The New England Sickle Cell Institute

The Hematology/Oncology Service has grown from a faculty of four to now eight with more growth expected in the next year. Our Hematology service has gone from 2 to 5 faculty with growing expertise in coagulation (thrombosis and hemostasis), hemoglobinopathies in particular sickle cell anemia, hematologic malignancies, immune cytopenias and bone marrow failure disorders. Close collaboration and partnership with hematopathology in both coagulation and malignant hematology enhance patient care and growing regional expertise. We support many growing programs at the health center including the building of a thoracic oncology, melanoma and neuro-oncology programs. Additionally, we participate in clinical/translational trials with colleagues across both UConn Health and the Storrs campus. Ten nurse practitioners support our program and make it stronger allowing faculty to play significant roles in education and research.

The New England Sickle Cell Institute is our most successful program with proven excellence in research, education and clinical care not only at UConn but also nationally and internationally. It has served as a model throughout the world for the care of this underserved population. Its existence is due to the vision and hard work of Dr. Biree Andemariam. Some accomplishments are:

Clinical

• 325 patients (largest in New England); acute and chronic disease management as well as care coordination, mental health services, and multi-disciplinary care for comorbidities
• Referrals statewide, regional, and national
• March 2020 established state’s first crizanlizumab infusion program (FDA-approved 11/2019 for VOC frequency reduction)
• Despite pandemic and temporary physical move x 2, clinic operations maintained including apheresis, transfusion, infusion, and acute pain management
• Rapid and sustained implementation of telemedicine to maximize safety of this vulnerable patient population

Research

• 4 therapeutic clinical trials accruing in 2020
  • Leading enrollment site in U.S. for phase2A IMR-687 trial (n=10 subjects); Andemariam global PI
  • Trial endpoints include safety/tolerability, fetal hgb induction, VOC reduction, priapism reduction
  • 3 new trials to open in 2021 including acute inpatient VOC anti-P-selectin monoclonal antibody therapy
• 3 federally-funded grants (HRSAx2; PCORI)
• $667,000 research funding in FY 2020 alone

Publications

• 6 peer-reviewed manuscripts in 2020 (includes Blood Adv., Lancet Haematol., British J. Haematol., Ann Hemtol.)

Oral Presentations

• 8 peer-reviewed oral abstracts national/international meetings; 8 peer-reviewed posters
• 19 invited national/international presentations

Grants

• State of Connecticut Department of Public Health (PI: Andemariam; UConn Health) Connecticut Sickle Cell Disease Initiative
• American Society of Hematology (PI: Andemariam; UConn Health) American Society of Hematology Research Collaborative Sickle Cell Disease Clinical Trials Network
• HRSA 17-078 (PIs: Stewart/Lanzkron; Johns Hopkins University) Sickle Cell Disease Treatment Regional Collaboratives Program
• PCORI (PIs: Rubin/Smith-Whitley; Children’s Hospital of Philadelphia) Management of Care Transitions for Emerging Adults with Sickle Cell Disease Care: The COMETS Study

Awards

• Genice T. Nelson, DNP, APRN—Florence Nightingale Award
• Biree Andemariam—Sickle Cell Disease Association of America, Inc. Chairman’s Award

Highlights

• Andemariam invited to present at United States Congressional Hearing on “Current State of Sickle Cell Disease” (October ‘20)
• Andemariam appointed to United States Department of Health and Human Services Advisory Committee on Blood & Tissue Safety & Availability (August ‘20)
• Andemariam appointed to prestigious American Society of Hematology Scientific Committee on Red Cell Biology (December ‘20)
• Nelson and Dr. Andemariam served on national planning committee of 2020 Sickle Cell Disease Assoc. of America Annual Convention and Scientific Symposium (October ‘20)

Dr. Andemariam led an international committee of 33 medical/scientific experts in developing Guidelines for the Management of COVID in Individuals with Sickle Cell Disease. Dr. Nelson served on this committee.

UConn Health International Travelers’ Medical Service

Travel is back!

During the darkest moments of the pandemic, each of us has longed to be away from our Zoom world, out of lockdown, and enjoying freedom of movement with the possibility to go on new adventures or visit loved ones abroad. Although the pandemic is still quite active in many parts the developing world, the United States may be emerging from the worst of the pandemic and international travel is slowly rebounding. The UConn Division of Infectious Diseases is poised to meet our travelers’ needs as the world re-opens to a radically altered travel environment.

The restructuring of work culture during the pandemic has given way to unintended consequences including the reframing of the concept of leisure, with the realities of post-pandemic travel likely to not only include the realities of wide-ranging COVID regulations, but also a focus on “low travel” (ground transportation such as trains and buses), less frequent but longer stays, and a general change in ethos from quantity of locations experienced to a greater quality of an experience that may have greater immersion at fewer locations.

Drs. Nina Carley, Kevin Dieckhaus, and Mary Snayd operate the UConn International Travelers’ Medical Service, with sites in West Hartford and Farmington. This service has been an operation since 1984 and has evaluated over 1100 patients annually prior to the near-complete shutdown of international travel due to the pandemic. With the recovery of the travel industry and increased international bookings, the International Travelers Medical Service has responded by increasing the availability of travel related consultations. The travel consultation entails a detailed analysis of travel-related health risks based on itinerary, planned activities and exposures, and personal health conditions. Based on these factors, we develop a detailed and personalized preventive health plan.

The clinic stocks a wide variety of vaccines that may be required for maintain good health in low-resourced areas. The clinic is an official Yellow Fever Vaccination Center. Yellow fever vaccine, which is mandatory for entry into some countries in South America and Africa, had been unavailable due to manufacturing shortage since 2018 but is now back in stock and available. Other vaccines for Hepatitis A, Japanese encephalitis, typhoid, polio, rabies, meningitis, hepatitis B, and tetanus are available on site for immediate administration as indicated. For travelers going to areas with malaria, prescriptions for appropriate malaria medications will be provided with other prevention strategies. Medications for management of travelers’ diarrhea, the most common medical event associated with travel, are also provided. Country-specific guidance on COVID-19 regulations are discussed in detail to allow appropriate planning of itineraries, medical testing and contingency plans.

Travelers should ideally plan to be evaluated 6 to 8 weeks before anticipated departure to allow adequate time for vaccination to be effective. Patients may be seen in-person with on-site inoculations, or by telemedicine with follow-up nursing appointments scheduled for any inoculations that may be necessary. Families traveling together are encouraged to be evaluated as a group. Adults and children 16 years of age or older may be seen in Farmington. Children and families with children can be seen in West Hartford. To make an appointment with the International Travelers’ Medical Service, please call 860-679-2411 or refer through Epic as “Ambulatory Referral to Travel Clinic”.