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Farzana Pashankar, MD, MRCP, MBBS

Professor of Pediatrics (Hematology/Oncology)
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Additional Titles

Fellowship Director, Pediatric Hematology & Oncology Program

Director, Solid Tumor Program, Pediatric Hematology & Oncology Program

Children's Oncology Group Site PI, Pediatric Hematology & Oncology Program

About

Titles

Professor of Pediatrics (Hematology/Oncology)

Fellowship Director, Pediatric Hematology & Oncology Program; Director, Solid Tumor Program, Pediatric Hematology & Oncology Program; Children's Oncology Group Site PI, Pediatric Hematology & Oncology Program

Biography

Dr Farzana Pashankar is an accomplished pediatric hematologist oncologist, specializing in care of children with sickle cell disease and solid tumors. She is an international expert in germ cell tumors and rare tumors. Her research has focused on clinical trial development through Children's Oncology Group, and she is the Chair and Vice Chair of international trials in germ cell tumors. Dr Pashankar is Director of Pediatric Solid Tumor Program, Disease Aligned Research Team Leader for Pediatrics at Smilow Cancer Center and Director of the Pediatric Hematology Oncology Fellowship Program.

Dr Pashankar received her MBBS and MD from University of Pune, India. She trained in United Kingdom, receiving an MRCP. She subsequently did a residency at University of Iowa and fellowship at British Columbia Children's Hospital, before joining Yale in 2005.

Appointments

Education & Training

Fellow
University of Iowa Hospitals & Clinics (2004)
Resident
University of Iowa Hospitals & Clinics (2003)
Fellow
British Columbia Children's Hospital, Canada (1999)
MD
Poona University (1992)
Resident
Sassoon General Hospital (1991)
MBBS
University of Pune (1989)

Research

Overview

1. Sickle Cell Disease

My research has focused on a variety of areas including identifying the prevalence and risk factors of various complications, management of these complications and quality improvement projects to decrease the burden of disease and improve quality of life.

In the 1990’s, a landmark study from the NIH reported that pulmonary hypertension occurred in a third of adults and was associated with increased mortality. There was limited data in children. I thus designed the first prospective screening study and identified that elevated pulmonary artery pressures (PAP) occur in 30% of children, and is associated with hypoxia, hemolysis and a high platelet count. This was published in Pediatrics and has been widely quoted. Although elevated PAP occurred in children, there was no data on the long-term outcome and possible reversibility of this complication. I conducted a single institution pilot study to determine if treatment with Hydroxyurea, an antihemolytic agent could reverse elevated PAP in children. This study showed that elevated PAP was reversible with hydroxyurea and was published in British Journal of Hematology. Due to the exciting results from our single center pilot, we secured CTSA funding and conducted a multicenter study. This study showed that hydroxyurea improved oxygenation in SCD and had a trend in decreasing PAP.

Working with a medical student, we studied the association of PAP with other complications and found that elevated PAP was associated with early signs of nephropathy. This was the first study describing this association.

Over the years I have collaborated with colleagues at Yale and through the New York Connecticut Consortium and New England Pediatric Sickle Cell consortium to study other complications such as retinopathy, AVN, obesity and determine genetic determinants of hydroxyurea response and look at barriers to hydroxyurea use.

Recently I have focused on quality improvement projects to improve pain management at home and decrease ED visits and hospitalizations. This has been very successful in reducing hospitalizations and improving the quality of life for these families. This work was published and has been adopted by many institutions.

Current Studies and Future Direction:

1. Understanding and Addressing the Social Determinants of Health for Families of Children with Sickle Cell Anemia within Pediatric Hematology

2. Rare Tumors

I was the chair of the Infrequent Tumor Subcommittee at COG till 2020. We developed and published guidelines for several rare tumors and have recently completed two international clinical trials, on adrenocortical carcinoma and nasoparyngeal carcinoma.

3. Germ Cell Tumors

In germ cell tumors, my research has focused on redefining management of immature teratomas (IT) and clinical trial development. The management of ovarian IT is controversial. In children, ovarian IT is treated with surgery alone, whereas adults treat all patients with chemotherapy except those with Stage I, grade 1 tumors. I analyzed pediatric and adult clinical trial data from the MaGIC database and found that grade was the most important risk factor for relapse. In patients with grade 3 tumors, the outcome was similar between the pediatric and adult cohort despite a marked difference in treatment, questioning the role of chemotherapy. Since that initial analyses, I have published other reports showing chemo unresponsiveness of ovarian IT. We have also diligently worked with the adult gynecologic oncology community to move away from using chemotherapy postoperatively in ovarian IT.

Our efforts have been somewhat successful and while designing the current open trial AGCT1531 in conjunction with Gynecology Oncology Group, they agreed to observation alone not only for stage I, grade 1 tumors but also for Stage I, grade 2 and 3 tumors. This is a major change and has the potential to spare chemotherapy to many adult women if the trial proves our hypothesis. We are currently working on an amendment to expand surveillance alone to all patients with ovarian IT, irrespective of stage and I am also organizing a pathology consensus conference to standardize grading of IT.

Another area that I have been actively involved in is clinical trial development at Children’s Oncology Group (COG). Currently we have two clinical trials open – I am the Vice Chair on an international trial for low and intermediate risk germ cell tumors and am the Chair for all US sites for an international trial for poor risk germ cell tumors run by Australia New Zealand Urogenital group, that is open in the US through National Clinical Trials Network.

At Yale, I direct the solid tumor program, and have been actively working to bring innovative industry sponsored trials in addition to trial through COG to broaden our trial portfolio.



Medical Subject Headings (MeSH)

Anemia, Sickle Cell; Echocardiography; Hematology; Hypertension, Pulmonary; Medical Oncology; Pediatrics

Research at a Glance

Yale Co-Authors

Frequent collaborators of Farzana Pashankar's published research.

Publications

2024

2023

2022

Clinical Trials

Current Trials

Academic Achievements & Community Involvement

  • activity

    Journal Reviewer

  • activity

    Children's Oncology Group

  • activity

    Appointments and Promotions Committee

  • activity

    Faculty Development Committee

  • activity

    Protocol Review Committee

Clinical Care

Overview

Farzana D. Pashankar, MD, is a pediatric hematologist-oncologist who takes care of children with blood disorders and cancer, and says she is amazed by the advances in her field.

“It’s ever-changing, and we are always improving the outcome and the prognosis—even in my career, there’s been such remarkable improvements,” says Dr. Pashankar, who has a particular interest in sickle cell diseases, solid tumors, and rare types of pediatric cancers. “Nowadays, we can cure 80 to 85 percent of all children diagnosed with cancer. And for certain types, like leukemia, we can cure more than 95 percent. It’s been a rewarding journey of watching these new inventions and discoveries.”

When it comes to reassuring parents, Dr. Pashankar tells them, “This is the most difficult time you will face as a parent. Your child is precious, and I can assure you that I will do everything to provide your child with the best possible care.”

Building relationships with families is particularly meaningful, she says. “The bonds we form can be long-lasting, and that drives all of us to want to continue what we do and do better,” Dr. Pashankar says, adding that her work can take an emotional toll. “There are many nights you spend tossing and turning and wondering how you can best take care of a particular child going through a difficult time, but it’s also extremely rewarding to have an amazing network of people here at Yale and across the nation to collaborate with, and it’s all worth it. It’s a privilege when people entrust us with their children.”

Dr. Pashankar is an associate professor of pediatric hematology/oncology at Yale School of Medicine.

Clinical Specialties

Pediatric Hematology & Oncology; Sickle Cell Disease

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Contacts

Academic Office Number
Appointment Number
Clinic Fax Number
Mailing Address

Pediatric Hematology & Oncology

PO Box 208064

New Haven, CT 06520-8064

United States

Locations

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