At the time I entered my hematology/oncology fellowship, I was eager to pursue clinical research aimed at bridging knowledge gaps in the area of cancer associated thrombosis. The University of Colorado is a large malignant hematology treatment center and performs among the most umbilical cord blood stem cell transplants in the world. My first research question focused around the VTE incidence in individuals who underwent stem cell transplant from different stem cell donor sources. I conducted a retrospective chart review on VTE characteristics in individuals from our institution after allogeneic HSCT, focusing on differences between cord blood and non-cord blood recipients. I discovered that not only was post-transplant VTE a serious problem in all individuals who undergo allogeneic stem cell transplant regardless of donor source, but also that these patients were at an extremely high risk of bleeding with anticoagulation. As a result of this endeavor, I have developed an interest in pursuing a career aimed at developing tools to risk stratify complex patients who develop VTE in the setting of a high risk of bleeding such as during thrombocytopenia. This has led me to my current project, aimed at prospectively evaluating clinical and laboratory variables which have been shown to be predictive of post-transplant VTE in retrospective studies, as well as the use of thromboelastography (TEG) to predict bleeding and re-thrombosis in these patients.
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