Clinical Focus
- Cancer > Hematology
- Hematology
Professional Education
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Board Certification: American Board of Internal Medicine, Internal Medicine (1990)
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Medical Education: Icahn School of Medicine at Mount Sinai (1987) NY
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Residency: Harbor UCLA Internal Medicine Residency (1990) CA
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Internship: Harbor UCLA Internal Medicine Residency (1988) CA
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Fellowship: University of Rochester Hematology and Oncology Fellowship (1996) NY
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Fellowship: University of Rochester Hematology and Oncology Fellowship (1994) NY
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Board Certification: American Board of Internal Medicine, Medical Oncology (1995)
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Board Certification: American Board of Internal Medicine, Hematology (1994)
All Publications
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Daratumumab, Lenalidomide, and Dexamethasone (DRD), an Active Regimen in the Treatment of Immunosuppression-Associated Plasmablastic Lymphoma (PBL) in the Setting of Gorham's Lymphangiomatosis: Review of the Literature.
Case reports in hematology
2022; 2022: 8331766
Abstract
Characterized by an aggressive course with a poor overall survival due to treatment refractoriness, plasmablastic lymphoma (PBL) is a rare variant of diffuse large cell B cell lymphoma. Gorham's lymphangiomatosis or Gorham-Stout disease (GSD) is a rare skeletal condition of unknown etiology characterized by progressive bone loss and nonmalignant proliferation of vascular and lymphatic channels within the affected bone. Neither disease has a standard of care. We present a 23-year-old HIV-negative woman with GSD, managed medically with octreotide and sirolimus, who developed PBL. After progressing on V-EPOCH (bortezomib, etoposide, vincristine, cyclophosphamide, doxorubicin, and prednisone), she was treated with daratumumab, lenalidomide, and dexamethasone (DRD) therapy and achieved complete remission after two cycles with progression after eight cycles. This is a report of treatment of PBL with DRD therapy. Clinical investigations of the DRD regimen in PBL in conjunction with other agents to improve both depth and durability of response are warranted.
View details for DOI 10.1155/2022/8331766
View details for PubMedID 35795542
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Rare and fatal complication of immune checkpoint inhibition: a case report of haemophagocytic lymphohistiocytosis with severe lichenoid dermatitis.
British journal of haematology
2021
View details for DOI 10.1111/bjh.17442
View details for PubMedID 33954981
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Daratumumab, Lenalidomide, and Dexamethasone (DRD), an Active Regimen in the Treatment of Sirolimus-Associated Plasmablastic Lymphoma (PBL) in the Setting of Gorham's Lymphangiomatosis: A Case Report
CIG MEDIA GROUP, LP. 2020: S275
View details for Web of Science ID 000564055100270
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Successful treatment of thrombocytopenia with daratumumab after allogeneic transplant: a case report and literature review.
Blood advances
2020; 4 (5): 815–18
View details for DOI 10.1182/bloodadvances.2019001215
View details for PubMedID 32119735
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STAGE IV EPSTEIN-BARR VIRUS (EBV) CLASSIC HODGKIN LYMPHOMA (CHL) WITH HEPATIC INVOLVEMENT MEETING CRITERIA FOR HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH) AT STANFORD: CLOSE MIMIC VERSUS TRUE HLH?
WILEY. 2019: S29–S30
View details for Web of Science ID 000449991100059
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PROCALCITONIN IS NONSPECIFICALLY ELEVATED IN ADULT HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS
WILEY. 2019: S24
View details for Web of Science ID 000449991100049
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A Case Report of Refractory Immune Thrombocytopenia (ITP) Following Reduced Intensity Conditioning (RIC) Hematopoietic Cell Transplantation (HCT) for Myelodysplastic Syndrome (MDS) Successfully Treated with Off-Label Use of Daratumumab
AMER SOC HEMATOLOGY. 2018
View details for DOI 10.1182/blood-2018-99-116560
View details for Web of Science ID 000454842805252
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Bone marrow histomorphological criteria can accurately diagnose hemophagocytic lymphohistiocytosis
HAEMATOLOGICA
2018; 103 (10): 1635–41
View details for DOI 10.3324/haematol.2017.186627
View details for Web of Science ID 000445883500026
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Orbital and chorioretinal manifestations of Erdheim-Chester disease treated with vemurafenib.
American journal of ophthalmology case reports
2018; 11: 158–63
Abstract
Purpose: We report a patient with severe multi-organ dysfunction of unknown origin who presented with bilateral orbital and chorioretinal manifestations that led to the diagnosis of Erdheim-Chester Disease (ECD).Observations: ECD is a rare, histiocytic, proliferative disorder characterized by multi-systemic organ involvement that has historically lacked effective therapy. Our patient underwent genetic testing that was positive for the BRAF V600E mutation; therefore, the patient was treated with vemurafenib.Conclusions and importance: This case demonstrates the rare orbital and intraocular manifestations of ECD and the unfortunate impact of a delayed diagnosis, the importance of early gene therapy testing for management decisions, and the utilization of targeted directed therapy to improve visual outcomes and quality of life.
View details for PubMedID 30094395
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Bone marrow histomorphologic criteria can accurately diagnose hemophagocytic lymphohistiocytosis.
Haematologica
2018
Abstract
Hemophagocytic lymphohistiocytosis is a rare multi-system inflammatory disorder with diagnostic criteria based on the HLH-2004 trial. Hemophagocytosis is the only histomorphologic criterion, but in isolation is neither specific nor sensitive for the diagnosis of hemophagocytic lymphohistiocytosis. While objective thresholds for clinical and laboratory criteria have been established, specific criteria for histomorphologic evidence of hemophagocytosis in hemophagocytic lymphohistiocytosis have not been rigorously evaluated or established. We sought to determine if numerical and objective criteria for morphologic hemophagocytosis could be identified, and if such criteria would aid in the diagnosis of hemophagocytic lymphohistiocytosis. We analyzed the morphologic features of hemophagocytosis in 78 patients presenting with clinical features suspicious for hemophagocytic lymphohistiocytosis: 40 patients with hemophagocytic lymphohistiocytosis and 38 patients without hemophagocytic lymphohistiocytosis. We demonstrate that non-nucleated erythrophagocytosis alone is a non-specific finding, while hemophagocytosis of granulocytes (1 per 1000 cells, area under the curve: 0.92, 95% confidence interval: 0.86, 0.99), nucleated erythrocytes (4 per 1000 cells, area under the curve: 0.92, 95% confidence interval: 0.87, 0.98), and at least one hemophagocyte containing multiple nucleated cells (area under the curve: 0.91, 95% confidence interval: 0.85, 0.95) are strongly associated with hemophagocytic lymphohistiocytosis. Joint modeling of hemophagocytes containing engulfed granulocytes, nucleated erythrocytes, and lymphocytes effectively distinguished between hemophagocytic lymphohistiocytosis and non-hemophagocytic lymphohistiocytosis (cross-validated area under curve: 0.90, 95% confidence interval: 0.83, 0.97).
View details for PubMedID 29903767
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HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS ASSOCIATED WITH IMPLANTATION OF VENTRICULAR ASSIST DEVICES AND OUTCOMES FOLLOWING SUBSEQUENT ORTHOTROPIC HEART TRANSPLANTATION (OHT)
ELSEVIER SCIENCE INC. 2017: 864
View details for Web of Science ID 000397342301386
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Persistent Fever Can be Associated with Transient but Severe Hemophagocytic Lymphohistiocytosis (HLH) in Adult Recipients of Ventricular Assist Devices (VAD) for Treatment of Cardiomyopathy (CM)
AMER SOC HEMATOLOGY. 2016
View details for Web of Science ID 000394452701099
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YTIC Lymphohistiocytosis (HLH) in Adult Recipients of Ventricular Assist Devices (VADS) for Cardiomyopathy (CM) and Favorable Outcomes in Subsequent Orthotopic Heart Transplantation (OHT)
WILEY-BLACKWELL. 2016: S49
View details for Web of Science ID 000383581100088
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G-CSF Dosing to Prevent Recurrent Clozapine-Induced Agranulocytosis
AMERICAN JOURNAL OF PSYCHIATRY
2016; 173 (6): 643-643
View details for DOI 10.1176/appi.ajp.2016.15101303
View details for PubMedID 27245191
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Thalidomide for treatment of gastrointestinal angiodysplasia in patients with left ventricular assist devices: Case series and treatment protocol.
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
2015; 34 (1): 132–34
View details for PubMedID 25447569
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High-dose cyclophosphamide in refractory myasthenia gravis with MuSK antibodies
MUSCLE & NERVE
2006; 33 (3): 433-435
Abstract
We describe a 48-year-old woman with seronegative myasthenia gravis (MG) and high-titer of anti-MuSK antibody. She had severe bulbar and respiratory weakness with minimal limb weakness for 2 years. Her disease responded poorly to all the conventional immunosuppressive regimens. Treatment with immunoablative dose of cyclophosphamide led to dramatic and sustained remission of her symptoms. High-dose cyclophosphamide is an effective alternative in patients with unusually refractory disease.
View details for DOI 10.1002/mus.20411
View details for PubMedID 16116645