|Name of Conference||Date From – Date To||City||Contact Details
|Mid-term CME||1-2 (Sat, Sun) July 2017||Venue: India Habitat Center, New Delhi||Organizing secretary: Dr Gaurav Kharya email@example.com|
|PHOCON 2017||25-26 (Sat, Sun) November 2017. Pre-conference workshop: 24 Nov.||Venue: Novotel Kolkata Hotel and Residences, Kolkata.||Organizing secretary: Dr Arpita Bhattacharyya
Kindly block dates. Further details of scientific program, etc.shall be informed, in due course.
|PHOCON 2016 Annual Conference||04-Nov-16 – 06-NOv-16||Mumbai||Name: Email: Website: Contact:
|International Symposium on Pediatric Neuro-Oncology||28-Jun-14 – 02-Jul-14||Singapore||Name:Dr Stewart Kellie Email:firstname.lastname@example.org Website:http://www.ispno2014.com/ Contact:6564116687
|St Jude-Viva Forum||28-Jun-14 – 29-Jun-14||Singapore||Name:Ms Elaiyarani Email:email@example.com Website:http://www.viva.sg/stjude/ Contact:6567726572
|Advanced Neuroblastoma Research (ANR)||May 9th – 12th, 2018||San Francisco, USA||Name: Email:firstname.lastname@example.org Website:anr2018.org Contact:
|EBMT||26 – 29 March 2017||Marseille, France||Name: Email:EBMT@cme-congress.com
Website:ebmt2017.org Contact: 972 3 555 0188
- One of the main objectives of the PHO Chapter is to improve care of children in India having cancer or blood disorders through awareness, education and advocacy. In this regard, the Chapter has been active in training pediatricians, pediatric surgeons and postgraduate students in basic concepts in the management of pediatric oncology and hematology. Two successful and ongoing projects National Training Project in Practical Pediatric Oncology (NTP-PPO) and National Training Project in Practical Pediatric Hematology (NTP-PPH) have not only helped in improving the awareness regarding treatment and outcome of pediatric cancers and blood disorders, but have also become role models for similar projects in other countries.
- The InPOG is a National Group for conducting cooperative clinical studies in pediatric oncology. The formation of a national co-operative group will help being together institutions with pediatric cancer units. It will help collect and record data, thereby enabling to know better the incidence and epidemiology of childhood cancers in India. It will help to run clinical trials and research protocols across the country. It will help improve overall care and outcomes by sharing expertise and experiences.
Mid Term – CME
InPOG: The first meeting of the proposed national cooperative group to conduct clinical trials and research in pediatric oncology in our country was held on 17th September 2008 at Sir Gangaram Hospital, New Delhi. It was sponsored partly by ICMR and partly by the Pediatric Hematology Oncology Department of Sir Gangaram Hospital through the good offices of Dr Anupam Sachdev, the President of the PHO Chapter. It was attended by 23 members of the PHO chapter. In the deliberations that followed, it was decided to name the group InPOG Indian Pediatric Oncology Group. The objectives and the mission statement of InPOG were defined. The rules for individual and institutional membership of InPOG were laid down. The Executive group was defined and its role was spelt out. Potential sources of funding were discussed. An interim team was proposed to carry on the activities of InPOG till the first executive group could be elected. Dr Anupam Sachdev, Dr Bharat Agarwal, Dr Anupama Borker and Dr Satyaprakash Yadav would constitute this team.
Indian Pediatric Oncology Group (InPOG) Background: The cure rates for most childhood cancers have improved from less than 10-20% in the early sixties to over 60% -80% by 2000.This improvement in the last 4-5 decades can be attributed to several factors. Better understanding of the nature of the disease and the tremendous improvement in supportive care including the availability of more potent antibiotics, advances in blood component therapy, use of central venous access devices have all contributed to this success. Equally important has been the establishment of national and international co-operative groups. These groups treat large number of patients on research protocols. New protocols are designed with the aim of improvising on the results of previous protocols. This has enabled us to study systematically and scientifically various factors-related to patients, their disease and their treatment that influence outcome. Thus every few years a new protocol can be designed to improve on the results of the previous one. The advantages of treating oncology patients on clinical trials and research protocols have been very well established. Treating patients on clinical trials needs discipline and dedication. The detailed documentation needed results in precise information, which in turn can be used for further improvisation.
Current status in India: The first attempt at starting a multi-centric trial to treat childhood acute lymphoblastic leukemia (ALL) in India started way back in 1984. Pediatric oncologists from three leading institutes across India viz. All India Institute of Medical Sciences (AIIMS), New Delhi, Tata memorial Hospital (TMH), Mumbai and Cancer Institute, Chennai got together and in collaboration with the National Cancer Institute (NCI) ,USA, planned a multi-centric protocol for childhood ALL. Dr. Ian Magrath from the NCI, helped design the protocol considering the available facilities and resources at that time. The MCP841 protocol was implemented from 1986 onwards. MCP 841 was a relatively intense chemotherapy protocol for children and young adults up to 25 years of age with newly diagnosed ALL. Over the years accrual increased and results started improving. When the results of this protocol were last analyzed in 2004, the 5 years EFS for all 3 centers for the period 1990 1997 ranged from 41-60%. Considering that before the initiation of this protocol, the survival rates in childhood ALL in India were < 30%, there has been vast improvement. Oncology residents from different parts of the country, who trained in any of these 3 major tertiary centers, got familiar and comfortable using this protocol for children with ALL. They started using this protocol for treating childhood ALL in their individual centers. Apart from the improvement in the survival rates, this effort of starting a multi-centric research protocol had several other advantages. Firstly it got the entire treating team attuned to treating patients on clinical trials. It ensured detailed documentation of clinic visits, laboratory reports and hospitalization records. Secondly treating a large volume of patients on a uniform protocol taught to anticipate complications and thereby prevent them or treat them early. Thirdly it trained everybody involved in data collection and data recording. Thus it brought a lot of discipline in the system ensuring better adherence to the protocol. Most practicing Pediatric Hematologists Oncologists in India have obtained fellowship training from foreign universities or have trained in tertiary institutes within the country itself. Childhood cancers are not always treated by them, but by adult physicians, adult medical oncologists and sometimes in smaller centers by radiation / surgical oncologists who have experience with chemotherapy for adult solid tumors. Thus secondary and tertiary centers all across the country treat children with malignancies. They use different protocols for different diseases depending on familiarity and comfort and their own previous experience with the protocol. Unfortunately there are very few published results and no national data regarding the characteristics and treatment outcomes of childhood malignancies in India.
Need of the hour: For the past few years there is a felt need among the Pediatric Hematology Oncology community in India to get together to form a national co-operative group. India stands to be the world’s second most populous nation with a population of over one billion, of which 31% is constituted by children less than 14 years of age. The resultant burden of childhood cancer is phenomenal, posing a huge challenge. But with this challenge comes a great opportunity the opportunity to conduct large clinical trials in an effort to improve survival. There is paucity of data regarding the nature of childhood malignancies in our country. Hence there is a felt need to conduct our own trials. There is a need to study the nature and biology of different malignancies as to how they differ from those in the West. Our patients differ racially and genetically from patients in the West and hence differ in their tolerance and metabolism of drugs. Implementing Western protocols does not always give similar results. There is a need to develop indigenous protocols. The formation of a national co-operative group will help being together institutions with pediatric cancer units. It will help collect and record data, thereby enabling to know better the incidence and epidemiology of childhood cancers in India. It will help to run clinical trials and research protocols across the country. Institution in turn will have the backing of a national co-operative group in treating children with malignancies. It will help improve overall care and outcomes by sharing expertise and experiences.
Proposed project: The first step is to set up a national co-operative group. The aims of this group will be to:
- Identify eligible institutes who have pediatric oncology units with basic diagnostic facilities and supportive care services and trained personnel including doctors and nurses.
- Design clinical trials.
- Establish guidelines for conducting clinical trials and running research protocols.
- Set up data management systems in participating institutes. This will include technological assistance with computer software for data recording and storage and for training of personnel in data management.
- Conduct interim review meetings to review ongoing and proposed projects and assess their status to indentify shortcomings.
The structure of the cooperative group could be broad based with institutional as well as individual memberships or maybe restricted only to institutional membership.
Institutional membership: Institutes who have pediatric oncology units and fulfill certain eligibility criteria will be able to participate. These eligibility criteria should include availability of basic diagnostic facilities, supportive care services and trained personnel including physicians, nurses and data managers.
Governing Body: The governance of the national cooperative group to be through an elected board or an executive committee, with tenure of 1-3 years. Working Groups/Committees: Several working groups or committees to be appointed for various tasks. eg. Disease wise scientific committees, Ethics committee, Data management / monitoring committee, etc. Secretariat: The national cooperative group secretariat to be set up for day to day functioning. With a secretary and a data manager, it will ensure prompt and speedy communication between members, committees and the board. Funding: A corpus fund to be set up, the interest from which will be utilized for the daily functioning of the group. Grants to be applied for individual clinical trials and research protocols.
NDIAN NATIONAL TRAINING PROJECT IN PRACTICAL PEDIATRIC ONCOLOGY
Pediatric Oncology is rapidly developing super speciality in our country. At present its practice is limited to major cancer centres and bigger cities only . Pediatric patients form about 5% of cancer cases seen at any regional cancer centre. Due to recent advances and better understanding of pediatric cancer problems many childhood cancers are considered curable. In the developing countries like India, with limited infrastructural facilities and far from adequate number of pediatric oncologists, it is most important to spread correct information and educate general pediatricians in the field of pediatric oncology. Early referral for prompt diagnosis and for ensuring efficient follow up, the community pediatricians role is crucial. With this purpose PHO chapter initiated the development of a training module in Practical Pediatric Oncology in conjunction with the International Society of Pediatric Oncology (SIOP). We are more than twenty years deep into this national training project since August-96. The first year was spent in evolving the consensus amongst pediatric oncologists and obtaining endorsement from national societies and the SIOP. In the 2nd year, a Teachers conclave was organized, training module was finalized (Annexure-II) and a reference manual and common set of slides were produced. Nineteen workshops were held between 1998-2001(Annexure-III) for training pediatricians, pediatric surgeons and postgraduates. There has been a uniformly positive response from the participants at these workshops, the cancer centres where these workshops were held and also from the faculty members involved in this training project.
In February 2002, a second national teachers review meeting was held in Mumbai where a consensus was reached to modify the training module (Annexure IV), revise the reference manual and common set of slides. Mechanism to evaluate this project was also discussed at this meeting. The major part of the year 2002/2003 was spent in publishing the second edition of the reference manual, new teaching slide sets for the modified training module and creation of a new problem oriented case series.
Workshops were restarted in the new revised format from August 2003. Ten workshops have been held so far (Annexure V). Half a day CME module has been piloted on 2 occasions (Annexure-VI) and has been very popular & well received. Many inquires have come for conduct of the CME programmes. Busy practicing pediatricians are not able to spare full two days from their busy practice. It will be very productive and useful to pursue this module through all branches of Indian Academy Of Pedaitric (IAP) as it does not need intensive infrastructure mandatory for skill stations in two day module.
The success of Indian National Training Project in Practical Paediatric Oncology backed by International Society of Pediatric Oncology (SIOP) generated an enthusiasm & eagerness to expand this project to SAARC member countries, which share the problems of delay in diagnosis, only 15-20% children with cancer having an access to network of pediatric oncologist and treatment dropouts. As a pilot project, the training programme in Practical Pediatric Oncology was conducted at Kanti Children Hospital Kathmandu, Nepal in June, 2004 in collaboration with Nepal Pediatric Society, using human and financial resources of Indian National Training Project. The training programme was well received and appreciated.
The workshop on Childhood Cancer as part of MY CHILD MATTERS initiative of UICC was conducted at Dhaka, Bangladesh on 18th-19th February 2007. The objective of the workshop was very similar to Indian National training project- to involve pediatricians from medical colleges across Bangladesh and sensitize them for early diagnosis of paediatric cancers and initiate them to participate meaningfully in optimal care of children with cancer. National coordinator of Indian National training project facilitated the workshop & provided local expertise.(Annexure VI)
In light of many advancements made in the field of pediatric oncology in the nearly 20 years since the workshops were initiated, in 2013 it was decided that the NTP PPO training manual needs revision. Hence with the able assistance of many PHO colleagues and NTP PPO faculty the third edition was brought out in September of 2014. It was formally released in Chennai at the inaugural function of our annual conference, PHOCON 2014. Subsequently, the workshop slide sets have also been updated. Hence 2014 and 2016 showed renewed interest in the workshops. A one day oncology module and a combined hem-onc CME module are now gaining popularity. Twelve workshops and two CMEs were conducted during this three year period, and seven of these were one day workshops.
The launch of this national training project apart from achieving its objectives has had a number of spin-off effects. The most relevant of these has been the bringing together of a large number of pediatric cancer specialists situated in various far flungcentres of this vast country. It is for the first time that many heads worked together and important ideas emerged to raise the standards of pediatric oncology care offered to cancer afflicted children in India.
Annexure– I & II
Office Bearers of INTP-PPO since its inception
(1998-2003) National Co-ordinator: Dr. Bharat R. Agarwal
Zonal Co-Ordinators: West Zone :- Dr. (Mrs) Purna A. Kurkure North Zone:- Dr. R.K. Marwaha South Zone:- Dr. John Solomon Central Zone: Dr. Dinesh Pendharkar
(2004-2006) National Co-ordinator: Dr.(Mrs) P.A. Kurkure
Zonal Co-ordinators: West Zone :- Dr. Rashmi Dalvi North Zone:- Dr. Gauri Kapoor South Zone:- Dr. Anita Chandra Central Zone: Dr. Archana Kumar East Zone: Dr. J. N. Sharma
(2006-2007) National Co-ordinator: Dr.(Mrs) P.A. Kurkure Zonal Co-ordinators: West Zone :- Dr. Rashmi Dalvi North Zone:- Dr. Gauri Kapoor South Zone:- Dr. Anita Chandra Central Zone: Dr. Archana Kumar East Zone: Dr. J. N. Sharma
(2008-2012) National Co-ordinator: Dr. Rashmi Dalvi;
Zonal Co-ordinators: North Zone:- Dr. Gauri Kapoor, South Zone:- Dr. Anita Chandra Central Zone: Dr. Archana Kumar East Zone: Dr. J. N. Sharma
(2013-2016) National Co-ordinator: Dr. Gauri Kapoor;
Zonal Co-ordinators West Zone :- Dr. Akanksha Chichra, North Zone:- Dr. Shruti Ahuja, South Zone:- Dr. Aruna R, East Zone: Dr. Arpita Bhattacharyya
|Training Module for workshop (1998-2001)|
|Day 1||Pre-test and introductory lecture|
|8.30 a.m. to 12.30 p.m :||Lectures on :|
|1. Approach to diagnosis of pediatric cancer 2. Principles of pediatric oncology 3. Emergencies and Supportive care 4. Acute leukemias and lymphomas|
|2.00 p.m. to 5.00 p.m. :||Skill / Work stations and interactive sessions on :|
|a. Procedures in pediatric oncology IV Access and long lines b. Pediatric Oncology Ward rounds c. Blood banking|
|8.30 a.m. to 12.30 p.m :||Lectures on :|
|5. Brain tumors and retinoblastoma 6. Wilms tumor and Neuroblastoma 7. Soft tissues and other sarcomas 8. Day to day care, Late effects 9. Summary lecture|
|2.00 to 5.00 p.m. :||Skill / Work stations and interactive sessions on :|
|d. Chemotherapy Injections & Drugs e. Infection control f. Case studies, Miscellaneous: slides, nutrition, BMT etc.|
|5.00 to 5.30 p.m. :||MCQ Exam.|
|INTP-PPO Workshops : 1998 – 2001|
|Chennai||J. Solomon||R. Dalvi||PCU, Aug. 98|
|Chandigarh||R. K. Marwaha||P A. Kurkure||PCU, Oct. 98|
|Mumbai||P A. Kurkure||A.Sachdev||PCU, Dec.98|
|Indore||D. Pendharkar||M. Manglani||MC, Dec.98|
|Jodhpur||S. Sanchetee||R. K. Marwaha||MC. Jan 99|
|Guwahati||C.Bhuyan||P A. Kurkure||CU, April 99|
|Ahmedabad||B. Parikh||A. Sachdev||PCU, April 99|
|Burdwan||N. Choudhary||P A. Kurkure||MC, June 99|
|Calcutta||A. Mukherjee||L..S. Arya||PCU, Oct.99|
|New Delhi||A. Sachdev||P. Kurkure||PCU, Nov 99|
|Vellore||C. Kirubakaran||B. Agarwal||PCU, Jan 2000|
|Cuttack||U. Nayak||L.S. Arya||MC, March 2000|
|Ludhiana||P. Sobti||S. Banavalli||MC, April 2000|
|Mangalore||U.V. Shenoy||P. Kurkure||MC, Aug 2000|
|Pune||S. Kanvinde||LS. Arya||PCU, Nov 2000|
|Trivandrum||P. KusumKumary||R. Dalvi||PCU, Nov 2000|
|Nagpur||V. S. Dani||SVSS Prasad||MC, July 2001|
|Jaipur||H. Malhotra||G. Kapoor||MC, Nov. 2001|
|Lucknow||A. Kumar||R. Dalvi||PCU, Nov 2001|
|* PCU = Pediatric Cancer Unit, MC = Medical College, CU = Cancer Unit|
|Modified Training Module for two day Workshop|
|Day 1||Pre-test and introduction|
|8.30 a.m. to 10.30 a.m :||Lectures on :|
|1. Approach to diagnosis of pediatric cancer|
|2. Principles of pediatric oncology|
|10.30a.m. to 12.30 noon :||Problem oriented discussions on :-|
|1. Lump in abdomen|
|2. Mediastinal mass / SVCS & pleural effusion.|
|3. Neurologic stymptoms Brain|
|4. Extremity mass soft tissues, bones.|
|2.00 p.m. to 5.00 p.m. :||Skill / Work stations and interactive sessions on :|
|a. Procedures in pediatric oncology|
|IV Access and long lines|
|b. Pediatric Oncology Ward rounds|
|c. Blood banking and blood components.|
|8.30 a.m. to 10.30 p.m:||Lectures on :|
|3. Emergencies and Supportive care|
|4. Acute leukemias and lymphomas|
|10.30 a.m. to 1.30 p.m :||Problem oriented discussions on :|
|1. White eye reflex and proptosis|
|2. Neck lymphnode mass|
|3. Febrile neutropenia|
|4. Spinal cord compression|
|5. Transfusion problem|
|6. Gonadal mass|
|8. Long term effects|
|2.00 to 5.00 p.m. :||SkillWork stations and interactive : sessions on|
|d. Chemotherapy Injections & Drugs|
|e. Infection control|
|f. Case studies, Miscellaneous: slides, nutri-tion, BMT etc.|
|5.00 to 5.30 p.m.||Summary Lecture â€“ Role of pediatrician in managing children with cancer.|
|5.30 to 6.00 p.m.:||MCQ test.|
|CME Module for half-day Workshop|
|8.00 to 9.00 a.m.||: Registration|
|9.00 to 9.45 a.m.||: Approach to pediatric cancer.|
|9.45 to 10.30 a.m.||: Principles in management of pediatric cancer.|
|10.30 to 10.45 a.m.||: Tea break|
|10.45 to 11.30 a.m.||: Emergencies in supportive care.|
|11.30 to 12.00 noon||: Role of pediatrician in managing children with cancer.|
|12.00 noon to 1.00 p.m||: Lunch break|
INTP-PPO Workshops : 2003 -2016
|Hyderabad||D.Ragunath Rao||P.Kurkure||PCU Aug.03|
|Vadodara||Vibha Naik||A.Sachdeva||MC Nov.03|
|Jaipur||R.Bansal||B. Agarwal||CU Jan.04|
|Manglore||ATK.Rau||R. Marvaha||MC Nov.04|
|Bilaspur||P. Sihare||A.Sachdeva||MC April 05|
|Lucknow||A. Kumar||R. Dalvi||MC Nov-05|
|Cochin||K. Pavithran||G. Kapoor||CU Aug.06|
|Delhi||Gauri Kapoor||Archana Kumar||PCU May 08|
|Rohtak||Pankaj Abrol||Rashmi Dalvi||MC Nov 08|
|Ludhiana||Praveen Sobti||Rashmi Dalvi||MC April 10|
|Jammu||Rashmi||Rashmi Dalvi||MC July 11|
|Manipal||Anupama Borker||Gauri Kapoor||PCU Aug 12|
|Kolkata||Madhusmita Sengupta||Gauri Kapoor||MC Aug 13|
|Kolkata||Madhusmita Sengupta||Gauri Kapoor||MC Dec 14|
|Delhi||Tulika Seth||Rachna Seth||MC Dec 2014|
|Ahmedabad||Urmila Uparker||Gauri Kapoor||CU Aug 15|
|Mumbai||Anupama Borker||Girish Chinnaswamy||CU Aug 15|
|Ludhiana||Praveen Sobti||Gauri Kapoor||MC Sept 15|
|Chennai||Aruna R||Julius Scott||PCU Sept 15|
|Guwhati||Munlima Hazarika/ Jima||Arpita Bhattacharyya||CU Jan15|
|Lucknow||Archana Kumar||Gauri Kapoor||MC May 16|
|Varanasi||Vineeta Gupta||Gauri Kapoor||MC March 16|
|Nashik||Pinky||Akanksha Chichra||PCU Aug16|
|Kolkata||Madhusmita Sengupta||Vineeta Gupta||MC Nov 16|
|* PCU = Pediatric Cancer Unit, MC = Medical College, CU = Cancer Unit|
|Patna||J. Singh / B. Agarwal||Nov.06|
|Delhi||Ramandeep Arora||March 2014 combo PPO-PPH|
|Pune||Vibha||April 2014 combo PPO-PPH|
|Kathmandu||Dr. Kailash||Dr. A. Sachdeva||June 2004
|Dhaka||Dr Mannan||Dr P Kurkure||Feb. 2007
National Training Program – Practical Pediatric Hematology
Pediatric hematology is a branch, which is evolving fast with many recent advances in the diagnosis and management of these disorders. There are many preventable disorders like nutritional anemia, thalassemia and sickle cell anemia. With adequate treatment many lives of many children can be saved and their quality of life improved. With above background the concept to train pediatricians in practical pediatric hematology came into existence. In year 2001 a committee of faculty for this project was formed which started working on preparing a manual in practical pediatric hematology and standard set of slides for teaching. Over next 4 years more hard work went into bringing this project to light of the day.
In Jan 2006 under aegis of Pediatric Hematology Oncology (PHO) chapter of Indian academy of Pediatrics (IAP) a program was started with aim of train pediatricians across the country in early diagnosis, management and shared care of blood disorders in children. This Program is called NTP-PPH. Programs main ethos is to conduct workshops in different regions of the country by faculty from tertiary care centres, trained in pediatric hematology. Each 2-day workshop is aimed at training 25-30 pediatricians. Two faculty members and a central observer conduct the workshop with the help of local organizers. Standard set of slides, videos and practical workstations are the methods used to train the pediatricians. Trainees who register for the workshop are provided with a study material in the form of Manual of Practical Pediatric Hematology edited by Dr Anupam Sachdeva published by PHO Chapter of IAP about 4 weeks in advance. Each workshop covers different aspects of Pediatric hematology like ABC of CBC, Nutritional Anemia, Intractable anemia, hemoglobinopathies, aplastic anemia, visual diagnosis of anemia, Approach to bleeding disorders, Dos Donats of ITP, approach to thrombotic disorders, approach to lymphadenopathy, hepato-splenomegaly, white cell disorders including eosinophilia, diagnosis of leukemia and principles of therapy, Bone marrow transplantation, peripheral blood smear, lumbar puncture, bone marrow aspirate biopsy, Fine needle aspiration cytology , central and peripheral line insertions, drugs used in hematology and blood component therapy. Pretest and post-test methodology is used to assess assimilation by the trainees of the topics covered during the workshop. So far 12 workshops have been conducted in seven states across the country with enthusiastic participation of pediatricians. Around 360 pediatricians have been trained so far. Workshops have been held in Gurgaon (Haryana), Jallandhar (Punjab), Surat (Gujarat), Pune and Miraj( Maharashtra), Gandhidham (Gujarat), Lucknow (UP),New Delhi and Central Delhi (Delhi), two in Kanpur ( UP) and Shimla (Himachal Pradesh).