Morphologic leukemia-free state in acute myeloid leukemia is sufficient for successful allogeneic hematopoietic stem cell transplant.

survival analysis, dynamic treatment regimes, clinical trials

Clinical research projects have focused on new and innovative treatments for myelodysplastic syndromes, paroxysmal nocturnal hemoglobinuria, adult leukemias, and lymphomas

As a diagnostic hematopathologist and molecular genetic pathologist, my clinical interests are focused on the histologic examination of tissue and bone marrow biopsies to diagnose hematologic malignancies (leukemia, lymphoma, myeloma, etc.) as well as testing DNA from tumors or from blood to detect inherited or acquired mutations that can guide therapeutic management and predict clinical outcome.  My research interests involve 1) understanding the biology of T-cell and NK-cell neoplasms; 2) defining the immunomodulatory response to neoplastic disease; 3) developing methods to monitor immune response and thereby refine tumor immunotherapy; and 4) exploring novel applications of tumor genetics in the diagnosis, prognosis, and management of cancer.

Allogeneic stem cell transplantation with a focus on the use of umbilical cord blood grafts; Allogenic stem cell transplantation for Sickle Cell Disease; Prevention of acute and chronic graft versus host disease; Improving immune recovery following alternative donor stem cell transplantation using donor graft manipulation.

1. High dose therapy and autologous and allogeneic stem cell rescue for hematologic malignancies (especially multiple myeloma) and solid tumors.
2. Non-myeloablative allogeneic transplants for hematologic malignancies and solid tumors.
3. Supportive care for hematopoietic stem cell transplants.
4. Prevention and therapy of graft versus host disease.

I am dedicated to the treatment of hematologic malignancies through cellular therapies such as hematopoietic stem cell transplantation (HCT). My research focuses on strategies to reduce complications of HCT and ranges from preclinical studies using murine models of HCT to Phase 1 and Phase 2 clinical trials. Areas of interest include the role of the microbiota (the trillions of bacteria living in and on our bodies), nutrition, and exercise in modulating HCT outcomes such as graft-versus-host disease (GVHD) and infections. In addition to advancing new pharmacological and cellular immunotherapies in support of these goals, we also are developing mobile health technologies (mHealth) to monitor patients at home, both as part of our innovative home transplant program as well as to improve follow up care of all our patients when they return home after transplant.

My research interests are in two broad areas, clinical hematopoietic stem cell and cord blood transplantation and in the laboratory studies related to graft vs. host disease and immune reconstitution. On the clinical side we are currently conducting approximately 50 different clinical protocols ranging from preparatory regimens, supportive care studies and disease specific protocols. Most of these clinical studies are centered around studies of the sources of stem cells and the methods to improve the long term outcome. There are exploratory protocols for novel therapies such as dendritic cell therapy for several malignancies, antiangiogenesis therapy, graft engineering to prevent graft-versus-host disease and antigen specific T cells or non specific NK cells to prevent relapse. Moreover a strong focus of the program is to develop cord-blood transplantation for adult patients with hematologic malignancies. The laboratory studies center on understanding the immunological events that occur with graft-vs-host disease and methods to prevent this disease. The current efforts focus on understanding murine reconstitution following transplantation, use of a peptide polymer to block MHC class II recognition of minor histocompatibility antigens, use of T cell engineering to prevent graft-versus-host disease at the same time preserving a graft-versus-malignancy effect.

For more information see http://ed-media.mc.duke.edu/BMT.nsf

Dr. Gasparetto performs both laboratory and clinical research in the field of multiple myeloma. Her primary research interests are in developing immunotherapy approaches to treating multiple myeloma particularly in conjunction with hematopoietic stem cell transplantation. Ongoing laboratory research projects include the development of dendritic cell vaccines and antibody therapies. Clinical studies include a recently approved trial involving vaccination with autologous dendritic cells pulsed with idiotypic protein following high dose chemotherapy and autologous peripheral blood stem cells transplant. Upcoming trials include novel antibody therapies for multiple myeloma. Dr. Gasparetto is also an investigator on several other clinical trials for myeloma including non-myeloablative allogeneic transplantation, high dose sequential chemotherapy and autologous peripheral blood stem cell transplantation and transplantation of partially HLA matched unrelated cord blood.

I am a clinical investigator in the Division of Hematologic Malignancies and Cellular Therapy in the Department of Medicine.  I serve as Director of the Leukemia Program and Director of Phase I Development in Hematologic Malignancies.  I am also the Chair of the SWOG Leukemia Committee.  I am interested in the clinical development of novel therapies for acute myeloid leukemia, myelodysplastic syndromes, myeloproliferative neoplasms (such as chronic myeloid leukemia, polycythemia vera, essential thrombocythemia and myelofibrosis), and acute lymphoblastic leukemia.  Specifically, I have been the Principal Investigator for small molecular inhibitors, antibody-drug conjugates and cytotoxic chemotherapy.