The Children’s International Consortium on Acute Leukemia (C-ICAL) is an international network that seeks to improve the care of pediatric patients with acute leukemia.
Dr. Corrine Sin Quee (Princess Margaret Hospital, Nassau, Bahamas) is a pediatric hematologist/oncologist who has been an active participant in C-ICAL since its inception in 2016. Dr. Sin Quee is a champion of the consortium and touts the opportunity it provides for hematologists in the Caribbean to connect with each other and with leaders from ASH and SickKids Hospital with the goal of implementing a common single protocol to treat their pediatric patients. Here she discusses the need that C-ICAL helps meet and the array of possibilities that could emerge by working together.
ASH has other international initiatives to foster clinical networks with leading experts in the field of leukemia and sickle cell disease. C-ICAL enabled physicians in the Caribbean to work together, along with leaders in the field from ASH and SickKids Hospital, Canada, to develop a common single protocol to treat children with acute lymphoblastic leukemia (ALL). There are no more than one or two specialist doctors caring for children with cancer in each of the Caribbean countries, so the ability to meet monthly to discuss these patients with the foremost clinical research experts in leukemia around the world is more than a dream come true.
Getting local institutional review board approval of the protocol was not difficult as it followed standard treatment for ALL. The participation was a monitoring process to encourage compliance — treatment, record keeping, and reporting. It is well recognized that conforming to a protocol helps to improve outcomes, and this initiative is helping us to develop a uniform standard of practice and performance. As far as enrollment, patients in general put trust in the doctor and are willing to participate in studies, and this one was easy since again the treatment was standard. A lot has to do with spending time explaining the purpose of the study.
This initiative proves that we can work together, and conform to following the same protocol, even though we live in four different countries. Together we can! We can be accountable for all we have to do. And we can freely discuss our progress, challenges, and complications. There is no element of competition. We share experiences and solutions, and I expect that the Caribbean collaboration will be strengthened and continue for years to come. Maybe one day we can share a common procurement operation to improve our buying power for medications for the entire Caribbean.
Our greatest accomplishment is the unity achieved among the Caribbean pediatric hematologists/oncologists and the commitment to work together. There are only six of us, and two more are in training. Our combined population is about 5 million in the four participating countries (the Bahamas, Barbados, Jamaica, and Trinidad and Tobago). The remaining English-speaking countries in the Caribbean have a combined population of approximately another 1 million, with no specialist doctors in the field. Open sharing and support for our expertise will hopefully be enhanced by cross-country governmental support. Ideally, centers of excellence might also be identified in the future and provide spaces where patients can be transferred for initial care to auger best outcomes. This way we can pool our limited resources and maximize the financial and nonfinancial benefits. However, it is a mammoth task to engage governments to get the required commitment at the regional level to create the necessary platform for centralized procurement of drugs or centers of excellence.
Visit www.hematology.org/global-initiatives to learn more about ASH’s global initiatives.
HHS Office of the Assistant Secretary for Health Awards ASH Member and CONSA Volunteer Dr. Kwaku Ohene-Frempong
On October 15, 2020, the Assistant Secretary for Health, ADM Brett P. Giroir, MD presented the Assistant Secretary of Health Exceptional Service Medal to Professor Kwaku Ohene-Frempong, MD, recognizing him for his outstanding contributions on behalf of people worldwide living with sickle cell disease. The medal is awarded for exceptional achievement to the cause of public health and medicine and is the highest civilian award from the Public Health Service, though Professor “KOF” is the first "civilian” (non-US uniformed person) to receive the award A key leader of CONSA and national coordinator of the CONSA network in Accra, Ghana, Professor “KOF” has been a long-time champion for pediatric SCD patients in Africa and the United States.His leadership was instrumental in the development of newborn screening in Ghana, and he is a mentor to colleagues throughout Africa working to develop SCD newborn screening and care efforts. Dr. Ohene-Frempong is Professor Emeritus of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania and President of the Sickle Cell Foundation of Ghana. Please join us in congratulating Dr. Ohene-Frempong on this significant achievement.
