- Pediatric Hematology-Oncology
- Relapsed leukemia
- Infectious complication of oncology treatment
- Fungal infections
Clinical Assistant Professor, Pediatrics - Hematology & Oncology
Honors & Awards
AOA, Medical Honor Society (2007)
Fellow, Rachleff Hem-Onc Pediatric Fellowship fund (2012-2013)
Board Certification: Pediatrics, American Board of Pediatrics (2010)
Board Certification: Pediatric Hematology-Oncology, American Board of Pediatrics (2015)
Medical Education:Tufts University School of Medicine (2007) MA
Residency:Massachusetts General HospitalMA
Internship:Massachusetts General HospitalMA
Fellowship:Lucile Packard Children's HospitalCA
Chief Resident, Massachusetts General Hospital for Children, Pediatrics (2011)
Resident, Massachusetts General Hospital for Children, Pediatrics (2010)
Doctor of Medicine, Tufts University School of Medicine (2007)
Current Research and Scholarly Interests
I am interested in the prevention and management of infectious complication in pediatric oncology patients. I am also interested in developing a protocol for the management of low risk patients with fever and neutropenia.
Evaluation of Febrile, Nonneutropenic Pediatric Oncology Patients with Central Venous Catheters Who Are Not Given Empiric Antibiotics
JOURNAL OF PEDIATRICS
2015; 166 (1): 157-162
To evaluate the practice of empiric antibiotics for febrile, nonneutropenic pediatric oncology patients with a central venous catheter (CVC) in place.Episodes of fever without neutropenia (absolute neutrophil count [ANC] ≥500 cells/mm(3)) were reviewed retrospectively in pediatric oncology patients with a CVC undergoing chemotherapy. Characteristics and symptoms were compared between patients with bacteremia and patients without bacteremia.A total of 392 episodes of nonneutropenic fever in 138 subjects (52 females; 38%) were reviewed. In this cohort, the median age at an episode was 7 years, and the majority of patients had a diagnosis of acute leukemia (54%). Median ANC was 3100 cells/mm(3) (IQR, 1570-5980 cells/mm(3)). Median temperature was 38.7°C (IQR, 38.3-39.2°C). Twenty-four infectious episodes (6%) occurred in 18 subjects, and 5 CVCs required removal; all patients requiring removal admitted and received antibiotics owing to chills. There were no significant difference in age, sex, or ANC between patients with bacteremia and those without bacteremia; however, mean temperature was higher in the patients with bacteremia (39.4°C vs 38.7°C; P = .003). No deaths due to sepsis occurred, and no CVCs were removed because antibiotics were not administered empirically.Our practice of observing pediatric oncology patients undergoing chemotherapy with CVCs who are not neutropenic does not appear to lead to increased serious adverse outcomes and avoids antibiotic exposure for >90% of patients without a bacterial infection.
View details for DOI 10.1016/j.jpeds.2014.09.008
View details for Web of Science ID 000346584000032
View details for PubMedID 25444524
The Neutropenic Diet ... Still Ageless? C. Aftandilian Article Reviewed
2012; 26 (6): 586-589
View details for Web of Science ID 000305794100012
The neutropenic diet... still ageless?
Oncology (Williston Park, N.Y.)
2012; 26 (6): 586-?
View details for PubMedID 22870544
Burkitt Lymphoma With Pancreatic Involvement
JOURNAL OF PEDIATRIC HEMATOLOGY ONCOLOGY
2010; 32 (8): E338-E340
A 10-year-old boy was referred to our clinic for tonsillectomy and was found to have a large mass within his oropharynx. Intraoperative biopsies confirmed Burkitt lymphoma. Further imaging and biopsy revealed pancreatic involvement. He was treated with multiagent chemotherapy. He remains disease-free 6 years later. Review of the literature demonstrates other cases of non-Hodgkin lymphoma with pancreatic involvement with good outcomes. Pancreatic involvement is a relatively rare occurrence in childhood lymphoma.
View details for DOI 10.1097/MPH.0b013e3181ed1178
View details for Web of Science ID 000283538300021
View details for PubMedID 20930650
Group therapy for substance use disorders: What do we know?
HARVARD REVIEW OF PSYCHIATRY
2004; 12 (6): 339-350
Although group therapy is the most prevalent treatment modality for substance use disorders, an up-to-date review of treatment outcome literature does not exist. A search of the literature yielded 24 treatment outcome studies comparing group therapy to other treatment conditions. These studies fell into one of six research design categories: (1) group therapy versus no group therapy; (2) group therapy versus individual therapy; (3) group therapy plus individual therapy versus group therapy alone; (4) group therapy plus individual therapy versus individual therapy alone; (5) group therapy versus another group therapy with different content or theoretical orientation; and (6) more group therapy versus less group therapy. In general, treatment outcome studies did not demonstrate differences between group and individual modalities, and no single type of group therapy reliably demonstrated greater efficacy than others. Unique methodological and logistical hurdles encountered in research on group therapy for substance use disorders, as well as considerations for future research, are also discussed.
View details for DOI 10.1080/1067322049095723
View details for Web of Science ID 000226593100004
View details for PubMedID 15764469
Requiring remission of undue influence of weight and shape on self-evaluation in the definition of recovery for bulimia nervosa
INTERNATIONAL JOURNAL OF EATING DISORDERS
2003; 34 (2): 200-210
The current study evaluated the concurrent validity of requiring remission of undue influence of weight and shape on self-evaluation (undue influence) in defining recovery from bulimia nervosa (BN).Three groups completed the Beck Depression Inventory, the Mood and Anxiety Symptom Questionnaire, the Body Shape Questionnaire, and the Social Adjustment Scale: 31 women were fully recovered from BN (FR), 28 women had no behavioral symptoms of BN (partially recovered [PR]), and 59 matched non-eating-disordered controls (MC).The PR group had more pathologic scores on depression, anxiety, body dissatisfaction, and social adjustment compared with both the FR and MC groups, which did not differ from each other.These findings suggest that including remission of cognitive symptoms in a standardized definition of recovery may prove to be clinically useful in establishing reliable prognostic indicators. Future research should evaluate the role played by cognitive symptoms in triggering relapse.
View details for DOI 10.1002/eat.10187
View details for Web of Science ID 000184510900003
View details for PubMedID 12898556