Hematology Section Treats the Routine and Unique
from Practice Update, Summer 2005
The Hematology Section is an integral part of The Children’s Hospital Center for Cancer and Blood Disorders. The nationally recognized program provides the most comprehensive diagnosis, treatment, research and support program for infants, adolescents and young adults with congenital and acquired blood disorders. The hematology team at The Children’s Hospital includes four pediatric hematologists, two registered nurses, a pediatric nurse practitioner and a physician assistant.
In addition to the care they provide at Children’s and their commitment to research, the hematologists are recognized nationally and internationally. Taru Hays, MD, clinical director of the hematology program, doctors Daniel Ambruso, Marilyn Manco-Johnson and Rachelle Nuss are recognized nationally and internationally. They deliver lectures on a national and international circuit and are involved in the training of pediatric fellows in hematology and oncology.
The Hematology Section at The Children’s Hospital includes several unique diagnosis and treatment programs:
- Mountain States Regional Hemophilia and Thrombosis Center
- Pediatric sickle cell center
- Pediatric immunohematology program
- General hematology program, including severe aplastic anemia
The Mountain States Regional Hemophilia and Thrombosis Center 
The hemophilia center is a nationally and internationally recognized center spearheading multi-institutional research projects in collaboration with pediatric hematologists around the world. The staff consists of director Marilyn Manco-Johnson, MD, a registered nurse, a physical therapist, a social worker, a data manager and several research assistants. It is a federally-funded center managing over 200 active patients with hemophilia and 250 patients with other bleeding disorders. Each year the hemophilia program diagnoses 10-15 new patients with hemophilia and close to 50 new patients with bleeding disorders. All of the patients are seen in the comprehensive multidisciplinary clinic every six to 12 months.
The nationally recognized thrombosis center provides specialized services for patients who have developed thrombosis (blood clots), as well as those at risk for developing thrombosis. The clinic follows approximately 150 patients who have been diagnosed with thrombosis and 350 patients who have risk factors (acquired or congenital) for thrombosis.
The Hemophilia and Thrombosis Center develops research protocols with different sections of the Department of Pediatrics and Surgery:
- Stroke clinic with neurology
- Prophylactic anticoagulations with pulmonary medicine
- New agents research with cardiology and cardiac surgery
The Hemophilia and Thrombosis Center has established a registry enabling these programs to receive national and local funding. In addition, the registry provides patients and practitioners access to ongoing research and clinical trials. There are only a few active pediatric registries for hemophilia and thrombosis in the United States and the Center serves the entire Rocky Mountain region.
The Pediatric Sickle Cell Center : Treatment and Research
The Pediatric Sickle Cell Program at The Children’s Hospital is a part of the Colorado Sickle Cell Center at the University of Colorado Health Sciences Center. The state funded sickle cell program treats 150 children with sickle cell disease and diagnoses 10-15 new cases each year. In addition, other hemoglobinopathies are diagnosed and treated. The sickle cell program is a part of several national research projects, including a sickle cell registry, which is a Center for Disease Control project in collaboration with the Colorado Department of Public Health and Environment. The multidisciplinary sickle cell clinic at The Children’s Hospital includes director Rachelle Nuss, MD, nurses, a physician assistant, a social worker, nutritionists and geneticists dedicated to improving the lives of children with sickle cell disease. The Children’s Hospital Sickle Cell Program is involved in the research of crisis of sickle cell anemia, specifically the use of nitric oxide in pain management. In collaboration with the Blood Donor Center at The Children’s Hospital, over 15 children with sickle cell disease now receive erythrocytophoresis once a month. The Bonfils Blood Center provides minor antigen matched blood units for erythrocytophoresis. This program has effectively kept children pain free and has reduced admissions to the hospital for pain crises of sickle cell disease.
The Immunohematology Program
The Immunohematology Program at Children’s is dedicated to the diagnosis and treatment of patients with immunohematological disorders such as neutropenias, chronic granulomatous disease, autoantibody diseases and immunodeficiency diseases. The clinic is directed by Daniel Ambruso, MD, and attended by an immunologist, a rheumatologist along with a nurse and physician assistant. The program is in the process of establishing standards and research protocols to study and treat these disorders.
General Hematology Program
The Children’s Hospital general hematology clinic follows 350 active patients with approximately 100 new patients diagnosed each year with a variety of hematological disorders. The general hematology clinic at Children’s is held three days a week by a team of pediatric hematologists, led by Taru Hays, MD. All of the hematologists are involved in laboratory and clinical research that is both locally and federally funded. The Children’s Hospital hematologists participate in several National Institutes of Health research projects, advancing the quality of research and care that takes place at Children’s.
They also participate in a locally funded research project for aplastic anemia that is dedicated to furthering the understanding of the clinical and long term effects of treating bone marrow failure. This ongoing project follows patients long after their treatment is complete with an emphasis on the late effects that may impact these patients.
When treating patients with hemophilia, bleeding and clotting disorders, hematological diseases and immuno-hematological diseases, The Children’s Hospital hematologists will often have more frequent interaction with patients than their primary care providers (PCPs). They are dedicated to communicating with the patient’s PCP at every stage of treatment. In addition, they will call with unexpected findings and to communicate termination of treatment. The Children’s Hospital hematologists also provide telephone consultation to PCPs who are treating patients with blood diseases in their offices. In addition, the hematologists provide consultation to other specialists at The Children’s Hospital for patients with complicated disorders.
