Pediatric Academic Societies'
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Mail Address:

3400 Research Forest Dr., Ste B-7
The Woodlands, TX  77381 USA

Email:  info@pas-meeting.org

Telephone:  281-419-0052

Facsimile:  281-419-0082

 

2006 PAS Annual Meeting

April 29–May 2 
San Francisco, California

ASPHO Daily Schedule


(as of February 1, 2006)

Friday, April 28

5:00pm–6:00pm
1600A—Bone Marrow Failure—Treatment of Acquired Aplastic Anemia in Children
ASPHO Workshop
Chairs: Akiko Shimamura, Children’s Hospital, Boston, MA; and Adrianna Vlachos, Schneider Children’s Hospital, New Hyde Park, NY

This session will focus on acquired marrow failure. The first presentation will focus on the treatment and management of acquired aplastic anemia in children. Studies pertaining to the pediatric population will be highlighted. Issues guiding the choice of therapy at diagnosis, at relapse and for refractory disease will be discussed. The second presentation will discuss the diagnosis and management of paroxysmal nocturnal hemoglobinuria (PNH) in the pediatric population. The clinical significance and management of PNH clones arising in patients with aplastic anemia will be discussed.

  • Treatment Options and Management of Aplastic Anemia in Children
    Peter Kurre, Oregon Health & Science University, Portland, OR

  • Paroxysmal Nocturnal Hemoglobinuria in Pediatric Patients
    Russell E. Ware, St. Jude Children's Research Hospital, Memphis, TN

5:00pm–6:00pm
1610A—Thrombosis—Going with the Flow: Anticoagulation Issues in Children with Congenital Heart Disease
ASPHO Workshop
Chairs: Patricia Massicotte, University of Alberta Hospital, Edmonton, AB, Canada; and Lori Luchtman-Jones, Washington University, St. Louis, MO

Warfarin is commonly used in children with congenital heart disease (CHD). There are many challenges with the use of this anticoagulant in children. Ultimate dosing depends on the individuals genetic composition. Child-focused education on warfarin will improve compliance, efficacy and safety. The hematologist with expertise in anticoagulation can provide child-focused education on anticoagulation and offer the cardiovascular team management solutions for managing the complex issues associated with anticoagulation in children with CHD.

  • Case Study and Discussion
    Therese Giglia, Schneider Children's Hospital, New Hyde Park, NY

  • Child-Focused Education Package: Warfarin
    Mary Bauman, Stollery Children's Hospital, Edmonton, AB, Canada

  • Keep the Flow: Hematologists as Part of the Cardiovascular Team in Children with Congenital Heart Disease
    Therese Giglia, Schneider Children's Hospital, New Hyde Park, NY

  • Panel Discussion

7:00pm–9:00pm
1850A—Pediatric Hematology/Oncology Training Program Directors' Dinner Meeting
ASPHO Dinner


Saturday, April 29

7:00am–8:00am
2050A—Hemorrhagic Disorders
ASPHO Workshop
Chairs: Pedro A. de Alarcon, St. Jude Research Hospital, Memphis, TN; and Marilyn Manco-Johnson, Mountain States Hemophilia Treatment Center, Aurora, CO

This workshop will present current information about hemophilia A and B inhibitors and therapy with immune tolerance, including a discussion of Factor VIII inhibitors and the International ITI Study, Factor IX inhibitors and anaphylaxis syndrome.

7:00am–8:00am
2055A—Histiocytosis
ASPHO Workshop
Chairs: James Whitlock,Vanderbilt Children's Hospital, Nashville, TN; and Alexandra Filipovich, Children’s Hospital Medical Center, Cincinnati, OH

This workshop will present recent developments in the biology, diagnosis, evaluation and management of children with Langerhans cell histiocytosis and hemophagocytic lymphohistiocytosis, including updates from recently completed and ongoing international clinical trials for these disorders. The availability of new internet-based patient registries will also be discussed.

  • Update on Hemophagocytic Lymphohistiocytosis
    Alexandra H. Filipovich, Children's Hospital Medical Center, Cincinnati, OH

  • Update on Langerhans Cell Histiocytosis
    James A. Whitlock, Vanderbilt Children's Hospital, Nashville, TN

  • Update on Rare Histiocytosis Registries
    James A. Whitlock, Vanderbilt Children's Hospital, Nashville, TN

8:00am–11:00am
2100—Adult Stem Cells—A Primer for the Clinician
PAS/ASPHO Mini Course
Chairs: Jakub Tolar, University of Minnesota, Minneapolis, MN; and Mervin C. Yoder, Jr., Indiana University School of Medicine, Indianapolis, IN

Target Audience: Hematologists/oncologists, endocrinologists, basic scientists and neurologists.

Adult stem cells represent a technology that is being intensively investigated currently, and this research may have wide implications for human health. This mini course will focus on recent research and potential applications in human health.

  • Introduction
    Jakub Tolar, University of Minnesota, Minneapolis, MN
    Mervin C. Yoder, Indiana University School of Medicine, Indianapolis, IN

  • Multipotent Adult Progenitor Cell: Hype or Reality?
    Catherine M. Verfaillie, University of Minnesota, Minneapolis, MN

  • Mesenchymal Stem Cell: Harnessing the Power of Adult Stem Cells To Repair Tissues
    Darwin Prockop, Tulane University Health Science Center, New Orleans, LA

  • Hierarchy of Endothelial Progenitors in Human Blood and Blood Vessels
    David A. Ingram, Indiana University School of Medicine, Indianapolis, IN

  • Cancer Stem Cell: Concept of Human Leukemic Development
    Craig T. Jordan, James P. Wilmot Cancer Center, University of Rochester School of Medicine, Rochester, NY

Sponsored jointly by the American Society of Pediatric Hematology/Oncology and the Pediatric Academic Societies

8:15am–10:15am
2190A—Difficult Coagulation Consults
ASPHO Symposium
Chairs: Guy Young, Children’s Hospital of Orange County, Mattel Children's Hospital at UCLA, Orange, CA; and Prasad Mathew, University of New Mexico, Albuquerque, NM

Pediatric hematologist/oncologists are frequently asked to consult on patients with a variety of coagulation problems. While some of these are fairly straightforward, there are some that create significant diagnostic and therapeutic dilemmas. This session will focus on three such areas. The first lecture will discuss the pre-operative assessment for coagulation disorders in both asymptomatic and symptomatic children. This lecture will focus on what if any evaluation is needed and how to proceed if screening tests are abnormal. The second talk will discuss the difficulties in diagnosing and treating rare bleeding disorders, including rare factor deficiencies and rare platelet function disorders. The last presentation will focus on the management of patients who wish to avoid blood products (for religious beliefs, for example). This lecture will discuss the available strategies for the avoidance of blood products both in the surgical and non-surgical setting. After attending this session, it is expected that the learner will be able to: 1) describe the approach to the pre-operative evaluation of children undergoing surgery from the standpoint of potential bleeding complications; 2) discuss the diagnosis and treatment of rare bleeding disorders; 3) identify strategies for the avoidance of blood products for patients/families wishing to avoid the use of such products.

  • Introduction

  • Pre-operative Evaluation for Coagulation Disorders
    Marilyn J. Manco-Johnson, University of Colorado Denver, The Health Sciences Center, Aurora, CO

  • Rare Bleeding Disorders
    Diane J. Nugent, Children's Hospital of Orange County, Orange, CA

  • Bloodless Medicine: Strategies To Avoid/Minimize Transfusion of Blood Products
    Aryeh Shander, Englewood Hospital and Medical Center, Englewood, NJ

  • Discussion

10:30am–11:30am
2300A—Best of SIOP (International Society of Paediatric Oncology)
ASPHO Original Science Abstracts - Platform Session

  • Omission of Required Radiotherapy in Group III Rhabdomyosarcoma Patients
    Mhamed Harif

  • MLL Rearranged Infant Acute Lymphoblastic Leukemia is Characterized by Silencing of the Tumor Suppressor Gene FHIT
    R. Stam

  • Updated Therapeutic Results of 286 Burkitt’s Lymphoma in French African Pediatric Oncology Group (FAPOG)
    O. Shokek

10:30am–12:30pm
2330—Hematology/Oncology I
PAS/ASPHO Original Science Abstracts - Platform Session

12:45pm–2:45pm
2550A—Challenges in Neonatal Care: Coagulation Disturbances, IVH and Bleeding Control
ASPHO Industry Sponsored Symposium
Supported by a grant from Novo Nordisk Pharmaceuticals, Inc.

12:45pm–2:45pm
2551A—Advances in the Diagnosis and Management of Thalassemia and Sickle Cell Disease in Pediatric Patients
ASPHO Industry Sponsored Symposium
Supported by a grant from Novartis Oncology

1:00pm–3:00pm
2620   Neonatal Hematology–Immunology
PAS Poster Symposium

3:00pm–5:00pm
2710A—Hematopoietic Cell Transplantation—An Update
ASPHO Symposium
Chairs: Jakub Tolar and K. Scott Baker, University of Minnesota, Minneapolis, MN

The program will begin with a review of unrelated umbilical cord blood transplantation, now a common practice in the treatment of pediatric malignancies. The program will follow with a presentation of the most recent data on reduced intensity hematopoietic cell transplantation for treatment of malignant and non-malignant diseases in children. The symposium will conclude with an overview of immune implications of mesenchymal stem cell infusion, including their use for graft versus host disease prophylaxis and treatment. Cellular therapy has yielded notable successes in the past decade and holds considerable promise, and one should walk away from the session with a realistic overview of the possibilities and limitations of cellular therapy for childhood cancer.

After attending this session, it is expected that the learner will be able to:

1. Identify efficacious cellular therapy approaches.
2. Recognize the limitations of cellular therapy for childhood cancer.

  • Introduction
    Jakub Tolar, University of Minnesota, Minneapolis, MN

  • Umbilical Cord Blood Transplantation: Current Practice and Future Innovations
    John E. Wagner, University of Minnesota Medical School, Minneapolis, MN

  • Non-myeloablative Hematopoietic Cell Transplantation in Children
    Morris Kletzel, Northwestern University Feinberg School of Medicine, Chicago, IL

  • Immunobiology of Mesenchymal Stem Cells
    Katarina Le Blanc, Karolinska University, Stockholm, Sweden

  • Question and Answer Session


Sunday, April 30

7:00am–8:00am
3060A—Practice Management—Results of the 2005 ASPHO Compensation Study
ASPHO Workshop
Chair: Timothy C. Griffin, Cook Children's Medical Center, Fort Worth, TX

In the spring of 2005, ASPHO conducted a survey of its membership regarding compensation. The preliminary results of this survey will be presented, and members will have an opportunity to ask questions and provide insights into the results in an open forum.


7:00am–8:00am
3065A—Young Investigators
ASPHO Workshop
Chair: Kathleen M. Sakamoto, University of California Los Angeles, Los Angeles, CA

This workshop will focus on career options in pediatric hematology–oncology. Pediatric hematologists–oncologists representing basic/translational research, clinical research and industry will discuss their experiences and the reasons for their career choices. The workshop provides an opportunity for fellows and junior faculty to interact with each other and established faculty members and to discuss issues related to career decisions, research directions and career development.

  • Clinical Research—Building Your Career from the Ground Up
    Smita Bhatia, Mattel Children's Hospital at UCLA, Los Angeles, CA

  • Choosing a Career in Basic/Translational Research
    Kathleen M. Sakamoto, University of California Los Angeles, Los Angeles, CA

  • Choosing a Career in Industry
    Anne E. Hagey, Oncology Cytotoxics, Abbott Laboratories, Abbott Park, IL

  • Discussion

8:00am–9:30am
3150—Hematology/Oncology II
PAS/ASPHO Original Science Abstracts - Platform Session

9:45am–11:45am
3300A—Pure Red Cell Aplasia
ASPHO Symposium
Chair: Jeffrey M. Lipton, Schneider Children’s Hospital, New Hyde Park, NY

The pure red cell aplasias (PRCA) represent a form of bone marrow restricted to the erythroid lineage. Research has led to new insights into the molecular basis of erythroid development. Transcriptional regulation of erythropoiesis will be discussed in this symposium. In pediatrics, intrinsic stem/progenitor cell defects are the most important cause of red cell failure. One of the most common forms of pure red cell aplasia in pediatric patients is Diamond-Blackfan Anemia. The clinical and molecular basis of this disease will be presented. Congenital dyserythropoietic anemias (CDA) are rare forms of erythroid cytopenias. New information on the pathophysiology of CDA will be presented during this symposium.

After attending this session, it is expected that the learner will be able to:

1. Describe the biology of erythropoiesis.
2. Describe the clinical presentation and molecular basis of Diamond-Blackfan Anemia.
3. Describe the clinical presentation and pathophysiology of congenital dyserythropoietic anemia.

  • Introduction: How "Pure" Is Pure Red Blood Cell Aplasia?
    Jeffrey M. Lipton, Schneider Children's Hospital, New Hyde Park, NY

  • Biology of Erythroid Development
    Mitchell Weiss, Children's Hospital of Phiadelphia, Philadelphia, PA

  • Clinical and Molecular Biology of Diamond-Blackfan Anemia
    Adrianna Vlachos, Schneider Children's Hospital, New Hyde Park, NY

  • Congenital Dyserythropoietic Anemias 2006: Where Are We Now?
    Bertil E. Glader, Stanford University School of Medicine, Stanford, CA

  • Question and Answer Session

9:45am–11:45am
3305A—Rhabdomyosarcoma
ASPHO Symposium
Chairs: K. Scott Baker, University of Minnesota, Minneapolis, MN; and Douglas Hawkins, Children's Hospital and Regional Medical Center, Seattle, WA

This session will focus on current results of recent clinical trials in the treatment of rhabdomyosarcoma (RMS) and review progress made over the consecutive Intergroup Rhabdomyosarcoma Study Group Trials and current trials of the Soft Tissue Sarcoma Committee within COG. The importance of radiation therapy to achieve local control in the treatment of RMS, as well as some of the controversies of radiation therapy in this disease, will be discussed. New treatment modalities available for radiation therapy delivery and their role in the treatment of RMS will be reviewed. Finally, the session will end with a state of the art update on current understanding of the biological and molecular genetic features of RMS and their implications in the diagnosis and treatment of children with RMS.

After attending this session, it is expected that the learner will be able to:

1. Discuss current treatment results of recent trials in the treatment of RMS.
2. Identify the importance of radiation therapy in the management of RMS and describe new ways that this treatment may be delivered.
3. Describe recent advances in the biology of RMS and how these impact therapeutic decisions.

  • Introduction
    K. Scott Baker, University of Minnesota, Minneapolis, MN

  • Lessons Learned About the Local Control Issues and Radiation Therapy in the Management of Childhood Rhabdomyosarcoma
    Sarah S. Donaldson, Stanford Cancer Center, Stanford, CA

  • Clinical Trials in Rhabdomyosarcoma: Current Results
    Douglas Hawkins, Children's Hospital and Regional Medical Center, Seattle, WA

  • Impact of Biology and Genetics on the Diagnosis and Treatment of Rhabdomyosarcoma
    Frederic Barr, University of Pennsylvania School of Medicine, Philadelphia, PA

  • Question and Answer Session

1:45pm–3:45pm
3650—Hematologic Issues in the PICU
PAS/ASPHO Topic Symposium
Chairs: Roshni Kulkarni, Michigan State University, East Lansing, MI; and Prasad Mathew, University of New Mexico, Albuquerque, NM

Target Audience: Pediatric hematologists/oncologists, pediatric critical care physicians, pediatric surgeons and basic science researchers in hematology.

Critically ill children often suffer complications related to hematological consequences of the primary illness or injury. Timely realization of these by critical care physicians and hematology consultants is key to improving outcomes in critically ill children. During the past decade, hematology research (particularly in coagulation and thrombophilia) has given new information that will help clinicians care for these children.

  • Introduction: Hematologic Issues in the PICU
    Prasad Mathew, University of New Mexico, Albuquerque, New Mexico

  • Disseminated Intravascular Coagulation
    Keith Hoots, The University of Texas Health Science Center and The University of Texas M.D. Anderson Cancer Center, Houston, TX

  • Massive Hemorrhage: A Hematologists Perspective
    Roshni Kulkarni, Michigan State University, East Lansing, MI

  • Thrombosis Including Heparin-Induced Thrombocytopenia in the PICU
    Guy Young, Children's Hospital of Orange County, Mattel Children's Hospital at UCLA, Orange County, CA

  • Discussion

Sponsored jointly by the American Society of Pediatric Hematology/Oncology and the Pediatric Academic Societies

4:00pm–6:00pm
3800A—ASPHO Presidential Symposium and Awards
ASPHO Presidential Lecture
Chair: F. Leonard Johnson, Oregon Health Sciences University, Portland, OR

  • Welcome
    F. Leonard Johnson, Oregon Health & Science University, Portland, OR

  • ASPHO Young Investigator Award Lectures
    Rac GTPases Regulate the Morphology and Deformability of the Erythrocyte Cytoskeleton
    Theodosia A. Kalfa 
    Phosphorylation-Mediated Control of Transcriptional Repression by the Myeloid Translocation Gene Protein, MTG16: Implications for Hematopoietic stem Cell Self-Renewal and Leukemogenesis
    Michael Engel

  • Frank A. Oski Memorial Lecture:
    Cell–Cell Interactions in the Bone Marrow: How Basic Studies in Stem Cell Biology Informed New Therapeutics in Cancer and Gene Therapy
    David A. Williams, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

  • Distinguished Career Award
    Archie Bleyer, M. D. Anderson Cancer Center, Houston, TX

6:00pm–6:30pm
3920A—ASPHO Business Meeting
ASPHO Business Meeting

6:30pm–7:00pm
3960A—ASPHO Distinguished Career Award Reception
ASPHO Reception

7:00pm–9:00pm
3980A—Exploring von Willebrand Disease (VWD): Approaches to Age- and Gender-Related Issues
ASPHO Industry Sponsored Symposium
Supported by a grant from ZLB Behring


Monday, May 1

7:00am–8:00am
4050A—Congenital Thrombotic Thrombocytopenic Purpura (TTP) Registry
ASPHO Workshop
Chair: David G. Motto, University of Michigan, Ann Arbor, MI

Last year we established that there was interest in the pediatric hematology community to establish a registry for patients with congenital TTP. This year we will describe the formation of the registry and how individual physicians can access it and contribute patient information. This registry will contain descriptive information regarding the presentation, diagnosis, treatment and outcome of patients with congenital TTP, along with a database of ADAMTS13 mutations. Information will also be provided regarding where physicians can obtain clinical and research laboratory testing for ADAMTS13 activity and mutation analysis.

7:00am–8:00am
4060A—Pediatric Cancer—Pharmacogenetics and Pharmacogenomics: Do They Have Practical Applications?
ASPHO Workshop
Chairs: Brigitta U. Mueller, Baylor College of Medicine, Houston, TX; and Craig A. Mullen, University of Rochester Medical Center, Rochester, NY

This session will review genetic polymorphisms related to drug metabolism and their relationship to toxicity. Available pediatric data will be reviewed specifically related to current recommendations for genetic testing in relationship to specific agents, as well as dose modifications. This program will also contain a case review to highlight potential clinical scenarios in relationship to pharmacogenetic testing.

  • Pharmacogenetics in Clinical Trials
    Lisa Bomgaars, Texas Children's Cancer Center, Houston, TX

  • Pharmacogenetics and Toxicity Secondary to Cancer Therapy
    Fatih Okcu, Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX

  • Case Discussion

8:15am–10:15am
4180A—Chronic Organ Damage in Sickle Cell Disease: Diagnosis, Prevention and Treatment
ASPHO Symposium
Chair: Russell E. Ware, St. Jude Children’s Hospital, Memphis, TN

Chronic organ damage is increasingly recognized as an important source of morbidity and mortality for young persons with sickle cell disease. This symposium will include descriptions of several prospective multicenter clinical trials that focus on the diagnosis, treatment and prevention of organ damage in this common hematological disorder.

After attending this session, it is expected that the learner will be able to:

1. Discuss ongoing prospective multicenter randomized clinical trials that focus on brain damage in pediatric patients with sickle cell anemia.
2. Describe prospective clinical trials that focus on spleen and kidney damage in very young patients with sickle cell anemia.
3. Describe new imaging modalities for transfusional iron overload in the liver and heart, as well as studies using new oral iron chelating agents for its therapeutic management.

  • Introduction and Overview
    Russell E. Ware, St. Jude Children's Research Hospital, Memphis, TN

  • Brain—Silent Infarct Transfusion (SIT) Trial
    Michael R. DeBaun, Washington University School of Medicine, St. Louis, MO

  • Brain—Stroke with Transfusions Changing to Hydroxyurea (SWiTCH) Trial
    Russell E. Ware, St. Jude Children's Research Hospital, Memphis, TN

  • Spleen and Kidney—Splenic Function in Young Children: Lessons from BABY HUG
    Zora R. Rogers, The University of Texas Southwestern Medical Center, Dallas, TX

  • Spleen and Kidney—Renal Function in Young Children: BABY HUG, Toddler HUG
    Sherri A. Zimmerman, Duke University Medical Center, Durham, NC

  • Liver and Heart—New Imaging Techniques for Transfusional Iron Overload
    Thomas D. Coates, Children's Hospital of Los Angeles, Los Angeles, CA

  • Liver and Heart—Oral Iron Chelators for the Management of Transfusional Iron Overload
    Alan R. Cohen, Children's Hospital of Philadelphia, Philadelphia, PA

  • Questions and Panel Discussion

10:15am–12:15pm
4340—Hematology/Oncology III
PAS/ASPHO Original Science Abstracts - Platform Session

12:45pm–2:45pm
4490A—Exploring Inhibitors: Hemophilia A, Hemophilia B
ASPHO Industry Sponsored Symposium
Supported by a grant from ZLB Behring

12:45pm–2:45pm
4492A—ASPHO Corporate Forum Satellite Luncheon Symposia TBA
ASPHO Industry Sponsored Symposium

3:00pm–5:00pm
4625A—Cancer Etiology
ASPHO Symposium
Chairs: Doug K. Graham, University of Colorado at Denver and Health Sciences Center, Denver, CO; and Julie A. Ross, University of Minnesota, Minneapolis, MN

This program will highlight both clinical and basic science research into the causes of childhood cancer. The program will begin with an overview of the epidemiology of childhood cancer including incidence, trends and putative risk factors. Obstacles to conducting well-designed studies in North America will be discussed, and the establishment of a North American Childhood Cancer Research Network will be introduced as a means to help address some of these challenges. The program will follow with a discussion of genetic susceptibility to childhood cancer from single gene disorders with high individual risk but low population frequency to common population polymorphisms with low individual risk but high population frequency. In the final presentation, the role the family of tyrosine kinases has in the pathogenesis of childhood cancer will be addressed. Current research on a novel receptor kinase, Mer, will be presented to suggest a potential role of this proto-oncogene in the development of pediatric T cell leukemia and lymphoma.

After this session, participants should be able to:

1. Discuss the current state of knowledge regarding the epidemiology of childhood cancer in the United States.
2. Describe the major activities of the Childhood Cancer Research Network.
3. Identify the role of genetic susceptibility in the development of childhood cancer.
4. Describe the role of tyrosine kinases in the pathogenesis of pediatric cancer, and discuss how these oncogenes are being targeted in the development of new drugs.

  • Introduction
    Doug K. Graham, University of Colorado at Denver and Health Sciences Center, Denver, CO

  • Causes of Childhood Cancer: Where to Next?
    Julie A. Ross, University of Minnesota, Minneapolis, MN

  • Tyrosine Kinases as Oncogenes in Pediatric Cancer: The Role of the Mer Receptor Tyrosine Kinase in Lymphoblastic Leukemia and Lymphoma
    Doug K. Graham, University of Colorado at Denver and Health Sciences Center, Denver, CO

  • Genetic Susceptibility to Cancer—The Weak and the Strong
    Stella M. Davies, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

  • Question and Answer Session  

Additional PAS Programming of Interest

Saturday, April 29

12:00pm–3:00pm
2505    Embryonic Stem Cells: A Primer for Clinicians
PAS Mini Course

2:15pm–5:15pm
2705    Vitamin D: More Than Just Calcium and Bone
PAS/LWPES Mini Course

3:15pm–5:15pm
2735    Update on Therapeutic Monoclonal Antibodies
PAS Topic Symposium

Sunday, April 30

4:15pm–5:45pm
3810    RNA Interference, Technological Development of siRNAs and Potential Treatments for Childhood Diseases
PAS State of the Art Plenary

Monday, May 1

10:15am–12:15pm
4300    SPR Presidential Plenary and Awards           

12:00pm–1:00pm
4410A  23rd Annual Audrey K. Brown Kernicterus Symposium
Club

 

   
 

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Last Updated: September 26, 2006