Hematology Outreach Around the World Charlotte Niemeyer, MD
Dr. Niemeyer is Professor at the University Children's Hospital in Freiburg, Germany. She is also Chair of the International Members Committee at ASH.
ASH launched its first international outreach effort in 1999 and its activities have been expanding ever since to help address the hematology-related needs in training, practice, and research in developing countries. Currently, the Society’s efforts are focused on the areas of support for research experiences of visiting trainees, distribution of ASH educational materials free of charge, and facilitation of clinical networks like those recently established in Brazil, Mexico, and Jordan on acute promyelocytic leukemia (see article below).
The ASH™ Visiting Trainee Program was established in 2004. It provides scientists and hematologists in developing countries with an opportunity to gain training experience on a specific topic at a host institution within or outside the United States. The special training over a period of up to 12 weeks can be sought in clinical care, technological experience, or laboratory expertise. It is expected that the trainee will transfer the specific training experience to his/her host institution. The following clip taken from an e-mail of a visiting trainee illustrates the importance of this program for talented young scientists. Samuel A., a young visiting trainee from Kenya, writes:
I just wanted to share with you my progress... As a Master of Science student in Medical Biochemistry at the time of my visit... I am happy to note that I will be graduating this May... With regard to the training experience I had at Baylor, there has been tremendous success in transferring the knowledge to my home laboratory in Kenya... As a result I have been awarded a PhD grant by the London School of Tropical Medicine, UK...
Each applicant selected for participation in the Visiting Trainee Program is assigned to a program mentor from the membership of ASH’s International Members Committee. The mentor stays in personal contact with the applicant during the training experience and oversees the evaluation and follow-up. It can be really heartwarming to see how an opportunity like a fellowship in the Visiting Trainee Program can open doors for talented young researchers in less privileged countries.
The distribution of ASH educational materials free of charge through the ASH™ International Outreach Initiative (IOI) is greatly appreciated by physicians and scientists in less privileged parts of the world. Single institutions or cooperative groups from countries with a gross national income per capita of $6,000 or less are eligible for this program. In addition to educational materials from the annual meeting, such as Hematology (the ASH Education Program Book) and CD-ROMs containing abstracts and audiovisual presentations of the Education and Scientific Sessions, the materials distributed include the ASH™ Self-Assessment Program and an online subscription to Blood. Currently 45 institutions around the globe take advantage of the program.
ASH members with special insight into hematology in developing countries are kindly requested to provide contact information of potential applicants through the IOI section of the ASH Web site. ASH is delighted to see the growth of this initiative that is serving the needs of hematology around the world.
Return to Top
International Consortium on Acute Promyelocytic Leukemia Helps First Patients in Brazil, Mexico, and Jordan
Charlotte Niemeyer, MD
Dr. Niemeyer is Professor at the University Children's Hospital in Freiburg, Germany. She is also Chair of the International Members Committee at ASH.
A young woman from Pueblo, Mexico, with acute promyelocytic leukemia (APL) became one of the first patients benefiting from the International Consortium on APL (IC-APL). She was provided medical care according to the IC-APL protocol, achieved remission without bleeding complications, and enjoys a high probability of being cured of her leukemia.
With current therapy, including all-trans retinoic acid, 70-80 percent of patients with APL are alive and free of disease at five years. In certain geographic areas, such as Latin America, the incidence of APL is greatly increased, with APL accounting for up to 20-25 percent of all acute myelogenous leukemia cases. In these same developing countries, however, a lack of infrastructure and funding has inhibited the adoption of current cutting-edge therapy.
In December of 2004 at a workshop hosted by ASH’s International Members Committee (IMC), a group of international experts on APL and investigators from Brazil, Mexico, and Jordan met to initiate a concerted effort designed to introduce and foster clinical and laboratory procedures that represent standards of care for the treatment of APL. For capacity-building purposes, standard therapy was implemented modeling a clinical trial. This will allow the participating countries to later undertake network-based clinical studies on patients with APL or other hematologic diseases.
Within only 18 months, the IC-APL protocol was written and approved by the respective national and local ethics committees, allowing the first patients to be enrolled. The IC-APL Subcommittee on Laboratory and Diagnostic Guidelines specified general recommendations and protocols for sample collection, banking, genetic diagnosis, and coagulation studies. Bylaws outlining the concerted efforts of this unique consortium were also finalized.
The St. Jude Children’s Hospital International Outreach Program, under the direction of Dr. Raul Ribeiro, provides active support to the IC-APL with respect to Web registration and data management. In April 2006, a Brazilian colleague, Dr. Rafael Jacomo, visited St. Jude Children’s Research Hospital to learn all aspects of patient registration and data management. Dr. Jacomo has created a data manager training manual and started coordinating and facilitating training for all other data managers.
Under the coordination of Drs. Eduardo Rego (Brazil), Guillermo Ruiz-Arguelles (Mexico), and Mohammed Milhem (Jordan), seven centers in Brazil, five centers in Mexico, and two institutions in Jordan are currently involved in the initiative.
Work within the different groups of IC-APL is extremely active and lively. Using the Web conferencing technology of Cure4Kids, an established part of the St. Jude International Outreach Program, live meetings amongst members of the different groups have been initiated. Local investigators discuss their patients weekly, while data managers, IC-APL subcommittees, and the Steering Committee meet on separate schedules.
In June of 2006, the Veronesi Foundation of Milano, Italy, pledged a two-year grant of 100,000 euros to the IC-APL. This generous donation is greatly appreciated by all who have worked so hard on this important project. Financial support from public and private organizations will be essential for fostering research in hematology in countries with limited resources.
By modeling all aspects of clinical trials through implementing the standard-of-care protocol, we expect the participating countries to be poised to undertake network-based clinical studies at the end of an initial period. The IMC is proud of the progress of the IC-APL to date and believes that models like the IC-APL will stimulate clinical collaboration and hematologic research around the world.
Return to Top
Return to Table of Contents
|
