Fact Sheet: Phoenix Children's Hospital Pediatric Blood and Marrow Transplant Program Provided in Cooperation with Mayo Clinic

Wednesday, September 10, 2003

Each year, 35-40 children are sent out of Phoenix for a blood and marrow transplant (BMT), a procedure that requires about two to three months of intensive inpatient and outpatient medical services.

With BMT services previously unavailable in the Valley, families already struggling with the burden of having a child with cancer had to face the additional stress and inconvenience of having a child hospitalized in a distant facility for several months. Now, the Phoenix Children's Hospital Pediatric Blood and Marrow Transplant Program provided in cooperation with Mayo Clinic will allow families to remain close to home through the duration of the BMT episode of care. Patients and families will interact continually with the cancer doctors and nurses whom they already know, and be in familiar medical surroundings.

History of the Program

In 2000, leaders of Phoenix Children's Hospital contacted Mayo Clinic in Scottsdale concerning to the feasibility of jointly developing and operating a pediatric blood and marrow transplant (BMT) program. The underpinnings of this initiative were the two organizations' shared values which focused foremost on the needs of the patients, a commitment to research and education, physician leadership, and fiscal responsibility.

Over the past three years, countless hours of planning and deliberations have occurred for the purpose of insuring the new pediatric BMT program would open in very controlled and high-quality manner. Leaders from both organizations paid attention to every detail – from training nurses to care for the special needs of BMT patient to insuring the staff in the hospital cafeteria knew what food should and should not be brought to a BMT patient's room.

In this cooperative effort, each organization brought unique resources and strengths.

Phoenix Children's Hospital:

• The Children's Cancer Center at Phoenix Children's Hospital (PCH) cares for the majority of pediatric cancer patients in Arizona, and is known statewide as the leader in pediatric cancer treatment.
• PCH's Children's Cancer Center is the only Valley affiliate of the Children's Oncology Group, meaning they able to be among the nation's first users of new cancer treatment medications and procedures for children. Only centers that meet rigorous criteria are allowed access to these new treatments during their initial phase of use. These are sometimes experimental treatments only used when no other traditional measures have succeeded.)
• PCH's new in-patient hospital and outpatient clinics are designed and equipped exclusively for the care of children. Given the often long-duration of cancer treatment, including the BMT episode of care, PCH's extensive family support programs, including individual counseling, family support groups, school re-entry programs, camps, and scholarships, are vital underpinnings to the complete care of these patients.

Mayo Clinic:

• Mayo Clinic in Scottsdale has physician and administrative leaders who are experienced in directing and operating BMT programs, including the highly-specialized billing and managed care contracting aspects of BMT services.
• Mayo Clinic in Rochester, Minnesota, the headquarters for the Mayo Clinic, has operated a very successful pediatric BMT program for almost 2 decades, offering invaluable experience and input to the new BMT Program In addition, the Program in Rochester will serve as important source of cutting-edge BMT clinical trials for Phoenix area patients.
• Through its voice and video networks, Mayo Clinic will allow the PCH BMT Program staff to interact regularly with the other Mayo Clinic pediatric BMT Programs in Rochester, and in Jacksonville, Florida.

Ensuring Quality Care in a New Program

Mayo Clinic in Scottsdale and Phoenix Children's Hospital recruited a nationally-recognized pediatric hematology/oncology expert, Roberta Adams, MD, to serve as the program's medical director. Dr. Adams holds a subspecialty certification in Pediatric Hematology/Oncology from the American Board of Pediatrics. She is a member of the American Academy of Pediatrics, American Society of Blood and Marrow Transplantation, and the Pediatric Bone Marrow Transplant Consortium.

Prior to joining Mayo Clinic and Phoenix Children's Hospital, Dr. Adams practiced at Primary Children's Hospital and University Hospital in Salt Lake City, Utah. During her fifteen years there, she rose to the rank of Assistant Professor and served as the Director of the Pediatric BMT Program. Prior to time in Salt Lake City, Dr. Adams served as a physician in the Indian Health Service, spending 3 years in Kayenta on the Navajo reservation. Her medical degree is from Columbia University College of Physicians in New York, and she completed her pediatric residency at Boston Children's Hospital.

The pediatric BMT healthcare team includes 2 physicians, a BMT Nurse Coordinator, and 30 nursing and other health care professionals, all specially trained in the care of immuno-compromised patients. In addition to physicians and nurses, the team includes social workers, pharmacists, surgeons, pathologists, nutritionists, physical therapists, child-life specialists — even the hospital school teacher. This team provides an integrated approach that treats the entire child, not just the disease.

In constructing its new pediatric-dedicated facilities, Phoenix Children's Hospital included state-of-the-art rooms dedicated to the care of BMT patients who are immuno-compromised. The BMT inpatient unit is located within the hospital's hematology/oncology care area and currently has four beds in positive pressure hepa-filtered rooms, with room to expand over the next several years as needed.

Attention has been given to the highly-specialized needs of BMT patients, as evidenced by the 45 new patient care policies and procedures that were established as part of the program development.

About Blood and Marrow Transplants

Performing a blood and marrow transplant involves introducing special cells, called stem cells, into the patient's blood. The patient, a family member or an unrelated volunteer may be the donor of the stem cells. The stem cells are collected in a variety of ways.

Many people are familiar with the concept of having marrow extracted from the bone of a volunteer donor. However, two newer methods are becoming more common due to their less invasive nature. One method uses a device that is similar to a dialysis machine to collect stem cells from the bloodstream, and the second is a technique that gathers stem cells from a newborn child's discarded umbilical cord. While the majority of the stem cell harvesting for the pediatric BMT Program will take place at Phoenix Children's Hospital, harvesting from adult donors for pediatric patients can be arranged to occur at Mayo Clinic's hospital in north Phoenix.

Clinical indications, or diseases, for which BMT services should be considered include:

• Leukemia
• Lymphoma
• Neuroblastoma
• Brain Tumors
• Aplastic Anemia
• Inherited immune Deficiencies
• Certain Metabolic Disorders
• Hemoglobinopathies

The program expects to provide BMT services to four or five patients by the end of 2003.Over the next 2 to 3 years, it is anticipated that the annual number of BMT patients will grow to average between 40 to 50 children.

For more information, contact the BMT Nurse Coordinator at (602) 546-0920.

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