This is a K23 career development award proposal from Ashley Rosko, MD, an Assistant Professor in the Division of Hematology at The Ohio State University. The K23 mentored research award will be used to assist Dr. Rosko in becoming an independently funded investigator to conduct research to improve treatment health outcomes of older adults with hematologic malignancy. Dr. Rosko has a diverse mentoring team with a proven track record, including Dr. John C. Byrd (translational science), Dr. Electra Paskett (population health), and Dr. Michelle Naughton (outcomes assessment and behavioral science). Together this mentoring team will advise and support Dr. Rosko in her research aims and career development plan. Dr. Rosko's career development plan includes formal coursework to further her knowledge of aging, research methods and biostatistics, as well as professional development activities to increase networking, paper and grant writing skills. Dr. Rosko's research interests are in identifying occult geriatric factors that affect clinical outcomes in adults with hematologic malignancy in order to develop effective interventions to improve survival and quality of life. Her research plan will test baseline fitness metrics with an intervention of a structured exercise program, combined with select aging biomarkers, to assess changes in physiologic fitness among patients with hematologic malignancies awaiting bone marrow transplant. Maintaining physical function is an important part of cancer care. Patients with hematologic malignancy are prone to deconditioning due to the toxicities associated with treatment and bone marrow transplant. Exercise programs are a proven intervention to prevent functional decline and improve quality of life, but are underutilized in patients with hematologic malignancy. Deconditioning is associated with serious adverse consequences, such as falls, which are common and dangerous in this patient population. Thus, the objective of the research project is to complete a feasibility study implementing a structured exercise program, the Otago Exercise Program (OEP), to improve physical fitness in pre-transplant patients with hematologic malignancies. The central hypothesis is that the OEP can be implemented safely and successfully in patients with hematologic malignancies awaiting transplant. The rationale is that structured exercise programs can improve outcomes in cancer patients, but feasibility, practicality and disease/treatment characteristics can be barriers to implementation, and need to be evaluated first. The work accomplished here will provide preliminary data regarding the safe implementation of the OEP and feasibility of recruitment, data collection, and patient adherence. Data obtained from this study will be used to apply for an R21 grant to support a randomized clinical trial to prevent physical decline and improve health and quality of life outcomes in adults with hematologic malignancy.

Public Health Relevance

The proposed research is relevant to public health as over 10,000 autologous blood and/or bone marrow transplants (BBMT) are performed in the United States per year. Thirty-nine percent of autologous transplant recipients in 2006-2012 were older than age 60. Our proposal aims to better understand ?fitness? for BBMT to improve clinical outcomes and survival for older adults undergoing autologous BBMT.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23CA208010-01
Application #
9164752
Study Section
Special Emphasis Panel (ZCA1-RTRB-4 (M1))
Program Officer
Radaev, Sergei
Project Start
2016-07-22
Project End
2021-06-30
Budget Start
2016-07-22
Budget End
2017-06-30
Support Year
1
Fiscal Year
2016
Total Cost
$171,828
Indirect Cost
$12,728
Name
Ohio State University
Department
Type
Schools of Medicine
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Koll, Thuy T; Rosko, Ashley E (2018) Frailty in Hematologic Malignancy. Curr Hematol Malig Rep 13:143-154
Richardson, Daniel R; Huang, Ying; McGinty, Heather L et al. (2018) Psychosocial risk predicts high readmission rates for hematopoietic cell transplant recipients. Bone Marrow Transplant 53:1418-1427
Rosko, Ashley E; Huang, Ying; Benson, Don M et al. (2018) Use of a comprehensive frailty assessment to predict morbidity in patients with multiple myeloma undergoing transplant. J Geriatr Oncol :
Rosko, Ashley E; Olin, Rebecca L; Artz, Andrew et al. (2018) A call to action in hematologic disorders: A report from the ASH scientific workshop on hematology and aging. J Geriatr Oncol 9:287-290
Barr, Hallie; Dempsey, Jessica; Waller, Allyson et al. (2018) Ninety-minute daratumumab infusion is safe in multiple myeloma. Leukemia 32:2495-2518
Krok-Schoen, Jessica L; Fisher, James L; Stephens, Julie A et al. (2018) Incidence and survival of hematological cancers among adults ages ?75 years. Cancer Med :
Rosko, Ashley; Wang, Hai-Lin; de Lima, Marcos et al. (2017) Reduced intensity conditioned allograft yields favorable survival for older adults with B-cell acute lymphoblastic leukemia. Am J Hematol 92:42-49
Rosko, Ashley; Artz, Andrew (2017) Aging: Treating the Older Patient. Biol Blood Marrow Transplant 23:193-200
Guerard, Emily J; Nightingale, Ginah; Bellizzi, Keith et al. (2016) Survivorship care for older adults with cancer: U13 conference report. J Geriatr Oncol 7:305-12