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Reggiani G, Boaro MP, Menzato F, De Bon E, Bertomoro A, Casonato A, Lucente F, Fortino C, Sartori M, Steffan A, Martella M, D'Agnolo M, Sainati L, Colombatti R. Early-onset indicators of a hypercoagulable state and clinical complications in a cohort of children with sickle cell trait. Pediatr Blood Cancer 2024; 71:e30971. [PMID: 38553897 DOI: 10.1002/pbc.30971] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/31/2024] [Accepted: 03/08/2024] [Indexed: 04/24/2024]
Abstract
Adults with sickle cell trait (SCT) have a procoagulant state with increased risk of thromboembolism, but limited data are available for children. We compared the coagulation profile of children with SCT, different sickle cell disease (SCD) genotypes, and healthy controls. Compared to controls and similarly to HbSC patients, 41 SCT children (mean age 6.85 years; 20 males; 88% Africans) had a characteristic procoagulant profile: higher levels of factor VIII, von Willebrand factor (VWF) Ag and CBA, D-dimer; lower levels of ADAMTS 13 activity, ADAMTS13 activity: VWFAg, plasminogen activator inhibitor, tissue plasminogen activator. Moreover, 13/41 had clinical complications of SCD, five requiring hospitalization.
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Affiliation(s)
- Giulia Reggiani
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Maria Paola Boaro
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Federica Menzato
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Emiliano De Bon
- UOC General Medicine, Cittadella's Hospital, Cittadella, Italy
| | - Antonella Bertomoro
- Department of Medicine, Internal Medicine 1 Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Alessandra Casonato
- Department of Medicine, Internal Medicine 1 Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Fabrizio Lucente
- Department of Medicine, Internal Medicine 1 Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Cecilia Fortino
- Department of Medicine, Internal Medicine 1 Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - MariaTeresa Sartori
- Department of Medicine, Internal Medicine 1 Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Agostino Steffan
- Department of Diagnostic Laboratory and Cellular Therapy, Centro Riferimento Oncologico, Aviano, Italy
| | - Maddalena Martella
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Mirco D'Agnolo
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Laura Sainati
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Raffaella Colombatti
- Department of Women's and Child's Health, Pediatric Hematology-Oncology Unit, Azienda Ospedaliera-Università di Padova, Padua, Italy
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2
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de Guimaraes TAC, Lai F, Colombatti R, Sato G, Rizzo R, Kalitzeos A, Michaelides M. Structural and functional characterization of an individual with the M285R KCNV2 hypomorphic allele. Ophthalmic Genet 2024:1-10. [PMID: 38454848 DOI: 10.1080/13816810.2024.2324046] [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: 09/20/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Disease-causing variants in the KCNV2 gene are associated with "cone dystrophy with supernormal rod responses," a rare autosomal recessive retinal dystrophy. There is no previous report of hypomorphic variants in the disease. MATERIAL AND METHODS Medical history, genetic testing, ocular examination, high-resolution retinal imaging including adaptive optics scanning light ophthalmoscopy (AOSLO), and functional assessments. RESULTS A 16-year-old male with mild cone-rod dystrophy presented with reduced central vision and photophobia. Genetic testing showed two variants in KCNV2, c.614_617dupAGCG (p.207AlafsTer166) and c.854T>G (p.Met285Arg), the latter which was previously considered benign. Electrophysiological assessment revealed the pathognomic electroretinogram waveforms associated with KCNV2-retinopathy. Optical coherence tomography showed discrete focal ellipsoid zone disruption, while fundus autofluorescence was normal. Non-waveguiding cones corresponding to areas of loss of photoreceptor integrity were visible on adaptive optics scanning light ophthalmoscopy. Retinal sensitivity and fixation were relatively preserved, with a demonstrable deterioration after 14 months of follow-up. CONCLUSIONS We provide functional and structural evidence that the variant M285R is disease-causing if associated with a loss-of-function variant. To the best of our knowledge, this is the first hypomorphic allele reported in KCNV2.
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Affiliation(s)
- Thales A C de Guimaraes
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Francesco Lai
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Giovanni Sato
- Unit of Low Vision Rehabilitation, Sant'Antonio Hospital, University of Padova, Padova, Italy
| | - Roberta Rizzo
- Unit of Low Vision Rehabilitation, Sant'Antonio Hospital, University of Padova, Padova, Italy
| | - Angelos Kalitzeos
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Michel Michaelides
- UCL Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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3
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Munaretto V, Corti P, Bertoni E, Tripodi SI, Guerzoni ME, Cesaro S, Arcioni F, Piccolo C, Mina T, Zecca M, Cuzzubbo D, Casale M, Palazzi G, Notarangelo LD, Masera N, Samperi P, Perrotta S, Russo G, Sainati L, Colombatti R. Acute chest syndrome in children with sickle cell disease: Data from a national AIEOP cohort identify priority areas of intervention in a hub-and-spoke system. Br J Haematol 2024; 204:1061-1066. [PMID: 37671902 DOI: 10.1111/bjh.19084] [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: 06/28/2022] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023]
Abstract
Acute chest syndrome (ACS) is a frequent cause of hospitalization in sickle cell disease (SCD). Despite advances in acute care, many settings still lack knowledge about ACS best practices. After the AIEOP Guidelines were published in 2012, suggesting standardized management in Italy, a retrospective study was performed to assess the diagnostic and therapeutic pathways of ACS in children. From 2013 to 2018, 208 ACS episodes were presented by 122/583 kids in 11 centres. 73 were male, mean age 10.9 years, 85% African, 92% HbSS or Sβ°. In our hub-and-spoke system, a good adherence to Guidelines was documented, but discrepancies between reference centres and general hospitals were noted. Improvement is needed for timely transfer to reference centres, use of incentive spirometry, oxygen therapy and pain management.
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Affiliation(s)
- V Munaretto
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - P Corti
- Clinica si Onco-Ematologia Pediatrica, Fondazione MBBM Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - E Bertoni
- Clinica di Onco-Ematologia Pediatrica, ASS Spedali Civili di Brescia, Brescia, Italy
| | - S I Tripodi
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M E Guerzoni
- Azienda Ospedaliera-Università di Modena, Modena, Italy
| | - S Cesaro
- Pediatric Hematology-Oncology, Ospedale della Donna e del Bambino, Verona, Italy
| | - F Arcioni
- Clinica di Oncoematologia Pediatrica, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - C Piccolo
- Clinica di Onco-Ematologia Pediatrica, Ospedale del Ponte, Varese, Italy
| | - T Mina
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - D Cuzzubbo
- Clinica di Onco-EmatologiaPediatrica, Azienda Ospedaliero Universitaria Meyer, Florence, Italy
| | - M Casale
- Università degli studi della Campania Luigi Vanvitelli, Naples, Italy
| | - G Palazzi
- Azienda Ospedaliera-Università di Modena, Modena, Italy
| | - L D Notarangelo
- Clinica di Onco-Ematologia Pediatrica, ASS Spedali Civili di Brescia, Brescia, Italy
| | - N Masera
- Clinica si Onco-Ematologia Pediatrica, Fondazione MBBM Azienda Ospedaliera S. Gerardo, Monza, Italy
| | - P Samperi
- Pediatric Hematology/Oncology Unit, Azienda Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - S Perrotta
- Università degli studi della Campania Luigi Vanvitelli, Naples, Italy
| | - G Russo
- Pediatric Hematology/Oncology Unit, Azienda Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - L Sainati
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - R Colombatti
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
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Corti P, Ferrari GM, Faraguna MC, Capitoli G, Longo F, Corradini E, Casini T, Boscarol G, Pinto VM, Ghilardi R, Russo G, Colombatti R, Mariani R, Piperno A. Haemochromatosis in children: A national retrospective cohort promoted by the A.I.E.O.P. (Associazione Italiana Emato-Oncologia Pediatrica) study group. Br J Haematol 2024; 204:306-314. [PMID: 37990447 DOI: 10.1111/bjh.19208] [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: 07/21/2023] [Revised: 10/25/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023]
Abstract
Haemochromatosis (HC) encompasses a range of genetic disorders. HFE-HC is by far the most common in adults, while non-HFE types are rare due to mutations of HJV, HAMP, TFR2 and gain-of-function mutations of SLC40A1. HC is often unknown to paediatricians as it is usually asymptomatic in childhood. We report clinical and biochemical data from 24 paediatric cases of HC (10 cases of HFE-, 5 TFR2-, 9 HJV-HC), with a median follow-up of 9.6 years. Unlike in the adult population, non-HFE-HC constitutes 58% (14/24) of the population in our series. Transferrin saturation was significantly higher in TFR2- and HJV-HC compared to HFE-HC, and serum ferritin and LIC were higher in HJV-HC compared to TFR2- and HFE-HC. Most HFE-HC subjects had relatively low ferritin and LIC at the time of diagnosis, so therapy could be postponed for most of them after the age of 18. Our results confirm that HJV-HC is a severe form already in childhood, emphasizing the importance of early diagnosis and treatment to avoid the development of organ damage and reduce morbidity and mortality. Although phlebotomies were tolerated by most patients, oral iron chelators could be a valid option in early-onset HC.
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Affiliation(s)
- Paola Corti
- Pediatria, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | | | - Martha Caterina Faraguna
- Pediatria, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Residency in Pediatrics, University of Milano Bicocca, Milan, Italy
| | - Giulia Capitoli
- Bicocca Bioinformatics Biostatistics and Bioimaging B4 Center, Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Filomena Longo
- Thalassemia Reference Centre, Orbassano, Italy
- Regional HUB Centre for Thalassaemia and Haemoglobinopathies, Department of Medicine, AOU S. Anna, Ferrara, Italy
| | - Elena Corradini
- Internal Medicine Unit and Centre for Hemochromatosis and Hereditary Liver Diseases, ERN-EuroBloodNet and ERN-RARE-LIVER, Azienda Ospedaliero-Universitaria di Modena-Policlinico, Modena, Italy
| | - Tommaso Casini
- Pediatric Hematology/Oncology Department, Meyer's Children University Hospital, Firenze, Italy
| | | | - Valeria Maria Pinto
- Centro della Microcitemia e delle Anemie Congenite, Ospedale Galliera, Genova, Italy
| | - Roberta Ghilardi
- Department of Pediatrics, Ospedale Maggiore Policlinico, IRCCS, Milano, Italy
| | - Giovanna Russo
- Pediatric Hematology and Oncology Unit, Azienda Policlinico "Rodolico-San Marco", University of Catania, Catania, Italy
| | - Raffaella Colombatti
- Pediatric Hematology Oncology and Bone Marrow Transplantation Unit, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Raffaella Mariani
- SSD Rare Diseases-European Reference Network for Rare Hematological Diseases-EuroBloodNet-Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Alberto Piperno
- SSD Rare Diseases-European Reference Network for Rare Hematological Diseases-EuroBloodNet-Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- Centro Ricerca Tettamanti, Monza, Italy
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5
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Quotti Tubi L, Canovas Nunes S, Mandato E, Pizzi M, Vitulo N, D’Agnolo M, Colombatti R, Martella M, Boaro MP, Doriguzzi Breatta E, Fregnani A, Spinello Z, Nabergoj M, Filhol O, Boldyreff B, Albiero M, Fadini GP, Gurrieri C, Vianello F, Semenzato G, Manni S, Trentin L, Piazza F. CK2β Regulates Hematopoietic Stem Cell Biology and Erythropoiesis. Hemasphere 2023; 7:e978. [PMID: 38026791 PMCID: PMC10673422 DOI: 10.1097/hs9.0000000000000978] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
The Ser-Thr kinase CK2 plays important roles in sustaining cell survival and resistance to stress and these functions are exploited by different types of blood tumors. Yet, the physiological involvement of CK2 in normal blood cell development is poorly known. Here, we discovered that the β regulatory subunit of CK2 is critical for normal hematopoiesis in the mouse. Fetal livers of conditional CK2β knockout embryos showed increased numbers of hematopoietic stem cells associated to a higher proliferation rate compared to control animals. Both hematopoietic stem and progenitor cells (HSPCs) displayed alterations in the expression of transcription factors involved in cell quiescence, self-renewal, and lineage commitment. HSPCs lacking CK2β were functionally impaired in supporting both in vitro and in vivo hematopoiesis as demonstrated by transplantation assays. Furthermore, KO mice developed anemia due to a reduced number of mature erythroid cells. This compartment was characterized by dysplasia, proliferative defects at early precursor stage, and apoptosis at late-stage erythroblasts. Erythroid cells exhibited a marked compromise of signaling cascades downstream of the cKit and erythropoietin receptor, with a defective activation of ERK/JNK, JAK/STAT5, and PI3K/AKT pathways and perturbations of several transcriptional programs as demonstrated by RNA-Seq analysis. Moreover, we unraveled an unforeseen molecular mechanism whereby CK2 sustains GATA1 stability and transcriptional proficiency. Thus, our work demonstrates new and crucial functions of CK2 in HSPC biology and in erythropoiesis.
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Affiliation(s)
- Laura Quotti Tubi
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Sara Canovas Nunes
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
- Division of Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Elisa Mandato
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marco Pizzi
- Department of Medicine, Cytopathology and Surgical Pathology Unit, University of Padova, Italy
| | - Nicola Vitulo
- Department of Biotechnology, University of Verona, Italy
| | - Mirco D’Agnolo
- Department of Women’s and Child’s Health, University of Padova, Italy
| | | | | | - Maria Paola Boaro
- Department of Women’s and Child’s Health, University of Padova, Italy
| | - Elena Doriguzzi Breatta
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Anna Fregnani
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Zaira Spinello
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Mitja Nabergoj
- Hematology Service, Institut Central des Hôpitaux (ICH), Hôpital du Valais, Sion, Switzerland
| | - Odile Filhol
- Institut National de la Santé Et de la Recherche Médicale (INSERM) U1036, Institute de Reserches en Technologies et Sciences pour le Vivant/Biologie du Cancer et de l’Infection, Grenoble, France
| | | | - Mattia Albiero
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy
- Veneto Institute of Molecular Medicine, Experimental Diabetology Lab, Padova, Italy
| | - Gian Paolo Fadini
- Veneto Institute of Molecular Medicine, Experimental Diabetology Lab, Padova, Italy
- Department of Medicine, University of Padova, Italy
| | - Carmela Gurrieri
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Fabrizio Vianello
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Gianpietro Semenzato
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Sabrina Manni
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Livio Trentin
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
| | - Francesco Piazza
- Department of Medicine, Division of Hematology, University of Padova, Italy
- Laboratory of Normal and Malignant Hematopoiesis and Pathobiology of Myeloma and Lymphoma. Veneto Institute of Molecular Medicine (VIMM), Padova, Italy
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Colombatti R, Casale M. Early splenectomy in sickle cell disease: another piece of the puzzle. Haematologica 2023; 108:3197-3198. [PMID: 37439345 PMCID: PMC10690901 DOI: 10.3324/haematol.2023.283481] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
Not available.
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Affiliation(s)
- Raffaella Colombatti
- Pediatric Hematology-Oncology Unit, Department of Women's and Child's Health, University of Padova, Padova.
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7
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Segbefia C, Campbell J, Tartaglione I, Asare EV, Andemariam B, Zempsky W, Colombatti R, Boatemaa GD, Boruchov D, Rao S, Piccone CM, Smith A, Haile H, Kim E, Wilson S, Farooq F, Urbonya R, Rivers A, Manwani D, Gai J, Sey F, Inusa B, Antwi-Boasiako C, Strunk C, Campbell AD. Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises. J Womens Health (Larchmt) 2023; 32:1284-1291. [PMID: 38011013 DOI: 10.1089/jwh.2023.0023] [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] [Indexed: 11/29/2023] Open
Abstract
Background: Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. Materials and Methods: A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Results: Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, p = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, p = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Conclusions: Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.
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Affiliation(s)
- Catherine Segbefia
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Jillian Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Biree Andemariam
- Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut, Farmington, Connecticut, USA
| | - William Zempsky
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Raffaella Colombatti
- Department of Women's and Child Health, Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Donna Boruchov
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Connie M Piccone
- Department of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Ashya Smith
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Haikel Haile
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Esther Kim
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Angela Rivers
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA
| | - Jiaxiang Gai
- Division of Biostatistics and Study Methodology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, College of Nursing, London, United Kingdom
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
- College of Health Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Crawford Strunk
- Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrew D Campbell
- Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology, Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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8
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Reggiani G, Boaro MP, Colombatti R. Prevention of neurovascular complications in children with Sickle Cell Disease in the real-world setting: What adult medicine physicians should know. Presse Med 2023; 52:104201. [PMID: 37939876 DOI: 10.1016/j.lpm.2023.104201] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/05/2023] [Indexed: 11/10/2023] Open
Abstract
Neurovascular complications represent one of the most detrimental manifestations of Sickle Cell Disease (SCD), affecting many patients since infancy. They include overt stroke, silent cerebral infarcts and neurocognitive disorders. In fact, neurodevelopment can be impaired in children resulting in cognitive dysfunction in adults with SCD. This review is meant to resume the most recent guidelines about the prevention of SCD neurovascular complications and to highlight the open challenges in their implementation. Transcranial Doppler, Magnetic Resonance Imaging/Angiography and neurocognitive test are useful screening tools. Chronic transfusion regimen, hematopoietic stem cell transplantation and neurocognitive rehabilitation find indications in the context of primary and secondary prevention of neurovascular complications of SCD. However, international guidelines are often difficult to bring into the real world due to the lack of appropriate instruments and trained personnel. Many challenges have still to be faced to guarantee the best possible neurocognitive function to each child affected by SCD.
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Affiliation(s)
- Giulia Reggiani
- Department of Women's and Children's Health, University of Padua, Via Giustiniani, 3, 35128 Padua, Italy.
| | - Maria Paola Boaro
- Department of Women's and Children's Health, University of Padua, Via Giustiniani, 3, 35128 Padua, Italy
| | - Raffaella Colombatti
- Department of Women's and Children's Health, University of Padua, Via Giustiniani, 3, 35128 Padua, Italy
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Pellegrini M, Chakravorty S, Del Mar Manu Pereira M, Gulbis B, Gilmour-Hamilton C, Hayes S, de Montalembert M, Inusa BPD, Colombatti R, Roy NB. Sickle cell disease: embedding patient participation into an international conference can transform the role of lived experience. Orphanet J Rare Dis 2023; 18:341. [PMID: 37908000 PMCID: PMC10619309 DOI: 10.1186/s13023-023-02951-8] [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: 03/13/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is an inherited chronic life-threatening disorder with increasing prevalence in Europe. People living with SCD in Europe mainly belong to vulnerable minorities, have a lower level of health education and suffer from isolation compared to those living with other chronic conditions. As a result, SCD patients are much less likely to partner in the design of research related to their condition and are limited in their ability to influence the research agenda. Aiming to increase the influence of patient voice in the development of SCD-related research, we set out to develop patient centered actions in the frame of International Scientific Conferences in collaboration with the ERN-EuroBloodNet, Oxford Blood Group, Annual Sickle Cell Disease and Thalassaemia Conference (ASCAT), the European Hematology Association and the British Society of Hematology. RESULTS Two events were organized: a one-day research prioritization workshop and a series of education sessions based on topics chosen by SCD patients and their families. Methodology and outcomes were analyzed in terms of influence on scientific, medical and patient communities. CONCLUSION The ERN-EuroBloodNet workshops with patients at annual ASCAT conferences have provided an opportunity to enhance patient experience and empowerment in SCD in Europe, producing benefits for patients, caregivers, patient associations and health professionals. Future work should focus on delivering the research questions identified at this workshop and the opportunities to share information for patient education.
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Affiliation(s)
- Mariangela Pellegrini
- European Reference Network on Rare Hematological Disease, the ERN-EuroBloodNets, Hôpitaux de Paris, Hôpital Saint Louis, Paris, France.
| | | | - Maria Del Mar Manu Pereira
- European Reference Network on Rare Hematological Diseases, the ERN-EuroBloodNet, Vall d'Hebron Research Institute/Vall d'Hebron University Hospital, Barcelona, Spain
| | - Beatrice Gulbis
- European Reference Network on Rare Hematological Diseases, the ERN-EuroBloodNet, Hôpital Erasme/LHUB-ULB, Brussels, Belgium
| | | | - Sandy Hayes
- Oxford University Hospitals NHS Trust, Oxford, England
| | - Mariane de Montalembert
- European Reference Network On Rare Hematological Diseases, the ERN-EuroBloodNet, Hôpitaux de Paris, Hôpital Necker, Paris, France
| | - Baba Psalm Duniya Inusa
- Paediatric Haematology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Raffaella Colombatti
- European Network of Rare Hematological Diseases, the ERN-EuroBloodNetPediatric Hematology Oncology Unit, Department of Women's and Child's Health, University of Padova, Padua, Italy
| | - Noémi Ba Roy
- Oxford University Hospitals NHS Trust, Oxford, England
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Boaro MP, Reggiani G, D’Agnolo M, Munaretto V, Pozzebon F, Trapanese R, Martella M, Colombatti R. Hematological characteristics and hepatobiliary complications of hereditary spherocytosis in a tertiary care pediatric center: optimizing diagnosis and care through local and international networks. Front Pediatr 2023; 11:1269645. [PMID: 37886235 PMCID: PMC10598659 DOI: 10.3389/fped.2023.1269645] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Background Hereditary Spherocytosis (HS) is a rare, congenital red blood cell disorder presenting with variable clinical manifestations ranging from mild hemolytic anemia to severe anemia with hypersplenism and hepatobiliary complications. Methods The objectives of the study were to evaluate the diagnostic pathway of HS, the presence and management of hepatobiliary complications in pediatric patients with HS followed in a tertiary care center. The demographic, clinical, hematological information were retrieved from medical records of patients having at least 1 hematology visit between 2010 and 2020. Results Forty-two patients were enrolled, 23 M. Mean age at onset of symptoms was 2.8 years, at diagnosis was 3.5 years. Anemia was the first manifestation in 73%; suspect of HS arose for all patients in first or second level outpatient clinics. Only 64% of patients performed two confirmation tests in the reference center. 28/42 had familiarity for HS; of the 13/42 who did not, only 47% performed further analysis. Sixteen patients developed gallbladder stones (40%), visible at the first ultrasound (5.6 years). Hemolytic crises and parvovirus infections were more frequent in patients with stones (53.6% vs. 26.1% and 63.6% vs. 28.6%, respectively). 10/16 (62.5%) underwent elective cholecystectomy: 8 had concomitant splenectomy. Conclusions our study highlights the need to optimize the diagnostic pathway in networks of care involving general and specialized centers in order to reduce time to diagnosis and ensure that all patients receive confirmatory tests. A high frequency of hepatobiliary complications since young age was observed suggesting that screening with ultrasound should begin earlier.
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Affiliation(s)
- Maria Paola Boaro
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Giulia Reggiani
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Mirco D’Agnolo
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Vania Munaretto
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Francesco Pozzebon
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Roberta Trapanese
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Maddalena Martella
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
| | - Raffaella Colombatti
- UOC Pediatric Hematology Oncology, Azienda Ospedale Università di Padova, Padova, Italy
- Department of Women’s and Child’s Health, University of Padova, Padova, Italy
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Colombatti R, Hegemann I, Medici M, Birkegård C. Systematic Literature Review Shows Gaps in Data on Global Prevalence and Birth Prevalence of Sickle Cell Disease and Sickle Cell Trait: Call for Action to Scale Up and Harmonize Data Collection. J Clin Med 2023; 12:5538. [PMID: 37685604 PMCID: PMC10488271 DOI: 10.3390/jcm12175538] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Sickle cell disease (SCD) is an inherited monogenic disorder with high prevalence throughout sub-Saharan Africa, the Mediterranean basin, the Middle East, and India. Sources of SCD epidemiology remain scarce and fragmented. A systematic literature review (SLR) to identify peer-reviewed studies on SCD epidemiology was performed, with a search of bibliographic databases and key conference proceedings from 1 January 2010 to 25 March 2022 (congress abstracts after 2018). The SLR followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Meta-analyses, using a binomial normal random-effects model, were performed to estimate global and regional prevalence and birth prevalence. Of 1770 journal articles and 468 abstracts screened, 115 publications met the inclusion criteria. Prevalence was highest in Africa (~800/100,000), followed by the Middle East (~200/100,000) and India (~100/100,000), in contrast to ~30/100,000 in Europe. Birth prevalence was highest in Africa (~1000/100,000) and lowest in North America (~50/100,000) and Europe (~30/100,000). This SLR confirmed that sub-Saharan and North-East Africa, India, the Middle East, and the Caribbean islands are global SCD hotspots. Publications including mortality data were sparse, and no conclusions could be drawn about mortality. The identified data were limited due to gaps in the published literature for large parts of the world population; the inconsistent reporting of SCD genotypes, diagnostic criteria, and settings; and a sparsity of peer-reviewed publications from countries with assumed high prevalence. This SLR demonstrated a lack of systematic knowledge and a need to provide uniform data collection on SCD prevalence and mortality.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Child and Maternal Health, Azienda Ospedaliera, University of Padova, 35122 Padua, Italy
| | | | - Morten Medici
- Novo Nordisk A/S, 2860 Søborg, Denmark; (M.M.); (C.B.)
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12
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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: 16] [Impact Index Per Article: 16.0] [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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Mañú Pereira MDM, Colombatti R, Alvarez F, Bartolucci P, Bento C, Brunetta AL, Cela E, Christou S, Collado A, de Montalembert M, Dedeken L, Fenaux P, Galacteros F, Glenthøj A, Gutiérrez Valle V, Kattamis A, Kunz J, Lobitz S, McMahon C, Pellegrini M, Reidel S, Russo G, Santos Freire M, van Beers E, Kountouris P, Gulbis B. Sickle cell disease landscape and challenges in the EU: the ERN-EuroBloodNet perspective. Lancet Haematol 2023:S2352-3026(23)00182-5. [PMID: 37451300 DOI: 10.1016/s2352-3026(23)00182-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Sickle cell disease is a hereditary multiorgan disease that is considered rare in the EU. In 2017, the Rare Diseases Plan was implemented within the EU and 24 European Reference Networks (ERNs) were created, including the ERN on Rare Haematological Diseases (ERN-EuroBloodNet), dedicated to rare haematological diseases. This EU initiative has made it possible to accentuate existing collaborations and create new ones. The project also made it possible to list all the needs of people with rare haematological diseases not yet covered health-care providers in the EU to allow optimised care of individuals with rare pathologies, including sickle cell disease. This Viewpoint is the result of joint work within 12 EU member states (ie, Belgium, Cyprus, Denmark, France, Germany, Greece, Ireland, Italy, Portugal, Spain, Sweden, and The Netherlands), all members of the ERN-EuroBloodNet. We describe the role of the ERN-EuroBloodNet to improve the overall approach to and the management of individuals with sickle cell disease in the EU through specific on the pooling of expertise, knowledge, and best practices; the development of training and education programmes; the strategy for systematic gathering and standardisation of clinical data; and its reuse in clinical research. Epidemiology and research strategies from ongoing implementation of the Rare Anaemia Disorders European Epidemiological Platform is depicted.
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Affiliation(s)
- María Del Mar Mañú Pereira
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebrón Institut de Recerca, Barcelona, Spain; Pediatric Hematology and Oncology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
| | - Raffaella Colombatti
- Pediatric Hematology Oncology Unit, Department of Women's and Child's Health, Azienda Ospedale-Università degli Studi di Padova, Padua, Italy
| | - Federico Alvarez
- Information Processing and Telecommunications Center, Universidad Politécnica de Madrid, Madrid, Spain
| | - Pablo Bartolucci
- Sickle Cell and Red Cell Disorders Referral Center-UMGGR, Hôpitaux Universitaires Henri Mondor, Assistance Publique Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France; Institut Mondor de Recherche Biomédicale, Laboratory of Excellence LABEX GRex, Créteil, France
| | - Celeste Bento
- Hematology Department, University Hospital, Research Centre for Anthropology and Health (CIAS), University Coimbra, Coimbra, Portugal
| | - Angelo Loris Brunetta
- Thalassaemia International Federation, Nicosia, Cyprus; ERN-EuroBloodNet, Paris, France
| | - Elena Cela
- Pediatric Hematology and Oncology Unit, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Anna Collado
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebrón Institut de Recerca, Barcelona, Spain; Pediatric Hematology and Oncology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mariane de Montalembert
- Department of General Pediatrics and Pediatric Infectious Disease, Sickle Cell Center, Necker-Enfants malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Laurence Dedeken
- Haemato-oncology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - Pierre Fenaux
- Département d'hématologie et immunologie, hôpital St Louis, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Frédéric Galacteros
- Red Cell Genetic Disease Unit, Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, GHU Henri Mondor; U-PEC, Paris, France
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Victoria Gutiérrez Valle
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebrón Institut de Recerca, Barcelona, Spain; Pediatric Hematology and Oncology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antonis Kattamis
- Thalassemia Unit, First Department of Pediatrics, National and Kapodistrian University of Athens-'Aghia Sophia' Children's Hospital, Athens, Greece
| | - Joachim Kunz
- Department of Pediatric Oncology, Hematology, Oncology and Immunology, University of Heidelberg, Heidelberg, Germany
| | - Stephan Lobitz
- Department of Pediatric Hematology and Oncology, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany
| | - Corrina McMahon
- Department of Haematology, Children's Health Ireland at Crumlin, University College Dublin, Ireland
| | - Mariangela Pellegrini
- Département d'hématologie et immunologie, hôpital St Louis, Assistance Publique Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Sara Reidel
- Rare Anemia Disorders Research Laboratory, Cancer and Blood Disorders in Children, Vall d'Hebrón Institut de Recerca, Barcelona, Spain; Pediatric Hematology and Oncology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Giovanna Russo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Miriam Santos Freire
- ERN-EuroBloodNet, Paris, France; Associação Portuguesa de Pais e Doentes com Hemoglobinopatias-APPDH, Almada, Portugal; European Hematology Association, The Hague, Netherlands; Portugal for the European Sickle Cell Federation, Brussels, Belgium
| | - Eduard van Beers
- Center for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Petros Kountouris
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Béatrice Gulbis
- Laboratoire Hospitalier Universitaire de Bruxelles, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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Reggiani G, Coppadoro B, Munaretto V, Pieroni A, Viaro F, Manara R, Beaubrun A, Biffi A, Baracchini C, Sainati L, Colombatti R. Relationship between hemoglobin, hemolysis, and transcranial Doppler velocities in children with sickle cell disease: Results from a long-term natural history study in Italy in the era of multimodal therapy. Eur J Haematol 2023. [PMID: 37282348 DOI: 10.1111/ejh.14022] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Stroke and cerebral vasculopathy are leading causes of morbidity and mortality in patients with sickle cell disease (SCD). Transcranial Doppler (TCD) is a reliable and validated predictor of stroke risk. Children with conditional or abnormal TCD are at an increased risk for stroke, which can be mitigated by red blood cell transfusion or hydroxyurea. Elucidating the relationship between cerebral hemodynamics and hemolytic anemia can help identify novel therapeutic approaches to reduce stroke risk and transfusion dependence. METHODS This long-term, real-world study was designed to evaluate the prevalence of TCD imaging (TCDi)-assessed flow velocities in children and to interrogate their relationship with markers of anemia and hemolysis. RESULTS In total, 155 children (median follow-up 79.8 months, 1358.44 patient-years) had 583 evaluable TCDi results. Only patients with HbSS or HbSβ0 had abnormal (1.6%) or conditional (10.9%) TCDi. Children with abnormal or conditional TCDi had lower hemoglobin (Hb) and higher hemolysis markers. A linear correlation was detected between TCD velocity and Hb: an Hb increase of 1 g/dL corresponded to decreases in velocity in the internal carotid and middle cerebral arteries (6.137 cm/s and 7.243 cm/s). Moreover, patients with Hb >9 g/dL presented a lower risk of TCDi-associated events. CONCLUSION These results support the need to optimize disease-modifying treatments that increase Hb and reduce hemolysis for stroke prevention in young children with SCD.
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Affiliation(s)
- Giulia Reggiani
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Beatrice Coppadoro
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Vania Munaretto
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Alessio Pieroni
- Stroke Unit and Neurosonology Laboratory, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Federica Viaro
- Stroke Unit and Neurosonology Laboratory, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Renzo Manara
- Department of Neuroscience, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Anne Beaubrun
- Global Health Economic and Outcomes Research, Medical Affairs, Global Blood Therapeutics, Inc, South San Francisco, USA
| | - Alessandra Biffi
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Claudio Baracchini
- Stroke Unit and Neurosonology Laboratory, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Laura Sainati
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Raffaella Colombatti
- Pediatric Hematology Oncology Unit, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padua, Italy
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Munaretto V, Martella M, Francescato S, Reggiani G, Boaro MP, Bianchi P, Fermo E, Barcellini W, Sainati L, Colombatti R. Severe hemolytic anemia in a newborn: Look out for rare Gardos channelopathies due to KCNN4 mutation. Pediatr Blood Cancer 2023:e30325. [PMID: 37132095 DOI: 10.1002/pbc.30325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 05/04/2023]
Affiliation(s)
- Vania Munaretto
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Maddalena Martella
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Samuela Francescato
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Giulia Reggiani
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Maria Paola Boaro
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Paola Bianchi
- UOC Ematologia, UOS Fisiopatologia delle anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fermo
- UOC Ematologia, UOS Fisiopatologia delle anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Wilma Barcellini
- UOC Ematologia, UOS Fisiopatologia delle anemie, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Sainati
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
| | - Raffaella Colombatti
- Onco-Ematologia Pediatrica, Dipartimento di Salute della Donna e del Bambino, Azienda Ospedaliera-Università di Padova, Padua, Italy
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Mulimani P, Abas AB, Karanth L, Colombatti R, Kulkarni P. Treatment of dental and orthodontic complications in thalassaemia. Cochrane Database Syst Rev 2023; 2:CD012969. [PMID: 36732291 PMCID: PMC9893875 DOI: 10.1002/14651858.cd012969.pub3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Thalassaemia is a quantitative abnormality of haemoglobin caused by mutations in genes controlling production of alpha or beta globins. Abnormally unpaired globin chains cause membrane damage and cell death within organ systems and destruction of erythroid precursors in the bone marrow, leading to haemolytic anaemia. The life-long management of the general health effects of thalassaemia is highly challenging, and failure to deal with dental and orthodontic complications exacerbates the public health, financial and personal burden of the condition. There is a lack of evidence-based guidelines to help care seekers and providers manage such dental and orthodontic complications. This review aimed to evaluate the available evidence on methods for treating dental and orthodontic complications in people with thalassaemia to inform future recommendations. This is an update of a Cochrane Review first published in 2019. OBJECTIVES To assess different methods for treating dental and orthodontic complications in people with thalassaemia. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register in September 2022, and we searched nine online databases and trials registries in January 2022. We searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organisations, pharmaceutical companies and researchers working in this field. SELECTION CRITERIA We searched for published or unpublished randomised controlled trials (RCTs) that evaluated treatment of dental and orthodontic complications in individuals diagnosed with thalassaemia, irrespective of phenotype, severity, age, sex and ethnic origin. DATA COLLECTION AND ANALYSIS Two review authors independently screened the 37,242 titles retrieved by the search. After deduplication, we identified two potentially relevant RCTs. On assessing their eligibility against our inclusion and exclusion criteria, we excluded one and included the other. MAIN RESULTS We included one parallel-design RCT conducted in Saudi Arabia and involving 29 participants (19 males, 10 females) with thalassaemia. It aimed to assess the effectiveness of photodynamic therapy as an adjuvant to conventional full-mouth ultrasonic scaling for the treatment of gingivitis. The average age of participants was around 23 years. There is very low-certainty evidence from this trial that full-mouth ultrasonic scaling plus photodynamic therapy compared to full-mouth ultrasonic scaling alone may improve gingival index score and bleeding on probing after 12 weeks in people with thalassaemia. We found no studies that assessed other interventions for the various dental or orthodontic complications of thalassaemia. AUTHORS' CONCLUSIONS Although the included study showed greater reduction in gingivitis in the group treated with full-mouth ultrasonic scaling plus photodynamic therapy, the evidence is of very low certainty. The study had unclear risk of bias, a short follow-up period and no data on safety or adverse effects. We cannot make definitive recommendations for clinical practice based on the limited evidence of a single trial. Future studies will very likely affect the conclusions of this review. This review highlights the need for high-quality RCTs that investigate the effectiveness of various treatment modalities for dental and orthodontic complications in people with thalassaemia. It is crucial that future trials assess adverse effects of interventions.
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Affiliation(s)
- Priti Mulimani
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Adinegara Bl Abas
- Department of Community Medicine, Melaka-Manipal Medical College (Manipal Academy of Higher Education), Melaka, Malaysia
| | - Laxminarayan Karanth
- Department of Obstetrics and Gynaecology, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology-Oncology, Department of Child and Maternal Health, Azienda Ospedaliera-University of Padova, Padova, Italy
| | - Palna Kulkarni
- Department of Maxillofacial Surgery, Al Qassimi Hospital, Sharjah, United Arab Emirates
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17
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Colombatti R. Standardizing elements of care in pediatric sickle cell disease centers: The road toward health equity. Pediatr Blood Cancer 2023; 70:e30078. [PMID: 36326131 DOI: 10.1002/pbc.30078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 09/30/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Raffaella Colombatti
- Pediatric Hematology Oncology and Bone Marrow Transplantation Unit, Department of Woman's and Child's Health, University of Padova, Padova, Italy
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18
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Menzato F, Bosa L, Sifna A, Da Silva L, Gasperoni E, Martella M, Mustik A, Da Dalt L, Reggiani G, Munaretto V, Liotta G, Riccardi F, Colombatti R. Point-of-care testing allows successful simultaneous screening of sickle cell disease, HIV, and tuberculosis for households in rural Guinea-Bissau, West Africa. Pediatr Blood Cancer 2022; 69:e30009. [PMID: 36161764 DOI: 10.1002/pbc.30009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/07/2022]
Abstract
Diagnosis of noncommunicable genetic diseases like sickle cell disease (SCD) and communicable diseases such as human immunodeficiency virus (HIV) or tuberculosis (TB) is often difficult in rural areas of Africa due to the lack of infrastructures, trained staff, or capacity to involve families living in remote areas. The availability of point-of-care (POC) tests for the above diseases offers the opportunity to build joint programs to tackle all conditions. We report successful simultaneous screening of SCD, HIV, and TB utilizing POC tests in 898 subjects in Fanhe, in rural Guinea-Bissau. Adherence was 100% and all diagnosed subjects were enrolled in care programs.
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Affiliation(s)
- Federica Menzato
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Luca Bosa
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Armando Sifna
- Hospital Raoul Follereau (HRF), Centro de Referencia Nacional para Tuberculose, Bissau, Guinea-Bissau
| | - Luisa Da Silva
- Hospital Raoul Follereau (HRF), Centro de Referencia Nacional para Tuberculose, Bissau, Guinea-Bissau
| | - Elena Gasperoni
- Aid Health and Development Onlus (AHEAD), Rome, Italy.,San Marino Hospital, San Marino, San Marino
| | - Maddalena Martella
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Alfa Mustik
- Non-profit organization "Amici della Guinea-Bissau", Milan, Italy
| | - Liviana Da Dalt
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Giulia Reggiani
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Vania Munaretto
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Fabio Riccardi
- Aid Health and Development Onlus (AHEAD), Rome, Italy.,Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Raffaella Colombatti
- Department of Woman's and Child's Health, Università di Padova, Padua, Italy.,Aid Health and Development Onlus (AHEAD), Rome, Italy
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Andemariam B, Inati A, Colombatti R, Minniti C, Brown C, Hottmann M, Gray S, Hoppe C, Montealegre-Golcher F, Yue P. TRIALS IN PROGRESS: THE THRIVE STUDIES EVALUATING THE EFFICACY, SAFETY, AND LONG-TERM TREATMENT WITH INCLACUMAB, A P-SELECTIN INHIBITOR, IN PATIENTS WITH SICKLE CELL DISEASE. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.046] [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: 11/06/2022] Open
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20
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Guerzoni ME, Marchesi S, Palazzi G, Lodi M, Pinelli M, Venturelli D, Bigi E, Quaglia N, Corti P, Serra R, Colombatti R, Sainati L, Masera N, Colombo F, Barone A, Iughetti L. Environmental Factors in Northern Italy and Sickle Cell Disease Acute Complications: A Multicentric Study. Children (Basel) 2022; 9:1478. [PMID: 36291415 PMCID: PMC9600492 DOI: 10.3390/children9101478] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/13/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Environmental factors seem to influence clinical manifestations of sickle cell disease (SCD), but few studies have shown consistent findings. We conducted a retrospective multicentric observational study to investigate the influence of environmental parameters on hospitalization for vaso-occlusive crises (VOC) or acute chest syndrome (ACS) in children with SCD. METHODS Hospital admissions were correlated with daily meteorological and air-quality data obtained from Environmental Regional Agencies in the period 2011-2015. The effect of different parameters was assessed on the day preceding the crisis up to ten days before. Statistical analysis was performed using a quasi-likelihood Poisson regression in a generalized linear model. RESULTS The risk of hospitalization was increased for low maximum temperature, low minimum relative humidity, and low atmospheric pressure and weakly for mean wind speed. The diurnal temperature range and temperature difference between two consecutive days were determined to be important causes of hospitalization. For air quality parameters, we found a correlation only for high levels of ozone and for low values at the tail corresponding to the lowest concentration of this pollutant. CONCLUSIONS Temperature, atmospheric pressure, humidity and ozone levels influence acute complications of SCD. Patients' education and the knowledge of the modes of actions of these factors could reduce hospitalizations.
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Affiliation(s)
- Maria Elena Guerzoni
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stefano Marchesi
- Arpae-Agenzia Regionale per la Prevenzione, L’ambiente e L’energia dell’Emilia, Romagna, 41121 Modena, Italy
| | - Giovanni Palazzi
- Oncology and Hematology Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Mariachiara Lodi
- Department of Medical and Surgical Sciences for Mothers, Child and Adults, Post Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Margherita Pinelli
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Donatella Venturelli
- Department of Transfusion Medicine, University Hospital of Modena, 41124 Modena, Italy
| | - Elena Bigi
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Nadia Quaglia
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Paola Corti
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Roberta Serra
- Pediatric Onco-Hematology, Department of Pediatrics, University Hospital of Parma, 43126 Parma, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman’s and Child’s Health, University Hospital of Padova, 35128 Padova, Italy
| | - Nicoletta Masera
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Francesca Colombo
- Department of Pediatrics, University of Milano Bicocca, Fondazione MBBM, 20900 Monza, Italy
| | - Angelica Barone
- Pediatric Onco-Hematology, Department of Pediatrics, University Hospital of Parma, 43126 Parma, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Oncology and Hematology Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Department of Medical and Surgical Sciences for Mothers, Child and Adults, Post Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41121 Modena, Italy
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21
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van der Veen S, van Dijk M, Jans J, Verhoeven-Duif N, van Wijk R, Bartels M, Mañú Pereira M, Colombatti R, Martella M, Munaretto V, Boaro M, Bartolucci P, Cnossen M, Biemond B, van Beers E. P1500: 2,3-DIPHOSPHOGLYCERATE DETECTION VIA DIRECT INFUSION HIGH RESOLUTION MASS SPECTROMETRY CORRELATES WITH QUANTITATIVE DETECTION IN BLOOD OF PATIENTS WITH SICKLE CELL DISEASE. Hemasphere 2022. [PMCID: PMC9429661 DOI: 10.1097/01.hs9.0000848856.08012.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Graziadei G, De Franceschi L, Sainati L, Venturelli D, Masera N, Bonomo P, Vassanelli A, Casale M, Lodi G, Voi V, Rigano P, Pinto VM, Quota A, Notarangelo LD, Russo G, Allò M, Rosso R, D'Ascola D, Facchini E, Macchi S, Arcioni F, Bonetti F, Rossi E, Sau A, Campisi S, Colarusso G, Giona F, Lisi R, Giordano P, Boscarol G, Filosa A, Marktel S, Maroni P, Murgia M, Origa R, Longo F, Bortolotti M, Colombatti R, Di Maggio R, Mariani R, Piperno A, Corti P, Fidone C, Palazzi G, Badalamenti L, Gianesin B, Piel FB, Forni GL. Transfusional Approach in Multi-Ethnic Sickle Cell Patients: Real-World Practice Data From a Multicenter Survey in Italy. Front Med (Lausanne) 2022; 9:832154. [PMID: 35372393 PMCID: PMC8967327 DOI: 10.3389/fmed.2022.832154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/09/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Sickle cell disease (SCD) is a worldwide distributed hereditary red cell disorder characterized by recurrent acute vaso-occlusive crises (VOCs and anemia). Gold standard treatments are hydroxycarbamide (HC) and/or different red blood cell (RBC) transfusion regimens to limit disease progression. Here, we report a retrospective study on 1,579 SCD patients (median age 23 years; 802 males/777 females), referring to 34 comprehensive Italian centers for hemoglobinopathies. Although we observed a similar proportion of Caucasian (47.9%) and African (48.7%) patients, Italian SCD patients clustered into two distinct overall groups: children of African descent and adults of Caucasian descent. We found a subset of SCD patients requiring more intensive therapy with a combination of HC plus chronic transfusion regimen, due to partial failure of HC treatment alone in preventing or reducing sickle cell-related acute manifestations. Notably, we observed a higher use of acute transfusion approaches for SCD patients of African descent when compared to Caucasian subjects. This might be related to (i) age of starting HC treatment; (ii) patients' low social status; (iii) patients' limited access to family practitioners; or (iv) discrimination. In our cohort, alloimmunization was documented in 135 patients (8.5%) and was more common in Caucasians (10.3%) than in Africans (6.6%). Alloimmunization was similar in male and female and more frequent in adults than in children. Our study reinforces the importance of donor-recipient exact matching for ABO, Rhesus, and Kell antigen systems for RBC compatibility as a winning strategy to avoid or limit alloimmunization events that negatively impact the clinical management of SCD-related severe complications.
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Affiliation(s)
- Giovanna Graziadei
- Rare Diseases Center, General Medicine Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Laura Sainati
- Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Azienda Ospedaliera Universitaria, Padova, Italy
| | - Donatella Venturelli
- Servizio Immunotrasfusionale, Azienda Ospedaliero Universitaria Modena, Modena, Italy
| | - Nicoletta Masera
- Pediatric Clinic Hemato-Oncology Department, University of Milano-Bicocca, MBBM Foundation, San Gerardo Hospital, Monza, Italy
| | - Piero Bonomo
- Servizio Immunotrasfusionale, Azienda Ospedaliera Maria Paternò Arezzo, Ragusa, Italy
| | - Aurora Vassanelli
- UOC Medicina Trasfusionale, Azienda Ospedaliera Universitaria, Verona, Italy
| | - Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University “Luigi Vanvitelli”, Naples, Italy
| | - Gianluca Lodi
- Medicina Trasfusionale, Azienda Ospedaliera Universitaria Sant'Anna, Ferrara, Italy
| | - Vincenzo Voi
- Centro per le Emoglobinopatie – Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Ospedale San Luigi Gonzaga, Torino, Italy
| | - Paolo Rigano
- Campus of Haematology Franco e Piera Cutino, A.O.O.R. “Villa Sofia-Cervello” di Palermo, Palermo, Italy
| | - Valeria Maria Pinto
- Hematology, Thalassemia and Congenital Anemia Center, Ospedale Galliera, Genova, Italy
| | - Alessandra Quota
- Unità Operativa Semplice Dipartimentale Talassemia P.O. Vittorio Emanuele, Gela, Italy
| | - Lucia D. Notarangelo
- Italian Association of Pediatric Hematology Oncology (AIEOP) Coagulation Disorders Working Group, Brescia, Italy
| | - Giovanna Russo
- Pediatric Hematology/Oncology Unit, Università di Catania, Catania, Italy
| | - Massimo Allò
- Servizio Microcitemia, Presidio Ospedaliero SL 5, Crotone, Italy
| | - Rosamaria Rosso
- UOSD di Talassemia ed Emoglobinopatie, Azienda Ospedaliero-Universitaria Policlinico San Marco, Catania, Italy
| | - Domenico D'Ascola
- Centro Microcitemie, Azienda Ospedaliera “Bianchi-Melacrino-Morelli”, Reggio Calabria, Italy
| | - Elena Facchini
- SSD Oncoematologia Pediatrica - Policlinico di S.Orsola, Bologna, Italy
| | - Silvia Macchi
- Servizio Trasfusionale, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | | | - Enza Rossi
- Unità Operativa Ematologia, Centro di Microcitemia, Azienda Ospedaliera di Cosenza, Presidio Ospedaliero “Annunziata” Cosenza, Cosenza, Italy
| | | | - Saveria Campisi
- Department of Talassemia, Siracusa Hospital, Siracusa, Italy
| | | | - Fiorina Giona
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Roberto Lisi
- Unità Operativa Dipartimentale Talassemia, Presidio Garibaldi-Centro ARNAS Garibaldi, Catania, Italy
| | - Paola Giordano
- UOC Pediatria Universitaria, Università di Bari, Bari, Italy
| | | | - Aldo Filosa
- UOSD Malattie rare del globulo rosso, AORN A. Cardarelli, Naples, Italy
| | - Sarah Marktel
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Maroni
- Servizio di Immunoematologia e Medicina Trasfusionale, ASST Sette Laghi, Varese, Italy
| | - Mauro Murgia
- Centro Provinciale per le Microcitemia, Ospedale San Martino di Oristano, Oristano, Italy
| | - Raffaella Origa
- Ospedale Pediatrico Microcitemico, Università di Cagliari, Cagliari, Italy
| | - Filomena Longo
- Hematology, Thalassemia and Congenital Anemia Center, Ospedale Galliera, Genova, Italy
| | - Marta Bortolotti
- Department of Oncology and Oncohematology, University of Milan, Milan, Italy
| | - Raffaella Colombatti
- Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Azienda Ospedaliera Universitaria, Padova, Italy
| | - Rosario Di Maggio
- Unità Operativa Semplice Dipartimentale Talassemia P.O. Vittorio Emanuele, Gela, Italy
| | - Raffaella Mariani
- Rare Disease Centre - Hereditary anemias - ASST-Monza, S. Gerardo Hospital - University of Milano-Bicocca, Monza, Italy
| | - Alberto Piperno
- Rare Disease Centre - Hereditary anemias - ASST-Monza, S. Gerardo Hospital - University of Milano-Bicocca, Monza, Italy
| | - Paola Corti
- Pediatric Clinic Hemato-Oncology Department, University of Milano-Bicocca, MBBM Foundation, San Gerardo Hospital, Monza, Italy
| | - Carmelo Fidone
- Servizio Immunotrasfusionale, Azienda Ospedaliera Maria Paternò Arezzo, Ragusa, Italy
| | - Giovanni Palazzi
- Servizio Immunotrasfusionale, Azienda Ospedaliero Universitaria Modena, Modena, Italy
| | - Luca Badalamenti
- Biomedicina, Neuroscienze e Diagnostica avanzata, University of Palermo, Palermo, Italy
| | | | - Frédéric B. Piel
- Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Gian Luca Forni
- Italian Association of Pediatric Hematology Oncology (AIEOP) Coagulation Disorders Working Group, Brescia, Italy
- *Correspondence: Gian Luca Forni
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Martella M, Campeggio M, Pulè G, Wonkam A, Menzato F, Munaretto V, Viola G, Da Costa SP, Reggiani G, Araujo A, Cumbà D, Liotta G, Sainati L, Riccardi F, Colombatti R. Distribution of HbS Allele and Haplotypes in a Multi-Ethnic Population of Guinea Bissau, West Africa: Implications for Public Health Screening. Front Pediatr 2022; 10:826262. [PMID: 35463879 PMCID: PMC9021572 DOI: 10.3389/fped.2022.826262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/23/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sickle Cell Disease (SCD) is an inherited condition that is widespread globally and especially in malaria-endemic West African countries. Limited epidemiological data on SCD are available for Guinea Bissau, where newborn screening is not yet implemented, routine diagnosis is not available, and care is case directed. METHODS Dried blood spots were collected from children accessing two hospitals managed by Italian Non-Governmental Organizations in the capital city of Bissau and sent to Padova for Hemoglobin (Hb) quantification through HPLC and molecular analysis. Beta globin gene analysis was performed in all; and Hb haplotype of the HbSS and HbSA patients was performed in South Africa. One hundred samples belonging to the most frequent ethnic groups were randomly selected for detection of G6PD mutations. RESULTS Samples from 848 consecutive children (498 males and 350 females, mean age 6.8 years) accessing the two hospitals were analyzed: 6.95% AS (4.42% allelic frequency), 0.94% SS, and 0.23% AC. 376G G6PD allelic frequency was 24%; 14.8% in AS individuals. The Senegal haplotype was the most prevalent (31%), and the proposition of chromosomes with the atypical haplotype was surprisingly high (56%). CONCLUSION Our study demonstrates a significant frequency of the HbS allele in the population of Guinea Bissau supporting the implementation of screening strategies. The differences among ethnic groups can help guide targeted interventions for SCD awareness campaigns and determine priority areas for public health interventions. The pilot analysis on haplotypes reveals a large proportion of the atypical haplotype, which may be indicative of a genetically heterogeneous population.
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Affiliation(s)
- Maddalena Martella
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Mimma Campeggio
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Gift Pulè
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | - Federica Menzato
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Vania Munaretto
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Giampietro Viola
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | | | - Giulia Reggiani
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | | | | | | | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Fabio Riccardi
- Università di Tor Vergata, Rome, Italy.,Aid, Health and Development Onlus, Rome, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy.,Aid, Health and Development Onlus, Rome, Italy
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Po' C, Nosadini M, Zedde M, Pascarella R, Mirone G, Cicala D, Rosati A, Cosi A, Toldo I, Colombatti R, Martelli P, Iodice A, Accorsi P, Giordano L, Savasta S, Foiadelli T, Sanfilippo G, Lafe E, Thyrion FZ, Polonara G, Campa S, Raviglione F, Scelsa B, Bova SM, Greco F, Cordelli DM, Cirillo L, Toni F, Baro V, Causin F, Frigo AC, Suppiej A, Sainati L, Azzolina D, Agostini M, Cesaroni E, De Carlo L, Di Rosa G, Esposito G, Grazian L, Morini G, Nicita F, Operto FF, Pruna D, Ragazzi P, Rollo M, Spalice A, Striano P, Skabar A, Lanterna LA, Carai A, Marras CE, Manara R, Sartori S. Pediatric Moyamoya Disease and Syndrome in Italy: A Multicenter Cohort. Front Pediatr 2022; 10:892445. [PMID: 35601411 PMCID: PMC9120837 DOI: 10.3389/fped.2022.892445] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Moyamoya is a rare progressive cerebral arteriopathy, occurring as an isolated phenomenon (moyamoya disease, MMD) or associated with other conditions (moyamoya syndrome, MMS), responsible for 6-10% of all childhood strokes and transient ischemic attacks (TIAs). METHODS We conducted a retrospective multicenter study on pediatric-onset MMD/MMS in Italy in order to characterize disease presentation, course, management, neuroradiology, and outcome in a European country. RESULTS A total of 65 patients (34/65 women) with MMD (27/65) or MMS (38/65) were included. About 18% (12/65) of patients were asymptomatic and diagnosed incidentally during investigations performed for an underlying condition (incMMS), whereas 82% (53/65) of patients with MMD or MMS were diagnosed due to the presence of neurological symptoms (symptMMD/MMS). Of these latter, before diagnosis, 66% (43/65) of patients suffered from cerebrovascular events with or without other manifestations (ischemic stroke 42%, 27/65; TIA 32%, 21/65; and no hemorrhagic strokes), 18% (12/65) of them reported headache (in 4/12 headache was not associated with any other manifestation), and 26% (17/65) of them experienced multiple phenotypes (≥2 among: stroke/TIA/seizures/headache/others). Neuroradiology disclosed ≥1 ischemic lesion in 67% (39/58) of patients and posterior circulation involvement in 51% (30/58) of them. About 73% (47/64) of patients underwent surgery, and 69% (45/65) of them received aspirin, but after diagnosis, further stroke events occurred in 20% (12/61) of them, including operated patients (11%, 5/47). Between symptom onset and last follow-up, the overall patient/year incidence of stroke was 10.26% (IC 95% 7.58-13.88%). At last follow-up (median 4 years after diagnosis, range 0.5-15), 43% (26/61) of patients had motor deficits, 31% (19/61) of them had intellectual disability, 13% (8/61) of them had epilepsy, 11% (7/61) of them had behavioral problems, and 25% (13/52) of them had mRS > 2. The proportion of final mRS > 2 was significantly higher in patients with symptMMD/MMS than in patients with incMMS (p = 0.021). Onset age <4 years and stroke before diagnosis were significantly associated with increased risk of intellectual disability (p = 0.0010 and p = 0.0071, respectively) and mRS > 2 at follow-up (p = 0.0106 and p = 0.0009, respectively). CONCLUSIONS Moyamoya is a severe condition that may affect young children and frequently cause cerebrovascular events throughout the disease course, but may also manifest with multiple and non-cerebrovascular clinical phenotypes including headache (isolated or associated with other manifestations), seizures, and movement disorder. Younger onset age and stroke before diagnosis may associate with increased risk of worse outcome (final mRS > 2).
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Affiliation(s)
- Chiara Po'
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Department of Women's and Children's Health, University of Padova, Padova, Italy.,Unit of Pediatrics, AULSS 2 Marca Trevigiana, Ca' Foncello Hospital, Treviso, Italy
| | - Margherita Nosadini
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padova, Italy
| | - Marialuisa Zedde
- Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosario Pascarella
- Neuroradiology Unit, Arcispedale S. Maria Nuova AUSL Reggio Emilia - IRCCS, Reggio Emilia, Italy
| | - Giuseppe Mirone
- Pediatric Neurosurgery Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Domenico Cicala
- Pediatric Neuroradiology, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Anna Rosati
- Department of Neuroscience, Children's Hospital Anna Meyer, University of Firenze, Firenze, Italy
| | - Alessandra Cosi
- Department of Neuroscience, Children's Hospital Anna Meyer, University of Firenze, Firenze, Italy
| | - Irene Toldo
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Paola Martelli
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alessandro Iodice
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Patrizia Accorsi
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Lucio Giordano
- Child Neurology and Psychiatry Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Salvatore Savasta
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Thomas Foiadelli
- Pediatric Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Giuseppina Sanfilippo
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elvis Lafe
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCSS Policlinico San Matteo, Pavia, Italy
| | - Federico Zappoli Thyrion
- Department of Diagnostic and Interventional Radiology and Neuroradiology, IRCSS Policlinico San Matteo, Pavia, Italy
| | - Gabriele Polonara
- Neuroradiology - Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Serena Campa
- Neuroradiology Unit, University Hospital "Ospedali Riuniti di Ancona, " Università Politecnica delle Marche, Ancona, Italy
| | | | - Barbara Scelsa
- Department of Pediatric Neurology, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Stefania Maria Bova
- Department of Pediatric Neurology, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Filippo Greco
- Pediatric Clinic, Department of Clinical and Experimental Medicine, University Hospital A.U.O. "Policlinico-San Marco" of Catania, Catania, Italy
| | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell'età Pediatrica, Bologna, Italy.,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Luigi Cirillo
- Neuroradiology Unit, IRCSS "Istituto delle Scienze Neurologiche di Bologna, " Ospedale Bellaria, Bologna, Italy
| | - Francesco Toni
- Neuroradiology Unit, IRCSS "Istituto delle Scienze Neurologiche di Bologna, " Ospedale Bellaria, Bologna, Italy
| | - Valentina Baro
- Academic Neurosurgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Francesco Causin
- Neuroradiology, Department of Neurological Sciences, University of Padova, Padova, Italy
| | - Anna Chiara Frigo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Agnese Suppiej
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Pediatric Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Manuela Agostini
- Department of Pediatrics, Regina Margherita Children's Hospital, Torino, Italy
| | - Elisabetta Cesaroni
- Department of Child Neuropsychiatry, University Hospital Ospedali Riuniti, Ancona, Italy
| | - Luigi De Carlo
- Pediatric Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Gabriella Di Rosa
- Unit of Child Neurology and Psychiatry, Department of Human Pathology of the Adult and Developmental Age, Messina, Italy
| | - Giacomo Esposito
- Pediatric Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Roma, Italy
| | - Luisa Grazian
- Unit of Pediatrics, AULSS 2 Marca Trevigiana, Ca' Foncello Hospital, Treviso, Italy
| | - Giovanna Morini
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Francesco Nicita
- Unit of Neuromuscular and Neurodegenerative Disorders, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Child Neurology Division, Department of Pediatrics, Sapienza University, Rome, Italy
| | - Francesca Felicia Operto
- Child and Adolescent Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Dario Pruna
- Neurology and Epileptology Unit, Department of Pediatric, ARNAS Brotzu, Cagliari, Italy
| | - Paola Ragazzi
- Department of Neurosurgery, "Regina Margherita" Children's Hospital, Torino, Italy
| | - Massimo Rollo
- Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Alberto Spalice
- Department of Maternal Sciences, Sapienza University, Rome, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS "Istituto Giannina Gaslini", Genova, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Aldo Skabar
- Department of Pediatrics, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Andrea Carai
- Pediatric Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Roma, Italy
| | - Carlo Efisio Marras
- Pediatric Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Roma, Italy
| | - Renzo Manara
- Neuroradiology Unit, Department of Neurological Sciences, University of Padova, Padova, Italy
| | - Stefano Sartori
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.,Department of Women's and Children's Health, University of Padova, Padova, Italy.,Department of Neuroscience, University of Padova, Padova, Italy.,Neuroimmunology Group, Paediatric Research Institute "Città della Speranza", Padova, Italy
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25
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Rodigari F, Brugnera G, Colombatti R. Health-related quality of life in hemoglobinopathies: A systematic review from a global perspective. Front Pediatr 2022; 10:886674. [PMID: 36090573 PMCID: PMC9452907 DOI: 10.3389/fped.2022.886674] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/18/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) and thalassemia are inherited blood disorders, which can lead to life-threatening events and chronic organ damage. Recent advances in treatments have increased life expectancy, and hemoglobinopathies have become chronic illnesses with social and emotional impairments. Thus, health-related quality of life (HRQOL) assessment has a fundamental role in disease management and treatment, and generic and disease-specific questionnaires are reliable and validated measures to estimate disease burden. The heterogeneous distribution of treatment opportunities worldwide influences physical, social, and emotional disease perception. OBJECTIVES To review publications concerning HRQOL for SCD and thalassemia in different areas of the world in order to gather a global perspective of questionnaires used and outcomes evaluated. METHODS A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Medline databases were searched on 29 September 2021. Inclusion criteria were as follows: (1) studies of HRQOL assessment in SCD and thalassemia patients by using the PROMIS, the SF-36, the SCSES, the PedsQL-SCD, the PedsQOL generic core scale, the ASCQ-Me, and the TranQoL; and (2) every article type, including non-English studies. We excluded studies that were not limited to SCD or thalassemia and studies that were not specific to hemoglobinopathies, and not consistent with the topic of HRQOL assessment. We did not include the gray literature. A total of 102 out of 124 articles from PubMed, Cochrane Library, and Google Scholar were eligible for inclusion (66 SCD articles and 36 thalassemia articles). The quality of studies was assessed through Critical Appraisal tools for use in JBI Systematic Reviews. Data extraction was conducted using a standardized data collection form (authors, year and country of publication, study design, age and number of patients, HRQOL questionnaires, questionnaire language, and clinical outcomes). RESULTS The evaluation of HRQOL was conducted on all continents, but differences in the worldwide frequency of HRQOL assessment were observed. HRQOL of SCD patients was less investigated in Europe. HRQOL of thalassemia patients was less investigated in South-East Asia and Africa. Generic HRQOL questionnaires (PROMIS, SF-36, and PedsQL) were frequently adopted, while disease-specific ones (ASCQ-Me, SCSES for SCD, and TranQoL for thalassemia) were less used. Translation into local languages has been often performed. CONCLUSION Health-related quality of life is a complex outcome that has been increasingly incorporated in clinical research and clinical practice worldwide, although with regional differences. Disease-specific outcomes (pain for SCD and transfusion burden for thalassemia) and healthcare system characteristics, particularly in low-income countries, have an impact on HRQOL and should be considered in healthcare plans.
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Affiliation(s)
- Francesca Rodigari
- Department of Woman's and Child's Health, University of Padova, Padua, Italy
| | - Giorgia Brugnera
- Department of Woman's and Child's Health, University of Padova, Padua, Italy
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26
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Montalembert M, Voskaridou E, Oevermann L, Cannas G, Habibi A, Loko G, Joseph L, Colombatti R, Bartolucci P, Brousse V, Galactéros F. Real-Life experience with hydroxyurea in patients with sickle cell disease: Results from the prospective ESCORT-HU cohort study. Am J Hematol 2021; 96:1223-1231. [PMID: 34224583 DOI: 10.1002/ajh.26286] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 12/28/2022]
Abstract
Several controlled studies have evidenced good efficacy and short-term and mid-term safety profiles for hydroxyurea (HU), which has become the cornerstone for prevention of sickle-cell disease (SCD)-related vaso-occlusive crises. However, there are few large-scale reports on its long-term use and certain caregivers and patients have concerns about its safety. Following the licensing of HU in Europe for children and adults with severe forms of SCD, ESCORT-HU was designed as a Phase IV observational cohort study. It included 1906 participants, of whom 55% were adults. The most common hemoglobin (Hb) genotypes were HbSS (84.7%) and HbSβ+ (7.0%). The median duration of follow-up was 45 months, for a total of 7309 patient-years of observation. The dose of HU after 1 year was 20.6 mg/kg/d for children and 16.3 mg/kg/d for adults. There was a statistically significant decrease in the number of vaso-occlusive episodes lasting >48 h, acute chest syndrome episodes, hospitalizations, and the percentage of patients requiring blood transfusions within the first 12 months relative to the year before enrolment. Neutropenia and thrombocytopenia were the most commonly reported adverse effects. No new HU toxicity was identified. Overall, 125 pregnancies were reported in 101 women and no malformations were observed in the neonates. There were 12 pregnancies for partners of male patients treated with HU. One case of fatal myelodysplastic syndrome was reported, for which a causal association with HU could not be excluded. This cohort study of patients with SCD highlights the positive benefit-to-risk ratio of HU in children and adults.
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Affiliation(s)
- Mariane Montalembert
- Reference Centre for Sickle Cell Disease, Department of General Pediatrics and Pediatric Infectious Diseases Necker‐Enfants malades Hospital, Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Ersi Voskaridou
- Centre of Excellence in Rare Hematological Disease‐Hemoglobinopathies, Laiko General Hospital Athens Greece
| | - Lena Oevermann
- Department of Pediatric Oncology & Hematology Charité University Medicine, Berlin and Berlin Institute of Health Berlin Germany
| | - Giovanna Cannas
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Interne, Centre de Référence Constitutif: Syndromes Drépanocytaires Majeurs, Thalassémies et Autres Pathologies Rares du Globule Rouge et de l'Erythropoïèse Lyon France
| | - Anoosha Habibi
- Sickle Cell Referral Center, Department of Internal Medicine Henri‐Mondor University Hospital‐UPEC, AP‐HP Créteil France
| | - Gylna Loko
- Centre hospitalier de la Martinique Fort‐de‐France Martinique France
| | - Laure Joseph
- Biotherapy Department Necker Children's Hospital, Assistance Publique‐Hôpitaux de Paris Paris France
| | | | - Pablo Bartolucci
- Sickle Cell Referral Center, Department of Internal Medicine Henri‐Mondor University Hospital‐UPEC, AP‐HP Créteil France
| | - Valentine Brousse
- Reference Centre for Sickle Cell Disease, Department of General Pediatrics and Pediatric Infectious Diseases Necker‐Enfants malades Hospital, Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris France
| | - Frédéric Galactéros
- Sickle Cell Referral Center, Department of Internal Medicine Henri‐Mondor University Hospital‐UPEC, AP‐HP Créteil France
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27
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Magni R, Rruga F, Alsaab FM, Sharif S, Howard M, Espina V, Kim B, Lepene B, Lee G, Alayouni MA, Steinberg H, Araujo R, Kashanchi F, Riccardi F, Morreira S, Araujo A, Poli F, Jaganath D, Semitala FC, Worodria W, Andama A, Choudhary A, Honnen WJ, Petricoin EF, Cattamanchi A, Colombatti R, de Waard JH, Oberhelman R, Pinter A, Gilman RH, Liotta LA, Luchini A. Author Correction: Lipoarabinomannan antigenic epitope differences in tuberculosis disease subtypes. Sci Rep 2021; 11:19546. [PMID: 34580341 PMCID: PMC8476616 DOI: 10.1038/s41598-021-98304-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ruben Magni
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Fatlum Rruga
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA.,Dipartimento Di Salute Della Donna e del Bambino, Laboratorio di Oncoematologia, Università di Padova, Padova, Italy
| | - Fahad M Alsaab
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA.,College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
| | - Sara Sharif
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Marissa Howard
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Virginia Espina
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | | | | | - Gwenyth Lee
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA.,Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Mohamad A Alayouni
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | | | - Robyn Araujo
- Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Fatah Kashanchi
- School of Systems Biology, George Mason University, Manassas, VA, USA
| | - Fabio Riccardi
- Aid Health and Development Onlus, Bissau, Guinea-Bissau.,University of Tor Vergata, Rome, Italy
| | | | | | - Fernando Poli
- Departamento de Tuberculosis, Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela
| | - Devan Jaganath
- Division of Pediatric Infectious Diseases, University of California, San Francisco, San Francisco, CA, USA.,Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Fred C Semitala
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - William Worodria
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Mulago National Referral Hospital, Kampala, Uganda
| | - Alfred Andama
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda.,Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Alok Choudhary
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - William J Honnen
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Emanuel F Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Adithya Cattamanchi
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Raffaella Colombatti
- Department of Women's and Child's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Jacobus H de Waard
- Departamento de Tuberculosis, Instituto de Biomedicina "Dr. Jacinto Convit", Universidad Central de Venezuela, Caracas, Venezuela.,One Health Research Group, Facultad de Ciencias de la Salud, Universidad de Las Américas, Quito, Ecuador
| | - Richard Oberhelman
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA, USA
| | - Abraham Pinter
- Public Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Robert H Gilman
- Laboratorio de Investigación en Enfermedades Infecciosas, Laboratorio de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.,Asociación Benéfica PRISMA, Lima, Peru.,Program in Global Disease Epidemiology and Control, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Lance A Liotta
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Alessandra Luchini
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA.
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28
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Strunk C, Tartaglione I, Piccone CM, Colombatti R, Andemariam B, Manwani D, Smith A, Haile H, Kim E, Wilson S, Asare EV, Rivers A, Farooq F, Urbonya R, Boruchov D, Boatemaa GD, Perrotta S, Ekem I, Sainati L, Rao S, Zempsky W, Sey F, Antwi-Boasiako C, Segbefia C, Inusa B, Campbell AD. Global geographic differences in healthcare utilization for sickle cell disease pain crises in the CASiRe cohort. Blood Cells Mol Dis 2021; 92:102612. [PMID: 34564050 DOI: 10.1016/j.bcmd.2021.102612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/13/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) is characterized by frequent, unpredictable pain episodes and other vaso-occlusive crises (VOCs) leading to significant healthcare utilization. VOC frequency is often an endpoint in clinical trials investigating novel therapies for this devastating disease. PROCEDURE The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaboration investigating clinical severity in SCD using a validated questionnaire and medical chart review standardized across four countries (United States, United Kingdom, Italy and Ghana). RESULTS This study, focused on pain crisis incidence and healthcare utilization, included 868 patients, equally represented according to age and gender. HgbSS was the most common genotype. Patients from Ghana used the Emergency Room/Day Hospital for pain more frequently (annualized mean 2.01) than patients from other regions (annualized mean 1.56 U.S.; 1.09 U.K.; 0.02 Italy), while U.K. patients were hospitalized for pain more often (annualized mean: U.K. 2.98) than patients in other regions (annualized mean 1.98 U.S.; 1.18 Ghana; Italy 0.54). Italy's hospitalization rate for pain (annualized mean: 0.57) was nearly 20 times greater than its emergency room/day hospital only visits for pain (annualized mean: 0.03). When categorized by genotype and age, similar results were seen. CONCLUSIONS Geographic differences in pain crisis frequency and healthcare utilization may correlate with variable organization of healthcare systems among countries and should be considered regarding trial design, endpoints, and analysis of results when investigating novel agents for clinical benefit.
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Affiliation(s)
- Crawford Strunk
- Department of Pediatric Hematology/Oncology, ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA.
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Connie M Piccone
- Pediatric Hematology, Carle Foundation Hospital, Urbana, IL, USA
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Biree Andemariam
- New England Sickle Cell Institute, Division of Hematology-Oncology, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Ashya Smith
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Haikel Haile
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Esther Kim
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Angela Rivers
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Donna Boruchov
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ivy Ekem
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - William Zempsky
- Division of Pain and Palliative Care, Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana; Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Catherine Segbefia
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana; Department of Child Health, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
| | - Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, Divison of Hematology, Children's National Hospital, George Washington University School of Medicine Health Sciences, Washington, DC, USA
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Colombatti R, Casale M, Russo G. Disease burden and quality of life of in children with sickle cell disease in Italy: time to be considered a priority. Ital J Pediatr 2021; 47:163. [PMID: 34325732 PMCID: PMC8323323 DOI: 10.1186/s13052-021-01109-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/18/2021] [Indexed: 01/12/2023] Open
Abstract
The objective of the present article is to highlight the need for attention to Quality of Life of patients with Sickle Cell Disease living in Italy. The transformation of sickle cell disease from a severe life-threatening disease of childhood into a chronic, lifelong condition due to the significant improvements in care and treatment options, imposes increasing new challenges to health care providers and patients. Patients now face physical, psychosocial and emotional challenges throughout their lives. They generally have to receive chronic treatments and regular multidisciplinary monitoring which increase social and emotional burden rendering adherence to treatment sometimes complicated. A chronic disease impacts all aspects of patients’ lives, not only the physical one, but also the social and emotional aspects as well as the educational and working life. The entire “Quality of Life” is affected and recent evidence demonstrates the importance quality of life has for patients with chronic illness. The results of this review focus on emerging data regarding quality of life across the lifespan of patients with Sickle Cell Disease, and highlight the need for more action in this field in Italy, where recent immigration and improved care determine an increasing population of children with sickle cell disease being taken into long term care.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, University of Padova, Padova, Italy
| | - Maddalena Casale
- Department of Women, Child and General and Specialized Surgery, University "Luigi Vanvitelli", Naples, Italy
| | - Giovanna Russo
- Pediatric Hemato-Oncology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Russo G, Colombatti R. American Society of Hematology 2020 Podcast Collection: Sickle Cell Anaemia. Adv Ther 2021; 38:1-7. [PMID: 33651281 PMCID: PMC8236475 DOI: 10.1007/s12325-021-01666-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Giovanna Russo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Raffaella Colombatti
- Department of Women’s and Children’s Health, University of Padova, Padova, Italy
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31
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Munaretto V, Voi V, Palazzi G, Notarangelo LD, Corti P, Baretta V, Casale M, Barone A, Cuzzubbo D, Samperi P, Tripodi S, Giona F, Miano M, Nocerino A, Del Vecchio GC, Piccolo C, Sau A, Filippini B, Casciana ML, Arcioni F, Migliavacca M, Saracco P, Gorio C, Cesaro S, Perrotta S, Zecca M, Giordano P, Fasoli S, Coppadoro B, Russo G, Sainati L, Colombatti R. Acute events in children with sickle cell disease in Italy during the COVID-19 pandemic: useful lessons learned. Br J Haematol 2021; 194:851-854. [PMID: 34036565 PMCID: PMC8239759 DOI: 10.1111/bjh.17546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Vania Munaretto
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Vincenzo Voi
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Ospedale San Luigi Gonzaga, Turin, Italy
| | - Giovanni Palazzi
- Dipartimento Integrato Materno Infantile, UO di Pediatria ad Indirizzo Oncoematologico, Azienda Ospedaliera-Università di Modena, Modena, Italy
| | | | - Paola Corti
- Clinica si Onco-Ematologia Pediatrica, Fondazione MBBM Azienda Ospedaliera S.Gerardo, Monza, Italy
| | - Valentina Baretta
- Onco-Ematologia Pediatrica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Maddalena Casale
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Angelica Barone
- Pediatria e Oncoematologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Daniela Cuzzubbo
- Clinica di Onco-Ematologia Pediatrica, Azienda Ospedaliero Universitaria Meyer, Florence, Italy
| | - Piera Samperi
- Clinica di Onco-Ematologia Pediatrica, Azienda Ospedaliero Universitaria "Policlinico Vittorio Emanuele", Catania, Italy
| | - Serena Tripodi
- Pavia Clinica di Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Fiorina Giona
- Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, AOU Policlinico Umberto I, Rome, Italy
| | - Maurizio Miano
- Hematology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Agostino Nocerino
- Clinica Pediatrica, AOU Santa Maria della Misericordia, Udine, Italy
| | - Gian Carlo Del Vecchio
- Department of Biomedical Science and Human Oncology-Paediatric Unit, Policlinico Hospital, Bari, Italy
| | - Chiara Piccolo
- Dipartimento Donna e Bambino, ASST-settelaghi, Università degli Studi dell'Insubria, Varese, Italy
| | - Antonella Sau
- Oncoematologia Pediatrica, Dipartimento Oncologico Ematologico, Azienda Sanitaria Locale di Pescara, Pescara, Italy
| | - Beatrice Filippini
- SSD Oncoematologia Pediatrica U.O Pediatria, Dipartimento Salute, Donna, Infanzia e Adolescenza Ospedale Infermi Rimini, Rimini, Italy
| | - Maria Luisa Casciana
- SC Pediatria, Dipartimento Materno -Infantile Azienda Ospedaliera Carlo Poma, Mantua, Italy
| | - Francesco Arcioni
- Pediatric Hematology and Oncology with Bone Marrow Transplation, Azienda Ospedaliera di Perugia, Perugia, Italy
| | | | - Paola Saracco
- Haematology Unit, Department of Paediatrics, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza, Turin, Italy
| | - Chiara Gorio
- Clinica di Onco-Ematologia Pediatrica, ASS Spedali Civili di Brescia, Brescia, Italy
| | - Simone Cesaro
- Onco-Ematologia Pediatrica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Silverio Perrotta
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Zecca
- Pavia Clinica di Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paola Giordano
- Department of Biomedical Science and Human Oncology-Paediatric Unit, Policlinico Hospital, Bari, Italy
| | - Silvia Fasoli
- SC Pediatria, Dipartimento Materno -Infantile Azienda Ospedaliera Carlo Poma, Mantua, Italy
| | - Beatrice Coppadoro
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Giovanna Russo
- Clinica di Onco-Ematologia Pediatrica, Azienda Ospedaliero Universitaria "Policlinico Vittorio Emanuele", Catania, Italy
| | - Laura Sainati
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Azienda Ospedale-Università di Padova, Padua, Italy
| | - Raffaella Colombatti
- Dipartimento di Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, Azienda Ospedale-Università di Padova, Padua, Italy
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Barcellini W, Colombatti R. The impact of Parvovirus B19 on hereditary haemolytic anaemias. Br J Haematol 2021; 193:703-704. [PMID: 33929757 DOI: 10.1111/bjh.17485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Wilma Barcellini
- Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Osunkwo I, Andemariam B, Minniti CP, Inusa BPD, El Rassi F, Francis‐Gibson B, Nero A, Trimnell C, Abboud MR, Arlet J, Colombatti R, Montalembert M, Jain S, Jastaniah W, Nur E, Pita M, DeBonnett L, Ramscar N, Bailey T, Rajkovic‐Hooley O, James J. Impact of sickle cell disease on patients' daily lives, symptoms reported, and disease management strategies: Results from the international Sickle Cell World Assessment Survey (SWAY). Am J Hematol 2021; 96:404-417. [PMID: 33264445 PMCID: PMC8248107 DOI: 10.1002/ajh.26063] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [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: 11/17/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 12/20/2022]
Abstract
Sickle cell disease (SCD) is a genetic disorder, characterized by hemolytic anemia and vaso‐occlusive crises (VOCs). Data on the global SCD impact on quality of life (QoL) from the patient viewpoint are limited. The international Sickle Cell World Assessment Survey (SWAY) aimed to provide insights into patient‐reported impact of SCD on QoL. This cross‐sectional survey of SCD patients enrolled by healthcare professionals and advocacy groups assessed disease impact on daily life, education and work, symptoms, treatment goals, and disease management. Opinions were captured using a Likert scale of 1‐7 for some questions; 5‐7 indicated “high severity/impact.” Two thousand one hundred and forty five patients (mean age 24.7 years [standard deviation (SD) = 13.1], 39% ≤18 years, 52% female) were surveyed from 16 countries (six geographical regions). A substantial proportion of patients reported that SCD caused a high negative impact on emotions (60%) and school achievement (51%) and a reduction in work hours (53%). A mean of 5.3 VOCs (SD = 6.8) was reported over the 12 months prior to survey (median 3.0 [interquartile range 2.0‐6.0]); 24% were managed at home and 76% required healthcare services. Other than VOCs, fatigue was the most commonly reported symptom in the month before survey (65%), graded “high severity” by 67% of patients. Depression and anxiety were reported by 39% and 38% of patients, respectively. The most common patient treatment goal was improving QoL (55%). Findings from SWAY reaffirm that SCD confers a significant burden on patients, epitomized by the high impact on patientsʼ QoL and emotional wellbeing, and the high prevalence of self‐reported VOCs and other symptoms.
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Affiliation(s)
- Ifeyinwa Osunkwo
- Sickle Cell Disease Enterprise The Levine Cancer Institute, Atrium Health Charlotte North Carolina USA
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health Farmington Connecticut USA
| | | | - Baba P. D. Inusa
- Evelina Childrenʼs Hospital Guyʼs and St Thomasʼ NHS Foundation Trust London UK
| | - Fuad El Rassi
- Emory University School of Medicine and Georgia Comprehensive Sickle Cell Center at Grady Health System Atlanta Georgia USA
| | | | - Alecia Nero
- University of Texas Southwestern Medical Center Dallas Texas USA
| | | | | | - Jean‐Benoît Arlet
- Sickle Cell Disease Referral Centre, Internal Medicine Department, Hôpital Européen Georges‐Pompidou, AP‐HP Université de Paris Paris France
| | | | | | - Suman Jain
- Thalassemia and Sickle Cell Society Hyderabad India
| | | | - Erfan Nur
- Academic Medical Center Amsterdam The Netherlands
| | - Marimilia Pita
- Pediatric Hematology, Hospital Samaritano Laureate University‐UAM São Paulo Brazil
| | - Laurie DeBonnett
- Novartis Pharmaceuticals Corporation East Hanover New Jersey USA
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Campbell AD, Colombatti R, Andemariam B, Strunk C, Tartaglione I, Piccone CM, Manwani D, Asare EV, Boruchov D, Farooq F, Urbonya R, Boatemaa GD, Perrotta S, Sainati L, Rivers A, Rao S, Zempsky W, Sey F, Segbefia C, Inusa B, Antwi-Boasiako C. An Analysis of Racial and Ethnic Backgrounds Within the CASiRe International Cohort of Sickle Cell Disease Patients: Implications for Disease Phenotype and Clinical Research. J Racial Ethn Health Disparities 2021; 8:99-106. [PMID: 32418182 PMCID: PMC7669607 DOI: 10.1007/s40615-020-00762-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/19/2020] [Revised: 04/06/2020] [Accepted: 04/13/2020] [Indexed: 12/13/2022]
Abstract
Millions are affected by sickle cell disease (SCD) worldwide with the greatest burden in sub-Saharan Africa. While its origin lies historically within the malaria belt, ongoing changes in migration patterns have shifted the burden of disease resulting in a global public health concern. We created the Consortium for the Advancement of Sickle Cell Research (CASiRe) to understand the different phenotypes of SCD across 4 countries (USA, UK, Italy, and Ghana). Here, we report the multi-generational ethnic and racial background of 877 SCD patients recruited in Ghana (n = 365, 41.6%), the USA (n = 254, 29%), Italy (n = 81, 9.2%), and the UK (n = 177, 20.2%). West Africa (including Benin Gulf) (N = 556, 63.4%) was the most common geographic region of origin, followed by North America (N = 184, 21%), Caribbean (N = 51, 5.8%), Europe (N = 27, 3.1%), Central Africa (N = 24, 2.7%), and West Africa (excluding Benin Gulf) (N = 21, 2.4%). SCD patients in Europe were primarily West African (73%), European (10%), Caribbean (8%), and Central African (8%). In the USA, patients were largely African American (71%), Caribbean (13%), or West African (10%). Most subjects identified themselves as Black or African American; the European cohort had the largest group of Caucasian SCD patients (8%), including 21% of the Italian patients. This is the first report of a comprehensive analysis of ethnicity within an international, transcontinental group of SCD patients. The diverse ethnic backgrounds observed in our cohort raises the possibility that genetic and environmental heterogeneity within each SCD population subgroup can affect the clinical phenotype and research outcomes.
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Affiliation(s)
- Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA.
- Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC, USA.
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Biree Andemariam
- Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Crawford Strunk
- ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA
| | - Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Connie M Piccone
- Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Eugenia Vicky Asare
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Hematology, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Donna Boruchov
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | | | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Angela Rivers
- Division of Pediatric Hematology/Oncology, University of Illinois-Chicago, Chicago, IL, USA
| | - Sudha Rao
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana
| | - William Zempsky
- Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Baba Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
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Tartaglione I, Strunk C, Antwi-Boasiako C, Andemariam B, Colombatti R, Asare EV, Piccone CM, Manwani D, Boruchov D, Tavernier F, Farooq F, Akatue S, Oteng B, Urbonya R, Wilson S, Owda A, Bamfo R, Boatemaa GD, Rao S, Zempsky W, Sey F, Inusa BP, Perrotta S, Segbefia C, Campbell AD. Age of first pain crisis and associated complications in the CASiRe international sickle cell disease cohort. Blood Cells Mol Dis 2021; 88:102531. [PMID: 33401140 DOI: 10.1016/j.bcmd.2020.102531] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/18/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
Pain is a hallmark of Sickle Cell Disease (SCD) affecting patients throughout their life; the first pain crisis may occur at any age and is often the first presentation of the disease. Universal newborn screening identifies children with SCD at birth, significantly improving morbidity and mortality. Without early screening, diagnosis is generally made after disease manifestations appear. The Consortium for the Advancement of Sickle Cell Research (CASiRe) is an international collaborative group evaluating the clinical severity of subjects with SCD using a validated questionnaire and medical chart review, standardized across 4 countries (United States, United Kingdom, Italy and Ghana). We investigated the age of first pain crisis in 555 sickle cell subjects, 344 adults and 211 children. Median age of the first crisis in the whole group was 4 years old, 5 years old among adults and 2 years old among children. Patients from the United States generally reported the first crisis earlier than Ghanaians. Experiencing the first pain crisis early in life correlated with the genotype and disease severity. Early recognition of the first pain crisis could be useful to guide counseling and management of the disease.
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Affiliation(s)
- Immacolata Tartaglione
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Crawford Strunk
- ProMedica Russell J. Ebeid Children's Hospital, Toledo, OH, USA
| | - Charles Antwi-Boasiako
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Biree Andemariam
- New England Sickle Cell Institute, Division of Hematology-Oncology, Neag Comprehensive Cancer Center, UCONN Health, University of Connecticut, Farmington, CT, USA
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Women's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | | | - Connie M Piccone
- Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Donna Boruchov
- Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fitz Tavernier
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Fatimah Farooq
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Sophia Akatue
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Bianca Oteng
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rebekah Urbonya
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Samuel Wilson
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Ahmed Owda
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Rose Bamfo
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Gifty Dankwah Boatemaa
- Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Sudha Rao
- Department of Child Health, University of Ghana Medical School Accra, Ghana
| | - William Zempsky
- Department of Pediatrics, University of Connecticut School of Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Fredericka Sey
- Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana
| | - Baba Pd Inusa
- Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, London, UK
| | - Silverio Perrotta
- Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Catherine Segbefia
- Department of Child Health, University of Ghana Medical School Accra, Ghana
| | - Andrew D Campbell
- Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, MI, USA; Center for Cancer and Blood Disorders, Children's National Medical Center; George Washington University School of Medicine Health Sciences, Washington, DC, USA.
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Strunk C, Campbell A, Colombatti R, Andemariam B, Kesse-Adu R, Treadwell M, Inusa BPD. Annual Academy of Sickle Cell and Thalassaemia (ASCAT) conference: a summary of the proceedings. BMC Proc 2020; 14:21. [PMID: 33323100 PMCID: PMC7739449 DOI: 10.1186/s12919-020-00204-1] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/24/2022] Open
Abstract
The fourteenth annual ASCAT conference was held 21-23 October 2019. The theme of the conference was 'Sickle Cell and Thalassaemia disorders new treatment horizon; while ensuring patient safety and delivering excellence in routine patient care.' Over the three-day conference, topics on current and novel models of care, advances in bone marrow transplant and gene therapy, as well as the psychosocial aspects of mind, body and health related quality of life were discussed. In addition, blood transfusion, apheresis, iron chelation therapy and acute haemolytic complications were presented. Quality standards in the diagnosis and treatment of sickle cell and thalassaemia were reviewed. Experts from Europe, the United Kingdom, the Middle East, the United States and Africa reported up-to-date scientific data, guides to comprehensive care, and current research into developing cures and advancing current therapy were described. In addition, oral and poster presentations on novel research from all over the world were shown during the conference.
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Affiliation(s)
- Crawford Strunk
- ProMedica Russell J. Ebeid Children’s Hospital, 2142 North Cove Blvd, Toledo, OH 43606 USA
| | - Andrew Campbell
- Center for Cancer and Blood Disorders, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010 USA
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology-Oncology, Department of Woman’s and Child’s Health, University of Padua, 35129 Padua, Italy
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Rachel Kesse-Adu
- Guy’s and St. Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH UK
| | - Marsha Treadwell
- Department of Hematology/Oncology, UCSF Benioff Children’s Hospital Oakland, 747 52nd Street, Oakland, CA 94609 USA
| | - Baba P. D. Inusa
- Department of Haematology, Evelina London Children’s Hospital and Guy’s and St. Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH UK
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Manara R, Dalla Torre A, Lucchetta M, Ermani M, Favaro A, Baracchini C, Favaretto S, Viaro F, Munaretto V, Sartori S, Ponticorvo S, Russo AG, Biffi A, Sainati L, Colombatti R. Visual cortex changes in children with sickle cell disease and normal visual acuity: a multimodal magnetic resonance imaging study. Br J Haematol 2020; 192:151-157. [PMID: 32789861 DOI: 10.1111/bjh.17042] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/22/2020] [Indexed: 11/29/2022]
Abstract
The visual system is primarily affected in sickle cell disease (SCD), and eye examination is recommended starting in late childhood. So far, to our knowledge, all studies have focused on the retina, neglecting the changes that might be present in the cortical portion of the visual system. We performed a multimodal magnetic resonance imaging (MRI) evaluation of the visual cortex in 25 children with SCD (mean age: 12·3 ± 1·9 years) and 31 controls (mean age: 12·7 ± 1·6 years). At ophthalmologic examination, 3/25 SCD children had mild visual acuity deficits and 2/25 had mild tortuosity of the retinal vessels. None showed optic pathway infarcts at MRI or Transcranial Doppler abnormal blood velocities, and 6/25 disclosed posterior cerebral artery stenosis (five mild and one severe) at MR-angiography. Compared to controls, SCD children had increased posterior pericalcarine cortical thickness, with a different trajectory of cortical maturation and decreased connectivity within medial and ventral visual neural networks. Our findings suggest that SCD affects the development and the tuning of the visual cortex, leading to anatomical and functional changes in childhood even in the absence of retinopathy, and set the basis for future studies to determine if these changes can represent useful predictors of visual impairment in adulthood, biomarkers of disease progression or treatment response.
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Affiliation(s)
- Renzo Manara
- Neuroradiology, Department of Neurosciences, University of Padova, Padova, Italy
| | - Alice Dalla Torre
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Marta Lucchetta
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Mario Ermani
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Claudio Baracchini
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Silvia Favaretto
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Federica Viaro
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Vania Munaretto
- Department of Child and Woman's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Stefano Sartori
- Neurology Unit, Department of Child and Woman's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Sara Ponticorvo
- Department of Neuroradiology, University of Salerno, Salerno, Italy
| | - Andrea G Russo
- Department of Neuroradiology, University of Salerno, Salerno, Italy
| | - Alessandra Biffi
- Department of Child and Woman's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Laura Sainati
- Department of Child and Woman's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Raffaella Colombatti
- Department of Child and Woman's Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
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Colombatti R, Andemariam B. Microvasculopathy and biomarkers in sickle cell disease: the promise of non-invasive real-time in vivo tools. Br J Haematol 2020; 190:309-310. [PMID: 32352154 DOI: 10.1111/bjh.16705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child's Health, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Biree Andemariam
- New England Sickle Cell Institute, University of Connecticut Health, Farmington, CT, USA
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Inusa BPD, Sainati L, MacMahon C, Colombatti R, Casale M, Perrotta S, Rampazzo P, Hemmaway C, Padayachee ST. An Educational Study Promoting the Delivery of Transcranial Doppler Ultrasound Screening in Paediatric Sickle Cell Disease: A European Multi-Centre Perspective. J Clin Med 2019; 9:jcm9010044. [PMID: 31878188 PMCID: PMC7019609 DOI: 10.3390/jcm9010044] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/13/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Effective stroke prevention in sickle cell disease (SCD) is recommended for children with sickle cell anaemia. Effective implementation relies on the correct stratification of stroke risk using Transcranial Doppler Ultrasound (TCD), prior to committing children to long-term treatment with transfusion. Nevertheless, less than 50% of children with SCD in Europe receive annual TCD—one of the reasons being a lack of trained personnel. The present European multi-centre study was designed to promote the standardisation and delivery of effective screening. Methods: Fifty-five practitioners from differing professional backgrounds were recruited to the TCD training program. The impact of the training programme was evaluated in three European haematology clinics by comparing stroke risk classification and middle cerebral artery time-averaged maximum velocity (TAMMV) obtained from a cohort of 555 patients, before and after training. Results: 42% (23/55) of trainees successfully completed the program. The TAMMV, used to predict stroke risk at each Centre, demonstrated the highest values in Centre 3 (p < 0.0001) before training. The imaging-TCD TAMMV was also higher in Centre 3 (p < 0.001). Following training, the TAMMV showed closer agreement between centres for both imaging-TCD and non-imaging TCD. The stroke risk distribution of children at each centre varied significantly before training (p < 0.001), but improved after training (Fisher’s Exact: no treatment = 5.6, p = 0.41, treatment = 13.8, p < 0.01). The same consistency in stroke risk distribution following training was demonstrated with both non-imaging and imaging-TCD data. Conclusion: The attainment of competency in stroke screening using transcranial Doppler scanning (TCD) in sickle cell disease is more feasible for professionals with an ultrasound imaging background. A quality assurance (QA) system is required to ensure that standards are maintained. Further work is in progress to develop an achievable and reproducible QA program.
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Affiliation(s)
- Baba P. D. Inusa
- Paediatric Haematology Department, Evelina London Children’s Hospital, Guy’s & St Thomas’ NHS Foundation Trust, St Thomas Street, London SE1 7EH, UK
- Correspondence: ; Tel.: +44-0207-1884676
| | - Laura Sainati
- Clinic of Pediatric Hematology-Oncology, Department of Child and Maternal Health, Azienda Ospedaliera-Università di Padova, Via 8 Febbraio 1848, 2, 35122 Padova, Italy; (L.S.); (R.C.)
| | - Corrina MacMahon
- Paediatric Haematology, Our Lady’s Children’s Hospital, Cooley Rd, Crumlin, D12 N512 Dublin, Ireland;
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology-Oncology, Department of Child and Maternal Health, Azienda Ospedaliera-Università di Padova, Via 8 Febbraio 1848, 2, 35122 Padova, Italy; (L.S.); (R.C.)
| | - Maddalena Casale
- Università degli Studi della Campania, Luigi Vanvitelli, Via Luciano Armanni, 14-20, 80138 Napoli, Italy; (M.C.); (S.P.)
| | - Silverio Perrotta
- Università degli Studi della Campania, Luigi Vanvitelli, Via Luciano Armanni, 14-20, 80138 Napoli, Italy; (M.C.); (S.P.)
| | - Paola Rampazzo
- Department of Neurosciences, Azienda Ospedaliera-Università di Padova, Via 8 Febbraio 1848, 2, 35122 Padova, Italy;
| | - Claire Hemmaway
- Department of Haematology, Queen’s Hospital, Rom Valley Way, Romford RM7 0AG, UK;
| | - Soundrie T. Padayachee
- Ultrasonic Angiology Department, Guy’s & St Thomas’ NHS Foundation Trust, London SE1 9RT, UK;
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Notarangelo LD, Agostini A, Casale M, Samperi P, Arcioni F, Gorello P, Perrotta S, Masera N, Barone A, Bertoni E, Bonetti E, Burnelli R, Casini T, Del Vecchio GC, Filippini B, Giona F, Giordano P, Gorio C, Marchina E, Nardi M, Petrone A, Colombatti R, Sainati L, Russo G. HbS/β+ thalassemia: Really a mild disease? A National survey from the AIEOP Sickle Cell Disease Study Group with genotype-phenotype correlation. Eur J Haematol 2019; 104:214-222. [PMID: 31788855 DOI: 10.1111/ejh.13362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/11/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES HbS/β+ patients' presence in Italy increased due to immigration; these patients are clinically heterogeneous, and specific guidelines are lacking. Our aim is to describe a cohort of HbS/β+ patients, with genotype-phenotype correlation, in order to offer guidance for clinical management of such patients. METHODS Retrospective cohort study of HbS/β+ patients among 15 AIEOP Centres. RESULTS A total of 41 molecularly confirmed S/β+ patients were enrolled (1-55 years, median 10.9) and classified on β+ mutation: IVS-I-110, IVS-I-6, promoter, and "others." Prediagnostic events included VOC 16/41 (39%), ACS 6/41 (14.6%), sepsis 3/41 (3.7%), and avascular necrosis 3/41 (7,3%). Postdiagnostic events were VOC 22/41 (53.6% %), sepsis 4/41 (9.7%), ACS 4/41 (9.7%), avascular necrosis 3/41 (7.3%), aplastic crisis 2/41 (4.8%), stroke 1/41 (2.4%), ACS 1/41 (2.4%), and skin ulcerations 1/41 (2.4%). The IVS-I-110 group presented the lowest median age at first SCD-related event (P = .02 vs promoter group) and the higher median number of severe events/year (0.26 events/patient/year) (P = .01 vs IVS-I-6 and promoter groups). Promoter group presented a specific skeletal phenotype. Treatment regimen applied was variable among the centers. CONCLUSIONS HbS/β+ is not always a mild disease. Patients with IVS-I-110 mutation could benefit from a standard of care like SS and S/β° patients. Standardization of treatment is needed.
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Affiliation(s)
| | - Annalisa Agostini
- Pediatrics Clinic, University of Brescia, Spedali Civili di Brescia, Brescia, Italy
| | - Maddalena Casale
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Piera Samperi
- Unit of Pediatric Hematology and Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesco Arcioni
- Pediatric Hematology and Oncology with Bone Marrow Transplation, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Paolo Gorello
- Department of Medicine, University of Perugia, CREO, Hematology, Perugia, Italy
| | - Silverio Perrotta
- Department of Woman, Child and General and Specialist Surgery, Università degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Nicoletta Masera
- Department of Pediatrics, Università di Milano Bicocca, Fondazione MBBM, Monza, Italy
| | - Angelica Barone
- Department of Pediatric Onco-Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Elisa Bertoni
- Hematology Oncology Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Elisa Bonetti
- Department of Pediatric Onco-Hematology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Roberta Burnelli
- Pediatric Oncology University Hospital, Sant'Anna Hospital, Ferrara, Italy
| | - Tommaso Casini
- Pediatric Hematology-Oncology, IRCCS Meyer Children's Hospital, Florence, Italy
| | - Giovanni Carlo Del Vecchio
- Pediatric Unit "F. Vecchio", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | | | - Fiorina Giona
- Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I, Sapienza University, Hematology, Rome, Italy
| | - Paola Giordano
- Pediatric Unit "F. Vecchio", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Chiara Gorio
- Hematology Oncology Unit, Children's Hospital, ASST Spedali Civili, Brescia, Italy
| | - Eleonora Marchina
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Margherita Nardi
- Onco-Hematologic Pediatric Center, University Hospital of Pisa, Pisa, Italy
| | - Angela Petrone
- Department of Pediatrics, Rovereto Hospital, Rovereto, Italy
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Giovanna Russo
- Unit of Pediatric Hematology and Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Colombatti R, Cela E, Elion J, Lobitz S. Editorial for Special Issue "Newborn Screening for Sickle Cell Disease and other Haemoglobinopathies". Int J Neonatal Screen 2019; 5:36. [PMID: 33072995 PMCID: PMC7510191 DOI: 10.3390/ijns5040036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 12/02/2022] Open
Abstract
Sickle cell disease (SCD) is among the most common genetic disorders in the world, affectingover 300,000 newborns annually, with estimates for further increases to over 400,000 annual birthswithin the next generation and with a wider geographical distribution of affected individuals due toglobal migration [1,2]. [...]
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Affiliation(s)
- Raffaella Colombatti
- Department of Child and Maternal Health, Clinic of Pediatric Hematology/Oncology, Azienda Ospedaliera-Università di Padova, 35129 Padova, Italy
- Correspondence:
| | - Elena Cela
- Department of Pediatric Oncology/Hematology, Hospital Universitario General Gregorio Marañón, Facultad de Medicina, Universidad Complutense Madrid, 28007 Madrid, Spain;
| | - Jacques Elion
- Laboratoire d’Excellence GR-Ex, UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Institut National de la Transfusion Sanguine, 75015 Paris, France;
| | - Stephan Lobitz
- Department of Pediatric Hematology and Oncology, Gemeinschaftsklinikum Mittelrhein gGmbH, 56073 Koblenz, Germany;
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Inusa BPD, Colombatti R, Rees DC, Heeney MM, Hoppe CC, Ogutu B, Hassab HM, Zhou C, Yao S, Brown PB, Heath LE, Jakubowski JA, Abboud MR. Geographic Differences in Phenotype and Treatment of Children with Sickle Cell Anemia from the Multinational DOVE Study. J Clin Med 2019; 8:jcm8112009. [PMID: 31744266 PMCID: PMC6912763 DOI: 10.3390/jcm8112009] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 11/30/2022] Open
Abstract
Background: DOVE (Determining Effects of Platelet Inhibition on Vaso-Occlusive Events) was a Phase 3, randomized, double-blind, placebo-controlled study conducted in children with sickle cell anemia at 51 sites in 13 countries across four continents. Procedure: Data from DOVE were assessed for regional differences in subject phenotype and treatment. Demographics, baseline clinical and laboratory data, hydroxyurea (HU) use, vaso-occlusive crisis (VOCs; composite endpoint of painful crisis or acute chest syndrome (ACS)), serious adverse events (SAEs), hospitalization, and treatments were compared across the Americas, Europe, North Africa/Middle East, and Sub-Saharan Africa (SSA). Results: Race, body mass index, and blood pressures differed by region. Pre-enrollment VOCs were highest in the Americas. For subjects not on HU, baseline hemoglobin was lowest in SSA; reticulocyte count was lowest in the Americas. Within SSA, Kenya subjects presented higher baseline hemolysis. Painful crisis was the most common SAE, followed by ACS in the Americas and infections in other regions. VOC rate and percentage of VOC hospitalizations were highest in Europe. Regardless of region, most VOCs were treated with analgesics; approximately half were treated with intravenous fluids. The proportion of VOC-related transfusions was greatest in Europe. Lengths of hospital stay were similar across regions. Conclusions: Overall differences in SAEs and hospitalization for VOCs may be due to cultural diversities, resource utilization, disease severity, or a combination of factors. These data are of importance for the planning of future trials in SCA in a multinational setting.
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Affiliation(s)
- Baba Psalm Duniya Inusa
- Evelina Children’s Hospital, and Guy’s and St. Thomas’ Hospital, London SE1 7EH, UK
- Women and Children’s Health, Faculty of Life Sciences & Medicine, King’s College, London SE1 7EH, UK
- Correspondence: ; Tel.: +44-791-959-7783; Fax: +44-207-188-4612
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology-Oncology, Azienda Ospedaliera-University of Padua, Padua 35129, Italy;
| | - David C. Rees
- Department of Paediatric Haematology, King’s College London, King’s College Hospital, Denmark Hill, London SE5 8RZ, UK;
| | - Matthew M. Heeney
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA 02115, USA;
| | - Carolyn C. Hoppe
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA 94609, USA;
| | - Bernhards Ogutu
- U.S. Army Medical Research Unit-Kenya, Centre for Clinical Research, Kenya Medical Research Institute, Kisumu 00200, Kenya;
| | - Hoda M. Hassab
- Pediatric Department and Clinical Research Center, Faculty of Medicine, Alexandria University, Alexandria 21500, Egypt;
| | - Chunmei Zhou
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Suqin Yao
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Patricia B. Brown
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Lori E. Heath
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Joseph A. Jakubowski
- Eli Lilly and Company, Indianapolis, IN 46285, USA; (C.Z.); (S.Y.); (P.B.B.); (L.E.H.); (J.A.J.)
| | - Miguel R. Abboud
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut 11-0236, Lebanon;
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Arfé B, Montanaro M, Mottura E, Scaltritti M, Manara R, Basso G, Sainati L, Colombatti R. Selective Difficulties in Lexical Retrieval and Nonverbal Executive Functioning in Children With HbSS Sickle Cell Disease. J Pediatr Psychol 2019; 43:666-677. [PMID: 29432593 DOI: 10.1093/jpepsy/jsy005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 01/17/2018] [Indexed: 11/14/2022] Open
Abstract
Language deficits in multilingual children with sickle cell disease (SCD) are poorly understood. We tested the hypothesis that selective language deficits in this population could relate to an impaired frontal lobe functioning often associated with high-risk homozygous HbS disease (HbSS). In all, 32 children from immigrant communities with HbSS SCD aged 6 to 12 years (mean age = 9.03, n = 9 with silent infarcts) and 35 demographically matched healthy controls (mean age = 9.14) were tested on their naming skills, phonological and semantic fluency, attention, and selected executive functions (response inhibition and planning skills). Analyses of variance showed significant differences between patients and controls in inhibition and planning (p = .001 and .001), and phonological fluency (p = .004). The poorer performance in phonological fluency of the children with SCD was not associated with any visible brain damage to language areas. Hierarchical regression analyses showed that, whereas the control children's vocabulary knowledge explained their performance in the phonological fluency tasks, only inhibition skills accounted for variance in the performance of the children with SCD. These results suggest a selective impairment of verbal and nonverbal executive functioning (i.e., planning, inhibition, and phonological fluency) in children with SCD, with deficits possibly owing to frontal area hypoxia.
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Affiliation(s)
- Barbara Arfé
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione-University of Padova
| | - Maria Montanaro
- Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova
| | - Elena Mottura
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione-University of Padova
| | - Michele Scaltritti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione-University of Padova
| | | | - Giuseppe Basso
- Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova
| | - Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova
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Abstract
BACKGROUND Thalassaemia is a quantitative abnormality of haemoglobin caused by mutations in genes controlling production of alpha or beta globins. Abnormally unpaired globin chains cause haemolytic anaemia by causing membrane damage and cell death within organ systems and destruction of erythroid precursors in the bone marrow. The life-long management of the general health effects of thalassaemia in affected individuals is a highly challenging issue in and of itself; and failure to deal with dental and orthodontic complications in people with thalassaemia exacerbates the public health, financial and personal burden posed by the condition. There exists a lack of evidence-based guidelines for care-seekers and providers to best deal with such dental and orthodontic complications in thalassaemia, which this review seeks to address. OBJECTIVES The main objective of this review was to assess different methods to treat dental and orthodontic complications in people with thalassaemia. SEARCH METHODS We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We searched the reference lists of relevant articles and reviews.Date of last search: 01 August 2019.We also searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 22 July 2019. SELECTION CRITERIA We searched for published or unpublished randomised controlled trials for treatment of dental and orthodontic complications in individuals diagnosed with thalassaemia, irrespective of phenotype, severity, age, gender and ethnic origin. DATA COLLECTION AND ANALYSIS Two review authors independently screened 35,202 titles from search results. We identified four unique randomised controlled trials, of which one seemed potentially relevant. Based on closer inspection, the trial was found not to be eligible for inclusion. MAIN RESULTS We did not find any relevant trials for inclusion in the review. AUTHORS' CONCLUSIONS We were unable to draw any conclusions due to the lack of available data and trials. This review highlights the need for conducting and appropriate reporting, of high-quality randomised controlled trials investigating the effectiveness of various treatment modalities for dental and orthodontic complications in people with thalassaemia.
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Affiliation(s)
- Priti Mulimani
- School of Dentistry, University of WashingtonOral Health Sciences1959 Pacific Street NESeattleWAUSA98195
| | - Adinegara BL Abas
- Melaka‐Manipal Medical College (Manipal Academy of Higher Education)Department of Community MedicineJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Laxminarayan Karanth
- Melaka Manipal Medical CollegeDepartment of Obstetrics and GynaecologyBukit Baru, Jalan BatuHamparMelakaMalaysia75150
| | - Raffaella Colombatti
- Azienda Ospedaliera‐University of PadovaClinic of Pediatric Hematology‐Oncology, Department of Child and Maternal HealthPadovaItaly
| | - Palna Kulkarni
- Al Qassimi HospitalDepartment of Maxillofacial SurgerySharjahUnited Arab Emirates
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Russo G, De Franceschi L, Colombatti R, Rigano P, Perrotta S, Voi V, Palazzi G, Fidone C, Quota A, Graziadei G, Pietrangelo A, Pinto V, Ruffo GB, Sorrentino F, Venturelli D, Casale M, Ferrara F, Sainati L, Cappellini MD, Piga A, Maggio A, Forni GL. Current challenges in the management of patients with sickle cell disease - A report of the Italian experience. Orphanet J Rare Dis 2019; 14:120. [PMID: 31146777 PMCID: PMC6543611 DOI: 10.1186/s13023-019-1099-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/19/2019] [Indexed: 12/22/2022] Open
Abstract
Sickle cell disease (SCD) is an inherited red blood cell disorder caused by a structural abnormality of hemoglobin called sickle hemoglobin (HbS). Clinical manifestations of SCD are mainly characterized by chronic hemolysis and acute vaso-occlusive crisis, which are responsible for severe acute and chronic organ damage. SCD is widespread in sub-Saharan Africa, in the Middle East, Indian subcontinent, and some Mediterranean regions. With voluntary population migrations, people harboring the HbS gene have spread globally. In 2006, the World Health Organization recognized hemoglobinopathies, including SCD, as a global public health problem and urged national health systems worldwide to design and establish programs for the prevention and management of SCD. Herein we describe the historical experience of the network of hemoglobinopathy centers and their approach to SCD in Italy, a country where hemoglobinopathies have a high prevalence and where SCD, associated with different genotypes including ß-thalassemia, is present in the native population.
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Affiliation(s)
- Giovanna Russo
- Oncoematologia Pediatrica, Azienda Policlinico-Vittorio Emanuele, Università di Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| | - Lucia De Franceschi
- Dipartimento di Medicina, Sezione Medicina Interna, Università di Verona, Policlinico GB Rossi, AOUI, Verona, Italy
| | - Raffaella Colombatti
- Clinica di Oncoematologia Pediatrica, Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Università di Padova, Padova, Italy
| | - Paolo Rigano
- U.O.C Ematologia e Malattie Rare del Sangue e degli Organi Ematopoietici-P.O. Cervello Palermo, Palermo, Italy
| | - Silverio Perrotta
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università̀ degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Vincenzo Voi
- Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Ospedale San Luigi Gonzaga, Orbassano, Italy
| | - Giovanni Palazzi
- Dipartimento Integrato Materno Infantile U. O. Complessa di Pediatria Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Carmelo Fidone
- Unità operativa semplice Studio Emoglobinopatie Simt, Ragusa, Italy
| | | | - Giovanna Graziadei
- UOC di Medicina Generale, Centro Malattie Rare Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pad, Granelli, Milano, Italy
| | - Antonello Pietrangelo
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Valeria Pinto
- Centro della Microcitemia e delle Anemie Congenite, Ospedale Galliera, Via Volta 6, 16128, Genova, Italy
| | | | - Francesco Sorrentino
- U.O. Talassemici Centro Anemia Rare e Disturbi del metabolismo del Ferro ASL ROMA 2 Ospedale S Eugenio, Roma, Italy
| | - Donatella Venturelli
- Struttura Complessa di Immuno-trasfusionale Azienda Ospedaliero, Universitaria di Modena, Modena, Italy
| | - Maddalena Casale
- Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università̀ degli Studi della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Francesca Ferrara
- Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Università degli Studi di Modena e Reggio Emilia, Modena, Italy
| | - Laura Sainati
- Clinica di Oncoematologia Pediatrica, Dipartimento della Salute della Donna e del Bambino Azienda Ospedaliera, Università di Padova, Padova, Italy
| | - Maria Domenica Cappellini
- UOC di Medicina Generale, Centro Malattie Rare Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pad, Granelli, Milano, Italy
| | - Antonio Piga
- Struttura Complessa di Pediatria-Microcitemie dell'Ospedale San Luigi di Orbassano, Orbassano, TO, Italy
| | - Aurelio Maggio
- U.O.C Ematologia e Malattie Rare del Sangue e degli Organi Ematopoietici-P.O. Cervello Palermo, Palermo, Italy
| | - Gian Luca Forni
- Centro della Microcitemia e delle Anemie Congenite, Ospedale Galliera, Via Volta 6, 16128, Genova, Italy.
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Colombatti R, Martella M, Cattaneo L, Viola G, Cappellari A, Bergamo C, Azzena S, Schiavon S, Baraldi E, Dalla Barba B, Trafojer U, Corti P, Uggeri M, Tagliabue PE, Zorloni C, Bracchi M, Biondi A, Basso G, Masera N, Sainati L. Results of a multicenter universal newborn screening program for sickle cell disease in Italy: A call to action. Pediatr Blood Cancer 2019; 66:e27657. [PMID: 30724025 DOI: 10.1002/pbc.27657] [Citation(s) in RCA: 12] [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: 08/16/2018] [Revised: 01/22/2019] [Accepted: 01/27/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is a chronic multisystem disorder requiring comprehensive care that includes newborn screening (NBS) as the first step of care. Italy still lacks a national SCD NBS program and policy on blood disorders. Pilot single-center screening programs and a regional targeted screening have been implemented so far, but more evidence is needed in order to impact health policies. POPULATION AND METHODS NBS was offered to parents of newborns in gynecology clinics in Padova and Monza, tertiary care university hospitals in northern Italy. High-performance liquid chromatography (HPLC) was performed as the first test on samples collected on Guthrie cards. Molecular analysis of the beta-globin gene was performed on positive samples. RESULTS A total of 5466 newborns were enrolled; for 5439, informed consents were obtained. A similar family origin was seen in the two centers (65% Italians, 9% mixed couples, 26% immigrants). Compared with SCD NBS programs in the United States and Europe, our results show a similar incidence of SCD patients and carriers. All SCD patients had a Sub-Saharan family background; HbS carriers were 15% Caucasians (Italian, Albanians) and 10% from other areas (North Africa-India-South America); carriers of other hemoglobin variants were mainly (47%) from other areas. CONCLUSIONS Our results demonstrate the feasibility of a multicentric NBS program for SCD, give information on HbS epidemiology in two Northern Italian Areas, and support previous European recommendation for a universal NBS program for SCD in Italy: a high incidence of patients and carriers has been detected, with a high percentage of Caucasian carriers, impossible to identify in a targeted NBS.
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Affiliation(s)
- Raffaella Colombatti
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Maddalena Martella
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Laura Cattaneo
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Giampietro Viola
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Anita Cappellari
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Chiara Bergamo
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Silvia Azzena
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Sara Schiavon
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Eugenio Baraldi
- Neonatal Unit, Department of Child and Maternal Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Beatrice Dalla Barba
- Neonatal Unit, Department of Child and Maternal Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Ursula Trafojer
- Neonatal Unit, Department of Child and Maternal Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Paola Corti
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Marzia Uggeri
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | | | - Chiara Zorloni
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Michela Bracchi
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Andrea Biondi
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Giuseppe Basso
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Nicoletta Masera
- Department of Pediatrics-Università di Mitlano Bicocca, Fondazione MBBM, Monza, Italy
| | - Laura Sainati
- Clinic of Pediatric Hematology Oncology, Department of Woman's and Child Health, Azienda Ospedaliera-Università di Padova, Padova, Italy
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Martella M, Viola G, Azzena S, Schiavon S, Biondi A, Basso G, Corti P, Colombatti R, Masera N, Sainati L. Evaluation of Technical Issues in a Pilot Multicenter Newborn Screening Program for Sickle Cell Disease. Int J Neonatal Screen 2019; 5:2. [PMID: 33072962 PMCID: PMC7510190 DOI: 10.3390/ijns5010002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/19/2018] [Indexed: 11/16/2022] Open
Abstract
A multicenter pilot program for universal newborn screening of Sickle cell disease (SCD) was conducted in two centres of Northern Italy (Padova and Monza). High Performance Liquid Chromatography (HPLC) was performed as the first test on samples collected on Guthrie cards and molecular analysis of the β-globin gene (HBB) was the confirmatory test performed on the HPLC-positive or indeterminate samples. 5466 samples of newborns were evaluated. Of these, 5439/5466 were submitted to HPLC analysis and the molecular analysis always confirmed in all the alteration detected in HPLC (62/5439 newborns); 4/5439 (0.07%) were SCD affected, 37/5439 (0.68%) were HbAS carriers and 21/5439 (0.40%) showed other hemoglobinopathies. Stored dried blood spots were adequate for HPLC and β-globin gene molecular analysis. Samples were suitable for analysis until sixteen months old. A cut-off of A1 percentage, in order to avoid false negative or unnecessary confirmation tests, was identified. Our experience showed that several technical issues need to be addressed and resolved while developing a multicenter NBS program for SCD in a country where there is no national neonatal screening (NBS) program for SCD and NBS programs occur on a regional basis.
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Affiliation(s)
- Maddalena Martella
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-49-8211451
| | - Giampietro Viola
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
| | - Silvia Azzena
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
| | - Sara Schiavon
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
| | - Andrea Biondi
- Dipartimento di Pediatria, Università di Milano-Bicocca-Fondazione MBBM, San Gerardo Hospital, 20900 Monza, Italy
| | - Giuseppe Basso
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
| | - Paola Corti
- Dipartimento di Pediatria, Università di Milano-Bicocca-Fondazione MBBM, San Gerardo Hospital, 20900 Monza, Italy
| | - Raffaella Colombatti
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
| | - Nicoletta Masera
- Dipartimento di Pediatria, Università di Milano-Bicocca-Fondazione MBBM, San Gerardo Hospital, 20900 Monza, Italy
| | - Laura Sainati
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, 35128 Padova, Italy
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48
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Daniel Y, Elion J, Allaf B, Badens C, Bouva MJ, Brincat I, Cela E, Coppinger C, de Montalembert M, Gulbis B, Henthorn J, Ketelslegers O, McMahon C, Streetly A, Colombatti R, Lobitz S. Newborn Screening for Sickle Cell Disease in Europe. Int J Neonatal Screen 2019; 5:15. [PMID: 33072975 PMCID: PMC7510219 DOI: 10.3390/ijns5010015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
The history of newborn screening (NBS) for sickle cell disease (SCD) in Europe goes back almost 40 years. However, most European countries have not established it to date. The European screening map is surprisingly heterogenous. The first countries to introduce sickle cell screening on a national scale were France and England. The French West Indies started to screen their newborns for SCD as early as 1983/84. To this day, all countries of the United Kingdom of Great Britain and Northern Ireland have added SCD as a target disease to their NBS programs. The Netherlands, Spain and Malta also have national programs. Belgium screens regionally in the Brussels and Liège regions, Ireland has been running a pilot for many years that has become quasi-official. However, the Belgian and Irish programs are not publicly funded. Italy and Germany have completed several pilot studies but are still in the preparatory phase of national NBS programs for SCD, although both countries have well-established concepts for metabolic and endocrine disorders. This article will give a brief overview of the situation in Europe and put a focus on the programs of the two pioneers of the continent, England and France.
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Affiliation(s)
- Yvonne Daniel
- Public Health England, NHS Sickle Cell and Thalassemia Screening Programme, London SE16LH, UK
- Correspondence:
| | - Jacques Elion
- Laboratoire d’Excellence GR-Ex, UMR_S1134, Inserm, Université Paris Diderot, Sorbonne Paris Cité, Institut National de la Transfusion Sanguine, 75015 Paris, France
| | - Bichr Allaf
- NBS Laboratory for Haemoglobinopathies, Hôpital Universitaire Robert-Debré, 75019 Paris, France
| | - Catherine Badens
- Département de génétique médicale, Aix-Marseille Université, Hôpital de la Timone, 13385 Marseille, France
| | - Marelle J. Bouva
- National Institute for Public Health and the Environment, Centre for Health Protection, 3720 Bilthoven, The Netherlands
| | - Ian Brincat
- Pediatric Medicine Laboratory, Department of Pathology, Mater Dei Hospital, Triq Tal-Qroqq, MSD2090 Msida, Malta
| | - Elena Cela
- Department of Pediatric Oncology/Hematology, Hospital Universitario General Gregorio Marañón, Facultad de Medicina, Universidad Complutense Madrid, 28007 Madrid, Spain
| | - Cathy Coppinger
- Public Health England, NHS Sickle Cell and Thalassemia Screening Programme, London SE16LH, UK
| | - Mariane de Montalembert
- Department of Pediatrics, Reference Center for Sickle Cell Disease, AP-HP Hôpital Universitaire Necker-Enfants Malades, 75743 Paris, France
| | - Béatrice Gulbis
- Department of Clinical Chemistry, Cliniques Universitaires de Bruxelles, Hôpital Erasme—ULB, 1070 Bruxelles, Belgium
| | - Joan Henthorn
- Public Health England, NHS Sickle Cell and Thalassemia Screening Programme, London SE16LH, UK
| | - Olivier Ketelslegers
- Laboratoire—Biologie Clinique, Centre Hospitalier Régional de la Citadelle, 4000 Liège, Belgium
| | - Corrina McMahon
- Our Lady’s Children’s Hospital, Crumlin, D12V004 Dublin, Ireland
| | - Allison Streetly
- School of Population Health and Environmental Sciences, Faculty of Life Sciences & Medicine, King’s College London, London WC2R2LS, UK
- Division of Healthcare Public Health, Health Protection and Medical Directorate, Public Health England, London SE18UG, UK
| | - Raffaella Colombatti
- Department of Child and Maternal Health, Clinic of Pediatric Hematology/Oncology, Azienda Ospedaliera-Università di Padova, 35129 Padova, Italy
| | - Stephan Lobitz
- Department of Pediatric Oncology/Hematology, Kinderkrankenhaus Amsterdamer Straße, 50735 Cologne, Germany
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49
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Lobitz S, Telfer P, Cela E, Allaf B, Angastiniotis M, Backman Johansson C, Badens C, Bento C, Bouva MJ, Canatan D, Charlton M, Coppinger C, Daniel Y, de Montalembert M, Ducoroy P, Dulin E, Fingerhut R, Frömmel C, García-Morin M, Gulbis B, Holtkamp U, Inusa B, James J, Kleanthous M, Klein J, Kunz JB, Langabeer L, Lapouméroulie C, Marcao A, Marín Soria JL, McMahon C, Ohene-Frempong K, Périni JM, Piel FB, Russo G, Sainati L, Schmugge M, Streetly A, Tshilolo L, Turner C, Venturelli D, Vilarinho L, Yahyaoui R, Elion J, Colombatti R. Newborn screening for sickle cell disease in Europe: recommendations from a Pan-European Consensus Conference. Br J Haematol 2018; 183:648-660. [DOI: 10.1111/bjh.15600] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/26/2018] [Indexed: 12/23/2022]
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50
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Kanter J, Heath LE, Knorr J, Agbenyega ET, Colombatti R, Dampier C, Hassab H, Manwani D, Robitaille N, Brown PB, Jakubowski JA, Yao S, Hoppe C. Novel findings from the multinational DOVE study on geographic and age-related differences in pain perception and analgesic usage in children with sickle cell anaemia. Br J Haematol 2018; 184:1058-1061. [PMID: 29676449 DOI: 10.1111/bjh.15250] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Julie Kanter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Jack Knorr
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Raffaella Colombatti
- Azienda Ospedaliera-Università di Padova, Clinica di Oncoematologia Pediatrica Via Giustiniani, Padova, Italy
| | - Carlton Dampier
- Emory University, AFLAC Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Hoda Hassab
- Paediatric Department and Clinical Research Center, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Deepa Manwani
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nancy Robitaille
- Division of Hematology-Oncology, Department of Pediatrics, CHU Sainte-Justine, Montréal, QC, Canada
| | | | | | - Suqin Yao
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Carolyn Hoppe
- Department of Hematology-Oncology, UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
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