J Laver

St. Jude Children's Research Hospital, Memphis, Tennessee, United States

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Publications (108)568.69 Total impact

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    ABSTRACT: Background Optimal therapy for children and adolescents with advanced stage anaplastic large cell lymphoma (ALCL) is unknown. ANHL0131 examined whether a maintenance regimen including vinblastine compared to the standard APO (doxorubicin, prednisone, vincristine, methotrexate, 6-mercaptopurine) regimen would result in superior event-free survival.ProcedureOne hundred and twenty five eligible patients were enrolled. Induction was identical for both arms. Post induction patients were randomized to receive APO with vincristine every 3 weeks or a regimen that substituted vincristine with weekly vinblastine (APV).ResultsThere was no difference between the patients randomized to the APO versus APV arms in either event free survival (EFS) or overall survival (OS) (three year EFS 74% vs. 79%, P = 0.68 and three years OS of 84% vs. 86%, P = 0.87, respectively). Patients in the APV arm required dose reduction secondary to myelosuppression and had a higher incidence of neutropenia as well as infection with neutropenia compared to those in the APO arm (P < 0.001, P = 0.019, respectively).Conclusions Treatment with weekly vinblastine instead of every three week vincristine as part of multi-agent maintenance therapy did not result in improvement in EFS or OS. Weekly vinblastine was associated with increased toxicity. (ClinicalTrials.gov Identifier NCT00059839) Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
    No preview · Article · Dec 2014 · Pediatric Blood & Cancer
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    ABSTRACT: Given the growing support for establishing a just patient safety culture in health-care settings, a valid tool is needed to assess and improve just patient safety culture. The purpose of this study was to develop a measure of individual perceptions of just culture for a hospital setting. The 27-item survey was administered to 998 members of a health-care staff in a pediatric research hospital as part of the hospital's ongoing patient safety culture assessment process. Subscales included balancing a blame-free approach with accountability, feedback and communication, openness of communication, quality of the event reporting process, continuous improvement, and trust. The final sample of 404 participants (40% response rate) included nurses, physicians, pharmacists, and other hospital staff members involved in patient care. Confirmatory factor analysis was used to test the internal structure of the measure and reliability analyses were conducted on the subscales. Moderate support for the factor structure was established with confirmatory factor analysis. After modifications were made to improve statistical fit, the final version of the measure included 6 subscales loading onto one higher-order dimension. Additionally, Cronbach α reliability scores for the subscales were positive, with each dimension being above 0.7 with the exception of one. The instrument designed and tested in this study demonstrated adequate structure and reliability. Given the uniqueness of the current sample, further verification of the JCAT is needed from hospitals that serve broader populations. A validated tool could also be used to evaluate the relation between just culture and patient safety outcomes.
    No preview · Article · Dec 2013 · Journal of Patient Safety
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    ABSTRACT: The objective of this study was to examine correlates of weight-based teasing, self-esteem, and depression among 119 treatment-seeking obese African American adolescents aged 11 to 18 years. Body satisfaction was examined as a potential mediator of the association between teasing and self-esteem and teasing and depression. Study participants (mean age = 13.9 years; 72% female) completed measures evaluating teasing, self-esteem, depression, and body satisfaction. Body satisfaction was measured using a multiethnic figure rating scale and a measure of overall satisfaction with appearance. The results indicated an association between teasing and decreased self-esteem and increased depression. Males exhibited higher body satisfaction than females. Body satisfaction partially mediated the association between teasing and self-esteem and teasing and depression. These data suggest that body satisfaction is relevant to well-being among obese African American adolescents seeking weight loss treatment.
    No preview · Article · Aug 2013 · Journal of Black Psychology
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    ABSTRACT: Human leukocyte antigen (HLA) matched related donor (MRD) hematopoietic stem cell transplant (HSCT) for patients with sickle cell disease (SCD) has been well established, however experience using alternative donors, including haploidentical donors for treatment of SCD is limited. We report the long-term outcome of 22 pediatric patients who underwent a related donor HSCT for SCD at St. Jude Children's Research Hospital. Patients received a myeloablative MRD from a sibling (14) or reduced intensity parental haploidentical (8) HSCT. The medianageforthe patients who underwent a MRD and haploidentical donor HSCT were11.0±3.9 yrs. and9.0±5.0 yrs., respectively. The median time to follow up for the MRD cohort was 9.0 ± 2.3 yrs. withan overallsurvival (OS) of93%andrecurrence/graftfailureof0%. The median follow up for the haploidentical donor cohort was 7.4 ± 2.4 years with an OSof75%, disease free survival of 38%anddisease recurrence of 38%. We report the long-term hematological response and organ function in patients undergoing a MRD and haploidentical donor HSCT for severe SCD. Our data demonstrate long-term hematologic improvements after HSCT for our patients with sustained engraftment. In summary, our dataconfirmsthatHSCT offerslong--termprotectionfromcomplicationsthat commonlydevelopinpatientswithSCDsuchasstroke,pulmonaryhypertension, acutechest and nephropathy, regardless of donor source.
    Full-text · Article · Feb 2013 · Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation
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    ABSTRACT: Children with relapsed or refractory solid tumors face dismal prognoses and novel therapies are desperately needed. Allogeneic hematopoietic cell transplantation (HCT) offers potential for cell-based therapy, but the toxicity of myeloablation limits this approach in heavily pre-treated patients. We sought to determine the feasibility of HCT in a cohort of 24 children with incurable solid tumors, using HLA-matched sibling or unrelated donors and a minimal conditioning regimen. Prior to stem cell infusion, all patients received three daily doses of 30 mg/m(2) fludarabine followed by 2 Gy of total body irradiation. Hematopoietic cell recovery was rapid and reliable. Median time to neutrophil engraftment was 13.5 days for sibling donors and 12 days for unrelated donors. Donor lymphocyte infusions were used safely in four patients, all of whom had either improved chimerism or apparent tumor response. Graft-versus-host disease was comparable across donor sources and did not impact survival. Relapse remains a substantial barrier, although objective graft-versus-tumor effect was observed in several patients. Four patients with detectable disease prior to HCT achieved a complete response (CR) for at least 30 days after HCT, and two remain long-term survivors. Three patients were in CR before HCT, and they remained in remission for 3, 6, and 74 months after HCT. Early disease response was associated with improved survival. Allogeneic HCT using this conditioning regimen offers a potential platform for novel immunotherapies.
    Full-text · Article · Oct 2012 · Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation
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    ABSTRACT: ALK+ anaplastic large cell lymphoma (ALCL) is usually a disease of young patients. We investigated phosphatidylinositol-3 kinase (PI3K)/Akt pathway-associated factors in pediatric cases and cell lines. Patient materials consisted of tissue slides of ALK+/CD30+ ALCL from 33 patients treated on Pediatric Oncology Group protocols (9219, n = 8 and 9315, n = 25). Slides were examined by immunohistochemistry for phospho(p)-Akt and PTEN, the primary feedback regulator of the pathway, as well as for p27kip1 and stathmin-1. ALCL cell lines SUDHL-1 and Karpas-299 were examined for ALK, pALK, pAkt, p27/Kip1, PTEN, pPTEN, CD30, pSTAT3, and pSTAT5; ALK inhibition was performed using compound PF-2341066 and PTEN genes were sequenced. A majority of patients expressed pAkt, PTEN, and stathmin, with p27kip1 levels less than controls. Cell lines showed expression of ALK, pALK, pSTAT3, pSTAT5, CD30, pAkt, PTEN, and pPTEN, with p27 slightly less than positive controls, and germline PTEN DNA. There was evidence of phosphorylated PTEN (pPTEN) associated with inhibited function. Pharmacologic inhibition of activated ALK diminished pSTAT3, pSTAT5, and CD30 expression but not pAkt or pPTEN in cultured cell lines. We conclude that the PI3K/Akt pathway is activated in many, though not all, pediatric ALK+ ALCL. Our data suggest that activation of this pathway involves post-translational regulation of PTEN. Pharmacologic inhibition of activated ALK does not reduce modest levels of activated Akt as it does with the more abundant levels of activated STAT3 or STAT5. Future therapy of ALCL might, in selected patients, best combine agents inhibiting PI3K/Akt with those targeting ALK.
    No preview · Article · Sep 2012 · Pediatric Blood & Cancer
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    ABSTRACT: This study analyzes the hematopoietic cell transplantation experience in patients with immune deficiency at a single institution. The objective is to comprehensively evaluate the short-term and long-term outcomes with various preparative regimens, donor grafts, and ex vivo manipulations to identify transplantation approaches that most likely favor early donor immune competency without generating excessive toxicity. Clinical outcomes were evaluated in 52 consecutive patients with immune deficiencies. Thirty-seven of the 52 patients (71%) survived with attenuation of their underlying disease. The use of a melphalan-based reduced-intensity conditioning preparative regimen and immunomagnetic CD3(+) T cell depletion techniques (when T cell depletion was indicated) were associated with improved event-free survival. Survivors who received a preparative regimen other than a melphalan-based reduced-intensity regimen suffered from therapy-related morbidities or chronic/recurrent infections. Our findings indicate that melphalan-based reduced-intensity conditioning regimens and immunomagnetic CD3(+) T cell depletion limit therapy-related toxicity, and demonstrate promising results for the early establishment of donor immune competency.
    Full-text · Article · Jul 2012 · Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation
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    ABSTRACT: In patients with acute leukemia, detection of minimal residual disease (MRD) before allogeneic hematopoietic cell transplantation (HCT) correlates with risk of relapse. However, the level of MRD that is most likely to preclude cure by HCT is unclear, and the benefit of further chemotherapy to reduce MRD before HCT is unknown. In 122 children with very-high-risk acute lymphoblastic leukemia (ALL; n = 64) or acute myeloid leukemia (AML, n = 58), higher MRD levels at the time of HCT predicted a poorer survival after HCT (P = .0019); MRD was an independent prognostic factor in a multivariate analysis (P = .0035). However, the increase in risk of death associated with a similar increment of MRD was greater in ALL than in AML, suggesting that a pretransplantation reduction of leukemia burden would have a higher impact in ALL. At any given MRD level, survival rates were higher for patients treated in recent protocols: the 5-year overall survival for patients with ALL was 49% if MRD was detectable and 88% if it was not and the corresponding rates for patients with AML were 67% and 80%, respectively. Although MRD before HCT is a strong prognostic factor, its impact has diminished and should not be regarded as a contraindication for HCT.
    No preview · Article · Apr 2012 · Blood
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    ABSTRACT: Obesity is associated with an array of negative physical and psychosocial symptoms in adolescents. Numerous interventions have emerged to address this significant public health concern. However, few have focused on African American females, a group at particularly high risk for negative health behaviors and associated complications. Moreover, although investigations with adults have yielded promising findings regarding psychosocial changes associated with increased physical activity and fitness, much less research has examined this relationship in adolescents. The current study addressed these gaps in the research and examined psychological outcomes of adolescent participants in TEENS, a culturally sensitive, multidisciplinary weight loss pilot intervention. From baseline to post-testing, participants demonstrated significant improvements in physical, emotional, and social functioning, as well as significant reductions in body dissatisfaction. Moreover, increases in physical activity and fitness were associated with significant enhancements in psychological well-being. Outcomes provide evidence for the psychological benefits of physical activity and highlight the importance of detailed cardiorespiratory fitness assessment to evaluate the complex relationship between physical and mental health in future obesity interventions.
    No preview · Article · Jun 2011 · Mental Health and Physical Activity
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    ABSTRACT: We evaluated 190 children with very high-risk leukemia, who underwent allogeneic hematopoietic cell transplantation in 2 sequential treatment eras, to determine whether those treated with contemporary protocols had a high risk of relapse or toxic death, and whether non-HLA-identical transplantations yielded poor outcomes. For the recent cohorts, the 5-year overall survival rates were 65% for the 37 patients with acute lymphoblastic leukemia and 74% for the 46 with acute myeloid leukemia; these rates compared favorably with those of earlier cohorts (28%, n = 57; and 34%, n = 50, respectively). Improvement in the recent cohorts was observed regardless of donor type (sibling, 70% vs 24%; unrelated, 61% vs 37%; and haploidentical, 88% vs 19%), attributable to less infection (hazard ratio [HR] = 0.12; P = .005), regimen-related toxicity (HR = 0.25; P = .002), and leukemia-related death (HR = 0.40; P = .01). Survival probability was dependent on leukemia status (first remission vs more advanced disease; HR = 0.63; P = .03) or minimal residual disease (positive vs negative; HR = 2.10; P = .01) at the time of transplantation. We concluded that transplantation has improved over time and should be considered for all children with very high-risk leukemia, regardless of matched donor availability.
    Full-text · Article · May 2011 · Blood
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    ABSTRACT: This study's objective was to examine dietary and metabolic changes in obese adolescents who completed 6 months of participation in an outpatient multidisciplinary weight management program (N = 67). Participants (75% African American, 66% female, mean age = 13.7 years) completed 24-hour dietary recalls and underwent measurement of anthropometrics and fasting blood lipid parameters at baseline and after 6 months of participation. General linear models suggested that participants significantly reduced total energy, total fat, saturated fat, carbohydrate, sodium, and sugar intakes, and increased fiber and fruit and vegetable intake (P < .05). Gender-stratified models showed differences in fruit/vegetable intake, percentage calories from fat, sodium, and dietary cholesterol intakes by gender. Significant improvements in body mass index percentile and lipid profiles were also found, lending objective support to the dietary changes participants made. Findings suggest that participation in this multidisciplinary treatment helped participants make behaviorally based dietary changes, which were associated with improved dietary intakes and health status.
    No preview · Article · Apr 2011 · Clinical Pediatrics
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    ABSTRACT: Computerized prescriber order entry (CPOE) for medications has been implemented in only approximately 1 in 6 United States hospitals, with CPOE for chemotherapy lagging behind that for nonchemotherapy medications. The high risks associated with chemotherapy combined with other aspects of cancer care present unique challenges for the safe and appropriate use of CPOE. This article describes the process for safe and successful implementation of CPOE for chemotherapy at a children's cancer center. A core principle throughout the development and implementation of this system was that it must be as safe (and eventually safer) as existing paper systems and processes. The history of requiring standardized, regimen-specific, preprinted paper order forms served as the foundation for safe implementation of CPOE for chemotherapy. Extensive use of electronic order sets with advanced functionality; formal process redesign and system analysis; automated clinical decision support; and a phased implementation approach were essential strategies for safe implementation of CPOE. With careful planning and adequate resources, CPOE for chemotherapy can be safely implemented.
    Full-text · Article · Feb 2011 · Journal of the National Comprehensive Cancer Network: JNCCN
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    ABSTRACT: Patients with sickle cell disease (SCD) receiving chronic blood transfusions are at risk of developing iron overload and organ toxicity. Chelation therapy with either subcutaneous (SQ) desferrioxamine (DFO) or oral deferasirox is effective in preventing and reducing iron overload but poses significant challenges with patient compliance. Intravenous (IV) infusions of high dose DFO have been utilized in non-compliant patients with heavy iron overload in small case series. We review our experience of high dose IV DFO in 27 patients with SCD who had significant iron overload and were noncompliant with subcutaneous (SQ) DFO. All patients were treated in-hospital with DFO 15 mg/kg/hr IV for 48 hr every 2-4 weeks with a mean duration of 19.6 months. We observed a significant decrease in liver iron burden with high dose intermittent IV DFO. Histological examination of liver biopsies revealed a decrease in the grade of liver iron storage. Also there was significant improvement in liver enzymes (ALT, AST) after high dose IV DFO. No audiologic or ophthalmologic toxicity or acute or chronic pulmonary complications were observed. In our cohort of patients with SCD we observed a significant decrease in liver iron burden with high dose IV DFO. Our patients tolerated the therapy well without any major toxicity. This regimen is safe and may be an option for poorly compliant patients with significant iron overload.
    No preview · Article · Dec 2010 · Pediatric Blood & Cancer
  • John T Sandlund · Joseph H Laver
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    ABSTRACT: central nervous system prophylaxis is recommended with the administration of high-dose methotrexate and/or intrathecal injection of chemotherapy in patients with anaplastic large-cell lymphoma (ALCL). researchers investigated whether methotrexate dose, infusion duration and intrathecal mode of administration had an impact on the risk of systemic and central nervous system relapses in children with ALCL.
    No preview · Article · Sep 2009 · Nature Reviews Clinical Oncology
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    ABSTRACT: The aim of this study was to determine the prevalence of the metabolic syndrome at baseline and after 6 months of lifestyle modification among obese adolescents referred to a multidisciplinary weight management program. A total of 165 obese adolescents were evaluated at baseline, and measurements were repeated in 57 subjects who completed 6 months of the program. Metabolic syndrome was defined as having three or more of the following: a body mass index (BMI) >97(th) percentile, hypertension, low high-density lipoprotein cholesterol (HDL-C), hypertriglyceridemia, and impaired fasting glucose (IFG). The prevalence of a BMI >97(th) percentile, hypertension, hypertriglyceridemia, low HDL-C, and IFG was 92.7, 54.5, 29.1, 26.7, and 2.4%, respectively. The prevalence of the metabolic syndrome at baseline was 30.3%. After 6 months of lifestyle modification, BMI z scores, percent body fat, total cholesterol, and low-density lipoprotein cholesterol (LDL-C) decreased significantly from baseline; however, there was no significant change in the number of subjects demonstrating >or=three criteria of the metabolic syndrome. Approximately one third of the study subjects met the criteria of the metabolic syndrome, emphasizing the growing concern for the future development of premature cardiovascular disease in this high-risk population. Our data suggest that new strategies for lifestyle modification may be needed to improve cardiovascular risk factors significantly among adolescents with obesity.
    Full-text · Article · Jul 2009 · Metabolic syndrome and related disorders
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    ABSTRACT: The role of cytokines in the development of acute chest syndrome (ACS) in patients with sickle cell disease (SCD) was studied. Serum interleukin 8 (IL-8) levels were elevated in 14 episodes and undetectable in six out of 20 episodes of ACS in 19 patients with SCD. In contrast, IL-8 levels were undetectable in the sera of 29 control patients with SCD studied during routine clinic visits or hospitalization for vaso-occlusive crises. The differences in mean IL-8 levels and the proportion of patients with detectable levels between the two groups were highly significant (P < 0·0001 and 0·04 respectively). The mean IL-8 level in bronchial fluid samples from children with ACS was also significantly higher than that in sickle cell patients undergoing elective surgery (5500 ± 1400 pg/ml vs. 1900 ± 470 pg/ml, P = 0·03). Granulocyte colony-stimulating factor (G-CSF) (2000 ± 1700 pg/ml) was present in five out of six samples of bronchial fluid, but not serum, from children with ACS. All but one of the patients with ACS studied were negative for the Duffy red cell antigen, which is a receptor that binds and inactivates IL-8 and other chemokines. These findings suggest that IL-8 and G-CSF may play a role in the development of the ACS and the complications associated with it.
    No preview · Article · Nov 2008 · British Journal of Haematology
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    ABSTRACT: This study evaluated preliminary physical fitness, physical activity, and blood lipid profile data obtained from overweight adolescents upon enrolling in a healthy weight management program and following 6 months of program participation. One hundred and sixty-eight participants (13.4+/-1.8 years, 37.9+/-8.3 kg/m(2), 59.5% female and 76.2% African-American) enrolled in the program. The intervention addressed factors related to nutrition, physical activity, and other behaviors related to weight management. Sixty-four participants (38.1%) completed 6 months of program participation. While there was no significant reduction in body mass or body mass index (BMI), BMI z-score was reduced by 1.2% (p < 0.05), cardiorespiratory fitness was increased by 10.8% (p = 0.001), body fat percentage was reduced by 2.6% (p = 0.001), total cholesterol was reduced by 7.2% (p < 0.001), and low density lipoprotein (LDL-C) was reduced by 8.4% (p < 0.001) at 6 months. Continued development and evaluation of programs designed to prevent and treat child and adolescent overweight is warranted to address this major public health issue.
    No preview · Article · Sep 2008 · International journal of pediatric obesity: IJPO: an official journal of the International Association for the Study of Obesity
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    ABSTRACT: Background Peripheral T-cell lymphomas (PTCL) other than anaplastic large cell lymphoma (ALCL) are rare in young patients. While a high proportion of adults with PTCL have poor risk disease, pediatric PTCL is not well characterized. This study examines the outcome of localized and advanced PTCL in pediatric patients treated in standardized fashion.ProcedureWe identified 20 pediatric patients diagnosed with PTCL whose tumor cells did not express CD30 and/or ALK, as determined by immunohistochemistry, between 1992 and 2000 on one of two treatment protocols for localized NHL (POG 9219) or advanced stage large cell lymphoma (POG 9315). All cases were centrally reviewed.ResultsThe median age was 12.6 (range 0.7–16.9)—9 male and 11 female. Histological subtypes in the WHO Classification included PTCL, unspecified (12), extra-nodal NK/T-cell lymphoma of nasal type (4), subcutaneous panniculitis-like T cell lymphoma (1) and enteropathy-type T-cell lymphoma (1). Two cases exhibited both T-cell and histiocyte markers and were reclassified as histiocytic sarcoma per the WHO, although T-lineage remains possible. Of 10 patients with localized disease, only two relapsed and 9 survive. Of 10 patients with advanced disease, six relapsed and five (50%) survive.Conclusions These results suggest that localized PTCL in children and adolescents is frequently cured with modern therapy, but that advanced stage cases may require novel therapy. Pediatr Blood Cancer 2008;51:29–33. © 2008 Wiley-Liss, Inc.
    Full-text · Article · Jul 2008 · Pediatric Blood & Cancer
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    ABSTRACT: Background Given the increase in 5- and 10-year survival rates of children and adolescents diagnosed with cancer, current psycho-oncology literature is focusing on finding correlates and predictors to their positive psychosocial adjustment. The purpose of this study was to evaluate two potential mediators to adolescent cancer survivors' quality of life (QOL) and depressive symptomology. Procedure: Adolescent cancer survivors (N = 50; 50% males; mean diagnosis age, 13.7; mean age at study, 20.2) were surveyed, testing the mediation effects of their happiness (Subjective Happiness Scale) and past-negative time perspective (Zimbardo Time Perspective Inventory) on QOL (PedsQL 4.0) and depressive symptomology (CES-D). Independent variables included gender and treatment intensity.ResultsHappiness significantly mediated the relationship between treatment intensity in both depressive symptomology (β = −0.65, P < 0.05, CI = −2.46, −6.41) and QOL (β = 0.54, P < 0.05, CI = 3.66, 9.01). A past-negative time perspective significantly mediated the relationship between gender and depressive symptomology (β = 0.60, P < 0.05, CI = 3.34, 9.78). Survivors' gender was not associated with happiness and treatment intensity was not associated with time perspective.Conclusions Happiness may be a more direct predictor of QOL and depression than the intensity of treatment for cancer. Also, thinking negatively about one's past may be a more direct predictor of depressive symptomology than being female. Therefore, interventions that cultivate happiness and reframe time perspective may be effective ways to improve survivors' QOL and decrease depressive symptoms—regardless of gender and intensity of treatment protocol. Pediatr Blood Cancer 2008;50:613–619. © 2007 Wiley-Liss, Inc.
    Full-text · Article · Mar 2008 · Pediatric Blood & Cancer
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    ABSTRACT: Chronic transfusions are effective in preventing stroke and other complications of sickle cell disease. The aim of this study was to determine whether serum ferritin levels correlated with liver iron content in sickle cell patients on chronic transfusion. Forty-four liver biopsy specimens from 38 patients with homozygous sickle cell anemia (HbSS) and one patient with sickle thalassemia receiving chronic transfusions were studied. Five patients underwent a second liver biopsy for follow up. Three ferritin measurements were used to calculate a mean for each patient. The association between serum ferritin levels and liver iron quantitation was measured using the Spearman rank correlation, and sensitivity and specificity were determined for selected threshold values of serum ferritin. Serum ferritin levels ranged from 515 to 6076 ng/ml, liver iron concentration ranged from 1.8 to 67.97 mg/g dry weight. The amount of iron per gram liver dry weight was moderately correlated with serum ferritin values (r = 0.46). The correlation of duration of transfusion with serum ferritin (r = 0.40) and with liver iron content (r = 0.41) also indicated moderate correlation. Liver biopsy results led to changes in the management after 29/44 (66%) of the biopsies. Serum ferritin ≥2500 ng/ml predicted high liver iron content (≥7 mg/g), with a sensitivity of 62.5% and a specificity of 77.8%. We found a poor correlation between serum ferritin levels and liver iron content (LIC). Despite being on chelation therapy, many patients on chronic transfusion had high levels of liver iron. Measurement of LIC is highly recommended in these patients. Pediatr Blood Cancer 2008;50:62–65.
    Full-text · Article · Jan 2008 · Pediatric Blood & Cancer

Publication Stats

3k Citations
568.69 Total Impact Points


  • 1994-2014
    • St. Jude Children's Research Hospital
      • Department of Bone Marrow Transplantation and Cellular Therapy
      Memphis, Tennessee, United States
    • Indiana University-Purdue University School of Medicine
      • Division of Hematology/Oncology
      Indianapolis, Indiana, United States
    • Mount Sinai Medical Center
      New York, New York, United States
    • Indiana University-Purdue University Indianapolis
      • Division of Hematology/Oncology
      Indianapolis, IN, United States
  • 2009
    • University of Tennessee
      Knoxville, Tennessee, United States
  • 2005-2009
    • Virginia Commonwealth University
      • Department of Pediatrics
      Richmond, VA, United States
    • Harvard University
      Cambridge, Massachusetts, United States
    • Richmond VA Medical Center
      Richmond, Virginia, United States
  • 1993-2008
    • Medical University of South Carolina
      • • Division of Pediatric Hematology/Oncology
      • • Department of Medicine
      • • Department of Pediatrics
      Charleston, South Carolina, United States
  • 1999
    • Soroka Medical Center
      Be'er Sheva`, Southern District, Israel
  • 1998
    • University of Washington Seattle
      • Division of Hematology
      Seattle, Washington, United States
  • 1986-1992
    • Memorial Sloan-Kettering Cancer Center
      • • Bone Marrow Transplant Service
      • • Pediatric Surgical Service
      New York, New York, United States