Pediatric Hematology & Oncology

These are exciting times in the Yale Pediatric Hematology and Oncology Program. Under the leadership of Dr. Gary Kupfer, our Program is in an expansion mode in order to provide the children of the region and, indeed, the country and world with state-of-the-art care and access to cutting edge advances in research. Care of our patients and advances in treatment of pediatric cancer and blood diseases require a team approach of medical professionals as well as critical mass of basic and clinical researchers that can only be found at a place like Yale.

Dr. Kupfer has engineered the consolidation of pediatric oncology care under the Yale umbrella for all of Southern Connecticut. This has resulted in the transformation of the Yale Pediatric Hematology and Oncology Program from a small program into an internationally recognized research program poised to meet the clinical needs of all our patients as well as to advance the cause of pediatric cancer cures and prevention.

Clinical trials network: collaborating for better science

As part of the Children’s Oncology Group (COG), members of the Pediatric Hematology and Oncology Program work cooperatively with other academic health centers to conduct large-scale investigations. Because childhood cancer is relatively rare, medical centers must work together to compile enough data to yield reliable science. Yale’s participation also assures that our patients have access to the newest and best treatments available. Efforts such as these over the last 60 years have yielded dramatic increases in cure rates of pediatric cancers, such as lymphocytic leukemia in which 80% of children are cured.

On the other hand, we still have a long way to go in many different tumors. Smilow Cancer Hospital treats 80-100 newly diagnosed pediatric cancer patients annually, and our goal is to place as many of these patients onto research protocols as is possible.

As we expand our clinical research activities, more and more of our focus will include efforts that are “homegrown” ideas. That is, members of the Program who have nurtured their own research interests are nearing the initial stage of adapting their findings to the direct benefit of patients. For example, Dr. Farzana Pashankar has pioneered the diagnosis and treatment of pulmonary complications of sickle cell disease and has begun the first national clinical trial for therapy. Another example of our Yale generated-trials includes Dr. Nina Kadan-Lottick’s work on childhood cancer survivorship and neurocognitive outcomes after therapy. Our new neurocognitive testing program not only provides a needed service to our patients but also collects data on our patients in order to more fully understand the long term effects of what we do in order to cure our patients.

Brain tumors: the great frontier of pediatric oncology

While great successes in pediatric oncology have been achieved, one area that has lagged is in the treatment of brain tumors, which are among the most common type of childhood malignancy. With this great challenge in mind we have formed a comprehensive clinic in pediatric neuro-oncology, led by Dr. Paul Jubinsky. The neuro-oncology clinic at Smilow Cancer Hospital is the only one of its kind in the state of Connecticut and involves a collaboration of pediatric oncologists, neurologists, endocrinologists, neurosurgeons, psychologists, and social workers to care for this very complex and medically needy group of patients. In addition we are actively participating in national clinical trials for brain tumor patients as well as developing trials for more experimental therapies through brain tumor consortiums.

Bleeding and Clotting: a balancing act

The Yale Hemophilia Center (YHC) is located within the Section of Hematology and Oncology in the Department of Pediatrics. The YHC became a federally funded comprehensive treatment center in 1986. Over the past 23 years, the YHC has provided excellence in hemophilia care through a multidisciplinary approach and is well established as a comprehensive treatment center for patients with bleeding disorders. An active thrombophilia clinical program has also been developed within the YHC in recent years. Although the administration of the YHC is based in the Department of Pediatrics, patients include both children and adults. Additionally, YHC is a major referral center in Southwestern Connecticut for hemostasis patient evaluations. We follow a total of 71 patients with serious inherited coagulation disorders, 189 individuals with von Willebrand disease, and 36 with qualitative platelet disorders. More than 100 new patients are seen in consultation annually for the diagnosis and management of disorders of hemostasis. The YHC is one of eight comprehensive hemophilia treatment centers in New England. We participate in the CDC’s national hemophilia clinical research study, the Universal Data Collection Study that tracks longitudinal complications and quality of life in individuals with hemophilia and other bleeding disorders.

Community Outreach: partnering with the general pediatrician

Dr. Joe McNamara is a leader in establishing efficient and highly regarded clinic models that are highly rated by our patients and staff.

A former solo practitioner in Guilford, CT, Dr. McNamara now supervises the Guilford clinic that is a part of our Yale Pediatric Hematology and Oncology clinic. Our outlying clinic allows a convenient option for patient to the East to follow up and receive therapy without necessitating a visit into downtown New Haven.