Table of Contents

HK J Paediatr (New Series)
Vol 11. No. 1, 2006

HK J Paediatr (New Series) 2006;11:1-2


United for a Better Care for Children with Cancer and Blood Diseases

GCF Chan

Children with cancer or blood diseases are in general a minority among different diseases that may occur in childhood. However, the impact of this group of children on our health care system is extremely significant. It is because they account for a large proportion of children who require in-patient care in the hospital nowadays. In addition, childhood cancer remains the second commonest cause of mortality in children of industrialised communities. A great deal of resource has to be infused into this relatively small and yet needy group of children currently.

Since very few institution or hospital could accumulate adequate number of patients to conduct any meaningful study; it has been recognised by most developed countries that multi-centre collaboration is the only way to improve the skill of the specialists and the care for this small group of patients. In view of this necessity and reality, the Hong Kong Paediatric Haematology & Oncology Study Group (HKPHOSG) was formed in 1992. Since then, the group has been working cohesively and has been able to obtain good local data for benchmarking in comparison with other developed countries. From there, we could identify existing service gaps for improvement. In recent years, we have been moving even further by participating in the international clinical trials and we hope to contribute to children not only in our community, but also around the world.

This issue of our Journal witnesses the fruits of some of such collaborations. Ling SC et al surveyed the care of local haemophilic patients treated in all the paediatric units of Hospital Authority hospitals. With this effort, we can now have a more holistic view of this group of patients. The survey revealed that we are in fact lagging behind in several areas such as on the use of primary prophylaxis and on providing genetic work-up for the carriers. Furthermore, Lee ACW et al analysed the current recommended product of choice for patients with Factor IX deficiency. All of these provided us ideas to improve further on our existing service for haemophilia.

While we are rejoicing in achieving a high cure rate for many cancers commonly found in local children such as acute lymphoblastic leukaemia, brain tumours and other solid tumours, one of the current issues is how to minimise the therapy-related toxicity. Chan GCF, Chow CM, et al and Lepatan, et al described some of the relatively common complications found in our children with cancer and the potential way to prevent them in the future.

Haematopoietic stem cells transplantation, known also as bone marrow transplantation previously, has long been advocated for the treatment of children with refractory or relapsed leukaemia since early 80's. But it is also useful for the management of "benign" blood diseases with poor prognosis. Li CK, et al, Cheuk KL, et al and Ha SY, at al summarised their experiences in using this approach on children with marrow failure due to either congenital or acquired aetiology. This highly effective approach is no longer considered as a form of experimental treatment nowadays.

Some of our colleagues contributed by adding new knowledge to the management of some locally prevalent diseases such as thalassaemia intermedia by using hydroxyurea (Chik KW, et al); and others (Ma ESK, et al) had identified new genetic basis of our children suffering from a rare disease known as relapsing thrombotic thrombocytopenic purpura. Several case reports in this issue also heighten our awareness of the occurrence of rare haematologic or oncologic diseases in Chinese patients.

Finally, though not directly related to our current theme but yet very relevant to our local children is the guidelines of management on children with acute otitis media. Lam B, et al summarised the current evidences and views (by both paediatrician and otolaryngologist) on this issue; and this will be very helpful for our colleagues to take reference when they have to diagnose or manage this common illness found in children.

GCF Chan
Associate Editor and Chairman,
Hong Kong Paediatric Haematology &
Oncology Study Group

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