Department of Pediatrics

Hematology/Oncology

New Faces coming to the WVU Pediatric Hematology/Oncology Section

Lisa Palmer, D.O. University of North Texas University of Michigan Children's Hospital Fellowship Trained	Angela Stefan, M.D.

Laura Gibson, PhD
Associate Professor
West Virginia University

Carla Corbin, RN
Anita Graham, MSW

Ruth Walsh, POG Data Manager

Patricia Royce, Administrative Secretary

This section sees patients in the Physician Office Center, the Mary Babb Randolph Cancer Center, and within West Virginia University Children’s Hospital.

Appointments are made after referral from the patient’s primary care physician. For more information please contact Patti Royce at (304) 293-1217 Fax (304) 293-1216. Referring physicians may speak to a pediatric hematologist/oncologist by calling the above number or through the Medical Access Referral Service (MARS) at 1-800-WVA-MARS (1-800-982-6277)

The aim of the section is to provide comprehensive, state of the art care for children and young adults from birth through college with cancer or diseases of the blood. We have an emphasis on family centered care including financial, educational and psychological support and counseling for families dealing with a child facing a life threatening disease. Clinical and basic research are also an important focus of the section.

History of Section: The Division of Pediatric Hematology/Oncology at WVU has a long-standing record of service and research in the care of children in West Virginia and surrounding areas with cancer and blood disorders. WVU, under the leadership of Dr. Barbara Jones, was an early member of the Pediatric Oncology Group as it was formed in 1979 out of the pediatric divisions of CALGB and SWOG. Dr. Jones was already well respected nationally, and contributed significantly to the care of children with leukemia and Wilms’ tumor through her clinical research activities within the cooperative groups. As a consequence WVU was one of the pioneering institutions in the country to offer state of the art therapy for these now highly curable diseases.

Dr. A. Kim Ritchey was recruited to further develop the program in 1987, and remained at WVU as division chief, and vice-chairman of the department, until his departure in 1998. Under his leadership the program continued to provide excellent clinical care to children. His work within the POG centered on the treatment of isolated central nervous system relapse of acute lymphoblastic leukemia, and the current standard of care for this potentially devastating complication is based on his pioneering work. During Dr. Ritchey’s tenure Dr. Laura Gibson, Ph.D. joined the division. Her laboratory work in hematopoiesis, funded by the NIH, has greatly strengthened the basic science research of the division and department.

Numerous persons have contributed to the success of the pediatric hematology/oncology program, including many colleagues in pediatric and surgical subspecialties, pathologists, and radiation therapists as well as family members, dedicated nurses, child life therapists, data managers, secretaries, child psychologists, students and volunteers. They have allowed the delivery of care of the highest quality to children with life threatening illness in our state and region for many years.

Overview of our activities: Clinical: WVU serves a wide geographic area that is predominantly rural in character. The majority of patients are referred from West Virginia, however western Maryland, southern Pennsylvania, and eastern Ohio (especially around the Wheeling, WV area) also serve as referral sites. Within West Virginia referrals are predominantly from the northern and eastern portions of the state, although some patients are referred from Princeton/Bluefield and Beckley areas. Similarly sized pediatric oncology programs exist in Huntington and Charleston.

The diagnosis and management of children and adolescents with malignant disease consumes the majority of clinical time and effort. These children and families require a team approach to navigate the complex medical, educational, financial and social issues that arise in the setting of childhood cancer. WVU is well situated to offer a comprehensive team approach to families with the current members of the team listed above. Community support is required to maintain the team, and such support is provided at present by the Cards of Hope, a community effort which helps provide the social services component of the team, as well as some of the educational materials, communications and networking/travel expenses of the team.

Participation in clinical research trials through national cooperative groups is essential for a pediatric oncology program, as these trials represent the state of the art for pediatric malignant disease. WVU is currently a member of the Children’ s Oncology Group, which was recently created by the merger of the Pediatric Oncology Group and the Children’s Cancer Group. COG is now the only national cooperative group for pediatric malignant diseases, and participation in this group promotes the standardization of care throughout North America. Therefore WVU is able to offer state of the art therapy for almost all newly diagnosed malignant diseases which occur in children and adolescents. In addition WVU has access, through the cooperative group, to highly investigational therapies for children with very high risk or refractory malignancies for which established treatments are not likely to be effective.

The delivery of excellent care to children with cancer also requires expertise in a number of specialties other than pediatric oncology. WVU has substantial strength in several such areas, including Dr. Peter Ehrlich (pediatric surgery), Dr. Eric Jones (pediatric orthopedics) and Dr. John Collins (pediatric neurosurgery). Dr. William Tarry of pediatric urology, Dr. Robert Gustafson of pediatric cardiothoracic surgery and Dr. Richard Vaughn of general surgery have also contributed greatly to the delivery of care to children with cancer. Dr. Drew Bradlyn has been very active at the local and national level as a psychologist with expertise in the care of children with malignant disease.

Hematological disorders are more frequently referred to our program than are malignant diseases. A very wide variety of hematological disorders are seen here, often for only a few visits. One exception is the hemophilia population, which represents a significant chronic process with substantial short and long-term morbidity. The Comprehensive Hemophilia Center is based in the Cancer Center, and provides medical care, physical therapy and psychosocial support for adult and pediatric patients and families. The Center is supported by grants from the MCHB and the CDC.

Research: Clinical research: The advancement of effective therapy against childhood cancer has been one of the remarkable successes of clinical research. Due to the relative rarity of childhood cancer, such clinical research occurs in the setting of large cooperative groups, with many institutions in North America, and more recently globally, enrolling patients in order to achieve statistically meaningful data. Individual institutions contribute by enrolling patients in investigational studies, and by collecting data in a careful manner. Individual investigators have the opportunity to contribute by developing new investigational studies, and by serving on study and disease committees within the cooperative groups. As noted above WVU has a long track record of participating in the national cooperative groups, including CALGB, POG, and now COG, and as a result WVU has made a significant contribution to the remarkable success in the understanding and treatment of childhood cancer. Currently Dr. Keller is active on the Hodgkins disease committee of COG, and is in the process of developing the protocol that will be the next trial for children and adolescents with low-risk Hodgkins disease in COG. Dr. Bradlyn is the Co-Chair of the Cancer Control Committee and Chair of the Outcomes Research Committee in COG, and Dr. Ehrlich serves as the surgical representative on the intermediate risk Hodgkins disease study in the cooperative group.

Basic and translational research: Basic and translational Pediatric Oncology research at WVU represents a collaborative effort between faculty members of the Mary Babb Randolph Cancer Center and the Department of Pediatrics. Currently, the group is comprised of laboratories that focus on various elements of childhood cancer including genetic components that underlie initiation of disease, factors that regulate response of children to chemotherapy, and deficits in hematopoietic reconstitution that result from cancer treatment. As a predominant form of cancer in children less than 10 years of age, the study of childhood leukemia has been established as an area of focus. Current efforts are underway to expand this focus to include the study of lymphoma as an additional cancer of significance in individuals under 21 years of age.