Showing papers by "Lori C. Jordan published in 2020"
Vanderbilt University1, Vanderbilt University Medical Center2, Washington University in St. Louis3, University of South Carolina4, Children's Hospital Oakland Research Institute5, University of California, San Francisco6, Queen Mary University of London7, Johns Hopkins University8, Mayo Clinic9, University Hospital Southampton NHS Foundation Trust10, University College London11, University of Southampton12
TL;DR: These evidence-based guidelines of the American Society of Hematology are intended to support the SCD community in decisions about prevention, diagnosis, and treatment of the most common neurological morbidities in SCD.
151 citations
Johns Hopkins University School of Medicine1, University of Manitoba2, University of Colorado Boulder3, Children's National Medical Center4, Ain Shams University5, Vanderbilt University Medical Center6, Washington University in St. Louis7, Boston Children's Hospital8, University of California, San Francisco9
TL;DR: To characterize predictors of recovery and outcome following pediatric arterial ischemic stroke, hypothesizing that age influences recovery after stroke is hypothesized.
Abstract: OBJECTIVE
To characterize predictors of recovery and outcome following pediatric arterial ischemic stroke, hypothesizing that age influences recovery after stroke.
METHODS
We studied children enrolled in the International Pediatric Stroke Study between January 1, 2003 and July 31, 2014 with 2-year follow-up after arterial ischemic stroke. Outcomes were defined at discharge by clinician grading and at 2 years by the Pediatric Stroke Outcome Measure. Demographic, clinical, and radiologic outcome predictors were examined. We defined changes in outcome from discharge to 2 years as recovery (improved outcome), emerging deficit (worse outcome), or no change.
RESULTS
Our population consisted of 587 patients, including 174 with neonatal stroke and 413 with childhood stroke, with recurrent stroke in 8.2% of childhood patients. Moderate to severe neurological impairment was present in 9.4% of neonates versus 48.8% of children at discharge compared to 8.0% versus 24.7% after 2 years. Predictors of poor outcome included age between 28 days and 1 year (compared to neonates, odds ratio [OR] = 3.58, p < 0.05), underlying chronic disorder (OR = 2.23, p < 0.05), and involvement of both small and large vascular territories (OR = 2.84, p < 0.05). Recovery patterns differed, with emerging deficits more common in children <1 year of age (p < 0.05).
INTERPRETATION
Outcomes after pediatric stroke are generally favorable, but moderate to severe neurological impairments are still common. Age between 28 days and 1 year appears to be a particularly vulnerable period. Understanding the timing and predictors of recovery will allow us to better counsel families and target therapies to improve outcomes after pediatric stroke. ANN NEUROL 2020;87:840-852.
46 citations
TL;DR: This is the first clinical safety and efficacy study of TruUCARTM GC027: The first-in-human, universal CAR-T therapy for adult relapsed/refractory T-cell acute lymphoblastic leukemia (r/r T-ALL) at the Virtual Annual Meeting I 2020.
Abstract: REFERENCES 1. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375-2390. 2. Fielding AK, Richards SM, Chopra R, et al. Outcome of 609 adults after relapse of acute lymphoblastic leukemia (ALL); an MRC UKALL12/ECOG 2993 study. Blood. 2007;109:944-950. 3. Jain N, Stevenson KE, Winer ES, et al. A Multicenter Phase I Study Combining Venetoclax with Mini-Hyper-CVD in Older Adults with Untreated and Relapsed/Refractory Acute Lymphoblastic Leukemia. Blood. 2019;134:3867-3867. 4. Lacayo NJ, Pullarkat VA, Stock W, et al. Safety and Efficacy of Venetoclax in Combination with Navitoclax in Adult and Pediatric Relapsed/Refractory Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma. Blood. 2019;134:285. 5. Bride KL, Vincent TL, Im SY, et al. Preclinical efficacy of daratumumab in T-cell acute lymphoblastic leukemia. Blood. 2018;131:995-999. 6. Wang SL X, Gao L, Yuan Z, Wu K, Liu L, Luo L, et al. Clinical safety and efficacy study of TruUCARTM GC027: The first-in-human, universal CAR-T therapy for adult relapsed/refractory T-cell acute lymphoblastic leukemia (r/r T-ALL). American Association for Cancer Research (AACR), Virtual Annual Meeting I 2020. SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section at the end of this article.
28 citations
TL;DR: Meta-analytic findings indicate that hemoglobin and hematocrit were positively correlated with Full Scale IQ, language and verbal reasoning, and executive function with small effects and significant heterogeneity, while total behavioral problems were negatively associated with FSIQ such that participants with lower FSIZ exhibited greater behavioral and emotional problems.
Abstract: Objective To provide a comprehensive quantitative review of biological, environmental, and behavioral correlates across domains of cognitive function in sickle cell disease (SCD). Methods Forty-seven studies were identified in PubMed, MedLine, and PsycINFO involving 2573 participants with SCD. Results Meta-analytic findings across all identified samples indicate that hemoglobin and hematocrit were positively correlated with Full Scale IQ [FSIQ; r = .15, 95% confidence interval (CI) = .10 to .21], language and verbal reasoning (r = .18, 95% CI = .11 to .24), and executive function (r = .10, 95% CI = .01 to .19) with small effects and significant heterogeneity. Transcranial Doppler velocity was negatively associated with visual spatial and perceptual reasoning (r = -.18, 95% CI = -.31 to -.05). Socioeconomic status was positively associated with FSIQ (r = .23, 95% CI = .17 to .28), language and verbal reasoning (r = .28, 95% CI = .09 to .45), visual spatial and perceptual reasoning (r = .26, 95% CI = .09 to .41), and executive function (r = .18, 95% CI = .07 to .28) with small to medium effects. Finally, total behavioral problems were negatively associated with FSIQ (r = -.12, 95% CI = -.21 to -.02) such that participants with lower FSIQ exhibited greater behavioral and emotional problems. Conclusions Findings provide evidence for biological, environmental, and psychosocial corelates across multiple domains of cognitive function in SCD. More research on more specific cognitive domains and psychosocial correlates is needed in addition to assessments of interactional models among risk factors.
23 citations
TL;DR: It is provided that epilepsy occurs in approximately one-quarter of patients by one year after diagnosis of cerebral sinovenous thrombosis, and no clinical predictors associated with epilepsy were identified.
18 citations
TL;DR: Pediatric stroke protocol implementation improved over time with increased use of the PedNIHSS and use of MRI as the first imaging study, however, with increased utilization, the frequency of confirmed strokes and other neurologic emergencies remained stable.
17 citations
TL;DR: Findings highlight the relevance of hemodynamic imaging and machine learning for identifying cerebrovascular impairment and evaluate discriminatory capacity for stenotic flow territories using k-fold cross-validation and receiver-operating-characteristic-area-under-the-curve to quantify variable combination relevance.
Abstract: Translation of many non-invasive hemodynamic MRI methods to cerebrovascular disease patients has been hampered by well-known artifacts associated with delayed blood arrival times and reduced microvascular compliance. Using machine learning and support vector machine (SVM) algorithms, we investigated whether arrival time-related artifacts in these methods could be exploited as novel contrast sources to discriminate angiographically confirmed stenotic flow territories. Intracranial steno-occlusive moyamoya patients (n = 53; age = 45 ± 14.2 years; sex = 43 F) underwent (i) catheter angiography, (ii) anatomical MRI, (iii) cerebral blood flow (CBF)-weighted arterial spin labeling, and (iv) cerebrovascular reactivity (CVR)-weighted hypercapnic blood-oxygenation-level-dependent MRI. Mean, standard deviation (std), and 99th percentile of CBF, CVR, CVRDelay, and CVRMax were calculated in major anterior and posterior flow territories perfused by vessels with vs. without stenosis (≥70%) confirmed by catheter angiogr...
16 citations
TL;DR: Cogmed intervention demonstrated greater improvement than controls on measures of working memory, the Wechsler Intelligence Scale for Children-V Working Memory Index and the National Institutes of Health Toolbox Cognitive Battery post-training that were statistically significant.
10 citations
TL;DR: Severe anaemia was significantly associated with the lower educational level of the head of the household, as a proxy for poverty, and a greater number of children per room in the household and body mass index.
Abstract: Severe anaemia, defined as haemoglobin level < 6·0 g/dl, is an independent risk factor for death in individuals with sickle cell disease living in resource-limited settings. We conducted a cross-sectional study of 941 children with sickle cell anaemia, who had been defined as phenotype HbSS or HbSβ0 thalassaemia, aged five to 12 years, and were screened for enrollment into a large primary stroke prevention trial in Nigeria (SPRING; NCT02560935). The main aim of the study was to determine the prevalence and risk factors for severe anaemia. We found severe anaemia to be present in 3·9% (37 of 941) of the SPRING study participants. Severe anaemia was significantly associated with the lower educational level of the head of the household (P = 0·003), as a proxy for poverty, and a greater number of children per room in the household (P = 0·004). Body mass index was not associated with severe anaemia. The etiology of severe anaemia in children living with sickle cell anaemia in Nigeria is likely to be multifactorial with an interplay between an individual's disease severity and other socio-economic factors related to poverty.
9 citations
TL;DR: Testing the hypothesis that fixed-moderate dose hydroxyurea therapy for primary stroke prevention results in a 66% relative risk reduction when compared to fixed low-dose hydroxyUREa therapy in a randomized controlled trial, found it to be effective.
7 citations
TL;DR: This review focuses on using advanced neuroimaging methods to assess stroke risk in individuals with SCA and such methods may be utilized before and after bone marrow or hematopoietic stem cell transplant to assess cerebral hemodynamic response.
TL;DR: Clinical significance of CD33 nonsynonymous single-nucleotide polymorphisms in pediatric patients with acute myeloid leukemia treated with gemtuzumabozogamicin-containing chemotherapy and their associated outcomes is studied.
Abstract: 2016;30(2):268-273. 5. Lamba J, Chauhan L, Shin M, et al. CD33-Single Nucleotide Polymorphism (CD33-SNP) Score Predicts Gemtuzumab Ozogamicin Response in Childhood Acute Myeloid Leukemia: Report from Children's Oncology Group AAML0531 Trial. Blood. 2017;130(suppl 1): 3826. 6. Stanchina M, Pastore A, Devlin S, Famulare C, Stein E, Taylor J. CD33 splice site genotype was not associated with outcomes of patients receiving the anti-CD33 drug conjugate SGN-CD33A. J Hematol Oncol. 2019;12(1):85. 7. Mortland L, Alonzo TA, Walter RB, et al. Clinical significance of CD33 nonsynonymous single-nucleotide polymorphisms in pediatric patients with acute myeloid leukemia treated with gemtuzumabozogamicin-containing chemotherapy. Clin Cancer Res. 2013;19(6): 1620-1627.
TL;DR: Perinatal hemorrhagic stroke survivors had favorable outcomes in early childhood; at two years moderate to severe deficits occurred in 5%.
TL;DR: Evidence is provided that HU therapy may be an effective therapy for secondary prevention of strokes when compared to no therapy, and the hypothesis that for secondary stroke prevention among children with SCA and acute overt ischemic stroke, fixed moderated dose HU Therapy results in 80% relative risk reduction.
01 Jan 2020
TL;DR: A novel case of an infant with neurofibromatosis type 1 who presented with new onset presumed focal impaired awareness seizures with motor onset followed by rapid progression to infantile spasms, electroencephalography captured evolution from focal epileptiform discharges to multifocal and generalized discharges, then to hypsarrhythmia over three days.
Abstract: We report a novel case of an infant with neurofibromatosis type 1 (NF1) who presented with new onset presumed focal impaired awareness seizures with motor onset followed by rapid progression to infantile spasms (IS). Electroencephalography (EEG) captured evolution from focal epileptiform discharges to multifocal and generalized discharges, then to hypsarrhythmia over three days. Development of IS within days of focal seizure onset is rapid, and to our knowledge, has not been demonstrated electrographically. The pattern of rapid ictal transition to hypsarrhythmia is essential for neurologists to be able to recognize as it can help lead to early treatment, which is necessary for improved outcomes in IS.
University of Texas Health Science Center at Houston1, University of Michigan2, Duke University3, Case Western Reserve University4, Cedars-Sinai Medical Center5, The Ohio State University Wexner Medical Center6, Yale University7, University of Wisconsin-Madison8, University of Chicago9, Georgetown University Medical Center10, Roy J. and Lucille A. Carver College of Medicine11, Vanderbilt University Medical Center12, University of California, Los Angeles13, University of Washington14, National Institutes of Health15, Columbia University Medical Center16, University of Cincinnati17
TL;DR: A descriptive account of the rationale, organization, and activities of the NIH StrokeNet Training Core (NSTC) since its inception in 2013 is provided, demonstrating strong contribution of trainees towards academic scholarship.
Abstract: Background and Purpose- The National Institutes of Health (NIH) StrokeNet provides a nationwide infrastructure to advance stroke research. Capitalizing on this unique opportunity, the NIH StrokeNet Training Core (NSTC) was established with the overarching goal of enhancing the professional development of a diverse spectrum of professionals who are embedded in the stroke clinical trials network of the NIH StrokeNet. Methods- This special report provides a descriptive account of the rationale, organization, and activities of the NSTC since its inception in 2013. Current processes and their evolution over time for facilitating training of NIH StrokeNet trainees have been highlighted. Data collected for monitoring training are summarized. Outcomes data (publications and grants) collected by NSTC was supplemented by publicly available resources. Results- The NSTC comprises of cross-network faculty, trainees, and education coordinators. It helps in the development and monitoring of training programs and organizes educational and career development activities. Trainees are provided directed guidance towards their mandated research projects, including opportunities to present at the International Stroke Conference. The committee has focused on developing sustainable models of peer-to-peer interaction and cross-institutional mentorships. A total of 124 professionals (43.7% female, 10.5% underrepresented minorities) have completed training between 2013 and 2018, of whom 55% were clinical vascular neurologists. Of the total, 85% transitioned to a formal academic position and 95% were involved in stroke research post-training. Altogether, 1659 indexed publications have been authored or co-authored by NIH StrokeNet Trainees, of which 58% were published during or after their training years. Based on data from 109 trainees, 33% had submitted 72 grant proposals as principal or co-principal investigators of which 22.2% proposals have been funded. Conclusions- NSTC has provided a foundation to foster nationwide training in stroke research. Our data demonstrate strong contribution of trainees towards academic scholarship. Continued innovation in educational methodologies is required to adapt to unique training opportunities such as the NIH StrokeNet.
TL;DR: The literature on posterior circulation stroke in children is limited and highly variable because most studies have been single-center with small numbers of patients.
Abstract: Posterior circulation strokes often strike fear in the hearts of neurologists. We think of them as high risk for poor outcome and death because the posterior circulation supplies blood flow to the brainstem and there is high risk for stroke recurrence. The literature on posterior circulation stroke in children is limited and highly variable because most studies have been single-center with small numbers of patients.1–3