Dr. Vinod Gunasekaran

Consultant, Pediatric Hematology Oncology Unit, Kauvery Hospital, Trichy, Tamilnadu, India

*Correspondence: gvinod86@gmail.com

Pediatric Hematology and Oncology (PHO) is a relatively new area of study in medicine, yet has seen significant advances in the recent decades. The American Board of Medical Specialties approved the sub-specialty of PHO in 1973 [1]. This was after a special committee of the American Board of Pediatrics in 1970 processed the requirements and later decided there should be a single certification for Pediatric Hematology Oncology, unlike in Internal Medicine that offers separate certifying examinations for Medical Hematology and Medical Oncology [1]. Many training institutes in India (public and private) follow similar policy.

Blood disorders in children may be acquired or genetic. Common problems include anemia, thrombocytopenia, aplastic anemia, coagulation disorders, primary immunodeficiency disorders and hematological malignancies including leukemia and lymphoma. Iron deficiency anemia is a major public health problem in our country. According to National Family Health Survey 4 (2015 – 2016), 58% of children aged 6 months to 5 years have anemia (Hb < 11 g%). Hereditary causes of anemia include thalassemia, sickle cell anemia, hereditary spherocytosis, pure red cell aplasia, etc. In this issue, we have highlighted a relatively less discussed topic i.e., the importance of premarital and prenatal interventions needed to prevent thalassemia major.

Solid tumors in children can arise from brain, kidney, adrenal gland, liver, retina, bone, soft tissue, etc. These need a multidisciplinary approach including pediatricians, pediatric hemato-oncologists, surgeons and radiation oncologists. In this issue, we have summarized our two years experience in the management of children with cancer and their short-term outcome as of date. The survival rate of children with cancer has reached 75–80% in developed countries [2]. The first dedicated pediatric cancer unit was started in Tata Memorial Hospital, Mumbai in 1985 [2]. We need simplified and low cost approaches in treatment wherever possible without affecting the efficacy. Financial aid is mandatory for the lower and middle socio-economic population to complete the lengthy treatment without interruption to maximize the survival chances.

Dr. Manivannan S, Founder and Managing Director and Dr. Senguttuvan D, Executive Director and Chief Consultant Paediatrician, Kauvery Hospital were the pillars behind the execution of making affordable treatment available to these needy children in Kauvery Hospital, Trichy. NGOs like Trichy Moon Rock Round Table Trust 108 and Cankids, India have largely wiped out the financial barriers to the underprivileged families in getting the quality treatment at their vicinity.

I should thank Dr. Suresh Venkita, Group Medical Director, for being my inspiration to continue the art of writing while in daily practice. After working on this special Hematology Oncology issue of Kauverian eMedical Journal, I realized that analyzing our own data in daily practice and framing a manuscript help us to make better treatment decisions more confidently in future practice.

References

  • Pearson HA. History of pediatric hematology oncology. Pediatr Res. 2002;52:979–92.
  • Arora B, Banavali SD. Pediatric oncology in India: past, present and future. Indian J Med Paediatr Oncol. 2009;30(4):121–3.

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