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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.
Non-Invasive Diagnosis of Pediatric Pulmonary Invasive Mold Infections
This study will establish a non-invasive diagnostic approach and evaluate clinical outcomes
for children at high-risk for pulmonary invasive fungal infection (PIFI).
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Phase I Dose Escalation Study of CD19/CD22 Chimeric Antigen Receptor (CAR) T Cells in Children and Young Adults With Recurrent or Refractory B Cell Malignancies
This phase I trial studies the best dose and side effects of CD19/CD22 chimeric antigen
receptor (CAR) T cells when given together with chemotherapy, and to see how well they work
in treating children or young adults with CD19 positive B acute lymphoblastic leukemia that
has come back or does not respond to treatment. A CAR is a genetically-engineered receptor
made so that immune cells (T cells) can attack cancer cells by recognizing and responding to
the CD19/CD22 proteins. These proteins are commonly found on B acute lymphoblastic leukemia.
Drugs used in chemotherapy, such as fludarabine phosphate and cyclophosphamide, 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. Giving CD19/CD22-CAR T cells and
chemotherapy may work better in treating children or young adults with B acute lymphoblastic
Home Away From Home - Quality of Life Surveys
Treatment for pediatric acute myeloid leukemia (AML) involves intensive chemotherapy regimens
that result in periods of profound neutropenia leaving patients susceptible to severe
infectious complications. Infectious complications are the leading cause of treatment related
mortality among AML patients, but there are little clinical data to inform whether management
of neutropenia post AML chemotherapy should occur in an outpatient or inpatient setting.
Further, no studies have been conducted that assess the impact of neutropenia management
strategy on the quality of life of pediatric patients with AML and their caregivers.
Symptom Screening Linked to Care Pathways
Most children with cancer survive because they are given intensive treatments, but
unfortunately, these treatments are associated with distressing symptoms. To address this
problem, we developed the Symptom Screening in Pediatrics Tool (SSPedi) so that children
receiving cancer treatments can communicate their bothersome symptoms, and Supportive care
Prioritization, Assessment and Recommendations for Kids (SPARK), a web-based application that
links identified symptoms to supportive care guidelines for symptom management. To establish
that these tools improve the lives of children newly diagnosed with cancer, we will conduct a
trial that randomizes 20 pediatric cancer institutions and measures the impact of three times
weekly symptom screening, symptom feedback to healthcare providers and the development of
care pathways for symptom management to improve total symptom burden, fatigue and quality of