A5077038928- Acute Lymphoblastic Leukemia research
- Childhood Cancer Survivors' Quality of Life
- Acute Myeloid Leukemia Research
- Lymphoma Diagnosis and Treatment
- Hematopoietic Stem Cell Transplantation
- Chronic Lymphocytic Leukemia Research
- Neutropenia and Cancer Infections
- Neuroblastoma Research and Treatments
- Cancer Treatment and Pharmacology
- Histone Deacetylase Inhibitors Research
- Lung Cancer Research Studies
- Chronic Myeloid Leukemia Treatments
- Pharmaceutical studies and practices
- Glioma Diagnosis and Treatment
- CAR-T cell therapy research
- Cancer therapeutics and mechanisms
- Adolescent and Pediatric Healthcare
- T-cell and Retrovirus Studies
- Pregnancy and Medication Impact
- Brain Metastases and Treatment
- Microtubule and mitosis dynamics
- PI3K/AKT/mTOR signaling in cancer
- Viral-associated cancers and disorders
- Pneumocystis jirovecii pneumonia detection and treatment
- Cancer Genomics and Diagnostics
Baylor College of Medicine
2016-2025
Texas Children's Hospital
2015-2025
Children's Cancer Center
2019-2025
Praxis für Hämatologie und Onkologie
2020
Johns Hopkins University
2009-2011
Sidney Kimmel Comprehensive Cancer Center
2011
Johns Hopkins Medicine
2010
To improve the outcomes of patients with T-cell acute lymphoblastic leukemia (T-ALL) and lymphoma (T-LL), proteasome inhibitor bortezomib was examined in Children's Oncology Group phase III clinical trial AALL1231, which also attempted to reduce use prophylactic cranial radiation (CRT) newly diagnosed T-ALL.
Abstract Purpose We conducted a phase 1/2 trial of the poly(ADP‐ribose) polymerase inhibitor talazoparib in combination with low‐dose temozolomide (TMZ) to determine dose‐limiting toxicities (DLTs), recommended 2 dose (RP2D), and pharmacokinetics this children recurrent/refractory solid tumors; explore clinical activity Ewing sarcoma (EWS) (NCT02116777). Methods Talazoparib (400‐600 µg/m /dose, maximum daily 800‐1000 µg) was administered q.d. or b.i.d. orally on day 1 followed by dosing...
Survival outcomes for relapsed/refractory pediatric acute myeloid leukemia (R/R AML) remain dismal. Epigenetic changes can result in gene expression alterations which are thought to contribute both leukemogenesis and chemotherapy resistance. We report results from a phase I trial with dose expansion cohort investigating decitabine vorinostat combination fludarabine, cytarabine, G-CSF (FLAG) patients R/R AML [NCT02412475]. Thirty-seven enrolled median age at enrollment of 8.4 (range, 1-20)...
Survival of pediatric AML remains poor despite maximized myelosuppressive therapy. The pneumocystis jiroveci pneumonia (PJP)-treating medication atovaquone (AQ) suppresses oxidative phosphorylation (OXPHOS) and reduces burden in patient-derived xenograft (PDX) mouse models, making it an ideal concomitant Poor palatability limited product formulations have historically routine use AQ patients. Patients with de novo were enrolled at two hospitals. Daily established PJP dosing was combined...
ABSTRACT INTRODUCTION Vincristine sulfate liposome injection (VSLI), a liposomal formulation of vincristine, may be better tolerated than standard aqueous vincristine and enable dose intensification. PROCEDURES Based on single‐agent tolerability, activity, FDA approval in adults with acute lymphoblastic leukemia (ALL), we tested the safety feasibility VSLI as replacement for UK ALL R3 mitoxantrone‐based four‐drug induction (Cohort A), three‐drug anthracycline‐free B), maintenance...
PURPOSE Infusions of high-dose methotrexate at 5 g/m 2 over 24 (HDMTX) as a single infusion for pediatric patients with high-risk precursor B-cell ALL are known to lead superior outcomes. The Hospital Nacional de Niños Dr Carlos Sáenz Herrera, part the public system Caja Costarricense Seguro Social in Costa Rica (HNN), has been historically unable provide this therapy secondary required intensive monitoring and cost-prohibitive toxicity support. METHODS We report our experience providing...
Abstract Background High‐dose methotrexate (HD‐MTX; 5000 mg/m 2 ) is an important component of curative therapy in many treatment regimens for high‐risk pediatric acute lymphoblastic leukemia (ALL). However, can result dose‐limiting neurotoxicity, which may disproportionately affect Latino children. This study evaluated risk factors neurotoxicity after HD‐MTX ethnically diverse population patients with ALL. Methods The authors retrospectively reviewed the medical records who were diagnosed...
Mercaptopurine (6-MP), a critical component of acute lymphoblastic leukemia (ALL) therapy, is metabolized to 6-thioguanine (6-TGN) which responsible for its anti-leukemic effect, and 6-methylmercaptopurine nucleotides (6-MMPN/6-MMP) can be hepatotoxic. Some patients preferentially metabolize 6-MP 6-MMPN may increase the risk liver injury, reduce serum levels 6-TGN potentially relapse. The addition allopurinol oral has been shown optimize metabolism towards in with inflammatory bowel disease...
10005 Background: Ceritinib is a potent ALK inhibitor with durable efficacy in adult pts ALK-translocated non-small cell lung cancer. This report describes the results of phase I study (NCT01742286) pediatric ALK-aberrant malignancies: anaplastic large lymphoma (ALCL); myofibroblastic tumor (MT)/inflammatory (IMT) rhabdomyosarcoma (RMS) and neuroblastoma (NB). In these tumors aberrations differ: ALCL IMT carry gene translocations, NB amplifications or mutations, RMS copy number gain no...
Phosphatidylinositol 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) signaling is commonly dysregulated in acute lymphoblastic leukemia (ALL). The TACL2014-001 phase I trial the mTOR inhibitor temsirolimus combination with cyclophosphamide and etoposide was performed children adolescents relapsed/refractory ALL. Temsirolimus administered intravenously (IV) on days 1 8 440 mg/m2 100 IV daily 1-5. starting dose 7.5 (DL1) escalation to 10 (DL2), 15 (DL3), 25 (DL4). PI3K/mTOR pathway...
Sinus histiocytosis with massive lymphadenopathy (SHML), or Rosai–Dorfman disease (RDD), is a non‐neoplastic, lymphoproliferative disorder that usually resolves spontaneously minimal conventional chemotherapy. Rarely, SHML can be associated autoimmune findings. Such cases are often treatment resistant and have high rates of morbidity mortality. We present case patient long‐standing autoimmunity in the context SHML, dependent on standard‐treatment until he was transitioned to novel...
Abstract Current therapies for relapsed/refractory (R/R) pediatric myeloid neoplasms are inadequately effective. Real‐world data (RWD) can improve care by augmenting traditional studies and include individuals not eligible clinical trials. The Therapeutic Advances in Childhood Leukemia Lymphoma (TACL) consortium recently completed T2016‐003, a phase 1 study of decitabine, vorinostat, fludarabine, cytarabine, granulocyte colony‐stimulating factor (G‐CSF) R/R acute leukemia (AML), which added...
Abstract Background Eribulin mesylate is a novel anticancer agent that inhibits microtubule growth, without effects on shortening, and promotes nonproductive tubulin aggregate formation. We performed phase 1 trial to determine the dose‐limiting toxicities (DLTs), maximum tolerated or recommended 2 dose (MTD/RP2D), pharmacokinetics (PK) of eribulin in children with refractory recurrent solid (excluding central nervous system) tumors. Methods was administered intravenously days 8 21‐day...
The overall survival of children with acute lymphoblastic leukemia (ALL) is over 90%. Much this success comes from the daily use 6-mercaptopurine (6-MP) during maintenance therapy [1]. Mercap...
Abstract High‐dose methotrexate (HD‐MTX) is used in the treatment of children with central nervous system (CNS) tumors; however, toxicity information limited. We characterized toxicities following 102 administrations HD‐MTX (4.6–13.5 g/m 2 ) infused over 4 or 24 h 38 a CNS tumor before 6 years age (2010–2020). Delayed clearance occurred 24% infusions. Common Terminology Criteria for Adverse Events v5 grade 2–3 mucositis was observed 47% individuals, Grade neutropenia 76%, and 3–4...
Abstract Skewing of mercaptopurine (6‐MP) metabolism preferentially toward the 6‐methylmercaptopurine (6‐MMP) metabolite over antileukemic 6‐thioguanine (6‐TGN) is associated with 6‐MP‐related hepatotoxocity. Allopurinol when coadministered 6‐MP can reduce this skewing and ameliorate adverse effects. The cases we report here demonstrate that aberrant overproduction 6‐MMP also profound 6‐MP‐associated hypoglycemia, which be reversed by administration allopurinol. This case series contributes...
Abstract Hepatosplenic T‐cell lymphoma (HTCL) is a rare malignancy. Prognosis poor with only few case reports of long‐term survivors. While HTCL universally involves the bone marrow, condition has been most often treated multimodal specific chemotherapy. We report durable, sustained first remission in an adolescent for who received induction therapy according to high risk leukemia regimen, nucleoside analog‐based consolidation, and allogeneic transplantation associated GVHD. Pediatr Blood...
We developed a bedside algorithm for individually adjusting the high-dose methotrexate (HDMTX) dose (5 g/m) given to patients with acute lymphoblastic leukemia at high risk toxicity. Data were reviewed 8 receiving 21 cycles of HDMTX as per our algorithm. Eleven began 5 g/m, 10 preinfusion 20% 25% reduction. Neither mean MTX AUC (2320.5±179.1 vs. 2080.4±161.7 μmol×h/L), Cpss (64.3±7.9 60.8±6.1 μM), nor toxicities statistically different between groups. Our allowed safe administration and obviated need