Pediatric and Adolescent Committee (PAC)
Pediatric and Adolescent Committee (PAC) – formally known as the Pediatric Initiative Network (PIN) is one of the scientific committees of the Oncofertility Consortium (OFC). It’s an international group of providers dedicated to preserving and protecting the fertility of children and adolescents at risk for infertility due to medical conditions or treatments. The mission of the PAC is to optimize evidence-based fertility counseling and preservation for children, adolescents, and young adults around the globe.
The PAC meets biannually – a virtual meeting in the spring and the annual OFC meeting in the fall. We also have 2-4 webinars annually. To be added to the PAC listserv for up to date information and invitations to the meetings and webinars, please email: french21@msu.edu
The PAC leadership was recently restructured. We now have a chair, past-chair, and vice-chair. These leadership positions are 2 years each and are chosen from the current members of the leadership team. There are 12 members of the leadership team, including the chairs, who head three subcommittees or members-at-large.
Best Practices subcommittee: The mission of the Best Practices subcommittee is to develop strategies to optimize fertility related care for youth at risk for future fertility impairment. The committee generally adopts 1-2 new projects annually based on participants’ interest. The work of the committee includes literature review, survey design and administration and working group conference calls. Previous projects have included the development of a stratification system for risk for future infertility after gonadotoxic treatment (Meacham 2020 JAYAO) and literature review and a survey of the OFC to ascertain current practice in use of AMH to guide clinical practice.
Research subcommittee: The mission of the Research committee is to facilitate and implement collaborative multi-site research studies to advance fertility related care for at-risk youth. Recent/ongoing projects include an ovarian tissue database through Washington University and an ovarian tissue cryopreservation survey. This group is also working with the OFC initiative’s Reproductive Health Outcomes and Preservation Evaluation (HOPE) collaborative.
Education and Outreach subcommittee: The newest subcommittee, the Education and Outreach subcommittee provides pediatric fertility-related education via online webinars (~2-4/year with at least one dedicated to under-resourced regions) and development of an online library to provide resources for patients and clinicians. Previous webinars included Building a Comprehensive Pediatric Oncofertility Program, and Oncofertility in Low to Middle Income Settings.
Members-at-large: Purpose is to support co-chairs across committees, generate new ideas for PAC initiatives.
Bios –
Chair: Lillian R Meacham MD is the Director of the Fertility Preservation and Reproductive Health Program Aflac Cancer and Blood Disorders Center/Children’s Healthcare of Atlanta. She is a Pediatric Endocrinologist and Professor of Pediatrics at Emory University. Dr Meacham started the fertility preservation and reproductive health program for oncology and non-oncology patients in 2017 at Children’s Healthcare of Atlanta and has served as its Medical Director for 7 years. She also had provided endocrine and reproductive care in cancer survivorship for more than 20 years. She has serves on the expert panel for the Children’s Oncology Group Long-Term Follow-Up Guidelines and chairs or is a member of several international reproductive health harmonization groups. She was chair of the Best Practice Committee from 2018-2023 and led the work for the risk stratification guidelines and provided oversight for the AMH survey of the OFC.
Past-Chair: Leena Nahata, M.D. is an Associate Professor of Clinical Pediatrics at The Ohio State University College of Medicine, board-certified pediatric endocrinologist and Associate Division Chief of Research for Endocrinology at Nationwide Children’s Hospital, and the founding Medical Director of their Fertility and Reproductive Health Program. As an NIH-funded Principal Investigator in the Center for Biobehavioral Health at the Abigail Wexner Research Institute at Nationwide Children’s Hospital, she is conducting several clinical research studies focused on fertility counseling and decision making in pediatric populations at risk for infertility, including youth with cancer, sickle cell disease, and sexual and gender minority populations. She has served a member of the Children’s Oncology Group, PanCareLIFE, and American Society for Reproductive Medicine fertility preservation task forces; the Reproductive Health chapter lead for the World Professional Association for Transgender Health Standards of Care Version 8; and Chair of the Pediatric and Adolescent Committee of the OFC (formerly known as the PIN) from 2018-2023.
Leena.nahata@nationwidechildrens.org
Vice-Chair: Allison Close, MD MS is an Assistant Professor of Pediatrics at Michigan State University College of Human Medicine, a board-certified pediatric hematologist/oncologist and the founder and Director of the Adolescent and Young Adult Oncology and Oncofertility Program at Helen DeVos Children’s Hospital. She is the associate program director of the fellowship program and a member of the leukemia and lymphoma and survivorship team. She serves on the Children’s Oncology Group Sexual Health Task Force and on the NCTN Intergroup GnRHa Randomized Control Trial Committee. She has been a member of the PAC (formally known as the PIN) leadership team since 2020.
Allison.close@helendevoschildrens.org
Best Practices committee:
Seth Rotz, MD is an Assistant Professor of the Department of Pediatrics and is a physician in the department of pediatric hematology oncology and blood with the Cleveland Clinic. He is the director of the pediatric cancer survivorship program. He is presently completing a multi-institutional study of fertility potential in pediatric and young adult patients who received reduced intensity conditioning for hematopoietic cell transplantation (HCT) and is leading an international team to update recommendations for screening and preventative practices for long-term survivors of HCT and cellular therapy. He is also involved in the study team of two additional COG protocols and has active collaborations with the Childhood Cancer Survivorship Study (CCSS). He currently serves as the vice chair of the Pediatric Transplantation and Cellular Therapy Consortium (PTCTC) Late-Effects and Outcomes committee.
Kari Bjornard MD, MPH is an Assistant Professor of Pediatric Hematology/Oncology/Stem Cell Transplant at Riley Hospital for Children at Indiana University, where she specializes in pediatric solid tumors. She is the director of the survivorship program, and co-director of the Adolescent and Young Oncology program, as well as a member of the fertility team. Her academic interests center around reproductive and sexual health outcomes in childhood cancer survivors. She is a member of the Children’s Oncology Group Ovarian Task Force and is on the NCTN Intergroup GnRHa Randomized Control Trial Committee. She has led the AMH survey efforts through the PAC (previously the PIN).
Education and Outreach committee:
Holly Hoefgen, M.D. is Assistant Professor of Obstetrics and Gynecology within the Division of Pediatric and Adolescent Gynecology at Washington University School of Medicine in St. Louis. She is also the co-founder and co-director of the Integrated Care & Fertility Preservation Program at St. Louis Children’s Hospital. Her academic interests include ovarian tissue preservation, improving access to fertility preservation and gynecologic late effects of gonadotoxic treatments in this population.
Anthony Kayiira, MD Mmed MSc EMB is a board-certified reproductive embryologist with background in reproductive endocrinology and infertility. IVF laboratory director at the National Specialized Women and Neonatal Hospital in Kampala, Uganda. His research interests include oncofertility care among at risk children and adolescents in low resource settings. He has been a member of the PAC leadership team since 2020.
Research committee:
Veronica Gomez-Lobo MD is an obstetrician gynecologist who specializes in pediatric and adolescent gynecology. She currently serves as Senior Clinician and Director of Pediatric and Adolescent Gynecology (PAG) Program within NICHD. She started the fourth pediatric and adolescent gynecology fellowship in North America and served as President of the North American Society for Pediatric and Adolescent Gynecology in 20016-2017. She has published and lectured extensively regarding the issues in the field of pediatric gynecology, including fertility preservation, variations in sex characteristics, and transgender care. She has served on the PAC leadership committee for many years and has helped to facilitate many research projects through the PAC (previously PIN).
Veronica.Gomez-Lobo@MedStar.net
Maggie Dwiggins, M.D. is an Assistant Professor at Washington University in St. Louis. She is a board certified pediatric and adolescent gynecologist. She is an active member of the North American Society for Pediatric and Adolescent Gynecology (NASPAG). She is the principal investigator of the ovarian tissue database through the OFC. Her research interests include disparities in fertility preservation and surgical options regarding preservation.
Maggie.Dwiggins@nortonhealthcare.org
Mary Van den Heuvel-Eibrink MD, PhD is a Professor of Translational Pediatric Oncology and a pediatric oncologist at the Princess Maxima Center for Pediatric Oncology in Utrecht. She is the previous chair of the international EWOG-MDS foundation (2007-2016). The chair of the national core group member Dutch Late effects group, and co-PI of the DCOG LATER study (2007-2020). Leading the international SIOP-RTSG office trial management team (launched in >25 countries) for the UMBRELLA study, since 2018. Chair of the SIOP RTSG (2022 onwards), and co-chair of the SIOP-RTSG & COG-RTG consortium (HARMONICA). Since 2016 she has served as the medical director of the late effects clinics in the Princess Maxima Center for Pediatric Oncology.
Members at Large:
Gina Sundmacher RN, BSN is a nurse navigator and program coordinator for the Cardinals Adolescent and Young Adult Cancer Program at Mercy Health Ministries in St. Louis, MO. She has been a nurse for 10+ years and a nurse navigator for 4 years. Her interests include educating patients and their families about fertility preservation before and after cancer treatment. She is also an active member of the Patient Navigator Committee.
Tyler Ketterl MD, MS is an Assistant Professor in the Department of Pediatric Hematology & Oncology at the Seattle Children’s Hospital, University of Washington, and Fred Hutchinson Cancer Center. He holds 3 board certifications in internal medicine, pediatrics, and pediatric hematology/oncology. Dr. Ketterl serves as the Medical Director of the Adolescent Young Adult Oncology Program as well as the Medical Director of the Fertility Care and Preservation Program. Dr. Ketterl is a member of the Children’s Oncology Group Germ Cell Tumor Committee and is the stratum leader of the standard risk arm of the study. Dr. Ketterl’s academic work currently focuses on the long-term impact of cancer therapy on adolescent and young adult survivors of cancer including infertility. Dr. Ketterl is also working with others in the OFC to create a national fertility preservation database called Reproductive HOPE in partnership with the Pediatric Cancer Data Commons.
Tyler.Ketterl@seattlechildrens.org
Important links:
PAC Webinars:
2022 Pediatric Initiative Network (PIN) Webinar: Anthony Kayiira MD (youtube.com)
Recent PAC(PIN) Publications:
- Moravek MB, Appiah LC, Anazodo A, Burns KC, Gomez-Lobo V, Hoefgen HR, Jaworek Frias O, Laronda MM, Levine J, Meacham LR, Pavone ME, Quinn GP, Rowell EE, Strine AC, Woodruff TK, Nahata L. Development of a Pediatric Fertility Preservation Program: A Report From the Pediatric Initiative Network of the Oncofertility Consortium. J Adolesc Health. 2019 May;64(5):563-573. doi: 10.1016/j.jadohealth.2018.10.297. Epub 2019 Jan 14. PMID: 30655118; PMCID: PMC6478520.
- Nahata L, Woodruff TK, Quinn GP, Meacham LR, Chen D, Appiah LC, Finlayson C, Orwig KE, Laronda MM, Rowell EE, Anazodo A, Frias O, Rios JS, Whiteside S, Gomez-Lobo V, Dwiggins M, Childress KJ, Hoefgen HR, Levine JM, Jayasinghe Y, Moravek M. Ovarian tissue cryopreservation as standard of care: what does this mean for pediatric populations? J Assist Reprod Genet. 2020 Jun;37(6):1323-1326. doi: 10.1007/s10815-020-01794-7. PMID: 32390071; PMCID: PMC7311630.
- Nahata L, Gomez-Lobo V, Meacham L, Appiah L, Childress K, Hoefgen H, Dwiggins M, Whiteside S, Bjornard K, Rios J, Anazodo A, Finlayson C, Frias O, Woodruff T, Moravek M. 2019 Pediatric Initiative Network: Progress, Proceedings, and Plans. J Adolesc Young Adult Oncol. 2020 Aug;9(4):457-463. doi: 10.1089/jayao.2020.0020. Epub 2020 May 27. PMID: 32460662; PMCID: PMC7415883.
- Meacham LR, Burns K, Orwig KE, Levine J. Standardizing Risk Assessment for Treatment-Related Gonadal Insufficiency and Infertility in Childhood Adolescent and Young Adult Cancer: The Pediatric Initiative Network Risk Stratification System. J Adolesc Young Adult Oncol. 2020 Dec;9(6):662-666. doi: 10.1089/jayao.2020.0012. Epub 2020 May 26. PMID: 32456570.
- Nahata L, Anazodo A, Cherven B, Logan S, Meacham LR, Meade CD, Zarnegar-Lumley S, Quinn GP. Optimizing Health Literacy to Facilitate Reproductive Health Decision-making in Adolescent and Young Adults with Cancer. Pediatr Blood Cancer. 2020 Jul 6:e28476. doi: 10.1002/pbc.28476. Epub ahead of print. PMID: 32633029.
- Frederick NN, Lehmann V, Ahler A, Carpenter K, Cherven B, Klosky JL, Nahata L, Quinn GP. Psychosexual Functioning in Cancer Survivorship: what the pediatric oncologist needs to know. Pediatr Blood Cancer. 2023 Aug, 70(8):e28437.
- Burns K, Appiah L, Schmidt S, Franklin A, Saraf A, Anazodo A. Male Pediatric and AYA Reproductive Survivorship. Pediatr Blood Cancer. 2023 Sep: 70 Suppl 5:e28823.
- Whiteside S, Frias O, Clifford L, Schultz K, Erickson L, Caldwell M, Prebus O, Smith K. Oncofertility Patient Navigation: The Frontlines of Fertility and Reproductive Health Care in Cancer. Pediatr Blood Cancer. 2023 Sep:70 Suppl 5:e28810.
- Hoefgan H, Benoit J, Chan S, Jaysinghe Y, Lustberg M, Pohl V, Saraf A, Schmidt D, Appiah L. Female reproductive health in pediatric, adolescent, and young adult cancer survivors. Pediatr Blood Cancer. 2023 Sep:70 Suppl e28854.