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Gordon RD, Welkie RL, Quaye N, Hankins JS, Kassim AA, Thompson AA, Treadwell M, Lin CJ, Cronin RM. Burden of employment loss and absenteeism in adults and caregivers of children with sickle cell disease. Blood Adv 2024; 8:1143-1150. [PMID: 38231083 PMCID: PMC10909714 DOI: 10.1182/bloodadvances.2023012002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024] Open
Abstract
ABSTRACT Sickle cell disease (SCD) is a genetic disorder affecting 100 000 people with an estimated annual medical cost of $3 billion in the United States; however, the economic impact on patients is not well described. We aimed to examine the indirect economic burden and test the hypothesis that socioeconomic status and greater social vulnerability risks are associated with increased absenteeism and employment loss. We surveyed adults and caregivers of children with SCD at 5 US centers from 2014 to 2021. Logistic regression models were used to examine the associations of employment loss and missed days of work with demographics and social determinants. Indirect costs were estimated by multiplying the self-reported missed days of work and job loss by 2022 average wages by the state of the participating institution. Of the 244 participants, 10.3% reported employment loss in the last 5 years, and 17.5% reported missing 10 or more days of work. Adults had 3 times more employment loss compared with caregivers of children with SCD (OR, 3.18; 95% CI, 1.12-9.01) but fewer missed days of work (OR, 0.24; 95% CI, 0.11-0.0.51). Participants who did not live with a partner reported increased employment loss (OR, 4.70; 95% CI, 1.04-21.17) and more missed days of work (OR, 4.58; 95% CI, 1.04-20.15). The estimated annual indirect economic burden was $2 266 873 ($9290 per participant). Adults with SCD and caregivers of children with SCD commonly report employment loss and missed days of work as important risk factors. The high indirect economic burden suggests that future economic evaluations of SCD should include SCD-related indirect economic burden.
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Affiliation(s)
- Rachel D'Amico Gordon
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
| | - Rina Li Welkie
- Division of Hematology, The Ohio State University College of Medicine, Columbus, OH
| | - Nives Quaye
- Division of Hematology, The Ohio State University College of Medicine, Columbus, OH
| | - Jane S Hankins
- Departments of Global Pediatric Medicine and Hematology, St Jude Children's Research Hospital, Memphis, TN
| | - Adetola A Kassim
- Department of Hematology/Oncology, Vanderbilt University Medical Center, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN
| | - Alexis A Thompson
- Department of Pediatrics, Department of Medicine, Northwestern University, Evanston, IL
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Marsha Treadwell
- Department of Pediatrics, Division of Hematology, University of California San Francisco, San Francisco, CA
| | | | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH
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Kwiatkowski JL, Thompson AA, Tricta F, Temin NT, Rozova A, Fradette C, Badawy SM. Real-world evidence: Long-term safety of deferiprone in a large cohort of patients with sickle cell disease enrolled in a registry for up to 10 years. Am J Hematol 2024. [PMID: 38429922 DOI: 10.1002/ajh.27276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
Patients with sickle cell disease (SCD) and other anemias who receive blood transfusions are at risk of organ damage due to transfusional iron overload. Deferiprone is an iron chelator with a well-established safety and efficacy profile that is indicated for the treatment of transfusional iron overload. Here, we report safety data from the large-scale, retrospective Ferriprox® Total Care Registry, which involved all patients with SCD taking deferiprone following the 2011 approval of deferiprone in the United States through August 2020. A total of 634 patients who had initiated deferiprone treatment were included. The mean (SD) duration of deferiprone exposure in the registry was 1.6 (1.6) years (range 0 to 9.7 years). In the overall patient population (N = 634), 64.7% (n = 410) of patients reported a total of 1885 adverse events (AEs). In subgroup analyses, 54.6% (n = 71) of pediatric patients and 67.3% (n = 339) of adult patients reported AEs. The most common AEs reported in patients receiving deferiprone were sickle cell crisis (22.7%), nausea (12.1%), vomiting (8.7%), abdominal discomfort (5.4%), and fatigue (5.4%). Neutropenia was reported in four (0.6%) patients and severe neutropenia/agranulocytosis (defined as absolute neutrophil count <0.5 × 109 /L) was reported in two (0.3%) patients. Of patients with evaluable data, all cases of neutropenia and severe neutropenia/agranulocytosis resolved with deferiprone discontinuation. Results from the nearly 10 years of real-world data collected in the Ferriprox® Total Care Registry demonstrate that deferiprone is safe and well tolerated in patients with SCD or other anemias who have transfusional iron overload.
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Affiliation(s)
- Janet L Kwiatkowski
- Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexis A Thompson
- Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Anna Rozova
- Chiesi Canada Corporation, Toronto, Ontario, Canada
| | | | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Ntoulia A, Darge K, Thompson AA, Back SJ. Safety of Ultrasound Contrast Agents in Pediatric Patients With Sickle Cell Disease and Trait. J Ultrasound Med 2024; 43:189-200. [PMID: 37929626 DOI: 10.1002/jum.16341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 11/07/2023]
Abstract
Ultrasound contrast agent (UCA) use is increasing. Recent isolated reports observed a rise in pain-related adverse events with the intravenous administration of the UCA Definity in adults with sickle cell disease. To date, no studies have investigated the incidence of similar adverse events with UCA Lumason or Optison. We describe our experience regarding the safety of Lumason and Optison in children with sickle cell disease and trait who underwent contrast-enhanced ultrasound exams in our department with intravenous, intravesical, and other intracavitary routes. No pain-related or other adverse events were observed in this pediatric population with any route of UCA administration.
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Affiliation(s)
- Aikaterini Ntoulia
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexis A Thompson
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Coleman KD, McKinley K, Ellison AM, Alpern ER, Hariharan S, Topoz I, Wurtz M, Nielsen B, Cook LJ, Morris CR, Brandow AM, Campbell AD, Liem RI, Nuss R, Quinn CT, Thompson AA, Villella A, King AA, Baumann A, Frankenberger W, Brousseau DC. Return visit rates after an emergency department discharge for children with sickle cell pain episodes. Pediatr Blood Cancer 2023; 70:e30553. [PMID: 37458568 DOI: 10.1002/pbc.30553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND High return visit rates after hospitalization for people with sickle cell disease (SCD) have been previously established. Due to a lack of multicenter emergency department (ED) return visit rate data, the return visit rate following ED discharge for pediatric SCD pain treatment is currently unknown. PROCEDURE A seven-site retrospective cohort study of discharged ED visits for pain by children with SCD was conducted using the Pediatric Emergency Care Applied Research Network Registry. Visits between January 2017 and November 2021 were identified using previously validated criteria. The primary outcome was the 14-day return visit rate, with 3- and 7-day rates also calculated. Modified Poisson regression was used to analyze associations for age, sex, initial hospitalization rate, and a visit during the COVID-19 pandemic with return visit rates. RESULTS Of 2548 eligible ED visits, approximately 52% were patients less than 12 years old, 50% were female, and over 95% were non-Hispanic Black. The overall 14-day return visit rate was 29.1% (95% confidence interval [CI]: 27.4%-30.9%; site range 22.7%-31.7%); the 7- and 3-day return visit rates were 23.0% (95% CI: 21.3%-24.6%) and 16.7% (95% CI: 15.3%-18.2%), respectively. Younger children had slightly lower 14-day return visit rates (27.3% vs. 31.1%); there were no associations for site hospitalization rate, sex, and a visit occurring during the pandemic with 14-day returns. CONCLUSION Nearly 30% of ED discharged visits after SCD pain treatment had a return visit within 14 days. Increased efforts are needed to identify causes for high ED return visit rates and ensure optimal ED and post-ED care.
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Affiliation(s)
- Keli D Coleman
- Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin and the Children's Research Institute of Children's Wisconsin, Milwaukee, Wisconsin, USA
| | - Kenneth McKinley
- Children's National Medical Center, Washington, District of Columbia, USA
| | - Angela M Ellison
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth R Alpern
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Selena Hariharan
- University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Irina Topoz
- Department of Pediatrics, Section of Emergency Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Morgan Wurtz
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | | | - Claudia R Morris
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Amanda M Brandow
- Department of Pediatrics, Section of Hematology/Oncology/Bone Marrow Transplantation, Medical College of Wisconsin and Children's Research Institute of Children's Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew D Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
| | - Robert I Liem
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Rachelle Nuss
- Center for Cancer and Blood Disorders, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Charles T Quinn
- Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Alexis A Thompson
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | - Allison A King
- Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ana Baumann
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - David C Brousseau
- Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, Delaware, USA
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5
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Piel FB, Rees DC, DeBaun MR, Nnodu O, Ranque B, Thompson AA, Ware RE, Abboud MR, Abraham A, Ambrose EE, Andemariam B, Colah R, Colombatti R, Conran N, Costa FF, Cronin RM, de Montalembert M, Elion J, Esrick E, Greenway AL, Idris IM, Issom DZ, Jain D, Jordan LC, Kaplan ZS, King AA, Lloyd-Puryear M, Oppong SA, Sharma A, Sung L, Tshilolo L, Wilkie DJ, Ohene-Frempong K. Defining global strategies to improve outcomes in sickle cell disease: a Lancet Haematology Commission. Lancet Haematol 2023; 10:e633-e686. [PMID: 37451304 DOI: 10.1016/s2352-3026(23)00096-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Frédéric B Piel
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
| | - David C Rees
- Department of Paediatric Haematology, King's College London, King's College Hospital, London, UK
| | - Michael R DeBaun
- Department of Pediatrics, Vanderbilt-Meharry Center of Excellence for Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Obiageli Nnodu
- Department of Haematology and Blood Transfusion, College of Health Sciences and Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Brigitte Ranque
- Department of Internal Medicine, Georges Pompidou European Hospital, Assistance Publique-Hopitaux de Paris Centre, University of Paris Cité, Paris, France
| | - Alexis A Thompson
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Russell E Ware
- Division of Hematology and Global Health Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Miguel R Abboud
- Department of Pediatrics and Adolescent Medicine, and Sickle Cell Program, American University of Beirut, Beirut, Lebanon
| | - Allistair Abraham
- Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, DC, USA
| | - Emmanuela E Ambrose
- Department of Paediatrics and Child Health, Bugando Medical Centre, Mwanza, Tanzania
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, Connecticut, USA
| | - Roshan Colah
- Department of Haematogenetics, Indian Council of Medical Research National Institute of Immunohaematology, Mumbai, India
| | - Raffaella Colombatti
- Pediatric Oncology Hematology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Nicola Conran
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Fernando F Costa
- Department of Clinical Medicine, School of Medical Sciences, Center of Hematology and Hemotherapy (Hemocentro), University of Campinas-UNICAMP, Campinas, Brazil
| | - Robert M Cronin
- Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Mariane de Montalembert
- Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hopitaux de Paris Centre, Paris, France
| | - Jacques Elion
- Paris Cité University and University of the Antilles, Inserm, BIGR, Paris, France
| | - Erica Esrick
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Anthea L Greenway
- Department Clinical Haematology, Royal Children's Hospital, Parkville and Department Haematology, Monash Health, Clayton, VIC, Australia
| | - Ibrahim M Idris
- Department of Hematology, Aminu Kano Teaching Hospital/Bayero University Kano, Kano, Nigeria
| | - David-Zacharie Issom
- Department of Business Information Systems, School of Management, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | - Dipty Jain
- Department of Paediatrics, Government Medical College, Nagpur, India
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zane S Kaplan
- Department of Clinical Haematology, Monash Health and Monash University, Melbourne, VIC, Australia
| | - Allison A King
- Departments of Pediatrics and Internal Medicine, Divisions of Pediatric Hematology and Oncology and Hematology, Washington University School of Medicine, St Louis, MO, USA
| | - Michele Lloyd-Puryear
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Samuel A Oppong
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Leon Tshilolo
- Institute of Biomedical Research/CEFA Monkole Hospital Centre and Official University of Mbuji-Mayi, Mbuji-Mayi, Democratic Republic of the Congo
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Kwaku Ohene-Frempong
- Division of Hematology, Children's Hospital of Philadelphia, Pennsylvania, USA; Sickle Cell Foundation of Ghana, Kumasi, Ghana
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Sidonio RF, Thompson AA, Peyvandi F, Stasyshyn O, Yeoh SL, Sosothikul D, Antmen AB, Maggiore C, Engl W, Ewenstein B, Tangada S. Immunogenicity, safety, and efficacy of rurioctocog alfa pegol in previously untreated patients with severe hemophilia A: interim results from a phase 3, prospective, multicenter, open-label study. Expert Rev Hematol 2023; 16:793-801. [PMID: 37646148 DOI: 10.1080/17474086.2023.2247160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/18/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023]
Abstract
AIM To determine the immunogenicity, safety, and efficacy of rurioctocog alfa pegol in previously untreated patients (PUPs) with severe hemophilia A (HA). METHODS This prospective, phase 3 study (NCT02615691) was conducted in PUPs, or patients with ≤2 exposure days (EDs) prior to screening, aged <6 years with severe HA. The primary endpoint was incidence of factor VIII (FVIII) inhibitor development. This protocol-specified interim analysis was conducted after 50 patients had completed ≥50 EDs without developing FVIII inhibitors or had developed a confirmed inhibitor at any time. RESULTS Of the enrolled patients, 59/80 (73.8%) received ≥1 dose of rurioctocog alfa pegol; 54 received prophylaxis, and 35 on-demand treatment. Incidence of inhibitor development was 0.19 (10/52). Total annualized bleeding rate (95% CIs) was 3.2 (2.0-5.0) for patients receiving prophylaxis and 3.2 (1.6-6.3) for on-demand treatment. Hemostatic efficacy of most bleedings was rated as 'excellent' or 'good' after 24 hours (122/131 [93.1%]) and at resolution (161/170 [94.7%]). Five patients received ≥1 dose of rurioctocog alfa pegol for immune tolerance induction (ITI) and 1 patient was defined as having ITI success. Thirteen patients experienced 14 treatment-related adverse events, including 10 cases of FVIII inhibitor development. CONCLUSION This is the first prospective study of rurioctocog alfa pegol for the treatment of PUPs with severe HA. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02615691).
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Affiliation(s)
- Robert F Sidonio
- Aflac Cancer and Blood Disorders Center, Emory University, Atlanta, GA, USA
| | - Alexis A Thompson
- Division of Hematology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre and Fondazione Luigi Villa, Milan, Italy
- Department of Pathophysiology and Transplantation, Universitàdegli Studi di Milano, Milan, Italy
| | | | - Seoh Leng Yeoh
- Department of Pediatrics, Hospital Pulau Pinang, George Town, Malaysia
| | - Darintr Sosothikul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Integrative and Innovative Hematology/Oncology Research Unit, Faculty of Medicine, Chulalonkorn University, Bangkok, Thailand
| | - Ali Bulent Antmen
- Department of Pediatric Hematology and Oncology, Acibadem Adana Hospital, Adana, Turkey
| | | | - Werner Engl
- Pharmacometrics & Biostatistics, Baxalta Innovations GmbH, A Takeda Company, Vienna, Austria
| | - Bruce Ewenstein
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
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Cappellini MD, Taher AT, Piga A, Shah F, Voskaridou E, Viprakasit V, Porter JB, Hermine O, Neufeld EJ, Thompson AA, Tang D, Yucel A, Lord-Bessen J, Yu P, Guo S, Shetty JK, Miteva D, Zinger T, Backstrom JT, Oliva EN. Health-related quality of life in patients with β-thalassemia: Data from the phase 3 BELIEVE trial of luspatercept. Eur J Haematol 2023. [PMID: 37095595 DOI: 10.1111/ejh.13975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Patients with transfusion-dependent (TD) β-thalassemia require long-term red blood cell transfusions (RBCTs) that lead to iron overload, impacting health-related quality of life (HRQoL). METHODS The impact of luspatercept, a first-in-class erythroid maturation agent, versus placebo on HRQoL of patients with TD β-thalassemia was evaluated in the phase 3 BELIEVE trial. HRQoL was assessed at baseline and every 12 weeks using the 36-item Short Form Health Survey (SF-36) and Transfusion-dependent Quality of Life questionnaire (TranQol). Mean change in HRQoL was evaluated from baseline to week 48 for patients receiving luspatercept + best supportive care (BSC) and placebo + BSC and between luspatercept responders and non-responders. RESULTS Through week 48, for both groups, mean scores on SF-36 and TranQol domains were stable over time and did not have a clinically meaningful change. At week 48, more patients who achieved clinical response (≥50% reduction in RBCT burden over 24 weeks) in the luspatercept + BSC group had improvement in SF-36 Physical Function compared with placebo + BSC (27.1% vs. 11.5%; p = .019). CONCLUSIONS Luspatercept + BSC reduced transfusion burden while maintaining patients' HRQoL. HRQoL domain improvements from baseline through 48 weeks were also enhanced for luspatercept responders.
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Affiliation(s)
| | - Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antonio Piga
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Farrukh Shah
- Department of Haematology, Whittington Health NHS Trust, London, UK
| | - Ersi Voskaridou
- Centre of Excellence in Rare Haematological Diseases-Haemoglobinopathies, Laiko General Hospital, Athens, Greece
| | | | - John B Porter
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Olivier Hermine
- Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Imagine Institute, INSERM Unité 1163, University of Paris, Paris, France
| | - Ellis J Neufeld
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Derek Tang
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Aylin Yucel
- Bristol Myers Squibb, Princeton, New Jersey, USA
| | | | - Peiwen Yu
- Evidera, Waltham, Massachusetts, USA
| | - Shien Guo
- Evidera, Waltham, Massachusetts, USA
| | | | | | | | - Jay T Backstrom
- Acceleron Pharma Inc., a Subsidiary of Merck & Co., Inc., Rahway, New Jersey, USA
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8
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Eapen M, Brazauskas R, Williams DA, Walters MC, St Martin A, Jacobs BL, Antin JH, Bona K, Chaudhury S, Coleman-Cowger VH, DiFronzo NL, Esrick EB, Field JJ, Fitzhugh CD, Kanter J, Kapoor N, Kohn DB, Krishnamurti L, London WB, Pulsipher MA, Talib S, Thompson AA, Waller EK, Wun T, Horowitz MM. Secondary Neoplasms After Hematopoietic Cell Transplant for Sickle Cell Disease. J Clin Oncol 2023; 41:2227-2237. [PMID: 36623245 PMCID: PMC10448940 DOI: 10.1200/jco.22.01203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 01/11/2023] Open
Abstract
PURPOSE To report the incidence and risk factors for secondary neoplasm after transplantation for sickle cell disease. METHODS Included are 1,096 transplants for sickle cell disease between 1991 and 2016. There were 22 secondary neoplasms. Types included leukemia/myelodysplastic syndrome (MDS; n = 15) and solid tumor (n = 7). Fine-Gray regression models examined for risk factors for leukemia/MDS and any secondary neoplasm. RESULTS The 10-year incidence of leukemia/MDS was 1.7% (95% CI, 0.90 to 2.9) and of any secondary neoplasm was 2.4% (95% CI, 1.4 to 3.8). After adjusting for other risk factors, risks for leukemia/MDS (hazard ratio, 22.69; 95% CI, 4.34 to 118.66; P = .0002) or any secondary neoplasm (hazard ratio, 7.78; 95% CI, 2.20 to 27.53; P = .0015) were higher with low-intensity (nonmyeloablative) regimens compared with more intense regimens. All low-intensity regimens included total-body irradiation (TBI 300 or 400 cGy with alemtuzumab, TBI 300 or 400 cGy with cyclophosphamide, TBI 200, 300, or 400 cGy with cyclophosphamide and fludarabine, or TBI 200 cGy with fludarabine). None of the patients receiving myeloablative and only 23% of those receiving reduced-intensity regimens received TBI. CONCLUSION Low-intensity regimens rely on tolerance induction and establishment of mixed-donor chimerism. Persistence of host cells exposed to low-dose radiation triggering myeloid malignancy is one plausible etiology. Pre-existing myeloid mutations and prior inflammation may also contribute but could not be studied using our data source. Choosing conditioning regimens likely to result in full-donor chimerism may in part mitigate the higher risk for leukemia/MDS.
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Affiliation(s)
- Mary Eapen
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Ruta Brazauskas
- Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
| | - David A. Williams
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Mark C. Walters
- University of California San Francisco Benioff Children's Hospital, Oakland, CA
| | - Andrew St Martin
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Benjamin L. Jacobs
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Joseph H. Antin
- Dana-Farber Cancer Center, Harvard Medical School, Boston, MA
| | - Kira Bona
- Dana-Farber Cancer Center, Harvard Medical School, Boston, MA
| | | | | | | | - Erica B. Esrick
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Joshua J. Field
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Courtney D. Fitzhugh
- Cellular and Molecular Therapeutics Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Julie Kanter
- University of Alabama Birmingham, Birmingham, AL
| | - Neena Kapoor
- Children's Hospital of Los Angeles, Los Angeles, CA
| | - Donald B. Kohn
- David Geffen School of Medicine, University of California, Los Angeles, CA
| | | | - Wendy B. London
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | | | - Sohel Talib
- California Institute for Regenerative Medicine, San Francisco, CA
| | | | | | - Ted Wun
- University of California Davis School of Medicine, Davis, CA
| | - Mary M. Horowitz
- Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
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Walters MC, Thompson AA, Kwiatkowski JL, Parikh S, Mapara MY, Rifkin-Zenenberg S, Aygun B, Kasow KA, Miller A, Zhang L, Chawla A, Macari ER, Pierciey FJ, Tisdale JF, Kanter J. Lovo-cel (bb1111) Gene Therapy for Sickle Cell Disease (SCD): Updated Group C Clinical Results and Investigations into Two Cases of Anemia from the Phase 1/2 HGB-206 Study. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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10
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Williford DN, McTate EA, Hood AM, Reader SK, Hildenbrand AK, Smith-Whitley K, Creary SE, Thompson AA, Hackworth R, Raphael JL, Crosby LE. Psychologists as leaders in equitable science: Applications of antiracism and community participatory strategies in a pediatric behavioral medicine clinical trial. Am Psychol 2023; 78:107-118. [PMID: 37011163 PMCID: PMC10474572 DOI: 10.1037/amp0001086] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Psychologists have an ethical responsibility to advance health equity and can play a significant role in improving health care experiences for families racialized as Black, including those with sickle cell disease (SCD), a group of genetic blood disorders primarily affecting communities of color. Parents of children with SCD report experiences of stigma and discrimination due to racism in the health care system. The current commentary describes the application of antiracism and participatory strategies to the research design, implementation, and dissemination of a behavioral medicine clinical trial (Engage-HU; NCT03442114) of shared decision-making (SDM) for pediatric patients with SCD, including (a) the development of a research question to promote justice for racialized groups; (b) a focus on "redressing imbalances" through SDM and a multidisciplinary, inclusive research team led by a Black psychologist; (c) community participatory approaches through the integration of stakeholder feedback across the study; and (d) centering context by attending to structural realities in response to the COVID-19 and racism pandemics. With attention to the fact that most primary caregivers of children with SCD are Black women, an intersectionality lens was applied. Implications and considerations for psychologists working to advance health equity in medical settings are also discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Desireé N. Williford
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Emily A. McTate
- Department of Psychiatry and Psychology, Department of Pediatrics, Mayo Clinic, Rochester, MN USA
| | - Anna M. Hood
- Division of Psychology and Mental Health, University of Manchester, Manchester, England GBR
| | - Steven K. Reader
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE USA
| | - Aimee K. Hildenbrand
- Center for Healthcare Delivery Science, Nemours Children’s Health System, Wilmington, DE USA
| | - Kim Smith-Whitley
- Division of Hematology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Susan E. Creary
- Division of Hematology & Oncology, Nationwide Children’s Hospital, Columbus, OH USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH USA
| | - Alexis A. Thompson
- Division of Hematology, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Rogelle Hackworth
- Cincinnati Children’s Hospital Medical Center Partner, Cincinnati, OH USA
| | - Jean L. Raphael
- Department of Pediatrics, Section of Hematology-Oncology and Section of Academic General Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Lori E. Crosby
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
- College of Medicine, University of Cincinnati, Cincinnati, OH USA
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11
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Olson TS, Walters MC, Kwiatkowski JL, Porter JB, Schneiderman J, Hongeng S, Kulozik AE, Cavazzana M, Sauer MG, Thrasher AJ, Thuret I, Lal A, Rasko JE, Yannaki E, Ali S, Colvin RA, Locatelli F, Thompson AA. Long-term Outcomes of 63 Patients with Transfusion-Dependent β-Thalassemia (TDT) Followed-up to 7 Years after Treatment with betibeglogene autotemcel (beti-cel) Gene Therapy (GT) and Factors Impacting Neutrophil and Platelet Engraftment. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Kanter J, Thompson AA, Pierciey FJ, Hsieh M, Uchida N, Leboulch P, Schmidt M, Bonner M, Guo R, Miller A, Ribeil JA, Davidson D, Asmal M, Walters MC, Tisdale JF. Lovo-cel gene therapy for sickle cell disease: Treatment process evolution and outcomes in the initial groups of the HGB-206 study. Am J Hematol 2023; 98:11-22. [PMID: 36161320 PMCID: PMC10092845 DOI: 10.1002/ajh.26741] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 02/04/2023]
Abstract
lovo-cel (bb1111; LentiGlobin for sickle cell disease [SCD]) gene therapy (GT) comprises autologous transplantation of hematopoietic stem and progenitor cells transduced with the BB305 lentiviral vector encoding a modified β-globin gene (βA-T87Q ) to produce anti-sickling hemoglobin (HbAT87Q ). The efficacy and safety of lovo-cel for SCD are being evaluated in the ongoing phase 1/2 HGB-206 study (ClinicalTrials.gov: NCT02140554). The treatment process evolved over time, using learnings from outcomes in the initial patients to optimize lovo-cel's benefit-risk profile. Following modest expression of HbAT87Q in the initial patients (Group A, n = 7), alterations were made to the treatment process for patients subsequently enrolled in Group B (n = 2, patients B1 and B2), including improvements to cell collection and lovo-cel manufacturing. After 6 months, median Group A peripheral blood vector copy number (≥0.08 c/dg) and HbAT87Q levels (≥0.46 g/dL) were inadequate for substantial clinical effect but stable and sustained over 5.5 years; both markedly improved in Group B (patient B1: ≥0.53 c/dg and ≥2.69 g/dL; patient B2: ≥2.14 c/dg and ≥6.40 g/dL, respectively) and generated improved biologic and clinical efficacy in Group B, including higher total hemoglobin and decreased hemolysis. The safety of the lovo-cel for SCD treatment regimen largely reflected the known side effects of HSPC collection, busulfan conditioning regimen, and underlying SCD; acute myeloid leukemia was observed in two patients in Group A and deemed unlikely related to insertional oncogenesis. Changes made during development of the lovo-cel treatment process were associated with improved outcomes and provide lessons for future SCD GT studies.
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Affiliation(s)
- Julie Kanter
- Department of Hematology-Oncology, University of Alabama Birmingham, Birmingham, Alabama, USA
| | - Alexis A Thompson
- Division of Hematology, Oncology, and Stem Cell Transplantation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | | | - Matthew Hsieh
- Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute/National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Naoya Uchida
- Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute/National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Philippe Leboulch
- Commissariat à l'énergie atomique et aux énergies alternatives, Institute of Emerging Disease and Innovative Therapies, Fontenay-aux-Roses, France.,Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | | | - Ruiting Guo
- bluebird bio, Inc., Somerville, Massachusetts, USA
| | - Alex Miller
- bluebird bio, Inc., Somerville, Massachusetts, USA
| | | | | | | | - Mark C Walters
- Division of Hematology, University of California San Francisco Benioff Children's Hospital, Oakland, California, USA
| | - John F Tisdale
- Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute/National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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13
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Pollard JA, Furutani E, Liu S, Esrick E, Cohen LE, Bledsoe J, Liu CW, Lu K, de Haro MJR, Surrallés J, Malsch M, Kuniholm A, Galvin A, Armant M, Kim AS, Ballotti K, Moreau L, Zhou Y, Babushok D, Boulad F, Carroll C, Hartung H, Hont A, Nakano T, Olson T, Sze SG, Thompson AA, Wlodarski MW, Gu X, Libermann TA, D’Andrea A, Grompe M, Weller E, Shimamura A. Metformin for treatment of cytopenias in children and young adults with Fanconi anemia. Blood Adv 2022; 6:3803-3811. [PMID: 35500223 PMCID: PMC9631552 DOI: 10.1182/bloodadvances.2021006490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/15/2022] [Indexed: 11/26/2022] Open
Abstract
Fanconi anemia (FA), a genetic DNA repair disorder characterized by marrow failure and cancer susceptibility. In FA mice, metformin improves blood counts and delays tumor development. We conducted a single institution study of metformin in nondiabetic patients with FA to determine feasibility and tolerability of metformin treatment and to assess for improvement in blood counts. Fourteen of 15 patients with at least 1 cytopenia (hemoglobin < 10 g/dL; platelet count < 100 000 cells/µL; or an absolute neutrophil count < 1000 cells/µL) were eligible to receive metformin for 6 months. Median patient age was 9.4 years (range 6.0-26.5 ). Thirteen of 14 subjects (93%) tolerated maximal dosing for age; 1 subject had dose reduction for grade 2 gastrointestinal symptoms. No subjects developed hypoglycemia or metabolic acidosis. No subjects had dose interruptions caused by toxicity, and no grade 3 or higher adverse events attributed to metformin were observed. Hematologic response based on modified Myelodysplastic Syndrome International Working Group criteria was observed in 4 of 13 evaluable patients (30.8%; 90% confidence interval, 11.3-57.3). Median time to response was 84.5 days (range 71-128 days). Responses were noted in neutrophils (n = 3), platelets (n = 1), and red blood cells (n = 1). No subjects met criteria for disease progression or relapse during treatment. Correlative studies explored potential mechanisms of metformin activity in FA. Plasma proteomics showed reduction in inflammatory pathways with metformin. Metformin is safe and tolerable in nondiabetic patients with FA and may provide therapeutic benefit. This trial was registered at as #NCT03398824.
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Affiliation(s)
- Jessica A. Pollard
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Elissa Furutani
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Shanshan Liu
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Harvard Medical School, Boston, MA
| | - Erica Esrick
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Laurie E. Cohen
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Department of Endocrinology, and
| | - Jacob Bledsoe
- Department of Pathology, Boston Children’s Hospital, Boston, MA
| | - Chih-Wei Liu
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Kun Lu
- Department of Environmental Sciences and Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Maria Jose Ramirez de Haro
- Joint Research Unit UAB-Sant Pau Biomedical Research Institute,Institut de Recerca Hospital de la Santa Creu i Sant Pau-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona Spain
- Center for Biomedical Network Research on Rare Diseases, Madrid, Spain
| | - Jordi Surrallés
- Joint Research Unit UAB-Sant Pau Biomedical Research Institute,Institut de Recerca Hospital de la Santa Creu i Sant Pau-IIB Sant Pau, Universitat Autònoma de Barcelona, Barcelona Spain
- Center for Biomedical Network Research on Rare Diseases, Madrid, Spain
| | - Maggie Malsch
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Clinical Research Operations Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Ashley Kuniholm
- Clinical Research Operations Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Ashley Galvin
- Clinical Research Operations Center, Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA
| | - Myriam Armant
- Trans Laboratory, Boston Children’s Hospital, Boston, MA
| | - Annette S. Kim
- Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Kaitlyn Ballotti
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
| | - Lisa Moreau
- Comprehensive Center for Fanconi Anemia, Dana-Farber Cancer Institute, Boston, MA
| | - Yu Zhou
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
| | - Daria Babushok
- Division of Hematology-Oncology, University of Pennsylvania, Philadelphia, PA
| | - Farid Boulad
- Pediatric Hematology-Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Clint Carroll
- Pediatric Hematology-Oncology, The Children's Hospital at TriStar Centennial, Nashville, TN
| | - Helge Hartung
- Pediatric Hematology-Oncology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Amy Hont
- Pediatric Hematology-Oncology, Children’s National Medical Center, Washington, DC
| | - Taizo Nakano
- Pediatric Hematology-Oncology, Children’s Hospital Colorado, Denver, CO
| | - Tim Olson
- Pediatric Hematology-Oncology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Sei-Gyung Sze
- Department of Pediatrics, Maine Medical Center, Tufts University School of Medicine, Portland, ME
| | - Alexis A. Thompson
- Pediatric Hematology-Oncology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Marcin W. Wlodarski
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Xuesong Gu
- Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Towia A. Libermann
- Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Alan D’Andrea
- Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Markus Grompe
- Oregon Stem Cell Center, Department of Pediatrics, Papé Family Institute, Oregon Health and Science University, Portland, OR; and
| | - Edie Weller
- Department of Pediatrics, Harvard Medical School, Boston, MA
- Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Harvard Medical School, Boston, MA
| | - Akiko Shimamura
- Pediatric Hematology-Oncology, Boston Children’s Hospital, Boston, MA
- Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
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14
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O'Connor FG, Franzos MA, Nye NS, Nelson DA, Shell D, Voss JD, Anderson SA, Coleman NJ, Thompson AA, Harmon KG, Deuster PA. Response to Letter to the Editor. Curr Sports Med Rep 2022; 21:164-165. [PMID: 35522442 DOI: 10.1249/jsr.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Aygun B, Bello A, Thompson AA, Davis L, Sun Y, Luo H, Cui S, Chui DHK. Clinical phenotypes of three children with sickle cell disease caused by HbS/Sicilian (δβ) 0 -thalassemia deletion. Am J Hematol 2022; 97:E156-E158. [PMID: 35045200 DOI: 10.1002/ajh.26470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Banu Aygun
- Cohen Children's Medical Center of New York New Hyde Park New York USA
| | | | - Alexis A. Thompson
- The Ann and Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine Chicago Illinois USA
| | - Lance Davis
- Boston Medical Center Boston University School of Medicine Boston Massachusetts USA
| | - Yanan Sun
- Boston Medical Center Boston University School of Medicine Boston Massachusetts USA
| | - Hong‐yuan Luo
- Boston Medical Center Boston University School of Medicine Boston Massachusetts USA
| | - Shuaiying Cui
- Boston Medical Center Boston University School of Medicine Boston Massachusetts USA
| | - David H. K. Chui
- Boston Medical Center Boston University School of Medicine Boston Massachusetts USA
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16
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Thompson AA, Wood JL, Palombo EA, Green WK, Wade SA. From laboratory tests to field trials: a review of cathodic protection and microbially influenced corrosion. Biofouling 2022; 38:298-320. [PMID: 35361009 DOI: 10.1080/08927014.2022.2058395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 06/14/2023]
Abstract
Cathodic protection (CP), an electrochemical method for managing corrosion, is widely used in many industries in both marine and buried environments. However, literature surrounding cathodic protection and its ability to prevent microbially influenced corrosion (MIC) is mixed. This review describes the mechanics of CP, how CP may influence MIC, and collates and summarises tests on CP and MIC reported in literature. The aim of the review is to identify any trends and knowledge gaps requiring further study. While the outcomes of CP testing are generally mixed, some trends can be seen and, overall, MIC is detrimental to the protective effects of CP, with CP being less effective when used according to current international standards. Tests conducted in the field or with mix communities of microbes showed that CP could be effective at preventing MIC, while tests with sulfate-reducing bacteria generally proved CP to be highly ineffective. It was commonly seen that the effectiveness of CP can be improved by increasing polarization, to potentials as low as -1000 mV (Ag/AgCl). However, a balance does need to be met via careful monitoring to ensure negative side effects of over protection do not become a major problem.
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Affiliation(s)
- A A Thompson
- Swinburne University of Technology, Melbourne, VIC, Australia
| | - J L Wood
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, VIC, Australia
| | - E A Palombo
- Swinburne University of Technology, Melbourne, VIC, Australia
| | - W K Green
- Vinsi Partners Pty Ltd, Sydney, NSW, Australia
| | - S A Wade
- Swinburne University of Technology, Melbourne, VIC, Australia
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17
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Walters MC, Thompson AA, Mapara MY, Kwiatkowski JL, Krishnamurti L, Aygun B, Kasow KA, Rifkin-Zenenberg S, Schmidt M, Pierciey Jr. FJ, Whitney D, Rogers C, Nnamani M, Foos M, Miller A, Zhang X, Lynch J, Kanter J, Tisdale JF, Bonner M. Polyclonality Strongly Correlates with Biologic Outcomes and Is Significantly Increased Following Improvements to the Phase 1/2 HGB-206 Protocol and Manufacturing of Lentiglobin for Sickle Cell Disease (SCD; bb1111) Gene Therapy (GT). Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00178-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Walters MC, Tisdale JF, Mapara MY, Krishnamurti L, Kwiatkowski JL, Aygun B, Kasow KA, Rifkin-Zenenberg S, Jaroscak J, Garbinsky D, Chirila C, Gallagher M, Zhang X, Ho PR, Thompson AA, Kanter J. Sustained Improvements in Patient Reported Quality of Life up to 24 Months Post-Treatment with LentiGlobin for Sickle Cell Disease (bb1111) Gene Therapy. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00441-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Schneiderman J, Locatelli F, Thompson AA, Kwiatkowski JL, Porter JB, Hongeng S, Kulozik AE, Cavazzana M, Sauer MG, Thrasher AJ, Thuret I, Lal A, Rasko JE, Yannaki E, Schmidt M, Du L, Colvin RA, Walters MC. Efficacy and Safety of Betibeglogene Autotemcel (beti-cel) Gene Therapy in 63 Patients with Transfusion-Dependent β-Thalassemia (TDT): 7-Year Post-Infusion Follow-up of Phase 1/2 and Phase 3 Studies. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00189-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Kanter J, Walters MC, Krishnamurti L, Mapara MY, Kwiatkowski JL, Rifkin-Zenenberg S, Aygun B, Kasow KA, Pierciey FJ, Bonner M, Miller A, Zhang X, Lynch J, Kim D, Ribeil JA, Asmal M, Goyal S, Thompson AA, Tisdale JF. Biologic and Clinical Efficacy of LentiGlobin for Sickle Cell Disease. N Engl J Med 2022; 386:617-628. [PMID: 34898139 DOI: 10.1056/nejmoa2117175] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sickle cell disease is characterized by the painful recurrence of vaso-occlusive events. Gene therapy with the use of LentiGlobin for sickle cell disease (bb1111; lovotibeglogene autotemcel) consists of autologous transplantation of hematopoietic stem and progenitor cells transduced with the BB305 lentiviral vector encoding a modified β-globin gene, which produces an antisickling hemoglobin, HbAT87Q. METHODS In this ongoing phase 1-2 study, we optimized the treatment process in the initial 7 patients in Group A and 2 patients in Group B with sickle cell disease. Group C was established for the pivotal evaluation of LentiGlobin for sickle cell disease, and we adopted a more stringent inclusion criterion that required a minimum of four severe vaso-occlusive events in the 24 months before enrollment. In this unprespecified interim analysis, we evaluated the safety and efficacy of LentiGlobin in 35 patients enrolled in Group C. Included in this analysis was the number of severe vaso-occlusive events after LentiGlobin infusion among patients with at least four vaso-occlusive events in the 24 months before enrollment and with at least 6 months of follow-up. RESULTS As of February 2021, cell collection had been initiated in 43 patients in Group C; 35 received a LentiGlobin infusion, with a median follow-up of 17.3 months (range, 3.7 to 37.6). Engraftment occurred in all 35 patients. The median total hemoglobin level increased from 8.5 g per deciliter at baseline to 11 g or more per deciliter from 6 months through 36 months after infusion. HbAT87Q contributed at least 40% of total hemoglobin and was distributed across a mean (±SD) of 85±8% of red cells. Hemolysis markers were reduced. Among the 25 patients who could be evaluated, all had resolution of severe vaso-occlusive events, as compared with a median of 3.5 events per year (range, 2.0 to 13.5) in the 24 months before enrollment. Three patients had a nonserious adverse event related or possibly related to LentiGlobin that resolved within 1 week after onset. No cases of hematologic cancer were observed during up to 37.6 months of follow-up. CONCLUSIONS One-time treatment with LentiGlobin resulted in sustained production of HbAT87Q in most red cells, leading to reduced hemolysis and complete resolution of severe vaso-occlusive events. (Funded by Bluebird Bio; HGB-206 ClinicalTrials.gov number, NCT02140554.).
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Affiliation(s)
- Julie Kanter
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Mark C Walters
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Lakshmanan Krishnamurti
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Markus Y Mapara
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Janet L Kwiatkowski
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Stacey Rifkin-Zenenberg
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Banu Aygun
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Kimberly A Kasow
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Francis J Pierciey
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Melissa Bonner
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Alex Miller
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Xinyan Zhang
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Jessie Lynch
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Dennis Kim
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Jean-Antoine Ribeil
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Mohammed Asmal
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Sunita Goyal
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - Alexis A Thompson
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
| | - John F Tisdale
- From the University of Alabama Birmingham, Birmingham (J.K.); UCSF Benioff Children's Hospital, Oakland, CA (M.C.W.); Aflac Cancer and Blood Disorders Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University, Atlanta (L.K.); the Division of Hematology-Oncology, Columbia Center for Translational Immunology, Columbia University Medical Center, New York (M.Y.M.), the Division of Pediatric Hematology, Oncology and Cellular Therapy, Cohen Children's Medical Center, New Hyde Park (B.A.), and Zucker School of Medicine at Hofstra-Northwell, Hempstead (B.A.) - all in New York; the Division of Hematology, Children's Hospital of Philadelphia, and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine - both in Philadelphia (J.L.K.); Hackensack University Medical Center, Hackensack, NJ (S.R.-Z.); the University of North Carolina at Chapel Hill, Chapel Hill (K.A.K.); Bluebird Bio, Cambridge, MA (F.J.P., M.B., A.M., X.Z., J.L., D.K., J.-A.R., M.A., S.G.); Northwestern University Feinberg School of Medicine and Ann and Robert H. Lurie Children's Hospital - both in Chicago (A.A.T.); and the Cellular and Molecular Therapeutics Branch, National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases (NHLBI-NIDDK), National Institutes of Health, Bethesda, MD (J.F.T.)
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Locatelli F, Thompson AA, Kwiatkowski JL, Porter JB, Thrasher AJ, Hongeng S, Sauer MG, Thuret I, Lal A, Algeri M, Schneiderman J, Olson TS, Carpenter B, Amrolia PJ, Anurathapan U, Schambach A, Chabannon C, Schmidt M, Labik I, Elliot H, Guo R, Asmal M, Colvin RA, Walters MC. Betibeglogene Autotemcel Gene Therapy for Non-β 0/β 0 Genotype β-Thalassemia. N Engl J Med 2022; 386:415-427. [PMID: 34891223 DOI: 10.1056/nejmoa2113206] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Betibeglogene autotemcel (beti-cel) gene therapy for transfusion-dependent β-thalassemia contains autologous CD34+ hematopoietic stem cells and progenitor cells transduced with the BB305 lentiviral vector encoding the β-globin (βA-T87Q) gene. METHODS In this open-label, phase 3 study, we evaluated the efficacy and safety of beti-cel in adult and pediatric patients with transfusion-dependent β-thalassemia and a non-β0/β0 genotype. Patients underwent myeloablation with busulfan (with doses adjusted on the basis of pharmacokinetic analysis) and received beti-cel intravenously. The primary end point was transfusion independence (i.e., a weighted average hemoglobin level of ≥9 g per deciliter without red-cell transfusions for ≥12 months). RESULTS A total of 23 patients were enrolled and received treatment, with a median follow-up of 29.5 months (range, 13.0 to 48.2). Transfusion independence occurred in 20 of 22 patients who could be evaluated (91%), including 6 of 7 patients (86%) who were younger than 12 years of age. The average hemoglobin level during transfusion independence was 11.7 g per deciliter (range, 9.5 to 12.8). Twelve months after beti-cel infusion, the median level of gene therapy-derived adult hemoglobin (HbA) with a T87Q amino acid substitution (HbAT87Q) was 8.7 g per deciliter (range, 5.2 to 10.6) in patients who had transfusion independence. The safety profile of beti-cel was consistent with that of busulfan-based myeloablation. Four patients had at least one adverse event that was considered by the investigators to be related or possibly related to beti-cel; all events were nonserious except for thrombocytopenia (in 1 patient). No cases of cancer were observed. CONCLUSIONS Treatment with beti-cel resulted in a sustained HbAT87Q level and a total hemoglobin level that was high enough to enable transfusion independence in most patients with a non-β0/β0 genotype, including those younger than 12 years of age. (Funded by Bluebird Bio; HGB-207 ClinicalTrials.gov number, NCT02906202.).
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Affiliation(s)
- Franco Locatelli
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Alexis A Thompson
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Janet L Kwiatkowski
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - John B Porter
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Adrian J Thrasher
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Suradej Hongeng
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Martin G Sauer
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Isabelle Thuret
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Ashutosh Lal
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Mattia Algeri
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Jennifer Schneiderman
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Timothy S Olson
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Ben Carpenter
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Persis J Amrolia
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Usanarat Anurathapan
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Axel Schambach
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Christian Chabannon
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Manfred Schmidt
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Ivan Labik
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Heidi Elliot
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Ruiting Guo
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Mohammed Asmal
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Richard A Colvin
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
| | - Mark C Walters
- From IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Rome (F.L., M. Algeri); Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago (A.A.T., J.S.); Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia (J.L.K., T.S.O.); University College London Hospital (J.B.P., B.C.) and University College London Great Ormond Street Institute of Child Health and Great Ormond Street Hospital NHS Trust (A.J.T., P.J.A.) - all in London; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A.); the Department of Pediatric Hematology, Oncology, and Stem Cell Transplantation in Children (M.G.S.) and the Institute of Experimental Hematology (A.S.), Hannover Medical School, Hannover, and GeneWerk, Heidelberg (M.S., I.L.) - both in Germany; Hôpital de la Timone (I.T.) and Institut Paoli-Calmettes Comprehensive Cancer Center (C.C.) - both in Marseille, France; the University of California, San Francisco, Benioff Children's Hospital, Oakland (A.L., M.C.W.); and the Division of Hematology-Oncology, Boston Children's Hospital, Harvard Medical School, Boston (A.S.), and Bluebird Bio, Cambridge (H.E., R.G., M. Asmal, R.A.C.) - all in Massachusetts
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22
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Wood WA, Marks P, Plovnick RM, Hewitt K, Neuberg DS, Walters S, Dolan BK, Tucker EA, Abrams CS, Thompson AA, Anderson KC, Kluetz P, Farrell A, Rivera D, Gertzog M, Pappas G. ASH Research Collaborative: a real-world data infrastructure to support real-world evidence development and learning healthcare systems in hematology. Blood Adv 2021; 5:5429-5438. [PMID: 34673922 PMCID: PMC9153041 DOI: 10.1182/bloodadvances.2021005902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/02/2021] [Indexed: 12/03/2022] Open
Abstract
The ASH Research Collaborative is a nonprofit organization established through the American Society of Hematology's commitment to patients with hematologic conditions and the science that informs clinical care and future therapies. The ASH Research Collaborative houses 2 major initiatives: (1) the Data Hub and (2) the Clinical Trials Network (CTN). The Data Hub is a program for hematologic diseases in which networks of clinical care delivery sites are developed in specific disease areas, with individual patient data contributed through electronic health record (EHR) integration, direct data entry through electronic data capture, and external data sources. Disease-specific data models are constructed so that data can be assembled into analytic datasets and used to enhance clinical care through dashboards and other mechanisms. Initial models have been built in multiple myeloma (MM) and sickle cell disease (SCD) using the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) and Fast Healthcare Interoperability Resources (FHIR) standards. The Data Hub also provides a framework for development of disease-specific learning communities (LC) and testing of health care delivery strategies. The ASH Research Collaborative SCD CTN is a clinical trials accelerator that creates efficiencies in the execution of multicenter clinical trials and has been initially developed for SCD. Both components are operational, with the Data Hub actively aggregating source data and the SCD CTN reviewing study candidates. This manuscript describes processes involved in developing core features of the ASH Research Collaborative to inform the stakeholder community in preparation for expansion to additional disease areas.
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Affiliation(s)
- William A Wood
- Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Peter Marks
- U.S. Food and Drug Administration, Silver Spring, MD
| | | | | | - Donna S Neuberg
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - Brendan K Dolan
- The University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Charles S Abrams
- Department of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Kenneth C Anderson
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA
| | - Paul Kluetz
- U.S. Food and Drug Administration, Silver Spring, MD
| | - Ann Farrell
- U.S. Food and Drug Administration, Silver Spring, MD
| | - Donna Rivera
- U.S. Food and Drug Administration, Silver Spring, MD
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23
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Chapin J, Cohen AR, Neufeld EJ, Vichinsky E, Giardina PJ, Boudreaux J, Le BC, Kenney K, Trimble S, Thompson AA. An update on the US adult thalassaemia population: a report from the CDC thalassaemia treatment centres. Br J Haematol 2021; 196:380-389. [PMID: 34775608 DOI: 10.1111/bjh.17920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/13/2021] [Indexed: 01/19/2023]
Abstract
Thalassaemia is caused by genetic globin defects leading to anaemia, transfusion-dependence and comorbidities. Reduced survival and systemic organ disease affect transfusion-dependent thalassaemia major and thalassaemia intermedia. Recent improvements in clinical management have reduced thalassaemia mortality. The therapeutic landscape of thalassaemia may soon include gene therapies as functional cures. An analysis of the adult US thalassaemia population has not been performed since the Thalassemia Clinical Research Network cohort study from 2000 to 2006. The Centers for Disease Control and Prevention supported US thalassaemia treatment centres (TTCs) to compile longitudinal information on individuals with thalassaemia. This dataset provided an opportunity to evaluate iron balance, chelation, comorbidities and demographics of adults with thalassaemia receiving care at TTCs. Two adult cohorts were compared: those over 40 years old (n = 75) and younger adults ages 18-39 (n = 201). The older adult cohort was characterized by higher numbers of iron-related comorbidities and transfusion-related complications. By contrast, younger adults had excess hepatic and cardiac iron and were receiving combination chelation therapy. The ethnic composition of the younger cohort was predominantly of Asian origin, reflecting the demographics of immigration. These findings demonstrate that comprehensive care and periodic surveys are needed to ensure optimal health and access to emerging therapies.
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Affiliation(s)
- John Chapin
- Division of Hematology & Medical Oncology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - Alan R Cohen
- Division of Hematology, Children's Hospital Philadelphia, Philadelphia, PA, USA
| | - Ellis J Neufeld
- Boston Children's Hospital- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA, USA.,Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Elliott Vichinsky
- Division of Hematology/Oncology, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Patricia J Giardina
- Division of Pediatric Hematology/Oncology, Weill Cornell Medicine-New York Presbyterian Hospital, New York, NY, USA
| | - Jeanne Boudreaux
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta at Scottish Rite, Atlanta, GA, USA
| | - Binh C Le
- Bleeding Team, Epidemiology & Surveillance Branch, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristy Kenney
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sean Trimble
- NCIRD, Immunization Services Division, Vaccine Supply and Assurance Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alexis A Thompson
- Robert H Lurie Comprehensive Cancer Center of Northwestern University, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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24
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Badawy SM, Payne AB, Hulihan MM, Coates TD, Majumdar S, Smith D, Thompson AA. Concordance with comprehensive iron assessment, hepatitis A vaccination, and hepatitis B vaccination recommendations among patients with sickle cell disease and thalassaemia receiving chronic transfusions: an analysis from the Centers for Disease Control haemoglobinopathy blood safety project. Br J Haematol 2021; 195:e160-e164. [PMID: 34431082 DOI: 10.1111/bjh.17798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School Medicine, Chicago, IL, USA
| | - Amanda B Payne
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary M Hulihan
- Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas D Coates
- Cancer and Blood Disease Institute, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | | | - Dominic Smith
- Michigan Department of Health and Human Services, Lansing, MI, USA
| | - Alexis A Thompson
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School Medicine, Chicago, IL, USA
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25
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Ballas SK, Kuypers FA, Gordeuk VR, Hankins JS, Thompson AA, Vichinsky E. Time to rethink haemoglobin threshold guidelines in sickle cell disease. Br J Haematol 2021; 195:518-522. [PMID: 34131897 PMCID: PMC9292304 DOI: 10.1111/bjh.17578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/07/2021] [Indexed: 12/05/2022]
Abstract
Alleviating anaemia in patients with sickle cell disease (SCD) is crucial in managing acute complications, mitigating end‐organ damage and preventing early mortality. Some disease‐modifying and curative therapies have increased haemoglobin (Hb) levels to exceed 100 g/l, a threshold above which complications from red blood cell (RBC) transfusions have occurred, raising concern about whole‐blood viscosity‐related complications with these therapies. Here we discuss the rationale behind this limit, the effect of viscosity on blood flow and the applicability of this Hb threshold to therapies for SCD beyond RBC transfusions.
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Affiliation(s)
- Samir K Ballas
- Department of Medicine, Cardeza Foundation for Hematologic Research, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Frans A Kuypers
- Children's Hospital Oakland Research Institute, Oakland, CA, USA
| | | | - Jane S Hankins
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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26
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Hood AM, Strong H, Nwankwo C, Johnson Y, Peugh J, Mara CA, Shook LM, Brinkman WB, Real FJ, Klein MD, Hackworth R, Badawy SM, Thompson AA, Raphael JL, Yates AM, Smith-Whitley K, King AA, Calhoun C, Creary SE, Piccone CM, Hildenbrand AK, Reader SK, Neumayr L, Meier ER, Sobota AE, Rana S, Britto M, Saving KL, Treadwell M, Quinn CT, Ware RE, Crosby LE. Engaging Caregivers and Providers of Children With Sickle Cell Anemia in Shared Decision Making for Hydroxyurea: Protocol for a Multicenter Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e27650. [PMID: 34018965 PMCID: PMC8178738 DOI: 10.2196/27650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 11/21/2022] Open
Abstract
Background Sickle cell anemia (SCA) is a genetic blood disorder that puts children at a risk of serious medical complications, early morbidity and mortality, and high health care utilization. Until recently, hydroxyurea was the only disease-modifying treatment for this life-threatening disease and has remained the only option for children younger than 5 years. Evidence-based guidelines recommend using a shared decision-making (SDM) approach for offering hydroxyurea to children with SCA (HbSS or HbS/β0 thalassemia) aged as early as 9 months. However, the uptake remains suboptimal, likely because caregivers lack information about hydroxyurea and have concerns about its safety and potential long-term side effects. Moreover, clinicians do not routinely receive training or tools, especially those that provide medical evidence and consider caregivers’ preferences and values, to facilitate a shared discussion with caregivers. Objective The aim of this study is to understand how best to help parents of young children with sickle cell disease and their clinicians have a shared discussion about hydroxyurea (one that considers medical evidence and parent values and preferences). Methods We designed our study to compare the effectiveness of two methods for disseminating hydroxyurea guidelines to facilitate SDM: a clinician pocket guide (ie, usual care) and a clinician hydroxyurea SDM toolkit (H-SDM toolkit). Our primary outcomes are caregiver reports of decisional uncertainty and knowledge of hydroxyurea. The study also assesses the number of children (aged 0-5 years) who were offered and prescribed hydroxyurea and the resultant health outcomes. Results The Ethics Committee of the Cincinnati Children’s Hospital Medical Center approved this study in November 2017. As of February 2021, we have enrolled 120 caregiver participants. Conclusions The long-term objective of this study is to improve the quality of care for children with SCA. Using multicomponent dissemination methods developed in partnership with key stakeholders and designed to address barriers to high-quality care, caregivers of patients with SCA can make informed and shared decisions about their health. Trial Registration ClinicalTrials.gov NCT03442114; https://clinicaltrials.gov/ct2/show/NCT03442114 International Registered Report Identifier (IRRID) DERR1-10.2196/27650
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Affiliation(s)
- Anna M Hood
- Developmental Neurosciences, Institute of Child Health, University College London, London, United Kingdom
| | - Heather Strong
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Cara Nwankwo
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Yolanda Johnson
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - James Peugh
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Constance A Mara
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Lisa M Shook
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - William B Brinkman
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Melissa D Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Rogelle Hackworth
- Cincinnati Children's Hospital Medical Center Partner, Cincinnati, OH, United States
| | - Sherif M Badawy
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Alexis A Thompson
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Jean L Raphael
- Center for Child Health Policy and Advocacy, Baylor College of Medicine, Houston, TX, United States
| | - Amber M Yates
- Department of Pediatrics, Division of Hematology/Oncology, Baylor College of Medicine, Houston, TX, United States
| | - Kim Smith-Whitley
- Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Perelman School of Medicine, Philadelphia, PA, United States
| | - Allison A King
- Program in Occupational Therapy and Pediatrics, Division of Hematology and Oncology, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, MO, United States.,Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis, MO, United States
| | - Cecelia Calhoun
- Division of Pediatric Hematology/Oncology, Washington University School of Medicine, St. Louis, MO, United States
| | - Susan E Creary
- Center for Innovation in Pediatric Practice, Division of Pediatric Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, OH, United States
| | - Connie M Piccone
- University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH, United States
| | - Aimee K Hildenbrand
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, United States.,Division of Behavioral Health, Nemours/ Alfred I duPont Hospital for Children, Wilmington, DE, United States
| | - Steven K Reader
- Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, DE, United States.,Division of Behavioral Health, Nemours/ Alfred I duPont Hospital for Children, Wilmington, DE, United States
| | - Lynne Neumayr
- Department of Hematology/Oncology, Children's Hospital Oakland, Oakland, CA, United States.,AbbVie, North Chicago, IL, United States.,University of California San Francisco, San Francisco, CA, United States
| | - Emily R Meier
- Pediatrics, Pediatric Hematology/Oncology, Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, United States
| | - Amy E Sobota
- Pediatric Hematology and Oncology, Boston Medical Center, Boston, MA, United States
| | - Sohail Rana
- Pediatrics and Child Health, College of Medicine, Howard University, Washington, DC, United States
| | - Maria Britto
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Kay L Saving
- Department of Pediatrics, University of Illinois College of Medicine, Peoria, IL, United States
| | - Marsha Treadwell
- Department of Hematology/Oncology, University of California San Francisco Benioff Children's Hospital, Oakland, CA, United States
| | - Charles T Quinn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Cancer and Blood Diseases Institute, Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Russell E Ware
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Lori E Crosby
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.,James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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27
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Casella JF, Barton BA, Kanter J, Black LV, Majumdar S, Inati A, Wali Y, Drachtman RA, Abboud MR, Kilinc Y, Fuh BR, Al-Khabori MK, Takemoto CM, Salman E, Sarnaik SA, Shah N, Morris CR, Keates-Baleeiro J, Raj A, Alvarez OA, Hsu LL, Thompson AA, Sisler IY, Pace BS, Noronha SA, Lasky JL, de Julian EC, Godder K, Thornburg CD, Kamberos NL, Nuss R, Marsh AM, Owen WC, Schaefer A, Tebbi CK, Chantrain CF, Cohen DE, Karakas Z, Piccone CM, George A, Fixler JM, Singleton TC, Moulton T, Quinn CT, de Castro Lobo CL, Almomen AM, Goyal-Khemka M, Maes P, Emanuele M, Gorney RT, Padgett CS, Parsley E, Kronsberg SS, Kato GJ, Gladwin MT. Effect of Poloxamer 188 vs Placebo on Painful Vaso-Occlusive Episodes in Children and Adults With Sickle Cell Disease: A Randomized Clinical Trial. JAMA 2021; 325:1513-1523. [PMID: 33877274 PMCID: PMC8058640 DOI: 10.1001/jama.2021.3414] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Although effective agents are available to prevent painful vaso-occlusive episodes of sickle cell disease (SCD), there are no disease-modifying therapies for ongoing painful vaso-occlusive episodes; treatment remains supportive. A previous phase 3 trial of poloxamer 188 reported shortened duration of painful vaso-occlusive episodes in SCD, particularly in children and participants treated with hydroxyurea. OBJECTIVE To reassess the efficacy of poloxamer 188 for vaso-occlusive episodes. DESIGN, SETTING, AND PARTICIPANTS Phase 3, randomized, double-blind, placebo-controlled, multicenter, international trial conducted from May 2013 to February 2016 that included 66 hospitals in 12 countries and 60 cities; 388 individuals with SCD (hemoglobin SS, SC, S-β0 thalassemia, or S-β+ thalassemia disease) aged 4 to 65 years with acute moderate to severe pain typical of painful vaso-occlusive episodes requiring hospitalization were included. INTERVENTIONS A 1-hour 100-mg/kg loading dose of poloxamer 188 intravenously followed by a 12-hour to 48-hour 30-mg/kg/h continuous infusion (n = 194) or placebo (n = 194). MAIN OUTCOMES AND MEASURES Time in hours from randomization to the last dose of parenteral opioids among all participants and among those younger than 16 years as a separate subgroup. RESULTS Of 437 participants assessed for eligibility, 388 were randomized (mean age, 15.2 years; 176 [45.4%] female), the primary outcome was available for 384 (99.0%), 15-day follow-up contacts were available for 357 (92.0%), and 30-day follow-up contacts were available for 368 (94.8%). There was no significant difference between the groups for the mean time to last dose of parenteral opioids (81.8 h for the poloxamer 188 group vs 77.8 h for the placebo group; difference, 4.0 h [95% CI, -7.8 to 15.7]; geometric mean ratio, 1.2 [95% CI, 1.0-1.5]; P = .09). Based on a significant interaction of age and treatment (P = .01), there was a treatment difference in time from randomization to last administration of parenteral opioids for participants younger than 16 years (88.7 h in the poloxamer 188 group vs 71.9 h in the placebo group; difference, 16.8 h [95% CI, 1.7-32.0]; geometric mean ratio, 1.4 [95% CI, 1.1-1.8]; P = .008). Adverse events that were more common in the poloxamer 188 group than the placebo group included hyperbilirubinemia (12.7% vs 5.2%); those more common in the placebo group included hypoxia (12.0% vs 5.3%). CONCLUSIONS AND RELEVANCE Among children and adults with SCD, poloxamer 188 did not significantly shorten time to last dose of parenteral opioids during vaso-occlusive episodes. These findings do not support the use of poloxamer 188 for vaso-occlusive episodes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01737814.
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Affiliation(s)
- James F. Casella
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Julie Kanter
- Medical University of South Carolina, Charleston
- University of Alabama at Birmingham, Birmingham
| | - L. Vandy Black
- Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana
- University of Florida College of Medicine, Gainesville
| | - Suvankar Majumdar
- University of Mississippi Medical Center, Jackson
- Children’s National Hospital, Washington, DC
| | - Adlette Inati
- Lebanese American University, Byblos and Beirut, Lebanon
- Nini Hospital, Tripoli, Lebanon
| | | | | | | | - Yurdanur Kilinc
- Çukurova University Medical Faculty Balcali Hospital, University of Çukurova, Adana, Turkey
| | - Beng R. Fuh
- East Carolina University, Greenville, North Carolina
| | | | - Clifford M. Takemoto
- Johns Hopkins University School of Medicine, Baltimore, Maryland
- St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Emad Salman
- Golisano Children’s Hospital of Southwest Florida, Ft Myers
| | - Sharada A. Sarnaik
- Wayne State University School of Medicine, Detroit, Michigan
- Children’s Hospital of Michigan, Detroit
| | - Nirmish Shah
- Duke University School of Medicine, Durham, North Carolina
| | - Claudia R. Morris
- Emory University School of Medicine, Atlanta, Georgia
- Children’s Healthcare of Atlanta, Atlanta, Georgia
| | | | - Ashok Raj
- University of Louisville/Norton Children’s Hospital, Louisville, Kentucky
| | | | | | - Alexis A. Thompson
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Evanston, Illinois
| | - India Y. Sisler
- Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond
| | | | - Suzie A. Noronha
- University of Rochester School of Medicine and Dentistry, Golisano Children’s Hospital at University of Rochester Medical Center, Rochester, New York
| | - Joseph L. Lasky
- Harbor-UCLA Medical Center, Torrance, California
- Cure 4 The Kids Foundation, Las Vegas, Nevada
| | - Elena Cela de Julian
- Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Courtney Dawn Thornburg
- Rady Children’s Hospital - San Diego, San Diego, California
- UC San Diego School of Medicine, La Jolla, California
| | - Natalie L. Kamberos
- University of Iowa Children’s Hospital, Iowa City
- Loyola University Medical Center, Maywood, Illinois
| | - Rachelle Nuss
- Children’s Hospital Colorado, University of Colorado, Aurora
| | - Anne M. Marsh
- UCSF Benioff Children’s Hospital Oakland (UBCHO), Oakland, California
- University of Wisconsin–Madison, Madison
| | - William C. Owen
- Children’s Hospital of the King’s Daughters, Norfolk, Virginia
| | - Anne Schaefer
- Joe DiMaggio Children’s Hospital, Hollywood, Florida
| | | | | | - Debra E. Cohen
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Studer Family Children’s Hospital Ascension Sacred Heart, University of Florida, Pensacola
| | - Zeynep Karakas
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Connie M. Piccone
- Rainbow Babies and Children’s Hospital, Cleveland, Ohio
- Carle Foundation Hospital, Urbana, Illinois
| | - Alex George
- Baylor College of Medicine, Houston, Texas
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jason M. Fixler
- The Herman and Walter Samuelson Children’s Hospital at Sinai, Baltimore, Maryland
| | - Tammuella C. Singleton
- Tulane University, New Orleans, Louisiana
- Mississippi Center for Advanced Medicine, Slidell, Louisiana
| | - Thomas Moulton
- Bronx-Lebanon Hospital, Bronx, New York City, New York
- Bayer Pharmaceuticals, Whippany, New Jersey
| | | | | | - Abdulkareem M. Almomen
- Blood and Cancer Center, King Khalid University Hospital (KKUH), King Saud University Medical City, Riyadh, Saudi Arabia
| | - Meenakshi Goyal-Khemka
- Phoenix Children’s Hospital, Phoenix, Arizona
- Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Philip Maes
- University Hospital of Antwerp (UZA), Edegem, Belgium
| | - Marty Emanuele
- Visgenx, San Diego, California
- Mast Therapeutics Inc, San Diego, California
| | | | - Claire S. Padgett
- Mast Therapeutics Inc, San Diego, California
- Sanifit Therapeutics, San Diego, California
| | - Ed Parsley
- Mast Therapeutics Inc, San Diego, California
- Biotechnology, San Diego, California
| | | | - Gregory J. Kato
- CSL Behring, King of Prussia, Pennsylvania
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mark T. Gladwin
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Walters MC, Kwiatkowski JL, Porter JB, Hongeng S, Yannaki E, Kulozik AE, Sauer MG, Thrasher AJ, Thuret I, Lal A, Guo R, Liu W, Colvin RA, Locatelli F, Thompson AA. Safety and Efficacy Outcomes in Pediatric Patients with Transfusion-Dependent β-Thalassemia (TDT) Receiving Betibeglogene Autotemcel (beti-cel; LentiGlobin for β-thalassemia) Gene Therapy in the Phase 3 Hgb-207 (Northstar-2) and Hgb-212 (Northstar-3) Studies. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hongeng S, Thompson AA, Kwiatkowski JL, Locatelli F, Porter JB, Rasko J, Cavazzana M, Sauer MG, Thrasher AJ, Thuret I, Lal A, Kulozik AE, Yannaki E, Schmidt M, Chen Y, Guo R, Liu W, Colvin RA, Walters MC. Efficacy and Safety of Betibeglogene Autotemcel (beti-cel; LentiGlobin for β-thalassemia) Gene Therapy in 60 Patients with Transfusion-Dependent β-Thalassemia (TDT) Followed for up to 6 Years Post-Infusion. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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Walters MC, Thompson AA, Mapara MY, Kwiatkowski JL, Krishnamurti L, Aygun B, Kasow KA, Rifkin-Zenenberg S, Schmidt M, DelCarpini J, Pierciey FJ, Miller A, Chen R, Goyal S, Kanter J, Tisdale JF. Resolution of Serious Vaso-Occlusive Pain Crises: Results from the Ongoing Phase 1/2 HGB-206 Group C Study of LentiGlobin for Sickle Cell Disease (SCD; bb1111) Gene Therapy. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00039-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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O'Connor FG, Franzos MA, Nye NS, Nelson DA, Shell D, Voss JD, Anderson SA, Coleman NJ, Thompson AA, Harmon KG, Deuster PA. Summit on Exercise Collapse Associated with Sickle Cell Trait: Finding the "Way Ahead". Curr Sports Med Rep 2021; 20:47-56. [PMID: 33395130 DOI: 10.1249/jsr.0000000000000801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Although largely benign, sickle cell trait (SCT) has been associated with exertion-related events, to include sudden death. In 2011, a summit on SCT introduced the term exercise collapse associated with SCT (ECAST). A series of ECAST deaths in military personnel in 2019 prompted reevaluation of current efforts and led to a second summit in October 2019 hosted by the Consortium for Health and Military Performance of the Uniformed Services University in Bethesda, MD. The goals were to (1) review current service policies on SCT screening, (2) develop draft procedural instructions for executing current policy on SCT within the Department of Defense, (3) develop draft clinical practice guidelines for management of ECAST, (4) establish a framework for education on SCT and ECAST, and (5) prepare a research agenda to address identified gaps.
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Affiliation(s)
- Francis G O'Connor
- Department of Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD
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Al-Samkari H, van Beers EJ, Morton DH, Barcellini W, Eber SW, Glader B, Yaish HM, Chonat S, Kuo KHM, Kollmar N, Despotovic JM, Pospíšilová D, Knoll CM, Kwiatkowski JL, Pastore YD, Thompson AA, Wlodarski MW, Ravindranath Y, Rothman JA, Wang H, Holzhauer S, Breakey VR, Verhovsek MM, Kunz J, Sheth S, Sharma M, Rose MJ, Bradeen HA, McNaull MN, Addonizio K, Al-Sayegh H, London WB, Grace RF. Characterization of the severe phenotype of pyruvate kinase deficiency. Am J Hematol 2020; 95:E281-E285. [PMID: 32619047 DOI: 10.1002/ajh.25926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Hanny Al-Samkari
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - D Holmes Morton
- Central Pennsylvania Clinic for Special Children & Adults, Belleville, Pennsylvania
- Lancaster General Hospital, Lancaster, Pennsylvania
| | - Wilma Barcellini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefan W Eber
- Schwerpunktpraxis für Pädiatrische Hämatologie-Onkologie and Children's Hospital, Technical University, Munich, Germany
| | - Bertil Glader
- Lucile Packard Children's Hospital, Stanford University, Palo Alto, California
| | - Hassan M Yaish
- Primary Children's Hospital, University of Utah, Salt Lake City, Utah
| | - Satheesh Chonat
- Emory University School of Medicine, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Kevin H M Kuo
- University of Toronto, University Health Network, Toronto, Ontario, Canada
| | | | - Jenny M Despotovic
- Texas Children's Hematology Center, Baylor College of Medicine, Houston, Texas
| | | | | | - Janet L Kwiatkowski
- Children's Hospital of Philadelphia and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Marcin W Wlodarski
- St. Jude Children's Research Hospital, Memphis, Tennessee
- University of Freiburg, Freiburg, Germany
| | | | | | - Heng Wang
- DDC Clinic for Special Needs Children, Middlefield, Ohio
| | | | | | | | - Joachim Kunz
- Zentrum für Kinder-und Jugendmedizin, Heidelberg, Germany
| | - Sujit Sheth
- Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York
| | - Mukta Sharma
- Children's Mercy, University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Melissa J Rose
- Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | | | | | - Kathryn Addonizio
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Harvard Medical School, Boston, Massachusetts
| | - Hasan Al-Sayegh
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Harvard Medical School, Boston, Massachusetts
| | - Wendy B London
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Harvard Medical School, Boston, Massachusetts
| | - Rachael F Grace
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Harvard Medical School, Boston, Massachusetts
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Tisdale JF, Pierciey FJ, Bonner M, Thompson AA, Krishnamurti L, Mapara MY, Kwiatkowski JL, Shestopalov I, Ribeil J, Huang W, Asmal M, Kanter J, Walters MC. Safety and feasibility of hematopoietic progenitor stem cell collection by mobilization with plerixafor followed by apheresis vs bone marrow harvest in patients with sickle cell disease in the multi-center HGB-206 trial. Am J Hematol 2020; 95:E239-E242. [PMID: 32401372 DOI: 10.1002/ajh.25867] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 11/09/2022]
Affiliation(s)
- John F. Tisdale
- Cellular and Molecular Therapeutics Branch, National Heart, Lung and Blood Institute National Institutes of Health Bethesda Maryland USA
| | | | | | - Alexis A. Thompson
- Division of Hematology, Oncology & Stem Cell Transplant Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University Chicago Illinois USA
| | - Lakshmanan Krishnamurti
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta Emory University Atlanta Georgia USA
| | - Markus Y. Mapara
- Division of Hematology/Oncology, Columbia Center for Translational Immunology Columbia University Medical Center New York New York USA
| | - Janet L. Kwiatkowski
- Division of Hematology Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | | | | | | | | | - Julie Kanter
- Division of Hematology/Oncology University of Alabama at Birmingham Birmingham Alabama USA
| | - Mark C. Walters
- University of California San Francisco, Benioff Children's Hospital Oakland Oakland California USA
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Harmon KG, Pottinger PS, Baggish AL, Drezner JA, Luks AM, Thompson AA, Swaminathan S. Comorbid Medical Conditions in Young Athletes: Considerations for Preparticipation Guidance During the COVID-19 Pandemic. Sports Health 2020; 12:456-458. [PMID: 32579436 PMCID: PMC7315380 DOI: 10.1177/1941738120939079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Kimberly G Harmon
- Departments of Family Medicine and Orthopaedics and Sports Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Paul S Pottinger
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle, Washington
| | - Aaron L Baggish
- Harvard Medical School, Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Jonathan A Drezner
- Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Andrew M Luks
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Alexis A Thompson
- Hematology Section, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sankar Swaminathan
- Division of Infectious Diseases, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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35
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Cronin RM, Yang M, Hankins JS, Byrd J, Pernell BM, Kassim A, Adams-Graves P, Thompson AA, Kalinyak K, DeBaun M, Treadwell M. Association between hospital admissions and healthcare provider communication for individuals with sickle cell disease. ACTA ACUST UNITED AC 2020; 25:229-240. [PMID: 32552526 DOI: 10.1080/16078454.2020.1780737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: To test the hypothesis that caregivers' or adult participants' low ratings of provider communication are associated with more hospital admissions among adults and children with sickle cell disease (SCD), respectively. Secondarily, we determined whether there was an association between the caregivers' or participants' health literacy and rating of providers' communication. Methods: Primary data were collected from participants through surveys between 2014 and 2016, across six sickle cell centers throughout the U.S. In this cross-sectional cohort study, 211 adults with SCD and 331 caregivers of children with SCD completed surveys evaluating provider communication using the Consumer Assessment of Healthcare Providers and Systems (CAHPS), healthcare utilization, health literacy, and other sociodemographic and behavioral variables. Analyses included descriptive statistics, bivariate analyses, and logistic regression. Results: Participants with better ratings of provider communication were less likely to be hospitalized (odds ratio (OR) = 0.54, 95% confidence interval (CI) = [0.35, 0.83]). Positive ratings of provider communication were associated with fewer readmissions for children (OR = 0.23, 95% CI = [0.09, 0.57]). Participants with better ratings of provider communication were less likely to rate their health literacy as lower (regression coefficient (B) = -0.28, 95% CI = [-0.46, -0.10]). Conclusions: Low ratings of provider communication were associated with more hospitalizations and readmissions in SCD, suggesting the need for interventions targeted at improving patient-provider communication which could decrease hospitalizations for this population.
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Affiliation(s)
- Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, RI, USA.,American Institutes for Research, Chapel Hill, NC, USA
| | - Jane S Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Jeannie Byrd
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandi M Pernell
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Division of Hematology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Adetola Kassim
- Department of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Patricia Adams-Graves
- Department of General Internal Medicine and Hematology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Alexis A Thompson
- Department of Pediatrics, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - Karen Kalinyak
- Division of Hematology in Cancer and Blood Diseases Institute, University of Cincinnati, Cincinnati, OH, USA
| | - Michael DeBaun
- Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marsha Treadwell
- Department of Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
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Barriteau CM, Murdoch A, Gallagher SJ, Thompson AA. A patient-centered medical home model for comprehensive sickle cell care in infants and young children. Pediatr Blood Cancer 2020; 67:e28275. [PMID: 32277797 DOI: 10.1002/pbc.28275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The patient-centered medical home (PCMH) has been proposed as a model for comprehensive care coordination and delivery for children with sickle cell disease (SCD), yet little is known regarding the implementation of PCMH core concepts on adherence to preventative care measures, health care utilization, and parent satisfaction. PROCEDURE We implemented the newborn cohort clinic (NCC) to explore the application of the PCMH model for infants and children with SCD from birth to age 3 years in 2011. In July 2017, we conducted a retrospective chart review to evaluate subjects currently or previously followed in the clinic. We surveyed parents in the NCC to assess their satisfaction with their experience. RESULTS A total of 112 patients have been managed in the NCC. All patients received penicillin prophylaxis, while 70% and 73% of patients, respectively, received the 23-valent pneumococcal vaccine and an initial transcranial Doppler by age 36 months. Most (92 of 112) of the subjects utilized the emergency department (569 encounters), with 86% of encounters for fever or other sickle cell-related complications. The majority of parents indicated satisfaction with the clinic, with 71% saying clinic providers always or usually spent enough time with their child, listened carefully to them (81%) and were sensitive to family values and customs (77%). CONCLUSIONS A comprehensive sickle cell clinic as a component of a PCMH is feasible and can achieve high levels of preventative care. Parents are largely satisfied with this model of care.
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Affiliation(s)
- Christina M Barriteau
- Division of Hematology and Oncology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Alexandra Murdoch
- Division of Hematology and Oncology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Shannon J Gallagher
- Division of General Surgery, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, United States
| | - Alexis A Thompson
- Division of Hematology and Oncology, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
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Al-Samkari H, Addonizio K, Glader B, Morton DH, Chonat S, Thompson AA, Kuo KHM, Ravindranath Y, Wang H, Rothman JA, Kwiatkowski JL, Kung C, Kosinski PA, Al-Sayegh H, London WB, Grace RF. The pyruvate kinase (PK) to hexokinase enzyme activity ratio and erythrocyte PK protein level in the diagnosis and phenotype of PK deficiency. Br J Haematol 2020; 192:1092-1096. [PMID: 32463523 DOI: 10.1111/bjh.16724] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Diagnosis of pyruvate kinase deficiency (PKD), the most common cause of hereditary non-spherocytic haemolytic anaemia, remains challenging in routine practice and no biomarkers for clinical severity have been characterised. This prospective study enrolled 41 patients with molecularly confirmed PKD from nine North American centres to evaluate the diagnostic sensitivity of pyruvate kinase (PK) enzyme activity and PK:hexokinase (HK) enzyme activity ratio, and evaluate the erythrocyte PK (PK-R) protein level and erythrocyte metabolites as biomarkers for clinical severity. In this population not transfused for ≥90 days before sampling, the diagnostic sensitivity of the PK enzyme assay was 90% [95% confidence interval (CI) 77-97%], whereas the PK:HK ratio sensitivity was 98% (95% CI 87-100%). There was no correlation between PK enzyme activity and clinical severity. Transfusion requirements correlated with normalised erythrocyte ATP levels (r = 0·527, P = 0·0016) and PK-R protein levels (r = -0·527, P = 0·0028). PK-R protein levels were significantly higher in the never transfused [median (range) 40·1 (9·8-73·9)%] versus ever transfused [median (range) 7·7 (0·4-15·1)%] patients (P = 0·0014). The PK:HK ratio had excellent sensitivity for PK diagnosis, superior to PKLR exon sequencing. Given that the number of PKLR variants and genotype combinations limits prognostication based on molecular findings, PK-R protein level may be a useful prognostic biomarker of disease severity and merits further study.
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Affiliation(s)
- Hanny Al-Samkari
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn Addonizio
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Bertil Glader
- Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA
| | - D Holmes Morton
- Central Pennsylvania Clinic for Special Children & Adults, Belleville, PA, USA.,Lancaster General Hospital, Lancaster, PA, USA
| | - Satheesh Chonat
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kevin H M Kuo
- University of Toronto, University Health Network, Toronto, ON, Canada
| | | | - Heng Wang
- DDC Clinic for Special Needs Children, Middlefield, OH, USA
| | | | - Janet L Kwiatkowski
- Children's Hospital of Pennsylvania and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Hasan Al-Sayegh
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Wendy B London
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
| | - Rachael F Grace
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA
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38
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Schneiderman J, Thompson AA, Walters MC, Kwiatkowski JL, Kulozik AE, Sauer MG, Porter JB, Thuret I, Hongeng S, Lal A, Thrasher AJ, Yannaki E, Elliot H, Tao G, Liu W, Colvin RA, Locatelli F. Interim Results from the Phase 3 Hgb-207 (Northstar-2) and Hgb-212 (Northstar-3) Studies of Betibeglogene Autotemcel Gene Therapy (LentiGlobin) for the Treatment of Transfusion-Dependent β-Thalassemia. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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39
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Rogers ZR, Nakano TA, Olson TS, Bertuch AA, Wang W, Gillio A, Coates TD, Chawla A, Castillo P, Kurre P, Gamper C, Bennett CM, Joshi S, Geddis AE, Boklan J, Nalepa G, Rothman JA, Huang JN, Kupfer GM, Cada M, Glader B, Walkovich KJ, Thompson AA, Hanna R, Vlachos A, Malsch M, Weller EA, Williams DA, Shimamura A. Immunosuppressive therapy for pediatric aplastic anemia: a North American Pediatric Aplastic Anemia Consortium study. Haematologica 2019; 104:1974-1983. [PMID: 30948484 PMCID: PMC6886407 DOI: 10.3324/haematol.2018.206540] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 03/28/2019] [Indexed: 12/21/2022] Open
Abstract
Quality of response to immunosuppressive therapy and long-term outcomes for pediatric severe aplastic anemia remain incompletely characterized. Contemporary evidence to inform treatment of relapsed or refractory severe aplastic anemia for pediatric patients is also limited. The clinical features and outcomes for 314 children treated from 2002 to 2014 with immunosuppressive therapy for acquired severe aplastic anemia were analyzed retrospectively from 25 institutions in the North American Pediatric Aplastic Anemia Consortium. The majority of subjects (n=264) received horse anti-thymocyte globulin (hATG) plus cyclosporine (CyA) with a median 61 months follow up. Following hATG/CyA, 71.2% (95%CI: 65.3,76.6) achieved an objective response. In contrast to adult studies, the quality of response achieved in pediatric patients was high, with 59.8% (95%CI: 53.7,65.8) complete response and 68.2% (95%CI: 62.2,73.8) achieving at least a very good partial response with a platelet count ≥50×109L. At five years post-hATG/CyA, overall survival was 93% (95%CI: 89,96), but event-free survival without subsequent treatment was only 64% (95%CI: 57,69) without a plateau. Twelve of 171 evaluable patients (7%) acquired clonal abnormalities after diagnosis after a median 25.2 months (range: 4.3-71 months) post treatment. Myelodysplastic syndrome or leukemia developed in 6 of 314 (1.9%). For relapsed/refractory disease, treatment with a hematopoietic stem cell transplant had a superior event-free survival compared to second immunosuppressive therapy treatment in a multivariate analysis (HR=0.19, 95%CI: 0.08,0.47; P=0.0003). This study highlights the need for improved therapies to achieve sustained high-quality remission for children with severe aplastic anemia.
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Affiliation(s)
- Zora R Rogers
- Pediatric Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taizo A Nakano
- Center for Cancer and Blood Disorders, Department of Pediatrics, Children's Hospital Colorado and the University of Colorado School of Medicine, Aurora, CO, USA
| | | | | | - Winfred Wang
- Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Alfred Gillio
- Hackensack University Medical Center, Hackensack, NJ, USA
| | | | | | | | - Peter Kurre
- Oregon Health and Science University, Portland, OR, USA
| | | | | | - Sarita Joshi
- Nationwide Childrens Hospital, Columbus, OH, USA
| | | | - Jessica Boklan
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Grzegorz Nalepa
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - James N Huang
- UCSF Benioff Children's Hospital, San Francisco, CA, USA
| | | | | | - Bertil Glader
- Stanford University School of Medicine, Palo Alto, CA, USA
| | | | | | | | | | - Maggie Malsch
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA
| | - Edie A Weller
- Division of Hematology and Oncology and Biostatistics and Research Design Center of the Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA
| | - David A Williams
- Boston Children's Hospital and Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Akiko Shimamura
- Boston Children's Hospital and Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
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Anurathapan U, Locatelli F, Kwiatkowski JL, Rasko JE, Schiller GJ, Porter J, Sauer MG, Thrasher AJ, Chabannon C, Elliot H, Deary B, Chen Y, Tao G, Asmal M, Thompson AA, Walters MC. Lentiglobin Gene Therapy for Transfusion-Dependent β-Thalassemia: Outcomes from the Phase 1/2 Northstar and Phase 3 Northstar-2 Studies. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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van Beers EJ, van Straaten S, Morton DH, Barcellini W, Eber SW, Glader B, Yaish HM, Chonat S, Kwiatkowski JL, Rothman JA, Sharma M, Neufeld EJ, Sheth S, Despotovic JM, Kollmar N, Pospíšilová D, Knoll CM, Kuo K, Pastore YD, Thompson AA, Newburger PE, Ravindranath Y, Wang WC, Wlodarski MW, Wang H, Holzhauer S, Breakey VR, Verhovsek M, Kunz J, McNaull MA, Rose MJ, Bradeen HA, Addonizio K, Li A, Al-Sayegh H, London WB, Grace RF. Prevalence and management of iron overload in pyruvate kinase deficiency: report from the Pyruvate Kinase Deficiency Natural History Study. Haematologica 2018; 104:e51-e53. [PMID: 30213831 DOI: 10.3324/haematol.2018.196295] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Eduard J van Beers
- Van Creveldkliniek, University Medical Centre Utrecht, University of Utrecht, the Netherlands
| | - Stephanie van Straaten
- Van Creveldkliniek, University Medical Centre Utrecht, University of Utrecht, the Netherlands
| | - D Holmes Morton
- Central Pennsylvania Clinic for Special Children & Adults, Belleville, PA, USA Lancaster General Hospital, Lancaster, PA, USA
| | - Wilma Barcellini
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefan W Eber
- Schwerpunktpraxis für Pädiatrische Hämatologie-Onkologie and Children's Hospital, Technical University, Munich, Germany
| | - Bertil Glader
- Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA, USA
| | - Hassan M Yaish
- Primary Children's Hospital, University of Utah, Salt Lake City, UT, USA
| | - Satheesh Chonat
- Emory University School of Medicine, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, GA, USA
| | - Janet L Kwiatkowski
- Children's Hospital of Philadelphia and Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Mukta Sharma
- Children's Mercy Hospital, University of Missouri, Kansas City, MO, USA
| | | | - Sujit Sheth
- Weill Cornell Medical College, New York Presbyterian Hospital, NY, USA
| | - Jenny M Despotovic
- Texas Children's Hematology Center, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | - Kevin Kuo
- University of Toronto, University Health Network, ON, Canada
| | | | - Alexis A Thompson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | | | | | | | - Marcin W Wlodarski
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Heng Wang
- DDC Clinic for Special Needs Children, Middlefield, OH, USA
| | | | | | | | - Joachim Kunz
- Zentrum für Kinder-und Jugendmedizin,University of Heidelberg, Heidelberg, Germany
| | | | - Melissa J Rose
- Nationwide Children's Hospital,The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Kathryn Addonizio
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Anran Li
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Hasan Al-Sayegh
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Wendy B London
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Rachael F Grace
- Dana-Farber Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
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Abstract
BACKGROUND Sickle cell disease (SCD) complications lead to poor health-related quality of life (HRQOL) and increased healthcare utilization in this population, which could be mitigated with hydroxyurea therapy; however, adherence is suboptimal. We assessed the relationship of healthcare utilization to hydroxyurea adherence and HRQOL amongst youth with SCD. METHODS Thirty-four patients with SCD (median age 14 years, IQR 12-18) on hydroxyurea participated in this cross-sectional study and completed Morisky Adherence Scale 8-items and Patient Reported Outcomes Measurement Information System (PROMIS®) HRQOL measures. A medical chart review was conducted to assess healthcare utilization. RESULTS Participants with more frequent hospitalizations and emergency room (ER) visits and longer length of stay (LOS) had significantly lower fetal hemoglobin (rs=-0.44; rs=-0.45; rs=-0.46, p < 0.05) and mean corpuscular volume (rs=-0.47; rs=-0.42; rs=-0.48, p < 0.05), respectively. More frequent hospitalizations and ER visits and longer LOS correlated significantly with worse fatigue (rs=0.51; rs=0.41; rs=0.53, p < 0.05), pain (rs=0.41; rs=0.38; rs=0.47, p < 0.05), physical function mobility (rs=-0.67; rs=-0.59; rs=-0.67, p < 0.05), depression (rs=0.38; rs=0.31; rs=0.42, p < 0.05), and social isolation (rs=0.76; rs=0.76; rs=-0.84, p < 0.05), respectively. CONCLUSIONS We conclude that increased healthcare utilization in youth with SCD is associated with low adherence to hydroxyurea and worse HRQOL domain scores. It is important emphasize the clinical benefits of high adherence to hydroxyurea, particularly among youth with SCD. Future longitudinal studies are warranted to assess the directionality of these relationships, and may reveal modifiable behavioral factors associated with early changes in hydroxyurea adherence levels.
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Affiliation(s)
- Sherif M Badawy
- a Department of Pediatrics , Feinberg School of Medicine at Northwestern University , Chicago , IL, USA.,b Division of Hematology , Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL, USA
| | - Alexis A Thompson
- a Department of Pediatrics , Feinberg School of Medicine at Northwestern University , Chicago , IL, USA.,b Division of Hematology , Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL, USA
| | - Jane L Holl
- a Department of Pediatrics , Feinberg School of Medicine at Northwestern University , Chicago , IL, USA.,c Center for Healthcare Studies, Institute for Public Health and Medicine , Chicago , IL, USA
| | - Frank J Penedo
- d Department of Medical Social Sciences , Feinberg School of Medicine at Northwestern University , Chicago , IL, USA
| | - Robert I Liem
- a Department of Pediatrics , Feinberg School of Medicine at Northwestern University , Chicago , IL, USA.,b Division of Hematology , Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago , Chicago , IL, USA
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Badawy SM, Cronin RM, Hankins J, Crosby L, DeBaun M, Thompson AA, Shah N. Patient-Centered eHealth Interventions for Children, Adolescents, and Adults With Sickle Cell Disease: Systematic Review. J Med Internet Res 2018; 20:e10940. [PMID: 30026178 PMCID: PMC6072976 DOI: 10.2196/10940] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/06/2018] [Accepted: 06/21/2018] [Indexed: 12/18/2022] Open
Abstract
Background Sickle cell disease is an inherited blood disorder that affects over 100,000 Americans. Sickle cell disease–related complications lead to significant morbidity and early death. Evidence supporting the feasibility, acceptability, and efficacy of self-management electronic health (eHealth) interventions in chronic diseases is growing; however, the evidence is unclear in sickle cell disease. Objective We systematically evaluated the most recent evidence in the literature to (1) review the different types of technological tools used for self-management of sickle cell disease, (2) discover and describe what self-management activities these tools were used for, and (3) assess the efficacy of these technologies in self-management. Methods We reviewed literature published between 1995 and 2016 with no language limits. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, and other sources. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers screened titles and abstracts, assessed full-text articles, and extracted data from articles that met inclusion criteria. Eligible studies were original research articles that included texting, mobile phone–based apps, or other eHealth interventions designed to improve self-management in pediatric and adult patients with sickle cell disease. Results Of 1680 citations, 16 articles met all predefined criteria with a total of 747 study participants. Interventions were text messaging (4/16, 25%), native mobile apps (3/16, 19%), Web-based apps (5/16, 31%), mobile directly observed therapy (2/16, 13%), internet-delivered cognitive behavioral therapy (2/16, 13%), electronic pill bottle (1/16, 6%), or interactive gamification (2/16, 13%). Interventions targeted monitoring or improvement of medication adherence (5/16, 31%); self-management, pain reporting, and symptom reporting (7/16, 44%); stress, coping, sleep, and daily activities reporting (4/16, 25%); cognitive training for memory (1/16, 6%); sickle cell disease and reproductive health knowledge (5/16, 31%); cognitive behavioral therapy (2/16, 13%); and guided relaxation interventions (1/16, 6%). Most studies (11/16, 69%) included older children or adolescents (mean or median age 10-17 years; 11/16, 69%) and 5 included young adults (≥18 years old) (5/16, 31%). Sample size ranged from 11 to 236, with a median of 21 per study: <20 in 6 (38%), ≥20 to <50 in 6 (38%), and >50 participants in 4 studies (25%). Most reported improvement in self-management–related outcomes (15/16, 94%), as well as high satisfaction and acceptability of different study interventions (10/16, 63%). Conclusions Our systematic review identified eHealth interventions measuring a variety of outcomes, which showed improvement in multiple components of self-management of sickle cell disease. Despite the promising feasibility and acceptability of eHealth interventions in improving self-management of sickle cell disease, the evidence overall is modest. Future eHealth intervention studies are needed to evaluate their efficacy, effectiveness, and cost effectiveness in promoting self-management in patients with sickle cell disease using rigorous methods and theoretical frameworks with clearly defined clinical outcomes.
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Affiliation(s)
- Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Division of Hematology and Oncology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Robert M Cronin
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jane Hankins
- Department of Hematology, St Jude Children's Research Hospital, Memphis, TN, United States
| | - Lori Crosby
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.,Department of Psychology, University of Cincinnati, Cincinnati, OH, United States
| | - Michael DeBaun
- Division of Hematology and Oncology, Department of Pediatrics, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Alexis A Thompson
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Nirmish Shah
- Division of Hematology, Duke University School of Medicine, Durham, NC, United States
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Vichinsky E, Cohen A, Thompson AA, Giardina PJ, Lal A, Paley C, Cheng WY, McCormick N, Sasane M, Qiu Y, Kwiatkowski JL. Epidemiologic and clinical characteristics of nontransfusion-dependent thalassemia in the United States. Pediatr Blood Cancer 2018; 65:e27067. [PMID: 29637688 DOI: 10.1002/pbc.27067] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/05/2018] [Accepted: 02/26/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Nontransfusion-dependent thalassemia (NTDT) refers to a diverse group of thalassemia mutations and clinical phenotypes that do not require chronic transfusions. It is increasingly prevalent in the United States. PROCEDURE This study reviews the epidemiology and clinical characteristics of 138 patients with NTDT treated at four US thalassemia centers from 1997 to 2014. Data on laboratory results, transfusions, and clinical complications were collected from patient charts. RESULTS Overall, 84 patients with α-thalassemia (62 deletional hemoglobin H; 22 nondeletional hemoglobin H), 39 with β-thalassemia (26 with homozygous or double heterozygous β mutations; 13 with single β mutations with or without α triplication), and 15 with E/β-thalassemia (12 E/β0 ; three E/β+ ) were identified. At study entry, the median age for patients with α-thalassemia was 2.3 years; 9.2 years for patients with β-thalassemia and 2.2 years for patients with E/β-thalassemia. Most patients with α-thalassemia were Asian. Patients with β-thalassemia were predominantly Caucasian (46%) or of African descent (36%). Twenty percent of patients were born outside the United States and 5% were transfused before immigration. Complications varied by genotype and age. Individuals with nondeletional hemoglobin H were severely affected and, despite their young age, had many complications. Iron overload increased with age and was more common in patients who received transfusions. CONCLUSIONS NTDT in the United States is a multi-ethnic disease with different genotypic mutations and phenotypic manifestations. A higher than expected proportion of patients was Black/African American. NTDT-related complications are common and increase with age, supporting a need for early diagnosis.
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Affiliation(s)
- Elliott Vichinsky
- Department of Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, California
| | - Alan Cohen
- Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alexis A Thompson
- Division of Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Patricia J Giardina
- Department of Hematology/Oncology, Weill Cornell Medical College, New York City, New York
| | - Ashutosh Lal
- Department of Hematology/Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, California
| | - Carole Paley
- Department of Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | | | | | - Medha Sasane
- Department of Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Ying Qiu
- Department of Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Janet L Kwiatkowski
- Division of Hematology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Shenoy S, Walters MC, Ngwube A, Soni S, Jacobsohn D, Chaudhury S, Grimley M, Chan K, Haight A, Kasow KA, Parikh S, Andreansky M, Connelly J, Delgado D, Godder K, Hale G, Nieder M, Pulsipher MA, Trachtenberg F, Neufeld E, Kwiatkowski JL, Thompson AA. Unrelated Donor Transplantation in Children with Thalassemia using Reduced-Intensity Conditioning: The URTH Trial. Biol Blood Marrow Transplant 2018; 24:1216-1222. [PMID: 29374585 PMCID: PMC5993578 DOI: 10.1016/j.bbmt.2018.01.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 01/18/2018] [Indexed: 01/19/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) can cure transfusion-dependent thalassemia (TDT). In a multicenter trial we investigated the efficacy of reduced-intensity conditioning (RIC) before unrelated donor (URD) HSCT in children with TDT. Thirty-three children, ages 1 to 17 years, received bone marrow (BM) or umbilical cord blood (UCB) allografts. Median time to neutrophil engraftment was 13 days (range, 10 to 25) and 24 days (range, 18 to 49) and platelet engraftment 23 days (range, 12 to 46) and 50 days (range, 31 to 234) after BM and UCB allografts, respectively. With a median follow-up of 58 months (range, 7 to 79), overall and thalassemia-free survival was 82% (95% CI, .64% to .92%) and 79% (95% CI, .6% to .9%), respectively. The cumulative incidence of grades II to IV acute graft-versus-host disease (GVHD) after BM and UCB allografts was 24% and 44%; the 2-year cumulative incidence of chronic extensive GVHD was 29% and 21%, respectively; 71% of BM and 91% of UCB recipients discontinued systemic immunosuppression by 2 years. Six patients who had Pesaro risk class 2 (n = 5) and class 3 (n = 1) died of GVHD (n = 3), viral pneumonitis (n = 2) and pulmonary hemorrhage (n = 1). Outcomes after this RIC compared favorably with URD HSCT outcomes for TDT and supported engraftment in 32 of 33 patients. Efforts to reduce GVHD and infectious complications are being pursued further.
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Affiliation(s)
- Shalini Shenoy
- Department of Pediatrics, St. Louis Children's Hospital, Washington University, St. Louis, Missouri.
| | - Mark C Walters
- Department of Pediatrics, UCSF Benioff Children's Hospital, Oakland, California
| | - Alex Ngwube
- Department of Pediatrics, Phoenix Children's Hospital, Phoenix, Arizona
| | - Sandeep Soni
- Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, California
| | - David Jacobsohn
- Department of Pediatrics, Children's National Medical Center, Washington, DC
| | - Sonali Chaudhury
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois
| | - Michael Grimley
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Kawah Chan
- Department of Pediatrics, Texas Transplant Institute, San Antonio, Texas
| | - Ann Haight
- Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia
| | - Kimberley A Kasow
- Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
| | - Suhag Parikh
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
| | - Martin Andreansky
- Department of Pediatrics, University of Miami, Holtz Children's Hospital, Miami, Florida
| | - Jim Connelly
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - David Delgado
- Department of Pediatrics, Riley Children's Hospital, Indianapolis, Indiana
| | - Kamar Godder
- Department of Pediatrics, Nicklaus Children's Hospital, Miami, Florida
| | - Gregory Hale
- Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Michael Nieder
- Department of Pediatrics, Johns Hopkins All Children's Hospital, St. Petersburg, Florida
| | - Michael A Pulsipher
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Felicia Trachtenberg
- Department of Pediatrics, New England Research Institutes, Boston, Massachusetts
| | - Ellis Neufeld
- Department of Pediatrics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Janet L Kwiatkowski
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexis A Thompson
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois
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Thompson AA, Walters MC, Kwiatkowski J, Rasko JEJ, Ribeil JA, Hongeng S, Magrin E, Schiller GJ, Payen E, Semeraro M, Moshous D, Lefrere F, Puy H, Bourget P, Magnani A, Caccavelli L, Diana JS, Suarez F, Monpoux F, Brousse V, Poirot C, Brouzes C, Meritet JF, Pondarré C, Beuzard Y, Chrétien S, Lefebvre T, Teachey DT, Anurathapan U, Ho PJ, von Kalle C, Kletzel M, Vichinsky E, Soni S, Veres G, Negre O, Ross RW, Davidson D, Petrusich A, Sandler L, Asmal M, Hermine O, De Montalembert M, Hacein-Bey-Abina S, Blanche S, Leboulch P, Cavazzana M. Gene Therapy in Patients with Transfusion-Dependent β-Thalassemia. N Engl J Med 2018; 378:1479-1493. [PMID: 29669226 DOI: 10.1056/nejmoa1705342] [Citation(s) in RCA: 431] [Impact Index Per Article: 71.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Donor availability and transplantation-related risks limit the broad use of allogeneic hematopoietic-cell transplantation in patients with transfusion-dependent β-thalassemia. After previously establishing that lentiviral transfer of a marked β-globin (βA-T87Q) gene could substitute for long-term red-cell transfusions in a patient with β-thalassemia, we wanted to evaluate the safety and efficacy of such gene therapy in patients with transfusion-dependent β-thalassemia. METHODS In two phase 1-2 studies, we obtained mobilized autologous CD34+ cells from 22 patients (12 to 35 years of age) with transfusion-dependent β-thalassemia and transduced the cells ex vivo with LentiGlobin BB305 vector, which encodes adult hemoglobin (HbA) with a T87Q amino acid substitution (HbAT87Q). The cells were then reinfused after the patients had undergone myeloablative busulfan conditioning. We subsequently monitored adverse events, vector integration, and levels of replication-competent lentivirus. Efficacy assessments included levels of total hemoglobin and HbAT87Q, transfusion requirements, and average vector copy number. RESULTS At a median of 26 months (range, 15 to 42) after infusion of the gene-modified cells, all but 1 of the 13 patients who had a non-β0/β0 genotype had stopped receiving red-cell transfusions; the levels of HbAT87Q ranged from 3.4 to 10.0 g per deciliter, and the levels of total hemoglobin ranged from 8.2 to 13.7 g per deciliter. Correction of biologic markers of dyserythropoiesis was achieved in evaluated patients with hemoglobin levels near normal ranges. In 9 patients with a β0/β0 genotype or two copies of the IVS1-110 mutation, the median annualized transfusion volume was decreased by 73%, and red-cell transfusions were discontinued in 3 patients. Treatment-related adverse events were typical of those associated with autologous stem-cell transplantation. No clonal dominance related to vector integration was observed. CONCLUSIONS Gene therapy with autologous CD34+ cells transduced with the BB305 vector reduced or eliminated the need for long-term red-cell transfusions in 22 patients with severe β-thalassemia without serious adverse events related to the drug product. (Funded by Bluebird Bio and others; HGB-204 and HGB-205 ClinicalTrials.gov numbers, NCT01745120 and NCT02151526 .).
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Affiliation(s)
- Alexis A Thompson
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Mark C Walters
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Janet Kwiatkowski
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - John E J Rasko
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Jean-Antoine Ribeil
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Suradej Hongeng
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Elisa Magrin
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Gary J Schiller
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Emmanuel Payen
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Michaela Semeraro
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Despina Moshous
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Francois Lefrere
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Hervé Puy
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Philippe Bourget
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Alessandra Magnani
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Laure Caccavelli
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Jean-Sébastien Diana
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Felipe Suarez
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Fabrice Monpoux
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Valentine Brousse
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Catherine Poirot
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Chantal Brouzes
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Jean-François Meritet
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Corinne Pondarré
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Yves Beuzard
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Stany Chrétien
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Thibaud Lefebvre
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - David T Teachey
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Usanarat Anurathapan
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - P Joy Ho
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Christof von Kalle
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Morris Kletzel
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Elliott Vichinsky
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Sandeep Soni
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Gabor Veres
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Olivier Negre
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Robert W Ross
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - David Davidson
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Alexandria Petrusich
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Laura Sandler
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Mohammed Asmal
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Olivier Hermine
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Mariane De Montalembert
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Salima Hacein-Bey-Abina
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Stéphane Blanche
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Philippe Leboulch
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
| | - Marina Cavazzana
- From the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.A.T., M.K.); University of California, San Francisco, Benioff Children's Hospital, Oakland (M.C.W., E.V.), Lucile Salter Packard Children's Hospital at Stanford, Palo Alto (S.S.), and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles (G.J.S.) - all in California; Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia (J.K., D.T.T.); Centenary Institute (J.E.J.R.), University of Sydney, Sydney Medical School (J.E.J.R., P.J.H.), and Royal Prince Alfred Hospital (J.E.J.R., P.J.H.), Camperdown, NSW, Australia; Hôpital Universitaire Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (J.-A.R., E.M., D.M., F.L., P.B., A.M., L.C., J.-S.D., F.S., F.M., V.B., C.B., O.H., M.D.M., S.B., M.C.), Groupe Hospitalier Universitaire Ouest (J.-A.R., A.M., L.C., M.C.), IMAGINE Institute (E.M., M.S., D.M., M.C.), Université Paris Descartes (M.S., C. Poirot, S.H.-B.-A.), Université Paris Diderot (H.P., T.L.), Pierre et Marie Curie University (C. Poirot), and Hôpital Cochin (J.-F.M.), Paris, CEA University Paris-Sud, Institute of Emerging Diseases and Innovative Therapies, Fontenay-aux-Roses (E.P., Y.B., S.C., P.L.), Hôpital Louis-Mourier, Colombes (H.P., T.L.), Centre Hospitalier Intercommunal de Créteil, Créteil (C. Pondarré), and Hôpital Bicêtre, Le Kremlin-Bicêtre (S.H.-B.-A.) - all in France; Bluebird Bio, Cambridge (J.-A.R., S.S., G.V., O.N., R.W.R., D.D., A.P., L.S., M.A.), and Harvard Medical School, Brigham and Women's Hospital, Boston (P.L.) - both in Massachusetts; Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (S.H., U.A., P.L.); and the National Center for Tumor Diseases-German Cancer Research Center, Heidelberg, Germany (C.K.)
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Cronin RM, Hankins JS, Byrd J, Pernell BM, Kassim A, Adams-Graves P, Thompson AA, Kalinyak K, DeBaun MR, Treadwell M. Modifying factors of the health belief model associated with missed clinic appointments among individuals with sickle cell disease. ACTA ACUST UNITED AC 2018; 23:683-691. [PMID: 29595096 DOI: 10.1080/10245332.2018.1457200] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Outpatient care is critical in the management of chronic diseases, including sickle cell disease (SCD). Risk factors for poor adherence with clinic appointments in SCD are poorly defined. This exploratory study evaluated associations between modifying variables from the Health Belief Model and missed appointments. METHODS We surveyed adults with SCD (n = 211) and caregivers of children with SCD (n = 331) between October 2014 and March 2016 in six centres across the U.S. The survey tool utilized the framework of the Health Belief Model, and included: social determinants, psychosocial variables, social support, health literacy and spirituality. RESULTS A majority of adults (87%) and caregivers of children (65%) reported they missed a clinic appointment. Children (as reported by caregivers) were less likely to miss appointments than adults (OR:0.22; 95% CI:(0.13,0.39)). In adults, financial insecurity (OR:4.49; 95% CI:(1.20, 20.7)), health literacy (OR:4.64; 95% CI:(1.33, 16.15)), and age (OR:0.95; 95% CI:(0.91,0.99)) were significantly associated with missed appointments. In all participants, lower spirituality was associated with missed appointments (OR:1.83; 95%CI:(1.13, 2.94)). The most common reason for missing an appointment was forgetfulness (adults: 31%, children: 26%). A majority thought reminders would help (adults: 83%, children: 71%) using phone calls (adults: 62%, children: 61%) or text messages (adults: 56%, children: 51%). CONCLUSIONS Our findings demonstrate that modifying components of the Health Belief Model, including age, financial security, health literacy, spirituality, and lacking cues to action like reminders, are important in missed appointments and addressing these factors could improve appointment-keeping for adults and children with SCD.
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Affiliation(s)
- Robert M Cronin
- a Department of Biomedical Informatics , Vanderbilt University Medical Center , Nashville , TN , USA.,b Department of Internal Medicine , Vanderbilt University Medical Center , Nashville , TN , USA.,c Department of Pediatrics , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Jane S Hankins
- d Department of Hematology , St Jude Children's Research Hospital , Memphis , TN , USA
| | - Jeannie Byrd
- e Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Brandi M Pernell
- e Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA.,f Department of Pediatrics, Division of Hematology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Adetola Kassim
- g Department of Hematology/Oncology , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Patricia Adams-Graves
- h Department of General Internal Medicine , University of Tennessee Health Science Center , Memphis , TN , USA
| | - Alexis A Thompson
- i Ann and Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics , Northwestern University , Chicago , IL , USA
| | - Karen Kalinyak
- j Division of Hematology in Cancer and Blood Diseases Institute , University of Cincinnati , Cincinnati , OH , USA
| | - Michael R DeBaun
- e Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Marsha Treadwell
- k Department of Hematology/Oncology , UCSF Benioff Children's Hospital Oakland , Oakland , CA , USA
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Walters MC, Kwiatkowski JL, Rasko JE, Hongeng S, Schiller GJ, Anurathapan U, Cavazzana M, Ho PJ, von Kalle C, Kletzel M, Leboulch P, Vichinsky EP, Deary B, Asmal M, Thompson AA. Safety Following Autologous Transplantation with Lentiglobin Gene Therapy for Transfusion-Dependent β-Thalassemia (TDT) in the Northstar Hgb-204 Study. Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Badawy SM, Thompson AA, Kuhns LM. Medication Adherence and Technology-Based Interventions for Adolescents With Chronic Health Conditions: A Few Key Considerations. JMIR Mhealth Uhealth 2017; 5:e202. [PMID: 29273573 PMCID: PMC5756319 DOI: 10.2196/mhealth.8310] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 11/28/2017] [Accepted: 11/30/2017] [Indexed: 11/22/2022] Open
Abstract
The number of children and adolescents with chronic health conditions (CHCs) has doubled over the past two decades. Medication adherence is a key component of disease management within these groups. Low adherence to prescribed medications is a known problem in adolescents with CHCs and is related to health outcomes, including quality of life, disease complications, and mortality. Adolescence is a critical time to create routines and health behaviors that optimize disease self-management and transition to adult care. The mounting interest in the development and use of mobile health tools provides novel opportunities to connect patients, particularly adolescents, with their providers outside of the clinic and to improve health outcomes. There is growing evidence to support the efficacy of technology-based approaches, in particular text-messaging and mobile apps, to improve adherence behavior in adolescents, although cost-effectiveness and long-term health benefits remain unclear. In this short viewpoint article, we review some important considerations for promoting medication adherence in adolescents with CHCs using technology-based approaches.
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Affiliation(s)
- Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Pediatrics, Division of Hematology and Oncology, Zagazig University Faculty of Medicine, Zagazig, Egypt
| | - Alexis A Thompson
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lisa M Kuhns
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Division of Adolescent Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
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50
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Liem RI, Akinosun M, Muntz DS, Thompson AA. Feasibility and safety of home exercise training in children with sickle cell anemia. Pediatr Blood Cancer 2017; 64. [PMID: 28598539 DOI: 10.1002/pbc.26671] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/09/2017] [Accepted: 05/11/2017] [Indexed: 11/09/2022]
Abstract
Exercise guidelines do not exist for individuals with sickle cell anemia (SCA) despite the impact of disease-related complications on physical functioning. Thirteen subjects (mean 15.1 ± 2.8 years old) with SCA were prescribed three exercise sessions/week for 12 weeks on a stationary bicycle placed at home. In total, 77% of subjects completed 89% of prescribed sessions without exercise-related adverse events, thus meeting feasibility and safety criteria. Adherence to prescribed duration and target heart rate during training decreased during the second half of the study. Future trials are warranted to further evaluate training benefits associated with regular exercise in children with SCA.
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Affiliation(s)
- Robert I Liem
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Moriyike Akinosun
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Devin S Muntz
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Alexis A Thompson
- Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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