Texas Medical Center
6701 Fannin St., Ste. 1580.17
Houston, TX 77030
Jacquelyn M. Powers, MD, MS
Dr. Jackie Powers is an expert in the management of iron deficiency anemia. She was the principal investigator for the BESTIRON clinical trial, which compared the efficacy of two commonly prescribed oral iron medications for the treatment of iron deficiency anemia — ferrous sulfate and NovaFerrum — in young children. This trial was one of only a few randomized clinical trials conducted in the United States specifically aimed at children with iron deficiency anemia.
Dr. Powers was initially drawn to a career in blood and cancer disorders from an experience early in her pediatric training. As a pediatric intern, Dr. Powers helped care for a young girl newly diagnosed with leukemia. The hematology/oncology physician on-call taught Dr. Powers about the diagnosis and reviewed the girl's blood under the microscope with her. The ability to look at a patient's blood to diagnose their condition was fascinating to her.
During her hematology/oncology fellowship, Dr. Powers became particularly interested in improving the management of children with blood disorders. In particular, she noted that many children and adolescents presented to the emergency department or were admitted to the hospital with moderate to severe anemia due to iron deficiency. She set out to optimize patient care with the goal of improving their anemia as well as important patient-centered outcomes - fatigue, health-related quality of life, and overall school and physical performance.
Iron deficiency anemia is the most common blood condition in the world. In the United States, the two age groups most affected are young children (infants and toddlers) and adolescent girls. Young children typically develop iron deficiency anemia due to insufficient dietary iron intake. In contrast, adolescent girls may develop iron deficiency anemia due to blood loss from heavy menstrual bleeding. Many other children of all ages may develop iron deficiency anemia due to a variety of risk factors such as premature birth and/or gastro-intestinal conditions or surgery that result in loss of blood from the intestinal tract or poor iron absorption. Children with chronic inflammatory conditions may develop anemia of chronic disease with or without concomitant iron deficiency anemia and develop symptoms of fatigue and poor concentration. Dr. Powers treats all such affected patients from birth through adolescence and tailors her diagnostic and treatment plan based on each individual child. She involves the family in the decision-making process to determine the best plan to optimize the child or teen's health and functioning.
Dr. Powers led the BESTIRON clinical trial for young children with iron deficiency anemia and was instrumental in the design, conduct, analysis, and dissemination of the study results. In addition to her experiential training, she received formal clinical research training and received a Master's degree in Clinical Sciences. The program provided formal training in clinical research design, biostatistics, and health outcomes and services research methodologies. Dr. Powers was also accepted as a participant in the American Society of Hematology Clinical Research Training Institute (ASH CRTI), which fosters the development of early career hematologists who wish to pursue a career in academic medicine as a clinical investigator.
Dr. Powers' clinical research efforts led to her selection as the lead author of a new, joint clinical report from the American Academy of Pediatrics (AAP) and American Society of Pediatric Hematology/Oncology (ASPHO) on the treatment of children with iron deficiency anemia, which is currently under development.
Dr. Powers' ultimate goal is to identify the most successful treatment approach for children with iron deficiency anemia from both hematologic and comparative effectiveness (including cost-effectiveness) perspectives. She additionally hopes to apply her knowledge and skills to improving the diagnostic and treatment strategies utilized for children affected by iron deficiency anemia globally.
In addition to caring for children with iron deficiency anemia, Dr. Powers cares for children with other nutritional anemias (such as vitamin B12 and folate) as well as children with elevated iron levels due to hereditary hemochromatosis. She has specific interests in caring for children with other general hematology conditions such as red blood cell membrane disorders like hereditary spherocytosis and elliptocytosis, and red blood cell enzyme disorders such as pyruvate kinase deficiency. She also enjoys assessing children with anemia when the diagnosis has not been determined, as well as those with neutropenia, and thrombocytopenia or thrombocytosis.
American Board of Pediatrics
Texas Medical Board
Dr. Powers' current research aims to identify the most successful treatment approach for children with iron deficiency anemia. Her immediate goal is to better understand the diagnosis of iron deficiency anemia from the parent or caregiver perspective, including the facilitators and barriers to taking iron medication. She then aims to use that information to develop tools for health care providers and families to better care for young children with iron deficiency anemia. As part of this study, she is also determining what groups of children with iron deficiency anemia may benefit from receiving intravenous iron therapy as their initial treatment.
From this research, Dr. Powers hopes to provide improved information and therapy to affected patients and their families with the goal of better hematologic and important patient-centered outcomes. This research is supported by a career development award from the National Heart Lung Blood Institute (NHLBI) of the National Institutes of Health (NIH).
Overview of Dr. Powers’ Current Research Aims
Iron deficiency and iron deficiency anemia affect approximately 3 to 7% of young children in the United States and 9 to 16% of adolescent girls. Inadequate treatment, including treatment failure due to non-adherence to oral iron therapy, results in prolonged treatment courses and worse long-term neurodevelopmental outcomes. Two promising alternative approaches exist to oral iron:
- Optimization of oral iron delivery via a behavioral adherence intervention, and
- Directly observed therapy (DOT) via a one-time infusion of intravenous iron.
The specific aims of Dr. Powers' K23 career development award are to:
- Characterize barriers to and facilitators of iron therapy in children with nutritional IDA;
- Develop an adherence intervention for caregivers of children with IDA; and
- Pilot the intervention against standard oral iron and a DOT regimen with a one-time dose of IV iron.
Given the safety, low rates of adverse effects and anticipated improvement in patient-centered outcomes, a randomized controlled trial of a directly-observed therapy regimen with intravenous iron versus oral iron therapy versus an "optimized" oral iron arm with an adherence intervention, will be of utmost value for patients with iron deficiency anemia. Should either regimen demonstrate improved outcomes, the result would lead to a paradigm shift in the treatment of patients with IDA.
2021 Young Investigator Award, Baylor College of Medicine 2020 Scholar Award, American Society of Hematology (ASH)
* Texas Children's Hospital physicians' licenses and credentials are reviewed prior to practicing at any of our facilities. Sections titled From the Doctor, Professional Organizations and Publications were provided by the physician's office and were not verified by Texas Children's Hospital.