Marysol Chu Carty/ Dr.Alexandra Gomez Week 3

    As in the previous two weeks, I spent most of my time in the day hospital and the clinic with Dr.Gomez. It's been pretty nice getting to see the same patients every few days and seeing their progress every time they come back.  Additionally, I also was able to observe how an apheresis machine works. One patient who has been diagnosed with Lymphoma will undergo T cell therapy in the coming weeks and the first step to that was to collect his T cells. This machine collects the patient's blood and then centrifuges it to separate it into its various components by their density. This isn't a surgical procedure but it does take a few hours to complete. The blood is taken through an IV from one arm, goes into the machine which separates the white blood cells into a separate compartment, and then returns the plasma, platelets,  and red blood cells back to the patients through the other arm. While the patient waits for the T cells to come back from the lab he will undergo bridging therapy which is just chemo that will be given in the meantime to manage his disease and prevent it from progressing while he waits for his treatment. 
    On Thursday, I was able to shadow another clinician, Dr.Yamshon, who focuses on a different group of hematological diseases. While Dr.Gomez focuses on myeloid diseases which are diseases of hematopoeitic stem cells, Dr. Yamshon focuses on Lymphoma and the various different types that exist, thus his patients undergo CART or T cell therapy. It was interesting to see how follow-ups and checkups can vary from patients who undergo allogeneic bone marrow transplants to those who undergo CAR T or auto transplants. I did learn about a new type of treatment called multi-tumor associated antigen (multiTAA) which target various antigens at the same time, improving the cytotoxic activity of the therapy. Additionally, it has been shown to result in epitope spreading where the patient's immune system becomes activated further increasing the effectiveness of the treatment. 
    

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