An Advocate For Omani Children

Dr. Al-Lamki

Dr. Zakia Al-Lamki, a pediatric oncologist and founding director of the hematology unit at Sultan Qaboos University Hospital in Muscat, Oman, seemed destined to enter the field of cancer medicine.

She grew up in a family of doctors, and her father encouraged her study of medicine. She was attracted early in her career to genetics because of the unique characteristics of her country’s population. Oman has only 2.4 million citizens, more than 40% of whom are closely related. If marriage between distant cousins is factored in, that figure is closer to 50%. With such a high consanguinity rate, she explains, genetic disorders are very common in her country. Single-gene blood disorders such as hemophilia, sickle cell anemia and thalassemia are prevalent among Omani children.

Dr. Al-Lamki studied general medicine in Cairo, then returned to Oman.

“When I started in 1979 there was one general hospital and no teaching university,” she recalls. “My mentor was a dynamic American-trained Omani physician who became an inspirational role model for me.” He sent her for additional training at the Institute of Child Health in London where she obtained a diploma in child health and eventually became a Fellow of the Royal College of Physicians (UK) in her speciality of child health.

By 1989, the University Hospital (a government hospital associated with the Sultan Qaboos University) had opened in Muscat and Dr. Al-Lamki became one of the first staff members of the newly established department of child health. A year later, she faced the greatest challenge of her medical career. Dr. Al-Lamki’s third child — a two-year-old daughter — was diagnosed with osteosarcoma.

“She was the youngest patient ever recorded with that disease,” Al-Lamki says. “I therefore took her to the M.D. Anderson Cancer Center in Texas for treatment. It was there that my interest in oncology was stimulated. I took up an honorary clinical attachment for six months. My daughter is now 16,” she says with a broad smile.

In 1994, her career took another step. “We had a visitor from the Baylor College of Medicine in Texas, Dr. David G. Poplack, then Head of Hematology/Oncology and now Director of the Texas Children’s Cancer Center,” Al-Lamki recalls. “He invited me to go to Texas for a fellowship in pediatric oncology.” Today Baylor’s department of pediatrics remains an important collaborative partner with doctors at SQU.

In addition to her administration of the Child Health Department and her clinical work, Dr. Al-Lamki is an academician teaching the next generation of physicians. The University graduated its first class of doctors in 1993.

Her own research focuses on “benign” hematology and leukemias, in collaboration with the Texas Children’s Center. In one project funded by His Majesty’s Research Trust Fund, doctors are studying the gene expression profiles in patients with acute lymphoblastic leukemia in both Oman and the USA. “We want to understand why some Omani children relapse early and to improve our ability to predict treatment outcome, ” says Dr. Al-Lamki.

Dr. Al-Lamki is also working with Dr. Louis Parker of the University of Newcastle in the UK to build a comprehensive children’s cancer registry. Her department is participating (as the only center outside the USA) in a multi-center National Institutes of Health trial in sickle cell avascular necrosis of the hip. Another collaboration with Karolinska Institute in Stockholm focuses on familial hemophagocytic lymphohistiocytosis (HLH), a very rare genetic disorder that is prevalent in Oman. Contributing new knowledge to the field, Dr. Al-Lamki and her colleagues have found two new mutations associated with the disease.

Using MRC (UK) trials to treat patients, and with access to updated protocols through Texas Children’s Oncology Group, Dr. Al-Lamki has seen survival rates climb during the past 15 years from less than 10% to over 70% — outcomes comparable to Western figures. “My goal now is capacity-building,” she says, “training others to carry out research and clinical activities.”

Marcia Landskroener for INCTR