Kathryn Culos

In February 2019, Kathryn (Katie) Culos, PharmD BCOP, was awarded the Pharmacy Special Interest Group (SIG) New Practitioner Award by the American Society for Transplantation and Cellular Therapy (ASTCT). The award is presented to an ASTCT Pharmacy SIG member who has spent 1–5 years in the field and has made significant contributions in the area of hematopoietic stem cell transplantation. In an interview in November 2019, she spoke about her career, her involvement in HOPA, and the sources of inspiration for her work.

Please describe your current position and the types of patients you see in clinical practice.
Since finishing residency, I have worked as an adult cellular therapy clinical pharmacy specialist at Vanderbilt University Medical Center (VUMC). The majority of my patients are undergoing autologous or allogeneic hematopoietic cell transplant (HCT); however, more patients are also receiving chimeric antigen receptor (CAR) T cell therapy. My involvement begins as early as when the patient is being presented as a candidate to receive HCT and includes preparation of all chemotherapy, prescribing of all prophylactic and supportive care medications, and monitoring through day 100 after HCT. We are fortunate to have the resources to do the majority of treatments on an outpatient basis, which allows me to rotate—with my colleague Dr. Katie Gatwood—every 3 months between our outpatient transplant clinic and the inpatient HCT unit. The variety of clinical settings involves different patient care roles and clinical duties, which keeps me engaged and on my toes!

Tell us about your ASTCT New Practitioner Award and what this means to you.
Receiving the ASTCT New Practitioner Award was truly an honor. I have been working very hard to establish my practice since residency, and it was very satisfying to be recognized for my dedication and hard work. It was also gratifying to feel appreciated by my peers at VUMC, whom I value highly. I was also greatly honored to be included in the company of the past awardees.

What have you done to improve oncology pharmacy care at your place of employment that may have contributed to your winning this award?
Since my arrival at VUMC, I have been a fierce proponent of advancing clinical pharmacy services for oncology patients. Particularly with the HCT team, I expanded the pharmacy role to direct patient care related to immunosuppression, supportive care, and an ambulatory collaborative practice agreement. Three years ago, we added a second HCT PharmD position, which created a full-time presence in the outpatient transplant clinic. This had a dramatic impact on the continuity of care as HCT patients move between inpatient and outpatient care and increased the quantity and quality of pharmacy patient visits. Within our HCT team, the pharmacist now provides a vital presence on committees responsible for quality, staff education, the development and maintenance of standard operating procedures, and the creation of an immune effector cell program, I have also been able to capitalize on the academic environment at VUMC and collaborate with interdisciplinary practitioners on numerous practice-changing research projects, publications, and presentations.

What first drew you to HOPA, and how long have you been a member?
I have been a HOPA member since I started my residency in 2011 and found it essential to define myself as an oncology pharmacy specialist. Involvement with HOPA has provided me many educational resources, important practitioner forums, and countless networking opportunities to develop my career and practice.

Who was your mentor, and how did that person influence your career path?
I am very fortunate to have had several key mentors during my career development. At my pharmacy school, the University of Illinois at Chicago, I had tremendous instructors and preceptors who guided and prepared me to pursue residency training. An early mentor, Dr. Shellee Grim, was brave enough to mentor my first publication during my second year in pharmacy school and set a bar for quality that I still strive to meet. Dr. Brad Cannon, a very impactful mentor to me throughout pharmacy school, was always available with honest and insightful advice. Both of my residency directors, Dr. Frank Paloucek and Dr. Sandra Cuellar, gave me independence while constantly challenging me to do more and think bigger. At VUMC I currently have an amazing group of physicians and colleagues who teach, challenge, and support my career growth.

What would you define as keys to your success?
I would point to having a clear vision of my goals, a strong work ethic, knowledgeable mentors, and an extremely supportive family. Within the first few months of pharmacy school I knew I wanted to be a clinical pharmacist, and not long after that I was drawn to oncology. Mentors coached me on how to get there, and I stayed focused and worked! Choosing my first position out of residency, I looked for an institution where I could continue to learn and be challenged. At VUMC I have been fortunate to work with a challenging and complex patient population alongside expert clinicians who trusted me with opportunities I appreciated. Each day I try to practice with an intense sense of ownership and respect for our profession and patients.

What advice would you offer to other oncology pharmacists who are either just beginning their career or expanding their role?
For new practitioners I say put yourself out there and welcome responsibility. Volunteer for committees, work groups, projects, and presentations. During your residency training you are constantly expected to take on new challenges, and that shouldn’t stop when you transition into practice. In order to expand your role, be curious. Educate yourself on the “why” of all your clinical practices and workflows. Often this process will help you identify areas of excellence to promote about your institution and practice or areas for improvement to investigate. Continual assessment will ensure that your practice is on the cutting edge and is focused on optimizing patient care.

What are your areas of interest in research and education?
I am interested in anything related to HCT or CAR T cell therapy! However, in the past few years our practice has evolved to include a much larger population of haploidentical-donor HCTs. We have conducted multiple investigations examining immune reconstitution following haplo-HCT, specifically looking at infection rate and type and post-transplant diabetes risks and impact. As the treatment armamentarium for acute myeloid leukemia has exploded, we are very interested in learning how to use these agents in the setting of post-HCT relapse. Finally, the approval of commercial CAR T cell therapy has created an exciting new treatment avenue with continual opportunities for education and innovation.

Sidney Keisner, PharmD BCOP
Assistant Director, Evidence-Based Prescription Drug Program
University of Arkansas for Medical Sciences College of Pharmacy
Little Rock, AR

Renee McAlister, PharmD BCOP
Clinical Pharmacy Specialist, Genitourinary/Melanoma Outpatient Clinics
Vanderbilt University Medical Center
Nashville, TN