M.D., University of Miami, School of Medicine, 1986.
Ph.D., Harvard University, Immunology, 1983.
Relapse remains a major issue following an autologous transplant. Relapses result from either the infusion of contaminating tumor cells in the stem cell product and/or from the incomplete eradication of endogenous malignant cells by the treatment regimens. Directly following an autologous transplant, the immune system is relatively incompetent and this immune incompetence may contribute to the high relapse rates seen after autologous transplantation.
My current clinical research interests have focused on trying to augment the immune system after an autologous transplant. A number of clinical trials using different approaches have been developed. Initially, a phase I dose escalating study was conducted to determine the maximum tolerated dose and duration of sequential IL2 therapy as immune stimulation, after infusion of IL2-incubated PBSC. Upon completion, this Phase I study led to a phase II study to determine the efficacy of this type of immunotherapy in treating patients with multiple myeloma. Other clinical trials have been designed for ongoing evaluation of various mobilization regimens to maximize immune responsiveness of PBSC product and to study the effect of adding IL2 with GM-CSF to treat breast cancer and IL2 with Rituxan to treat Non-Hodgkin’s lymphoma. The ability of tumor specific vaccines to maintain a primed immune system after transplant has also been investigated.
The hope is that the addition of immunotherapy to a standard high dose autologous transplant regimen will result in fewer relapses and thus prolong the survival for our patients.
NCCN Guidelines Insights: Multiple Myeloma, Version 3.2016.. Journal of the National Comprehensive Cancer Network : JNCCN. 14(4):389-400.. 2016.
Multiple Myeloma, Version 2.2016.. Journal of the National Comprehensive Cancer Network : JNCCN. 13(11):1398-435.. 2015.
Panobinostat: a review of trial results and future prospects in multiple myeloma.. Expert review of hematology. 8(1):9-18.. 2015.
Autologous haematopoietic cell transplantation for non-Hodgkin lymphoma with secondary CNS involvement.. British journal of haematology. 162(5):648-56.. 2013.
Salvage Second Hematopoietic Cell Transplantation in Myeloma.. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation.. 2013.
Allo-SCT for multiple myeloma: a review of outcomes at a single transplant center.. Bone marrow transplantation. 47(10):1312-7.. 2012.
The effective use of plerixafor as a real-time rescue strategy for patients poorly mobilizing autologous CD34(+) cells.. Journal of clinical apheresis. 27(2):81-7.. 2012.
The role of autologous and allogeneic hematopoietic stem cell transplantation for Hodgkin lymphoma.. Journal of the National Comprehensive Cancer Network : JNCCN. 9(9):1060-71.. 2011.
Effect of obesity on outcomes after autologous hematopoietic stem cell transplantation for multiple myeloma.. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 17(12):1765-74.. 2011.
Mantle cell lymphoma international prognostic index but not pretransplantation induction regimen predicts survival for patients with mantle-cell lymphoma receiving high-dose therapy and autologous stem-cell transplantation.. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 29(22):3023-9.. 2011.
Race and outcomes of autologous hematopoietic cell transplantation for multiple myeloma.. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 16(3):395-402.. 2010.
Busulfan in hematopoietic stem cell transplant setting.. Expert opinion on drug metabolism & toxicology. 5(8):957-69.. 2009.
High-dose chemotherapy with BEAM or Busulphan/Melphalan and Thiotepa followed by hematopoietic cell transplantation in malignant lymphoma.. Leukemia & lymphoma. 49(10):1899-906.. 2008.
Effect of remission status and induction chemotherapy regimen on outcome of autologous stem cell transplantation for mantle cell lymphoma.. Leukemia & lymphoma. 49(6):1062-73.. 2008.