Summary Hematology referral for evaluation is a key step for hematopoietic stem cell transplantation for sickle cell disease (SCD). Pediatric SCD providers in the US Northeast (New York-Mid-Atlantic and New England regions) were surveyed anony-mously for perspectives and practices regarding transplant referral and compared by whether they practiced at SCD transplant centers. Data were analyzed using the Fisher exact test, χ2 test, and logistic regression. Half of the respondents practiced primarily at transplant sites. Most (79%) were enthusiastic about transplant for SCD and 78% had recently referred ≥1 child for evaluation. Overall, 77% limited referral to certain sickle hemoglobinopathies and 44% preferred referral for β-thalassemia to SCD. Indications selected for referral resembled current transplant criteria, plus family request or poor response to therapy. Referral for children on chronic transfusions predicted enthusiasm and prior referral. Many (66%) referred children with multiple SCD complications, even without matched sibling donors, 37% with sibling donors despite limited disease. Practitioners at transplant centers more commonly accepted event-free survival rates of ≤90% (P = 0.002). North-eastern providers expressed varying enthusiasm for referral for evaluation based on eligibility, donor availability, and acceptable risk, with modestly more interest from practitioners at transplant centers. Differing provider perspectives may affect patient referral for transplant consideration.
The treatment of anaplastic large cell lymphoma (ALCL) has largely relied on anthracycline-based chemotherapy. Targeted lymphoma therapy, using an anti-CD30 antibody, provides an innovative treatment modality for specific lymphomas, particularly ALCL. Brentuximab vedotin (BV; SGN-35) uses a CD30 monoclonal antibody to generate apoptosis of targeted lymphoma cells. We present a pediatric patient with ALCL who experienced second relapse after standard chemotherapy and autologous and allogeneic hematopoietic stem cell transplantation. This patient has been treated with BV as a single agent and has sustained remission for several months. BV offers a targeted treatment for relapsed ALCL, even after multiple relapses.
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