Overweight Leukemia Patient Is Given Fatal Chemotherapy Treatment

ByWendy Ketner, M.D.

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Updated onMarch 28, 2019

This case involves a 33-year-old obese woman with leukemia who developed a fatal plaque buildup in her arteries after receiving chemotherapy treatment. Upon discovery of her leukemia, the patient was treated with imatinib mesylate. Within 3 months of her initial treatment, the patient developed occlusion of her femoral artery and severely high cholesterol. The patient was admitted for an angioplasty procedure, during which she suffered a fatal stroke. The autopsy revealed 85% occlusion throughout her body. It was alleged that the pharmaceutical manufacturer did not put proper warning labels to inform physicians of the drug’s dangers. An expert in oncology was sought to opine on whether there is a link between imatinib mesylate and high cholesterol.

Question(s) For Expert Witness

1. Please describe your background in treating leukemia?

2. What are the risks involved in using imatinib mesylate to treat leukemia?

Expert Witness Response E-034164

inline imageI have had a long, 25+ year-long academic career as a leukemia doctor and clinical leukemia researcher. I spent the first 19 years of my career on the Leukemia Service at a prestigious cancer treatment center where I saw patients and participated in clinical research on adult leukemias. I participated in the care of thousands of patients with leukemia and hundreds with bone marrow cancer. At my most recent appointment, I oversaw all aspects of clinical care and research for patients with bone marrow based diseases including bone marrow cancer. It is now very clear that the targeted agents used to treat bone marrow cancer can have toxic effects. Imatinib mesylate appears to be the worst choice in terms of cardiovascular disease. This risk was not appreciated at the time imatinib mesylate was FDA approved, but subsequent data is very convincing. The most important point in my mind is the timeline in terms of what was known at the time this patient was on imatinib mesylate and what the pharmaceutical company did to inform patients and doctors about changes to informed consent and monitoring for atherosclerotic disease. I understand the proposed mechanism of action of imatinib mesylate on the vascular endothelium quite well -- though, while we know it can cause accelerated atherosclerosis, the precise mechanism of action is not known with absolute certainty. I also understand the risks and balances for using the various approved TKIs for treating bone marrow cancer and I believe that knowledge is critical in assessing the risks and/or rewards involved when using imatinib mesylate.

About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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