Assistant professor, University of Pennsylvania School of Medicine
- Primary Address:
Division of Oncology
Children's Hospital of Philadelphia
3501 Civic Center Blvd, CTRB 3004
Philadelphia, PA 19104
- Assistant Professor of Pediatrics at the Children's Hospital of Philadelphia (2011 – present)
- MD, Oregon Health Sciences University (2002)
- MPH, Epidemiology and Biostatistics, Oregon Health Sciences University (2002)
- MA, Linguistics, McGill University (1995)
- BA, Linguistics - Honours, First Class, McGill University (1992)
Blood and marrow transplantation
Despite advances in treating pediatric acute lymphoblastic leukemia (ALL), children with relapsed disease have dismal outcomes and are often not curable with chemotherapy alone. Furthermore, children with residual leukemia cells after chemotherapy are highly likely to relapse. Simply adding more traditional chemotherapy will not treat chemotherapy-resistant cells and just adds toxicity; we are developing other approaches to eliminating chemoresistant ALL with the goal of improving efficacy and reducing toxicity.
We have shown that a drug that stimulates the immune system like a virus or bacteria does can cure ALL in mice, results leading to a national phase I/II pediatric clinical trial. This type of immune stimulation generates long-term immune memory like a vaccine does, allowing the immune system to recognize and kill residual leukemia cells long after the leukemia is in remission. Our current focus takes a novel two-pronged approach to enhance the immune system’s ability to kill ALL, combining our immune stimulant with drugs already in clinical use that make tumor cells more recognizable to the immune system. In addition, we have identified the largest group of pediatric ALL patients ever reported and will use this cohort to evaluate our findings in children with ALL who have had immune stimulation by infections.
Immune stimulation may help children with chemotherapy-resistant ALL and may improve efficacy of current therapies without adding new toxicity. Furthermore, if we stimulate a child’s immune system to recognize ALL, long-term memory effects may prevent relapse for his or her lifespan. We have compelling laboratory data that immune stimulation is effective; however, most treatments that work in the lab fail in clinical trials. Using existing data from a nationwide group of children with ALL, we can evaluate immune stimulation in children long before Phase III testing. This approach will also apply to other rare pediatric cancers, such as acute myeloid leukemia (AML).
- Kavcic M, Fisher BT*, Seif AE*, Li Y, Huang YS, Walker D, Aplenc R.. Leveraging Administrative Data to Monitor Rituximab Use in 2,875 Patients at 42 Free Standing Children?s Hospitals Across the United States. Journal of Pediatrics. Vol 162(6) . 2013:1252-8.e1.
- Kavcic M, Fisher BT, Li Y, Seif AE, Torp K, Walker DM, Huang YS, Lee GE, Tasian SK, Vujkovic M, Bagatell R, Aplenc R.. Induction Mortality and Resource Utilization in Children Treated for Acute Myeloid Leukemia at Free-Standing Pediatric Hospitals in the United States. Cancer. Vol 119(10) . 2013:1916-23.
- Kavcic M, Fisher BT, Torp K, Li Y, Huang YS, Seif AE, Vujkovic M, Aplenc R. Assembly of a Cohort of Children Treated for Acute Myeloid Leukemia at Free-standing Children?s Hospitals in the United States using an Administrative Database. Pediatric Blood & Cancer. Vol 60(3) . 2013:508-11.
- Fisher BT, Singh S, Huang YSV, Li Y, Gregory J, Walker D, Seif AE, Kavcic M, Aplenc R. Induction mortality, ATRA administration, and resource utilization in a nationally representative cohort of children with acute promyelocytic leukemia in the United States from 1999 to 2009. Pediatric Blood & Cancer. 2013.
- Lothstein K, Fisher BT, Li Y, Seif A, Harris T, Torp K, Kavcic M, Huang YSV, Rheingold SR, Aplenc R.. Zoonotic Infections in Pediatric Patients with Acute Leukemia. Pediatric Blood & Cancer. 2013.
- Teachey DT, Rheingold SR, Maude SL, Zugmaier G, Barrett DM, Seif AE, Nichols KE, Suppa EK, Kalos M, Berg RA, Fitzgerald JC, Aplenc R, Gore L, and Grupp SA. Cytokine release syndrome after blinatumomab treatment related to abnormal macrophage activation and ameliorated with cytokine directed therapy. Blood. Vol 121(26) . 2013:5154-7.
- Fisher BT, Gerber JS, Leckerman K, Seif AE, Huang YS, Li Y, Harris T, Torp K, Rheam D, Shah A, Walker D, Aplenc R.. Variation in Hospital Antibiotic Prescribing Practices for Children with Acute Lymphoblastic Leukemia. Leukemia and Lymphoma. Vol 54(8) . 2013:1633-9.