My research is focused on studying the impacts of medical comorbidities on outcomes of hematopoietic cell transplantation (HCT) for hematologic malignancies in order to improve decision-making and lessen the HCT morbidity and mortality.
A new HCT-specific comorbidity index (HCT-CI) was developed to capture comorbidities at time of HCT and to predict outcomes. Current research is focused on validating the discriminative capacity of this index among patients transplanted at different institutions. The index is being modified by adding biomarkers and objective laboratory data to further improve its prognostic value.
The index is also used to investigate the biologic link between pretransplant comorbidities and post-transplant toxicities, graft-versus-host disease, causes of death, and quality of life. Other research efforts include evaluating the impact of comorbidities on rate of referral of acute myeloid leukemia patients to HCT, investigating molecular mechanisms that explain the association between comorbidities and HCT morbidity, and assessing the role of iron overload in HCT.
My research also involves new methods to maximize the benefits of nonmyeloablative conditioning and allogeneic HCT for older and medically infirm patients diagnosed with chronic lymphocytic leukemia or lymphoma. One approach is investigating whether the addition of anti-CD20 monoclonal antibody (rituximab) to the nonmyeloablative conditioning could improve survival. Another approach is combining high-dose myeloablative autologous HCT, for disease debulking, with allogeneic HCT from HLA-haploidentical donor using nonmyeloablative regimen, for continued graft-versus disease consolidation.