Current and future commitment to hematology research

NHLBI plans for the promise of cell-based therapies

This article presents the National Heart, Lung and Blood Institute (NHLBI) perspective on the status of cell-based therapies. A summary of current and future NHLBI/National Institutes of Health (NIH) programs is given along with a history of the development of NHLBI/NIH resources to aid the advancement of cell-based therapies. A brief discussion of clinical research programs to utilize cell-based therapies is also included.

Enhancing measurement in health outcomes research supported by Agencies within the US Department of Health and Human Services

Many of the Institutes, Agencies and Centers that make up the US Department of Health and Human Services (DHHS) have recognized the need for better instrumentation in health outcomes research, and provide support, both internally and externally, for research utilizing advances in measurement theory and computer technology (informatics). In this paper, representatives from several DHHS agencies and institutes will discuss their need for better instruments within their discipline and describe current or future initiatives for exploring the benefits of these technologies. Together, the perspectives underscore the importance of developing valid, precise, and efficient measures to capture the full burden of disease and treatment on patients. Initiatives, like the Patient-Reported Outcomes Measurement Information System (PROMIS) to create health-related quality of life item banks, represent a trans-DHHS effort to develop a standard set of measures for informing decision making in clinical research, practice, and health policy.

Current challenges in the management of children with idiopathic thrombocytopenic purpura

Much progress has been made during the past several decades in the diagnosis and management of childhood idiopathic thrombocytopenic purpura (ITP). Although we do not yet know ITP's cause, opportunities for research discovery in other areas have blossomed in recent years. One major step forward has been realization that outcomes other than platelet count are important in children with ITP, most especially the severity of hemorrhage, cost and side effects of treatment, and overall quality of life. The classical definition of chronic ITP (thrombocytopenia lasting greater than 6 months) has been questioned. Debate continues whether ITP can truly be cured, especially when it lasts for years. Much excitement has recently been generated as a result of a new mechanism of ITP treatment, that is, enhancing platelet production. Yet problems continue regarding how best to conduct research involving newly diagnosed ITP patients, for a number of barriers are still to be overcome. Fortunately, however, abundant information and support for ITP patients and their families is now much more available than in years past.