Leslie J. Raffini, MD

Leslie J. Raffini, MD
Leslie J. Raffini, MD, is the Medical Director of the Hemostasis and Thrombosis Center at Children's Hospital of Philadelphia.

Areas of Expertise: Diagnosis and management of children with bleeding and clotting disorders

Education and Training

Medical School

MD - University of Wisconsin, Madison, WI

Residency

Pediatrics - Johns Hopkins Hospital, Baltimore, MD

Fellowship

Pediatric Hematology/Oncology - The Children's Hospital of Philadelphia, Philadelphia, PA

Board Certification

Pediatric Hematology/Oncology
Pediatrics

Graduate Degree

MS in Clinical Epidemiology - University of Pennsylvania, Philadelphia, PA

Titles and Academic Titles

Attending Physician

Medical Director, Hemostasis and Thrombosis Center

Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania

Conditions Treated

Departments and Services

Publications

Papers

2019

Yu JK, Iorio A, Edginton A; WAPPS co-investigators. Using pharmacokinetics for tailoring prophylaxis in people with hemophilia switching between clotting factor proteins. Res Pract Thromb Haemost 2019 20;3(3):528-54.

Croteau S, Cheng D, Cohen A, Holmes C, Kouides P, Raffini L, Silvey M, Thornburg C, Wheeler A, Malec L, Neufeld E. Regional variation and cost implications of prescribed extended half-life concentrates among U.S. Hemophilia Treatment Centers for patients with moderate and severe hemophilia. Haemophilia 2019:25(4):668-675 DOI:10.1111/hae.1378.

Kearney S, Raffini L, Pham T, Lee X, von Mackensen S, Landorph A, Takedani H, Oldenburg J. Health-related quality of life of individuals with haemophilia A treated with turoctocog alfa pegol (N8-GP): a new recombinant extended half-life FVIII. Patient Prefer Adherence 2019;13:497-513.

2018

Monagle P, Cuello C, Augustine C, Bonduel M, Brandao L, Capman T, Chan A, Hanson S, Male C, Meerpohl J, Newall F, O’brien S, Raffini L, van Ommen H, Wiernikowski J, Williams S, Bhatt M, Riva J, Roldan Y, Schwab N, Mustafa R, Vesely S. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv 2018;2(22):3292-3316.

Croteau S, Callahan M, Davis J, Dunn A, Guerrera M, Khan O, Neufeld E, Raffini l, Recht M, Wang M, Iorio A, Focusing in on use of PK profiles in routine hemophilia care. RPTH 2018;2(3):607-614.

Lyren A, Coffey M, Shepherd M, Lashutka N, Muething S, and the SPS Leadership Group. We will not compete on safety: How children’s hospitals of come together to hasten harm reduction, Joint Commission Journal on Quality and Patient Safety 2018;44:377-88.

2017

Russell S, Bennett J, Wellman J, Chung D, Yu Z, Tillman A, Wittes J, Pappas J, Elci O, McCague A, Cross D, Marshall K, Walshire J, Kehoe T, Reichert H, Davis M, Raffini L, George L, Hudson F, Dingfield L, Zhu X, Haller J, Sohn E, Mahajan A, Pfeifer W, Weckmann M, Johnson C, Gewaily D, Drack A, Stone E, Wachtel K, Simonelli F, Leroy B, Wright J, High K, Maguire A. Efficacy and safety of voretigene neparvovec (AAV2-hRPE65v2) in patients with RPE65-mediated inherited retinal dystrophy: a randomized, controlled, open-label, phase 3 trial. Lancet 2017;390:849-860.

Branchford B, Mahajerin A, Raffini L, Chalmers E, van Ommen CH, Chan A, Goldenberg N. Recommendations for standardized risk factor definitions in pediatric hospital-acquired venous thromboembolism to inform future prevention trials: communication from the SSC of the ISTH.  J Thromb Haemost 2017;15:2274-8.

Witmer C, Sauck S, Raffini L. A survey of pediatric hematologist/oncologists regarding the management of central line associated thrombosis. Pediatr Blood Cancer 2017;64:e26383.

Ragni M, Yabes J, Fogarty P, Josephson N, Kessler C, Neff A, Raffini L, Patterson C. Pilot randomized, non-inferiority, cross-over trial of once-weekly versus three times-weekly recombinant Factor VIII prophylaxis in adults with severe hemophilia A. Haemophilia 2017:23(1)e43-e46.

2016

Neshat-Vahid S, Pierce R, Hershey D, Raffini L, Faustino V. Association of thrombophilia and catheter associated thrombosis in children: A systematic review and meta-analysis. J Thromb Haemost 2016;14(9):1749-1758 .

Guzman A, Zahra M, Trerotola S, Raffini L, Itkin M, Keller M, Cahill A. IVC filter removal in adolescents: experience in a tertiary pediatric center. Ped Radiol 2016;46(4):534-40.

Gaballah M, Shi J, Kukreia K, Raffini L, Tarango C, Keller M, Krishnamurthy G, Racadio J, Patel M, Cahill A. Endovascular thrombolysis in management of iliofemoral thrombosis in children: A multi-institutional experience. JVIR 2016;27(4):524-30.

2015

Raffini L, Davenport J, Bevilaqua L, Iosifescu S. Comparison of three post-thrombotic syndrome assessment tools demonstrates significant variability in children and adolescents with deep vein thrombosis. J Pediatr Hematol Oncol  2015;37:611-5.

Blevins E, Glanz K, Huang YS, Raffini L, Shinohara R, Witmer C. A multicenter cohort study of inferior vena cava filter use in children. Pediatr Blood Cancer 2015;(62):2089-93.

George L, Thalji N,  Raffini L, Gimotty P, Camire R. Correction of human hemophilia A whole blood abnormalities with a novel bypass agent: zymogen-like Xa. J Thromb Haemost 2015;13(9):1694-8.

Mahajerin A, Branchford B, Amankwah E, Raffini L, Chalmers A, van Ommen C, Goldenberg N. Hospital-associated venous thromboembolism (HA-VTE) in pediatrics: a systematic review and meta-analysis of risk factors and risk assessment models. Haematologica 2015;100(8):1045-50 .

McGee S, Raffini L, Witmer C. Organized sports participation and the association with injury in pediatric patients with haemophilia. Haemophilia 2015;21(4):538-42 .

Glatz A, Keashen R, Chang J, Balsama L, Dori Y, Gillespie M, Giglia T, Raffini L, Rome J. Outcomes using a clinical practice pathway for the management of pulse loss following pediatric cardiac catheterization. Catheter Cardiovasc Interv 2015;85(1):111-7.

Blevins E, Raffini L. Extensive thrombotic complications after inferior vena cava filter placement in two pediatric patients with spinal cord injury: A cautionary tale and review. J Pediatr Hematol Oncol 2015;37(4);e227-9.

2014

Greene L, Law C, Jung M, Walton S, Ignjatovic V, Monagle P, Raffini L. Lack of anti-Xa standardization results in significant low molecular weight heparin (enoxaparin) dose variation in neonates and children. J Thromb Haemost 2014;12(9);1554-7.

Leissinger C, Josephson C, Granger S, Konkle B, Kruse-Jarre R, Ragni M, Journeycake J, Valentino L, Key N, Gill J, McCrae K, Neufeld E, Manno C, Raffini L, Saxena K, Torres M, Marde V, Bennett C, Assmann S. Rituximab for Treatment of Inhibitors in Hemophilia A: A Phase II Study. Thromb Haemost 2014;112(3):445-58.

2013

Stem J, Christensen A, Davis D, Raffini L. Safety of prophylactic anticoagulation at a pediatric hospital. J Pediatr Hematol Oncol 2013;35(7):e287-91.

2012

Peutz J, Huang Y-S, Witmer C, Raffini L. Widespread use of fresh frozen plasma in U.S. Children's Hospitals despite limited evidence demonstrating a beneficial effect J Pediatr 2012;160(2):210-215.

Ragni M, Fogarty P, Josephson N, Neff A, Raffini L, Kessler C. Survey of current prophylaxis practice and bleeding characteristics of hemophilia children in U.S. Hemophilia Treatment Centers. Haemophilia 2012;18(1):63-8.

2011

Raffini L, Trimarchi T, Beliveau J, Davis D. Thromboprophylaxis in a pediatric hospital: a patient safety and quality improvement initiative. Pediatrics 2011;127:e1326-e1332.

Young G, Boshkov L, Sullivan J, Raffini L, Cox D, Boyle D, Kallender H, Tarka E, Soffer J, Hursting M. Argatroban therapy in pediatric patients requiring non-heparin anticoagulation: An open-label safety, efficacy, and pharmacokinetic study. Pediatr Blood Cancer 2011;56(7):1103-1109.

Gentilomo C, Huang Y-S, Raffini L. Significant increase in clopidogrel use in U.S. Children’s Hospitals. Pediatr Cardiol 2011;32:167-172.

Witmer C, Presley R, Kulkarni R, Soucie M, Manno C, Raffini L. Associations between intracranial hemorrhage and prescribed prophylaxis in a large cohort of hemophilia patients in the United States. Br J Haematol 2011;152:211-6.

Witmer C, Huang Y-S, Lynch K, Raffini L, Shah S. Off label recombinant factor VIIa use in pediatrics: A multicenter cohort study. J Pediatr 2011;158(5);820-825.

2010

Kenet G, Aronis S, Berkun Y, Bonduel M, Chan A, Goldenberg N, Holzhauer S, Iorio A, Journeycake J, Junker R, Male C, Manco-Johnson M, Massicotte P, Mesters R, Monagle P, van Ommen H, Raffini L, Simioni P, Young G, Nowak-Gottl U. Impact of persistent antiphospholipid antibodies on risk of incident symptomatic thromboembolism in children: a systematic review and meta-analysis. Seminars in thrombosis and hemostasis 2010;37(7):802-9.

Kenet G, Lukhoff L, Albisetti M, Bernard T, Bonduel M, Brandao L, Chabrier S, Chan A, Cowan F, Fiedler B, Fullerton H, Ganesan V, Goldenberg N, Golumb M, Grabowski E, Heller C, Holzhaur S, Iorio A, Journeycake J, Kirkham F, Kurnik K, Lynch J, Male C, Manco-Johnson M, Mesters R, Monagle P, van Ommen H, Raffini L, Simioni P, Strater R, Young G, Nowak-Gottle U. Impact of thrombophilia on arterial ischemic stroke or cerebral sinovenous thrombosis in children: A systematic review and meta-analysis of observational studies. Circulation 2010;121:1838-47.

2009

Maquire A, High K, Auricchio A, Wright J, Pierce E, Testa F, Mingozzi F, Bennicelli J, Ying G,  Rossi S, Fulton A, Marshall K, Banfi S, Chung D, Morgan J, Hauck B, Zelanaia O, Zhu X, Raffini L, Coppieters F, De Baere E, Shindler K, Volpe N, Surace E, Acerra C, Lyubarsky A, Redmond M, Stone E, Sun J, McDonnell J, LeRoy B, Simonelli F, Gauderman, Bennett J. Age-dependent effects of RPE65 gene therapy for Leber’s congenital amaurosis: a phase 1 dose-escalation trial. Lancet 2009;374:1597-605.

Yee D, Chan A, Williams S, Goldenberg N, Raffini L. Varied opinions of thrombolysis for venous thromboembolism in infants and children: Results of a survey of pediatric hematology-oncology specialists. Pediatr Blood Cancer 2009;53:960-6.

Raffini L, Huang Y-S, Witmer C, Feudtner C, A dramatic increase in venous thromboembolism in children’s hospitals in the United States from 2001 to 2007. Pediatrics 2009;124:1001-8.

Witmer C, Manno C, Raffini L. The clinical management of hemophilia and head trauma: A survey of current clinical practice among pediatric hematology/oncology physicians. Pediatr Blood Cancer 2009;53:406-10.

Raffini L, Schwed A, Zheng X, Tanzer M, Nicolson S, Gaynor J, Jobes D. Thromboelastography in patients post-Fontan compared to healthy children. Pediatr Card 2009;30:771-6.

Witmer C, Elden L, Butler R, Manno C, Raffini L. Incidence of bleeding complications in pediatric patients with type 1 von Willebrand disease undergoing adenotonsillar procedures. J Pediatr 2009; 155:68-72.

Victoria T, Mong A, Altes T, Jawad A, Hernandez A, Gonzalez L, Raffini L, Kramer S. Evaluation of pulmonary embolism in a pediatric population with high clinical suspicion.  Pediatr Rad 2009;39:35-41.

2008

Raffini L, Cahill A, Hellinger J, Manno C. A prospective observational study of IVC filters in pediatric patients. Pediatr Blood Cancer 2008;51:517-520.

2007

Heltzer M, Paessler M, Raffini L, Bunin N, Perez E. Successful haplo-identical bone marrow transplant in a patient with reticular dysgenesis: Three year follow-up. J Allergy Clin Immunol 2007;120:950-952.

Witmer C, Raffini L, Manno C. Utility of computed tomography of the head following head trauma in boys with haemophilia. Haemophilia 2007;13:560-566.

Niebanck A, Pollock A, Smith-Whitley K, Raffini L, Zimmerman R, Ohene-Frempong K, Kwiatkowski J. Headache in children with sickle cell disease: prevalence and associated factors. J Pediatr 2007:151:67-72.

Witmer C, Steenhoff A, Shah S, Raffini L. Mycoplasma pneumoniae, splenic infarct, and transient antiphospholipid antibodies: A new association? Pediatrics 2007;119(1):e292-295.

2006

Raffini L, Raybagkar D, Cahill A, Kaye R, Blumenstein M., Manno C. May-Thurner syndrome (iliac vein compression) and thrombosis in adolescents with additional thrombophilic risk factors. Pediatr Blood Cancer 2006;47:834-839.

Raffini L, Niebanck A, Hrusovsky J, Stevens A, Blackwood-Chirchir A, Ohene-Frempong K, Kwiatkowski J. Prolongation of the prothrombin time and activated partial thromboplastin time in children with sickle cell disease. Pediatr Blood Cancer 2006;47:589-593.

Raffini L, Raybagkar D, Blumenstein M, Rubenstein R, Manno C. Cystic fibrosis as a risk factor for recurrent venous thrombosis at a pediatric tertiary care hospital. J Pediatr 2006;148:659-664.

2005

Niebanck A, Kwiatkowski J, Raffini L. Neutropenia following IVIG therapy in pediatric patients with immune mediated thrombocytopenia. J Pediatr Hematol Oncol 2005;27:145-147.

2004

Raffini L, Tsarouhas N. Subgaleal hematoma from hair braiding leads to the diagnosis of Von Willebrand Disease. Pediatr Emerg Care 2004;20;316-318.

2002

Raffini L, Slater D, Rappaport E, LoNigro L, Cheung N,  Biegel J,  Nowell J,  Lange B,  Felix C.  Panhandle and reverse-panhandle PCR enable cloning of der(11) and der(other) genomic breakpoint junctions of MLL translocations and identify complex translocation of MLL, AF4 and CDK6. Proc Natl Acad Sci USA 2002;99:4568-4573.

1997

Cassela C, Raffini L, Panganiban A. Pleiotropic mutations in the HIV-1matrix protein that affect diverse steps in replication. Virology 1997;228:294-306.

Abstracts

2019

Tran D, Barry V, Buckner T, Croteau S, Cuker A, Raffini L, Recht M, Kempton C. A U.S. multicenter analysis of characteristics associated with prescribed factor prophylaxis. ISTH Melbourne Australia July 2019

Demkin T, Cecere L, Oliver A, Steele A, Law C, Giglia T, Raffini L, Gillespie M, O’Byrne M, Dori Y, Rome J, Glatz A. The use of bivalirudin as procedural thromboprophylaxis in the cardiac catherization laboratory for infants at risk for arterial thrombosis. Society for Cardiovascular Angiography Annual Meeting, Las Vegas, NV May 2019

2018

Giglia T, Keashen R, Glatz A, Raffini L. Predictive model for hospital acquired thrombosis in pediatric cardiac patients under one year of age. American College of Cardiology Annual Meeting, Orlando, FL March 2018.

Books

Zorc J (ed.), Alpern E, Brown L, Loomes K, Marino B, Mollen C, Raffini L. (assoc. eds). Schwartz’s Clinical Handbook of Pediatrics, 4th and 5th editions, Lippincott William and Wilkins, 2008, 2013.

Chapters

2015

Raffini L. Hereditary Predisposition to Thrombosis, Thrombotic Disorders in Children, Antithrombotic Therapy. In: Nelson’s Textbook of Pediatrics, 19th and 20th edition, (p. 1707-1712) Elsevier Health Sciences, 2015.

2014

Branchford B. and Raffini L. Prevention of VTE in Children, In: Goldenberg N, Manco-Johnson M (eds) Pediatric Thrombotic Disorders, 1st edition, (p. 207-219) Cambridge University Press, 2014.

2012

Raffini L. Pediatric Aspects of Thrombophilia, In: Kitchens C. Consultative Hemostasis and Thrombosis, 3rd edition Elsevier Health Sciences, (p. 240-247), 2012.

2011

Raffini L. Hereditary Predisposition to Thrombosis, Thrombotic Disorders in Children, Antithrombotic Therapy. In: Nelson’s Textbook of Pediatrics, 19th and 20th edition, (p. 1707-1712) Elsevier Health Sciences, 2011.

2008

Raffini L. Leukocytosis, Lymphadenopathy. In: Zorc J, (ed.) Swartz’s Clinical Handbook of Pediatrics, 4th edition (p. 559-569, 580-591), Lippincott William and Wilkins, 2008.

2005

Witmer C, Raffini L. Hematology. In: Frank G, Shah SS, Catallozzi MC, Zaoutis LB (eds.) Philadelphia Guide to Inpatient Pediatrics. 1st edition, Blackwell Publishing: Malden, MA 2005.

Raffini L. Abnormal Bleeding, Pallor, Thrombosis, G6PD Deficiency, Hereditary Spherocytosis, Thalassemia. In: Schwartz MW, ed. The 5-Minute Pediatric Consult, 4th edition (p. 6-7, 64-65, 82-83, 400-401, 438-439, 840-841), Lippincott William and Wilkins, 2005.

1999

Raffini L, Ebel B. Hematology.  In: Siberry G, Iannone R, (eds.) Harriet Lane Handbook, 15th edition, (p. 307-330) Mosby 1999.

Posters and Presentations

2017

Kamdar A, Raffini L, Witmer C. Children with CVC-VTE: A very high-risk group for recurrent thrombosis (poster presentation at American Society of Hematology Annual Meeting, Atlanta, GA Dec. 2017)

Doshi B, Raffini L, Arruda V, Lacey S, Chen F, Novel correlation between B cell survival cytokines and inhibitors in hemophilia A (poster presentation at American Society of Hematology Annual Meeting, Atlanta, GA Dec. 2017)

Kearney S, Raffini L, Pham T, Adalsteinsson, Landorph A, Health related quality of life and satisfaction of children with severe hemophilia A treated with turoctocog alfa pegol (N8-GP). (poster presentation at American Society of Hematology Annual Meeting, Atlanta, GA Dec. 2017)

Croteau S, Raffini L, Neufeld E, Thornburg C, Cheng D, Cohen A, Holmes C, Kouides P, Silvey M, Wheeler A. Practical application of the Athndataset: Evaluating uptake of extended factor half-life concentrates in patients with moderate and severe hemophilia (oral presentation at American Society of Hematology Annual Meeting, Atlanta, GA Dec. 2017)

Doshi B, Arruda V, Lambert M, Raffini L, George L. Anti-CD20 and Sirolimus for immune tolerance in boys with congenital hemophilia A with inhibitors. (poster presentation at International Society of Thrombosis and Hemostasis Meeting, Berlin, Germany July 2017)

Invited Lectures

2019

Raffini L. “Bivalirudin for VADs- No” Debate, Pediatric Circulatory Support Consortium, Melbourne, Australia. July 5, 2019.

2018

Raffini L. “DOAC registry for pediatrics” Pediatric and Neonatal Thrombosis Hemostasis Subcommittee, International Society of Thrombosis and Hemostasis, Dublin, Ireland. July 17, 2018.

Raffini L. “DOACS in children: Are the ready for routine use? YES” Debate, Pediatric and Neonatal Thrombosis Hemostasis Subcommittee, International Society of Thrombosis and Hemostasis, Dublin, Ireland. July 17, 2018.

Raffini L. “Bivalirudin for ECMO: Not Yet” Debate: Annual ELSO Meeting, Scottsdale, AZ. Sept 14, 2018.

2017

Raffini L. “Anticoagulation in Ventricular Assist Devices and Extracorporeal Membrane Oxygenation: walking the tightrope”, Education Session, American Society of Hematology Annual Meeting, Atlanta, GA. Dec 8, 2017.

Raffini L. “Preventing thrombosis in children: A historical perspective”, Hemostasis/Thrombosis Research Society Annual Meeting, Scottsdale, AZ. April 8, 2017.

Raffini L. “Debating the Sippet Study: Pro-plasma derived products”, HTC Region III Annual Meeting, Alexandria, VA. March 23, 2017.

Raffini L. “Prevention of Thrombosis in Children”, Visiting Lectureship, CHLA, Los Angelos, CA. Feb. 28, 2017.

Awards and Honors

2016, CHOP Heme/Onc Fellowship Distinguished Teaching Award
2015, Master Clinician Award, Department of Pediatrics, Perelman School of Medicine
2013, Blockley-Osler Teaching Award, Perelman School of Medicine
2007, Hospital and Healthsystem of Pennsylvania Achievement Award
2003, National Hemophilia Foundation Clinical Fellowship
2000, American Society of Hematology Travel Award
1995, Alpha Omega Alpha Honor Medical Society
1994, 1994 Lange Medical Publication Award
1993, 1993 Medical Student Association Student Leadership Award
1991, 1991 Mary Shrine Peterson Scholarship for undergraduate research
1990, Phi Beta Kappa National Honor Society

Editorial and Academic Positions

Editorial Positions

2007-present, Editorial Advisory Board, HemeAware
2003-present, Ad hoc reviewer for Blood, New England Journal of Medicine, Pediatrics, Circulation

Academic and Institutional Committees

2010-present, Hematology-Oncology Fellowship Committee
2008-present, Director, Anticoagulation Safety Program

Leadership and Memberships

Memberships in Professional Organizations

International

2003-present, International Society of Thrombosis and Hemostasis
 - 2017-present, Co-chair, Pediatric and Neonatal Thrombosis Hemostasis  Subcommittee

National

2013-present, Hemostasis and Thrombosis Research Society
 - 2013-present, Board of Directors, Board Member
2008-present, Clinical Advisory Board, Bayer Health Care
2003-present, National Hemophilia Foundation
 - 2012-present, Medical and Scientific Advisory Committee
2002-present, American Society of Hematology
 - 2015-present, Venous Thrombosis Guidelines Pediatric Panel
 - 2014-present, Venous Thrombosis Guideline Oversight Panel
2002-present, American Society of Pediatric Hematology/Oncology