Mhamed Harif

Tangiers University Hospital

Background: In 2018, the World Health Organization (WHO) launched the Global Initiative for Childhood Cancer (GICC). The goal is to achieve a global survival rate of at least 60% for all children with cancer by 2030. Morocco was designated as a pilot country for this initiative. Procedure: This retrospective study included a cohort of children a...

Anemias in 100 questions.

This is a concise overview of20 years experience of a group working on putting in place pediatric oncology program in Africa. It is a story of successes and difficulties.

Résumé La greffe de cellules souches hématopoïétiques (CSH) est le traitement curatif de nombreuses hémopathies malignes, non malignes et quelques cancers solides. Cependant, les procédures de greffes de CSH sont considérées comme des soins de niveau tertiaire relevant d’un haut degré de technicité et d’expertise et engendrant des coûts très élevés...

Background In low‐ and middle‐income countries, therapeutic options for advanced, refractory, or relapsing malignancies are limited due to local constraints such as cost of drugs, distance from oncology centers, and lack of availability of new anticancer drugs. Metronomics, which combines metronomic chemotherapy (MC) and drug repositioning, allows...

Résumé La microtransplantation (MT) est une procédure de thérapie cellulaire basée sur l’injection de cellules souches hématopoïétiques mobilisées par G-CSF HLA-incompatibles, en association à une chimiothérapie anti-tumorale, mais sans conditionnement de greffe préalable ni traitement immunosuppresseur. Il en résulte un microchimérisme transitoire...

Le cancer chez l’enfant est une maladie curable dans plus près de 80% des cas. Il s’agit cependant d’une urgence diagnostique et thérapeutique. Savoir gérer un enfant atteint de cancer au diagnostic ou au cours de son traitement a un impact majeur sur les chances de réussite du programme de prise en charge dans sa globalité. Cette prise en charge p...

PURPOSE To evaluate the results of an intensive polychemotherapy regimen for Burkitt lymphoma (BL) in sub-Saharan African pediatric centers. PATIENTS AND METHODS Children with advanced-stage BL (stages II bulky, III, and IV) treated with the GFAOP–Lymphomes Malins B (GFALMB) 2009 protocol in 7 centers between April 2009 and September 2015 were pro...

Haploidentical hematopoietic stem cell transplantation has been growing steadily since 2012. The SFGM-TC has twice published guidelines concerning T-cell repleted haploidentical grafts with high dose cyclophosphamide post-transplantation. The 2013 workshop recommended using the non-myeloablative Baltimore protocol with bone marrow and developed pro...

Purpose: In 2012, the French African Pediatric Oncology Group established the African School of Pediatric Oncology (EAOP), a training program supported by the Sanofi Espoir Foundation's My Child Matters program. As part of the EAOP, the pediatric oncology training diploma is a 1-year intensive training program. We present this training and certifi...

Case Report Primary hepatic lymphoma (PHL) is a rare extranodal non-Hodgkin's lymphoma which can be missed easily. We present a case of extranodal high grade lymphoma of the liver in a 57-year-old lady with no particular pathological history. Lymphoma manifested with sharp significant pain in the right hypochondrium, weakness, and profuse night swe...

L’ostéonécrose aseptique de la tête fémorale (ONATF) est une complication ostéo-articulaire fréquente chez le drépanocytaire. Sa survenue est insidieuse et son traitement reste un vrai challenge. Peu de données sont disponibles sur le sujet dans notre contexte. Objectif : rapporter les cas d’ONATF chez les patients drépanocytaires au Service d’Hém...

The first meeting of the African Blood and Marrow Transplantation (AfBMT) was held in Casablanca from April 19, 2018 to April 21, 2018, with the aim of fostering hematopoietic stem cell transplantation (HSCT) activity in Africa. Out of the 54 African countries, HSCT is available only in six (Algeria, Egypt, Morocco, Nigeria, South Africa, and Tunis...

Introduction : l’ostéonécrose aseptique de la tête fémorale (ONATF) est une complication ostéo-articulaire fréquente chez le drépanocytaire. Sa survenue est insidieuse et son traitement reste un vrai challenge. Peu de données sont disponibles sur le sujet dans notre contexte. Objectif de ce travail : rapporter les cas d’ONATF chez les patients drép...

La gref fe des cellules souches hématopoïétiques (GCSH) est une thérapie cellulaire dont l’efficacité est actuellement bien établie dans beaucoup d’hémopathies malignes ou bénignes ainsi que dans des pathologies du système immunitaire. C’est un processus complexe qui fait intervenir une équipe d’hématologie spécialisée, travaillant en étroite colla...

In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middl...

In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middl...

Introduction: Patients suffering from hematological diseases frequently undergo autologous peripheral blood stem cell transplantation (PBSCT). Pulmonary infectious complications are a cause of morbimortality, reported in the literature with an incidence of 40 to 60%, and a mortality up to 30%. Risk factors are also described in the literature, such...

Introduction: Autologous peripheral blood stem cell transplantation (PBCST) is frequently used during the treatment of hematological malignancies. Infectious complications are a major cause of morbimortality in this procedure. Their incidence is variable from one center to another and depends on the ecology of each unit. Objective: The aim of this...

Introduction: Neuroblastoma is the most common extracranial solid tumor in children, constituting 6-10% of all childhood cancers. In Morocco it comes fourth after leukemia, lymphomas and nephroblastoma. The course of this disease varies, depending on the biologic features of the tumor. Treatments adapted to risk stratification have improved surviva...

We report the case of a 6-year-old male child whose father and mother were grandfather are carriers of multiple neurofibroma and who have a neurofibromatosis type 1 (NF1), cranial deformity, hepatosplenomegaly and staturoponderal delay. The CBC showed hyperleukocytosis, highly regenerative macrocytic anemia and thrombocytopenia with blood smear bla...

Many children with cancer in low- and middle-income countries are treated in hospitals lacking key infrastructure, including diagnostic capabilities, imaging modalities, treatment components, supportive care, and personnel. Childhood cancer treatment regimens adapted to local conditions provide an opportunity to cure as many children as possible wi...

1 Background Retinoblastoma (Rb) is the most common intraocular primary malignancy in children. In industrialised countries, the cure rate is about 95%. We present the results of a prospective study on the management of Rb in the paediatric oncology unit of Gabriel Touré Teaching Hospital and African Institute of Tropical Ophthalmology, from Novemb...

Report on SIOP Africa meeting in Marrakech in 2017. An update on the activity of various African teams is presented.

La pratique de l'oncologie pédiatrique dans les pays en voie de développement doit prendre en considération les contraintes majeures liées à la rareté des ressources et aux croyances et pratiques traditionnelles très présentes. Le Groupe franco-africain d'oncologie pédiatrique a mis en place un ambitieux programme en Afrique francophone ayant démon...

This study represents findings from a questionnaire completed before a cancer control workshop by 47 pediatric cancer control stakeholder participants from 27 countries. Respondents reported their knowledge of their country's cancer control plan, their understanding of childhood cancer control priorities in their local setting, and barriers to high...

1. To be able to identify the early warning signs and symptoms of childhood cancer 2. To understand the factors leading to delayed diagnosis and the implication thereof 3. To understand the importance of awareness campaigns and education 4. To be able to identify children at high risk of developing cancer 5. To be able to conduct an appropriate dia...

By the end of this chapter, you will be able to: Understand the mechanisms of nociceptive pain and neuropathic pain. Assess pain according to the age of the child. Know how to prevent iatrogenic pain. Know how to adapt treatment according to the mechanism and the intensity of the pain.

By the end of this chapter, you will be able to: Define a cancer registry and know the different types of a registry Understand the use of a registry as an essential statistical instrument for a cancer control plan Understand the regional differences in the distribution of various cancers of children in Africa

To know the signs and symptoms of presentation of rare tumors in children To know and be able to diagnose them To know the main therapeutic options

By the end of this chapter, you will be able to: Know the clinical manifestations of brain tumors. Know how to conduct a diagnostic evaluation of a patient with a brain tumor. Evaluate the prognosis of a brain tumor. Know the therapeutic principles adapted to location and histopathology.

To know the distribution of the main childhood cancers and differences between developed countries and developing countries To know the epidemiology of childhood cancer in Africa To know a selected number of cancers in children associated with predisposing factors, syndromes, and genetic abnormalities

To learn about the clinical presentation of the main malignancies of soft tissues in children and in particular the rhabdomyosarcoma. To be able to diagnose the tumors of soft tissues. To know the prognosis of malignancies of soft tissue. To learn about the principles of the treatment of soft tissue tumors and in particular of rhabdomyosarcoma.

By the end of this chapter, you will be able to: Understand the impact of childhood cancer on the family, in Africa. Understand the definition of a parent support group and how to form one. Understand the typical areas of involvement of a parent support group. Understand the challenges of the parent support group and the collaboration with the heal...

By the end of this chapter, you will be able to: Know the ethical requirements of the Pediatric Oncology Research. Understand the ethical importance of respect for persons and informed consent. Understand the ethical issue of end-of-life care.

To know the required criteria for the creation of a pediatric oncology unit To know how to organize different activities of pediatric oncology unit To be aware of the importance of nongovernmental organizations (NGOs) and national and international support To Identify and prevent burnout syndrome of medical specialists

By the end of this chapter, you will be able to: Know the epidemiology and inheritance of retinoblastoma. Suspect and make the diagnosis. Evaluate and classify the extent of the disease. Propose the adapted treatment approach and follow-up.

By the end of this chapter, you will: Know the epidemiology of cancer in adolescents. Know how to confirm the diagnosis, establish the prognosis and share the news with the patient and the family. Know how to take into account psychological aspects specific to this age group.

By the end of this chapter, you will be able to: Understand the pathophysiology of chronic myeloïd leukemia (CML). Know how to confirm the diagnosis, treat, and follow up patients with CML. Make the diagnosis, treat, and follow up patients with juvenile myelomonocytic leukemia. Chronic leukemias are rare in children. Two main entities of chronic le...

By the end of this chapter, you will be able to: Describe the epidemiology of osteosarcoma. Describe the clinical presentation and differential diagnosis of the disease. Describe diagnostic work-up for the disease. Describe the approach to therapy and prognosis.

By the end of this chapter, you will be able to: Discuss the epidemiology of non-Hodgkin lymphoma (NHL) Describe the differences in the clinical presentation of each type of NHL and to provide a differential diagnosis Discuss the diagnostic work-up in NHL Describe staging, the approach to treatment, and the prognosis for each type of NHL.

By the end of this chapter, you will be able to: Describe the epidemiology of HIV-related malignancies. Describe the clinical presentation and differential diagnosis for Kaposi sarcoma (KS) and Non-Hodgkin Lymphomas (NHL). Describe the diagnostic work-up and staging for KS and NHL. Describe the approach to the treatment and the prognosis for HIV-re...

By the end of this chapter, you will be able to: Describe the hematological and oncological emergencies in children with cancer. Know how to make the diagnosis of each emergency. Describe the most appropriate emergency treatment.

By the end of this chapter, you will be able to: Know when to suspect acute leukemia in children. Know how to confirm the diagnosis of acute leukemia, and establish the prognosis. Prevent and treat initial complications. Know the principles of treatment and monitoring of acute leukemia in children.

To understand the role of nurses in the pediatric oncology ward. To understand the role of the nurse educator in the pediatric oncology nursing team. To understand the role of the nurse in providing information and care in pediatric oncology.

By the end of this chapter, you will be able to: Describe the epidemiology and etiology of Hodgkin lymphoma. Describe the clinical presentation of the disease. Establish the diagnosis of Hodgkin lymphoma (HL) and describe the histology. Describe diagnostic workup for HL. Describe approach to therapy and follow-up of therapy-related complications.

By the end of this chapter, you will be able to: Discuss the epidemiology of hepatoblastoma. Describe the clinical presentation and provide a differential diagnosis for the disease. Discuss the diagnostic work-up and staging for hepatoblastoma. Discuss the approach to treatment of hepatoblastoma and the prognosis.

By the end of this chapter you will be able to: Describe the definitions related to chemotherapy-induced nausea and vomiting. Describe the risk factors. List differential diagnoses for nausea and vomiting. Describe the emetogenic risk of the various chemotherapeutic agents. Discuss the characteristics and use of the available antiemetic agents.

By the end of this chapter, you will be able to: Understand the histopathogenesis of neuroblastoma. Know how to diagnose neuroblastoma according to clinical presentation and investigations. Evaluate the prognosis. Propose adapted treatment for the local conditions.

To understand the importance of developing a network in dealing with childhood cancer in Africa. To know the basic principles of a successful twinning program between 2 centres. By the end of this chapter, you will also be able to: Define telemedicine and its use in the treatment of children with cancer in Africa. Understand the essential elements...

By the end of this chapter, you will be able to: Understand the pathophysiology and risk factors associated with febrile neutropenia in children with cancer Perform an appropriate clinical examination looking for specific signs of underlying infection Request appropriate special investigations to identify the source of infection and to determine en...

By the end of this chapter, you will be able to: Describe the epidemiology of the disease Describe the clinical presentation and differential diagnosis of Ewing sarcoma Describe diagnostic work-up for Ewing sarcoma Describe staging, approach to therapy, and prognosis for Ewing sarcoma

By the end of this chapter, you will be able to: Understand the mechanisms and the consequences of malnutrition in a child diagnosed with cancer. Evaluate the nutritional status. Prevent malnutrition.

Learning Objectives By the end of this chapter, you will be able to: Describe the epidemiology and characteristics of cancers in the neonatal period. Describe the clinical presentation of a neonatal cancer. Establish the diagnosis and describe the diagnostic workup in a case of a neonatal cancer. Describe the approach to therapy and followup of the...

By the end of this chapter, you will be able to: Understand the embryogenesis and histogenesis of germ cell tumors. Know the clinical and radiological characteristics of germ cell tumors according to their localizations. Know how to diagnose germ cell tumors. Know the treatment approach according to tumor site, histological subtype, and extension.

By the end of this chapter, you will be able to: Describe the epidemiology of nephroblastoma. Describe the clinical presentation and differential diagnosis of the disease. Describe diagnostic work-up for nephroblastoma. Describe staging, approach to therapy, and prognosis for nephroblastoma.

By the end of this chapter, you will be able to: Understand the basics of health economics and the need for calculating costs in oncology Define direct and indirect costs contributing to the total cost of treatment of a specific childhood cancer Define cost-effective thresholds (cost-effective and very cost-effective intervention) Understand WHO-CH...

By the end of this chapter, you will be able to: Describe the cell cycle and basic concepts regarding tumor growth Name the different classes of chemotherapeutic agents Understand the mechanisms of action of the chemotherapeutic agents used most often in the treatment of childhood cancer Discuss the requirements and precautions for the safe adminis...

To know the indications for transfusion of the different blood products. To choose the most appropriate blood product and to order and prescribe the correct amount. How to ensure correct documentation of the transfusion. How to monitor transfusions, recognize the different types of transfusion reactions, and know which actions to take in case of a...

In the context of a convergent call for noncommunicable disease integration in the global agenda, recognizing cross-cutting needs and opportunities in national strategies across disease fields with shared priorities in low- and middle-income settings can enhance sustainable development approaches. We reviewed publicly available cancer control plans...

Typically, manuals of pediatric hematologyoncology are written by specialists from high-income countries, and usually target an audience with a sub-specialist level of training, oft en assisted by cutting-edge diagnostic and treatment facilities. However, approximately 80% of new cases of cancer in children appear in mid- and low-income countries....

Hairy cell leukemia is a chronic B-cell lymphoid leukemia characterized by pancytopenia, splenomegaly, myelofibrosis and the presence in peripheral blood, bone marrow and spleen of atypical lymphoid cells with a hairy aspect and a particular immunophenotypic profil. The association HCL and tuberculosis has been established, but only few cases have...

Introduction: Xeroderma pigmentosum (XP) is a rare, genetically heterogeneous, autosomal recessive disorder, more common in cases of consanguinity. The basic defect underlying the clinical manifestations is a nucleotide excision repair defect leading to the defective repair of DNA damaged by ultraviolet (UV) radiation. XP is characterized by a hig...

Volume 3, Cancer, presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The DCP3 evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packages that are cost-effective and suited to low-reso...

Investments in cancer control—prevention, detection, diagnosis, surgery, other treatment, and palliative care—are increasingly needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Cancer (the third volum...

States that childhood cancer is severely underrepresented in low- and middle-income country (LMIC) cancer registries despite the diagnosis of 175,000 children globally annually. In high-income countries (HICs) over 80 percent of children with cancer are cured, but LMIC cure rates remain significantly lower due to the need for specialized care cente...

Progress achieved in childhood cancer care in developed countries is a real success story of modern era. In tropical region, it is however challenging, and most of the children do not have access to adequate care. Lack of well-trained staff, medication, supplies, good organization of care, and parents’ support is the main characteristic of care in...

Advances in the treatment of childhood cancers have resulted in part from the development of national and international collaborative initiatives that have defined biologic determinants and generated risk-adapted therapies that maximize cure while minimizing acute and long-term effects. Currently, more than 80% of children with cancer who are treat...

Given the burden of childhood cancer and palliative care need in Africa, this paper investigated the paediatric and palliative care elements in cancer control plans. We conducted a comparative content analysis of accessible national cancer control plans in Africa, using a health systems perspective attentive to context, development, scope, and moni...

Le moment de l’annonce du diagnostic est excessivement difficile pour les familles, et il l’est aussi pour les médecins chargés de l’effectuer. Malgré cela, l’annonce d’un diagnostic de cancer doit être considérée comme un moment stratégique, pouvant clairement influencer la suite du traitement. Cette affirmation est encore plus vraie pour des unit...

In this chapter we summarize the status of Wilms tumor therapy in countries with limited resources, as well as the challenges faced in those settings. There is a complicated interrelationship of different factors that contribute to delayed diagnosis leading to advanced disease at presentation, inadequate therapy and often ‘abandonment’ of therapy....

In this chapter we summarize the status of Wilms tumor therapy in countries with limited resources, as well as the challenges faced in those settings. There is a complicated interrelationship of different factors that contribute to delayed diagnosis leading to advanced disease at presentation, inadequate therapy and often ‘abandonment’ of therapy....

Retinoblastoma is the most frequent intraocular cancer, affecting almost exclusively children. We report prospective study results assessing the national protocol for retinoblastoma treatment in Morocco. Treatment included, depending on stage and laterality, primary chemotherapy either to facilitate enucleation or to make conservative treatment pos...

Le cathéter à chambre implantable (CCI) est un dispositif sous cutané relié à une voie centrale par l'intermédiaire d'un cathéter. La ponction de ce dispositif sous cutané permet ainsi un accès direct à la voie centrale (Fig1). Une fois mise en place, le CCI peut être portée pendant des années permettant ainsi des utilisations multiples. Fig1 : Emp...

Hodgkin lymphoma (HL) in children and adolescents is one of the success stories in the quest to cure childhood cancer. However, this has not translated to all low and middle income countries (LMIC), where patients present with a long history of symptoms, in poor clinical condition with malnutrition, infections, signs of chronic illness, and advance...

L’utilisation des médecines alternatives et complémentaires (MAC) est très fréquente chez les patients cancéreux. Les objectifs de cette étude sont d’analyser la fréquence et les raisons d’utilisation des MAC chez 400 patients traités dans un service d’oncologie au Maroc. Un questionnaire anonyme a été proposé aux patients en cours de traitement. S...

Few population-based cancer registries are in place in developing countries. In order to know the burden of cancer in Moroccan population, cancer registry initiative was put in place in the Casablanca district, the biggest city of Morocco. The data collected covers 3.6 millions inhabitant and included Casablanca city and the administrative region....

Use of complementary and alternative medicine (CAM) is very frequent in cancer patients. The aims of this study were to analyze the frequency, the reasons of use of CAM in patients with a cancer treated in a Moroccan oncology department. We included in this study 400 patients. An anonymous questionnaire was proposed to patients during treatment. Ov...

Background: The event-free survival (EFS) of children with Hodgkin lymphoma (HL) exceeds 80% in high income countries (HIC), but little is known about this rate in developing countries. Procedure: A prospective national protocol for children with classical HL was implemented in Morocco to increase EFS by careful risk stratification, providing ea...

Treatment recommendations for endemic Burkitt lymphoma (BL) in settings with only minimum requirements for curative treatment (PODC setting 1) are described. The reported cure rate for endemic BL is usually <50%. Facilities within setting 1 differ. Three treatment schedules are proposed based on: (1) when accurate staging is not possible, (2) when...

Patterns of cancer incidence across the world have undergone substantial changes as a result of industrialisation and economic development. However, the economies of most countries remain at an early or intermediate stage of development-these stages are characterised by poverty, too few health-care providers, weak health systems, and poor access to...

Introduction The French-African Pediatric Oncology group (GFAOP) has contributed to a significant improvement in the prognosis of pediatric cancers in Africa through the development of therapeutic protocols adapted to local conditions. In parallel, the development of supportive care such as pain management, is now a major priority of our group. Ob...

Résumé Le rétinoblastome (RB) est une tumeur maligne embryonnaire rare et représente 1/16 000 naissances en France. Au Mali, une étude hospitalière a permis de caractériser les cas vus à Bamako dans l’unité d’oncologie pédiatrique de l’hôpital universitaire Gabriel Touré et dans l’Institut d’ophtalmologie tropicale de l’Afrique (IOTA), entre janvie...