|
 The
Working Report of the Lady Pao Children's Cancer Centre
Prof.
Chik Ki Wai
The Lady Pao Children's Cancer Centre
Department of Paediatrics
The Chinese University of Hong Kong
What
is CCC?
Do
you know what CCC stands for? It stands for the Lady Pao Children’s
Cancer Centre at Prince of Wales Hospital of the Chinese University
of Hong Kong. Since its opening in Shatin in 1984, the hospital
has always had a children’s cancer unit. The opening
of the Children’s Cancer Centre in 1995 signified a new
landmark in the treatment of children’s cancer. Our guiding
principle is to provide quality service through accurate diagnosis
and effective treatment in conjunction with all the specialist
departments in the hospital to help child patients regain
their health so that they can grow up to be useful members
of the society.
Our
Centre is under the charge of the Department of Paediatrics
of the University . It is staffed by a group of professionals
in medicine and social service, including doctors, nurses,
medical social workers, case workers, play therapists, palliative
care nurses, clinical psychologists, dietitians, physiotherapists
and laboratory technicians. The Centre is the largest
medical institution for the treatment of children’s cancer
in Hong Kong. Facilities in the Centre include isolation rooms,
day ward, bone marrow transplant centre and laboratory, play
room, a school operated by the Red Cross, parent rest room
and research laboratories.
Some
of our child patients came directly to us for treatment. Others
were referred by other public hospitals. There were also some
patients referred by private doctors. The Ronald McDonald
House near the Centre offers temporary accommodation to parents
who live far away from the Centre. Besides, we gain the support
from many organizations, such as Children’s Cancer Foundation,
Camp Quality and Make-A-Wish Foundation. They all contribute
to the physical, emotional and social well being of the child
patients.
Statistics
of Patients’ Survival Rate
At
present, the quality of medical care provided by this Centre
is up to international standard. Let us try to show our record
in two parts as follows:
|
|
1984
- 1992
|
1993
- 2000
|
|
Total
Patients
|
Survived
Patients
|
%
|
Total
Patients
|
Survived
Patients
|
%
|
|
1.
|
Acute
Lymphoblastic Leukaemia (ALL)
|
119
|
76
|
66%
|
138
|
114
|
83%
|
|
2.
|
Acute
Myeloid Leukaemia (AML)
|
34
|
12
|
35%
|
49
|
31
|
63%
|
|
3.
|
Junvenile
Chronic Myeloid (JCML)
|
4
|
0
|
0%
|
9
|
5
|
56%
|
|
4.
|
Chronic
Myeloid Leukaemia (CML)
|
8
|
3
|
38%
|
10
|
8
|
80%
|
|
5.
|
Brain
Tumour
|
35
|
9
|
26%
|
57
|
38
|
67%
|
|
6.
|
Hodgkin
Lymphoma (HL)
|
5
|
4
|
80%
|
3
|
3
|
100%
|
|
7.
|
Non-Hodgkin
Lymphoma (NHL)
|
19
|
14
|
74%
|
19
|
16
|
84%
|
|
8.
|
Bone
Tumour
|
8
|
4
|
50%
|
28
|
23
|
82%
|
|
9.
|
Germ
Cell Tumour
|
12
|
11
|
92%
|
24
|
24
|
100%
|
|
10.
|
Liver
Tumour
|
12
|
2
|
17%
|
22
|
13
|
59%
|
|
11.
|
Neuroblastoma
|
24
|
11
|
46%
|
25
|
17
|
68%
|
|
12.
|
Rhabdomyosarocoma
|
7
|
3
|
43%
|
25
|
12
|
48%
|
|
13.
|
Wilms
Tumour
|
17
|
14
|
82%
|
15
|
14
|
93%
|
|
14.
|
Ewing
Sarcoma
|
6
|
2
|
33%
|
14
|
10
|
71%
|
|
15.
|
Retinoblastoma
|
7
|
6
|
86%
|
11
|
11
|
100%
|
|
16.
|
Others
|
17
|
15
|
88%
|
32
|
24
|
75%
|
| |
Total
|
334
|
189
|
57%
|
481
|
363
|
75%
|
| |
Total
Survived Patients
(1984 - 2000):
|
605
|
|
|
|
|
Footnote:
These two sets of figures seem to suggest relatively better
results in 2000, but the follow-up duration is still too short
to be conclusive.
The above figures from the
Centre should help illustrate a few points. First, children’s
cancer is not a common disease, but it is life threatening.
Second, children’s cancer demands accurate diagnosis
and proper treatment schedule in order to achieve international
standard of cure, and, third, extra attention is needed to
ensure that the disease will not affect the future growth
and development of those who have recovered from it.
Bone
Marrow Transplant Cases
The
Bone Marrow Transplant Centre of our Department has conducted
172 cases of transplant since 1991. 106 patients have survived
the operation. Types of disease treated included transfusion
dependent thalassaemia, acute leukaemia, chronic leukaemia,
neuroblastoma, severe aplastic anaemia, immunodeficiency and
metabolic conditions. Bone marrow transplant is used only
on serious cases where the first line of treatment failed
to achieve the desirable result.
Our
record in treating cancer cases by bone marrow transplant
is as fol1ows:
|
|
Total
Patients
|
Survived
Patients**
|
%
**
|
|
Acute
Lymphoblastic Leukaemia (ALL)
|
36
|
17
|
47%
|
|
Acute
Myeloid Leukaemia (AML)*
|
23
|
17
|
74%
|
|
Chronic
Myeloid Leukaemia (CML)
|
16
|
5
|
31%
|
|
Other Leukaemia
|
13
|
2
|
15%
|
|
Neuroblastoma
*
|
10
|
4
|
40%
|
|
Solid
Tumour *
|
9
|
5
|
56%
|
|
Total
|
107
|
50
|
47%
|
* Some
of the acute leukaemia cases, neuroblastoma and other solid
tumour are treated with autologous or blood stem cell transplant.
**
The follow-up time is still too short to be conclusive for
the number of survived patients.
Results
of Other Serious Diseases Treated by Bone Marrow Transplant
|
|
Total
Patients
|
Survived
Patients
|
%
|
|
Transfusion
Dependent Thalassaemia
|
45
|
37
|
82%
|
|
Aplastic
Anaemia
|
11
|
10
|
91%
|
|
Metabolic
Diseases
|
6
|
3
|
50%
|
|
Immunodeficiency
|
3
|
2
|
67%
|
|
Total
|
65
|
52
|
80%
|
Types
of Stem Cell Transplant
|
Source
of the Cell
|
Cases
|
%
|
|
Bone
Marrow
|
107
|
62%
|
|
Peripheral
Blood Stem Cells
|
53
|
31%
|
|
Umbilical
Cord Blood
|
12
|
7%
|
|
Total
|
172
|
100%
|
Classification
of Stem Cell Providers
|
Provider
|
No.
of Persons
|
%
|
|
Related
Persons*
|
HLA
Matched Donor
|
82
|
48%
|
|
HLA
Mismatched Donor**
|
19
|
11%
|
|
Matched
Unrelated Donor
|
48
|
27%
|
|
Autologous
Stem Cells
|
24
|
14%
|
|
Total
|
172
|
100%
|
* Include
siblings and some parents
** Mismatched at one locus or phenotypically matched
Although
statistics show that the rate of success for previously unfavourable
conditions is rising, we are still not satisfied. We must
continue to develop new technology to enhance the effectiveness
and to minimize serious side-effects of bone marrow transplant.
In addition to providing
medical care, this Centre also serves as a teaching facility
for the study of cancer. We also contribute original articles
to international medical journals. At the same time, we are
doing systematic research in cancer disease to keep abreast
of the latest development in treatment.
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