Paul Martin

Overview:

For most of my career in Pediatric Hematology/Oncology I have focused on the use of stem cell transplant for the treatment of pediatric leukemias (ALL, AML, CML and JMML) and other non-malignant blood disorders, such as sickle cell disease, hemaphagocytic disorders, Wiskott-Aldrich, aplastic anemia, Diamond-Blackfan Anemia, as well as inherited metabolic diseases. In addition to focusing on determining the best use of stem cell transplants for these disorders, I have also been involved in clinical research investigating the prevention and treatment of transplant related morbidity, particularly veno-occlusive disease of the liver, infections and diffuse alveolar hemorrhage. As study chair for the Children's Oncology Group protocol 9904, I was involved in the development, implementation and analysis of a large, international frontline study of childhood acute lymphoblastic leukemia. Results from this study show that a significant number of children with certain favorable cytogenetic abnormalities in their leukemic cells and who have a rapid response to their initial chemotherapy can expect to have a >95% chance of cure when treated with relatively low intensity chemotherapy.  

For most of my time at Duke I have concentrated on providing high quality care for high risk leukemia patients who require high intensity therapies, such as stem cell transplant and immunotherapy.  As a member of the Pediatric Transplant and Cellular Therapy Division I provide clinical care for these patients.  As a member of various cooperative groups and local PI for several drug trials, I have worked to provide better care and more specific therapies for the toxicities associated with stem cell transplant.  

I have also collaborated with the Pediatric Immunology Division to provide a life-saving therapy for a small group of patients with thymic dysfunction, which causes severe immunodeficiency.  Our clinical team now provides support during these patients hospital admissions for donor thymus tissue implantation.

Positions:

Professor of Pediatrics

Pediatrics, Transplant and Cellular Therapy
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1987

Washington University in St. Louis

Ph.D. 1987

Washington University in St. Louis

Intern, Pediatrics

Yale University

Resident, Pediatrics

Yale University

Fellow, Pediatric Hematology/Oncology, Pediatrics

Yale University

Grants:

Pediatric Oncology Group (POG)

Administered By
Pediatrics, Transplant and Cellular Therapy
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

A Phase II, single arm, multicenter trial to determine the efficacy and safety of CTL019 in pediatric patients with relapsed and refractory B-cell acute lymphoblastic leukemia

Administered By
Pediatrics, Transplant and Cellular Therapy
Awarded By
Novartis Pharmaceuticals Corporation
Role
Principal Investigator
Start Date
End Date

A Phase 3, Randomized, Adaptive Study Comparing the Efficacy and Safety of Defibrotide vs Best Supportive Care in the Prevention of Hepatic Veno-Occlusive Disease in Adult and Pediatric Patients Undergoing Hematopoietic Stem Cell Transplant

Administered By
Pediatrics, Transplant and Cellular Therapy
Awarded By
Jazz Pharmaceuticals
Role
Principal Investigator
Start Date
End Date

PBMTC SUP 1601 Pathogen Identification in Pediatric HSCT

Administered By
Pediatrics, Transplant and Cellular Therapy
Awarded By
Children's Hospital Los Angeles
Role
Principal Investigator
Start Date
End Date

A Phase 2 Multicenter Single arm Study of Moxetumomab Pasudotox in Pediatric Subjects with Relapsed or Refractory pALL

Administered By
Pediatrics, Transplant and Cellular Therapy
Awarded By
MedImmune, Inc.
Role
Principal Investigator
Start Date
End Date

Publications:

Outcomes of pediatric patients with therapy-related myeloid neoplasms.

Long-term outcomes after allogeneic hematopoietic cell transplantation (HCT) for therapy-related myeloid neoplasms (tMNs) are dismal. There are few multicenter studies defining prognostic factors in pediatric patients with tMNs. We have accumulated the largest cohort of pediatric patients who have undergone HCT for a tMN to perform a multivariate analysis defining factors predictive of long-term survival. Sixty-eight percent of the 401 patients underwent HCT using a myeloablative conditioning (MAC) regimen, but there were no statistically significant differences in the overall survival (OS), event-free survival (EFS), or cumulative incidence of relapse and non-relapse mortality based on the conditioning intensity. Among the recipients of MAC regimens, 38.4% of deaths were from treatment-related causes, especially acute graft versus host disease (GVHD) and end-organ failure, as compared to only 20.9% of deaths in the reduced-intensity conditioning (RIC) cohort. Exposure to total body irradiation (TBI) during conditioning and experiencing grade III/IV acute GVHD was associated with worse OS. In addition, a diagnosis of therapy-related myelodysplastic syndrome and having a structurally complex karyotype at tMN diagnosis were associated with worse EFS. Reduced-toxicity (but not reduced-intensity) regimens might help to decrease relapse while limiting mortality associated with TBI-based HCT conditioning in pediatric patients with tMNs.
Authors
Sharma, A; Huang, S; Li, Y; Brooke, RJ; Ahmed, I; Allewelt, HB; Amrolia, P; Bertaina, A; Bhatt, NS; Bierings, MB; Bies, J; Brisset, C; Brondon, JE; Dahlberg, A; Dalle, J-H; Eissa, H; Fahd, M; Gassas, A; Gloude, NJ; Goebel, WS; Goeckerman, ES; Harris, K; Ho, R; Hudspeth, MP; Huo, JS; Jacobsohn, D; Kasow, KA; Katsanis, E; Kaviany, S; Keating, AK; Kernan, NA; Ktena, YP; Lauhan, CR; López-Hernandez, G; Martin, PL; Myers, KC; Naik, S; Olaya-Vargas, A; Onishi, T; Radhi, M; Ramachandran, S; Ramos, K; Rangarajan, HG; Roehrs, PA; Sampson, ME; Shaw, PJ; Skiles, JL; Somers, K; Symons, HJ; de Tersant, M; Uber, AN; Versluys, B; Cheng, C; Triplett, BM
MLA Citation
Sharma, Akshay, et al. “Outcomes of pediatric patients with therapy-related myeloid neoplasms.Bone Marrow Transplantation, Sept. 2021. Epmc, doi:10.1038/s41409-021-01448-x.
URI
https://scholars.duke.edu/individual/pub1496041
PMID
34480120
Source
epmc
Published In
Bone Marrow Transplantation
Published Date
DOI
10.1038/s41409-021-01448-x

Parental limited English proficiency in pediatric stem cell transplantation: Clinical impact and health care utilization.

BACKGROUND: Limited English proficiency (LEP) is associated with adverse clinical outcomes. The clinical impact of LEP in hematopoietic stem cell transplant (HSCT) has not been studied. The objectives of this study were to compare HSCT outcomes and health care utilization of Hispanic pediatric patients with and without parental LEP. METHODS: We conducted a retrospective review of Hispanic/Latino pediatric patients receiving HSCT at a single institution. Families were identified as LEP or English proficient (EP) based on clinicians' notes, social work documentation, or the signature of a Spanish interpreter on treatment consents. RESULTS: A total of 83 Hispanic/Latino patients were identified with 53 (65.1%) having parental LEP. More patients in the LEP group had a documented financial burden at pretransplant psychosocial evaluation (72.2% vs. 41.4%, p = .009). LEP patients were more likely to have health insurance coverage through government-sponsored Medicaid (76.9% vs. 27.6%, p < .001). LEP patients were hospitalized on average 13 days longer than EP patients, and LEP patients were more likely to have pretransplant cytomegalovirus (CMV) reactivity (67.3%) than EP patients (p = .001). Overall survival was lower in LEP than EP, but was not statistically significant (p = .193). Multivariable Cox modeling suggested a potentially higher risk of death in LEP versus EP (hazard ratio = 1.56, 95% CI: 0.38, 6.23). CONCLUSIONS: Parental LEP in HSCT is associated with prolonged hospitalization and pretransplant CMV reactivity. These factors are associated with posttransplant complications and death. Our results suggest parental LEP is a risk factor for poor HSCT outcomes. Further study is warranted in a larger cohort.
MLA Citation
Robles, Joanna M., et al. “Parental limited English proficiency in pediatric stem cell transplantation: Clinical impact and health care utilization.Pediatr Blood Cancer, vol. 68, no. 9, Sept. 2021, p. e29174. Pubmed, doi:10.1002/pbc.29174.
URI
https://scholars.duke.edu/individual/pub1484724
PMID
34109732
Source
pubmed
Published In
Pediatr Blood Cancer
Volume
68
Published Date
Start Page
e29174
DOI
10.1002/pbc.29174

Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer.

Cancer immunotherapies are associated with remarkable therapeutic response rates but also with unique and severe toxicities, which potentially result in rapid deterioration in health. The number of clinical applications for novel immune effector-cell therapies, including chimeric antigen receptor (CAR)-expressing cells, and other immunotherapies, such as immune-checkpoint inhibitors, is increasing. In this Consensus Statement, members of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Hematopoietic Cell Transplantation-Cancer Immunotherapy (HCT-CI) Subgroup, Paediatric Diseases Working Party (PDWP) of the European Society of Blood and Marrow Transplantation (EBMT), Supportive Care Committee of the Pediatric Transplantation and Cellular Therapy Consortium (PTCTC) and MD Anderson Cancer Center CAR T Cell Therapy-Associated Toxicity (CARTOX) Program collaborated to provide updated comprehensive recommendations for the care of children, adolescents and young adults receiving cancer immunotherapies. With these recommendations, we address emerging toxicity mitigation strategies, we advocate for the characterization of baseline organ function according to age and discipline-specific criteria, we recommend early critical care assessment when indicated, with consideration of reversibility of underlying pathology (instead of organ failure scores) to guide critical care interventions, and we call for researchers, regulatory agencies and sponsors to support and facilitate early inclusion of young patients with cancer in well-designed clinical trials.
Authors
Ragoonanan, D; Khazal, SJ; Abdel-Azim, H; McCall, D; Cuglievan, B; Tambaro, FP; Ahmad, AH; Rowan, CM; Gutierrez, C; Schadler, K; Li, S; Di Nardo, M; Chi, L; Gulbis, AM; Shoberu, B; Mireles, ME; McArthur, J; Kapoor, N; Miller, J; Fitzgerald, JC; Tewari, P; Petropoulos, D; Gill, JB; Duncan, CN; Lehmann, LE; Hingorani, S; Angelo, JR; Swinford, RD; Steiner, ME; Hernandez Tejada, FN; Martin, PL; Auletta, J; Choi, SW; Bajwa, R; Dailey Garnes, N; Kebriaei, P; Rezvani, K; Wierda, WG; Neelapu, SS; Shpall, EJ; Corbacioglu, S; Mahadeo, KM
MLA Citation
Ragoonanan, Dristhi, et al. “Diagnosis, grading and management of toxicities from immunotherapies in children, adolescents and young adults with cancer.Nat Rev Clin Oncol, vol. 18, no. 7, July 2021, pp. 435–53. Pubmed, doi:10.1038/s41571-021-00474-4.
URI
https://scholars.duke.edu/individual/pub1474851
PMID
33608690
Source
pubmed
Published In
Nature Reviews. Clinical Oncology
Volume
18
Published Date
Start Page
435
End Page
453
DOI
10.1038/s41571-021-00474-4

Effects of Vitamin D Levels on Outcomes after Allogeneic Hematopoietic Stem Cell Transplantation in Children

Authors
Bajwa, RPS; Taylor, K; Hoyt, AR; Kamboj, M; Auletta, JJ; Stanek, J; Mahadeo, KM; Alsaedi, HS; Abdel-Azim, H; Dvorak, CC; O'Kane, S; Stafford, L; Martin, PL
MLA Citation
Bajwa, Rajinder P. S., et al. “Effects of Vitamin D Levels on Outcomes after Allogeneic Hematopoietic Stem Cell Transplantation in Children.” Biology of Blood and Marrow Transplantation, vol. 25, no. 3, 2019.
URI
https://scholars.duke.edu/individual/pub1469333
Source
wos-lite
Published In
Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation
Volume
25
Published Date

Global Registration Trial of Efficacy and Safety of CTL019 in Pediatric and Young Adult Patients with Relapsed/Refractory (R/R) Acute Lymphoblastic Leukemia (ALL): Update to the Interim Analysis

Authors
Buechner, J; Grupp, SA; Maude, SL; Boyer, M; Bittencourt, H; Laetsch, TW; Bader, P; Verneris, MR; Stefanski, H; Myers, GD; Qayed, M; Pulsipher, MA; De Moerloose, B; Hiramatsu, H; Schlis, K; Davis, K; Martin, PL; Nemecek, E; Peters, C; Wood, P; Taran, T; Mueller, KT; Zhang, Y; Rives, S
MLA Citation
Buechner, Jochen, et al. “Global Registration Trial of Efficacy and Safety of CTL019 in Pediatric and Young Adult Patients with Relapsed/Refractory (R/R) Acute Lymphoblastic Leukemia (ALL): Update to the Interim Analysis.” Clinical Lymphoma Myeloma and Leukemia, vol. 17, Elsevier BV, 2017, pp. S263–64. Crossref, doi:10.1016/j.clml.2017.07.030.
URI
https://scholars.duke.edu/individual/pub1457166
Source
crossref
Published In
Clinical Lymphoma, Myeloma & Leukemia
Volume
17
Published Date
Start Page
S263
End Page
S264
DOI
10.1016/j.clml.2017.07.030