Student sics sickle cells

By the time senior Kenneth Ackerman finishes medical school, the formulas which he developed to determine the amount and type of blood transfusions to use for sickle cell patients undergoing surgery probably will be listed in his textbooks.

Ackerman, a chemistry and computer science major from Rye Brook, N.Y., developed the formulas during a summer job working with computers in the hematology-oncology division of Babies Hospital, a part of the Columbia Presbyterian Hospital. According to Dr. Sergio Piomelli, the pediatric hematologist who supervised his work, the formulas developed by Ackerman already are in use with patients at Columbia Presbyterian and are being included in a manual on sickle cell patient care prepared by the National Institutes of Health.

Patients suffering from sickle cell anemia a chronic inherited disorder characterized by abnormally-shaped red blood cells require a special type of blood transfusion during surgery because their own cells do not carry enough oxygen to the brain. To minimize the risks of stroke or other complications, sickle cell patients usually have one of three types of exchange transfusions, all of which involve the removal of some of their blood in exchange for normal blood.

Before Ackerman's formulas, however, the determination of the amount and type of exchange transfusion required lab tests which took hours, sometimes days, to complete.

Now, with Ackerman's work in the form of a computer program or a series of simple calculations that can be done with a pocket calculator a physician can determine in minutes exactly what is needed. Ackerman's formulas were checked against lab studies in ten cases at Columbia Presbyterian and were found to yield results within two percent of those obtained from the lab tests.

All of this was heady stuff for Ackerman, who had been thrilled just to find a job last summer that promised him some exposure to his combined interests in medicine and computing. Up until that point, his computer experience was limited to introductory computer science courses at Dartmouth and some word processing skills on his Apple lie personal computer he keeps in his dorm room in Butterfield Hall.

But three weeks into the summer job, Piomelli asked Ackerman to try to come up with a computer simulation of exchange transfusions. Ackerman agreed to the challenge, having already researched sickle cell anemia in high school and in a freshman biology class at Dartmouth. Two weeks later, Ackerman came back with a program written in BASIC which could turn out the desired answers on blood transfusions when provided with pertinent statistics. "That's fine, but what do physicians do if they don't have computers at their disposal or don't want to deal with computers?" Ackerman recalls the response from Dr. Piomelli. "Can you develop formulas they can use that will be as accurate as the computer results?"

Ackerman went back to the drawing board and by mid-August had found his answer in integral calculus. He returned to Columbia Presbyterian during breaks from his winter and spring terms at Dartmouth to put the finishing touches'on the program and formulas and to write a report about his work. And come this fall, he will begin studies at Stony Brook Medical School in New York.