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Farzana D Pashankar MD, MBBS, MRCP(UK)

Associate Professor of Pediatrics (Hematology / Oncology)

Research Interests

Clinical trials in Pediatric Oncology; Sickle cell anemia

Current Projects

1. Longitudinal Follow up of Elevated Pulmonary Artery Pressures in Children with sickle cell disease
2. Multicenter Trial of the Effect of Hydroxyurea on Elevated Pulmonary Artery Pressures in Children with Sickle Cell Disease
3. Pharmacogenetic Predictors of Hydroxyurea Response
4. Patient and Provider Barriers to Hydroxyurea
5. Prevalence and Risk Factors of Avascular Necrosis

Research Summary

My primary research interest is in pulmonary hypertension in Sickle Cell Disease. Pulmonary hypertension occurs in one third of adults with sickle cell disease and is an independent risk factor for mortality. There was limited data on this complication in children. I designed a prospective screening study with Dr Alan Friedman (Cardiology) and Dr Alia Bazzy-Asaad (Pulmonary) to determine the prevalence and risk factors of elevated pulmonary artery pressures in children with homozygous SS or S 0 thalassemia using echocardiography. This study identified that elevated pulmonary artery pressures do occur in approximately 30% of children with sickle cell disease, and are associated with hypoxia, hemolysis and a high platelet count. This was the first prospective screening study in children, and showed that similar to adults, children with sickle cell disease do develop elevated pulmonary artery pressures. Prevalence of elevated pulmonary artery pressures in children with sickle cell disease. Pediatrics 2008 Apr; 121(4):777-82). This study has been widely quoted and has had an impact on decision to screen children with sickle cell disease for pulmonary hypertension.

Extensive Research Description

My primary research interest is in pulmonary hypertension in Sickle Cell Disease. Pulmonary hypertension occurs in one third of adults with sickle cell disease and is an independent risk factor for mortality. There was limited data on this complication in children. I designed a prospective screening study with Dr Alan Friedman (Cardiology) and Dr Alia Bazzy-Asaad (Pulmonary) to determine the prevalence and risk factors of elevated pulmonary artery pressures in children with homozygous SS or S 0 thalassemia using echocardiography. This study identified that elevated pulmonary artery pressures do occur in approximately 30% of children with sickle cell disease, and are associated with hypoxia, hemolysis and a high platelet count. This was the first prospective screening study in children, and showed that similar to adults, children with sickle cell disease do develop elevated pulmonary artery pressures. This work was presented at the Pediatric Academic Society Meeting in May 2007 and published in Pediatrics (Pashankar FD, Carbonella J, Bazzy-Asaad A, Friedman A. Prevalence of elevated pulmonary artery pressures in children with sickle cell disease. Pediatrics 2008 Apr; 121(4):777-82). This study has been widely quoted and has had an impact on decision to screen children with sickle cell disease for pulmonary hypertension. Our screening study showed that similar to adults, children with sickle cell disease developed elevated pulmonary artery pressures. In adults, this complication is associated with significant mortality. However there was no data on the long term outcome and possible reversibility of this complication in children. Hemolysis has been shown to be a key factor in the pathogenesis of pulmonary hypertension. I designed a single institution pilot study to determine if treatment with Hydroxyurea, an antihemolytic agent could reverse elevated pulmonary artery pressures in children with sickle cell disease. This study showed that elevated pulmonary artery pressures were reversible with hydroxyurea in children with early detection and intervention. This study is important, because if elevated pulmonary artery pressures can be reversed in childhood with early detection and intervention, it will have a significant impact on reducing morbidity and mortality of this complication in adulthood. This work was published in the British Journal of Hematology (Pashankar FD, Carbonella J, Bazzy-Asaad A, Friedman A. Longitudinal follow up of elevated pulmonary pressures in children with Sickle Cell Disease. Br J Haematol. 2009 Mar;144(5):736-41 ). Due to the exciting results from our single center pilot study, we are currently conducting a multicenter study to determine the effect of hydroxyurea on elevated pulmonary artery pressures in children with sickle cell disease. In addition to these studies, we have several studies that are ongoing through regional and national sickle cell networks.


Selected Publications

  • Johnston LB, Pashankar FD, Camacho-Hubner C. Analysis of the intracellular signaling domain of the human growth hormone receptor in children with idiopathic short stature. Clin Endocrinol(Oxford) 2000 Apr; 52(4) 463-469.
  • Pashankar FD, Steinbok P, Blair G, Pritchard S. Successful Chemotherapeutic Decompression of Primary Endodermal Sinus Tumor presenting with severe Spinal Cord Compression. J Pediatr Hematol Oncol 2001;23(3):170-3
  • Pashankar F, Singhal V, Akabogu I, Goldman F. Intact T cell responses in ataxia telangiectasia. Clinical Immunology 2006; 120: 156-62.
  • Pashankar FD, Ment LR, Pearson H. Sickle cell disease complicated by post-streptococcal glomerulonephritis, cerebral hemorrhage and reversible posterior leucoencephalopathy syndrome. Pediatr Blood Cancer. 2008 Apr; 50(4):864-6.
  • Pashankar FD, Carbonella J, Bazzy-Asaad A, Friedman A. Prevalence of elevated pulmonary artery pressures in children with sickle cell disease. Pediatrics 2008 Apr; 121(4):777-82
  • Pashankar FD, Carbonella J, Bazzy-Asaad A, Friedman A. Longitudinal follow up of elevated pulmonary pressures in children with Sickle Cell Disease. Br J Haematol. 2009 Mar;144(5):736-41. Epub 2008 Dec 1.

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