Consorcio Latinoamericano de Enfermedades Hemato-Oncológicas Pediátricas

The 1st  Latin-american Children's
Hemato-Oncology Journey

 

On 24 and 25 April in the city of Montevideo the "1st Latin American Conference of Children's Hematology-Oncology " happened in the halls of the Hotel Cottage. Twelve researchers attended the event. They were: Drs . Ivan Maza (Peru), Juan Garcia (Peru), Oscar Gonzalez Ramella (Mexico), Arturo Moreno Ramirez (Mexico), Claudia Teresa Oliveira (Brazil) , Juliana Texeira Costa (Brazil) , Joanna de Figueiredo Bertolini (Brazil), Alejandro Arancibia (Brazil) , Mauricio Castellanos (AHOPCA), David Veron (GATLA - Argentina) , Cecilia Ricchieri (GATLA - Argentina), Daniel Freigeiro (GATLA - Argentina). The topics were related to the situation and treatment of children with cancer in Institutions and Regional Cooperative Groups involved different countries.

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Dr Freigeiro presented epidemiological data on childhood cancer registered in the Argentine Hospital Oncopediátrico. These data showed a population of 10,224,978 children with cancer aged 0-15. The incidence of cancer is 130-140 per million, with an annual average of 1281 cases. The most common tumor is leukemia with 472 new cases per year and an incidence of 48 per million. Public hospitals treat 75% of them and 50% three hospitals concentrate the treatment. Next, he explained to everyone the GATLA's role. He also presented the results of LLA according to International BFM Study Group protocol (Dr. Ricchieri ) and Hodgkin treatment study being done with the AHOPCA group (Dr Veron ).

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Dr. Arancibia presented data from Brazil with a population of 190.732.00 inhabitants. The annual number of new cases estimated in the age group of 0-19 is 9386. In the year of 2014 they were 11500, with an incidence of 154.3 per million. He presented data from the main protocols used in ALL, AML and Lymphomas. Dr. Juliana Texeira Costa described the experience of Martagão Gesteira Hospital in Salvador, which is the most important Children's Hospital of Bahia, Brazil, with 115 new cancer cases in 2014. 34 of them were leukemias and 14 where lymphomas. Dr. Joana Figueiredo presented the experience of Hospital Estadual Infantil Nossa Senhora Da Gloria in Vitoria, a brazilian city with a population of 3,885,000. It is the only public hospital in Pediatric Oncology Service of the State with 115 new cases per year.

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Dr. Claudia Oliveira showed the Amaral Carvalho Hospital situation of Sao Paulo, which also features Children's Oncology Unit of Bone Marrow Transplantation. There have been about 2000 transplants since 1996. In 13 years, this Hospital diagnosed 1600 new cases of cancer in children between 0-19 years old. All speakers also presented data protocols in ALL, AML and Lymphomas underway in their institutions.

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Drs García and Meza presented their experience in Childhood Cancer at their institutions which are located in Lima. This summarizes the treatment of almost all children with oncological pathology of Peru. This country has a population of 30,814,000, of which 9,000,000 live in Lima. 11,617,000 are distributed in the age group of 0-19. They presented different health services, either public and the Public Insurance Services and also the situation of the two institutions (National Edgardo Reboglioti Martins and INEN Hospital). They discussed the different treatment regimens used in these institutions.

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Drs. Oscar Arturo and Moreno Ramella presented the reality of Onco-Hematology childhood cancer in Mexico and also research and teaching. They introduced the health system and the problems of their country. In addition to the experience of a National Centre in Guadalajara and Puebla and the Mexican Association of Pediatric Hematology - Oncology (AMHOP) and the Mexican group Bone Marrow Transplantation in Pediatrics.

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In Mexico they are diagnosed between 5000-6000 new cases per year in children under 18 years old, with an incidence of 90 per million. Cancer is the leading cause of death in the group between 5 and 14 years old. Leukemia is the most frequent tumor (39.2 %). Nowadays, the Mexican People's Insurance provides health coverage for all tumors.

There are 54 medical units in Mexico accredited for the treatment of pediatric cancer.

 

The Guadalajara Hospital is a country reference center for the treatment of these patients having a Bone Marrow Transplantation Unit. They register about 450 new patients per year.

 

Dr. Mauricio Castellanos referred to the experience in Central America with the Cooperative Group AHOPCA, emphasizing the Hodgkin protocol used by the Group and in collaboration with the GATLA .

 

Then in the end of the discussion, it was raised the situation in Latin America, where according to data from OPS (OPS-2012 Report) was of 17,500 new cases of childhood cancer diagnosed per year, representing 65% of tumors registered in America. They cause around 8000 deaths annually in the group under 14 years old. In this age group, they were diagnosed 10137  leukemias,  Hodgkin Lymphomas 1881 and 1000 Non-Hodgkin's Lymphomas Lymphomas every year.

 

We then discussed the need to establish a joint work between the different countries of the region. While different realities in each country were recognized, the similarities in terms of different problems of the region where understood.

to be translated...

Se planteó la posibilidad de una asociación a través de la figura de un Consorcio  que permitiría mantener la autonomía institucional o de los Grupos Cooperativos que lo integren, sin la necesidad de crear un marco legal constitucional.

El propósito de este Consorcio Latinoamericano de Enfermedades Hematooncológicas Pediátricas es facilitar los esfuerzos cooperativos para mejorar los niveles de curación de los niños con cáncer.

Algunos objetivos planteados:

• Creación de  registro epidemiológico de patologías
• Mejorar la calidad de los cuidados y medidas de soporte en el tratamiento del cáncer infantil
• Contribuir a fortalecer la disponibilidad y calidad de medios diagnósticos y terapéuticos adecuados
• Fortalecer una política de prevención y detección del cáncer
• Favorecer la investigación en cáncer
• Elaborar estrategias de tratamiento en las diferentes patologías

Se consideró de vital importancia el poder desarrollar estudios clínicos coordinados multiinstitucionales con la participación de diferentes países para lograr un rápido reclutamiento de pacientes , con la expectativa de avanzar en el conocimiento y tratamiento de las enfermedades onco-hematológicas en la infancia.
La creación de este Consorcio constituido por (AHOPCA, GATLA, Instituciones de Brasil, Perú, México) permitirá un trabajo en conjunto en Latinoamérica para el logro de estos objetivos.

Se acordó efectuar reuniones quincenales utilizando la plataforma de Cure4Kids para continuar la organización de este Consorcio.

Además se planteó la necesidad de una reunión anual, que de acuerdo a las posibilidades podría ser propia del Consorcio o bien adjuntarse a otra reunión científica a la que los socios del Consorcio concurrirían, por ejemplo ASH o AHOPCA: Esta última parece la más adecuada ya que nos permitiría un contacto interpersonal  con los miembros del Grupo sino además con inteconsultores internacionales que concurren habitualmente a ese evento. El Dr Castellanos realizará las consultas con AHOPCA para determinar si sería posible asistir a su reunión, ya que se trata de un evento cerrado al grupo al que se accede con invitación del mismo.

Se planteó además la necesidad de contar con mentores internacionales para conseguir apoyo para trabajos conjuntos, acordando que el Hospital St Jude a través de Monika Metzer  y el grupo italiano podría ser adecuados. Se contactará con ellos.
Además se discutió sobre la posibilidad de comenzar a dar visibilidad al Consorcio por medio de una publicación, que podría ser una reseña histórica de tratamientos y situación de la hemato-oncología infantil en los países intervinientes. El Dr Gonzalez Ramella diseñará las normativas para comenzar.