J. Evan Sadler, MD, PhD
The American Society of Hematology Agenda for Hematology Research (2009-2011) highlights several scientific areas that have a great deal of potential for groundbreaking insights, including hematopoietic stem cells, hematopoiesis, sickle cell disease, hematologic malignancies, targeted and gene therapies, immunobiology, thrombosis,and vascular biology. A cursory look into any of these topics shows that hematologic diseases remain major threats to public health. At the same time, the opportunities for hematology research have never been more promising, but these societal needs have not been matched by a corresponding development of physician-scientists trained to perform the necessary clinical studies.
The National Heart, Lung, and Blood Institute (NHLBI) has addressed this imbalance by supporting institutional K12 career-development programs to provide comprehensive, multidisciplinary training in clinical hematology research. For the past five years, promising physicians at six centers around the United States have taken coursework to enhance their understanding of the fundamentals of clinical research and applied their expertise to challenging problems in classical hematology, including myelodysplastic syndromes, myeloproliferative neoplasms, sickle cell disease, autoimmune thrombocytopenia, antiphospholipid syndrome, paroxysmal nocturnal hemoglobinuria, and transfusion support for hemostatic disorders. A key component of the program is intensive mentoring by successful clinical investigators. Additional benefits include 75 percent protected time for career development and substantial support for salary and research expenses. These program features are similar to those of the much more numerous KL2 multidisciplinary career-development programs that are supported through CTSA funding but with the important difference that the NHLBI program focuses specifically on non-malignant hematology.
This targeted support has had an impact. More than 29 scholars have entered the hematology K12 program so far, and at least 14 have already started independent careers as academic clinical researchers in hematology at the rank of assistant professor or equivalent. This extraordinary record shows that a well-designed program can significantly increase the number of physicians who pursue careers in non-malignant hematology.
Building on the success of this career-development initiative, the NHLBI has reauthorized it for another five years and has expanded the scope to include adult and pediatric transfusion medicine. A major clinical need in this field is the optimization of transfusion strategies for neonates, pediatric and adult critical care patients, and geriatric patients. Applications were due June 20, and I’m confident that many institutions have responded with strong proposals. As this career-development program continues to mature, it has a good chance of transforming the clinical research landscape in hematology and transfusion medicine. Another feature of the program should be stressed: Scholar candidates from outside the supported institutions are encouraged to apply; the educational and research resources of this career-development program are open to any talented potential clinician-investigator. Based on my own experience in trying to identify faculty members with this kind of expertise, scholars who complete this program will be aggressively recruited at many institutions around the country.
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