I was born in Oregon and raised in Iowa, where I cultivated my initial interest in science and medicine. I completed my undergraduate degree and medical school at the University of Iowa before heading to Stanford University for my internal medicine residency and oncology fellowship training. I chose this field to try my best in assisting patients during times of great need, and working to understand what is of greatest importance to them as they navigate their unique journey of cancer care. My clinical focus is in the care of patients with lymphoma and other hematologic cancers. My scholarly interests include better understanding the efficacy cancer therapeutics, improving patients' experience as the proceed through treatment, and promoting strength in medical education.

Honors & Awards

  • Stanford Hematology and Oncology Fellowship Humanism Award, Stanford University School of Medicine, Divisions of Hematology and Oncology (2020)
  • Timothy F. Beckett, Jr. Award for Best Clinical Teaching by a Medicine Fellow, Stanford University School of Medicine, Department of Internal Medicine (2018)
  • Award for Best Clinical Teaching by a Medicine Resident, Stanford University School of Medicine, Department of Internal Medicine (2017)
  • Charles Dorsey Armstrong Award for Clinical Excellence in Patient Care, Stanford University School of Medicine, Department of Internal Medicine (2017)
  • Julian Wolfsohn Award for Outstanding Performance in Internal Medicine, Stanford University School of Medicine, Department of Internal Medicine (2017)
  • Medical Student Education Award, Stanford University School of Medicine (2015)
  • William R. Wilson Award for Outstanding Performance in Internal Medicine by a Senior Medical Student, Carver College of Medicine, University of Iowa (2014)

Boards, Advisory Committees, Professional Organizations

  • Member, American Society of Clinical Oncology (2017 - Present)
  • Member, American Society of Hematology (2016 - Present)
  • Member, American College of Physicians (2014 - Present)

Professional Education

  • Fellowship, Stanford University, Hematology and Oncology (2020)
  • Residency, Stanford University, Internal Medicine (2017)
  • MD, Carver College of Medicine, University of Iowa (2014)
  • BS, University of Iowa, Biomedical Engineering (2010)

All Publications

  • Sequential Pembrolizumab and AVD is Highly Effective at any PD-L1 Expression Level in Untreated Hodgkin Lymphoma. Blood advances Allen, P. B., Lu, X., Chen, Q., Kane, K. L., Chmiel, J. S., Barnea Slonim, L., Sukhanova, M., Savas, H., Evens, A. M., Advani, R., Pro, B., Karmali, R., Palmer, B., Bayer, R., Eisner, R. M., Mou, E., Dillehay, G., Gordon, L. I., Winter, J. N. 2022


    In a multicenter, phase II investigator-initiated trial of sequential pembrolizumab and AVD, nearly two-thirds of patients with untreated unfavorable or advanced stage classic Hodgkin Lymphoma (cHL) achieved PET-defined complete or near complete metabolic responses (CMR) following 3 doses of pembrolizumab monotherapy. Furthermore, all achieved CMR following 2 cycles of AVD chemotherapy and 100% of patients were alive without relapse at the time of initial publication. We now report long-term follow-up, including 3-year OS and planned correlative analyses. Thirty patients received single agent pembrolizumab every 3 weeks x 3, followed by AVD chemotherapy for 4-6 cycles depending on stage and bulk. PET/CT scan was performed after pembrolizumab monotherapy, 2 cycles of AVD, and at the end of therapy. Baseline biopsy samples were analyzed for genomic alterations of chromosome 9p24.1 and PD-1 pathway markers by immunohistochemistry. At a median follow up of 33.1 months (range, 26.0-43.0), PFS and OS remain 100%. All patients had genomic alterations in 9p24.1 and were positive for PD-L1 by immunohistochemistry. There was no relationship between response to single agent pembrolizumumab measured by decline in metabolic tumor volume and 9p24.1 alterations or PD-1 pathway H-scores. With additional follow-up, sequential pembrolizumab and AVD remains highly effective. The high response rates observed at all PD-ligand levels suggest that even low levels of PD ligand expression are sufficient for response to PD-1 blockade in untreated cHL. An international phase II trial (NCT05008224) to confirm these findings is ongoing.

    View details for DOI 10.1182/bloodadvances.2022008116

    View details for PubMedID 36083129

  • Global Cytopathology-Hematopathology Practice Trends. American journal of clinical pathology Zadeh, S. L., Balassanian, R., Cheung, M. C., Falchi, L., Hasserjian, R., Lin, O., Long, S. R., Menke, J. R., Mou, E., Natkunam, Y., Ruiz-Cordero, R., Volaric, A. K., Wang, L., Wen, K. W., Gratzinger, D. 2021


    OBJECTIVES: Small-volume biopsy-fine-needle aspiration biopsy (FNAB) with or without core biopsy-is in increasing use in diagnosis and management of lymphoma patients. Our objective was to survey the current practice in small-volume biopsy diagnosis of lymphoma, focusing on the interaction among hematopathologists and cytopathologists and the integration of FNAB, core biopsy, and flow cytometry studies at sign-out.METHODS: This study used a cross-sectional survey design employing the RedCap database distributed via nine pathology professional society email listservs. The survey consisted of 25 multiple-choice questions and several free text fields. In total, 128 pathologists participated.RESULTS: Most respondents indicated that FNAB specimens in which lymphoma is a diagnostic consideration (FNAB-L) are seen daily or weekly (68/116; 58.6%). However, most institutions have separate hematopathology and cytopathology services (72/116; 62.1%) with inconsistent communication. When communication occurred, respondents were frequently inclined to reconsider their original diagnoses. Barriers identified included lack of communication, inadequate access to diagnostic studies, no formal subspecialty training, and various opinions regarding FNAB in diagnosing lymphoma.CONCLUSIONS: This survey showed that FNAB-L specimens are common, with a lack of uniformity in how complementary fine-needle aspiration and core biopsy specimens or flow immunophenotyping results are shared across hematopathology and cytopathology services.

    View details for DOI 10.1093/ajcp/aqab111

    View details for PubMedID 34508545

  • Multicenter analysis of geriatric fitness and real-world outcomes in older patients with classical Hodgkin lymphoma. Blood advances Orellana-Noia, V. M., Isaac, K., Malecek, M., Bartlett, N. L., Voorhees, T. J., Grover, N. S., Hwang, S. R., Bennani, N. N., Hu, R., Hill, B. T., Mou, E., Advani, R., Carter, J., David, K. A., Ballard, H. J., Svoboda, J., Churnetski, M. C., Magarelli, G., Feldman, T., Cohen, J. B., Evens, A. M., Portell, C. 2021


    We performed a multicenter retrospective analysis across 10 US academic medical centers (2010 - 2018) to evaluate current treatment patterns and outcomes in patients age ≥60 with classical Hodgkin lymphoma (cHL). Among 244 eligible patients, median age was 68, 63% had advanced stage (III/IV), 14% had ECOG performance status (PS) 2-4, and 12% had documented loss of ≥1 activity of daily living (ADLs). Medical comorbidities were assessed by the Cumulative Illness Rating Scale - Geriatric (CIRS-G), where n=44 (18%) had total scores ≥10. Using multivariable Cox models, only ADL loss predicted shorter progression-free (PFS; HR 2.13, p=0.007) and overall survival (OS; HR=2.52, P=0.02). Most patients (n=203, 83%) received conventional chemotherapy regimens, including ABVD (56%), AVD (14%), and AVD with brentuximab vedotin (BV; 9%). Compared to alternative therapies, conventional regimens significantly improved PFS (HR 0.46, P=0.0007) and OS (HR 0.31, p=0.0003). Survival was similar following conventional chemotherapy in those ages 60-69 vs ≥70: PFS HR 0.88, p=0.63; OS HR 0.73, p=0.55. Early treatment discontinuation due to toxicity was more common with CIRS-G ≥10 (28 vs 12%, p=0.016) or documented geriatric syndrome (28 vs 13%, p=0.02). A competing risk analysis demonstrated improved disease-related survival with conventional therapy (HR 0.29, p=0.02) and higher mortality from causes other than disease or treatment in those with high CIRS-G or geriatric syndromes. These data suggest conventional chemotherapy regimens be considered standard of care in fit older patients with cHL, and highlights the importance of geriatric assessments in defining fitness for cHL therapy going forward.

    View details for DOI 10.1182/bloodadvances.2021004645

    View details for PubMedID 34448831

  • Impact of initial biopsy type on the time to final diagnostic biopsy in patients with follicular lymphoma and suspected histologic transformation. Leukemia & lymphoma Mou, E., Falchi, L., Sundaram, V., Abramson, J. S., Balassanian, R., Beygi, S., Fitzpatrick, M. J., Frank, A. K., Gupta, S., Lin, O., Long, S. R., Menke, J. R., Reed, D. R., Ruiz-Cordero, R., Volaric, A. K., Xie, Y., Wang, L., Wen, K. W., Zadeh, S. L., Natkunam, Y., Cheung, M. C., Gratzinger, D., Cyto-Heme Institutional Collaborative (CHIC) consortium 2021: 1-9


    Diagnosis of histologic transformation (HT) of follicular lymphoma (FL) requires tissue biopsy. While surgical biopsy represents the gold standard, less invasive procedures such as fine-needle aspiration biopsy (FNAB) and core needle biopsy (CNB) are frequently performed. In this retrospective multi-institutional study including 269 patients with FL and suspected HT, the median time from initial clinical suspicion to final diagnostic biopsy was similar whether the workup began with FNAB, CNB, or surgical biopsy (4, 9, and 6days, respectively; p=.27), despite more subsequent biopsies performed following initial FNAB. Periprocedural complications were uniformly minimal. Biopsy-proven HT was more common in the initial surgery group and in workups including positron emission tomography/computed tomography (PET/CT). Our findings, derived from US academic centers with specialized procedural and pathology expertise, suggest that FNAB, CNB, and surgical biopsy are all viable initial diagnostic procedures that can inform clinical decision-making in select FL patients with suspected HT.

    View details for DOI 10.1080/10428194.2021.1941936

    View details for PubMedID 34176413

  • A randomized study of a best practice alert for platelet transfusions. Vox sanguinis Murphy, C., Mou, E., Pang, E., Shieh, L., Hom, J., Shah, N. 2021


    BACKGROUND AND OBJECTIVES: Inappropriate platelet transfusions represent an opportunity for improvements in patient care. Use of a best practice alert (BPA) as clinical decision support (CDS) for red cell transfusions has successfully reduced unnecessary red blood cell (RBC) transfusions in prior studies. We studied the impact of a platelet transfusion BPA with visibility randomized by patient chart.MATERIALS AND METHODS: A BPA was built to introduce CDS at the time of platelet ordering in the electronic health record. Alert visibility was randomized at the patient encounter level. BPA eligible platelet transfusions for patients with both visible and non-visible alerts were recorded along with reasons given for override of the BPA. Focused interviews were performed with providers who interacted with the BPA to assess its impact on their decision making.RESULTS: Over a 9-month study period, 446 patient charts were randomized. The visible alert group used 25.3% fewer BPA eligible platelets. Mean monthly usage of platelets eligible for BPA display was 65.7 for the control group and 49.1 for the visible alert group (p=0.07). BPA-eligible platelets used per inpatient day at risk per month were not significantly different between groups (2.4 vs. 2.1, p=0.53).CONCLUSION: It is feasible to study CDS via chart-based randomization. A platelet BPA reduced total platelets used over the study period and may have resulted in $151,069 in yearly savings, although there were no differences when adjusted for inpatient days at risk. During interviews, providers offered additional workflow insights allowing further improvement of CDS for platelet transfusions.

    View details for DOI 10.1111/vox.13132

    View details for PubMedID 34081800

  • Type of tissue biopsy and outcomes in diffuse large B-cell lymphoma (DLBCL). Desai, S., Mwangi, R., King, R. L., Maurer, M. J., Cerhan, J., Feldman, A. L., Habermann, T., Mou, E., Farooq, U., Thompson, C. A., Wang, Y., Witzig, T. E., Nowakowski, G. S. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Hodgkin Lymphoma Williams Hematology, 10th ed. Spinner, M., Mou, E., Advani, R. McGraw-Hill. 2021
  • Pembrolizumab followed by AVD in untreated early unfavorable and advanced stage classical Hodgkin lymphoma. Blood Allen, P. B., Savas, H. n., Evens, A. M., Advani, R. n., Palmer, B. n., Pro, B. n., Karmali, R. n., Mou, E. n., Bearden, J. n., Dillehay, G. n., Bayer, R. n., Eisner, R. M., Chmiel, J. S., O'Shea, K. L., Gordon, L. I., Winter, J. N. 2020


    Pembrolizumab, a humanized IgG4 monoclonal antibody targeting programmed death-1 protein, has demonstrated efficacy in relapsed/refractory classical Hodgkin lymphoma (cHL). To assess the complete metabolic response (CMR) rate and safety of pembrolizumab monotherapy in newly diagnosed cHL, we conducted a multicenter, single-arm, phase II investigator-initiated trial of sequential pembrolizumab and doxorubicin, vinblastine, and dacarbazine (AVD) chemotherapy. Patients > 18 years of age with untreated early unfavorable or advanced stage disease were eligible for treatment. Thirty patients with either early unfavorable (n=12) or advanced (n=18) stage cHL were treated with 3 cycles of pembrolizumab monotherapy followed by AVD for 4-6 cycles depending on stage and bulk. Twelve had either large mediastinal masses and/or bulky disease (>10 cm). Following pembrolizumab monotherapy, 11 patients (37%) demonstrated CMR's, and an additional 7 of 28 (25%) patients with quantifiable positron emission tomography/computed tomography scanning (PET-CT) had >90% reductions in metabolic tumor volume. All patients achieved CMR following 2 cycles of AVD and maintained their responses at end of treatment. With a median follow-up of 22.5 months (range: 14.2-30.6) there have been no changes in therapy, progressions, or deaths. No patients received consolidation radiotherapy, including those with bulky disease. Therapy was well-tolerated. The most common immune-related adverse events were grade 1 rash (n=6), and grade 2 infusion reactions (n=4). One patient had a reversible grade 4 transaminitis and a second had a reversible Bell's palsy. Brief pembrolizumab monotherapy followed by AVD proved both highly effective and safe in newly diagnosed cHL patients including those with bulky disease. This trial was registered at as #NCT03226249.

    View details for DOI 10.1182/blood.2020007400

    View details for PubMedID 32992341

  • Long-Term Outcomes of Patients with Early-Stage Non-Bulky Hodgkin Lymphoma Treated with Combined Modality Therapy on the Stanford V Trials (The G4 and G5 Studies). International journal of radiation oncology, biology, physics Mou, E. n., Advani, R. H., von Eyben, R. n., Rosenberg, S. A., Hoppe, R. T. 2020


    Combined modality therapy (CMT) is standard therapy for early-stage Hodgkin lymphoma (ESHL). We previously reported excellent outcomes with the abbreviated Stanford V regimen. Herein we report updated results with median follow-up >10 years on survival, therapy-related late effects, and impact of disease risk factors on patient outcomes.The XXXXXX and YYYYYY studies enrolled patients with stage I-IIA non-bulky ESHL. Patients received eight weeks of Stanford V chemotherapy followed by 30 Gy modified involved-field radiotherapy (mIFRT) (XXXXXX) or Stanford V-C + 20 Gy mIFRT (YYYYYY). Patients were categorized as favorable or unfavorable risk per German Hodgkin Study Group (GHSG) criteria and outcomes between groups compared.129 patients were enrolled (68 favorable and 61 unfavorable risk). In the XXXXXX study (n = 87), at median follow-up of 19.7 years, 5-, 10-, and 15-year PFS and OS were 95.4%/97.7%, 91.8%/96.5%, and 91.8%/95.3%, respectively. In the YYYYYY study (n = 42), at median follow-up of 13.5 years, the 5-, 10-, and 15-year PFS and OS were 92.9%/100%, 92.9%/100%, and 88.4%/91.9%, respectively. PFS (p = 0.86) and OS (p = 0.86) were not significantly different between studies. There were also no significant differences between studies in patients with favorable or unfavorable risk for PFS (F: p = 0.53; U: p = 0.96), OS (F: p = 0.99; U: p = 0.78), secondary malignancies (F: p = .74; U: p = 1.0), and cardiovascular complications (F: no cases; U: p = 1.0).The XXXXXX and YYYYYY studies achieve high rates of durable remission. 20 versus 30 Gy mIFRT and cyclophosphamide substituted for mechlorethamine did not compromise nodal control, PFS, or OS in both favorable and unfavorable risk disease. These results support the efficacy of CMT in early-stage disease and lower-dose radiotherapy in patients with favorable and non-bulky unfavorable ESHL.

    View details for DOI 10.1016/j.ijrobp.2020.12.039

    View details for PubMedID 33385495

  • Thrombophilia testing in the inpatient setting: impact of an educational intervention. BMC medical informatics and decision making Kwang, H. n., Mou, E. n., Richman, I. n., Kumar, A. n., Berube, C. n., Kaimal, R. n., Ahuja, N. n., Harman, S. n., Johnson, T. n., Shah, N. n., Witteles, R. n., Harrington, R. n., Shieh, L. n., Hom, J. n. 2019; 19 (1): 167


    Thrombophilia testing is frequently ordered in the inpatient setting despite its limited impact on clinical decision-making and unreliable results in the setting of acute thrombosis or ongoing anticoagulation. We sought to determine the effect of an educational intervention in reducing inappropriate thrombophilia testing for hospitalized patients.During the 2014 academic year, we implemented an educational intervention with a phase implementation design for Internal Medicine interns at Stanford University Hospital. The educational session covering epidemiology, appropriate thrombophilia evaluation and clinical rationale behind these recommendations. Their ordering behavior was compared with a contemporaneous control (non-medicine and private services) and a historical control (interns from prior academic year). From the analyzed data, we determined the proportion of inappropriate thrombophilia testing of each group. Logistic generalized estimating equations were used to estimate odds ratios for inappropriate thrombophilia testing associated with the intervention.Of 2151 orders included, 934 were deemed inappropriate (43.4%). The two intervention groups placed 147 orders. A pooled analysis of ordering practices by intervention groups revealed a trend toward reduction of inappropriate ordering (p = 0.053). By the end of the study, the intervention groups had significantly lower rates of inappropriate testing compared to historical or contemporaneous controls.A brief educational intervention was associated with a trend toward reduction in inappropriate thrombophilia testing. These findings suggest that focused education on thrombophilia testing can positively impact inpatient ordering practices.

    View details for DOI 10.1186/s12911-019-0889-6

    View details for PubMedID 31429747

  • An Electronic Best Practice Alert Based on Choosing Wisely Guidelines Reduces Thrombophilia Testing in the Outpatient Setting JOURNAL OF GENERAL INTERNAL MEDICINE Jun, T., Kwang, H., Mou, E., Berube, C., Bentley, J., Shieh, L., Hom, J. 2019; 34 (1): 29-30
  • The Power of Trust JAMA ONCOLOGY Mou, E., Schapira, L., Kunz, P. 2018; 4 (9): 1173–74
  • Magnitude of Potentially Inappropriate Thrombophilia Testing in the Inpatient Hospital Setting. Journal of hospital medicine Mou, E. n., Kwang, H. n., Hom, J. n., Shieh, L. n., Kumar, A. n., Richman, I. n., Berube, C. n. 2017; 12 (9): 735–38


    Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule. Of the 1817 orders analyzed, 777 (42.7%) were potentially inappropriate, with an associated cost of $40,422. The tests most frequently inappropriately ordered were Factor V Leiden, prothrombin gene mutation, protein C and S activity levels, antithrombin activity levels, and the lupus anticoagulant. Potentially inappropriate thrombophilia testing is common and costly. These data demonstrate a need for institution-wide changes in order to reduce unnecessary expenditures and improve patient care.

    View details for PubMedID 28914278