AMCC Annual Report 2017
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Branch: INCTR France
President: Martine Rahael
Board Members: Pier Bey., Elisabeth Dupont
Volunteers/Employees:
Collaborators: Bamako (Mali), Lubumbashi (DRC), Abidjan (Ivory Coast), Dakar (Senegal) and Antananarivo (Madagascar). GFAOP, the Curie Institute, Prothelem, retinostop
Partners: Association Francophone pour les Soins Oncologiques de Support (AFSOS), the French-Benin Association for the Fight Against Cancer (AFBLCC), the Beninese Association of Palliative Care (ABSP) and the Beninese Cancer Association (ALCC_Bénin) with the support of the World Health Organization (WHO), Médecins Sans Frontières (MSF) and the Ministry of Health of Benin.
Address:
Country(s): Mali, DCR. Ivory Coast, Senegal, Madagasca, Togo, Benin, Congo, Uganda
Year Established:
Annual Report: AMCC – Annual Report 2017

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 2017, 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). This programme is run in collaboration with GFAOP, the Curie Institute, Prothelem, retinostop and supported by a grant from the Fondation Sanofi-Espoir as well as funding from the French Health Ministry.

Current outcomes of AMCC’s retinoblastoma Program

One of the components of this projects is a real-time study of cost of therapy for retinoblastoma patients. The objective is to develop a proof of concept through data, to demonstrate to authorities that children with early stage retinoblastoma can be cured with minimal relative expense compared to high stage disease, and also that these patients can be expected to become productive members of the society as their vision can also be preserved. The hope is that we will succeed in demonstrating the cost effectiveness of this initial intervention and the government and the ministry of health will then be willing to take up the expense of this disease as a public health improvement effort.


Training for the Bamako team:

- A second ophthalmologist (Dr Aïchata Tall has been trained in Institut Curie in January 2017). She is now working with FS at IOTA in a permanent position
- A nurse anaesthesiologist from IOTA will spent 2 weeks in Paris (beginning of 2018) to be trained for the specificities of anaesthesiology in young children with Rb

Research Project
Dr M Keita, assistant in the pathology department (Pr Cheick Traoré) in Bamako, Mali, continues his research project on the genomic abnormalities in Rb with Institut Curie with financial support of the french association, Retinostop. He will come again in Paris when he will have accumulated 24 samples of Rb of good quality (during 2018)

Meetings

A meeting was organized at the Curie Institute on 22 November 2017 with the participation of Dr Rokia Berete, Abidjan and Marcel Ngoy, Lubumbashi to discuss the early detection programmes, the conservative treatments and the financial support for retinoblastoma treatment (request to health ministries).

Acceleration of the project in Senegal

In 2017, the Fondation Sanofi-Espoir provided a special grant to accelerate and finalize the implementation of conservative treatments in Senegal. This made it possible to buy additional equipment, to provide training for Dr. Paule Ndoye at the Institut Curie oriented on techniques and indications of conservative treatments, to organize a 2-day visit with Laurence Desjardins, Pascal Sirignano and Pierre Bey in Dakar (with the participation of the Bamako team) to launch a media campaign for early diagnosis on the occasion of the start of the conservative treatments and to set up registration of all cases of retinoblastoma seen by the Dakar team.

Publications:

- Treatment of Retinoblastoma in Sub-Saharan Africa: Experience of the Pediatric Oncology Unit at Gabriel Toure Teaching Hospital and the Institute of African Tropical Ophthalmology (IOTA), Bamako-Mali.
Authors: F. Traoréa, F. Syllab, B. Togoa, B. Kamatéc, K. Diabatéd, A.A. Diakitéa, H. Dialla, F. Dickoa, M. Syllaa, P. Beye, L. Desjardinse, A. Gagnepain-Lacheteauf, C. Cozeg, F. Dozh
- A second article is in preparation by Fatoumata SYLLA on the 50 intraocular
unilateral cases

Events/presentations:
- Oral presentation at SIOP 2017, Washington
- Presentation in Dakar (Senegal) June 29, 2017 at Le Dantec Hospital for the acceleration of the development on the way conservative treatments in children with bilateral retinoblastoma and conference of Laurence Desjardins on retinoblastoma on the senegalese society of ophtalmology (60 ophtalmologists present)
- Oral presentation in Bamako (Mali) september 29, 2017, during the pediatric
malian congress by Fousseyni Traore on retinoblastoma (about 120 pediatricians from Mali and surrounding countries and presentation of P Bey on radiotherapy in children September 27.


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 fight against pain and discomfort in cancer and for the integration of palliative care into oncology programs in Sub-Saharan francophone countries

2. The training of competent teams with the objective to set up Reference Centers to take care of patients and to train nurses and local healthcare professionals

This programme is supported by the Foundation ‘Pierre Fabre’ for 5 years.

Palliative Care and Cancer Pain Management workshop, Cotonou, Benin

In 2017, the 3rd edition of the oncology pain management workshop was held on April 20-21, 2017 in Cotonou, Benin. The workshop was organized in partnership with the Association Francophone pour les Soins Oncologiques de Support (AFSOS), the French-Benin Association for the Fight Against Cancer (AFBLCC), the Beninese Association of Palliative Care (ABSP) and the Beninese Cancer Association (ALCC_Bénin) with the support of the World Health Organization (WHO), Médecins Sans Frontières (MSF) and the Ministry of Health of Benin.

The scientific program aimed at better integrating palliative care into oncology care at an early stage and focused on patient’s pain assessment, use of analgesics, use of morphine, breaking bad news, management of wounds and pediatric palliative care.

The major event of these days was the announcement of the delivery of the machine for the manufacture and dilution of morphine syrup and the imminent arrival of morphine powder in Benin in order to prescribe and distribute an effective oral analgesic.

Seven countries were represented in Cotonou and the workshop was an opportunity to exchange on practices from countries including Benin, Ivory Coast, Togo, Senegal, Congo Brazzaville, Uganda and France.

Palliafrique Forum

The Palliafrique Forum offers an exchange platform to all actors and associations active in the field of pain and palliative care in French-speaking Africa. It aims to support the creation of reference centers and to support training for care pain and palliative care in oncology.

The Forum was officially launched in April 2017 at the workshop in Cotonou. It can be accessed at www.forum-palliafrique.org.

This Forum is open to all health care professionals and students who want to improve their knowledge and/or exchange on palliative care and pain management issues.

The Forum was presented at the 4th International Francophone Congress of Palliative Care in Geneva in November 2017.


Pathology Program

During the year 2017 the major activity of the pathology program was the diagnostic support in hematopathology via telepathology with three actions

1 - The extension of the network of the platform i-Path with the purchase of a new microscopes for 3 centers: Abidjan (Ivory Cost), Bamako (Mali) and Kinshasa (DRC). This action was supported by a grant (30 000€) from the ‘Fondation Sanofi Espoir’’ in order to equip these new centers and to organize a meeting in Paris on telepathology in April 2018.

The analysis of the diagnostic support of cases from francophone Africa was presented as a pitch at the French meeting on ‘e-Santé’ of the network CATEL, Paris, October 2017, 216 cases from 7 centers (Dakar, Kinshasa, Lubumbashi, Vanga Hospital, Yaounde, Cotonou, Bamako) were analysed.

Martine Raphaël : Telepathology, experience in Sub-Saharan Francophone Africa. Pitch, e-Santé, Meeting CATEL, Maison de la chimie, 5-6 october 2017, Paris

2 – Participation in the therapeutic protocol for aggressive B-cell lymphoma in Adults in Dakar, coordinated by Pr Saliou Diop (Hematology, Dakar) and Pr Pierre Feugier (Hematology, CHU Nancy). This protocol is supported by INCa. The role of AMCC is to coordinate and review the slides for patients enrolled in the protocol through the i-Path platform.

3 – Support of the organization of the Pathology Committee of the GFAOP (Groupe Franco-Africain d’Oncologie Pédiatrique). This committee was launched in November 2017 during the meeting of the GFAOP. Dr Elisabeth Auberger, member of AMCC and Head of pathology Department of the General Hospital Simone Veil, Eaubonne) is the coordinator of the Committee. This Committee includes pathologists from francophone Sub-Saharan countries and from Maghreb. The pathologists from the South are connected to i-Path platform and they are invited to meetings for the review of slides of patients enrolled in therapeutic protocols for nephroblastoma, retinoblastoma and Burkitt lymphomas. These meetings are organized by Prof Aurore Coulomb-L’Hermine (Head of Pathology Department at CHU Trousseau, Paris).


The research activity on hematopathology is still ongoing. After the PhD thesis (University Cheick Anta Diop, Dakar) of Dr Abibatou Sall on lymphoproliferative disorders in Senegal in 2016, the analysis of immunoglobulins genes was done by the team of Prof Lorenzo Leoncini at the Department of Pathology, University of Siena. The material of Chronic Lymphocytic Leukemia (CLL) patients included in this study was analyzed by NGS (New Generation Sequencing) and showed preferential usage of specific immunoglobulin heavy chain variable region with unmutated profile and advanced stage at presentation in Senegalese patients in comparison with Italian CLL patients suggesting diverse genetic and microenvironmental background.

Publication:
Amato T, Sall A, Dièye TN, Gozzetti A, Iacono M, Ambrosio MR, Granai M, Somma S, Diop S, Touré AO, May E, Gattiollat CH, Wiels J, Ahmed Y, Raphael M, Leoncini L, Bellan C, Piccaluga PP.Preferential Usage of Specific Immunoglobulin Heavy Chain Variable Region Genes With Unmutated Profile and Advanced Stage at Presentation Are Common Features in Patients With Chronic Lymphocytic Leukemia From Senegal.Am J Clin Pathol. 2017 Nov 20;148(6):545-554. doi: 10.1093/ajcp/aqx105.



CONCLUSION

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
Future Plans:
Publications: F. Traoréa, F. Syllab, B. Togoa, B. Kamatéc, K. Diabatéd, A.A. Diakitéa, H. Dialla, F. Dickoa, M. Syllaa, P. Beye, L. Desjardinse, A. Gagnepain-Lacheteauf, C. Cozeg, F. Dozh
Treatment of Retinoblastoma in Sub-Saharan Africa: Experience of the Pediatric Oncology Unit at Gabriel Toure Teaching Hospital and the Institute of African Tropical Ophthalmology (IOTA), Bamako-Mali.

A second article is in preparation by Fatoumata SYLLA on the 50 intraocular unilateral cases

Amato T, Sall A, Dièye TN, Gozzetti A, Iacono M, Ambrosio MR, Granai M, Somma S, Diop S, Touré AO, May E, Gattiollat CH, Wiels J, Ahmed Y, Raphael M, Leoncini L, Bellan C, Piccaluga PP.Preferential Usage of Specific Immunoglobulin Heavy Chain Variable Region Genes With Unmutated Profile and Advanced Stage at Presentation Are Common Features in Patients With Chronic Lymphocytic Leukemia From Senegal.Am J Clin Pathol. 2017 Nov 20;148(6):545-554. doi: 10.1093/ajcp/aqx105.




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Month: Dec
Year: 2017
Date of Last Report: 12/2017
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