Bio

Clinical Focus


  • Internal Medicine
  • Thoracic and Urologic Malignancies

Academic Appointments


Professional Education


  • Fellowship:Stanford University - Hematology and Oncology (2013) CA
  • Residency:Albert Einstein College of Medicine Montefiore (2009) NY
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2009)
  • Medical Education:Albert Einstein College of Medicine (2006) NY
  • Master of Science, Johns Hopkins University (2001)
  • Bachelor of Arts, Johns Hopkins University (1999)

Stanford Advisors


Research & Scholarship

Current Research and Scholarly Interests


Epidemiologic research in thoracic and urologic malignancies; Epidemiology of elderly anemia; Medtech innovations in hematology/oncology.

Clinical Trials


  • Molecular Analysis of Thoracic Malignancies Recruiting

    Primary Objective: To collect detailed clinical information on patients with thoracic malignancies via the electronic medical record and a detailed patient questionnaire, collect blood samples, retrieve paraffin embedded tissue if not collected at Stanford, and perform exploratory molecular analysis of tumor tissues.

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Publications

Journal Articles


  • Multiplicative interaction between mean corpuscular volume and red cell distribution width in predicting mortality of elderly patients with and without anemia. American journal of hematology Lam, A. P., Gundabolu, K., Sridharan, A., Jain, R., Msaouel, P., Chrysofakis, G., Yu, Y., Friedman, E., Price, E., Schrier, S., Verma, A. K. 2013; 88 (11): E245-9

    Abstract

    Recent studies have shown that an elevated red cell distribution width (RDW) is an important predictor of adverse outcomes. However, the strength of this biomarker has not been tested in a large outpatient elderly population. Also since increased RDW can be due to a variety of etiologies, additional biomarkers are needed to refine the prognostic value of this variable. We assembled a cohort of 36,226 elderly (≥65yo) patients seen at an outpatient facility within the Einstein/Montefiore system from January 1st 1997 to May 1st 2008 who also had a complete blood count performed within 3 months of the initial visit. With a maximum follow-up of 10 years, we found that an elevated RDW (>16.6) was associated with increased risk of mortality in both non-anemic (HR=3.66, p<0.05) and anemic patients (HR=1.87, p<0.05). The effect of RDW on mortality is significantly increased in non-anemic patients with macrocytosis (HR=5.22, p<0.05) compared to those with normocytosis (HR=3.86, p<0.05) and microcytosis (HR=2.46, p<0.05). When comparing non-anemic patients with both an elevated RDW and macrocytosis to those with neither, we observed an elevated HR of 7.76 (higher than expected in an additive model). This multiplicative interaction was not observed in anemic patients (HR=2.23). Lastly, we constructed Kaplan-Meier curves for each RDW/MCV subgroup and found worsened survival for those with macrocytosis and an elevated RDW in both anemia and non-anemic patients. Based on our results, the addition of MCV appears to improve the prognostic value of RDW as a predictor of overall survival in elderly patients.

    View details for DOI 10.1002/ajh.23529

    View details for PubMedID 23828763

  • The prognostic value of diagnosing concurrent multiple myeloma in immunoglobulin light chain amyloidosis BRITISH JOURNAL OF HAEMATOLOGY Dinner, S., Witteles, W., Witteles, R., Lam, A., Arai, S., Lafayette, R., George, T. I., Schrier, S. L., Liedtke, M. 2013; 161 (3): 367-372

    Abstract

    The prevalence and prognostic value of a concomitant diagnosis of symptomatic or asymptomatic multiple myeloma (MM), as defined by the current International Myeloma Working Group (IMWG) criteria, in patients with immunoglobulin light chain amyloidosis (AL), are unknown. We studied 46 consecutive patients with AL who underwent quantification of serum M-protein and clonal bone marrow plasma cells, as well as a comprehensive evaluation for end organ damage by MM. Using standard morphology and CD138 immunohistochemical staining, 57% and 80% of patients were found to have concomitant MM, respectively. Nine patients exhibited end organ damage consistent with a diagnosis of symptomatic MM. While overall survival was similar between AL patients with or without concurrent myeloma (1-year overall survival 68% vs. 87%; P = 0.27), a diagnosis of symptomatic myeloma was associated with inferior outcome (1-year overall survival 39% vs. 81%; P = 0.005). Quantification of bone marrow plasma cells by both standard morphology and CD138 immunohistochemistry identified a much higher prevalence of concurrent MM in patients with AL than previously reported. Evaluation of bone marrow plasma cell infiltration and presence of myeloma associated end organ damage could be clinically useful for prognostication of patients with AL.

    View details for DOI 10.1111/bjh.12269

    View details for Web of Science ID 000317602300009

    View details for PubMedID 23432783

  • Phase II Study of Paclitaxel Plus the Protein Kinase C Inhibitor Bryostatin-1 in Advanced Pancreatic Carcinoma AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS Lam, A. P., Sparano, J. A., Vinciguerra, V., Ocean, A. J., Christos, P., Hochster, H., Camacho, F., Goel, S., Mani, S., Kaubisch, A. 2010; 33 (2): 121-124

    Abstract

    To determine the efficacy and toxicity of the protein kinase C inhibitor bryostatin-1 plus paclitaxel in patients with advanced pancreatic carcinoma.Each treatment cycle consisted of paclitaxel 90 mg/m by intravenous infusion over 1 hour on days 1, 8, and 16, plus bryostatin 25 mcg/m as a 1-hour intravenous infusion on days 2, 9, and 15, given every 28 days. Patients were evaluated for response after every 2 treatment cycles, and continued therapy until disease progression or prohibitive toxicity. The primary objective was to determine whether the combination produced a response rate of at least 30%.Nineteen patients with locally advanced or metastatic pancreatic adenocarcinoma received a total of 52 cycles of therapy (range: 1-10). Patients received the combination as first-line therapy for advanced disease (N = 5) or after prior chemotherapy used alone or in combination with local therapy. No patients had a confirmed objective response. The median time to treatment failure was 1.9 months (95% confidence intervals: 1.2, 2.6 months). Reasons for discontinuing therapy included progressive disease or death in 14 patients (74%) or because of adverse events or patient choice in 5 patients (26%). The most common grade 3 to 4 toxicities included leukopenia in 26%, anemia in 11%, myalgias in 11%, gastrointestinal bleeding in 11%, infection in 10%, and thrombosis in 10%.The combination of weekly paclitaxel and bryostatin-1 is not an effective therapy for patients with advanced pancreatic carcinoma.

    View details for DOI 10.1097/COC.0b013e3181a31920

    View details for Web of Science ID 000276714900003

    View details for PubMedID 19738452

  • Dysrhythmia of caloric nystagmus LARYNGOSCOPE Proctor, L. R., Lam, A. P. 2002; 112 (10): 1730-1736

    Abstract

    Objectives of the study were 1) to determine the prevalence and characteristics of dysrhythmia, 2) to identify associations between dysrhythmia and other patient variables, and 3) to determine whether dysrhythmia is more a characteristic of individuals than simply a correlate of alertness or response intensity.Cross-sectional.Review of records from 150 patients undergoing the caloric test.Dysrhythmia severe enough to interfere with accurate analysis of the caloric test was present in 40% of the cases. Individuals were entered into an "orderly" group (n = 67) or a "dysrhythmic" group (n = 83) and were 5.8 times more likely to remain in the same group on a second visit than to change groups. Stronger response scores were associated with less dysrhythmia. Higher caloric-induced vertigo scores were associated with both stronger response scores and lower dysrhythmia scores. Cases in the dysrhythmic group were 3.8 times more likely to have abnormal caloric test results than individuals in the orderly group.Dysrhythmia frequently interferes with valid and accurate interpretation of the caloric test. Current methods of "mental alerting" frequently fail to eliminate dysrhythmia. The presence of dysrhythmia appears to be a strong predictor of an abnormal caloric test result, and there is a moderate correlation between dysrhythmia and response intensity. Nevertheless, our results suggest that dysrhythmia is specific to individuals, rather than simply a manifestation of peripheral vestibular disease or a correlate of alertness or response intensity.

    View details for Web of Science ID 000178590500004

    View details for PubMedID 12368605

  • Epidemiology, prevention, and early detection of breast cancer. Current opinion in oncology Alberg, A. J., Lam, A. P., Helzlsouer, K. J. 1999; 11 (6): 435-441

    Abstract

    Globally, breast cancer is the third most common form of cancer and the most common among women. The age-adjusted incidence rates of breast cancer are 176% higher in developed than in developing nations. Male breast cancer is rare, but important studies provided risk factor information for comparison with studies of female breast cancer. There has been considerable interest in a possible role of organochlorines and polychlorinated biphenyls in the etiology of breast cancer, but the results of several null studies indicate the likelihood of such associations is extremely remote, providing reassuring news for the public. Prophylactic mastectomy was observed to significantly reduce a woman's chances of developing breast cancer, but it does not lower the risk to zero. Tamoxifen was found to be an effective chemopreventive agent in the Breast Cancer Prevention Trial, but this result was not replicated in two randomized trials in Europe. Striking reductions in the risk for breast cancer were observed for raloxifene in a randomized, placebo-controlled trial that had been designed for the prevention of osteoporosis. A large-scale, randomized trial of tamoxifen-verus-raloxifene among women at increased risk for developing breast cancer is now underway.

    View details for PubMedID 10550006

Conference Proceedings


  • The Independent Effect of Platelet Count On Mortality in a Large Inner City Elderly Outpatient Population Msaouel, P., Lam, A. P., Gundabolu, K., Chrysofakis, G., Yu, Y., Friedman, E. W., Verma, A. AMER SOC HEMATOLOGY. 2012
  • Multiplicative Interaction Between Mean Corpuscular Volume and Red Cell Distribution Width in Predicting Mortality of Elderly Patients with and without Anemia Lam, A. P., Gundabolu, K., Sridharan, A., Jain, R., Msaouel, P., Chrysofakis, G., Yu, Y., Friedman, E. W., Price, E., Schrier, S. L., Verma, A. AMER SOC HEMATOLOGY. 2012

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