Pediatr Blood Cancer 2015;62:S19–S20

COMMENTARY The ASPHO 2015 Distinguished Career Award Goes to Winfred C. Wang, MD Jane Hankins,

MS, MD,

1

* Ulrike Reiss,

Dr. Winfred C. Wang’s journey in the field of pediatric hematology reflects a life of dedication, passion, discipline, and mentorship. His love for patients and perseverance for discovering new ways to treat their diseases through clinical research have never wavered during a distinguished career which has spanned almost 50 years. His pursuit of honesty, integrity, and clinical excellence represent the highest professional standard, and should be emulated by young and established physicians and clinical investigators. Dr. Wang, affectionately known as Win to his colleagues and trainees, was born in Washington DC, received an undergraduate degree in chemistry from University of California, Berkeley, and graduated from the University of Chicago School of Medicine in 1967. After receiving his MD degree, he completed his Pediatric training at Montefiore Hospital and Medical Center, Bronx, New York, followed by a senior year of residency at Kapiolani Medical Center for Women & Children, Honolulu, Hawaii. He then completed a Pediatric Hematology/Oncology fellowship at the University of California, San Francisco (UCSF) School of Medicine, under the guidance of Dr. William Mentzer (the creator of the Mentzer index). Win began his professional career as an Assistant Professor in the Department of Pediatrics at the UCSF School of Medicine, serving as the Chief of the Newborn Nursery at San Francisco General Hospital. In 1979, he relocated to St. Jude Children’s Research Hospital (St. Jude), advancing to Associate Member in 1986 and Full Member in 1993. During his 37-year career at St. Jude, Win served as the Chief of the Division of Hematology (1996–2004) and also as the Director of the NIH-funded St. Jude Comprehensive Sickle Cell Disease (SCD) Center from 2003–2008. Win is an outstanding hematologist with expertise in all related pediatric disorders. However, he has dedicated most of his career to caring for children with SCD and seeking new treatments for this devastating disorder. He began this work in SCD in 1979 as the principal investigator for the Pediatric Component of the first NIHsupported Cooperative Study of Sickle Cell Disease (CSSCD), a natural history cohort study. During the following three decades, Win’s discoveries enhanced greatly our knowledge of SCD, including its pathophysiology, clinical course, and treatment of serious complications. He has authored more than 200 original manuscripts in SCD. His efforts have played a major role in the sharp decline in mortality and morbidity of pediatric SCD over the past 30 years. Some of Win’s noteworthy accomplishments in SCD include the following key areas of contribution: Use of hydroxyurea in children and infants with SCD: Win led the first study to investigate the effects of hydroxyurea in infants with SCD. Contrary to concerns at the time, he proved that hydroxyurea was safe and beneficial in children as young as

C

2015 Wiley Periodicals, Inc. DOI 10.1002/pbc.25489 Published online in Wiley Online Library (wileyonlinelibrary.com).

MD,

1

and Michael Jeng,

MD

2

9 months of age [1]. These results led to the BABY HUG study, a landmark multi-center phase III randomized trial of hydroxyurea therapy in infants and toddlers with SCD [2]. This work is reshaping the way hydroxyurea is perceived and used by all stakeholders, including healthcare providers, patients, and families. Indeed, the NIH has recently endorsed the results of this study through consensus guidelines, and currently recommends that hydroxyurea be offered to all young children with sickle cell anemia [3]. Prevention and treatment of life-threatening infections in SCD: Win made significant contributions to preventing and treating pneumococcal infections in SCD. He participated in the prophylactic penicillin studies, which investigated frequency of infections and antibiotic resistance to pneumococcus in the era preceding the use of pneumococcal vaccines [4]. His data supported the development of new improved vaccines and led to vigorous lifesaving treatment regimens for patients with suspected infection. He demonstrated that febrile children with SCD can be treated and monitored safely as outpatients [5]. This work not only produced high profile publications, but more importantly, has saved lives and improved the quality of life of SCD patients and their families. Diagnosis and treatment of CNS disease in SCD: Win has played a key role in creating current strategies for stroke prevention in atrisk patients. In an early work, he showed that it was unsafe to stop transfusions for secondary stroke prevention, even after an average of 8 years [6]. Later, he created and directed one of the first transcranial Doppler ultrasound screening programs to identify atrisk patients and initiate appropriate preventative measures via transfusion therapy (based on STOP studies results). Now, more than 10 years later, 99% of eligible children are successfully screened for stroke risk, consequently, strokes in Memphis children with SCD have nearly been eliminated [7]. Win was also a pioneer in investigating early cerebral damage in SCD. He showed that ischemic brain damage and cognitive dysfunction occur early in life and are progressive [8–11]. Overall, Win’s work has shaped our understanding of the magnitude and scope of neurologic complications in SCD. Education and academic progress for children with SCD: Win pioneered the field of education and academic progress for children with SCD. He designed and implemented an innovative and truly exceptional program that links the medical SCD program with schools in the Memphis community. The Success Through Academic Resources and Research Program (STARR) has helped hundreds of children with SCD receive appropriate academic

1 St. Jude Children’s Research Hospital, Memphis, Tennessee; 2Lucile Salter Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, California



Correspondence to: Jane Hankins, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105. E-mail: [email protected] Received 2 February 2015; Accepted 3 February 2015

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support in their schools. This program integrates medical providers, psychologists, social workers, school officials, and teachers toward improving the educational experience of children with SCD. Through this interchange, educational plans are tailored according to individual cognitive and functional status to enhance patient well-being and academic performance. Mentorship: Win has trained numerous individuals at all levels and inspired young physicians to pursue a career in pediatric hematology. His legacy is far-reaching and will continue to influence many generations of hematologists, both through Win’s continued clinical and teaching efforts, and through those whose careers he has shaped (including the authors of this manuscript). Win has taught us the value of clarity and objectiveness when reporting the results of our scientific findings, and how, above all, a clinical researcher should be honest and humble about his/her work. Now in his 70s, Win continues to work full steam. Several years ago, Win resolved to reduce his work effort to 60% and ease into retirement. While officially “at work,” Win wore his usual dress shirt with a characteristic festive necktie, usually highlighting a special theme or a vivid color. When “not working,” he still arrived at the clinic wearing polo shirts to signal his ostensible days off. His dedication to patients, peers and research were simply too strong and demanded that he continue. Now he is back to 100% effort, wearing his famous neckties every day, and his patients, peers and mentees continue to benefit from his continued presence in the clinic. Those of us fortunate enough to be touched by Win and his work are also keenly aware of his special interests, such as the maps decorating the walls of his office, nearby hallways, bathrooms, and home, and collection of red pens (recently switched to purple color), which he uses gleefully to correct the text of trainee manuscripts. He is also an avid marathoner and tennis player, and engages in these athletic activities regularly.

Pediatr Blood Cancer DOI 10.1002/pbc

In summary, Win is an amazing physician, colleague, researcher, teacher, and friend. He has shaped our field of pediatric hematology profoundly and is uniformly admired and loved by his patients and his professional community. He is most deserving of the ASPHO 2015 Distinguished Career Award. Please join us in congratulating Dr. Winfred Wang for his achievements and thank him for the legacy that he has created.

REFERENCES 1. Wang WC, Wynn LW, Rogers ZR, Scott JP, Lane PA, Ware RE. A two-year pilot trial of hydroxyurea in very young children with sickle-cell anemia. J Pediatr 2001;139:790–796. 2. Wang WC, Ware RE, Miller ST, Iyer RV, Casella JF, Minniti CP, Rana S, Thornburg CD, Rogers ZR, Kalpatthi RV, Barredo JC, Brown RC, Sarnaik SA, Howard TH, Wynn LW, Kutlar A, Armstrong FD, Files BA, Goldsmith JC, Waclawiw MA, Huang X, Thompson BW. BABY HUG investigators. Lancet 2011 May 14;377:1663–72. 3. Yawn BP, Buchanan GR, Afenyi-Annan AN. Management of sickle cell disease: Summary of the 2014 evidence-based report by expert panel members. JAMA 2014;312:1033–1048. 4. Woods GM, Jorgensen JH, Waclawiw MA, Reid C, Wang W, Pegelow CH, Rogers ZR, Iyer RV, Holbrook CT, Kinney TR, Vichinsky E, DeBaun MR, Grossman NJ, Thomas MD, Falletta JM. Influence of penicillin prophylaxis on antimicrobial resistance in nasopharyngeal S. pneumoniae among children with sickle cell anemia. The ancillary nasopharyngeal cculture study of prophylactic penicillin study II. J Pediatr Hematol Oncol 1997;19:327–333. 5. Wilimas JA, Flynn PM, Harris S, Day SW, Smith R, Chesney PJ, Rodman JH, Equiguren JM, Fairclough DL, Wang WC. A randomized study of outpatient treatment with ceftriaxone for selected febrile children with sickle cell disease. N Engl J Med 1993;329:472–476. 6. Wang WC, Kovnar EH, Tonkin IL, Mulhern RK, Langston JW, Day SW, Schell MJ, Wilimas JA. High risk of recurrent stroke after discontinuance of five to twelve years of transfusion therapy in patients with sickle cell disease. J Pediatr 1991;118:377–382. 7. McCarville MB, Goodin GS, Fortner G, Li CS, Smeltzer MP, Adams R, Wang W. Evaluation of a comprehensive transcranial doppler screening program for children with sickle cell anemia. Pediatr Blood Cancer 2008;50:818–821. 8. Wang WC, Langston JW, Steen RG, Wynn LW, Mulhern RK, Wilimas JA, Kim FM, Figueroa RE. Abnormalities of the central nervous system in very young children with sickle cell anemia. J Pediatr 1998;132:994–998. 9. Armstrong FD, Elkin TD, Brown RC, Glass P, Rana S, Casella JF, Kalpatthi RV, Pavlakis S, Mi Z, Wang WC. Baby Hug Investigators. Developmental function in toddlers with sickle cell anemia. Pediatrics 2013;131:e406–e414. 10. Wang WC, Pavlakis SG, Helton KJ, McKinstry RC, Casella JF, Adams RJ, Rees RC. Baby Hug Investigators. MRI abnormalities of the brain in one-year-old children with sickle cell anemia. Pediatr Blood Cancer 2008;51:643–646. 11. Wang W, Enos L, Gallagher D, Thompson R, Guarini L, Vichinsky E, Wright E, Zimmerman R, Armstrong FD. Cooperative study of sickle cell disease. Neuropsychologic performance in school-aged children with sickle cell disease: A report from the Cooperative Study of Sickle Cell Disease. J Pediatr 2001;139:391–397.

The ASPHO 2015 Distinguished Career Award goes to Dr. Winfred C. Wang, MD.

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