Henry Ddungu, MBCHb, Mmed

Nominated From: University of Washington

Research Site: Kampala, Uganda

Research Area: Cancer Supportive Care

Primary Mentor: Corey Casper

Research Project

Optimal Use of Blood and Platelet Support Transfusion in Patients with Hematological Cancers in Uganda

Cancer is a major cause of mortality and morbidity in sub-Saharan Africa with more than 1 million incident cancer cases and nearly 800,000 cancer-related deaths projected in the year 2030. Transfusion of blood and blood components plays an essential supportive role particularly in patients with hematologic malignancies whose disease predisposes them to anemia and thrombocytopenia, a tendency that is further exacerbated by chemotherapy. Unfortunately, blood products are rare, expensive, and may be associated with adverse effects – transmission of pathogens, and/or allergic responses. The shortages of products are further exacerbated by the un-guided practice of transfusion and the lack of appreciation for potential adverse effects related to transfusions.

We propose a prospective observational study with an objective to improve platelet transfusion services in Uganda in the context of developing high standards of care for patients with hematological malignancies at the Uganda Cancer Institute. Specifically, the study intends to: (a) describe the need, current practices, and challenges associated with blood and platelet support transfusion; and (b) implement Best Practices on platelet transfusions in Ugandan cancer patients with thrombocytopenia through a sequential study.

The study population will comprise clinicians as well as in-patients at UCI with hematological malignancies and a sample size of 350 in-patients and all clinicians at UCI during the study period. Thrombocytopenia will be defined as a platelet count of ≤50 x 109/L and bleeding assessed for according to a modified WHO definition of bleeding events; and bleeding severity divided into two: clinically not significant (grade ≤1) and clinically significant (grade ≥ 2).

Research Significance

The UCI is working on strategies to improve survival and quality of life for patients with cancer in Uganda. One of such strategies is to develop clinical guidelines based on locally generated evidence. This study is designed to address a very important concern in platelet transfusion therapy for prevention of bleeding among Uganda cancer patients with significant thrombocytopenia (platelet count ≤50000). Findings will help us understand the current need, and the challenges thereof, associated with platelets transfusion among Uganda cancer patients. Our study will eventually lead to optimal utilization of platelet transfusion for patients with hematologic malignancy.

Advice for Potential Applicants

My advice to potential applicants is to think of simple research ideas that are doable within the grant time but which could be further built on to enhance global health. Even when you have not been selected this time, do not give up on applying again when an opportunity arises.




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