Shernan Holtan, MD, Associate Professor of Medicine, Division of Hematology, Oncology and Transplantation, spreads the word about
#powerlifting
– a sport she says physicians and patients can benefit from.
🏋️♀️➡️
🪷 A personal update:
After a fulfilling decade of service at The University of Minnesota, I have decided to embark on a new chapter in 2024: I accepted a position as Chief of the Blood and Marrow Transplant Program at
@RoswellPark
in Buffalo, NY.
This decision was not made…
I don’t always look like a surgeon, but I do when I harvest bone marrow. 💪 First thing our donor said upon coming out of anesthesia was, “I saved a life today!” Yes! Yes you did! Thank you, donors!!! 🙏♥️ 🤩
@BeTheMatch
@marrowonthemove
Trump muses that he could’ve become a research scientist instead of president.
TRUMP: I like this stuff. I really get it… every one of these doctors said, ‘how do you know so much about this?’ Maybe I have a natural ability.
This is my dad’s best friend, Randi. He worked with my dad in the same custom cabinet shop when my dad’s immune system attacked his spinal cord. He was there when my dad took his last steps. Even though everything about my dad’s health changed, they stayed best friends. For the…
Something I didn't expect to see during my career:
Severe acute and chronic
#GVHD
<6% in well-matched myeloablative transplantation.
One death due to GVHD out of 125 patients, and that was too many.
It's undeniably a new era in
#BMT
.
Does
#BMT
age the hematopoietic system?
Yes, by 5-10 years, as estimated by loss of clonal diversity.
Also interesting that only ~30K stem cells engraft on average.
Great one,
@doctor_msc
🙏
Fascinating fundamental work, with implications for donor selection. 👇
#ASH22
Painful
#ASH22
reality 💔
Love seeing former beloved colleagues but struck by our loss to industry.
Hundreds of years of experience walked out the door in just the past 2 years.
Is it time to evolve the model of the academic physician before we lose more? If so, how?
“Why I Quit My Dream Job” by Meghan Rothenberger, MD.
Brave, beautiful talk. Vulnerability and honesty. 🙏♥️
How can we once again realign the work of medicine with our values???
I write this as I finish clinic at 7:45 pm on Friday. 🙃
Clinical trials,
@ASH_hematology
abstracts, and 💰:
A brief 🧵
Few investigator-initiated clinical trials are completed without
#industry
funding.
For that reason, I'm extra proud of our phase 2
#Pregnyl
for life-threatening
#GVHD
abstract:
Grateful to
@UMNews
for the support and to the
@US_FDA
for the Orphan Drug Designation — uhCG/EGF for treatment of acute
#GVHD
. Research funded by
@Regen_Med_MN
. Another Minnesota first!
"FDA Grants Orphan Drug Designation for New Treatment for Life-Threatening Acute GVHD Developed at the University of Minnesota"
Congrats to Dr. Shernan Holtan for her drive and passion to make this a reality.
#YourCancerCenter
#UMNCancer
#MNCancerCenter
Dr. Anne Blaes has assumed the role of interim division chief at
@UMNHOT
! We are now among the small but growing number of heme/onc divisions led by a female. She is an incredible clinician, researcher, mentor, and visionary. Big news for
#WomenInMedicine
and
#WomenInSTEM
! 🙏♥️
Eternally grateful to
@DanielWeisdorf
for his mentorship and guidance over the years! What a legend! Happy retirement! 🎉🍾 We are still probably going to be calling a lot to ask “what would Dan do?!” 😂❤️ Such good fortune to be able to learn from him.
Day 1 at
@RoswellPark
! Starting off the day with
@bfloannie
and Dr. Betts doing an interview for Buffalo News! Exciting to share our vision and goals. Let’s go! 🎉
Overwhelming. Thank you,
@ASTCT
, for taking the time to tell our stories in recognition of
#WomensHistoryMonth
! We have some amazing women in our field!!🌷💗
"I am most proud of the 12+ year journey from conception (of an idea!) through to obtaining FDA orphan drug designation for urinary-derived human chorionic gonadotropin for life-threatening acute GVHD."
@sghmd
Hearty congratulations to Dr. Mukta Arora! Today, she leaves
@umnmedschool
after 20+ years for a new adventure in industry. She is an incredible physician who has forever changed
#BMT
through her work in chronic
#GVHD
and
#frailty
. Thank you for years of inspiration!
Dr.
@DanielWeisdorf
’s last official day on the
@umnmedschool
payroll was last Friday. Nonetheless, we talked him into giving
#BMT
conference today. 🤗 Difficult to fathom how much he has done for the U, for patients, for trainees, for the field over the last 45 years. ♥️
ASH Abstract Koura et al = Calcineurin free GVHD PPx
Randomized phase II
Abatacept+PTCy vs CNI+MTX
moderate/severe cGVHD = 0% vs 66%!
No gut or liver aGVHD in aba+PTCy arm
@sghmd
My ❤️ is full after my last day of rounding on 5C
@umnmedschool
. 10 years have flown by, and I’ll always have deep admiration for this amazing team of nurses, NSTs, pharmacists, dieticians, APPs, social workers and therapists. This is a special place!
@acweyand
And then she was labeled as “difficult” by her leadership, was prohibited from engaging in real discussions about the group’s direction, and faced retaliation.
But saying no was still the right thing to do.
Much work remains. ❤️🩹
CC:
@RUBraveEnough
🤯 applying 1% progesterone to the forehead twice daily improved 👀 ocular
#GVHD
in 50% of pts. How does this work?
@sophpacz
suggests to check
#amphiregulin
in tears. 😱 Yay for low cost, low toxicity, novel supportive care. 🤗♥️🔥 Phase III planned.
@DanaFarber
nice work!
My best advice to physicians at all levels:
Listen to
#Nurses
Really listen. Trust them. Seek their point of view. Involve them in big decisions. Respect them.
If a nurse comes to you with a concern, from routine care to the conduct of first-in-human research, PAY ATTENTION.
Cytopenias after CAR T.
A conundrum, esp when not responsive to G-CSF.
Nice presentation re CAR-HEMATOTOX by
@MSubklewe
at
#MSKToxTCT
👇
Link to calculator:
I hope
@fredhutch
knows what a super 🌟 they are inheriting! Today was Dr.
Rashidi’s last day in
#BMT
clinic
@MHealthFairview
. 😩 Most productive, dedicated, and kind person you will ever meet. We will carry on the 💩 💊 torch (IYKYK) for you at
@UMNHOT
! ♥️♥️♥️
I grew up in the sprawling fields of western
#Nebraska
. I find it easiest to explain the process of allogeneic hematopoetic cell transplantation (
#BMT
) through a
#farming
or
#garden
analogy.
Please feel free to use/share if it works for you.
We can transplant and help grow a new immune system.
We can engineer immune cells to go after just about anything.
But we can’t develop a robust system that allows a physician with a panel of patients with complex needs to *actually* be away from time to time while maintaining…
PRE-PRINT: Phase II Study of
#Myeloablative
8/8- or 7/8-Matched Allotransplantation with
#PTCy
/Tac/MMF: Marked Reduction in
#GVHD
Risk Without Increased Relapse Risk Compared to Historical CSA/MTX…
I’ve had just as many conversations about weightlifting and music as I have had about
#GVHD
at
#Tandem23
. It’s
#WhyITweet
- connectedness. We are all complex humans and healers. We perform best when we grant ourselves the grace to work on our bodies, minds, and hearts. ❤️
PS - One of the best
#heforshe
advocates on
#MedTwitter
right here. He’s done an amazing job of promoting
#womeninSTEM
over the years. 🙏 Thank you, Miguel!!! 🥳 You are a great friend and colleague.
🥁Don’t miss
@sghmd
talk on
@bmtctn
1703 at Late breaking session on Tuesday - RCT of RIC alloHCT TacMTX vs PTCY. Will this study change practice??
#ASH22
@GvHD_Meade
Misogyny appears to be alive and well at
@WSJ
.
If a woman earns a doctoral degree, we address her by “Dr.”
Just like we would do for anyone else.
It’s not that complicated. 🤷♀️
#respect
Grateful for this family road trip, brought to us by vaccines, home testing, masking, downloaded podcasts and music, and caffeine. Recharging to head back to service right away in the new year. Between service, teaching, research, and family needs, 2022 will require laser focus.
2022
@ASTCT
@CIBMTR
Tandem meetings postponed until April 23-26!
Thank you!! This is highly appreciated.
We are short staffed, tired, and worried about travel during a
#COVID
surge.
It has been hard to concentrate on academic work amidst constant crises, TBH.
Exhale.
Most interesting and provocative
#Tandem23
abstract: reducing acute/chronic GVHD risk in peds/AYA with single dose pre-transplant vitamin A. 💊
Nicely conducted randomized, double blind, placebo controlled study 👏
Congrats to the authors!
@BmtCincy
Huge day at
@RoswellPark
-
#ArmoredCARs
are here! 🥳
Genetically Engineered Cells (EGFRt/19-28z/IL-12 CAR T Cells) for the Treatment of Relapsed or Refractory CD19+ Hematologic Malignancies - including
#lymphoma
and
#CLL
Incredible work
@BrentjensRenier
and team!…
Raise your hand if you have been to a scientific session, had a question, felt too nervous to ask it, only to have a more senior male step up to the 🎤 and ask what you were thinking? 🙋♀️
Thank you for shining a light on this,
@StephanieLeeMD
and team!
#ASH20
@ASH_hematology
Beyond excited to be a part of the "Updates in GVHD" education session at
#ASH21
led by Drs.
@hamiltkyb
and
@Areejmd
. Honor of a lifetime! 💗
Just....could the spelling of Dr. El-Jawahri's and my first name please be corrected,
@ASH_hematology
? 🙏🏽🙏🏽
The 🧠 drain is real. We know many reasons why ppl are leaving academic medicine and direct patient care.
Let’s flip it. What real changes could be made to retain and recruit to
#AcademicMedicine
?
What specific items would be on your wish list?
The kiddo who gave me the idea to develop a
#ClinicalTrial
to treat life-threatening
#GVHD
with
#hCG
turns 13 today. 🎂♥️.
Phase 1 published, phase 2 patients in follow up.
Please send 🍷
9 hours post-
#covid
vaccine and feeling great. No arm pain. Able to get my
#deadlift
session in tonight. Beyond grateful. Staying strong for 4 weeks of
#BMT
hospital service coming up very soon and 🏥 backup/relief wherever I’m needed. 💪
#VaccinesSaveLives
@marrowonthemove
Your friendly
#BMT
#GVHD
doc currently holds the USPA national
#squat
record and state
#bench
and
#deadlift
records for 82.5 kg masters. 🎉🙏 Made possible by the most inspiring coach ever, Jason Sweetnam.♥️ I’m sure this will be very transient but it sure feels good right now!
It’s one of those days that
#FathersDay
falls on my birthday. Cheers 🍻 to the guy who showed to find joy in hard work, to love progressive rock, and to keep a sense of humor in difficult times. Thank you for these and many more good and bad traits, Dad! 😂♥️
Every physician (and nurse, APP, MA - everyone!) I know has taken pay cuts and/or gone on furlough or worse due to
#COVID19
. This is NOT a way for our health systems or individuals within it to make $. We are working MORE with less support and less pay. And we are tired.
With record surge of cases in US, hospitalization & deaths rising, Trump accuses doctors of making up
#COVID19
...to make money?!
He’s clearly never filled out a death certificate. Trust us-we fill out too many.
We WILL
#VoteHimOut
#VoteHealth
Great news! After 8 straight hours of sitting in this chair, I got my first R code to run without errors!
Not so great news!
My table has no results. 😭
Please send carbs and/or 🍷.
GVHD YEAR-IN-REVIEW: The end of 2019 is here, and we are hopefully closer to eliminating
#GVHD
as a complication of
#BMT
. Here are the top papers that IMO have challenged us and helped us grow as a field over the past year. 1/10
Hospital, clinic, teaching, meetings, research, illness, stress, chaos. If I don’t get out here, my stress and worries 🚀. With all the challenges, even 30 mins of focus helps. Testing out the
@BarbellMedicine
#hypertrophy
program for a new fun adventure. 🏔 Will report back!
Disappointed to learn about this happening where I trained.
Disappointed in the institutional response.
Fear of retaliation is real. This took a lot of bravery. My heart goes out to the victims of abuse.
MaaT013 pooled microbiota 🦠💩compassionate use for refractory GI
#GVHD
. 61% CR in rux failure, 92% response in steroid dependent GVHD.
@Mohty_EBMT
navigating the challenge of the hybrid meeting platform with grace. 🕺
#ASH22
🚨USA
#GVHD
EXPERTS:
Can we finally change the paradigm of high-dose steroids for first-line acute GVHD?
We are starting to select a limited # of sites to participate in
#ruxolitinib
+ uhCG/EGF + steroid dose de-escalation in 1st LINE HIGH RISK aGVHD.
A brief 🧵:
BMT inpatients: 20
Clinic patients: 8
Vaccine dose: 2
My greatest thanks to the
@MHealthFairview
@umnmedschool
volunteers for delivering hope and keeping us going. ❤️
Discussing the history of GVHD prophylaxis on rounds today with
@MDPhD10
. We have an over-simplified figure showing its evolution, followed by how we hope GVHD prophylaxis will be imagined in the future in our recent review paper
@ASCO_pubs
#JCO
:
The proposed
@umnmedschool
hospital 😍😱! Co-sign from me. We have a legacy of innovation, hope, and world-class, barrier-breaking care. ❤️
University of Minnesota wants teaching hospital back as part of expansion plan
Do you know of any pts post-
#myeloma
autoHCT who later developed ALL?
If so, please connect with
@BMTjunkie
Dr. Hahn
@RoswellPark
. She is doing some important work related to this difficult topic.
Incredible poster
#Tandem24
👇
I’m honestly so proud of this trial and our team!
@AlexHooverMD
showing us important peds vs adult data with PTCy.
That chronic GVHD CI curve 👀
We hope the need for years and years of immunosuppression due to
#GVHD
is gone forever. 👋
👇♥️🙏
The incidence of severe acute/chronic graft-versus-host disease is <6% in matched donor myeloablative conditioned hematopoietic cell transplantation with post-transplantation cyclophosphamide/tacrolimus/mycophenolate mofetil. Read more:
#HSCT
#GVHD
I’m in my 20th year as a physician.
The past 20 years have been more difficult and more rewarding than anything I could have imagined as a child growing up on the prairie.
Currently in deep reflection. What to do with the next 20 years?
Pre-proof from
@ASTCT_Journal
of a project that took 17 years from idea 🤰💡 to completed clinical trial.🥵
Phase II
#uhCG
/
#EGF
+ standard immunosuppression for life-threatening acute
#GVHD
Brief takeaways in a thread 🧵:
First
#ASH22
adventure: my checked bag was overweight because of all the protein I packed to consume over the next few days. Still gotta hit the macros when on the road. 😂🏋️♀️💪
Key 🔑 question from
@StephanieLeeMD
: how will
#COVID19
vaccine work in
#immunocompromised
?
#Fauci
paraphrased: We don’t know now. May not be as robust response. However, some immune response to vaccine is better than none. Recommend to get vaccinated as soon as able ✅