). Conclusions No proof of sex predilection in retinoblastoma was found in the present study, which is estimated to include over half of new retinoblastoma patients worldwide in 2017. A high male to female ratio in Asian countries, India in specific, which may have had an impact on global-level analysis, is likely due to gender discrimination in access to care in these countries, rather than a biological difference between sexes.
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Affiliation(s)
- Ido Didi Fabian
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK. .,The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.
| | | | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Allen Foster
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK
| | - Dupe S Ademola-Popoola
- University of Ilorin Teaching Hospital, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Department of Rabat, Mohammed V University, Rabat, Morocco
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sandra Luna-Fineman
- Hematology/Oncology/SCT, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sharon Blum
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, VIC, Australia
| | | | | | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nicholas J Astbury
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK
| | - Covadonga Bascaran
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew Burton
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK
| | - Marcia Zondervan
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard Bowman
- International Centre for Eye Helath, London School of Hygiene & Tropical Medicine, London, UK.,Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK
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27
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Moreira DC, Sniderman E, Mukkada S, Chantada G, Bhakta N, Foster W, Avula M, Homsi MR, Faughnan L, Happ B, Andujar A, Sonnenfelt J, Dalvi R, Frazier AL, Hessissen L, Kearns PR, Luna‐Fineman S, Moreno A, Saghir Khan M, Sullivan M, Devidas M, Santana V, Caniza M, Pritchard‐Jones K, Rodriguez‐Galindo C. The Global COVID-19 Observatory and Resource Center for Childhood Cancer: A response for the pediatric oncology community by SIOP and St. Jude Global. Pediatr Blood Cancer 2021; 68:e28962. [PMID: 33629507 PMCID: PMC7994967 DOI: 10.1002/pbc.28962] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic quickly led to an abundance of publications and recommendations, despite a paucity of information on how COVID-19 affects children with cancer. This created a dire need for a trusted resource with curated information and a space for the pediatric oncology community to share experiences. The Global COVID-19 Observatory and Resource Center for Childhood Cancer was developed, launched, and maintained by the International Society of Pediatric Oncology and St. Jude Children's Research Hospital. The three components (Resource Library, Global Registry, and Collaboration Space) complement each other, establishing a mechanism to generate and transfer knowledge rapidly throughout the community.
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Affiliation(s)
- Daniel C. Moreira
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Elizabeth Sniderman
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Sheena Mukkada
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Guillermo Chantada
- Fundacion Perez Scremini‐Hospital Pereira RossellMontevideoUruguay
- Hospital Sant Joan de DéuBarcelonaSpain
| | - Nickhill Bhakta
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Whitney Foster
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Meghana Avula
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Maysam R. Homsi
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Lane Faughnan
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Brooke Happ
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Allyson Andujar
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Jason Sonnenfelt
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Rashmi Dalvi
- Bombay Hospital Institute of Medical Sciences and SRCC Children's HospitalMumbaiIndia
| | - A. Lindsay Frazier
- Dana‐Farber/Boston Children's Hospital Cancer and Blood Disorders CenterBostonMassachusettsUSA
| | | | - Pamela R. Kearns
- NIHR Birmingham Biomedical Research CentreInstitute of Cancer and Genomic Sciences and Birmingham Children's HospitalBirminghamUK
| | | | | | | | - Michael Sullivan
- University of Melbourne and Royal Children's HospitalMelbourneAustralia
| | - Meenakshi Devidas
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Victor Santana
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - Miguela Caniza
- Department of Global Pediatric MedicineSt. Jude Children's Research HospitalMemphisTennesseeUSA
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28
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Graetz D, Agulnik A, Ranadive R, Vedaraju Y, Chen Y, Chantada G, Metzger ML, Mukkada S, Force LM, Friedrich P, Lam C, Sniderman E, Bhakta N, Hessissen L, Dalvi R, Devidas M, Pritchard-Jones K, Rodriguez-Galindo C, Moreira DC. Global effect of the COVID-19 pandemic on paediatric cancer care: a cross-sectional study. Lancet Child Adolesc Health 2021; 5:332-340. [PMID: 33675698 PMCID: PMC7929816 DOI: 10.1016/s2352-4642(21)00031-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
Abstract
Background Although mortality due to COVID-19 has been reportedly low among children with cancer, changes in health-care services due to the pandemic have affected cancer care delivery. This study aimed to assess the effect of the COVID-19 pandemic on childhood cancer care worldwide. Methods A cross-sectional survey was distributed to paediatric oncology providers worldwide from June 22 to Aug 21, 2020, through the St Jude Global Alliance and International Society for Paediatric Oncology listservs and regional networks. The survey included 60 questions to assess institution characteristics, the number of patients diagnosed with COVID-19, disruptions to cancer care (eg, service closures and treatment abandonment), adaptations to care, and resources (including availability of clinical staff and personal protective equipment). Surveys were included for analysis if respondents answered at least two thirds of the items, and the responses were analysed at the institutional level. Findings Responses from 311 health-care professionals at 213 institutions in 79 countries from all WHO regions were included in the analysis. 187 (88%) of 213 centres had the capacity to test for SARS-CoV-2 and a median of two (range 0–350) infections per institutution were reported in children with cancer. 15 (7%) centres reported complete closure of paediatric haematology-oncology services (median 10 days, range 1–75 days). Overall, 2% (5 of 213) of centres were no longer evaluating new cases of suspected cancer, while 43% (90 of 208) of the remaining centers described a decrease in newly diagnosed paediatric cancer cases. 73 (34%) centres reported increased treatment abandonment (ie, failure to initiate cancer therapy or a delay in care of 4 weeks or longer). Changes to cancer care delivery included: reduced surgical care (153 [72%]), blood product shortages (127 [60%]), chemotherapy modifications (121 [57%]), and interruptions to radiotherapy (43 [28%] of 155 institutions that provided radiotherapy before the pandemic). The decreased number of new cancer diagnoses did not vary based on country income status (p=0·14). However, unavailability of chemotherapy agents (p=0·022), treatment abandonment (p<0·0001), and interruptions in radiotherapy (p<0·0001) were more frequent in low-income and middle-income countries than in high-income countries. These findings did not vary based on institutional or national numbers of COVID-19 cases. Hospitals reported using new or adapted checklists (146 [69%] of 213), processes for communication with patients and families (134 [63%]), and guidelines for essential services (119 [56%]) as a result of the pandemic. Interpretation The COVID-19 pandemic has considerably affected paediatric oncology services worldwide, posing substantial disruptions to cancer diagnosis and management, particularly in low-income and middle-income countries. This study emphasises the urgency of an equitably distributed robust global response to support paediatric oncology care during this pandemic and future public health emergencies. Funding American Lebanese Syrian Associated Charities. Translation For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Dylan Graetz
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Radhikesh Ranadive
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yuvanesh Vedaraju
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yichen Chen
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Guillermo Chantada
- Department of Pediatric Hematology and Oncology, Fundacion Perez Scremini-Hospital Pereira Rossell, Montevideo, Uruguay; Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Monika L Metzger
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sheena Mukkada
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lisa M Force
- Department of Health Metrics Sciences, and Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA; Division of Pediatric Hematology and Oncology, Seattle Children's Hospital, Seattle, WA, USA
| | - Paola Friedrich
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Catherine Lam
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Elizabeth Sniderman
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Laila Hessissen
- Department of Pediatric Haematology and Oncology Center, Mohammed V University, Rabat, Morocco
| | - Rashmi Dalvi
- Department of Pediatrics, Bombay Hospital Institute of Medical Sciences, Bombay, India
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kathy Pritchard-Jones
- Great Ormond Street Institute of Child Health, University College London, London, England
| | - Carlos Rodriguez-Galindo
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
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29
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Pritchard-Jones K, de C V Abib S, Esiashvili N, Kaspers GJL, Rosser J, Van Doorninck JA, Braganca JML, Hoffman RI, Rodriguez-Galindo C, Adams C, Connor SR, Abdelhafeez AH, Bouffet E, Howard SC, Challinor JM, Hessissen L, Dalvi RB, Kearns P, Chantada GL, Frazier LA, Sullivan MJ, Schulte FSM, Morrissey LK, Kozhaeva O, Luna-Fineman S, Khan MS. The threat of the COVID-19 pandemic on reversing global life-saving gains in the survival of childhood cancer: a call for collaborative action from SIOP, IPSO, PROS, WCC, CCI, St Jude Global, UICC and WHPCA. Ecancermedicalscience 2021; 15:1187. [PMID: 33777180 PMCID: PMC7987488 DOI: 10.3332/ecancer.2021.1187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic poses an unprecedented health crisis in all socio-economic regions across the globe. While the pandemic has had a profound impact on access to and delivery of health care by all services, it has been particularly disruptive for the care of patients with life-threatening noncommunicable diseases (NCDs) such as the treatment of children and young people with cancer. The reduction in child mortality from preventable causes over the last 50 years has seen childhood cancer emerge as a major unmet health care need. Whilst survival rates of 85% have been achieved in high income countries, this has not yet been translated into similar outcomes for children with cancer in resource-limited settings where survival averages 30%. Launched in 2018, by the World Health Organization (WHO), the Global Initiative for Childhood Cancer (GICC) is a pivotal effort by the international community to achieve at least 60% survival for children with cancer by 2030. The WHO GICC is already making an impact in many countries but the disruption of cancer care during the COVID-19 pandemic threatens to set back this global effort to improve the outcome for children with cancer, wherever they may live. As representatives of the global community committed to fostering the goals of the GICC, we applaud the WHO response to the COVID-19 pandemic, in particular we support the WHO’s call to ensure the needs of patients with life threatening NCDs including cancer are not compromised during the pandemic. Here, as collaborative partners in the GICC, we highlight specific areas of focus that need to be addressed to ensure the immediate care of children and adolescents with cancer is not disrupted during the pandemic; and measures to sustain the development of cancer care so the long-term goals of the GICC are not lost during this global health crisis.
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Affiliation(s)
- Kathy Pritchard-Jones
- UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1E, United Kingdom.,International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland
| | - Simone de C V Abib
- Division of Pediatric Surgery, Pediatric Oncology Institute (GRAACC), Federal University of São Paulo, Rua Pedro de Toledo, 572, 04039-001 São Paulo, Brazil.,International Society of Paediatric Surgical Oncology (IPSO), Tienrayseweg 10, 5961NL Horst, The Netherlands
| | - Natia Esiashvili
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, 1365 Clifton Road, NE, Atlanta, GA 30322, USA.,Paediatric Radiation Oncology Society (PROS), 28 rue Laennec, F-69373 Lyon, Cedex 08, France
| | - Gertjan J L Kaspers
- Academy and Outreach, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, NL-3584 CS Utrecht, The Netherlands.,Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands.,World Child Cancer (WCC), The Netherlands, P.O. Box 113, 3720 AC Bilthoven, The Netherlands
| | - Jon Rosser
- World Child Cancer (WCC) UK, 9 Maltings Place, London SE1 3JB, UK
| | - John A Van Doorninck
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, Rocky Mountain Hospital for Children, 2055 High Street, #340, Denver, CO 80211, USA.,World Child Cancer (WCC) USA, 1301 Arapahoe St Suite 105, Golden, CO 80401, USA
| | - João M L Braganca
- Childhood Cancer International (CCI), Kraijenhoffstraat 137A, 1018RG Amsterdam, The Netherlands
| | - Ruth I Hoffman
- Childhood Cancer International (CCI), Kraijenhoffstraat 137A, 1018RG Amsterdam, The Netherlands
| | - Carlos Rodriguez-Galindo
- Department of Global Medicine, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Cary Adams
- Union for International Cancer Control (UICC), 31-33 Avenue Giuseppe Motta, 1202 Geneva, Switzerland
| | - Stephen R Connor
- Worldwide Hospice Palliative Care Alliance (WHPCA), 10990 Rice Field Pl, Fairfax Station, VA 22039, USA
| | - Abdelhafeez H Abdelhafeez
- International Society of Paediatric Surgical Oncology (IPSO), Tienrayseweg 10, 5961NL Horst, The Netherlands.,Department of Surgery, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Eric Bouffet
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Division of Haematology/Oncology, University of Toronto, The Hospital for Sick Children, 555 University Ave, M5G 1X8, Toronto, Canada
| | - Scott C Howard
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Department of Acute and Tertiary Care, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Julia M Challinor
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,School of Nursing, University of California San Francisco, 36 Rockview Dr., Santa Cruz, CA 95062, USA
| | - Laila Hessissen
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Department of Pediatric Hematology and Oncology, Children Hospital of Rabat, Mohamed V university of Rabat, Ibn Rochd avenue, Rabat 6542, Morocco
| | - Rashmi B Dalvi
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Department of Pediatrics and Pediatric Hematology Oncology, Bombay Hospital Institute of Medical sciences, street 20, New Marine lines, Mumbai 400020, India
| | - Pamela Kearns
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Institute of Cancer and Genomic Sciences, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Vincent Drive, Birmingham B15 2TT, UK.,European Society for Paediatric Oncology (SIOP Europe), Clos Chapelle-aux-Champs 30, 1200 Brussels, Belgium
| | - Guillermo L Chantada
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Department of Hematology-Oncology, Hospital Pereira Rossell-Fundacion Perez-Scremini (secondary: Hospital Sant Joan De Deu), Bulevar Artigas 1556, 11600 Montevideo, Uruguay
| | - Lindsay A Frazier
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Department of Pediatric Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02115, USA
| | - Michael J Sullivan
- International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Children's Cancer Centre and Department of Paediatrics, Royal Children's Hospital and University of Melbourne, 50 Flemington Road, Parkville 3052, Melbourne, Australia.,Paediatric Oncology in Developing Countries (PODC) Committee, International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland
| | - Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, 2202 2 St., T2S 3C3, Calgary, Canada.,Paedatric Psycho-Oncology (PPO) Committee, International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland
| | - Lisa K Morrissey
- Nursing and Patient Services, Division of Hematology/Oncology/HSCT, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.,Nursing Committee, International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland
| | - Olga Kozhaeva
- Policy Affairs, European Society for Paediatric Oncology (SIOP Europe), Clos Chapelle-aux-Champs 30, 1200 Brussels, Belgium
| | - Sandra Luna-Fineman
- Paediatric Oncology in Developing Countries (PODC) Committee, International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Division of Hematology/Oncology/SCT, Department of Pediatrics, Children's Hospital Colorado, U Colorado, 13123 E 16th Ave, B115, Aurora, CO 80045, USA
| | - Muhammad S Khan
- Paediatric Oncology in Developing Countries (PODC) Committee, International Society of Paediatric Oncology (SIOP), Industriestrasse 25, 6312 Steinhausen, Switzerland.,Pediatric Hematology and Oncology Division, Tawam Hospital, Al Ain (Abu Dhabi), PO Box 15258, United Arab Emirates
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Edan C, Yao AJJ, Hessissen L, Moreira C, Viallard ML, Poulain P, Calmanti S, Thinlot C, Aubier F, Douçot MS, Gagnepain-Lacheteau A, Patte C. Integrating a palliative approach into the healthcare provided by the French-African Pediatric Oncology Group's pilot units. Insights from a 3-year training program. Arch Pediatr 2021; 28:166-172. [PMID: 33446430 DOI: 10.1016/j.arcped.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/20/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
Working alongside local stakeholders, members of the French-African Pediatric Oncology Group developed a 3-year program to train pediatric oncology teams from 15 French-speaking countries in Africa in using analgesics and providing palliative care. This program was rolled out in three phases: initial training, in situ assessment, and advanced training in selected topics. To access this program, multidisciplinary teams had to come up with a project to improve their existing palliative care and pain management practices, and commit themselves to implementing it. All the teams invited agreed to take part in the program, which explicitly broached a subject that is often avoided in oncology teaching. The first phase was rolled out in 2017, with 65 trainees from 19 units attending one of three sessions held in Dakar, Senegal, Abidjan, Côte d'Ivoire, and Rabat, Morocco. The subsequent assessment revealed that only half the teams had started to implement their projects. The advanced training phase was therefore adjusted accordingly. A collective training session held in Marseille was attended by 15 trainees from seven teams whose projects were already underway, while in situ mentoring was provided for six other teams, through French-African twinnings in four cases. The length and openness of the program meant that we were able to identify and share the units' diverse realities, and fine-tune their projects accordingly, as well as plan ways of continuing the training both locally and collectively.
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Affiliation(s)
- C Edan
- GFAOP, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - A J J Yao
- Treichville University Hospital, Abidjan, Côte d'Ivoire
| | - L Hessissen
- Pediatric Oncology Department, Children's Hospital, Rabat, Morocco
| | - C Moreira
- Pediatric Oncology Unit, Aristide Le Dantec Hospital, Dakar, Senegal
| | - M L Viallard
- Department of Perinatal Pain and Palliative Medicine, Necker University Hospital for Sick Children, Paris, France
| | - P Poulain
- Les Ormeaux palliative care unit, Tarbes, France
| | - S Calmanti
- La Brise regional pediatric palliative care team, Brittany, France
| | - C Thinlot
- GFAOP, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - F Aubier
- GFAOP, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - M S Douçot
- GFAOP, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | | | - C Patte
- GFAOP, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
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Traoré F, Couitchere L, Michon J, Hessissen L. Patient management in pediatric oncology during the COVID-19 pandemic: Report from francophone Africa. Pediatr Blood Cancer 2021; 68:e28571. [PMID: 32881256 DOI: 10.1002/pbc.28571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 06/25/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Fousseyni Traoré
- Pediatric oncology unit, Gabriel, Toure University Hospital, Bamako, Mali.,Groupe Franco-Africain d'Oncologie Pédiatrique, Paris, France
| | - Line Couitchere
- Groupe Franco-Africain d'Oncologie Pédiatrique, Paris, France.,Pediatric oncology unit, Treichville University Hospital, Abidjan, Ivory Coast
| | - Jean Michon
- Groupe Franco-Africain d'Oncologie Pédiatrique, Paris, France
| | - Laila Hessissen
- Groupe Franco-Africain d'Oncologie Pédiatrique, Paris, France.,Pediatric Haematology and Oncology Center, Rabat Children's Hospital, Mohammed V University, Rabat, Morocco.,International Society of Pediatric Oncology SIOP (SIOP Africa branch)
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Fabian ID, Stacey AW, Foster A, Kivelä TT, Munier FL, Keren-Froim N, Gomel N, Cassoux N, Sagoo MS, Reddy MA, Harby LA, Zondervan M, Bascaran C, Abdallah E, Abdullahi SU, Boubacar SA, Ademola-Popoola DS, Adio A, Aghaji AE, Portabella SA, Alfa Bio AI, Ali AM, Alia DB, All-Eriksson C, Almeida AA, Alsawidi KM, Antonino R, Astbury NJ, Atsiaya R, Balaguer J, Balwierz W, Barranco H, Popovic MB, Benmiloud S, Guebessi NB, Berete RC, Biddulph SJ, Biewald EM, Blum S, Bobrova N, Boehme M, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brichard BG, L MC, Castela G, Català-Mora J, Chantada GL, Chernodrinska VS, Chiwanga FS, Cieslik K, Comsa C, Correa Llano MG, Csóka M, Da Gama IV, Davidson A, Potter PD, Desjardins L, Dragomir MD, Bruyn MD, Kettani AE, Elbahi AM, Elgalaly D, Elhaddad AM, Ali Elhassan MM, Elzembely MM, Essuman VA, Evina TGA, Fasina O, Fernández-Teijeiro A, Gandiwa M, Aldana DG, Geel JA, Gizachew Z, Gregersen PA, Guedenon KM, Hadjistilianou T, Hassan S, Hederova S, Hessissen L, Hordofa DF, Hummlen M, Husakova K, Ida R, Ilic VR, Jenkinson H, Amani Kabesha TB, Kabore RL, Kalinaki A, Kapelushnik N, Kardava T, Kemilev PK, Kepak T, Khotenashvili Z, Klett A, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kyara A, Lachmann ES, Latinović S, Lecuona K, Lukamba RM, Lumbroso L, Lysytsia L, Maka E, Makan M, Manda C, Begue NM, Matende IO, Matua M, Mayet I, Mbumba FB, Mengesha AA, Midena E, Mndeme FG, Mohamedani AA, Moll AC, Moreira C, Msina MS, Msukwa G, Muma KI, Murgoi G, Musa KO, Mustak H, Muyen OM, Naidu G, Naumenko L, Ndoye Roth PA, Neroev V, Nikitovic M, Nkanga ED, Nkumbe H, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oscar AH, Osei-Bonsu P, Painter SL, Paintsil V, Paiva L, Papyan R, Parrozzani R, Parulekar M, Pawinska-Wasikowska K, Perić S, Philbert R, Pochop P, Polyakov VG, Pompe MT, Pons JJ, Raobela L, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Saakyan S, Said AM, Román Pacheco SS, Scanlan TA, Schoeman J, Seregard S, Sherief ST, Cheikh SS, Silva S, Sorochynska T, Ssali G, Stathopoulos C, Kranjc BS, Stones DK, Svojgr K, Sylla F, Tamamyan G, Tandili A, Tateshi B, Theophile T, Traoré F, Tyau-Tyau H, Umar AB, Urbak SF, Ushakova TL, Valeina S, Hoefen Wijsard MV, Veleva-Krasteva NV, Viksnins M, Wackernagel W, Waddell K, Wade PD, Wali Nigeria AH, Wime AD, Dod CW, Yanga JM, Yarovaya VA, Yarovoy AA, Zein E, Sharabi S, Zhilyaeva K, Ziko OA, Bowman R. Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries. Br J Ophthalmol 2020; 105:1435-1443. [PMID: 32933936 DOI: 10.1136/bjophthalmol-2020-316613] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
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Affiliation(s)
- Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK .,The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle, WA, US
| | - Allen Foster
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | | | - Nir Gomel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nathalie Cassoux
- Institut curie, université de Paris medicine Paris V Descartes, Paris, France
| | - Mandeep S Sagoo
- NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, UK
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V university, Rabat, Morocco
| | | | | | - Dupe S Ademola-Popoola
- University of Ilorin and University of IlorinTeaching Hospital, Ilorin, Kwara State, Nigeria
| | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | | | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rose Atsiaya
- Light House For Christ Eye Center, Mombasa, Kenya
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Maja Beck Popovic
- Unit of Pediatric Hematology-Oncology, University Hospital CHUV, Lausanne, Switzerland
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'ivoire
| | | | - Eva M Biewald
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Sharon Blum
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Nadia Bobrova
- The Filatov Institute of Eye diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Norbert Bornfeld
- University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi-Raïs d'Ophtalmologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | | | | | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Violeta S Chernodrinska
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Codruta Comsa
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | | | - Monika Csóka
- Semmelweis University Budapest, Budapest, Hungary
| | | | - Alan Davidson
- Red Cross Children's War Memorial Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | | | | | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, Tripoli University, Tripoli, Libya
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Oncology Department, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Jennifer A Geel
- University of the Witwatersrand, Johannesburg, South Africa.,Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Zelalem Gizachew
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Pernille A Gregersen
- Department of Clinical Genetics, and Center for Rare Disorders, Aarhus University Hopspital, Aarhus, Denmark
| | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Sadiq Hassan
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Department of Rabat - Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology, Belgrade, Serbia
| | - Helen Jenkinson
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Rolande L Kabore
- Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Abubakar Kalinaki
- Makerere University College of Health Sciences, Department of Ophthalmology, Kamplala, Uganda
| | - Noa Kapelushnik
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Pavlin Kroumov Kemilev
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | - Tomas Kepak
- University Hospital Brno, Masaryk University and ICRC/St. Anna University Hospital, Brno, Czech Republic
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Chidren's Ophthalmology Department, Chidren's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | | | - Slobodanka Latinović
- Clinical Center Of Vojvodina - University Eye Clinic, Eye Research Foundation Vidar - Latinović, Novi Sad, Serbia
| | - Karin Lecuona
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, DRC
| | | | - Lesia Lysytsia
- The Okhmatdyt National Children's Hospital, Kiev, Ukraine
| | - Erika Maka
- Semmelweis University Budapest, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | - Freddy B Mbumba
- Botswana Government - Scottish Livingstone Hospital, Molepolole, Botswana
| | | | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | - Ahmed A Mohamedani
- Pathology Department, Faculty of Medicine, University of Gezira, Wadi Madani, Sudan
| | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands
| | - Claude Moreira
- Service d'oncologie pédiatrique de l'hôpital Aristide le Dantec, Dakar, Senegal
| | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | - Gabriela Murgoi
- Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania
| | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital/College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Hamzah Mustak
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus
| | | | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | | | - Elizabeth D Nkanga
- Calabar Children's Eye Center, Department of Ophthalmology University of Calabar Teaching Hospital Calabar Cross River State, Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Alexander Hugo Oscar
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | - Sally L Painter
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Ruzanna Papyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland
| | - Sanja Perić
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Remezo Philbert
- Center Hospitaliere Universitaire de Kamenge, Bujumbura, Burundi
| | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | | | - Léa Raobela
- Center Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Lorna A Renner
- University of Ghana School of Medicine and Dentistry, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Azza Ma Said
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | | | - Sadik T Sherief
- Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia
| | - Sidi Sidi Cheikh
- Ophthalmology department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | - Grace Ssali
- Mulago National Referral and Teaching Hospital, Kamplala, Uganda
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free Sate, Bloemfontein, South Africa
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia
| | - Alketa Tandili
- University Hospital Center 'Mother Theresa', Tirana, Albania
| | | | | | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Ali B Umar
- Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Steen F Urbak
- Department of ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.,Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria
| | | | | | | | | | | | - Amelia Dc Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, DRC
| | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Ekhtelbenina Zein
- Assistante Hospitalo - Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Shirley Sharabi
- Radiology Department, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Othman Ao Ziko
- Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Richard Bowman
- Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK
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33
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Haddad SE, Hessissen L, Kababri ME, Lamalmi N, Kisra M, Allali N, Chat L. Primary mature adrenal teratoma in infant. Pan Afr Med J 2020; 37:27. [PMID: 33062128 PMCID: PMC7532853 DOI: 10.11604/pamj.2020.37.27.24016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/27/2020] [Indexed: 11/30/2022] Open
Abstract
Teratomas are neoplasms of the embryonic tissues that typically arise in the gonadal and sacrococcygeal regions. Primary adrenal teratoma are extremely rare and only few cases were published in literature. Teratomas contain more than one embryonic germ cell layer, mostly elements derived from ectoderm and least frequently from endoderm. Though these tumors are mostly benign, malignant transformation may occur. Treatment includes surgical removal. We report a rare case of a primary mature retroperitoneal teratoma in an infant with liver metastasis. Imaging modality CT and MRI were useful in diagnosis. The diagnostic and therapeutic challenges of dealing with such a case have been discussed and the literature reviewed.
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Affiliation(s)
- Siham El Haddad
- Pediatric Imaging Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Laila Hessissen
- Pediatric Oncology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Maria El Kababri
- Pediatric Oncology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Najat Lamalmi
- Pediatric Anatomical Pathology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Mounir Kisra
- Pediatric Surgery Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Nazik Allali
- Pediatric Imaging Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Latifa Chat
- Pediatric Imaging Department, Pediatric Teaching Hospital, Rabat, Morocco
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El Kababri M, Benmiloud S, Cherkaoui S, El Houdzi J, Maani K, Ansari N, Khoubila N, Kili A, El Khorassani M, Madani A, Tazi MA, Ahid S, Hessissen L, Quessar A, Harif M, Khattab M, André N. Metro-SMHOP 01: Metronomics combination with cyclophosphamide-etoposide and valproic acid for refractory and relapsing pediatric malignancies. Pediatr Blood Cancer 2020; 67:e28508. [PMID: 32658380 DOI: 10.1002/pbc.28508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/05/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In low- and middle-income countries, therapeutic options for advanced, refractory, or relapsing malignancies are limited due to local constraints such as cost of drugs, distance from oncology centers, and lack of availability of new anticancer drugs. Metronomics, which combines metronomic chemotherapy (MC) and drug repositioning, allows for the provision of new therapeutic options for patients in this setting. AIM OF THE STUDY To evaluate the activity and toxicity of a metronomic regimen in Moroccan pediatric patients with refractory or relapsing malignancies. PATIENTS AND METHODS From July 2014 to January 2018, patients with refractory/relapsing solid tumors treated in five pediatric oncology centers were consecutively enrolled. The metronomic regimen consisted of 28-day cycles with daily oral administration of cyclophosphamide (30 mg/m2 ) from days 1 to 21, together with oral etoposide (25 mg/m2 ) from days 1 to 21 followed by break of one week and daily valproic acid (20 mg/kg) from days 1 to 28. RESULTS Ninety-eight children (median age, 8 years) were included. Underlying malignancies were neuroblastoma (24 patients), Ewing sarcoma (18), osteosarcoma (14), rhabdomyosarcoma (14), and miscellaneous tumors (28). A total of 557 cycles were given (median: 6; range, 1-18 cycles). One-year progression-free survival of our patients was 19%, and one-year overall survival was 22%. Complete response was obtained in three cases (3%), partial response in 11 cases (11%), and tumor stabilization for more than six months in 28 cases (28%). CONCLUSION This three-drug metronomic combination was well tolerated and associated with tumor response and disease stabilization in 42 patients even for a long period.
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Affiliation(s)
- Maria El Kababri
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco.,Metronomics Global Health Initiative, Rabat, Morocco
| | - Sarra Benmiloud
- Paediatric Haematology and Oncology Unit, Hospital Hassan II, Fes, Morocco
| | - Siham Cherkaoui
- Paediatric Haematology and Oncology Service, Hospital 20 Aout, Casablanca, Morocco
| | - Jamila El Houdzi
- Pediatic Haematology and Oncology Unit, Hospital Mohamed VI, Marrakech, Morocco
| | - Khadija Maani
- Paediatric Haematology and Oncology Unit, Hospital Ibn Rochd, Casablanca, Morocco
| | - Nawal Ansari
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Nissrine Khoubila
- Paediatric Haematology and Oncology Service, Hospital 20 Aout, Casablanca, Morocco
| | - Amina Kili
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Mohammed El Khorassani
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Abdellah Madani
- Paediatric Haematology and Oncology Service, Hospital 20 Aout, Casablanca, Morocco
| | | | - Samir Ahid
- Pharmacoeconomics and Pharmacoepidemiology Research Team, Mohammed V University, Rabat, Morocco.,Laboratory of Biostatistics, Clinical and Epidemiological Research, Mohammed V University, Rabat, Morocco
| | - Laila Hessissen
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco.,Metronomics Global Health Initiative, Rabat, Morocco
| | - Asmaa Quessar
- Paediatric Haematology and Oncology Service, Hospital 20 Aout, Casablanca, Morocco
| | - Mhamed Harif
- Paediatric Haematology and Oncology Service, Hospital 20 Aout, Casablanca, Morocco
| | - Mohammed Khattab
- Paediatric Haematology and Oncology Center, Children's Hospital of Rabat, Mohammed V University, Rabat, Morocco
| | - Nicolas André
- Paediatric Haematology and Oncology Department, La Timone Children's Hospital, Assistance Publique Hopitaux de Marseille, Marseille, France.,SMARTc Unit, Centre de Recherche en Cancérologie de Marseille, Inserm U1068, Aix Marseille Univ, Marseille, France.,Metronomics Global Health Initiative, Marseille, France
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Sullivan M, Bouffet E, Rodriguez‐Galindo C, Luna‐Fineman S, Khan MS, Kearns P, Hawkins DS, Challinor J, Morrissey L, Fuchs J, Marcus K, Balduzzi A, Basset‐Salom L, Caniza M, Baker JN, Kebudi R, Hessissen L, Sullivan R, Pritchard‐Jones K. The COVID-19 pandemic: A rapid global response for children with cancer from SIOP, COG, SIOP-E, SIOP-PODC, IPSO, PROS, CCI, and St Jude Global. Pediatr Blood Cancer 2020; 67:e28409. [PMID: 32400924 PMCID: PMC7235469 DOI: 10.1002/pbc.28409] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is one of the most serious global challenges to delivering affordable and equitable treatment to children with cancer we have witnessed in the last few decades. This Special Report aims to summarize general principles for continuing multidisciplinary care during the SARS-CoV-2 (COVID-19) pandemic. With contributions from the leadership of the International Society for Pediatric Oncology (SIOP), Children's Oncology Group (COG), St Jude Global program, and Childhood Cancer International, we have sought to provide a framework for healthcare teams caring for children with cancer during the pandemic. We anticipate the burden will fall particularly heavily on children, their families, and cancer services in low- and middle-income countries. Therefore, we have brought together the relevant clinical leads from SIOP Europe, COG, and SIOP-PODC (Pediatric Oncology in Developing Countries) to focus on the six most curable cancers that are part of the WHO Global Initiative in Childhood Cancer. We provide some practical advice for adapting diagnostic and treatment protocols for children with cancer during the pandemic, the measures taken to contain it (e.g., extreme social distancing), and how to prepare for the anticipated recovery period.
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Affiliation(s)
- Michael Sullivan
- Children's Cancer CentreRoyal Children's Hospital and Department of PaediatricsFaculty of Medicine Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia
| | - Eric Bouffet
- Division of Haematology/OncologyHospital for Sick ChildrenTorontoOntarioCanada
| | | | - Sandra Luna‐Fineman
- Hematology/Oncology/SCT Children's Hospital ColoradoUniversity of ColoradoAuroraColorado
| | | | - Pam Kearns
- Birmingham Children's Hospital and Institute of Cancer and Genomic SciencesUniversity of BirminghamEdgbastonBirminghamUK
| | - Douglas S. Hawkins
- Pediatric Hematology/OncologySeattle Children's HospitalSeattleWashington
| | - Julia Challinor
- School of NursingUniversity of California San FranciscoSan FranciscoCalifornia
| | - Lisa Morrissey
- Division of NursingHematology/OncologyBoston Children's HospitalBostonMassachusetts
| | - Jörg Fuchs
- Department of Pediatric Surgery Children's HospitalUniversity of TuebingenTuebingenGermany
| | - Karen Marcus
- Dana‐Farber/Boston Children's Cancer and Blood Disorders CenterBrigham and Women's HospitalHarvard Medical School, Boston, Massachusetts
| | - Adriana Balduzzi
- Paediatric DepartmentMBBM FoundationASST Monza Ospedale San GerardoUniversity of Milano BicoccaMonzaItaly
| | - Luisa Basset‐Salom
- Childhood Cancer International (www.childhoodcancerinternational.org) and International representative of FedEspañola de Padres de NIÑOS CON Cáncer (www.cancerinfantil.org)MadridSpain
| | - Miguela Caniza
- Departments of Global Pediatric Medicine and Infectious DiseasesSt Jude Children's Research HospitalMemphisTennessee
| | - Justin N. Baker
- Division of Quality of Life and Palliative CareDepartment of OncologySt Jude Children's Research HospitalMemphisTennessee
| | - Rejin Kebudi
- Pediatric Hematology OncologyOncology InstituteIstanbul UniversityIstanbulTurkey
| | - Laila Hessissen
- Pediatric Hematology and OncologyMohammed V University of Rabat, RabatMorocco
| | - Richard Sullivan
- School of Cancer ScienceKing's College London, UKInstitute of Cancer Policy and Conflict and Health Research Groupand Research for Health Care in Conflict (https://r4hc‐mena.org/), London, UK
| | - Kathy Pritchard‐Jones
- International Society of Paediatric Oncology (SIOP)UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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36
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Adamou Boubacar S, Ademola-Popoola DS, Adio A, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Al Harby L, Al Ani MH, Alakbarova A, Portabella SA, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad C, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amiruddin PO, Antonino R, Astbury NJ, Atalay HT, Atchaneeyasakul LO, Atsiaya R, Attaseth T, Aung TH, Ayala S, Baizakova B, Balaguer J, Balayeva R, Balwierz W, Barranco H, Bascaran C, Beck Popovic M, Benavides R, Benmiloud S, Bennani Guebessi N, Berete RC, Berry JL, Bhaduri A, Bhat S, Biddulph SJ, Biewald EM, Bobrova N, Boehme M, Boldt HC, Bonanomi MTBC, Bornfeld N, Bouda GC, Bouguila H, Boumedane A, Brennan RC, Brichard BG, Buaboonnam J, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Cassoux N, Castela G, Castillo L, Català-Mora J, Chantada GL, Chaudhry S, Chaugule SS, Chauhan A, Chawla B, Chernodrinska VS, Chiwanga FS, Chuluunbat T, Cieslik K, Cockcroft RL, Comsa C, Correa ZM, Correa Llano MG, Corson TW, Cowan-Lyn KE, Csóka M, Cui X, Da Gama IV, Dangboon W, Das A, Das S, Davanzo JM, Davidson A, De Potter P, Delgado KQ, Demirci H, Desjardins L, Diaz Coronado RY, Dimaras H, Dodgshun AJ, Donaldson C, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Edison KS, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elgalaly D, Elhaddad AM, Elhassan MMA, Elzembely MM, Essuman VA, Evina TGA, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Gallie BL, Gandiwa M, Garcia JL, García Aldana D, Gassant PY, Geel JA, Ghassemi F, Girón AV, Gizachew Z, Goenz MA, Gold AS, Goldberg-Lavid M, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Garcia Pacheco HN, Graells J, Green L, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Hassan S, Hassan S, Hederova S, Hernandez J, Hernandez LMC, Hessissen L, Hordofa DF, Huang LC, Hubbard GB, Hummlen M, Husakova K, Hussein Al-Janabi AN, Ida R, Ilic VR, Jairaj V, Jeeva I, Jenkinson H, Ji X, Jo DH, Johnson KP, Johnson WJ, Jones MM, Kabesha TBA, Kabore RL, Kaliki S, Kalinaki A, Kantar M, Kao LY, Kardava T, Kebudi R, Kepak T, Keren-Froim N, Khan ZJ, Khaqan HA, Khauv P, Kheir WJ, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivelä TT, Klett A, Komba Palet JEK, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lachmann ES, Lam CPS, Lam GC, Larson SA, Latinovic S, Laurenti KD, Le BHA, Lecuona K, Leverant AA, Li C, Limbu B, Long QB, López JP, Lukamba RM, Lumbroso L, Luna-Fineman S, Lutfi D, Lysytsia L, Magrath GN, Mahajan A, Majeed AR, Maka E, Makan M, Makimbetov EK, Manda C, Martín Begue N, Mason L, Mason JO, Matende IO, Materin M, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Medina-Sanson A, Mehrvar A, Mengesha AA, Menon V, Mercado GJVD, Mets MB, Midena E, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Morales RA, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KI, Munier FL, Murgoi G, Murray TG, Musa KO, Mushtaq A, Mustak H, Muyen OM, Naidu G, Nair AG, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ngo H, Nieves RM, Nikitovic M, Nkanga ED, Nkumbe H, Nuruddin M, Nyaywa M, Obono-Obiang G, Oguego NC, Olechowski A, Oliver SCN, Osei-Bonsu P, Ossandon D, Paez-Escamilla MA, Pagarra H, Painter SL, Paintsil V, Paiva L, Pal BP, Palanivelu MS, Papyan R, Parrozzani R, Parulekar M, Pascual Morales CR, Paton KE, Pawinska-Wasikowska K, Pe'er J, Peña A, Peric S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov VG, Pompe MT, Pons JJ, Prat D, Prom V, Purwanto I, Qadir AO, Qayyum S, Qian J, Rahman A, Rahman S, Rahmat J, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Raobela L, Rashid R, Reddy MA, Reich E, Renner LA, Reynders D, Ribadu D, Riheia MM, Ritter-Sovinz P, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sayalith P, Scanlan TA, Schefler AC, Schoeman J, Sedaghat A, Seregard S, Seth R, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shetye NG, Shields CL, Siddiqui SN, Sidi Cheikh S, Silva S, Singh AD, Singh N, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Stathopoulos C, Stirn Kranjc B, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Sundy M, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Tehuteru ES, Teixeira LF, Teh KH, Theophile T, Toledano H, Trang DL, Traoré F, Trichaiyaporn S, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, van Hoefen Wijsard M, Varadisai A, Vasquez L, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Vishnevskia-Dai V, Vora T, Wachtel AE, Wackernagel W, Waddell K, Wade PD, Wali AH, Wang YZ, Weiss A, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wongwai P, Xiang D, Xiao Y, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang C, Zhang Y, Zhao J, Zheng X, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. Global Retinoblastoma Presentation and Analysis by National Income Level. JAMA Oncol 2020; 6:685-695. [PMID: 32105305 PMCID: PMC7047856 DOI: 10.1001/jamaoncol.2019.6716] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs.
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Affiliation(s)
| | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | - Elhassan Abdallah
- Ophthalmology Department of Rabat, Mohammed V University, Rabat, Morocco
| | | | | | | | | | - Adedayo Adio
- Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | | | | | - Ada E Aghaji
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Alia Ahmad
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | | | - Lamis Al Harby
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Aygun Alakbarova
- Zarifa Aliyeva National Center of Ophthalmology, Baku, Azerbaijan
| | | | - Safaa A F Al-Badri
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | | | - Amanda Alejos
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | | | | | | | - Christiane Al-Haddad
- Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Amany M Ali
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Donjeta B Alia
- University Hospital Center Mother Theresa, Tirana, Albania
| | - Mazin F Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | | | - Hind M Alkatan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Nicholas J Astbury
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hatice T Atalay
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | | | - Rose Atsiaya
- Lighthouse For Christ Eye Centre, Mombasa, Kenya
| | - Taweevat Attaseth
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Than H Aung
- Yangon Eye Hospital, University of Medicine 1, Yangon, Myanmar
| | | | - Baglan Baizakova
- Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Honorio Barranco
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Covadonga Bascaran
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maja Beck Popovic
- Pediatric Hematology-Oncology Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Raquel Benavides
- Hospital Nacional de Niños Dr Carlos Sáenz Herrera, San Jose, Costa Rica
| | - Sarra Benmiloud
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | | | - Rokia C Berete
- Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'Ivoire
| | - Jesse L Berry
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Sunil Bhat
- Department of Pediatric Hematology and Oncology, Narayana Health City, Bangalore, India
| | | | - Eva M Biewald
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nadia Bobrova
- The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine
| | - Marianna Boehme
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - H C Boldt
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | | | - Norbert Bornfeld
- Department of Ophthalmology, Essen University Hospital, University Duisburg-Essen, Essen, Germany
| | - Gabrielle C Bouda
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Hédi Bouguila
- Institut Hédi Raïs d'Ophtalmologie, Faculté de Médecine, Université Tunis El Manar, Tunis, Tunisia
| | - Amaria Boumedane
- Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria
| | - Rachel C Brennan
- Solid Tumor Division, Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | | | | | | | - Jayne E Camuglia
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Miriam R Cano
- Salud Ocular, Ministerio de Salud Publica, Asuncion, Paraguay
| | | | - Nathalie Cassoux
- Institut Curie, Université de Paris Medicine Paris V Descartes, Paris, France
| | - Guilherme Castela
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | | | | | - Guillermo L Chantada
- Hospital Sant Joan de Déu, Barcelona, Spain
- Hospital Garrahan, Buenos Aires, Argentina
- NationalScientific and Technical Research Council, CONICET, Buenos Aires, Argentina
| | - Shabana Chaudhry
- Paediatric Ophthalmology Department, Mayo Hospital and College of Allied Visual Sciences, King Edward Medical University, Lahore, Pakistan
| | - Sonal S Chaugule
- Department of Ophthalmic Plastic Surgery, Orbit and Ocular Oncology, PBMA's H. V. Desai Eye Hospital, Pune, Maharashtra, India
| | | | - Bhavna Chawla
- Ocular Oncology Service, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Violeta S Chernodrinska
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | | | - Krzysztof Cieslik
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | | | - Codruta Comsa
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Zelia M Correa
- Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | | | | | - Xuehao Cui
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Wantanee Dangboon
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Anirban Das
- Department of Pediatric Hematology-Oncology, Tata Medical Center, Kolkata, India
| | - Sima Das
- Ocular Oncology Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital and the University of Cape Town, Cape Town, South Africa
| | | | | | - Hakan Demirci
- Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor
| | | | | | - Helen Dimaras
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew J Dodgshun
- Department of Paediatrics, University of Otago, Christchurch, Children's Haematology and Oncology Center, Christchurch Hospital, Christchurch, New Zealand
| | - Craig Donaldson
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Monica D Dragomir
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | - Yi Du
- Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | | | - Kemala S Edison
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | - I Wayan Eka Sutyawan
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | - Asmaa El Kettani
- Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco
| | - Amal M Elbahi
- Tripoli Eye Hospital, University of Tripoli, Tripoli, Libya
| | - James E Elder
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Dina Elgalaly
- Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | | | - Moawia M Ali Elhassan
- Department of Oncology, National Cancer Institute, University of Gezira, Wadi Madani, Sudan
| | - Mahmoud M Elzembely
- Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Vera A Essuman
- Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana
| | | | | | | | - Mohammad Faranoush
- Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Rasool Akram Hospital, Tehran, Iran
| | - Oluyemi Fasina
- Department of Ophthalmology, University College Hospital, University of Ibadan, Ibadan, Nigeria
| | | | | | - Allen Foster
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Shahar Frenkel
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Soad L Fuentes-Alabi
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | | | - Moira Gandiwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | | | - Jennifer A Geel
- Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Fariba Ghassemi
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ana V Girón
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala
| | - Zelalem Gizachew
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Marco A Goenz
- Pediatric Oncology Department, Benjamin Bloom National Children's Hospital, San Salvador, El Salvador
| | - Aaron S Gold
- Murray Ocular Oncology and Retina, Miami, Florida
| | | | - Glen A Gole
- Department of Ophthalmology, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Nir Gomel
- Department of Ophthalmology, Sourasky Medical Center Tel Aviv, School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efren Gonzalez
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Henry N Garcia Pacheco
- Pediatric Oncology Unit, Instituto Regional de Enfermedades Neoplásicas del Sur, Arequipa, Perú
| | - Jaime Graells
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Liz Green
- IAM NOOR Eye Care Programme, Afghanistan
| | - Pernille A Gregersen
- Department of Clinical Genetics and Center for Rare Disorders, Aarhus University Hospital, Aarhus, Denmark
| | | | - Koffi M Guedenon
- Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo
| | | | - Ahmet K Gündüz
- Department of Ophthalmology, Ankara University School of Medicine, Ankara, Turkey
| | - Himika Gupta
- Bai Jerbai Wadia Hospital for Children, Mumbai, India
| | - Sanjiv Gupta
- King George's Medical University, Lucknow, India
| | | | - Patrick Hamel
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | | | | | - Eric D Hansen
- John A. Moran Eye Center, University of Utah, Salt Lake City
| | - J William Harbour
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | | | - Murat Hasanreisoglu
- Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey
| | - Sadiq Hassan
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Shadab Hassan
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Jose Hernandez
- Hospital Nacional Guillermo Almenara Irigoyen, Lima, Perú
| | | | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohammed V University, Rabat, Morocco
| | - Diriba F Hordofa
- Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia
| | - Laura C Huang
- Byers Eye Institute, Stanford University, Stanford, California
| | | | - Marlies Hummlen
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | | | | | - Russo Ida
- Bambino Gesù IRCCS Children's Hospital, Rome, Italy
| | - Vesna R Ilic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | | | - Helen Jenkinson
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong Hyun Jo
- Fight Against Angiogenesis-Related Blindness Laboratory, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - William J Johnson
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Michael M Jones
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Rolande L Kabore
- Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso
| | - Swathi Kaliki
- Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India
| | - Abubakar Kalinaki
- Department of Ophthalmology, Makerere University College of Health Sciences Kamplala, Uganda
| | - Mehmet Kantar
- Division of Pediatric Oncology, School of Medicine, Ege University, Izmir, Turkey
| | | | - Tamar Kardava
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine and Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Tomas Kepak
- St. Anne's University Hospital Brno, Masaryk University, and International Clinical Research Center/St Anna University Hospital, Brno, Czech Republic
| | | | | | - Hussain A Khaqan
- Department of Ophthalmology, Postgraduate Medical Institute, Ameer-Ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Phara Khauv
- Angkor Hospital for Children, Krong Siem Reap, Cambodia
| | - Wajiha J Kheir
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Alireza Khodabande
- Retina and Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zaza Khotenashvili
- Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia
| | - Jonathan W Kim
- Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jeong Hun Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Artur Klett
- East Tallinn Central Hospital, Tallinn, Estonia
| | | | - Dalia Krivaitiene
- Children's Ophthalmology Department, Children's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania
| | - Mariana Kruger
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Kittisak Kulvichit
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | - Alice Kyara
- Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Eva S Lachmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carol P S Lam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Geoffrey C Lam
- Perth Children's Hospital, University of Western Australia, Perth, Western Australia, Australia
| | - Scott A Larson
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City
| | - Slobodanka Latinovic
- Clinical Center of Vojvodina, University Eye Clinic, Eye Research Foundation Vidar-Latinović, Novi Sad, Serbia
| | - Kelly D Laurenti
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Bao Han A Le
- John A. Burns School of Medicine, University of Hawaii, Honolulu, and University of Southern California Roski Eye Institute, Los Angeles
| | - Karin Lecuona
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Cairui Li
- Affiliated Hospital of Dali University, Dali City, China
| | - Ben Limbu
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | | | - Juan P López
- Ophthalmology Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Robert M Lukamba
- University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, Democratic Rrepublic of Congo
| | | | - Sandra Luna-Fineman
- Pediatric Hematology/Oncology/Stem Cell Transplantation, Center for Global Health, Children's Hospital Colorado, University of Colorado, Aurora
| | - Delfitri Lutfi
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - George N Magrath
- Storm Eye Institute, Medical University of South Carolina, Charleston
| | - Amita Mahajan
- Pediatric Hematology-Oncology Unit, Apollo Center for Advanced Pediatrics, Indraprastha Apollo Hospital, New Delhi, India
| | | | - Erika Maka
- Semmelweis University, Budapest, Hungary
| | - Mayuri Makan
- Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe
| | | | - Chatonda Manda
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Nieves Martín Begue
- Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | - Miguel Materin
- Duke Eye Center, Duke University Hospital, Durham, North Carolina
| | | | - Marchelo Matua
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | - Ismail Mayet
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - John D McKenzie
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Ocular Oncology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Aurora Medina-Sanson
- Department of Oncology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | | | | | - Marilyn B Mets
- Division of Ophthalmology, Feinberg School of Medicine, Northwestern University, and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Edoardo Midena
- Department of Ophthalmology, University of Padova, Padova, Italy
| | | | | | - Ahmed A Mohamedani
- Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | | | - Annette C Moll
- Department of Ophthalmology, Amsterdam UMC, Amsterdam, the Netherlands
| | | | - Rosa A Morales
- Hospital Infantil Manuel de Jesús Rivera, Managua, Nicaragua
| | - Claude Moreira
- Service d'Oncologie Pédiatrique de l'Hôpital Aristide le Dantec, Dakar, Senegal
| | | | | | - Gerald Msukwa
- Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | | | | | - Francis L Munier
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Gabriela Murgoi
- Institute of Oncology, Prof. Dr Al. Trestioreanu, Bucharest, Romania
| | | | - Kareem O Musa
- Department of Ophthalmology, Lagos University Teaching Hospital, College of Medicine of the University of Lagos, Lagos, Nigeria
| | - Asma Mushtaq
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Hamzah Mustak
- Division of Ophthalmology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Gita Naidu
- University of the Witwatersrand, Johannesburg, South Africa
| | - Akshay Gopinathan Nair
- Aditya Jyot Eye Hospital, Mumbai, India
- Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, India
| | - Larisa Naumenko
- N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus
| | | | - Yetty M Nency
- Child Health Department, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Vladimir Neroev
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Hang Ngo
- Ho Chi Minh Eye Hospital, Ho Chi Minh, Vietnam
| | - Rosa M Nieves
- Hospital Infantil Dr Robert Reid Cabral, Santo Domingo, Dominican Republic
| | - Marina Nikitovic
- Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Elizabeth D Nkanga
- Department of Ophthalmology, Calabar Children's Eye Center, University of Calabar Teaching Hospital, Calabar Nigeria
| | - Henry Nkumbe
- Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon
| | - Murtuza Nuruddin
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | | | | | - Ngozi C Oguego
- Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Andrzej Olechowski
- Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Scott C N Oliver
- Sue Anschutz-Rodgers Eye Center, University of Colorado School of Medicine, Aurora
| | | | - Diego Ossandon
- Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | | | | | - Sally L Painter
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Luisa Paiva
- National Ophthalmological Institute of Angola, Luanda, Angola
| | - Bikramjit P Pal
- H M Diwan Eye Foundation, and Tata Medical Center, Kolkata, India
| | | | - Ruzanna Papyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | | | - Manoj Parulekar
- Eye Department, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | | | - Katarzyna Pawinska-Wasikowska
- Institute of Pediatrics, Jagiellonian University Medical College, Children's University Hospital of Krakow, Krakow, Poland
| | - Jacob Pe'er
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Sanja Peric
- University Hospital Center Zagreb, Zagreb, Croatia
| | - Chau T M Pham
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Remezo Philbert
- Centre Hospitalier Universitaire de Kamenge, Bujumbura, Burundi
| | | | - Pavel Pochop
- Department of Ophthalmology for Children and Adults, Second Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic
| | | | - Vladimir G Polyakov
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | - Manca T Pompe
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | | | - Daphna Prat
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | - Ignatius Purwanto
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Seema Qayyum
- The Children's Hospital and the Institute of Child Health, Lahore, Pakistan
| | - Jiang Qian
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Ardizal Rahman
- Ophthalmology Department, Dr M. Djamil General Hospital, Faculty of Medicine, Andalas University, West Sumatra, Indonesia
| | | | | | | | | | | | - Marco A Ramirez-Ortiz
- Department of Ophthalmology, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico
| | - Léa Raobela
- Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar
| | - Riffat Rashid
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - M Ashwin Reddy
- The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Ehud Reich
- Department of Ophthalmology, Davidoff Center for Oncology, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel
| | - Lorna A Renner
- School of Medicine and Dentistry, Korle-Bu Teaching Hospital, University of Ghana, Accra, Ghana
| | | | | | | | - Petra Ritter-Sovinz
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Livia Romero
- Unidad de Oncologia Ocular Hospital Oncologico Luis Razzetti, Caracas, Venezuela
| | - Soma R Roy
- Chittagong Eye Infirmary and Training Complex, Chittagong, Bangladesh
| | - Raya H Saab
- Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Svetlana Saakyan
- Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia
| | - Ahmed H Sabhan
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Mandeep S Sagoo
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, United Kingdom
| | - Azza M A Said
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rohit Saiju
- Tilganga Institute of Ophthalmology, Kathmandu, Nepal
| | - Beatriz Salas
- Hospital Dr Manuel Ascencio Villarroel, Cochabamba, Bolivia
| | | | | | | | | | | | | | - Ahad Sedaghat
- Department of Ophthalmology, Rasool Akram Hospital, Tehran, Iran
| | | | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ankoor S Shah
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | - Sadik T Sherief
- Department of Ophthalmology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sorath Noorani Siddiqui
- Department of Pediatric Ophthalmology and Strabismus, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Sidi Sidi Cheikh
- Ophthalmology Department, Nouakchott Medical University, Nouakchott, Mauritania
| | - Sónia Silva
- Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Usha Singh
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Penny Singha
- Department of Ophthalmology, Songklanagarind Hospital, Prince of Songkla University, Songkla, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Alison H Skalet
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Hendrian D Soebagjo
- Department of Ophthalmology, Dr Soetomo General Hospital, Airlangga University, Surabaya, Indonesia
| | | | - Grace Ssali
- Mulago National Referral Hospital, Kampala, Uganda
| | - Andrew W Stacey
- Department of Ophthalmology, University of Washington, Seattle
| | - Sandra E Staffieri
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
| | - Erin D Stahl
- Children's Mercy Hospital, Kansas City, Missouri
| | - Christina Stathopoulos
- Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland
| | - Branka Stirn Kranjc
- University Eye Hospital Ljubljana, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - David K Stones
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
| | | | | | - Sadia Sultana
- Department of Oculoplasty and Ocular Oncology, Ispahani Islamia Eye Institute and Hospital, Dhaka, Bangladesh
| | - Xiantao Sun
- Henan Children's Hospital, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
| | - Meryl Sundy
- Casey Eye Institute, Oregon Health & Science University, Portland
| | - Rosanne Superstein
- Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Quebec, Canada
| | - Eddy Supriyadi
- Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Shigenobu Suzuki
- Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Karel Svojgr
- Department of Pediatric Hematology and Oncology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | | | - Gevorg Tamamyan
- Department of Oncology, Yerevan State Medical University, and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R. H. Yeolyan, Yerevan, Armenia
| | - Deborah Tan
- Singapore National Eye Center, Singapore, Singapore
| | - Alketa Tandili
- University Hospital Center Mother Theresa, Tirana, Albania
| | | | - Maryam Tashvighi
- MAHAK Hematology Oncology Research Center, Mahak Hospital, Tehran, Iran
| | | | - Edi S Tehuteru
- National Cancer Center, Dharmais Cancer Hospital, Jakarta, Indonesia
| | - Luiz F Teixeira
- Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil
- Ophthalmology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Kok Hoi Teh
- Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Helen Toledano
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doan L Trang
- Vietnam National Institute of Ophthalmology, Ha Noi, Vietnam
| | - Fousseyni Traoré
- Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali
| | | | - Samuray Tuncer
- Department of Ophthalmology, Faculty of Medicine, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | | | - Ali B Umar
- Aminu Kano Teaching Hospital, Bayero University, Kano, Nigeria
| | - Emel Unal
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | | | - Steen F Urbak
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Tatiana L Ushakova
- Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology, N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
- Russian Medical Academy of Postgraduate Education, Moscow, Russia
| | | | | | | | - Adisai Varadisai
- Vitreo-Retina Research Unit, Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Nevyana V Veleva-Krasteva
- Eye Clinic, Department of Ophthalmology, University Hospital Alexandrovska, Medical University, Sofia, Sofia, Bulgaria
| | | | - Andi A Victor
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, and Dr Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | | | - Vicktoria Vishnevskia-Dai
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel
| | | | | | | | - Keith Waddell
- Ruharo Eye Centre, Ruharo Mission Hospital, Mbarara, Uganda
| | | | | | - Yi-Zhuo Wang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Avery Weiss
- Department of Ophthalmology, University of Washington, Seattle
| | - Matthew W Wilson
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Amelia D C Wime
- National Ophthalmological Institute of Angola, Luanda, Angola
| | | | | | | | - Phanthipha Wongwai
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daoman Xiang
- Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | | | - Jason C Yam
- Hong Kong Eye Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Huasheng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jenny M Yanga
- Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | | | - Vera A Yarovaya
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Andrey A Yarovoy
- S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia
| | - Huijing Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Putu Yuliawati
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Sanglah Eye Hospital, Bali, Indonesia
| | | | - Ekhtelbenina Zein
- Assistante Hospitalo Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania
| | - Chengyue Zhang
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Paediatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junyang Zhao
- Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Xiaoyu Zheng
- Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Nida Zia
- The Indus Hospital, Karachi, Pakistan
| | - Othman A O Ziko
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marcia Zondervan
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Ophthalmology Department, Great Ormond Street Hospital, London, United Kingdom
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Affdal AO, Grynberg M, Hessissen L, Ravitsky V. Impact of legislation and public funding on oncofertility: a survey of Canadian, French and Moroccan pediatric hematologists/oncologists. BMC Med Ethics 2020; 21:25. [PMID: 32245465 PMCID: PMC7118810 DOI: 10.1186/s12910-020-00466-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chemotherapy and/or radiotherapy treatments may cause premature ovarian failure and irreversible loss of fertility. In the context of childhood cancers, it is now acknowledged that possible negative effects of therapies on future reproductive autonomy are a major concern. While a few options are open to post-pubertal patients, the only immediate option currently open to pre-pubertal girls is cryopreservation of ovarian tissue and subsequent transplantation. The aim of the study was to address a current gap in knowledge regarding the offer of fertility preservation by Ovarian Tissue Cryopreservation (OTC) for prepubescent girls with cancer, and to explore current practices and attitudes of Canadian, French and Moroccan pediatric heme oncologists. The comparative perspective is relevant since legal frameworks surrounding fertility preservation and funding offered by the healthcare system vary greatly. METHODS An online survey was sent to the 45 pediatric oncology centers in Canada, France and Morocco. RESULTS A total of 39 centers responded (86.6%). OTC is offered by almost all pediatric heme oncologists in France (98%), very few in Canada (5%), and none in Morocco (0%). For pediatric hematologists/oncologists who do not propose fertility preservation in Canada, the reasons are: the technique is still experimental (54%), it is not available locally (26%) and cost of the technique for the family (14%). 97% of Canadian and 100% of Moroccan pediatric hematologists/oncologists think OTC should be funded by the healthcare system as it is in France and in the province of Quebec in Canada. CONCLUSIONS The results of this study show tremendous diversity in the provision of OTC across countries, whereby its offer is correlated with legislation and funding. We argue that the current reality, in which this technology is often not offered to families, raises ethical issues related to justice and equity of access, as well as informed consent and future reproductive autonomy.
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Affiliation(s)
- Aliya Oulaya Affdal
- Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montréal, Québec Canada
- Centre de Recherche en Santé Publique, Montreal, Québec Canada
| | - Michael Grynberg
- Department of Reproductive Medicine & Fertility Preservation, Hôpital Antoine Beclere, Clamart, France; Université Paris Saclay, Clamart, France
| | - Laila Hessissen
- Pediatric Hematology and Oncology Center, Mohamed V University, Rabat, Morocco
| | - Vardit Ravitsky
- Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montréal, Québec Canada
- Centre de Recherche en Santé Publique, Montreal, Québec Canada
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Khoubila N, Bendari M, Benmiloud S, ElHoudzi J, Maani K, Elmouden L, Alzemmouri M, Hachim J, Kili A, Kababri M, Khattab M, ElBouri H, Hassoune S, Nani S, Cherkaoui S, Quessar A, Madani A, Hessissen L. Pain Management in Children with Cancer: National Surveys of Practices and Perceptions in Morocco. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.5252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: The aim of the study was to improve the quality of pain management in Moroccan pediatric oncology units, the Moroccan Society of Paediatric Haematology/Oncology initiated a national quality improvement project in 2014 with the support of the Lalla Salma Foundation for Prevention and Treatment of Cancer.
METHODS: To assess the current situation of pain management in Moroccan pediatric oncology patients, two cross-sectional surveys were conducted, involving patient/parental proxies and health-care providers’.
RESULTS: The first survey concerned 108 care providers from five institutions. The second survey covered 155 children with cancer from the five Moroccan pediatric oncology units. Among them, 145 reported suffering from pain, which patients/families attributed to the underlying cancer (n = 85), to procedures and treatment (n = 46), or to both the cancer and procedures/treatment (n = 19). Procedural pain was mainly related to lumbar puncture and bone marrow aspirate. The majority of patients/parents reported that pain negatively impacted their emotional, physical, and social functioning. The majority of parents requested further information and communication about pain management.
CONCLUSION: Both health-care providers and families of children with cancer in Morocco report need for pain management improvement, including in institutional and educational practices. This current baseline data have informed the development of our ongoing project including continuing education, training, and practice policies development.
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Hessissen L, Patte C, Martelli H, Coze C, Howard SC, Kili A, Gagnepain-Lacheteau A, Harif M. African School of Pediatric Oncology Initiative: Implementation of a Pediatric Oncology Diploma Program to Address Critical Workforce Shortages in French-Speaking Africa. J Glob Oncol 2019; 5:1-12. [PMID: 31657980 PMCID: PMC6825251 DOI: 10.1200/jgo.19.00161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE In 2012, the French African Pediatric Oncology Group established the African School of Pediatric Oncology (EAOP), a training program supported by the Sanofi Espoir Foundation’s My Child Matters program. As part of the EAOP, the pediatric oncology training diploma is a 1-year intensive training program. We present this training and certification program as a model for subspecialty training for low- and middle-income countries. METHODS A 14-member committee of multidisciplinary experts finalized a curriculum patterned on the French model Diplôme Inter-Universitaire d’Oncologie Pédiatrique. The program trained per year 15 to 25 physician participants committed to returning to their home country to work at their parent institutions. Training included didactic lectures, both in person and online; an onsite practicum; and a research project. Evaluation included participant evaluation and feedback on the effectiveness and quality of training. RESULTS The first cohort began in October 2014, and by January 2019, 72 participants from three cohorts had been trained. Of the first 72 trainees from 19 French-speaking African countries, 55 (76%) graduated and returned to their countries of origin. Four new pediatric oncology units have been established in Niger, Benin, Central African Republic, and Gabon by the graduates. Sixty-six participants registered on the e-learning platform and continue their education through the EAOP Web site. CONCLUSION This training model rapidly increased the pool of qualified pediatric oncology professionals in French-speaking countries of Africa. It is feasible and scalable but requires sustained funding and ongoing mentoring of graduates to maximize its impact.
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Affiliation(s)
| | - Catherine Patte
- Institut Gustave Roussy, Villejuif, France.,Paris-Sud University, Orsay, France
| | - Helene Martelli
- Institut Gustave Roussy, Villejuif, France.,Paris-Sud University, Orsay, France
| | - Carole Coze
- Hôpital d'Enfants de La Timone, Marseille, France
| | - Scott C Howard
- University of Tennessee Health Science Center, Memphis, TN
| | | | | | - Mhamed Harif
- Ibn Rochd University Hospital, Casablanca, Morocco
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40
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Fouquet C, Le Rouzic M, Leblanc T, Fouyssac F, Leverger G, Hessissen L, Marlin S, Bourrat E, Fahd M, Raffoux E, Vannier J, Jäkel N, Knoefler R, Triolo V, Pasquet M, Bayart S, Thuret I, Lutz P, Vermylen C, Touati M, Rose C, Matthes T, Isidor B, Kannengiesser C, Ducassou S. Genotype/phenotype correlations of childhood‐onset congenital sideroblastic anaemia in a European cohort. Br J Haematol 2019; 187:530-542. [DOI: 10.1111/bjh.16100] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/08/2019] [Indexed: 01/19/2023]
Affiliation(s)
| | | | | | | | - Guy Leverger
- CHU de Paris Hôpital Armand Trousseau Paris France
| | | | | | | | - Mony Fahd
- CHU de Paris Hôpital Robert Debré Paris France
| | | | | | - Nadja Jäkel
- Department für Hämatologie Onkologie und Hämostaseologie Leipzig Germany
| | - Ralf Knoefler
- Department of Pediatric Haemostaseology University Hospital Carl Gustav Carus Dresden Germany
| | | | | | | | | | - Patrick Lutz
- CHU de Strasbourg Hôpital de Hautepierre Strasbourg France
| | - Christiane Vermylen
- Université Catholique de Louvain, Cliniques universitaires Saint‐Luc Brussels Belgium
| | | | | | - Thomas Matthes
- Geneva University Hospital, Hematology Service Geneva Switzerland
| | | | - Caroline Kannengiesser
- Assistance Publique des Hôpitaux de Paris, Département de Génétique Hôpital Bichat, Université Paris VII Paris France
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Khalek ER, Afungchwi GM, Beltagy ME, Mariam N, Zaki H, Israels T, Molyneux E, Howard SC, Patte C, Schoeman J, Ladas E, Zaghloul MS, ElDeen YS, Ahmed S, Kamal S, Bouffet E, Pritchard-Jones K, Hessissen L. Highlights from the 13th African Continental Meeting of the International Society of Paediatric Oncology (SIOP), 6-9 March 2019, Cairo, Egypt. Ecancermedicalscience 2019; 13:932. [PMID: 31281429 PMCID: PMC6592710 DOI: 10.3332/ecancer.2019.932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Indexed: 01/17/2023] Open
Abstract
The 13th African continental meeting of the international society of paediatric oncology, held on 6-9 March 2019 in Cairo, was organised in collaboration with the Children Cancer Hospital (57357) in Egypt and the global parents' organisation (Childhood Cancer International) and supported by a large international faculty. With 629 delegates from 37 countries (24 African), this was the largest forum of healthcare professionals focused on children and young people with cancer in Africa to showcase advances and discuss further improvements. Three targeted workshops, on nursing care, pharmacy and nutrition, attracted large numbers and catalysed new collaborative initiatives in supportive care studies, extended roles for pharmacists in quality control and care delivery and addressed malnutrition concurrently with cancer treatment. The Collaborative Wilms Tumour Africa Project, open in seven sub-Saharan countries, and the trials in Burkitt's lymphoma reported encouraging outcomes with further initiatives in supportive care (the supportive care for children with cancer in Africa project). While acknowledging deficits in radiotherapy provision, available in only 23 of 52 African countries, centres with facilities reported their technical advances that benefit patients. Of great importance for children with brain tumours, who are underdiagnosed in Africa, was the first announcement of African paediatric neuro-oncology society, whose 63 current members aim to tackle the shortage of neurosurgeons through training fellowships, workshops and a dedicated conference. The congress provided the opportunity to discuss how African countries will work with the WHO global initiative aiming to improve childhood cancer survival to 60% in all countries by 2030. This conference report is dedicated to the three Kenyan delegates who died tragically on the Ethiopian Airlines flight ET302 on their way home, full of new ideas and pride in what they had achieved so far. All those who heard their presentations are determined to continue their excellent work to improve cancer care for children in Africa.
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Affiliation(s)
- Elhamy Rifky Khalek
- Professor of Paediatric Oncology, Faculty of Medicine, Zagazig University, Children's Cancer Hospital Egypt 57357, Cairo 11617, Egypt
| | - Glenn M Afungchwi
- Manager, Cameroon Baptist Convention Health Services Childhood Cancer Programme, Cameroon University of Stellenbosch, Stellenbosch 7602, South Africa
| | - Mohamed El Beltagy
- Professor of neurosurgery, Faculty of Medicine, Cairo University, Kasr El Aini, Cairo, and Head of Neurosurgery, Children's Cancer Hospital Egypt 57357, Cairo 11617, Egypt
| | - Ndagire Mariam
- Nursing officer, Uganda Cancer Institute, Kampala, PO Box 3935 Uganda
| | - Hoda Zaki
- Dean, Faculty of Nursing, Helwan University, Modern University for Technology and Information (MTI), Cairo, Egypt
| | - Trijn Israels
- Princess Màxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Elizabeth Molyneux
- Paediatric Department, College of Medicine/Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Scott C Howard
- The University of Tennessee Health Science Center, Memphis, TN 38163 USA
| | - Catherine Patte
- CLCC G Groupe Franco-Africain d'Oncologie Pédiatrique (GFAOP), Institut Gustave Roussy, France and GFAOP, 94800 Villejuif, France
| | - Judy Schoeman
- Chief dietician, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town 7530, South Africa
| | - Elena Ladas
- Associate Professor for Global Integrative Medicine, Director, Integrative Therapies Program, Columbia University Medical Center, USA
| | - Mohamed S Zaghloul
- Professor of Radiation Oncology, National Cancer Institute; Chair, Radiation Oncology Department, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Yasser S ElDeen
- Professor of Pediatric Surgery, Alexandria University, Alexandria 21568, Egypt
| | - Soha Ahmed
- Chairman, Clinical Oncology Department, Aswan University and Consultant, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Sherif Kamal
- Director, Department of Pharmaceutical Services, Children's Cancer Hospital Egypt 57357, Cairo, Egypt
| | - Eric Bouffet
- President, International Society of Paediatric Oncology (SIOP), Professor of Neuro-oncology, Sick Children's Hospital, Toronto ON M5G 1X8, Canada
| | - Kathy Pritchard-Jones
- SIOP President-elect, Professor of Paediatric Oncology, UCL Great Ormond Street Institute of Child Health, University College London, London WC1E 6BT, UK
| | - Laila Hessissen
- SIOP Africa Continental President, Professor of Paediatrics, Pediatric Haematology and Oncology Center, University Mohamed V Rabat, Rabat BP.8007.UN, Morocco
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Boutahar FZ, Benmilou S, Kababri ME, Kili A, Khorassani ME, Allali N, Khattab M, Qaddoumi I, Hessissen L. Time to diagnosis of pediatric brain tumors: a report from the Pediatric Hematology and Oncology Center in Rabat, Morocco. Childs Nerv Syst 2018; 34:2431-2440. [PMID: 30054805 PMCID: PMC7685949 DOI: 10.1007/s00381-018-3927-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Delayed diagnosis of pediatric brain tumors is known to occur worldwide but is not well studied in developing countries. Here, we examined the extent of delayed pediatric brain tumor diagnoses in Rabat, Morocco, and consider its potential causes and possible solutions. METHODS We conducted a survey and interviews of the parents of children who were admitted to the Department of Hematology and Pediatric Oncology of Rabat Children's Hospital from January 1, 2016 to June 30, 2016. RESULTS The families of 27 patients (14 girls and 13 boys) participated in the survey and interview. The median patient age was 7 years (range, 1-15 years). The most common presenting symptoms were vomiting (n = 18) and headache (n = 17). The tumor locations were supratentorial in 13 cases and infratentorial in 14 cases. The median time to diagnosis was 2 months (range, 0.25-20 months). The longest times to diagnosis occurred in children older than 5 years and in patients with supratentorial tumors or low-grade glioma. We did not observe any differences in the time to diagnosis according to sex, socioeconomic status, or urban or rural origin. CONCLUSIONS Delayed diagnosis of pediatric brain tumors is a universal problem, evidenced by many studies in different countries. We propose that a paradigm shift in medical curricula addressing the delayed diagnosis of pediatric brain tumors should occur in medical schools and clinical training programs.
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Affiliation(s)
| | - Sarra Benmilou
- Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco
| | - Maria El Kababri
- Pediatric Hematology and Oncology Center, University Mohamed V Rabat, Rabat, Morocco
| | - Amina Kili
- Pediatric Hematology and Oncology Center, University Mohamed V Rabat, Rabat, Morocco
| | - Mohamed El Khorassani
- Pediatric Hematology and Oncology Center, University Mohamed V Rabat, Rabat, Morocco
| | - Nazik Allali
- Department of Pediatric Radiology, University Mohamed V Rabat, Rabat, Morocco
| | - Mohamed Khattab
- Pediatric Hematology and Oncology Center, University Mohamed V Rabat, Rabat, Morocco
| | - Ibrahim Qaddoumi
- Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, Tennessee
| | - Laila Hessissen
- Pediatric Hematology and Oncology Center, University Mohamed V Rabat, Ibn Rochd Avenue, 6542, Rabat, BP, Morocco.
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Chebihi ZT, Belkhayat A, Chadli E, Hessissen L, El Khorassani M, El Kababri M, Kili A, Khattab M, Bakri Y, Dakka N. The rare translocation t(14;21)(q11;q22) detected in a Moroccan patient with T-cell acute lymphoblastic leukemia. Leuk Res Rep 2018; 11:1-4. [PMID: 30533380 PMCID: PMC6260455 DOI: 10.1016/j.lrr.2018.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/08/2018] [Accepted: 11/21/2018] [Indexed: 11/04/2022] Open
Abstract
Cytogenetic studies of acute lymphoblastic leukemia have been at the forefront of research in the pathogenesis of cancer. The presence of recurring chromosomal abnormalities (either numeral or structural rearrangements) provides immediate clues to the genetic events leading to leukemia and many abnormalities have important prognostic significance. The rare translocation t(14,21)(q11.2;q22) has been described in pediatric T lineage ALL in only one case so far in 2000. The present study is a case report of an ALL case in which we found a t(14,21)(q11.2;q22) as a non random chromosomal abnormality among 70 analyzed pediatric ALL cases referred exclusively to BIOLAB Laboratory from the children hospital of Morocco.
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Affiliation(s)
- Z Takki Chebihi
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco.,BIOLAB Laboratory, Rabat, Morocco
| | | | - E Chadli
- BIOLAB Laboratory, Rabat, Morocco
| | - L Hessissen
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Morocco
| | - M El Khorassani
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Morocco
| | - M El Kababri
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Morocco
| | - A Kili
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Morocco
| | - M Khattab
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Morocco
| | - Y Bakri
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - N Dakka
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
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Howard SC, Zaidi A, Cao X, Weil O, Bey P, Patte C, Samudio A, Haddad L, Lam CG, Moreira C, Pereira A, Harif M, Hessissen L, Choudhury S, Fu L, Caniza MA, Lecciones J, Traore F, Ribeiro RC, Gagnepain-Lacheteau A. The My Child Matters programme: effect of public–private partnerships on paediatric cancer care in low-income and middle-income countries. Lancet Oncol 2018; 19:e252-e266. [DOI: 10.1016/s1470-2045(18)30123-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 12/18/2022]
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Chebihi ZT, Belkhayat A, Chadli E, Hilal L, Skhoun H, Hessissen L, El Khorassani M, El Kababri M, Kili A, Khattab M, Bakri Y, Dakka N. Cytogenetic Profile of Moroccan Pediatric Acute Lymphoblastic Leukemia: Analysis of 155 Cases With a Review of the Literature. Clin Lymphoma Myeloma Leuk 2018; 18:e241-e248. [PMID: 29748040 DOI: 10.1016/j.clml.2018.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/19/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) is the most common malignancy in children, with a peak incidence at 2 to 3 years of age and accounting for almost 30% of all cancers in this age group. It is well established that the identification of cytogenetic abnormalities is highly relevant for the prognosis of and therapeutic decisions in ALL. The purpose of the present study was to define the frequency of recurrent chromosomal abnormalities of ALL in Moroccan patients referred exclusively to the BIOLAB Laboratory of the Children's Hospital of Rabat during a 4-year period and compare our findings to the reported data. PATIENTS AND METHODS We performed conventional karyotyping of 155 ALL cases, with a successful cell culture rate of 94%. RESULTS We identified chromosomal abnormalities in 66% of the total studied cases, of which 70% revealed important recurrent abnormalities with high prognostic value, such as hyperdiploidy, hypodiploidy, t(9;22), t(8;14), t(1;19), and MLL rearrangements. In total agreement with the reported data, most of the patients (56%) in the present study were aged 1 to 5 years, with a male predominance, and B-ALL was the most common blast phenotype (85%). CONCLUSION The frequency of most chromosomal rearrangements successfully identified in our study and their lineage correlated with those reported in the published data.
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Affiliation(s)
- Zahra Takki Chebihi
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco; BIOLAB Laboratory, Rabat, Morocco.
| | | | | | - Latifa Hilal
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Hanaa Skhoun
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Laila Hessissen
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Rabat, Morocco
| | - Mohamed El Khorassani
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Rabat, Morocco
| | - Maria El Kababri
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Rabat, Morocco
| | - Amina Kili
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Rabat, Morocco
| | - Mohammed Khattab
- Department of Pediatric Hemato-Oncology, Children's Hospital of Rabat, Rabat, Morocco
| | - Youssef Bakri
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Nadia Dakka
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
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Hessissen L, Parkes J, Amayiri N, Mushtaq N, Sirachainan N, Anacak Y, Mitra D, Figaji A, Schouten-van Meeteren A, Sullivan M, Burger H, Davidson A, Bouffet E, Bailey S. SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings. Pediatr Blood Cancer 2017; 64 Suppl 5. [PMID: 29297618 DOI: 10.1002/pbc.26737] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 06/22/2017] [Indexed: 12/15/2022]
Abstract
Effective treatment of children with low grade glioma (LGG) requires a functioning multi-disciplinary team with adequate neurosurgical, neuroradiological, pathological, radiotherapy and chemotherapy facilities and personnel. In addition, the treating centre should have the capacity to manage a variety of LGG and treatment-associated complications. These requirements have made it difficult for many centers in low and middle-income countries (LMIC) to offer effective treatment and follow up. This article provides management recommendations for children with LGG according to the level of facilities available.
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Affiliation(s)
- Laila Hessissen
- Department of Hematology and Pediatric Oncology, Hospital University Ibn Sina, Rabat, Morocco
| | - Jeannette Parkes
- Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Nisreen Amayiri
- Department of Hematology and Oncology, King Hussein Cancer Centre, Amman, Jordan
| | - Naureen Mushtaq
- Department of Pediatric Haematology and Oncology, Aga Khan University Hopsital, Karachi, Pakistan
| | - Nongnuch Sirachainan
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yavuz Anacak
- Department of Radiation Oncology, Ege University School of Medicine & Hospital, Izmir, Turkey
| | - Dipayan Mitra
- Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
| | - Anthony Figaji
- Department of Neurosurgery, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | | | - Michael Sullivan
- Department of Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Melbourne, Victoria, Australia
| | - Hester Burger
- Department Medical Physics, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
| | - Alan Davidson
- Haematology Oncology Service, Red Cross War Memorial Children's Hospital, Department of Paediatrics and Child Health, University of Cape Town, South Africa
| | - Eric Bouffet
- Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Simon Bailey
- Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
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Abstract
Abstract 72 Background: Neuroblastoma is the most common extracranial solid tumor of childhood, accounting for 10% of childhood cancers in high-income countries (HIC), with an unknown incidence in most low- and middle-income countries (LMIC). A multidisciplinary approach to the treatment of high-risk (HR) neuroblastoma consisting of a combination of chemotherapy, surgery, radiation and immunotherapy, has lead to improvements in survival in HICs, approaching 40-50%. Morocco, a LMIC, has historically had a survival rate for HR neuroblastoma of 10-15% at three years, with almost no survival at five years from diagnosis, due to a combination of limited availability of accurate diagnosis, staging, and risk stratification, as well as lack of some of the necessary treatment modalities and high abandonment rates. The International Society for Pediatric Oncology (SIOP) Pediatric Oncology in Developing Countries (PODC) committee developed adapted risk stratification and treatment guidelines using locally available chemotherapeutic agents in doses that limit toxicity. This approach was implemented at the four cancer treatment centers in Morocco beginning in January of 2012. This study aims to describe HR neuroblastoma patients presenting in Rabat, Morocco, in the last four years; test feasibility of an intensive induction regimen for HR neuroblastoma; and assess response to a novel intensive induction chemotherapy regimen adapted for a LMIC setting. Methods: This treatment protocol was first implemented in January of 2012 with approval of the local ethics board. Chart review was performed on patients with high risk neuroblastoma enrolled on the protocol at Pediatric Hematology and Oncology Center of Rabat between January of 2012 and September of 2015. Data regarding demographics, toxicity, and outcomes was collected and descriptive statistics were performed. Results: 40 patients were diagnosed with high risk neuroblastoma between January of 2012 and September of 2015 in Rabat. There were 14 females (35%) and 26 males (65%) with a median age of 40 months (age range 13m to 11y5m). With regards to diagnostic testing, 100% of patients underwent CT scan, while 47.5% (19/40) of patients underwent MIBG and 47.5% underwent bone scintigraphy. Only 9 patients (22.5%) had MYCN status determined, however MYCN testing increased over time during this protocol, as 53.8% (7/13) of patients diagnosed with HR neuroblastoma in the past year had MYCN testing performed. 82.5% of patients (33/40) completed all five cycles of induction chemotherapy, with 9/40 (22.5%) experiencing delays of 1 or 2 cycles (delay defined as >5 weeks) due to toxicity. Of the 33 patients who completed induction, 60.6% (20 patients) experienced a PR or VGPR, continuing on to local control with surgery or consolidation therapy. Only one patient was lost to follow up due to abandonment. Conclusion: Adapted risk stratification and treatment guidelines for LMICs allow for more accurate diagnosis and systematic treatment. Standardizing a protocol for high risk patients has led to more consistent MYCN evaluation, performed by immunohistochemistry, as well as the introduction of MIBG to the Rabat Children's Hospital. While this is a multi-center study (a known study obstacle in LMICs), this protocol has led to a decrease in the barriers to accurate diagnosis and optimal treatment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.
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Affiliation(s)
- Zeena Salman
- Zeena Salman, Memorial Sloan Kettering Cancer Center, New York, NY; Maria El Kababri, Laila Hessissen, and Mohammed Khattab, Children’s Hospital Rabat, Morocco; and Katherine Matthay, University of California San Francisco School of Medicine, CA
| | - Maria El Kababri
- Zeena Salman, Memorial Sloan Kettering Cancer Center, New York, NY; Maria El Kababri, Laila Hessissen, and Mohammed Khattab, Children’s Hospital Rabat, Morocco; and Katherine Matthay, University of California San Francisco School of Medicine, CA
| | - Laila Hessissen
- Zeena Salman, Memorial Sloan Kettering Cancer Center, New York, NY; Maria El Kababri, Laila Hessissen, and Mohammed Khattab, Children’s Hospital Rabat, Morocco; and Katherine Matthay, University of California San Francisco School of Medicine, CA
| | - Mohammed Khattab
- Zeena Salman, Memorial Sloan Kettering Cancer Center, New York, NY; Maria El Kababri, Laila Hessissen, and Mohammed Khattab, Children’s Hospital Rabat, Morocco; and Katherine Matthay, University of California San Francisco School of Medicine, CA
| | - Katherine Matthay
- Zeena Salman, Memorial Sloan Kettering Cancer Center, New York, NY; Maria El Kababri, Laila Hessissen, and Mohammed Khattab, Children’s Hospital Rabat, Morocco; and Katherine Matthay, University of California San Francisco School of Medicine, CA
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Hessissen L, Amayiri N, Mushtaq N, Sirachainan N, Anacak Y, Mitra D, Figaji A, Meeteren ASV, Sullivan M, Davidson A, Parkes J, Bouffet E, Bailey S. LMI-01DEVELOPMENT OF CLINICAL GUIDELINES FOR THE TREATMENT OF LOW GRADE GLIOMAS IN LOWER AND LOWER MIDDLE INCOME COUNTRIES – A SIOP PODC INITIATIVE. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now077.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ziani A, El Kababri M, El Khorassani M, Kili A, Khattab M, Hessissen L. Quels sont les besoins des enfants en oncologie pédiatrique alors qu’ils entrent en phase palliative ? Enquête réalisée au Maroc auprès de leurs parents. PSYCHO-ONCOLOGIE 2015. [DOI: 10.1007/s11839-015-0530-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Harif M, Hessissen L, Patte C. [Realizations and challenges of childhood cancer in Africa: experiences of the Franco-African Group of Pediatric Oncology]. Arch Pediatr 2015; 22:61-2. [PMID: 26112523 DOI: 10.1016/s0929-693x(15)30032-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Harif
- Centre Hospitalier Universitaire Mohammed VI, 6 Rue Ibn Sina, Amarchich, Marrakech, Maroc.
| | - L Hessissen
- Centre Hospitalier Universitaire Ibn Sina, Rabat, Maroc
| | - C Patte
- Institut Gustave Roussy, Villejuif, France
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