Sylvester Pediatric Oncologists Form Collaboration with Peru

As part of a unique agreement with the nation of Peru, the Sylvester Comprehensive Cancer Center, part of UHealth – University of Miami Health System, is helping establish a new pediatric bone marrow transplant program in Lima, as well as treating patients in the United States. The collaboration with the Peruvian government was developed in 2012 to provide low-income residents with access to health care that would otherwise be unavailable to them, but Sylvester became particularly involved in the past 18 months, once infrastructure in Peru was in place.

“Peru constructed and opened the new children’s hospital, the National Institute of Child Health San Borja, a year ago,” said Julio Barredo, M.D., Director of Children’s Cancer Programs and Director of Pediatric Hematology-Oncology at Sylvester Comprehensive Cancer Center. “It was built as a national referral center and dedicated to four or five areas, including hematological malignancies and transplant.”

Marco Flores, M.D., head of business development for UM’s International Medicine Institute, said there are many cases of leukemia in Peru, particularly in children. Since opening the children’s hospital and launching the new bone marrow transplant program, more services have become available. However, at this time, bone marrow transplants are only available to patients with a sibling donor.

“What they can’t do, yet, is a transplant if the patient needs cord blood or an unrelated donor as the source of stem cells,” said Barredo, who is associate chair of pediatrics for basic research and Toppel Family Professor of Pediatric Hematology-Oncology at the University of Miami Miller School of Medicine. In those instances, patients are brought to Miami for treatment at Holtz Children’s Hospital at University of Miami/Jackson Memorial Medical Center, home to the only academic-based, pediatric stem cell transplant program in the region.

In addition to offering patient care support in Miami, Sylvester is providing consulting services. “In Miami, we provide care to critical patients,” said Barredo. “In Peru, we advise on the development of infrastructure, IT systems, laboratory services, everything needed to support a pediatric bone marrow transplant program.”

Part of Sylvester’s consulting services also includes training medical staff. “Obviously, this is very expensive for them,” said Flores. “The ultimate goal is to train Peruvian physicians and clinicians, which is why their doctors come here to train for six weeks to six months. We are starting with physicians, then we’ll have the nurses and tech-lab support coming in so that they can have a complete picture of what it takes to replicate our program in Lima.”

Sylvester has already conducted workshops for physicians and nurses, and is helping the Peruvian medical team develop standards of practice for their transplant program back home. “While we’re using American standards for the basis of the program’s standard of care, you can’t just export 100 percent of how we do things,” Barredo said. “The state of things in Peru and the realities of Peru’s current clinical operations must be incorporated into any plans.”

Barredo, who travels to Lima two or three times a year to meet with the Peruvian team, said that in the short time the Sylvester and Peru clinicians have worked together, considerable progress has been made. “What our combined teams have developed since we started is significant. Their program now has validated HLA-typing and some molecular testing lab capabilities, and with support they’ve been able to do the kind of typing we do here on a more limited scale. We will continue to be a part of this partnership until we can fully transfer the technology and clinical capabilities and they are able to run their own independent program.”

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