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CLINICAL PEDIATRIC HEMATOLOGY PROGRAM - INTRODUCTION
One of the first stand-alone pediatric hematology programs in the country, the hematology program of the Division of Pediatric Hematology and Blood and Marrow Transplantation provides inpatient and outpatient services for children and adolescents with a variety of hematologic disorders.
Approximately 500-600 children with various chronic hematologic disorders are followed by the Pediatric Hematology Program. There is a comprehensive program in sickle cell disease and programs in iron deficiency and overload anemias, coagulation and platelet disorders, bleeding disorders, vascular anomalies, primary immunodeficiencies, bone marrow failure syndromes and a variety of other rare syndromes, giving the hematology aspect of the program a very broad base. There are several specialized programs in the various broad categories of blood disorders. These include established multidisciplinary programs in sickle cell disease, thalassemias, iron deficiency and overload, thrombosis and hemostasis, bone marrow failure syndromes and primary immunodeficiencies.
Patients are cared for in a setting designed for children and their families by a team of physicians, nurse practitioners, clinical nurses, clinical research nurses, hematopathologists, pediatric radiologists, pediatric surgeons, pediatric geneticists, pediatric sub-specialists, pain specialists, child life specialists, psychologists, and social workers, all of whom coordinate their efforts to provide the best and most comprehensive care to all these patients.
CLINICAL PEDIATRIC BLOOD AND MARROW TRANSPLANTATION PROGRAM - INTRODUCTION
State-of-the-art, disease-specific treatment protocols delivered by an experienced, caring staff enable the BMT Program of the Division of Pediatric Hematology and Blood and Marrow Transplantation at Morgan Stanley Children’s Hospital of NewYork-Presbyterian to be an international leader in blood and marrow transplantation medicine.
Specialized Blood & Bone Marrow Transplant Physicians, Transplant coordinators, nurse practitioners, BMT clinical pharmacists, BMT research nurses, pathologists, radiologists, surgeons, medical specialists, child life specialists, and social workers are among the many highly trained and skilled medical care providers working together to respond to the needs of each individual patient.
The actual procedure for an infusion of stem cells resembles a typical blood transfusion and takes anywhere from 30 to 90 minutes. However, the process leading up to the moment when the physician infuses the blood or marrow stem cells into the child’s blood stream is preceded by stages of carefully organized preparation including critical evaluation of the child’s eligibility for BMT and pre-BMT test results, procurement of stem cells from the donor and/or child, and administration of conditioning chemotherapy, immunotherapy and/or radiotherapy.
Guiding each step of the patient’s care is a treatment plan, designed by the Blood and Marrow Transplantation Program physicians after in-depth review of each child’s specific needs. It is a highly detailed document that coordinates all phases of the transplantation process. Among the many different kinds of tests the BMT physicians may find necessary to arrive at an accurate diagnosis and effective treatment plan are: ultrasound, CT scan, MRI, gallium scan, bone scan, PET scan, bone marrow aspiration and biopsy, and specific blood tests including tissue typing for compatibility between donor and child. The BMT physician uses these tests and consultations with colleagues in other specialties to analyze the patient’s disease process before embarking on a specific course of treatment. The goal is to verify the proper diagnosis and assign an accurate level of severity of the disease with and without BMT. Often, the evaluation conducted by the BMT physicians is part of a second opinion and helps families clarify their treatment options.
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