| General Paediatrics | Cardiology | Endocrinology & Metabolism | Haematology & Oncology |
| Immunology, Rheumatology & Infection | Neurology, Developmental Paediatrics & Neurohabilition |
| Paediatric Intensive Care & Neonatology |
Chinese

Clinical Sub-specialties
Haematology and Oncology (血液及腫瘤科);

Bone Marrow Transplant Programme (骨髓移植)

Team Heads




Dr Shau-yin Ha
Consultant
夏修賢醫生
Dr Godfrey Chi-fung Chan
Professor
陳志峰醫生
Dr Alan Kwok-shing Chiang
Associate Professor
蔣國誠醫生
   
Fellow: Dr. Cheuk Ka Leung
Ward manager: Ms. Julia Fung
Nurse Specialist : Ms Sau-ying Chiu

Activity & Service
Team PhotoOur team provides comprehensive clinical services in the areas of paediatric haematology, oncology, and haemopoietic stem cell transplantation. We look after patients with a wide spectrum of blood disorders including thalassaemia and haemophilia. As a tertiary centre in Hong Kong we provide care for children with cancer. Bone marrow transplantation was first established in late 1991 as a quaternary service. This programme has gradually expended in the past 10 years because of wider field of application, better availability of donors, and alternate use of stem cell source other than bone marrow, i.e. cord blood and peripheral blood stem cell. We receive referrals from local doctors and hospitals, and also from Macau, Mainland China and overseas. Annually, we receive around 60 new oncology referrals, and 15 to 18 cases of blood or marrow transplantation are performed. Furthermore, over 60 patients with transfusion dependent thalassaemia are currently under our care. In addition, about 700 patients, most being long term survivor of various kinds of cancer, are regularly being followed up in our oncology clinic.

Team MeetingThe designated clinical area is located on the 8th floor of Block K at Queen Mary Hospital. In 2002, it was named as the Children's Centre for Cancer and Blood Disease (CCCBD). There are 21 in-patient beds and a day unit. Two of the beds are equipped with laminar airflow system and designated for blood or marrow transplantation. Four rooms are equipped with HEPA filter system. One room caters for step-down care of transplanted patient, while three others are for reverse isolation of neutropenic patients. In addition to regular outpatient clinics (oncology, haematology, bone marrow transplant), a number of multi-disciplinary clinics are collaborated with other specialists e.g. radiotherapist and endocrinologist in the long-term survivor clinic, and neurosurgeon in the brain tumor clinic.

Blood/ Marrow Transplantation Programme
Blood or marrow transplantation service is a combined programme in our hospital which serves both adult and paediatric patients. In 1994, we successfully transplanted a patient with thalassaemia major with sibling's cord blood; this is the first cord blood transplant in Hong Kong. Since then we have developed a flourishing cord blood transplant programme. In particular, we have performed the largest number of transplants for patients with primary immunodeficiencies. Currently our centre provides different forms of stem cell transplants (allogeneic or autologous, related or unrelated donor, bone marrow or peripheral blood stem cell or cord blood). Non-myeloablative approach has also been applied to selected patients. Autoimmune disease is a new indication for bone marrow transplant. We first transplanted a patient with such disease in 2001. By the end of 2003, 150 children and adolescents were treated in this 12-year period.

Distribution of disease type

  • high-risk or relapsed leukaemia 32%,
  • advanced stage or relapsed solid tumour 25%,
  • thalassaemia major 19%,
  • immunodeficiency 12%,
  • marrow aplasia 6%,
  • autoimmune disease 3%,
  • miscellaneous 3%.
Overall, 65% of patients survive the transplantation and most of them are expected to be long-term survivors. The survival rate of patients with non-cancerous diseases (73%) is higher than that of those with cancerous diseases (54%). The cure rate for thalassaemia major reached 80% with improved conditioning regimen. The seven children who received cord blood from their siblings were all cured. Despite rarity, bone marrow transplantation achieved good cure rate, 78%, in patients with marrow aplasia.

Strength & Development
Ward RoundFor clinical service, we continue to work for better care of our patients. To accommodate the need of our patients, we are switching the focus from in-patient care to ambulatory care. Besides, we plan to improve the ward environment and upgrade the facilities, including better isolation to reduce cross infection.

There is close multi-leveled collaboration within our hospital and the University. Within our own department, close cooperation exists between the University and hospital staffs, and between members of different subspecialty teams. Outside the department, we have actively collaborated with other departments, all work towards common goals. Cancer is one of the main foci of research in this University. Hence, the Hong Kong International Cancer Congress (HKICC), an annual venture jointly organized by different departments of the University is precisely targeted at cancers. In our unit, there have been track records of active researches on different aspects of thalassaemia. This hospital runs the biggest service in blood and marrow transplant, which involves multidiscipline. Through joint effort, we aim at improving the care of patients and enhancing the productivity of researches. In addition, we continue to strengthen our collaboration with hospitals outside our own cluster, and our link with institutes in China Mainland and overseas.

Research/ Grant & Awards
As part of a University department, our team is always actively teaching and training medical students, medical trainees and postgraduate students. We have frequent clinical and academic interaction with professionals from local, Mainland China and overseas countries. Our team members have been actively collaborated with other departments of Queen Mary Hospital and paediatric departments of other hospitals in carrying out researches. The 3 areas of focus are thalassaemia, childhood cancer and stem cell transplantation. Over the past 3 years, our team has published 44 journal papers and was awarded with research grants of more than HK$ 4.5 millions. Six research students (5 MPhil and 1 PhD) are currently under our supervision and another 2 MPhil students have already graduated over the past 2 years.

Our main fields of research interest are as followings:
a. Thalassaemia
We focus on the correlation between the genotype and phenotype of various thalassaemia syndromes; clinical trials on a new therapy for iron overload (i.e. oral chelator); new modality in monitoring iron overload (i.e. MRI assessment of visceral iron storage); improvement of supportive care (i.e. use of thalaset needle, quality of life evaluation, osteoporosis study) and transplantation (i.e. reduced intensity conditioning, cord blood transplant).

b. Childhood Cancers
Professorial RoundWe target at 2 common groups of childhood malignancies, namely, acute myeloid leukaemia/ myelodysplastic syndrome and neurogenic tumours (brain tumours and neuroblastoma). Dr. SY Ha and Dr. GCF Chan are the respective protocol coordinators of the Hong Kong Paediatric Haematology and Oncology Study Group responsible for these two groups of diseases. By in-vivo and in-vitro studies, we have been examining the use of novel agents or immunotherapy (i.e. arsenic trioxide, anti-GD2, etc.) in the treatment of these cancers. We also target at various clinical studies including the management of neutropenic fever, QOL evaluation, and anti-emetic treatment. As a city meeting East and West, we also look into the impact of traditional Chinese medicine on cancer by performing in-vitro & in-vivo studies (i.e. local prevalence on use of Chinese herbs, immunological and cytotoxic effects of Lingzhi extracts).

c. Blood and marrow Transplantation
In our clinical studies, we have been exploring the use of new conditioning regimens, non-myeloablative approach and different stem cell sources (i.e. cord blood, peripheral blood stem cells, haploid identical donor). On the laboratory side, we are currently investigating the biological and immunological behaviour of marrow derived mesenchymal stem cells and its role in engraftment.

Collaboration
Team DiscussionWithin the Department, our team works closely with other subspecialty teams both in clinical services and research. In particular, we partner up with the Immunology/ Rheumatology/ Infectious disease team for delivering the clinical service and running the transplantation programme. Outside the Department, we have close collaboration with colleagues from surgical, radiotherapy and pathology departments in delivering the clinical services and pursuing research.

We are an active member of the local collaborative study group, Hong Kong Paediatric Haematology/ Oncology Study Group. Within the Study Group, we share common treatment protocols for most of the childhood cancers and review the regimens regularly. Our treatment results are comparable to those from overseas.

Many other professionals are also involved in the provision of support to our patients and their families. These include nurses, social workers, psychologists, play specialists, and many others. Charitable organizations, including the Children's Cancer Foundation (CCF) and Children's Thalassaemia Foundation (CTF) have also provided unfailing support and resources in the improvement of research and clinical services. In the last 2 years, with the assistance from the CCF, we have established a palliative care team, which has been providing both in-patient, and home care services for children in the terminal phase of their illnesses. The Children's Catastrophic Disease Foundation (CCDF) is a newly established charitable organization, which also supports some of our needy patients who are not financed by other charitable bodies.

Patients and their families are our important partners as well. The "Sunbeam Club" is a support group formed by parents and patients with cancer or blood diseases. For the 10 years that the group has been established, it has been helping new patients and parents to face the challenges of the illnesses. The thalassaemic patient/ parents group has also been active for many years and made valuable contribution.

Team Dinner