Research Studies

This research project will examine fall history and fall risk in patients with hemophilia. Multiple risk factors for falls identified in the general population are prevalent in the hemophilia population. Existing data suggest that fall rates may be higher and that fall risk may begin at an earlier age in patients with hemophilia. Identification of fall risk enables early intervention, thereby preventing injury and fear of physical activity, both of which have been associated with falling and may carry an increased risk in patients with bleeding disorders.

Dr. Zia earned a MBBS degree from King Edward Medical College, Pakistan. Following an internship in pediatrics at the Children's Hospital, University of Oklahoma Health Sciences Center, she completed her second and third years of pediatric residency at the Children's Hospital of Michigan, Wayne State University in Detroit. Since becoming a hematology/oncology fellow in 2009, Dr. Zia presented at the American Society of Hematology and has had five abstracts accepted for presentation at other major hematology meetings. Dr. Zia will continue her specialized training in pediatric hemostasis-thrombosis under the directorship of Dr. Jeanne Lusher. The NHF-Baxter Clinical Fellowship award will foster Dr. Zia's development as a clinical scientist, allowing her to study clinical research design, statistical analysis as well as pursue research concerning the thrombogenicity of hormonal supplementation in adolescent girls under the mentorship of Drs. Madhvi Rajpurkar and Michael Callaghan, a previous NHF/Baxter clinical fellowship recipient.

Dr. Smith's research focuses on better understanding the development of factor VIII inhibitors. Specifically, she will focus on the effects of chemical signals, or cytokines, secreted by helper T cells on the development of inhibitor antibodies. She hypothesizes that certain cells, called Th17 cells, play an important role in the development of these antibodies by stimulating inflammation and driving the immune response toward inhibitor production. Dr. Smith received a BS from the University of Delaware before earning her Ph.D. from Montana State University. Prior to her appointment as an Assistant Professor at the University of Texas Medical School at Houston, she spent four years as a postdoctoral research fellow at the University of Michigan.

Per Dr. Ivanciu, the JGP award was the starting point of her career in the field of hemophilia. By receiving this award, she was able to advance her understanding of bleeding disorders and gained the necessary experience in state-of-the-art techniques in animals, molecular biology and biochemistry of clotting factors. All of this has prepared her for the next phase of her career.

The objective of this study is to collect a large data base of gait parameters on individuals from the age of 12 months to 99 years old who do not have neuromotor deficits. This ongoing study will be the basis of comparison for people with hemophilia as a means to identify gait deficits that occur due to joint or muscle involvement from the bleeding disorder as compared to gender and age matched controls. We are using the GaitRite electronic walkway evaluation system as the quantitative measurement tool for gait analysis. Enrolled subjects are consented to this study and to the storage of data in a gait repository for future studies. This data will be available to other Hemophilia Treatment Centers upon written request to our Gait Repository Guardian (currently Dave Oleson, PT at the Hemophilia Treatment Center at CDRC in Portland, OR).

Menstrual cycles for females with bleeding disorders can present special challenges not experienced by other girls and women. Having your period can be physically, social and emotionally exhausting. A new web-based application is now available and can be downloaded to your personal mobile device or desktop computer. With this application you can track how long your period lasts, how much you are bleeding, any interventions utilized and how it is affecting your daily life. This is a new web-based application you can download that is free and available to all girls and women with bleeding disorders through their federally funded hemophilia treatment center (HTC).

Individuals with hemophilia are living longer than previously expected because of advances in treatment, including the development of clotting factor replacement. However, we do not understand the psychological and emotional impact of aging with hemophilia, how this affects quality of life, and how resilience and healthy coping skills are developed and maintained. For example, we do not know if persons with hemophilia: (a) retire early because of having a disability, although this may be a reasonable assumption; (b) if they are financially secure; and (c) how much joint damage impacts the ability to move, walk, and perform everyday activities. We also do not know what special challenges arise from aging with hemophilia, and if this leads to more divorces, an increase in living alone, and a greater need for help to remain independent. There is little research showing which traits help persons with hemophilia continue to mature, and keep an emotional balance while dealing with a lifelong, chronic condition and how all these traits improve or reduce quality of life.

Dr. Grace joined Children's Hospital Boston / Dana Farber Cancer Institute as a Pediatric Resident after receiving both her undergraduate and doctoral degrees from Brown University. She has since gone on to become a fellow in the institution's Hematology/Oncology program and was chief fellow in her final year of fellowship. As Dr. Grace begins her NHF-Baxter fellowship, she will be on staff as a Hematologist at Children's Hospital Boston / Dana Farber Cancer Institute. As an NHF-Baxter fellow, Dr. Grace will spend two years developing advanced skills in clinical hemostasis and clinical trial design. Under the mentorship of Dr. Ellis Neufeld, she will continue her work on several ongoing clinical studies. Dr. Grace is currently the Co-Investigator of a study on the genetic modifiers of chronic ITP. Dr. Grace's goal is to become a clinical expert in hemostasis and thrombosis as well as a productive independent clinical investigator. She hopes to contribute towards improving the treatment, outcomes and quality of life of pediatric patients with bleeding and clotting disorders through a career in clinical research.

Since 2009, Dr. Branchford has been a hematology/oncology/bone marrow transplant fellow at the Children's Hospital of Denver. Prior to this post, he served as Chief Resident at the Children's Hospital of Wisconsin-Milwawukee. Dr. Branchford received his doctoral degree from the University of Wisconsin School of Medicine and Public Health and his BA in Biology from Lawrence University. He is also a member of the American Academy of Pediatrics and Colorado Medical Society as well as the American Societies of Hematology, Clinical Oncology and Pediatric Hematology/Oncology. As an NHF-Baxter Clinical Fellow, Dr. Branchford will be continuing both his clinical and research training under the mentorship of Dr. Marilyn Manco-Johnson. In addition to this, he will be working in the lab of Dr. Jorge DiPaola on a project researching the microfluidic properties of von Willebrand Disease as well as the role of the TAM pathway in platelet activation and thrombus formation. In the long-term, Dr. Branchford's career goal is to serve as Director of a Hemophilia/Thrombosis center, providing clinical care as well as basic or translational research within the structure of an academic pediatric department.

Dr. Yee earned his undergraduate Credentials from Rensselaer Polytechnic Institute before receiving his doctorate from Rice University. His eventual goal is to operate an independent research laboratory in the field of bioengineering with a focus on understanding molecular mechanisms of hemostasis, thrombosis and vascular diseases. Dr. Yee's research project deals with factor VIII and its adhesion to its chaperone protein, von Willebrand factor. In these experiments, fragments of von Willebrand factor are screened for optimal factor VIII stabilization. By further studying the architecture of the "Factor VIII-von Willebrand Factor" complex, Dr. Yee seeks to gain insight to improve designs of novel therapeutics.