Why did you decide to work in oncology?
My longstanding research interests are in how the immune system recognizes and responds to threats. In recent years, the successes of immunotherapy for treating cancer have exemplified the impact that immunology research can have in clinical care. Moreover, my rotations during internal medicine residency at Massachusetts General Hospital showed me the deep, caring relationships that oncologists formed with their patients, cementing my interest in this field as the ideal combination of patient-centered care with direct impact of cutting-edge research. I feel that hematopoietic stem cell transplantation, the specialized field in which I practice, is the ideal blend of both the science and art of medicine.
Tell us about the condition(s) you specialize in. Why is this an area of interest to you? What led you to focus here?
I specialize in the care of patients undergoing hematopoietic stem cell transplantation, a treatment that has the potential to cure blood cancers in patients, such as leukemias and lymphomas. Allogeneic (from a healthy donor) stem cell transplantation is my area of particular focus, and I find this area especially exciting because we are replacing the entire immune system of a patient with a brand new one. When we perform an allogeneic stem cell transplant, the immune cells from the donor play a role in curing the patient of their disease through a phenomenon known as the graft-versus-leukemia (GVL) (or more generally graft-versus-tumor) effect. We don't currently know how this GVL process works, which is one of the things that interests me the most in this field.
What are the main challenges in this area? How do you address these challenges with patients and families?
The main challenge in stem cell transplantation is that not every patient is cured from their original disease. In fact, many patients experience relapse of their original disease after transplantation. When this happens, we have limited treatment options available that work well, and very few patients who relapse are subsequently able to enter long-term remission with more treatment. This can be especially difficult for patients and families who have already been through intensive treatment, including transplant. Our field needs more research into different types of therapies that can be more effective in preventing and treating disease relapse.
Describe your research in stem cell transplantation.
My research centers around understanding how a patient's new immune system after allogeneic stem cell transplant can recognize and eliminate leukemia. Despite 50 years of research, the mechanism of the GVL effect remains uncertain. Dana-Farber has unparalleled resources to enable this type of work, including a long-standing bank of clinical specimens that I have been able to use for my research. I hope to use this work to generate new ideas and strategies for treating patients with relapsed disease after transplant.
What are you most excited about in your work in the area of stem cell transplantation? What holds promise for patients?
There have been multiple new medications in recent years that specifically target some mutations that drive disease. We are still learning how to best combine these treatments with other medications, especially for the challenging setting of disease relapse, and how to give these medications around the time of transplant to help prevent relapse. Other therapies, including immunotherapies, are currently being studied for use in transplant patients, and I think that these will provide new opportunities for both preventing and treating relapse after transplant. My hope is that the combination of these strategies will help us to improve outcomes for our patients.
What do you like to do when you're not doing research/caring for patients? What do you do for fun?
My favorite thing is spending time with my husband and our two-year-old son! We love taking our dog for walks together, trying new restaurants, and exploring Boston's museums. My husband and I do The New York Times crossword together every day, and our streak is going on four years.
Recent Research Publications
Coordinated Immune Cell Networks in the Bone Marrow Microenvironment Define the Graft versus Leukemia Response with Adoptive Cellular Therapy