INCTR France Annual Report 2015

Branch: AMCC (French Branch)
President: Martine Raphael
Board Members: Pierre Bey, Elisabeth Dupont
Collaborators: Institut Curie
Partners: GFAOP
Address: Paris
Country(s): Francophone Africa
Year Established:
Annual Report: The 3 programs of AMCC are each associated with one of AMCC’s research themes. They are undertaken with academic institutions, scientific societies, and French and African charities linked to the local authorities of the African countries in which the projects take place. The three thematic areas are Retinoblastoma treatment, Pain and Palliative Care and Pathology.

« Retinoblastoma » Program
Activities were continued in this program during 2015, with follow up of previously treated patients and extension of the program to improve early diagnosis, treatment and rehabilitation of children suffering from retinoblastoma in Sub-Saharan African countries. This program is active in Bamako (Mali), Lubumbashi (DRC), Abidjan (Ivory Coast), Dakar (Senegal) and Antananarivo (Madagascar). During the period of this project, 177 patients were treated in the 5 participating centers (Madagascar has only recently joined the network)..

Current status of AMCC’s retinoblastoma Program

Mali, Bamako : February 2015 : 128 cases have been registered and treated by the team in Bamako. For unilateral and intraocular 48 cases, the complete remission rate is over 80%. The thermo-chemotherapy conservative treatment began in the summer of 2014.
- DRC, Lubumbashi: There has been a positive beginning to the programme in Lubumbashi with respect to the number of patients entered on study (15) and the number with early clinical stages (3) but limited communication. Some contacts with Kinshasa et Bukavu (north/east) have taken place.
Senegal, Dakar: between May 2014 and January 2015, 23 cases were registered. Several reviews of the outcome of treatment in retinoblastoma cases have shown a decrease in the number of deaths: 94% in 1994, 29% in 2013 and 23% in 2014.
Ivory Coast, Abidjan: 21 cases were entered on study in 2014.
Madagascar, Antananarivo: 11 cases were observed in the unit with only 3 unilateral and intraocular stages. An awareness campaign is being set up.
Visit to Lubumbashi (15 - 20 March 2014, with GFAOP). P. Bevisited Lubumbashi with a representative from the GFAOP) to try expand the program.
Dr Sandrine Kouakou (from ophthalmology unit (Prof Fanny, CHU Treicheville, Abidjan, Ivory Coast) spent 4 days (12 – 24 May 2014) in the laboratory (called, “laboratory Prolethem) of P.Signano, an ocularist involved in the fabrication and fitting of prosthetic eyes to improve the ability of prosthetic eyes to be made and accurately fitted in the Ivory Coast..
Mr Faly Cissé (a member of the ophthalmology Service of Prof. Paule Aïda, in Dakar). visited the November 2014 Laboratory Prothelem, mentioned above, also to learn how to make prosthetic eyes.
Visit to Antananarivo (Madagascar) of L. Desjardins, F Traoré, P. Bey and P Sirignano (27 - 30 October 2014) to launch the retinoblastoma program in Madagascar
Dr Hoby Lalaina Randrianarisoa, from Antananarivo (22/02 - 08/03/2015) spent 18 days at the Institute Curie in Paris participating in all aspects of the management of retinoblastoma.
Visit of Mr Alisara Randrenanja (22/02 - 08/03/2015) (Ophthalmology unit, Antananarivo) in the laboratory Prothelem under the direction of P. Sirignano, ocularist, to learn about the fabrication and fitting of prosthetic eyes
Visit of P Bey et P Sirignano in Abidjan, (08 - 12/04/2015) during the meeting of ALIAM (to improve the fabrication of ocular prosthetic eyes)

Research Project:
The pathology team from Bamako is participating in the research presently being conducted by the Research Center of the Curie Institute (François Radvanyi) with Buenos Aires to identify new genes involved in the development and progression of early and late stage retinoblastomas. The genomic study will require access to 20 cases treated with primary enucleation (500 € per case) associated with an immuno-histochemical analysis on these cases.
Setting up of the retinoblastoma network of Sub-Saharan Africa
On the 7th of March 2015, the first meeting of the network was held at the Institute Curie with the teams from Mali, DRC, Ivory Coast, Senegal and Madagascar. The objective of the network is to share experiences and increase South–South exchanges and training.

Communication & publications

The program was presented on ‘Radio France International’ on the 4th of February 2014 and published in Cancer Control (2014) (« Retinoblastoma: an exemplary tumor in young children that can be cured in low income countries », P Bey, F Traoré, F Sylla, G Chenge, J Ilunga, R Lukamba, L Desjardins, P Sirignano.)
Several presentations were made at the AORTIC congress in Marrakech in November 2015.

Pain and palliative care programme
The program « Training in the management of pain and palliative care» of AMCC has as its objectives:

1. Advocacy for the struggle against pain and discomfort in cancer and tor the incorporation of palliative care into oncology programs in Sub-Saharan francophone countries

2. The training of competent teams able to establish Reference Centers to take care of patients and to train nurses and local people.

This program includes 2 types of training:
- An international course: basic training allowing physicians and nurses to control pain and understand the application of the basic principles of palliative care. This course is organized in Uganda in collaboration with Hospice Africa, France and took place in April 2014. There were approximately thirty participants from francophone Africa.

- A training programme to manage pain and to provide palliative care for cancer patients in Africa. This programme is supported by the foundation ‘Pierre Fabre Oncologie Afrique’ for 5 years and includes two components (one every two years):

- 1. Workshops in Africa organized in collaboration with the ‘Association Francophone pour les Soins Oncologiques de Support (AFSOS).”

Congo Brazzaville will host the next workshop. Pr Charles Gombé will be the coordinator in collaboration with Dr L. Copel and A. Burnod from AMCC. 150 participants from 10 different countries are expected.

- 2. Sessions on «Pain and palliative care in Africa» during the AFSOS congress.

A session on how to manage pain and provide palliative care in Africa was organized on the 17th of October 2014 during this congress.

Pathology Program
There are three components to the pathology program:
1. Continuing training of pathologists through the organization of workshops in haematopathology for francophone and anglophone African countries

- Diagnostic support in hematopathology via telepathology. Several centers of francophone African countries participate to this action.

- Research in hematopathology with the setting up of new technologies in Africa (immunohistochemistry, cytogenetics) Workshops and pathology meetings:

The fourth meeting in the series : « Lymphomas, what can we learn from Africa ?” took place in Arusha, Tanzania, from 13 - 15 February 2014

The 5th meeting in the series: « Lymphomas, what can we learn from Africa ?” took place in– Dakar, Senegal, 12 – 14 November 2015. This workshop was organized in collaboration with the francophone Africa Society of hematology (SAFHEMA) and with the support of the European Association for Hematopathology (EAHP) for the tutorial.

These workshops and Tutorials on lymphomas in Sub-Saharan Africa are integrated into the action of the telepathology network in Africa and the continuing training that takes place via this mechanism. The Sub-Saharan countries from west, central and east Africa participated and presented their experiences in hematopathology.

Support of diagnosis in hematopathology

Several centers in francophone African countries are already equipped for more precise diagnosis of haematological neoplasms using monoclonal antibodies and fluorescence in situ techniques. These include Lubumbashi, and Vanga hospital, DRC, Dakar, Senegal, and Cotonou, Benin. In 2015, funds were obtained to equip Kinshasa, Abidjan, Bamako with new microscopes with an incorporated digital camera (Foundation Obélisque) to enable immediate storage of photographs in an electronic format that can be sent to experienced haematopathologists anywhere in the world.

At the World Cancer Congress, a presentation was made on “The experience of telepathology in hematopathology” in which the results of cytology and histology using the software “iPath” were presented to the World Cancer Congress in Melbourne (UICC, 3 – 5th December 2014) and at the workshop ‘What can we learn from Africa” held in Dakar, Senegal, Africa’, held in Dakar, Senegal on 12 - 14 November 2015: Africa’, Dakar (12 - 14 November 2015): 179 cases were registered, 170 were analyzed including 79 adults and 91 children.

Research project on the characterization of lymphoproliferative syndromes in adults in Senegal with the support of the French Cancer National Institute (INCa),

This project, in collaboration with the University hospital Le Dantec and the University Cheikh Anta Diop of Dakar, Senegal, was the topic of a PhD thesis (Dr Abibatou Sall). The defense of the thesis was made on 9th of November 2015 at Dakar. One of the benefits of this thesis is a better characterization of lymphoproliferative disorders in Senegal and the possibility to continue some research projects such as the analysis of the immunoglobulin repertoire of CLL in Senegal in comparison with CLL in Europe in collaboration with the Siena University (Pr L Leoncini).

The results of this thesis were presented at the World Cancer Congress (UICC), in Melbourne (3 - 6 December 2014), and at the workshop “What can we learn from Africa” in Dakar (12 -14 November 2015). A case of well characterized prolymphocytic leukemia was published in the African Journal of Cancer (A Sall, A Sene, B Djiba et al. Leucémie Prolymphocytaire T. A propos d’une observation et revue de la littérature. African J Cancer, 9-2015, 7(4).
Programs developed by the AMCC are in line with the programs of INCTR. In some Francophone African countries they are conducted in collaboration with the GFAOP.
These programs are supported by public and private institutions or foundations. The ultimate objective is to improve the care of cancer patients (adults and children).

The actions of AMCC remain focused on 3 programs:

1. Retinoblastoma.
2. Pain and palliative care.
3. Pathology

They are underpinned by training and research.
Future Plans: Continue with the activities described, with expansion of the network as funds permit
Month: 12
Year: 2015
Date of Last Report: 12/2014
Image 1: file:profs-awa-toure-and-martine-raphael-1/Profs-Awa-Toure-and-Martine-Raphael.jpg
Image 2: file:what-can-we-learn-from-africa-5-1/What-can-we-learn-from-Africa-5.jpg

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