Bio
As the Chief Medical Officer of Cancer Care at Stanford Health Care, it is my privilege to partner with my colleagues in advancing innovative research alongside high quality, coordinated, and compassionate care.
I aim to provide high quality care in a diverse patient practice. My clinic includes all types of hematologic disorders, ranging from anemia, clotting/bleeding disorders, and low blood counts to complex malignancies such as leukemia, myelodysplastic syndrome, myeloma, and lymphoma. I aim to combine the efficiency of a private office with the complex care expected of a tertiary institution like Stanford. I value your time and strive to maintain an on-schedule clinic.
Clinical Focus
- Cancer > Hematology
- Hematology
- Oncology
Administrative Appointments
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Chief Medical Officer, Cancer Care, Stanford Health Care (2025 - Present)
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Ann and John Doerr Medical Director of the Stanford Cancer Center, Stanford Cancer Center (2023 - Present)
Honors & Awards
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Denise O'Leary Award for Clinical Excellence, Stanford Health Care (2025)
Professional Education
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Medical Education: UCLA David Geffen School Of Medicine (2007) CA
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Board Certification: American Board of Internal Medicine, Medical Oncology (2013)
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Board Certification: American Board of Internal Medicine, Hematology (2013)
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Fellowship: Stanford University Hematology and Oncology Fellowship (2012) CA
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Residency: Stanford University Internal Medicine Residency (2010) CA
Clinical Trials
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Combination 5-azacitidine and Gemtuzumab Ozogamicin Therapy for Treatment of Relapsed Acute Myeloid Leukemia (AML)
Not Recruiting
This study will test an experimental combination of the drugs Mylotarg and 5-azacitidine in the hopes of finding a treatment that may be effective against Acute Myeloid Leukemia that has come back after treatment.
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, (650) 723 - 2781.
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Expanded Tx Panobinostat(LBH589)+Bortezomib+Dexamethasone in Relapsed & Refractory Multiple Myeloma
Not Recruiting
This will be a multi-center, open label, expanded treatment protocol of panobinostat, bortezomib and dexamethasone in patients with relapsed and/or refractory multiple myeloma. Panobinostat will be administered at a starting dose of 20mg orally three times a week (every other day) for two weeks on and one week off, with dose adjustments permitted based on observed toxicity. Bortezomib will be administered either intravenously or sub-cutaneously, twice a week on days 1 and 4, two weeks on 1 week off. After 8 cycles of treatment, patients who have achieved stable disease or better by modified EBMT 1998 criteria may continue combination therapy with bortezomib dosing changed to days 1 and 8 of a 21 day cycle for up to 48 weeks of therapy. At the end of the treatment period, (48 weeks) patients with stable disease or better may continue on therapy at the discretion of their investigator until September 2015 or until drug is commercially available, whichever comes first. Patients who have not achieved at least stable disease by 8 cycles must discontinue from study treatment. Dexamethasone will be administered on the day of and the day immediately following bortezomib treatment. Patients will not receive any study treatment during the third week of each cycle. Cycles will be defined as 21 days of treatment. Investigators may not add any other anti-myeloma agents (with the exception of bisphosphonates) while patients remain on study treatment. Patients will remain on study until disease progression, unacceptable toxicity, or end of the study
Stanford is currently not accepting patients for this trial. For more information, please contact Ying Hao, 650-723-0646.
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Phase 1/2 NEOD001 in Light Chain (AL) Amyloidosis
Not Recruiting
Dose escalation study to determine the maximum tolerated dose of NEOD001 in approximately 30 subjects with AL amyloidosis. Expansion phase to evaluate safety, efficacy and pharmacokinetics of NEOD001 in 25 additional subjects at the maximum tolerated dose.
Stanford is currently not accepting patients for this trial. For more information, please contact Ying Hao, 650-723-0646.
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Phase I CAL-101 w/ Chemo & Anti-CD20 mAb in Relapsed or Refractory Indolent B-cell NHL, MCL or CLL
Not Recruiting
The primary objective of the study is to evaluate the safety of idelalisib in combination with an anti-CD20 monoclonal antibody (mAb), a chemotherapeutic agent, a mammalian target of rapamycin (mTOR) inhibitor, a protease inhibitor, an antiangiogenic agent, and/or an immunomodulatory agent in participants with relapsed or refractory indolent B-cell non-Hodgkin lymphoma (NHL), mantle cell lymphoma (MCL), or chronic lymphocytic leukemia (CLL).
Stanford is currently not accepting patients for this trial. For more information, please contact Nini Estevez, 650725-4041.
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Phase I Extension Study of Clinical Activity of GS-1101 in Hematologic Malignancies
Not Recruiting
This is a long-term safety extension study of idelalisib (GS-1101; CAL-101) in patients with hematologic malignancies who complete other idelalisib studies. It provides the opportunity for patients to continue treatment as long as the patient is deriving clinical benefit. Patients will be followed according to the standard of care as appropriate for their type of cancer. The dose of idelalisib will generally be the same as the dose that was administered at the end of the prior study, but may be titrated up to improve clinical response or down for toxicity. Patients will be withdrawn from the study if they develop progressive disease, unacceptable toxicity related to idelalisib, or if they no longer derive clinical benefit in the opinion of the investigator.
Stanford is currently not accepting patients for this trial. For more information, please contact Nini Estevez, 650-725-4041.
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Phase I Inotuzumab Ozogamicin with CVP in Relapsed/Refractory CD22+ Acute Leukemia
Not Recruiting
This phase I trial studies the side effects and best dose of inotuzumab ozogamicin when given together with combination chemotherapy in treating patients with relapsed or refractory acute leukemia. Immunotoxins, such as inotuzumab ozogamicin, can find cancer cells that express cluster of differentiation (CD)22 and kill them without harming normal cells. Drugs used in chemotherapy, such as cyclophosphamide, vincristine sulfate, and prednisone, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving inotuzumab ozogamicin together with combination chemotherapy may kill more cancer cells.
Stanford is currently not accepting patients for this trial. For more information, please contact Kevin Morrison, 650-725-5450.
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Phase IB BET Inhibitor RO6870810 - Given as Mono & Combination Therapy in Advanced Multiple Myeloma
Not Recruiting
This is a Phase Ib, open-label, multicenter, global study designed to assess the safety and tolerability of RO6870810 as monotherapy and in combination with daratumumab in participants with relapsed/refractory multiple myeloma. Each treatment cycle will be 21 days in length. There are two parts to this study. A dose-escalation phase (Part I) will be used to evaluate the safety and tolerability and dose limiting toxicities, and to establish the maximum tolerated dose (MTR)/optimum biological dose (OBD) of RO6870810 when given as monotherapy or in combination with daratumumab. A dose-expansion phase (Part II) will further characterize the safety, tolerability and activity of RO6870810 as monotherapy or in combination with daratumumab at the defined expansion dose-levels.
Stanford is currently not accepting patients for this trial. For more information, please contact Cancer Clinical Trials Office (CCTO), 650-498-7061.
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Phase Ib Panobinostat +/-Idarubicin &Cytarabine Induction &High-Dose Cytarabine-Based Therapy in AML
Not Recruiting
This study will be conducted to assess the maximum tolerated dose (MTD) of panobinostat given 3 times a week (administered on weeks 2 and 3 of a 4 week cycle) in combination with induction chemotherapy (idarubicin and cytarabine) in newly diagnosed patients with a cytopathologically confirmed diagnosis of high-risk AML, and to investigate the safety of the combination in this regimen.
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, (650) 723 - 2781.
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Phase IB/II Vismodegib in Relapsed/Refractory AML and Relapsed/Refractory High Risk MDS
Not Recruiting
This study will assess the safety and efficacy of vismodegib in patients with relapsed/refractory acute myelogenous leukemia (AML) and relapsed/refractory high-risk myelodysplastic syndrome (MDS). Patients in Cohort 1 will receive single-agent vismodegib 150 mg orally daily. In Cohort 2, patients will receive vismodegib 150 mg orally daily in combination with cytarabine 20 mg subcutaneously for 10 days. Anticipated time on study treatment is until disease progression, intolerable toxicity, or patient withdrawal of consent.
Stanford is currently not accepting patients for this trial. For more information, please contact Marlene Zuraek, (650) 736-4031.
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Phase II ABT-199 (GDC-0199) in CLL w/ Relapse or Refractory to BCR Signaling Pathway Inhibitor Tx
Not Recruiting
This was an open-label, non-randomized, multicenter, Phase 2 study evaluating the efficacy and safety of ABT-199 in 127 participants with relapsed or refractory chronic lymphocytic leukemia (CLL) after B-cell receptor signaling pathway inhibitors (BCR PI) treatment.
Stanford is currently not accepting patients for this trial. For more information, please contact Asma Khan, 650-724-6008.
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Phase II ACP-196 in Relapsed/Refractory CLL and Intolerant of Ibrutinib Therapy
Not Recruiting
A Phase 2 Study to evaluate the Efficacy and Safety of ACP-196 (acalabrutinib) in Subjects with Relapsed/Refractory CLL and Intolerant of Ibrutinib Therapy
Stanford is currently not accepting patients for this trial. For more information, please contact Cancer Clinical Trials Office (CCTO), 650-498-7061.
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Phase II ATRA, Arsenic Trioxide and Gemtuzumab Ozogamicin for High Risk Acute Promyelocytic Leukemia
Not Recruiting
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as gemtuzumab, can block cancer growth in different ways. Some find cancer cells and help kill them or carry cancer-killing substances to them. Others interfere with the ability of cancer cells to grow and spread. Gemtuzumab may also stop the growth of promyelocytic leukemia by blocking blood flow to the cancer. Giving gemtuzumab together with combination chemotherapy may be more effective in treating promyelocytic leukemia. PURPOSE: This phase II trial is studying how well giving gemtuzumab together with combination chemotherapy works in treating patients with previously untreated promyelocytic leukemia.
Stanford is currently not accepting patients for this trial. For more information, please contact Nini Estevez, (650) 725 - 4041.
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Phase II CPX-351 in Relapsed or Refractory AML or Higher Risk MDS
Not Recruiting
This phase 2 clinical trial studies how well CPX-351 (liposomal cytarabine-daunorubicin) works in treating patients with relapsed or refractory acute myeloid leukemia or myelodysplastic syndrome. Drugs used in chemotherapy, such as CPX-351, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, 650-723-2781.
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Phase II Hyper-CVAD + Dasatinib +/- Allogeneic Stem Cell Transplant in Ph Chromosome + and/or ALL
Not Recruiting
This phase II trial is studying the side effects of giving combination chemotherapy together with or without donor stem cell transplant and to see how well it works in treating patients with acute lymphoblastic leukemia. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. Giving chemotherapy and total-body irradiation before a donor stem cell transplant helps stop the growth of cancer cells. It also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect).
Stanford is currently not accepting patients for this trial. For more information, please contact Vani Jain, (650) 725 - 5459.
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Phase II Idarubicin & Ara-C +/- Pravastatin in Poor-Risk Acute Myelogenous Leukemia(AML)
Not Recruiting
RATIONALE: Drugs used in chemotherapy, such as idarubicin and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Pravastatin may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Pravastatin may also help idarubicin and cytarabine work better by making cancer cells more sensitive to the drugs. Giving idarubicin and cytarabine together with pravastatin may kill more cancer cells. PURPOSE: This phase II trial is studying how well giving idarubicin and cytarabine together with pravastatin works in treating patients with relapsed acute myeloid leukemia (AML). ADDITIONAL BACKGROUND: S0919 was initially designed for patients with relapsed acute myeloid leukemia (AML), where the patient's preceding remission had lasted ≥ 3 months. The null response rate was 30%. The study closed to accrual on Nov 1, 2012 after meeting the defined criterion for a positive study; and the results are being submitted to the American Society of Clinical Oncology meeting. Based on the promising results from this trial, the trial has now been amended to evaluate this therapeutic regimen in poor-risk patients (patients with newly diagnosed acute myeloid leukemia (AML) arising out of myelodysplastic syndrome (MDS), primary refractory acute myeloid leukemia (AML), and relapsed acute myeloid leukemia (AML) with the patient's preceding remission lasting \< 6 months).
Stanford is currently not accepting patients for this trial. For more information, please contact Joselene Sipin-Sayno, 650-736-8113.
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Phase II Idelalisib in Combo with Rituximab in Chronic Lymphocytic Leukemia with 17p Deletion
Not Recruiting
The primary objective of this study is to evaluate overall response rate (ORR) following treatment with idelalisib plus rituximab in participants with previously untreated chronic lymphocytic leukemia (CLL) with 17p deletion. An increased rate of deaths and serious adverse events (SAEs) among participants with front-line CLL and early-line indolent non-Hodgkin lymphoma (iNHL) treated with idelalisib in combination with standard therapies was observed by the independent data monitoring committee (DMC) during regular review of 3 Gilead Phase 3 studies. Gilead reviewed the unblinded data and terminated those studies in agreement with the DMC recommendation and in consultation with the US Food and Drug Administration (FDA). All front-line studies of idelalisib, including this study, were also terminated.
Stanford is currently not accepting patients for this trial. For more information, please contact Nini Estevez, 650-725-4041.
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Phase II Idelalisib Indolent B-Cell Non-Hodgkin Lymphoma Refractory to Rituximab &Alkylating Agents
Not Recruiting
The primary objective will be to assess the overall response rate and to evaluate the efficacy and safety of idelalisib (IDELA; GS-1101) in participants with previously treated indolent Non-Hodgkin Lymphoma (iNHL) that is refractory both to rituximab and to alkylating-agent-containing chemotherapy. Eligible participants will initiate oral therapy with idelalisib at a starting dose of 150 mg taken twice per day. Treatment with idelalisib can continue in compliant participants as long as the study is still ongoing and the participants appear to be benefiting from treatment with acceptable safety.
Stanford is currently not accepting patients for this trial. For more information, please contact Tessa St.Rose, (650) 736 - 4032.
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Phase II Lenolidomide +/- Azacitidine vs Azacitidine in Newly Diagnosed AML
Not Recruiting
The study aim is to compare safety and efficacy of high-dose lenalidomide regimen, sequential azacitidine and lenalidomide and an azacitidine in persons ≥65 years with newly-diagnosed acute myeloid leukemia (AML).
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, (650) 723 - 2781.
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Phase II Pracinostat plus Azacitidine in Elderly Patients with AML
Not Recruiting
The purpose of this study is to determine the safety and effectiveness of pracinostat when combined with azacitadine for patients who are 65 years of age or older and have Acute Myelogenous Leukemia (AML)
Stanford is currently not accepting patients for this trial. For more information, please contact Leilani Hong Lien, 650-725-0437.
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Phase III ACP-196 vs Ibrutinib in Previously Treated High Risk Chronic Lymphocytic Leukemia
Not Recruiting
This study is designed to evaluate progression-free survival (PFS) endpoint for acalabrutinib versus (vs) ibrutinib in previously treated chronic lymphocytic leukemia.
Stanford is currently not accepting patients for this trial. For more information, please contact Cancer Clinical Trials Office (CCTO), 650-498-7061.
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Phase III Axicabtagene Ciloleucel vs SoC Therapy in Relapsed/Refractory Diffuse Large BCell Lymphoma
Not Recruiting
The goal of this clinical study is to assess whether axicabtagene ciloleucel therapy improves the clinical outcome compared with standard of care second-line therapy in patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL).
Stanford is currently not accepting patients for this trial. For more information, please contact Cancer Clinical Trials Office (CCTO), 650-498-7061.
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Phase III Azacitidine + BSC vs BSC as Maintenance Tx in AML in Complete Remission
Not Recruiting
This study enrolled 472 participants, aged 55 or older, with a diagnosis of de novo acute myeloid leukemia (AML) or AML secondary to prior myelodysplastic disease or chronic myelomonocytic leukemia (CMML), and who have achieved first complete remission (CR)/ complete remission with incomplete blood count recovery (CRi) following induction with or without consolidation chemotherapy. The study is amended to include an extension phase (EP). The EP allows participants who are currently receiving oral azacitidine and who are demonstrating clinical benefit as assessed by the investigator, to continue receiving oral azacitidine after unblinding by sponsor until the participant meets the criteria for study discontinuation or until oral azacitidine becomes commercially available and reimbursed. In addition, all participants in the placebo arm and participants who had been discontinued from the treatment phase (irrespective of randomization arm) and continuing in the follow-up phase will be followed for survival in the EP.
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, 650-723-1269.
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Phase III Bendamustine +Rituximab vs Ibrutinib +Rituximab vs Ibrutinib Alone in CLL
Not Recruiting
This randomized phase III trial studies rituximab with bendamustine hydrochloride or ibrutinib to see how well they work compared to ibrutinib alone in treating older patients with previously untreated chronic lymphocytic leukemia. Rituximab is a monoclonal antibody that may interfere with the ability of cancer cells to grow and spread. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Chemotherapy drugs, such as bendamustine hydrochloride, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Ibrutinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. It is not yet known whether rituximab with bendamustine hydrochloride may work better than rituximab and ibrutinib or ibrutinib alone in treating chronic lymphocytic leukemia.
Stanford is currently not accepting patients for this trial. For more information, please contact Kevin Morrison, 650-725-5459.
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Phase III Blinatumomab for Newly Diagnosed BCR-ABL-negative B lineage ALL
Not Recruiting
This randomized phase III trial studies combination chemotherapy with blinatumomab to see how well it works compared to induction chemotherapy alone in treating patients with newly diagnosed breakpoint cluster region (BCR)-c-abl oncogene 1, non-receptor tyrosine kinase (ABL)-negative B lineage acute lymphoblastic leukemia. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as blinatumomab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. It is not yet known whether combination chemotherapy is more effective with or without blinatumomab in treating newly diagnosed acute lymphoblastic leukemia.
Stanford is currently not accepting patients for this trial. For more information, please contact Joselene Sipin-Sayno, 650-736-8113.
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Phase III Obinutuzumab +/- Chlorambucil, ACP-196 +/- Obinutuzumab & ACP-196 Monotherapy in CLL
Not Recruiting
This Primary objective is evaluating the efficacy of obinutuzumab in combination with chlorambucil (Arm A) compared with acalabrutinib in combination with obinutuzumab (Arm B) for the treatment of previously untreated chronic lymphocytic leukemia (CLL). Secondary objectives: 1) To evaluate the efficacy of obinutuzumab in combination with chlorambucil (Arm A) versus acalabrutinib monotherapy (Arm C) based on IRC assessment of PFS per IWCLL 2008 criteria. 2)To compare obinutuzumab plus chlorambucil (Arm A) versus acalabrutinib plus obinutuzumab (Arm B) and obinutuzumab plus chlorambucil (Arm A) versus acalabrutinib monotherapy (Arm C) in terms of: IRC-assessed objective response rate (ORR); Tine to next treatment (TTNT); Overall Survival (OS)
Stanford is currently not accepting patients for this trial. For more information, please contact Nini Estevez, 650-725-4041.
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Phase III Quizartinib vs Salvage Chemo in FLT3-ITD+ AML Refractory/Relapsed to First-Line Chemo
Not Recruiting
The primary objective of the study is to determine whether quizartinib monotherapy prolongs overall survival (OS) compared to salvage chemotherapy in subjects with FMS-like tyrosine kinase 3 - Internal Tandem Duplication (FLT3-ITD) positive AML who are refractory to or have relapsed within 6 months, after first-line AML therapy.
Stanford is currently not accepting patients for this trial. For more information, please contact Jack Taw, 650-723-2781.
All Publications
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Real time machine learning prediction of next generation sequencing test results in live clinical settings.
NPJ digital medicine
2025; 8 (1): 533
Abstract
Next-generation sequencing-based tests have advanced the field of medical diagnostics, but their novelty and cost can lead to uncertainty in clinical deployment. The Heme-STAMP is one such assay that tracks mutations in genes implicated in hematolymphoid neoplasms. Rather than limiting its clinical usage or imposing rule-based criteria, we propose leveraging machine learning to guide clinical decision-making on whether this test should be ordered. We trained a machine learning model to predict the outcome of Heme-STAMP testing using 3472 orders placed between May 2018 and September 2021 from an academic medical center and demonstrated how to integrate a custom machine learning model into a live clinical environment to obtain real-time model and physician estimates. The model predicted the results of a complex next-generation sequencing test with discriminatory power comparable to expert hematologists (AUC score: 0.77 [0.66, 0.87], 0.78 [0.68, 0.86] respectively) and with the capacity to improve the calibration of human estimates.
View details for DOI 10.1038/s41746-025-01816-7
View details for PubMedID 40830568
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Longitudinal study of 2 patients with cyclic thrombocytopenia, STAT3, and MPL mutations.
Blood advances
2022
Abstract
Cyclic thrombocytopenia (CTP) is a rare disease of periodic platelet count oscillations. The pathogenesis of CTP remains elusive. To study the underlying pathophysiology and genetic and cellular associations with CTP, we applied systems biology approaches to two patients with stable platelet cycling and reciprocal thrombopoietin (TPO) cycling at multiple time points through 2 cycles. Blood transcriptome analysis revealed cycling of platelet-specific genes, which are in parallel with and precede platelet count oscillation, indicating that cyclical platelet production leads platelet count cycling in both patients. Additionally, neutrophil and erythrocyte-specific genes also showed fluctuations correlating with platelet count changes, consistent with TPO effects on hematopoietic progenitors. Moreover, we found novel genetic associations with CTP. One patient had a novel germline heterozygous loss-of-function (LOF) thrombopoietin receptor (MPL) c.1210G>A mutation, and both had pathogenic somatic gain-of-function (GOF) variants in signal transducer and activator of transcription 3 (STAT3). In addition, both patients had clonal T-cell populations that remained stable throughout platelet count cycles. These mutations and clonal T cells may potentially involve in the pathogenic baseline in these patients rendering exaggerated persistent thrombopoiesis oscillations of their intrinsic rhythm upon homeostatic perturbations. This work provides new insights into the pathophysiology of CTP and possible therapies.
View details for DOI 10.1182/bloodadvances.2021006701
View details for PubMedID 35381066
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Machine Learning Predictability of Clinical Next Generation Sequencing for Hematologic Malignancies to Guide High-Value Precision Medicine.
AMIA ... Annual Symposium proceedings. AMIA Symposium
2021; 2021: 641-650
Abstract
Advancing diagnostic testing capabilities such as clinical next generation sequencing methods offer the potential to diagnose, risk stratify, and guide specialized treatment, but must be balanced against the escalating costs of healthcare to identify patient cases most likely to benefit from them. Heme-STAMP (Stanford Actionable Mutation Panel for Hematopoietic and Lymphoid Malignancies) is one such next generation sequencing test. Our objective is to assess how well Heme-STAMP pathological variants can be predicted given electronic health records data available at the time of test ordering. The model demonstrated AUROC 0.74 (95% CI: [0.72, 0.76]) with 99% negative predictive value at 6% specificity. A benchmark for comparison is the prevalence of positive results in the dataset at 58.7%. Identifying patients with very low or very high predicted probabilities of finding actionable mutations (positive result) could guide more precise high-value selection of patient cases to test.
View details for PubMedID 35308914
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A Case of G6PC3 Congenital Neutropenia, Misdiagnosed As Evans Syndrome
SPRINGER/PLENUM PUBLISHERS. 2020: S131–S132
View details for Web of Science ID 000540191100190
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Splenectomy for benign and malignant hematologic pathology: Modern morbidity, mortality, and long-term outcomes.
Surgery open science
2020; 2 (4): 19–24
Abstract
The role of splenectomy to diagnose and treat hematologic disease continues to evolve. In this single-center retrospective review, we describe modern morbidity, mortality, and long-term outcomes associated with splenectomy for benign and malignant hematologic disorders.We analyzed all nontrauma splenectomies performed for benign or malignant hematologic disorders from January 2009 to September 2018. Variables collected included demographics, preexisting comorbidities, laboratory results, intra- and postoperative features, and long-term follow-up. Outcomes of interest included postoperative complications, 30-day mortality, and overall mortality.We identified 161 patients who underwent splenectomy for hematologic disorders. Median age was 54 years (range 19-94), and 83 (52%) were female. Splenectomy was performed for 95 (59%) patients with benign hematologic disorders and for 66 (41%) with malignant conditions. Most splenectomies were laparoscopic (76%), followed by laparoscopic hand assisted (11%), open (8%), and laparoscopic converted to open (6%). Median follow-up was 761 days (interquartile range: 179-2025 days). Major complications occurred in 21 (13%) patients. Three (2%) patients died within 30 days; 16 (9%) died more than 30 days after operation, none from surgical complications, with median time to death of 438 days (interquartile range: 231-1497 days). Among malignant cases, only preoperative thrombocytopenia predicted death (odds ratio = 5.8, 95% confidence interval = 1.1-31.8, P = .04). For benign cases, increasing age was associated with inferior survival (odds ratio = 2.3, 95% confidence interval = 1.0-5.1, P = .05).Splenectomy remains an important diagnostic and therapeutic option for patients with benign and malignant hematologic disorders and can be performed with a low complication rate. Despite considerable burden of comorbid disease in these patients, early postoperative mortality was uncommon.
View details for DOI 10.1016/j.sopen.2020.06.004
View details for PubMedID 32939448
View details for PubMedCentralID PMC7479208
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Late presentation of dyskeratosis congenita.
British journal of haematology
2019
View details for DOI 10.1111/bjh.16131
View details for PubMedID 31385294
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A Kindred with a β-Globin Base Substitution [β89(F5)Ser→Arg (AGT>AGG); HBB: c.270T>G] Resulting in Hemoglobin Vanderbilt.
Hemoglobin
2019: 1–4
Abstract
High oxygen affinity hemoglobins (Hbs), characterized by a decreased ability to release oxygen to the tissues and a left-shifted oxygen dissociation curve, are a rare cause of secondary erythrocytosis. Here, we report a base substitution in the β-globin gene at codon 89 (AGT>AGG) in a kindred with familial erythrocytosis resulting in Hb Vanderbilt, a high oxygen affinity variant.
View details for DOI 10.1080/03630269.2019.1680382
View details for PubMedID 31657650