Sylvester/Jackson Team Launches Peru’s Pediatric Bone Marrow Transplant Unit

Extending Sylvester Comprehensive Cancer Center’s outreach to Peru, a University of Miami and Jackson Memorial Hospital team led by Julio C. Barredo, M.D., Director of Children’s Cancer Programs at Sylvester and the Toppel Family Chair in Pediatric Hematology-Oncology, recently conducted the initial training seminar and workshop for specialists who will operate Peru’s first comprehensive pediatric bone marrow transplant referral center.

For Barredo, who was born in and received his early medical training in Lima, the opportunity to make such a tangible contribution to his homeland is particularly rewarding. “It is really exciting for me, and I believe for everyone at UM and the cancer center because we have the opportunity to transfer medical technologies to places where they are not available and, obviously, when you do that, it has a positive effect on the delivery of care.”

Joining Barredo in the capital to present the September 4-6 workshop hosted by Peru’s Ministry of Health were the Miller School’s Krishna Komanduri, M.D., director of Sylvester’s Adult Stem Cell Transplant Program; Martin Andreansky, M.D., Director of the Pediatric Stem Cell Transplant Program; Marco Flores, M.D., vice president for business development at the International Medicine Institute; Cara Benjamin, Ph.D., Director of the Stem Cell Processing Lab; and Alexandra Amador, MT, CHS, manager of the Histocompatability Lab, which matches bone marrow recipients with potential donors by typing the antigens that determine the genetic makeup of a person’s immune system. On the team from Jackson were Silvia Willumsen, RN, BSN, Pediatric Stem Cell Transplant Coordinator, and Maria Cabello, RN, pediatric bone marrow transplant nurse.

In all, about 170 physicians, nurses, lab technicians, IT specialists and nurse coordinators from Peru’s National Institute of Child Health, which is establishing the bone marrow transplant center in its new pediatric specialty hospital, attended the two-day course. In addition to general sessions, the workshop included smaller group sessions for each of the technical areas.

“This was the first step for training the people who will create the infrastructure for the comprehensive pediatric bone marrow transplant center in Peru, which will be a referral center for the entire nation,’’ explained Barredo, who expects the unit to be on its own in two or three years. “Many of these people already have transplant experience, but not the kind we are talking about, so there is a learning curve – just not as steep as if they were starting from scratch.”

Some of the physicians will continue their training by rotating through the UM/Holtz Children’s Hospital’s pediatric bone marrow transplant unit. Until the National Institute of Child Health unit is accredited and equipped to operate on its own, the Holtz unit also will treat up to 10 children per year from Peru with leukemia, lymphoma, or other blood cancers and immune disorders requiring bone marrow transplants.

With Barredo’s help, Peru’s Ministry of Health established the nation’s first general bone marrow transplant unit in 1994, but it can transplant allogeneic (donor) bone marrow cells only from matched sibling donors, which has prevented a significant number of Peruvian patients from qualifying for this life-saving treatment. To resolve that problem, the Ministry turned to the UM Sylvester Comprehensive Cancer Center for help in setting up an allogeneic bone marrow program in the new pediatric specialty hospital, and establishing a national cord blood bank, where women who have just given birth can store or donate stem cells from their umbilical cord for potential future use.

“That’s a big advantage in Peru, which has a vastly diverse and intermixed population so matching donors with recipients is not easy there,” explained Barredo, who is also professor of pediatrics, biochemistry and molecular biology and Director of the Division of Pediatric Hematology-Oncology. “There are many unique antigen profiles, so if you have banked cord blood from that population, it becomes easier to find a match. In Miami, we understand this, which makes Miami a great place to do outreach to Latin America.”

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