Care organization in pediatric hematology/oncology in the Indian Ocean

Material and method The Department of Pediatric Hematology and Oncology at the Reunion Hospital is the only care structure to treat children and adolescents with cancer in the Indian Ocean. Here, we present the organization set up for an optimal care for all the patients of the territory according to the French national recommendations. Results Our service is the last pediatric oncology center affiliated within the Société française de lutte contre les cancers et les leucémies de l'enfant et de l'adolescent. All treatments are administered in line with national guidelines and are organized according to national standards. Each file is discussed in local and interregional multidisciplinary consultation meetings. Most treatments are carried out on Reunion Island. Clinical research is undergoing structuring and the SFCE research protocols are mostly open or in the process of being opened. However, some situations still require a transfer to metropolitan France, in national experts centers (therapeutic intensification, bone marrow transplant, irradiation). A specific feature of the service is linked to the geopolitical context with the geographical proximity of Mayotte and the Comoros, which results in illegal immigration of patients with major health and social issues (isolation of minors) requiring specific measures (sponsoring of a child, therapeutic families). Conclusion Thus, in spite of difficulties due to our geographical location, national standards of care are respected with a willingness to develop participation in regional/national networks and clinical research.