Publications by authors named "Allison L Martin"

14 Publications

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Evaluation of Montelukast for the Prevention of Infusion-related Reactions With Daratumumab.

Clin Lymphoma Myeloma Leuk 2020 10 7;20(10):e777-e781. Epub 2020 Jun 7.

Department of Hematologic Oncology and Blood Disorders, Atrium Health, Levine Cancer Institute, Charlotte, NC.

Background: Daratumumab is an anti-CD38 monoclonal antibody indicated for the treatment of multiple myeloma. Infusion-related reactions (IRRs) are among the most common adverse events associated with daratumumab. IRRs are most common with the first infusion of daratumumab. Recommended premedications to be given prior to the daratumumab dose include acetaminophen, diphenhydramine, and a corticosteroid. There is emerging data to suggest that the addition of montelukast to this premedication regimen can lower the incidence of daratumumab-related IRRs.

Patients And Methods: This was a single-center, retrospective chart review conducted at a large, multistate health system with several different hematology/oncology practice sites. Eligible patients included those with a primary diagnosis of a plasma cell disorder who received at least 1 dose of daratumumab. The primary outcome was the incidence of IRRs with the first daratumumab infusion.

Results: A total of 141 patients receiving daratumumab-based therapy were included in this study. All patients received acetaminophen, diphenhydramine, and a corticosteroid as premedications prior to the first infusion of daratumumab. Overall, 46 (33%) patients experienced an IRR with the first infusion of daratumumab. The incidence of IRR was lower in patients that received montelukast as a premedication compared with those that did not (montelukast, n = 25 [27%]; no montelukast, n = 21 [45%]; P = .0371). Patients in each arm experienced similar rates of overall, composite pulmonary, gastrointestinal, and systemic IRR manifestations.

Conclusion: The use of montelukast prior to the first daratumumab infusion led to a reduction in the incidence of IRRs in our experience.
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http://dx.doi.org/10.1016/j.clml.2020.05.024DOI Listing
October 2020

Spatial Sequencing: A Perspective.

J Biomol Tech 2020 07;31(2):44-46

Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA; and.

Fluorescent spatial sequencing brings next-generation sequencing into a new realm capable of identifying nucleic acids in the cell's natural environment. For the first time, scientists are able to multiplex the assignment of specific locations to hundreds of transcriptional targets and lay the foundation for understanding how genetic changes control the fate of each cell within the tissue microenvironment. In this perspective, we discuss the capabilities of fluorescent spatial sequencing in the context of other spatial imaging technologies and describe how these new technologies offer a data-rich, multiomic solution to many research applications. Fluorescent spatial sequencing has opened options for exploring many fundamental questions in biology, helping us gain a better understanding of cell and tissue development and disease progression.
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http://dx.doi.org/10.7171/jbt.20-3102-003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192195PMC
July 2020

Safety and Cost Benefits of the Rapid Daratumumab Infusion Protocol.

Clin Lymphoma Myeloma Leuk 2020 08 7;20(8):526-532.e1. Epub 2020 Mar 7.

Plasma Cell Disorders Division, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC. Electronic address:

Introduction: Daratumumab is approved for the treatment of multiple myeloma in both frontline and relapsed/refractory settings. Its major limitation is the long infusion time, especially with the first dose. Recent data demonstrated the feasibility of infusing daratumumab at an accelerated rate of 90 minutes starting from cycle 1 on day 15. Herein, we report the safety profile and cost associated with rapid daratumumab infusion protocol.

Patients And Methods: A chart review was performed to identify patients who completed at least 1 cycle of daratumumab (single agent or in combination) from April 2016 to October 2018. Patients were divided into 2 cohorts: cohort 1 received rapid daratumumab infusion after its implementation in March 2018, whereas cohort 2 included patients treated with daratumumab administered at the standard rate. The primary endpoint was to compare differences in rates of infusion-related reactions (IRRs). An Excel (Microsoft)-based model was developed to estimate cost and productivity.

Results: A total of 100 patients with relapsed/refractory disease were included in this study (53 in cohort 1 and 47 in cohort 2). Of the 53 patients in cohort 1, 18 (34%) received rapid daratumumab infusion starting with cycle 1. Overall, there was no statistically significant difference in rates of IRRs between cohort 1 and 2 (1.9% vs. 4.3%, P = .59); 1 patient in cohort 1 developed an IRR. The total costs estimated for a 52-week regimen of daratumumab infused at standard and rapid rates were $137,200 and $122,200 (P < .001), respectively.

Conclusion: Our findings indicate that rapid daratumumab infusion is safe and tolerable and provides cost savings for patients with relapsed/refractory disease.
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http://dx.doi.org/10.1016/j.clml.2020.02.014DOI Listing
August 2020

A Review of Growth Factor Support in Bloodless Autologous Hematopoietic Stem Cell Transplant.

Biol Blood Marrow Transplant 2019 10 8;25(10):e305-e309. Epub 2019 Jul 8.

Pennsylvania Hospital, Center for Bloodless Medicine and Surgery, Philadelphia, , Pennsylvania.

Bloodless autologous hematopoietic cell transplantation is associated with risks of severe bleeding and profound anemia. RBC or platelet transfusions are often used to prevent these hematologic complications. However, in patients such as Jehovah's Witnesses who refuse major blood components, the lack of transfusion support is not an absolute contraindication to an autologous hematopoietic cell transplant. Pennsylvania Hospital performed the world's first bloodless hematopoietic cell transplant more than 15 years ago and has gradually improved its technique with a sizable patient population. Erythropoiesis-stimulating agents were successfully employed as part of their pretransplant regimen to prevent severe anemia. Thrombopoietin agonists' potential role in bloodless transplant is also currently being explored. Although there is limited literature, available reports in combination with physiologic reasoning may support the use of these growth factors to promote transplant success. These agents offer potential benefit and may be of utility in minimizing complications of a bloodless transplant. In this review, we summarize the available literature and offer insight into how we may incorporate growth factors to allow bloodless autologous hematopoietic cell transplantation to be an available option to patients who may otherwise be denied.
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http://dx.doi.org/10.1016/j.bbmt.2019.07.003DOI Listing
October 2019

Systematic assessment of food item preference and reinforcer effectiveness: Enhancements in training laboratory-housed rhesus macaques.

Behav Processes 2018 Dec 9;157:445-452. Epub 2018 Jul 9.

Yerkes National Primate Research Center, Emory University, 954 Gatewood Rd NE, Atlanta, GA 30329, United States.

The use of systematic preference assessments can enhance positive reinforcement training with captive animals. We found that the multiple stimulus without replacement (MSWO) technique identified food preferences in laboratory housed rhesus macaques, with raisins and grapes being ranked higher on average than dried apricot, pasta, and green beans (Friedman Test, χ (4) = 35.52, p < .001). Agreement between individuals (N = 21) was moderate (Kendall's W = 0.42), and consistency across time varied among individuals (W = .03-.90). Highly preferred items identified by the MSWO assessment were subsequently found to increase subjects' engagement in a husbandry task on which they were being trained (Mann-Whitney U = 6.00, p = .002) and to improve performance on a progressive ratio schedule (Wilcoxon signed-rank test, Z = -2.17, p = .03) when compared with low preference items. The progressive ratio technique supplements other preference assessment techniques by measuring the amount of work a subject will do to gain access to an item. The use of more effective reinforcers identified through systematic assessment has the potential to increase animal performance on husbandry and research tasks and to improve animal welfare in the laboratory setting.
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http://dx.doi.org/10.1016/j.beproc.2018.07.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240383PMC
December 2018

Two Methods of Social Separation for Paired Adolescent Male Rhesus Macaques ().

J Am Assoc Lab Anim Sci 2017 Nov;56(6):729-734

Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.

Literature-based recommendations regarding how to separate pairs of laboratory-housed NHP when required for research, veterinary, or management needs are unavailable. This study assessed 2 separation techniques-rapid and stepwise-to determine whether a period of limited social access mitigates the behavioral stress response after complete separation. Researchers observed 12 pairs of mother-reared, adolescent male rhesus macaques before and after separation with a solid divider; 6 of the pairs experienced a transitional week of limited social access through a perforated panel. Observers collected 30-min focal animal scans during study phase, totaling 144 h of behavioral data. Target behaviors included those classified as protest, agitation, tension, and withdrawn or self-directed. Social separation resulted in a significant change in behavior. Separated monkeys displayed more withdrawn or self-directed behaviors (for example, huddling, self-directed stereotypies) than when pair-housed. Stepwise separation resulted in increased agitation behaviors in the limited contact phase and did not mitigate separation effects. Adverse behavioral changes during the limited contact phase support continuous pair housing until required individual housing.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710151PMC
November 2017

Making moves: Transitioning R-EPOCH to the ambulatory setting.

J Oncol Pharm Pract 2018 Dec 7;24(8):617-622. Epub 2017 Aug 7.

Pharmacy Department, Froedtert & The Medical College of Wisconsin, Milwaukee, WI, USA.

Purpose: Ambulatory administration of chemotherapy provides benefit to patients and institutions alike. We hypothesized that transitioning rituximab, etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (R-EPOCH) from an inpatient to ambulatory setting would reduce inpatient bed days and overall healthcare costs. The purpose of this effort was to create a guideline that would transition R-EPOCH to the ambulatory setting. To assess institutional benefit, we assessed inpatient bed days saved and financial impact.

Methods: A single center, retrospective analysis of inpatient R-EPOCH administration from January 2013 to December 2015 defined the need for medication use guidelines for ambulatory R-EPOCH administration. While this guideline targeted a reduction in inpatient bed days, it also created desired staff-and-patient education on R-EPOCH. Multidisciplinary collaboration enabled this comprehensive approach to outpatient chemotherapy administration.

Results: The 42 patients included received 147 cycles of R-EPOCH. Administration was primarily inpatient, amounting to 107 cycles and 799 inpatient days. Concurrently, 40 cycles of R-EPOCH were administered to 11 patients in the ambulatory setting. Only two patients received all cycles as outpatient; the other nine patients received chemotherapy in both settings. Financial analysis showed a 53% reduction in drug acquisition cost and 30% reduction in direct costs with ambulatory R-EPOCH administration. Based on our projection, after guideline implementation, 12 patients will be eligible for ambulatory R-EPOCH annually, resulting in a savings of 360 bed days and approximately $650,000 per year.

Conclusion: Transitioning R-EPOCH is a viable option to significantly decrease inpatient bed days and overall healthcare costs. Multidisciplinary collaboration is vital to successfully transitioning regimens to the ambulatory setting and to establishing consistent support for ambulatory administration.
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http://dx.doi.org/10.1177/1078155217722408DOI Listing
December 2018

The primatologist as a behavioral engineer.

Authors:
Allison L Martin

Am J Primatol 2017 Jan 5;79(1):1-10. Epub 2015 Nov 5.

Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.

The field of primate behavior management has had only limited success in preventing and treating abnormal behaviors, such as stereotypy and self-injury, in captive non-human primates (NHP). In contrast, applied behavior analysts have had great success in treating similar topographies of behavior in human clinical settings. By adapting and adopting the behavioral principles and methodologies commonly used by applied behavior analysts, primatologists may be able to develop more effective ways to analyze, reduce, and prevent these aberrant behaviors in NHP. This article reviews studies that have used behavior analytic techniques to successfully address problem behaviors in NHP. Additionally, relevant literature from the field of applied behavior analysis is reviewed to illustrate how adopting a theoretical framework that emphasizes the determination of the underlying operant functions of behavior could lead to new behavioral technologies and advance the field of captive primate management. Am. J. Primatol. 79:e22500, 2017. © 2015 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/ajp.22500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7427841PMC
January 2017

Pair housing of Macaques: A review of partner selection, introduction techniques, monitoring for compatibility, and methods for long-term maintenance of pairs.

Am J Primatol 2017 Jan 30;79(1):1-15. Epub 2015 Sep 30.

Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.

Pair housing of macaques has become a widely implemented compromise between meeting the social needs of the monkeys and allowing for their use in biomedical research. While beneficial to the animals, pair housing can provide challenges for those caring for them. Drawing from both scientific literature and direct experience, this paper provides a review of practical aspects of pair housing including partner selection, pairing methodologies, staff education, and equipment considerations. Recommendations include selecting a pairing method appropriate to the facility and the individual animals being paired, educating staff on social behavior, and establishing a pair monitoring program to facilitate long-term pair maintenance. Assessment of behavior is essential in determining the compatibility of new pairs and in identifying established pairs that may need interventions to enhance their long-term compatibility. The pair housing program at the Yerkes National Primate Research Center is described as one model of a successful program. Am. J. Primatol. 79:e22485, 2017. © 2015 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/ajp.22485DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419744PMC
January 2017

Play caging benefits the behavior of singly housed laboratory rhesus macaques (Macaca mulatta).

J Am Assoc Lab Anim Sci 2013 Sep;52(5):534-40

Yerkes National Primate Research Center, Atlanta, Georgia, USA.

This study addresses a recommendation in The Guide for the Care and Use of Laboratory Animals to provide singly housed nonhuman primates with intermittent access to large, enriched (play) caging. Research on the potential benefits of this type of caging is limited. The present study examines the effects of play caging on behavior, activity, and enrichment use. Singly housed, adult male, rhesus macaques (n = 10) underwent a baseline phase in their home cages, a 2-wk treatment phase with housing in play cages, and a posttreatment phase after returning to their home cages. Each subject underwent focal behavioral observations (n = 10; duration 30 min each) during each study phase, for a total of 150 h of data collection. Results showed increases in locomotion and enrichment use and a trend toward decreased abnormal behavior while subjects were in the play cage, with the durations of these behaviors returning to baseline levels after treatment. Anxiety-related behaviors decreased between the treatment and posttreatment phases but not between baseline and treatment, suggesting that outside factors may have influenced the decline. During the treatment phase, subjects spent more time in the upper quadrants of the play caging and preferred a mirror and forage boards as forms of enrichment. The greatest behavioral improvement occurred during the first week in the play cage. This study provides evidence to support the benefits of play caging for singly housed rhesus macaques.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784657PMC
September 2013

Functional analysis and treatment of human-directed undesirable behavior exhibited by a captive chimpanzee.

J Appl Behav Anal 2011 ;44(1):139-43

Georgia Institute of Technology and Yerkes National Primate Research Center, USA.

A functional analysis identified the reinforcer maintaining feces throwing and spitting exhibited by a captive adult chimpanzee (Pan troglodytes). The implementation of a function-based treatment combining extinction with differential reinforcement of an alternate behavior decreased levels of inappropriate behavior. These findings further demonstrate the utility of function-based approaches to assess and treat behavior problems exhibited by captive animals.
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http://dx.doi.org/10.1901/jaba.2011.44-139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050472PMC
August 2011

Factors affecting aggression in a captive flock of Chilean flamingos (Phoenicopterus chilensis).

Zoo Biol 2011 Jan-Feb;30(1):59-64

Zoo Atlanta, Atlanta, Georgia, USA.

The influence of pair bond status, age and sex on aggression rates in a flock of 84 captive Chilean flamingos at Zoo Atlanta was examined. Analysis showed no difference between aggression rates of male and female flamingos, but adult flamingos had higher rates of aggression than juveniles. There were also significant differences in aggression depending on pair bond status (single, same-sex pair, male-female pair or group). Bonded birds were significantly more aggressive than single birds, which is consistent with the concept that unpaired birds are not breeding and do not need to protect pair bonds or eggs. Birds in typical pair bonds (male-female) and atypical pair bonds (same-sex pairs or groups) exhibited similar rates of aggression. These results contribute to the existing body of research on aggression in captive flamingos.
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http://dx.doi.org/10.1002/zoo.20313DOI Listing
June 2011

Positive reinforcement training to enhance the voluntary movement of group-housed sooty mangabeys (Cercocebus atys atys).

J Am Assoc Lab Anim Sci 2009 Mar;48(2):192-5

Division of Animal Resources, School of Medicine, Emory University, Atlanta, Georgia, USA.

Positive reinforcement training (PRT) has successfully been used to train diverse species to execute behaviors helpful in the everyday care and wellbeing of the animals. Because little information is available about training sooty mangabeys (Cercocebus atys atys), we analyzed PRT with a group of 30 adult males as they were trained to shift from 1 side of their enclosure to the other. Over a 4-mo period we conducted 57 training sessions totaling 26.5 h of training and recorded compliance information. During training, compliance increased from 76% of the animals during the first 5 training sessions to 86% of the animals shifting during the last 5 sessions. This result indicated progress but fell short of our goal of 90% compliance. After 25 training sessions, problem-solving techniques were applied to help the consistently noncompliant animals become more proficient. The techniques included reducing social stress by shifting animals so that noncompliant monkeys could shift into an unoccupied space, using more highly preferred foods, and 'jackpot'-sized reinforcement. To determine whether social rank affected training success, animals were categorized into high, medium, and low dominance groups, based on 7 h of behavioral observations. A Kruskal-Wallis test result indicated a significant difference in compliance according to the category of dominance. Although training a group this large proved challenging, the mangabeys cooperated more than 90% of the time during follow-up sessions. The training program improved efficiency in caring for the mangabeys.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2679662PMC
March 2009