18 July 2004	Sunday	29 Jamadi-ul-Awwal 1425

KARACHI, July 17: The lymphomas - malignant tumours consisting of lymphoid tissue - among children is described as significantly treatable condition for which an efficient supportive care system is needed.

This was stated by Dr Naheed Usmani, a paediatric oncologist associated with the Massachusetts University's School of Medicine, while delivering a lecture on "Current trends in the management of lymphomas among children". The moot was held under the aegis of the Child Aid Association at National Institute of Child Health on Saturday.

Dr Naheed Usmani said that like many other developing countries, in Pakistan too, the incidence of malignancy was registered to be much higher than the developed world, but, still not as prevalent as in the African region.

The paediatric oncologist, who had been working at Shaukat Khanum Memorial Cancer Hospital some five years back and did her training at the Cancer Centre of New York, observed that the prognosis of the disease was almost the same in Pakistan as in the USA. However, she said that the measures adopted to control infections and environmental pollutants in the latter made the marked difference in the survival rates of young patients.

Some complications of the condition, including cardiomyopathy, chronic pulmonary disease, endocrine problems, soft tissue and bone growth alteration, were also discussed.

About the required treatment, Dr Naheed highlighted the significance of "multi-modal therapy" for lymphomas reminding that the current survival rate for the condition stood at 90 to 95 per cent. For this, she urged the doctors to ensure regular follow up of their patients.

She also spoke of different modes of treatment, varied drug therapies, besides pros and cons of each.

The oncologist also discussed emergency management of the condition with particular reference to metabolic derangements, air way obstruction from thoracic tumour and massive effusion in lungs.

Regarding the bone marrow transplantation, she said that the BMT did not offer extremely good chances of success and added that the patients who did not respond to chemotherapy could not react to the BMT either. In this regard, she referred to the issue of high infection rate and pollution.

Dr Barkat Huda, in charge of the paediatric oncology department of Aga Khan Hospital, acknowledged the fact that it was the absence of adequate support care that survival rates of child cancer patients in countries like Pakistan ranged not above 25 to 30 per cent as compared with 70 to 75 per cent in the advanced countries.

Dr Afroze Ramzan, the NICH director, while thanking the guest speaker and Prof Nizamul Hasan expressed hope that they would exercise their good offices in establishing linkage between their institution and the NICH oncology department in the larger interest of suffering children.

Reminding the shortage of nursing and paramedical staff, Prof Nizamul Hasan mentioned that a British Charity, as per request of the Child Aid Foundation, would soon be dispatching a master trainer to train local nurses in specialized oncology.

According to him, another training course for paramedics in sub-specialty of oncology is also in the offing.-APP