Pediatric Hematology/Oncology Fellowship Training Program

The discipline of Pediatric Hematology/Oncology has continued to expand in both the clinical and basic science arenas over the last several decades. Discoveries of dominant oncogenes, tumor suppressor genes, gene transfer technology and hematopoietic growth factors have opened new areas of clinical and basic research, as well as provided new potential therapies for patients. Both the demonstrated improvement in care for pediatric patients with hematologic-oncologic disorders as well as the scientific excitement generated through research directed toward understanding these disorders insures that the discipline of Pediatric Hematology/Oncology will continue to be an exciting part of pediatric medicine and science in the future.

The Pediatric Hematology/Oncology Fellowship Training Program at James Whitcomb Riley Hospital for Children is dedicated to the specialized training of physicians that will be excellent providers of pediatric hematology/oncology care and future leaders in academic pediatric hematology/oncology. Thus, the fellowship training program is designed to (1) prepare the trainee for the clinical practice of Pediatric Hematology/Oncology, (2) prepare the trainee for independent academic investigation, and (3) prepare the trainee to teach the discipline of Pediatric Hematology/Oncology to others.

To accomplish these goals, a faculty with demonstrated excellence in clinical care, research, and education is represented in the Section of Pediatric Hematology/Oncology at Riley Hospital. Equally important, we recognize that faculty will focus on various aspects of patient care, research or teaching but that a truly stimulating, complete training program requires extensive interactions among individuals with different areas of interest. The Section of Pediatric Hematology/Oncology at Indiana University strongly encourages interaction between clinicians, educators and investigators to provide a stimulating environment and a broad scope for the trainee in Pediatric Hematology/Oncology.

The fellowship training program in Pediatric Hematology/Oncology is fully accredited by the Residency Review Committee for Pediatrics of the Accreditation Council for Graduate Medical Education. It is a three year program but may extend beyond this depending on the individual needs of the trainee. We are committed to excellent clinical care and management of children with cancer and diseases of the blood. The trainee will have experience in all aspects of the sub-specialty by direct patient contact and support from our faculty. Clinical areas of training include the leukemias, solid tumors, brain tumors, hematopoietic/stem cell transplantation, general pediatric hematology, sickle cell disease, bone marrow failure syndromes, hemophilia and other coagulation disorders.

The bulk of this clinical training will occur in the first year of the fellowship. There will be three to four months of inpatient hematology/oncology service, three months on the Hematology/Oncology Consultative Service, three months on the Pediatric Stem Cell Transplant Service, one month devoted to aspects of radiation oncology, blood banking, hemostasis and hematopathology and one month of elective time to help prepare for clinical or basic science investigation that will be the focus during the next two to three years. Throughout the fellowship years, trainees will spend approximately one day/week seeing patients in the outpatient setting. Call will average every sixth night and weekend.

The second and third years of training are designed to prepare the trainee for clinical or laboratory investigation. Opportunities for investigation within the Section of Hematology/Oncology, the Herman B Wells Center for Pediatric Research, Riley Hospital and Indiana University School of Medicine are excellent and broadly based.

Fellows are encouraged to participate in two unique opportunities for training in clinical research at Indiana University: the Institute for Informatics and the federally funded Clinical Investigator Training Enhancement (CITE) program.

The Section of Hematology/Oncology sees approximately 150 new oncology patients each year and enters the majority onto Children's Oncology Group (COG) protocols. We have been a member of the Children's Cancer Group, and now COG, since 1971. The Section of Pediatric Hematology/Oncology has approximately 8000 outpatient visits per year and approximately 900 hospital admissions per year. In addition to our program for clinical care of general hematology/oncology patients, we have programs in sickle cell disease, cancer survivorship and stem cell transplantation. We are a member of the phase I consortium of the COG, and also have our own program in Clinical Gene Therapy. In addition to our 12 full-time faculty, we have seven full-time pediatric nurse practitioners, and three full-time social workers.

The Stem Cell Transplantation Program has four full-time faculty, two pediatric nurse practitioners, a clinical coordinator and a full-time social worker. Areas of clinical and research activity of the program include the investigation of alternate sources of hematopoietic stem cells for allogeneic and autologous transplantation, transplantation of children with solid tumors, and the use of gene transfer for the correction of congenital hematological and immunological disorders of childhood. Approximately 25-30 stem cell transplants are performed each year.

Inpatients are cared for in the Riley Children's Cancer Center, located on the fifth floor of Riley Hospital for Children. It is dedicated space for the care of children with hematologic and oncologic diseases. There are 19 beds for hematology/oncology patients, and 5 beds for stem cell transplantation. Outpatients are cared for in dedicated space at the Riley Outpatient Center. A specialized Apheresis Center is located within the Center for the acquisition of mobilized peripheral blood stem cells and platelets from normal donors.

Mary C. Dinauer, M.D., Ph.D. is the Scientific Director of the Section of Pediatric Hematology/Oncology at Riley Hospital as well as the Director of the Herman B Wells Center for Pediatric Research at Riley Hospital. The Wells Center is a 35,000 sq. ft. (net) research facility comprising of 26 faculty, with greater than $6 million per year in external grant support. Approximately 1/2 of the Wells Center is devoted to research in hematology/oncology. Programs in hematopoiesis (Hainline and Clapp), intracellular signaling (Durden), gene transfer (Dinauer and Clapp), fetal hematopoiesis (Yoder), molecular biology of gene expression (Skalnik), control of cell proliferation (Chun), molecular biology of WBC disorders (Goebel and Dinauer), and DNA repair (Kelley) are available within the Wells Center and the Section of Hematology/Oncology.

In addition, we have strong relationships with the Department of Medicine, and Biochemistry and Molecular Biology, the Walther Oncology Center and Department of Medical and Molecular Genetics at Indianapolis and excellent research programs within these departments are available for interested trainees.

The faculty of the Section is committed to providing strong back-up support and education for the trainee during his/her clinical training, as well as serving as mentors, and helping the trainee develop skill in manuscript and grant preparation, and scientific presentations.

Our fellowship training program is designed to train Pediatric Hematology/Oncology specialists who will assume full-time academic positions. Therefore, although we have a three year training format, some individuals may benefit from a fourth and fifth year of training in basic laboratory investigation in order to become more competitive for independent full-time academic positions. Such additional training is available through the Section.

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