2024
In-Human Clinical Experience with Direct Stick Embolization of Low-Flow Vascular Malformations Using an mTOR Inhibitor
Restrepo-Espinosa V, Lee A, Prozora S, Patel P, Nassiri N. In-Human Clinical Experience with Direct Stick Embolization of Low-Flow Vascular Malformations Using an mTOR Inhibitor. Journal Of Vascular Surgery Venous And Lymphatic Disorders 2024, 101997. PMID: 39515753, DOI: 10.1016/j.jvsv.2024.101997.Peer-Reviewed Original ResearchLow-flow vascular malformationsMTOR inhibitorsClinical successVascular malformationsSide effectsLocalized intravascular coagulopathyOral aphthous ulcersKlippel-Trenaunay syndromeLymphatic malformationsVenous malformationsRe-interventionDelayed complicationsNon-syndromicTechnical successAphthous ulcersIntravascular coagulopathyD-dimerEndovascular treatmentSystemic exposureAdjunctive therapySystemic toxicityFrequent bloodMalformationsSelf-limitingMTOR inhibitionCost-effectiveness of iptacopan in paroxysmal nocturnal hemoglobinuria
Ito S, Chetlapalli K, Wang D, Potnis K, Richmond R, Krumholz H, Lee A, Cuker A, Goshua G. Cost-effectiveness of iptacopan in paroxysmal nocturnal hemoglobinuria. Blood 2024 PMID: 39374533, DOI: 10.1182/blood.2024025176.Peer-Reviewed Original ResearchStandard-of-careParoxysmal nocturnal hemoglobinuriaIncremental net monetary benefitNocturnal hemoglobinuriaComplement-mediated hemolytic anemiaTreating paroxysmal nocturnal hemoglobinuriaComplement C5 inhibitor eculizumabPhase 3 studyQuality-adjusted life expectancyRare blood disorderComprehensive cost-effectiveness analysisProbabilistic sensitivity analysesCost-saving thresholdsC5 inhibitor eculizumabNet monetary benefitPersistent anemiaIptacopanExtravascular hemolysisIntravenous infusionMonotherapyHemolytic anemiaAnemia resolutionC5 inhibitionFDA approvalPrimary outcomePhenotypic and genotypic evaluation of bleeding diagnostic dilemmas: Two case studies
Gu S, Butt A, Schulz V, Rinder H, Lee A, Gallagher P, Hwa J, Bona R. Phenotypic and genotypic evaluation of bleeding diagnostic dilemmas: Two case studies. Blood Cells Molecules And Diseases 2024, 110: 102893. PMID: 39260211, DOI: 10.1016/j.bcmd.2024.102893.Peer-Reviewed Original ResearchInherited platelet disordersClinically significant bleedingCases of patientsHeterogeneous group of conditionsGroup of conditionsSignificant bleedingDiagnostic yieldDiagnostic dilemmaPlatelet disordersBleeding disordersEvaluating patientsPatient cohortMolecular pathogenesisMass cytometryHeterogeneous groupPatientsMultimodal approachBleedingImprove patient careDiagnosisDisordersPatient careGenetic sequencesLaboratory testing approachPotential utilityFactor VIII Levels and ISTH Disseminated Intravascular Coagulation Scores Do Not Distinguish Disseminated Intravascular Coagulation from the Coagulopathy of Liver Disease.
Allen C, Heskel M, Butt A, Tormey C, Pine A, Lee A, Gautam S. Factor VIII Levels and ISTH Disseminated Intravascular Coagulation Scores Do Not Distinguish Disseminated Intravascular Coagulation from the Coagulopathy of Liver Disease. Acta Haematologica 2024, 1-5. PMID: 39004080, DOI: 10.1159/000540239.Peer-Reviewed Original ResearchISTH DIC scoreFactor VIII levelsArea under the curveDIC scoreLiver diseaseFactor VIIIRetrospective chart review of patientsChart review of patientsCoagulopathy of liver diseaseReview of patientsRetrospective chart reviewCalculate area under the curveReceiver operating characteristic curveMultiple logistic regressionISTH scoreLaboratory parametersClinical challengeClinical utilityPatientsCharacteristic curveLab variablesLogistic regressionLiverDiseaseDiagnostic toolLongitudinal Curriculum to Address Wellness and Professional Development in a Hematology/Oncology Fellowship Program
Srikumar T, Stempel J, Goldberg S, Podoltsev N, Braun D, Lee A, Sanft T. Longitudinal Curriculum to Address Wellness and Professional Development in a Hematology/Oncology Fellowship Program. EMJ Oncology 2024, 1: 37-39. DOI: 10.33590/oncolamj/zgwb5064.Peer-Reviewed Original ResearchLongitudinal curriculum to address wellness and professional development in a hematology/oncology fellowship program.
Srikumar T, Stempel J, Goldberg S, Podoltsev N, Braun D, Lee A, Sanft T. Longitudinal curriculum to address wellness and professional development in a hematology/oncology fellowship program. Journal Of Clinical Oncology 2024, 42: 9004-9004. DOI: 10.1200/jco.2024.42.16_suppl.9004.Peer-Reviewed Original ResearchNeeds assessmentLongitudinal curriculumPatient Health Questionnaire 2Score of self-efficacyGeneral Self-Efficacy ScaleFellowship programsBaseline needs assessmentFaculty-led sessionsProfessional boundary settingSelf-Efficacy ScaleLevels of depressionProfessional developmentFirst-year fellowsDidactic sessionsPrevent burnoutChi-square testAcademic yearDebriefing sessionsQuestionnaire 2Baseline assessmentSelf-efficacyProfessional development skillsDepressed moodLeadership skillsBurnoutInternational medical graduates (IMG) representation at international oncology conference meetings.
Roy A, Bakouny Z, Dizman N, Ozay Z, Mohan Lal B, Nawfal R, Eid M, El Hajj Chehade R, Machaalani M, Butt A, Aggarwal C, Bekaii-Saab T, Chavez-MacGregor M, Lopes G, Marshall A, Murphy M, Owonikoko T, Lee A, CHOUEIRI T. International medical graduates (IMG) representation at international oncology conference meetings. Journal Of Clinical Oncology 2024, 42: 9000-9000. DOI: 10.1200/jco.2024.42.16_suppl.9000.Peer-Reviewed Original ResearchInternational medical graduatesAmerican medical graduatesASCO Annual MeetingMedical graduatesFaculty rolesMedical schoolsAmerican Society of Clinical Oncology (ASCOUS institutionsInternational oncology meetingsOncology workforceUnder-recognitionOncology meetingsSelection of presentationsAssess factorsMultivariate analysisPracticing oncologistsUS-basedASCOConference meetingsAcademic rankOriginal researchHighest proportionPodium presentationsAmerican SocietyUnited StatesCost‐effectiveness of sutimlimab in cold agglutinin disease
Ito S, Wang D, Purcell A, Chetlapalli K, Lee A, Cuker A, Goshua G. Cost‐effectiveness of sutimlimab in cold agglutinin disease. American Journal Of Hematology 2024, 99: 1475-1484. PMID: 38733355, DOI: 10.1002/ajh.27358.Peer-Reviewed Original ResearchPrimary cold agglutinin diseaseCold agglutinin diseaseStandard-of-careIncremental cost-effectiveness ratioUS willingness-to-pay thresholdRare autoimmune hemolytic anemiaPhase 3 studyWillingness-to-pay thresholdsAutoimmune hemolytic anemiaTime-limited treatmentHuman monoclonal antibodyCold-reactive antibodiesBinding to red blood cellsFollow-up dataCost-effectiveness ratioComplement-mediated hemolysisDeterministic sensitivity analysisHealth resource utilizationProbabilistic sensitivity analysesTransfusion-dependentClinical remissionTransfusion supportImprove quality of lifeRed blood cellsHemolytic anemiaProviding 0.1 Full-Time Equivalent (FTE) Support to Fellowship Core Faculty Improves Faculty Involvement in Fellowship Education and Recruitment
Butt A, Christian J, Kress A, Lu B, Hurwitz M, Goldberg S, Podoltsev N, Gilkes L, Lee A. Providing 0.1 Full-Time Equivalent (FTE) Support to Fellowship Core Faculty Improves Faculty Involvement in Fellowship Education and Recruitment. Journal Of Cancer Education 2024, 39: 325-334. PMID: 38430454, DOI: 10.1007/s13187-024-02414-z.Peer-Reviewed Original ResearchFull-time equivalent supportFull-time equivalentAmerican Council for Graduate Medical EducationCore facultyFellowship programsFellowship educationGraduate Medical EducationImprove job satisfactionCF programPotential unintended consequencesMedical educationSalary supportSurvey respondentsIncreased participationMedical oncologyUnintended consequencesSubspecialty fellowshipsIncreased senseSense of commitmentJob satisfactionFellowshipEducationFaculty involvement
2023
Comprehensive Characterization of Coagulation Parameters in Venous Malformations
Restrepo V, Pine A, Butt A, Chang E, Bar N, Baluha A, Brooks A, Chirico G, Curran J, Dumont A, Obura-Wilkes P, Rinder H, Tormey C, Nassiri N, Lee A, Prozora S. Comprehensive Characterization of Coagulation Parameters in Venous Malformations. Blood 2023, 142: 27. DOI: 10.1182/blood-2023-190609.Peer-Reviewed Original ResearchHigher thrombin-antithrombin complexesNormal D-dimerThrombin-antithrombin complexPlasminogen activator inhibitor-1Localized intravascular coagulopathyInternational normalized ratioD-dimerVenous malformationsCoagulation parametersPartial thromboplastin timeCoagulation testsFactor VIIIVWF activityChart reviewMost patientsHematology clinicProthrombin timeTissue involvementVWF antigenVon Willebrand factor antigenHigher TAT levelsMultiple coagulation parametersBaseline patient characteristicsRetrospective chart reviewCoagulation test resultsCAR T-Related Toxicities Based on Dynamic Proteomic Profiles Identifies Risk Factors for Cytokine Release Syndrome (CRS) and Immune Effector Cell -Associated Neurotoxicity Syndrome (ICANS)
Kewan T, Mirza S, Pine A, Rasheed Y, Hamouche R, Leveille E, Goshua G, Gu S, Liu Y, Vanoudenhove J, Bar N, Neparidze N, Foss F, Gowda L, Isufi I, Halene S, Lee A, Seropian S. CAR T-Related Toxicities Based on Dynamic Proteomic Profiles Identifies Risk Factors for Cytokine Release Syndrome (CRS) and Immune Effector Cell -Associated Neurotoxicity Syndrome (ICANS). Blood 2023, 142: 2132. DOI: 10.1182/blood-2023-187295.Peer-Reviewed Original ResearchCytokine release syndromeDiffuse large B-cell lymphomaCAR T-cell therapyCAR T-cell productsCAR-T productsNon-Hodgkin lymphomaBest cutoff pointMultiple myelomaHigher oddsDay 3Risk factorsTime pointsCutoff pointDay 5Day 0Median absolute lymphocyte countChimeric antigen receptor T cellsRefractory non-Hodgkin lymphomaCAR T-cell infusionAntigen receptor T cellsLarge B-cell lymphomaCAR-T activationFludarabine/cyclophosphamideHigher baseline CRPPossible inflammatory mediatorsThe Choice of Anticoagulant at First Recurrence Does Not Alter the Risk for the Second Recurrence
Muradashvili T, Restrepo V, Alameddine D, Soliman S, Feinn R, Chaar C, Lee A, Pine A. The Choice of Anticoagulant at First Recurrence Does Not Alter the Risk for the Second Recurrence. Blood 2023, 142: 5540. DOI: 10.1182/blood-2023-191084.Peer-Reviewed Original ResearchFirst VTE recurrenceDeep venous thrombosisFirst venous thromboembolismRecurrent VTE eventsVTE recurrenceVenous thromboembolismPulmonary embolismAnticoagulation regimenVTE eventsAnticoagulant regimenFirst recurrenceINR targetSecond recurrenceExact testFirst recurrent venous thromboembolismInferior vena cava atresiaLarge tertiary academic hospitalUnprovoked first venous thromboembolismMajor public health hazardDifferent anticoagulant agentsInterruption of anticoagulationCardiovascular risk factorsMay-Thurner syndromePatients 18 yearsRecurrent venous thromboembolismSetting Cost-Effective Price Thresholds before FDA Approval: Cost-Effectiveness of Iptacopan Monotherapy Versus Standard-of-Care Anti-C5 Therapy in Transfusion-Dependent, Treatment-Experienced Adult Patients with Paroxysmal Nocturnal Hemoglobinuria in the United States
Ito S, Chetlapalli K, Potnis K, Richmond R, Wang D, Lee A, Goshua G. Setting Cost-Effective Price Thresholds before FDA Approval: Cost-Effectiveness of Iptacopan Monotherapy Versus Standard-of-Care Anti-C5 Therapy in Transfusion-Dependent, Treatment-Experienced Adult Patients with Paroxysmal Nocturnal Hemoglobinuria in the United States. Blood 2023, 142: 5042. DOI: 10.1182/blood-2023-188063.Peer-Reviewed Original ResearchTreatment-experienced patientsParoxysmal nocturnal hemoglobinuriaIncremental net monetary benefitIncremental cost-effectiveness ratioNursing timeExtravascular hemolysisNocturnal hemoglobinuriaPhase III study resultsTreatment-experienced adult patientsTransfusion-associated adverse eventsCost-effective therapeutic optionAnti-C5 therapyComplement inhibition therapyComplement inhibitor therapyHealth resource utilizationCare of patientsIndirect medical costsComplement component 5Clinical trial dataLife-threatening hematological disorderCost-effectiveness ratioBreakthrough therapy designationProbabilistic sensitivity analysesFirst cost-effectiveness analysisCost-effectiveness analysisCharacterizing Outpatient Classical Hematology Referrals at an Academic Healthcare System
Chang E, Kress A, Ackermann F, Fradkin M, Halene S, Herbert E, Shomsky L, Sudhakar L, Lee A, Bona R. Characterizing Outpatient Classical Hematology Referrals at an Academic Healthcare System. Blood 2023, 142: 7196. DOI: 10.1182/blood-2023-186065.Peer-Reviewed Original ResearchIron deficiency anemiaAdvanced practice providersManual chart reviewChart reviewDeficiency anemiaHematology referralCommon diagnosisNew patientsAnemia groupDiagnosis levelClinical sitesIron deficiency groupAcademic healthcare systemHealthcare systemICD-10 codesNew patient encountersICD diagnosis codesSubstantial patient populationLevel 1 casesLevel 1Available cliniciansThrombosis groupAdditional patientsLevel 3New referralsCost-Effectiveness of Sutimlimab Versus Standard-of-Care in Transfusion Dependent Patients with Primary Cold Agglutinin Disease in the United States
Ito S, Wang D, Purcell A, Chetlapalli K, Lee A, Cuker A, Goshua G. Cost-Effectiveness of Sutimlimab Versus Standard-of-Care in Transfusion Dependent Patients with Primary Cold Agglutinin Disease in the United States. Blood 2023, 142: 2316. DOI: 10.1182/blood-2023-187270.Peer-Reviewed Original ResearchPrimary cold agglutinin diseaseCold agglutinin diseaseIncremental cost-effectiveness ratioTransfusion-dependent patientsIncremental net monetary benefitProbabilistic sensitivity analysesDistributional cost-effectiveness analysisAnemia severityBody weightPhase 3 clinical studiesHealth resource utilizationRed blood cell destructionDisease-specific mortalityHistory of transfusionAutoimmune hemolytic anemiaMarkov state transition modelCare of patientsHumanized monoclonal antibodyLower body weightBlood cell destructionCost-effectiveness ratioFDA package insertsCold-reactive antibodiesBase-case analysisCost-effectiveness analysisProteomic Profiling of Different Antiphospholipid Antibody-Positive Phenotypes: Results from Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) Registry
Pine A, Butt A, Garcia-Milian R, Gu S, Restrepo V, Chock Y, Hwa J, Tormey C, Rinder H, Goshua G, Belmont H, Bertolaccini M, Branch D, Erhan D, Kello N, Knight J, Petri M, Willis R, Lee A, Sharda A. Proteomic Profiling of Different Antiphospholipid Antibody-Positive Phenotypes: Results from Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) Registry. Blood 2023, 142: 2575. DOI: 10.1182/blood-2023-185232.Peer-Reviewed Original ResearchNeutrophil extracellular trapsAntiphospholipid syndromeHumoral immune responseImmune responseClinical phenotypePathophysiology of APSPathogenesis of APSSapporo classification criteriaAPL-positive patientsPathway enrichment analysisEffector cell differentiationAntiPhospholipid Syndrome AllianceDifferent clinical phenotypesProteomic profilingPlasma proteomic profilingPatient plasma samplesAPL antibodiesAPS pathogenesisAntiphospholipid antibodiesObstetric complicationsPositive aPLCytokine stormMedian ageMicrovascular disordersConcurrent diagnosisMultimodality Platelet Evaluation By Mass Cytometry and Genetic Analysis in Patients with Bleeding Disorders
Gu S, Gallagher P, Butt A, Gu V, Lezon-Geyda K, Schulz V, Prozora S, Lee A, Neparidze N, Bar N, Martin K, Cornell J, Chirico G, Chakraborty R, Rinder H, Hwa J, Bona R. Multimodality Platelet Evaluation By Mass Cytometry and Genetic Analysis in Patients with Bleeding Disorders. Blood 2023, 142: 1197. DOI: 10.1182/blood-2023-177946.Peer-Reviewed Original ResearchBleeding tendencyBleeding disorderPlatelet markersPlatelet aggregometryMass cytometryPlatelet functionPlatelet disordersSingle-center prospective studyLow-risk groupAbnormal bleeding tendencyQualitative platelet disordersLarge patient cohortQuantitative platelet disordersCommon underlying causeGenetic variantsMultimodality evaluationTotal patientsRisk stratificationLaboratory suspicionPlatelet dysfunctionProspective studyPatient cohortUnivariate analysisPlatelet volumeRisk groupsBurnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support
Lee A, Masselink LE, De Castro LM, Marshall AL, Connell NT, Dent GA, Fritz J, Homer M, Lucas TL, Naik RP, Nelson M, O’Connell C, Rajasekhar A, Reynolds R, Sharma D, Smith M, Weeks LD, Erikson CE. Burnout in US hematologists and oncologists: impact of compensation models and advanced practice provider support. Blood Advances 2023, 7: 3058-3068. PMID: 35476017, PMCID: PMC10331414, DOI: 10.1182/bloodadvances.2021006140.Peer-Reviewed Original ResearchConceptsCommunity physiciansProvider supportMultivariate logistic regression modelOverall survey response rateClinical support staffCommunity practiceLogistic regression modelsHigh burnoutUS hematologistsSurvey response rateComplete responseFemale genderAMA MasterfileResponse rateSignificant associationHematologistsOncologistsFinal analysisPhysiciansLarge-scale studiesProvider UtilizationPractice surveyAmerican SocietyOne-thirdPhysician compensationImpact of Prophylactic Antibacterials on Coagulation Profiles and Bleeding in Patients with Acute Myeloid Leukemia/Myelodysplastic Syndrome
Allen C, Gautam S, Cheng W, Pine A, Podoltsev N, Zeidan A, Lee A, Shallis R. Impact of Prophylactic Antibacterials on Coagulation Profiles and Bleeding in Patients with Acute Myeloid Leukemia/Myelodysplastic Syndrome. Acta Haematologica 2023, 146: 287-292. PMID: 37166332, DOI: 10.1159/000530153.Peer-Reviewed Original ResearchConceptsAML/myelodysplastic syndromeAcute myeloid leukemiaInternational normalized ratioAntibacterial prophylaxisMyelodysplastic syndromeProphylactic antibacterialsCoagulation profileAcute myeloid leukemia/myelodysplastic syndromeDiagnosis of AMLHigher international normalized ratioLeukemia/myelodysplastic syndromePartial thromboplastin time prolongationYale-New Haven HospitalYale-New HavenRetrospective cohort studyAbnormal coagulation profileGroup of patientsTime of admissionHigh rateIndividual patient encountersInstitutional review boardAntibacterial exposureRelevant bleedingAdult patientsCohort studySummiting thrombotic hazards in glioma
Goshua G, Lee A. Summiting thrombotic hazards in glioma. Blood 2023, 141: 1245-1246. PMID: 36929442, DOI: 10.1182/blood.2022019020.Peer-Reviewed Original Research