2008-11-01

On January 5, 2009, Dr. Hoots will assume the position of Senior Advisor to the Director of Blood Diseases at NHLBI. He will serve as liaison to NHLBI's Division of Blood Diseases and Resources (DBDR). We asked him to share his thoughts about this new role and provide insight into the future of the Blood Division at NHLBI.

Q: Why did you accept this position?

A: I accepted this position because of the challenge it presents to preserve and extend our nation's established role in doing research into the pathogenesis of diseases that manifest as abnormalities of the bone marrow and blood. In addition, having participated as a clinician scientist during the early days of HIV disease in the hemophilia and blood recipient populations, I have an abiding commitment to the safety of blood and blood components for transfusion therapy. Further, having spent my entire career in academic medicine, I appreciate the need to maximize training opportunities for the next generation of hematologists.

Q: What are the most immediate issues facing the Blood Division? What are your plans for the immediate future?

A: In my opinion, the highest priorities for DBDR (in no particular order) are to maintain (and extend if new funding becomes available) investigator-initiated research grants (e.g., RO1s, PO1s), support stem cell research including therapies utilizing stem cells, energize investigation into sickle cell anemia and hemoglobinopathies, enhance research in venous thrombosis/vascular injury states, explore new models of collaboration for translational research into rare hematologic diseases, and recruit more of the next generation of clinicians/scientists into hematology.

My plans for the immediate future, upon my arrival in Bethesda, are to work with existing leadership and staff to learn the operational nuances of the NIH and the breadth and depth of existing programs, to recruit new scientists and administrators into key vacant positions at DBDR, and to begin intramural and extramural dialogues with scientists across the United States and abroad to explore opportunities for collaboration.

Q: What is your vision/long-term plan for the Blood Division?

A: My long-term plans for DBDR include creating new opportunities for leveraging existing and new resources (funding and creative initiatives). These include public-private partnerships, intra-governmental collaborations, inter-Institute initiatives, and international joint ventures (particularly for rare hematologic diseases often precluded from statistically powered translational/clinical trials). I also want to partner with all stakeholders to maximize the likelihood that the next generation of hematologists is the best and the brightest to ensure that the number of practicing hematologists is sufficient to meet our national needs and priorities.

Q: Please talk about important issues facing the blood research community in the next five years.

A: As I alluded to in previous questions, I see the greatest challenges for NIH/NHLBI/DBDR in the next five years to be the following:

• To maintain and extend funding to meet the research needs of existing and evolving science as it relates to blood
• To ensure that we have adequate clinician scientists in our subspecialty to meet national needs
• To foster through funding and intellectual investment continued expertise in stem cell biology and therapeutics
• To make greater strides in the treatment of sickle cell disease and other hemoglobinopathies
• To invest so that hematology continues to be one of the scientific "homes" for vascular biology and endothelial injury investigation
• To continue the long-acknowledged worldwide excellence of DBDR in being an essential engine for investigation into the blood organ and its diseases

Q: What do you see as the role for professional organizations (such as ASH) in the Blood Division?

A: I believe that ASH provides an essential international face and voice for hematologists. As a non-governmental organization, it can undertake actions on behalf of the community of hematologists and scientists investigating the "biology of blood" that are both essential and sometimes unique. Some examples include lobbying Congress concerning important hematologic issues, crossing arbitrary disciplinary lines, and serving as the "keeper of the collective history/memory" of our subspecialty. The Blood Division can play none of these roles. Further, ASH and other professional organizations keep the international dialogue in hematology vibrant and open. Without the latter, I doubt that many of the ambitions for research sharing that I envision would be feasible. Finally, ASH and other professional organizations (and hopefully DBDR) play prominent roles in nurturing and helping to create learning opportunities for our young scientists.

Q: Is there anything else you would like to share with ASH in regard to your new position?

A: I and the staff at DBDR are actively seeking to extend our dialogue with members of the hematology community. We will need your insight, advice, and camaraderie in order to utilize most fully the resources that the citizens of the United States have placed in our trust. I pledge to try to create expanded opportunities for this dialogue to occur. Thank you for the opportunity to initiate my part of this conversation here.

The mission of the Division of Blood Diseases and Resources (DBDR) of NHLBI is to provide leadership for a national program in diseases of blood and blood resource management. In this role, DBDR plans and directs basic, translational, and clinical research and research training on the causes, treatment, and prevention of blood diseases and disorders. Areas of emphasis include:

• Stem cell biology
• Sickle cell disease and hemoglobinopathies
• Medical management of blood/bone marrow diseases of a destructive or pre-malignant nature
• Cell-based therapies
• Tissue repair and regeneration
• Pathogenesis and clinical management of diseases of bleeding and clotting
• Transfusion biology and medicine

The DBDR also assumes a major responsibility for improving the adequacy and safety of the nation's blood supply. It consists of three branches: Blood Diseases, Thrombosis and Hemostasis, and Transfusion Medicine and Cellular Therapeutics.

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