A5077657313- Hematopoietic Stem Cell Transplantation
- Renal Transplantation Outcomes and Treatments
- Multiple Myeloma Research and Treatments
- Chronic Lymphocytic Leukemia Research
- Venous Thromboembolism Diagnosis and Management
- Acute Lymphoblastic Leukemia research
- Transplantation: Methods and Outcomes
- Atrial Fibrillation Management and Outcomes
- Cholinesterase and Neurodegenerative Diseases
- Polyomavirus and related diseases
- Antifungal resistance and susceptibility
- Acute Myeloid Leukemia Research
- Lung Cancer Treatments and Mutations
- Central Venous Catheters and Hemodialysis
- Cancer Treatment and Pharmacology
- Cardiac Arrhythmias and Treatments
- Chronic Myeloid Leukemia Treatments
- HIV/AIDS drug development and treatment
- Cytomegalovirus and herpesvirus research
- Pharmaceutical Practices and Patient Outcomes
- Drug Transport and Resistance Mechanisms
- COVID-19 and healthcare impacts
- Cardiac tumors and thrombi
- Cancer Mechanisms and Therapy
- Blood disorders and treatments
Memorial Sloan Kettering Cancer Center
2012-2023
Low-molecular weight heparin (LMWH) has been the standard of care for treatment venous thromboembolism (VTE) in patients with cancer. Rivaroxaban was approved 2012 pulmonary embolism (PE) and deep vein thrombosis (DVT), but no prior studies have reported specifically evaluating efficacy safety rivaroxaban cancer-associated (CAT). Under a Quality Assessment Initiative (QAI), we established Clinical Pathway to guide use CAT now report validation analysis our first 200 patients. A patient...
Rivaroxaban is broadly used for the primary prevention of stroke and systemic embolism in general population with nonvalvular atrial fibrillation (AF). However, there little published evidence on safety efficacy rivaroxaban AF patients active cancer. The aim this study was to assess cancer AF. use at Memorial Sloan Kettering Cancer Center monitored setting a Quality Assessment Initiative. Patients AF, treated from January 1, 2014, March 31, 2016, are included analysis. Clinical end points...
Highlights•Higher total daily mycophenolate mofetil dose/kilogram reduces severe acute graft-versus-host disease after cord blood transplantation•Higher dose can reduce the risk of marked HLA mismatch week 1 and 2 mycophenolic acid troughs were associated with reduced dosing did not impair neutrophil engraftment transplantationAbstractAlthough (MMF) has replaced corticosteroids as immunosuppression in transplantation (CBT), optimal MMF yet to be established. We intensified from every 12 8...
Abstract Purpose The phosphoinositide 3‐kinase (PI3K)/protein kinase B (AKT) pathway controls insulin sensitivity and glucose metabolism. Hyperglycemia is one of the most common on‐target adverse effects (AEs) PI3K/AKT inhibitors. As several PI3K AKT inhibitors are approved by United States Food Drug Administration or being studied in clinical trials, characterizing this AE developing a management strategy essential. Methods Patients with hematologic solid malignancies treated at Memorial...
Objective. Vincristine is an important component in the treatment of acute lymphoblastic leukemia (ALL) and now backbone therapy induction consolidation phases this disease. Proper dosing vincristine required to maximize disease control while avoiding toxicity. The gastrointestinal toxicity such as decreased peristalsis can potentially be increased if CYP 3A4 enzyme inhibited. This interaction may become more prevalent with increasing use inhibitors azole antifungals. Since azoles are...
Purpose With the rapid spread of COVID-19 in New York City since early March 2020, innovative measures were needed for clinical pharmacy specialists to provide direct care safely cancer patients. Allocating workforce was necessary meet surging needs inpatient services due outbreak, which had potential compromise outpatient services. We present here our approach restructuring and providing patient clinics during pandemic. Data sources conducted a retrospective review electronic documentation...
Introduction: This study was designed to describe the landscape of oncology pharmacy practice at patient facing institutional healthcare organizations throughout United States. Methods: The Hematology/Oncology Pharmacy Association (HOPA) Practice Outcomes and Professional Benchmarking Committee conducted a multi-organization, voluntary survey HOPA members between March 2021 January 2022. Four overarching domains were targeted: description, job function, staffing, training/certification. Data...
Mycophenolate mofetil (MMF) is frequently combined with cyclosporine-A (CSA) as immunosuppression in CBT. Drug monitoring of MPA, the active MMF metabolite, advisable based on variable pharmacokinetics and association low unbound MPA AUCs increased aGVHD. This highly relevant CBT aGVHD a leading cause mortality. However, limited pharmacokinetic parameter such troughs ideal. Additionally, toxicity associated not established concern due to theoretical risk myelosuppression from high levels. We...
Background: For MM and AL patients undergoing AHCT, high-dose melphalan is given at a fixed dose based on body surface area with five-fold inter-patient variability in exposure by under the curve (AUC). Pts higher than median AUC have prolonged survival, but increased toxicity (Shaw et al., BBMT 2012). Pharmacokinetic (PK)-directed dosing can determine optimal concentration for each pt. We prospectively evaluated feasibility of PK-directed PGF-MEL, more stable possibly less toxic intravenous...
Abstract: Nowhere has targeted therapy been more successful in the hematologic malignancy arena than chronic myelogenous leukemia (CML). By targeting BCR–ABL fusion oncogene, introduction of tyrosine-kinase inhibitors (TKIs) dramatically improved outcomes this disease. Nilotinib is a second-generation TKI that initially gained approval for treatment imatinib-resistant or -intolerant disease patients with accelerated-phase CML. Investigation first-line setting also demonstrated efficacy, and...
Calcineurin-inhibitor/MMF based prophylaxis in DCBT is frequently associated with aGVHD. MMF dosing CBT has traditionally been every 12 hours (q12). We increased to 1 gm 8 (q8) potentially ameliorate severe However, the toxicity and efficacy of intensified not established. evaluated 173 4-6/6 HLA-matched recipients (median age 39 years) transplanted for hematologic malignancies 10/2005-5/2013. Patients received calcineurin-inhibitor/MMF from day -3 without ATG. Before 9/2009, 83 patients...
Background: Melphalan exposure as measured by area under the curve (AUC) has a 5-fold variability between pts, with higher AUCs associated improved outcomes but increased toxicity (Shaw BBMT 2012). Evomela® (propylene glycol free melphalan, PGF-MEL) is an intravenous formulation stability and possibly less related to solubilizing agent. We aimed determine pharmacokinetics (PK) relationship toxicities this in order optimize dosing. Methods: Serum samples were drawn for 63 pts at 5, 15, 30,...
Allogeneic hematopoietic stem cell transplant (HSCT) patients frequently reactivate cytomegalovirus (CMV) and human herpes virus type 6 (HHV-6). Administration of the antiviral foscarnet is efficacious therapy in many patients. Foscarnet administration, however, complex given need for dose modifications based on renal function considerable risk nephrotoxicity serious electrolyte abnormalities. This requirement, along with increases patient volume, mandates an efficient standard operating...
Mycophenolate mofetil (MMF) is frequently combined with cyclosporine-A as immunosuppression in unrelated donor CBT. Recent evidence suggests that therapeutic drug monitoring of mycophenolic acid (MPA), the active metabolite MMF, advisable based on intra- and inter-patient variability MMF pharmacokinetics (PK). Moreover, an increased incidence acute graft-versus-host disease (aGVHD) has been associated low unbound MPA AUCs adult allograft recipients. This highly relevant CBT aGVHD a leading...
Calcineurin inhibitors have become the standard of care for prophylaxis acute graft versus host disease, however both cyclosporine and tacrolimus can cause adverse effects. While many these reactions are dose dependent, others may require alternate therapy. Strategies be performed to minimize CNI toxicity: target lower serum levels, change another CNI, a steroid based regimen, or sirolimus and/or mycophenolate (MMF) regimen. The current study sought evaluate incidence GVHD as well survival...
Busulfan is an alkylating agent commonly used in preparative regimens for hematopoietic stem cell transplant (HSCT). Early clinical trials, prior to the use of seizure prophylaxis, revealed a high degree neurotoxicity associated with myeloablative doses this agent. Phenytoin has been widely as prophylaxis busulfan. However, potential concerns its include length time achieve therapeutic steady state, risk hepatotoxicity, and drug-drug interactions busulfan other agents during conditioning....