BFAM Member Spotlights

Meet the members of the Stanford Medicine Black Faculty Affinity Meetings (BFAM), a network created through OFDD's Community Support Initiative. BFAM is intended to provide networking and social engagement opportunities for Stanford Medicine faculty across all clinical lines and departments.

Melody Smith, MD, MS

Department of Medicine

Assistant Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Fun Facts About Me
I enjoy spending time with my family, playing the oboe, and trying to improve my golf game.

Full Stanford Profile

Assistant Professor of Medicine (Blood and Marrow Transplantation and Cellular Therapy)

Bio

Dr. Smith is a board-certified, fellowship-trained medical oncologist and hematologist. She is an Assistant Professor in the Department of Medicine within the Division of Blood & Marrow Transplantation and Cellular Therapy. She is also a physician-scientist who conducts extensive research. As a medical student, she completed a fellowship at the National Institutes of Health (NIH) in the Clinical Research Training (now, the Medical Research Scholars) Program. Subsequently, after her clinical fellowship, she was a post-doctoral researcher at Memorial Sloan Kettering Cancer Center. Her lab's research focuses on studying the biology of chimeric antigen receptor (CAR) T cells to improve the therapy's efficacy and safety (1) by examining donor (Nature Medicine, 2017) and off-the-shelf CAR T cells in mouse models and (2) by investigating how the intestinal microbiome affects CAR T cell response (Nature Medicine, 2022). Dr. Smith presents her research findings at regional, national, and international conferences. Additionally, she has co-authored articles on topics in cancer immunology, including cancer immunotherapy, stem cell transplantation, and CAR T cell therapy. Her work has been published in journals such as Nature, Nature Immunology, Nature Medicine, Blood, and Transplantation and Cellular Therapy. She serves as a peer reviewer for publications like NEJM Evidence, Science Advances, Blood, Cancer Cell, and Molecular Therapy. She has also contributed chapters to books, including Pocket Oncology, Current Concepts and Controversies in Hematopoietic Cell Transplantation, and Advanced Concepts in Human Immunology: Prospects for Disease Control. She has received numerous honors; the American Society of Hematology, the American Society for Clinical Investigation, the Society for Immunotherapy of Cancer, the European Society for Blood and Marrow Transplantation, and several other professional organizations have recognized her achievements as a clinician, researcher, and scholar.

Publications

Antibiotic Use: Impact on the Microbiome and Cellular Therapy Outcomes. Blood advances Darwin, A., Xie, J., Smith, M. 2025 More

Abstract

Antibiotics disrupt the delicate balance of bacteria, fungi, and viruses in the human microbiome. Growing evidence indicates a significant relationship between the intestinal microbiome and cellular therapy, which aligns with the established influence of the microbiome on immune responses. When examining the link between cellular therapy and the microbiome, it is essential to understand how disruptions in the microbiome-especially those caused by antibiotics-affect these therapies. Here, we discuss the impact of antibiotics on the intestinal microbiome, cellular therapy outcomes, and associated toxicities, particularly in the context of hematopoietic cell transplantation and chimeric antigen receptor T-cell therapy. Furthermore, we examine the mechanisms through which antibiotics affect cellular therapy, the future implications of this knowledge, and the areas that warrant further investigation.

View details for DOI 10.1182/bloodadvances.2024013809

View details for PubMedID 40030005
The intestinal microbiota and cellular therapy: implications for impact and mechanisms. Blood Xie, J., Smith, M. 2024 More

Abstract

The microbiota, comprising bacteria, fungi, and viruses residing within our body, functions as a key modulator in host health and states, including immune responses. Studies have linked microbiota and microbiota-derived metabolites to immune cell functions. In this review, we probe the complex relationship between the human microbiota and clinical outcomes of cellular therapies that leverage immune cells to fight various cancers. With a particular emphasis on hematopoietic cell transplantation and chimeric antigen receptor T cell therapy, we explore the potential mechanisms underpinning this interaction. We also highlight the interventional applications of the microbiota in cellular therapy, while outlining future research directions in the field.

View details for DOI 10.1182/blood.2024024219

View details for PubMedID 39141827
Gut microbiome correlates of response and toxicity following anti-CD19 CAR T cell therapy. Nature medicine Smith, M., Dai, A., Ghilardi, G., Amelsberg, K. V., Devlin, S. M., Pajarillo, R., Slingerland, J. B., Beghi, S., Herrera, P. S., Giardina, P., Clurman, A., Dwomoh, E., Armijo, G., Gomes, A. L., Littmann, E. R., Schluter, J., Fontana, E., Taur, Y., Park, J. H., Palomba, M. L., Halton, E., Ruiz, J., Jain, T., Pennisi, M., Afuye, A. O., Perales, M., Freyer, C. W., Garfall, A., Gier, S., Nasta, S., Landsburg, D., Gerson, J., Svoboda, J., Cross, J., Chong, E. A., Giralt, S., Gill, S. I., Riviere, I., Porter, D. L., Schuster, S. J., Sadelain, M., Frey, N., Brentjens, R. J., June, C. H., Pamer, E. G., Peled, J. U., Facciabene, A., van den Brink, M. R., Ruella, M. 2022 More

Abstract

Anti-CD19 chimeric antigen receptor (CAR) T cell therapy has led to unprecedented responses in patients with high-risk hematologic malignancies. However, up to 60% of patients still experience disease relapse and up to 80% of patients experience CAR-mediated toxicities, such as cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome. We investigated the role of the intestinal microbiome on these outcomes in a multicenter study of patients with B cell lymphoma and leukemia. We found in a retrospective cohort (n=228) that exposure to antibiotics, in particular piperacillin/tazobactam, meropenem and imipenem/cilastatin (P-I-M), in the 4 weeks before therapy was associated with worse survival and increased neurotoxicity. In stool samples from a prospective cohort of CAR T cell recipients (n=48), the fecal microbiome was altered at baseline compared to healthy controls. Stool sample profiling by 16S ribosomal RNA and metagenomic shotgun sequencing revealed that clinical outcomes were associated with differences in specific bacterial taxa and metabolic pathways. Through both untargeted and hypothesis-driven analysis of 16S sequencing data, we identified species within the class Clostridia that were associated with day 100 complete response. We concluded that changes in the intestinal microbiome are associated with clinical outcomes after anti-CD19 CAR T cell therapy in patients with B cell malignancies.

View details for DOI 10.1038/s41591-022-01702-9

View details for PubMedID 35288695
Donor CD19 CART cells exert potent graft-versus-lymphoma activity with diminished graft-versus-host activity NATURE MEDICINE Ghosh, A., Smith, M., James, S. E., Davila, M. L., Velardi, E., Argyropoulos, K. V., Gunset, G., Perna, F., Kreines, F. M., Levy, E. R., Lieberman, S., Jay, H. V., Tuckett, A. Z., Zakrzewski, J. L., Tan, L., Young, L. F., Takvorian, K., Dudakov, J. A., Jenq, R. R., Hanash, A. M., Motta, A. F., Murphy, G. F., Liu, C., Schietinger, A., Sadelain, M., van den Brink, M. R. M. 2017; 23 (2): 242-249 More

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative therapy for hematological malignancies. However, graft-versus-host disease (GVHD) and relapse after allo-HSCT remain major impediments to the success of allo-HSCT. Chimeric antigen receptors (CARs) direct tumor cell recognition of adoptively transferred T cells. CD19 is an attractive CAR target, which is expressed in most B cell malignancies, as well as in healthy B cells. Clinical trials using autologous CD19-targeted T cells have shown remarkable promise in various B cell malignancies. However, the use of allogeneic CAR T cells poses a concern in that it may increase risk of the occurrence of GVHD, although this has not been reported in selected patients infused with donor-derived CD19 CAR T cells after allo-HSCT. To understand the mechanism whereby allogeneic CD19 CAR T cells may mediate anti-lymphoma activity without causing a significant increase in the incidence of GVHD, we studied donor-derived CD19 CAR T cells in allo-HSCT and lymphoma models in mice. We demonstrate that alloreactive T cells expressing CD28-costimulated CD19 CARs experience enhanced stimulation, resulting in the progressive loss of both their effector function and proliferative potential, clonal deletion, and significantly decreased occurrence of GVHD. Concurrently, the other CAR T cells that were present in bulk donor T cell populations retained their anti-lymphoma activity in accordance with the requirement that both the T cell receptor (TCR) and CAR be engaged to accelerate T cell exhaustion. In contrast, first-generation and 4-1BB-costimulated CAR T cells increased the occurrence of GVHD. These findings could explain the reduced risk of GVHD occurring with cumulative TCR and CAR signaling.

View details for DOI 10.1038/nm.4258

View details for Web of Science ID 000393729000016

View details for PubMedID 28067900

View details for PubMedCentralID PMC5528161
American Society of Hematology: Building a Comprehensive Minority Recruitment and Retention Professional Program. Blood advances Rollins, M. R., Warsame, R., Smith, M., Molina, A., Rouce, R. H., Avalos, B. R., Johnson, C. S., Lopez, J. A., Thompson, A. A., Fanning, L., Frustace, P., Roche, K., van Havre, N., Mack, D., Flowers, C. R., Terrell, D. R. 2026 More

Abstract

In 2003, the Institute of Medicine noted the need to improve workforce diversity. The American Society of Hematology (ASH) responded by developing the Minority Recruitment Initiative (MRI) to recruit diverse physicians/scientists into hematology. We evaluated the outcomes of the program. From 2004-2022, there were 405 awardees. Compared to national estimates, MRI awardees were less likely to discontinue their degree programs. MRI graduate student awardees 0% attrition (97.5% confidence interval (CI) 10.6%) while national minority graduate student attrition was 36%. Medical student awardees had 2.2% (95% CI 0.61%, 5.6%) attrition compared to minority medical school attrition of 5.6%. Awardees were more likely than expected to pursue hematology-oncology (5.7% minority national estimate) as 14.4% (95% CI 8.1%, 23.0%) of medical student awardees and 88.5% (95% CI 70.0%, 97.6%) of early career awardees remain in the field. ASH has developed a successful program, but continued efforts are needed to advance equity in hematology.

View details for DOI 10.1182/bloodadvances.2024013519

View details for PubMedID 39570294

see all 63 publications

BFAM Member Spotlights

Melody Smith, MD, MS

Abstract

Abstract

Abstract

Abstract

Abstract