common presentations of childhood cancer

21
Doernbecher Pediatric Hematology/Oncology Fellowship Program 2008

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Page 1: Common Presentations of Childhood Cancer

DoernbecherPediatric Hematology/Oncology

Fellowship Program

2008

Page 2: Common Presentations of Childhood Cancer

History

• Current 3-yr program ACGME-approved in 1997– Established by Len Johnson and Gary Jones

• First fellow entered program in July 2000

• Kiwanis Clubs of OR and SW WA support 2 positions yearly, + growing an endowment– Grass roots fund raising

• Other funding: GME, DCH, NRSA, St Baldricks

• 2 first year and 6 total fellows now each year

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Applicants

• NRMP since 2001• ERAS starting 2009

• For 2 entry positions July 2009: – 42 applicants– 14 interviewed

• 4-yr Adolescent & Young Adult fellowship – for entry 7-09– combined medical oncology + PHO

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Residency Training Programsof our PHO Fellows

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PHO Fellowship Programs – National Data

For starting date 7-08:

150 applicants 129 positions

54 programs (1 – 6 positions/yr)

from 119 applicants for 7/05

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15 PHO Faculty

H.S. Nicholson L Stork L Wolff D Tilford G Thomas

T Lamkin S MalempatiB ChangP KurreE Nemecek

R TrueworthyM RechtK Nazemi R ButlerS Lindemulder

Page 7: Common Presentations of Childhood Cancer

PHO Clinical and Research Programs

• Leukemia & Lymphoma– Linda Stork; Bill Chang

• Neuro-Oncology– Kelly Nazemi; Kathy Perko, RN, PNP; Stacy Nicholson

• Solid Tumors– Suman Malempati; Thomas Lamkin

• Stem Cell Transplant– Eneida Nemecek; Peter Kurre – Tara Berhardt, RN, PNP; Amy Kenagy, RN, PNP

• Hemophilia & Non-Malignant Blood Disorders– Michael Recht; Greg Thomas

• Palliative Care– Greg Thomas; Kathy Perko, RN, PNP

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PHO Programs (con’t)

• Investigational Therapeutics– Suman Malempati; Linda Stork

• Survivorship– Susan Lindemulder; Larry Wolff; Kelly Anderson,

RN, FNP

• Adolescent & Young Adult– Susan Lindemulder; Kelly Anderson, RN, FNP

• Neuropsychology– Robert Butler, PhD

• Bone Marrow Failure– Peter Kurre

• Lab-based Research– Peter Kurre; Bill Chang

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Page 10: Common Presentations of Childhood Cancer

Some of our 2007 Team

Jan Naas: Fellowship coordinator

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Purpose - To Train Fellows to:

– Deliver exceptional patient care• Treat children • Support families

– Engage in scholarship and research• Treat, cure, and prevent

– Cancers and blood disorders• Improve the quality of a child’s long life

– Teach • Students, residents, fellows, RNs• Colleagues• Patients and families

Page 12: Common Presentations of Childhood Cancer

Training Program

• First year– Clinical rotations, continuity clinics– Week day night and weekend call– One month: Research Development

• Choose lab mentor before 2nd year

• Second and Third Years– 80% research: translational lab-based or

clinical, or MPH– Human Investigation Program x 2 years– Continuity clinic ½ day each week– Week day night and weekend call

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Learn From Patients

Dr. Suman Malempati

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Learn From Clinical Mentors and Other Fellows

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Learn in the Lab

Dr. Veronica Flood

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Learn From Other Subspecialists

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Fellows’ Research Projects and Mentors

• Grover Bagby, MD – Fanconi genes and cancer

• Sri Nagalla, MD, PhD – Gaba receptors in neuroblastoma

• Rosalie Sears, PhD – C-Myc stabilization• Dave Farrell, PhD – Dysfibrinogenemia• Mather Thayer,PhD – Chromosone instability• Rosalie Sears, PhD – C-Myc in brain tumors• Scott Howard, MD (St Jude’s) – Hodgkin’s

lymphoma RX in developing countries• Michael Deininger, MD, PhD – Tyrosine

kinase inhibitors in CML

Page 18: Common Presentations of Childhood Cancer

Fellows’ Research Projects and Mentors

• Sri Nagalla, MD, PhD – genomics and proteomics of neuroblastoma

• Dan Marks, MD, PhD – Glucose Tolerance in ALL survivors

• James Huang, MD – In Vitro Drug Sensitivity of ALL blasts

• Eneida Nemecek, MD – BMT toxicities in AYAs

• Michael Deininger, MD, PhD – Leukemia inhibitors

• Grover Bagby, MD – Fanconi proteins and informatics

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Where have they gone after training?

Page 20: Common Presentations of Childhood Cancer

100% PHO Boards passing rate

10 graduates as of July 2008

Page 21: Common Presentations of Childhood Cancer

What motivates our fellows to work so hard?

Kids like these