Clinical Hematology,ImmunoHematology, Cell Therapy Specialist

I am an Associate Professor of Pharmacy and a Hematology, Immunohematology, and Cell Therapy clinical pharmacy specialist. I have been in clinical practice and a professor for 30 years, specializing in immunologic disorders. Much of my research has been in the field stem cell transplant and more recently in chimeric antigen receptor T (CART) cells as well as in immune aspects of rare immunologic disorders. I have also developed and coordinated a world-wide research program on Cyclin D kinase like 5 (CDKL5) disorder, a rare neurologic disorder, for the International Foundation for CDKL5 Research. My daughter has CDKL5 and while this was partially a personal endeavor it gave me a new aspect on rare disorders and an even greater passion to do research that will potentially change lives. It has also significantly increased my ability to work with many different laboratories and clinicians to build a focused research program. I have a broad background in pharmacology, with specific training and expertise in hematology, oncology and stem cell transplant especially immunologic aspects of these fields. I am a co-investigator utilizing the PEdELISA technology developed at the University of Michigan to study cytokine release syndrome (CRS) and Immune Effector Cell Associated Neurotoxicity Syndrome (ICANS). By utilizing this technology we have found that tocilizumab, currently a standard therapy for CRS, actually increases IL-6 levels which may cause an increase in ICANS incidence and severity. Due to this I have piloted the use of Siltuximab in this population which was published in conjunction with outcomes from 4 other centers. This has led to a research trial which I developed to study Slituximab for prevention of CRS and ICANS, which causes significant morbidity and mortality associated with CART cell therapies. I have also helped to lay the groundwork for the proposed research by utilizing the PEdELISA technology in patients with severe COVID infections to help predict the most appropriate use of IL-6 inhibitors in this population. During most of my time at Michigan I have only had a 20% faculty appointment, resulting in limited research time, making it difficult to develop larger research studies. I now have a 50% faculty appointment and am focusing much of this to utilize techniques, including this PEdELISA technology, to personalize medicine and provide better outcomes in patients with immunologic disorders such as our recently presented work evaluating tacrolimus levels and the risk of GVHD as well as pharmacogenomic influence on tacrolimus levels. I have also recently developed clinical trials utilizing natalizumab to change T cell CNS migration with CAR-T cell therapy as well as a trial utilizing pomalidomide to change T cell exhaustion. Through the immunohematology clinic I have been collaborating with the pediatric GI group for the last few years to help build guidelines for immunologic testing and to evaluate non-responders to targeted therapies. I also am the main consult pharmacist to develop therapeutic strategies for patients with unknown disorders as well as develop new strategies for patients with cytokine driven disorders. I hope this shows that I do have the expertise, leadership, training, and motivation necessary to successfully carry out the proposed research project and most importantly to better patient outcomes through this work.