CHOC hematologist appointed to national COVID-19 therapy evaluation oversight committee

Dr. Diane Nugent has been named co-chair of the Steering Committee for the National Heart, Lung, and Blood Institute (NHLBI) Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies, or CONNECTS, which will coalesce projects into a national, coordinated effort. She will also serve on the Executive committee for CONNECTS to facilitate the rapid turnaround and implementation of these grants throughout the country.

In addition to her work at CHOC, Dr. Nugent, in this new role, will help fulfill the objectives and ensure compliance for CONNECTS, which will be will be responsible for selection, implementation and analysis of all COVID clinical trials; data streams; biorepository/cohorts; and molecular and phenotypic correlations with the overarching mission to fast track therapies and vaccines that are validated through the hypothesis driven process and proven truly effective.  

“I am honored to help advance the body of knowledge around COVID-19 treatments and contribute meaningfully to work that is so critically needed as we confront this global crisis,” says Dr. Nugent, medical director of hematology at CHOC. “I also wish to stress the importance of research specifically in children and patients with chronic disease to help us understand why certain individuals are at high risk and how this infection impacts health at various ages, and over time. We are beginning to see the late and long-term effects in patients now and need to be prepared for future evolution of disorders in the heart, lung, blood vessels and brain over the next years and decades.”

Dr. Diane Nugent, medical director of hematology at CHOC

CONNECTS is an integration of major NHLBI clinical networks to collaboratively and efficiently conduct clinical trials while ensuring standardization, shared resources and data, and flexibility to nimbly shift studies as needed based on new knowledge and the changing pandemic clinical landscape. Master protocol-driven adaptive platform trials will be aligned with, or formally part of, National Institutes of Health’s Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Initiative.

CONNECTS is directed by NHLBI in collaboration with the Biomedical Advanced Research and Development Authority (BARDA), U.S. Department of Health & Human Services’ Operation Warp Speed, and NIH initiatives.

The Executive and Steering committees are charged with overseeing the design, implementation, and analysis of CONNECTS study protocols, including:

  • interpretation, presentation and publication of results;
  • use of common data elements and data standards across CONNECTS study protocols; and
  • sharing of data, biospecimens, images, and other research products developed by CONNECTS.

A prolific author on innovative medicine, Dr. Nugent has coauthored more than 100 journal articles and book chapters. She specializes in all aspects of hematology, bone marrow failure, anemias, immune disorders, bleeding and clotting disorders. Her clinical and research interests include blood disorders, bone marrow failure, bleeding and clotting disorders, and white cell and immune deficiencies.

Refer a patient to a CHOC hematologist.

CHOC Becomes SCID Referral Center

CHOC is pleased to have recently become a referral center for severe combined immune deficiency (SCID), filling a regional gap that once required Orange County infants to go outside the county for care.

Led by Drs. David Buchbinder, Wan-yin Chan, Diane Nugent and Jasjit Singh, the immunodeficiency program is a multidisciplinary effort crossing multiple specialties at CHOC including allergy and immunology, hematology and infectious disease

Though they appear healthy at birth, infants with this primary immunodeficiency disease lack T lymphocytes, one of the white blood cells that help fight infections. 

Babies with SCID cannot fight even the most innocuous infections and often die. The condition is considered by the medical community as a pediatric emergency.

“Prior to development of SCID newborn screening, the diagnosis would be delayed,” Dr. Chan says. “Often times these patients would not get sick until after 6 months of age. No one would know they were affected until the antibodies from their mother would wane. They end up with life threatening infections with serious complications often resulting in death.”

However, studies show that early bone marrow or stem cell transplants can improve outcomes significantly, Dr. Chan says.

Survival rates increase to 94 percent if administered to an affected infant by age 3 ½ months. However, if transplants occur after that age, survival rates increase to only 70 percent, underscoring the importance of early detection and intervention. 

To that end, California became one of the first states to add SCID to its list of recommended newborn screenings in 2010. In the years since, all states have followed suit. 

Under CHOC’s program, immunodeficiency team physicians review each case of Orange County babies who test positive in newborn screenings for SCID and ask parents to immediately seek a confirmatory blood test for the infant, Dr. Chan says.

If the additional tests confirm the diagnosis, patients are urgently admitted to CHOC for workup and treatment, Dr. Chan says.

Since CHOC’s center was formed in August, more than 20 patients have been flagged in the surrounding communities and each individual case has been reviewed by the immunodeficiency team in collaboration with local pediatricians.

Those urgent blood tests confirmed the presence of SCID or a SCID-like disorder in more than 25 percent of cases thus far. 

Dr. Diane Nugent Profiled as a Leader in Hematology

The chief of CHOC hematology division has been featured in a leading publication as a leader in her field.

Dr. Diane Nugent, a nationally recognized expert in pediatric hematology, was profiled in a recent American Journal of Hematology supplement as one of 11 women who are making a significant impact on the specialty.

Dr. Diane Nugent

In the piece “Women Leaders in Hematology: Inspirations & Insights,” Dr. Nugent is recognized for her expertise in rare blood disorders, including platelet disorders; her research in platelets and factor XIII; and her strong advocacy for female physicians.

Dr. Nugent and her fellow subjects were selected based on frequent nominations by their peers. Their profiles were based on interviews conducted by other women who have been mentored, trained and colleagues of the subjects.

To that end, Dr. Nugent was interviewed in the piece by mentee Dr. Loan B. Hsieh, a CHOC hematologist who first met Dr. Nugent as a medical student.

“Dr. Nugent leads by example and consistently makes time for people, whether it is a researcher interested in collaborating with her or a team member needing her advice,” Dr. Hsieh says in the article. “She is committed to her faculty’s growth, and never misses an opportunity to connect them to other experts in the field.”

In the article, Dr. Nugent’s enthusiasm for teaching and clinical care is credited with attracting younger women physicians to the field.

The article notes that though men still outnumber women in medicine, female physicians have made significant gains in the field of benign hematology, most notably in hemostasis and thrombosis.

Read the full article, and learn how to refer patients for hematology services at CHOC.