Krisstina Gowin
- Associate Professor, Medicine - (Clinical Scholar Track)
Contact
- (520) 626-6453
- AHSC, Rm. 2301
- gowink@arizona.edu
Degrees
- D.O. Doctor of Osteopathic Medicine
- Chicago College of Osteopathic Medicine, Chicago, Illinois, United States
- M.A. Molecular, Cellular and Developmental Biology
- University of California, Santa Barbara, California, United States
- B.A. Biological Sciences
- University of California, Santa Barbara, California, United States
Work Experience
- University of Arizona Cancer Center (2018 - Ongoing)
- Salish Cancer Center (2016 - 2018)
Licensure & Certification
- Diplomate, American Board of Internal Medicine Certification (2012)
- Dipomate, American Board of Integrative Medicine (2022)
- Diplomate, American Board of Internal Medicine Hematology Certification (2017)
- Diplomate, American Board of Internal Medicine Oncology Certification (2016)
Interests
No activities entered.
Courses
No activities entered.
Scholarly Contributions
Journals/Publications
- Mahmud, M., Vasireddy, S., Gowin, K., & Amaraneni, A. (2023). Myeloproliferative Neoplasms: Contemporary Review and Molecular Landscape. International journal of molecular sciences, 24(24).More infoMyelofibrosis (MF), Myeloproliferative neoplasms (MPNs), and MDS/MPN overlap syndromes have a broad range of clinical presentations and molecular abnormalities, making their diagnosis and classification complex. This paper reviews molecular aberration, epigenetic modifications, chromosomal anomalies, and their interactions with cellular and other immune mechanisms in the manifestations of these disease spectra, clinical features, classification, and treatment modalities. The advent of new-generation sequencing has broadened the understanding of the genetic factors involved. However, while great strides have been made in the pharmacological treatment of these diseases, treatment of advanced disease remains hematopoietic stem cell transplant.
- Okolo, O., Wertheim, B. C., Larsen, A., Sweeney, N. W., Ahlstrom, J. M., & Gowin, K. (2023). Integrative medicine in multiple myeloma and plasma cell disorders. Complementary therapies in medicine, 73, 102939.More infoIntegrative Medicine (IM) use and efficacy is poorly defined in those with plasma cell disorders (PCD). A 69-question survey on the subject was hosted on HealthTree.org for 3 months.
- Pandya, S. K., Pandya, A., Larsen, A., & Gowin, K. (2023). A Review of The Synergistic Effects of Curcumin with Proteasome Inhibitors in Multiple Myeloma Preclinical Models. Integrative cancer therapies, 22, 15347354231159322.More infoProteasome inhibitors are the cornerstone of multiple myeloma treatment, but challenges still remain despite the increased survival rates. We conducted a review on the role of curcumin, a natural product, as an adjunct to bortezomib and carfilzomib in preclinical multiple myeloma models. Four studies reviewed showed enhanced anticancer effects when curcumin was combined with bortezomib compared to either treatment alone. Two additional studies showed similar results with carfilzomib. Synergistic mechanisms include inhibition of NF-kB, IL-6-induced signaling pathways, JNK pathway modulation, and increased cell cycle arrest.
- Gowin, K. (2022). TIMING IS EVERYTHING: When IS the Time Right for Transplant in Myelofibrosis Therapy?. Transplantation and cellular therapy, 28(4), 177-178.
- Gowin, K., & Gowin, K. (2021). Impact of COVID 19 Pandemic on an International MPN Patient Population: Survey results from 1560 MPN patients. Leukemia Lymphoma and Myeloma, unknown.
- Perram, J., Ross, D. M., McLornan, D., Gowin, K., Kröger, N., Gupta, V., Lewis, C., Gagelmann, N., & Hamad, N. (2022). Innovative strategies to improve hematopoietic stem cell transplant outcomes in myelofibrosis. American journal of hematology, 97(11), 1464-1477.More infoMyelofibrosis (MF) is a clonal myeloproliferative neoplasm characterized by inflammation, marrow fibrosis, and an inherent risk of blastic transformation. Hematopoietic allogeneic stem cell transplant is the only potentially curative therapy for this disease, however, survival gains observed for other transplant indications over the past two decades have not been realized for MF. The role of transplantation may also evolve with the use of novel targeted agents. The chronic inflammatory state associated with MF necessitates pretransplantation assessment of end-organ function. Applying the transplant methodology employed for other myeloid disorders to patients with MF fails to acknowledge differences in the underlying disease pathophysiology. Limited understanding of the causes of poor transplant outcomes in this cohort has prevented refinement of transplant eligibility criteria in MF. There is increasing evidence of heterogeneity in molecular disease grade, beyond the clinical manifestations which have traditionally guided transplant timing. Exploring the physiological consequences of disease chronicity unique to MF, acknowledging the heterogeneity in disease grade, and using advanced prognostic models, molecular diagnostics and other organ function diagnostic tools, we present an innovative review of strategies with the potential to improve transplant outcomes in this disease. Larger, prospective studies which consider the impact of molecular-based disease grade are needed for MF transplantation.
- Richardson, P. G., Jacobus, S. J., Weller, E. A., Hassoun, H., Lonial, S., Raje, N. S., Medvedova, E., McCarthy, P. L., Libby, E. N., Voorhees, P. M., Orlowski, R. Z., Anderson, L. D., Zonder, J. A., Milner, C. P., Gasparetto, C., Agha, M. E., Khan, A. M., Hurd, D. D., Gowin, K., , Kamble, R. T., et al. (2022). Triplet Therapy, Transplantation, and Maintenance until Progression in Myeloma. The New England journal of medicine, 387(2), 132-147.More infoIn patients with newly diagnosed multiple myeloma, the effect of adding autologous stem-cell transplantation (ASCT) to triplet therapy (lenalidomide, bortezomib, and dexamethasone [RVD]), followed by lenalidomide maintenance therapy until disease progression, is unknown.
- Win, H., Russell, S., Wertheim, B. C., Maizes, V., Crocker, R., Brooks, A. J., Mesa, R., Huberty, J., Geyer, H., Eckert, R., Larsen, A., & Gowin, K. (2022). Mobile App Intervention on Reducing the Myeloproliferative Neoplasm Symptom Burden: Pilot Feasibility and Acceptability Study. JMIR formative research, 6(3), e33581.More infoMyeloproliferative neoplasms (MPNs) are a group of myeloid malignancies associated with significant symptom burden. Despite pharmacological advances in therapies, inadequate management of MPN symptoms results in reduced quality of life.
- Gowin, K., Skerget, S., Keats, J. J., Mikhael, J., & Cowan, A. J. (2021). Plasma cell leukemia: A review of the molecular classification, diagnosis, and evidenced-based treatment. Leukemia research, 111, 106687.More infoPlasma cell leukemia is a rare and aggressive plasma cell dyscrasia associated with dismal outcomes. It may arise de novo, primary plasma cell leukemia, or evolve from an antecedent diagnosis of multiple myeloma, secondary plasma cell leukemia. Despite highly effective therapeutics, survival for plasma cell leukemia patients remains poor. Molecular knowledge of plasma cell leukemia has recently expanded with use of gene expression profiling and whole exome sequencing, lending new insights into prognosis and therapeutic development. In this review, we describe the molecular knowledge, clinical characteristics, evidenced-based therapeutic approaches and treatment outcomes of plasma cell leukemia.
- Gowin, K., Ballen, K., Ahn, K. W., Hu, Z. H., Ali, H., Arcasoy, M. O., Devlin, R., Coakley, M., Gerds, A. T., Green, M., Gupta, V., Hobbs, G., Jain, T., Kandarpa, M., Komrokji, R., Kuykendall, A. T., Luber, K., Masarova, L., Michaelis, L. C., , Patches, S., et al. (2020). Survival following allogeneic transplant in patients with myelofibrosis. Blood advances, 4(9), 1965-1973.More infoAllogeneic hematopoietic cell transplantation (HCT) is the only curative therapy for myelofibrosis (MF). In this large multicenter retrospective study, overall survival (OS) in MF patients treated with allogeneic HCT (551 patients) and without HCT (non-HCT) (1377 patients) was analyzed with Cox proportional hazards model. Survival analysis stratified by the Dynamic International Prognostic Scoring System (DIPSS) revealed that the first year of treatment arm assignment, due to upfront risk of transplant-related mortality (TRM), HCT was associated with inferior OS compared with non-HCT (non-HCT vs HCT: DIPSS intermediate 1 [Int-1]: hazard ratio [HR] = 0.26, P < .0001; DIPSS-Int-2 and higher: HR, 0.39, P < .0001). Similarly, in the DIPSS low-risk MF group, due to upfront TRM risk, OS was superior with non-HCT therapies compared with HCT in the first-year post treatment arm assignment (HR, 0.16, P = .006). However, after 1 year, OS was not significantly different (HR, 1.38, P = .451). Beyond 1 year of treatment arm assignment, an OS advantage with HCT therapy in Int-1 and higher DIPSS score patients was observed (non-HCT vs HCT: DIPSS-Int-1: HR, 2.64, P < .0001; DIPSS-Int-2 and higher: HR, 2.55, P < .0001). In conclusion, long-term OS advantage with HCT was observed for patients with Int-1 or higher risk MF, but at the cost of early TRM. The magnitude of OS benefit with HCT increased as DIPSS risk score increased and became apparent with longer follow-up.
- Gowin, K., Langlais, B. T., Kosiorek, H. E., Dueck, A., Millstine, D., Huberty, J., Eckert, R., & Mesa, R. A. (2020). The SIMM study: Survey of integrative medicine in myeloproliferative neoplasms. Cancer medicine, 9(24), 9445-9453.More infoMyeloproliferative neoplasms (MPNs) are characterized by significant symptom burden. Integrative medicine (IM) offers unique symptom management strategies. This study describes IM interventions utilized by MPN patients and the association with symptom burden, quality of life, depression, and fatigue adjusted for lifestyle confounders. MPN patients were surveyed online for IM utilization, MPN symptom burden (MPN-Symptom Assessment Form Total Symptom Score), depression (Patient Health Questionnaire), fatigue (Brief Fatigue Inventory), and a single question on overall quality of life. Measures were compared by IM participation and adjusted for alcohol and tobacco use, BMI, diet, and MPN type using multiple linear and logistic regression. A total of 858 participants were included in the analysis. Aerobic activity (p =
- Mann, S., Sidhu, M., & Gowin, K. (2020). Understanding the Mechanisms of Diet and Outcomes in Colon, Prostate, and Breast Cancer; Malignant Gliomas; and Cancer Patients on Immunotherapy. Nutrients, 12(8).More infoCancer patients often ask which foods would be best to consume to improve outcomes. This is a difficult question to answer as there are no case-controlled, prospective studies that control for confounding factors. Therefore, a literature review utilizing PubMed was conducted with the goal to find evidence-based support for certain diets in specific cancer patients-specifically, we reviewed data for colon cancer, prostate cancer, breast cancer, malignant gliomas, and cancer patients on immunotherapy. Improved outcomes in colon cancer and patients on immunotherapy were found with high-fiber diets. Improved outcomes in malignant gliomas were found with ketogenic diets. Improved outcomes in prostate cancer and breast cancer were found with plant-based diets. However, the data are not conclusive for breast cancer. Additionally, the increased intake of omega-3 fatty acids were also associated with better outcomes for prostate cancer. While current research, especially in humans, is minimal, the studies discussed in this review provide the groundwork for future research to further investigate the role of dietary intervention in improving cancer outcomes.
- Win, H., & Gowin, K. (2020). Treatment of scleromyxedema with lenalidomide, bortezomib and dexamethasone: A case report and review of the literature. Clinical case reports, 8(12), 3043-3049.More infoScleromyxedema is a rare and progressive disease that currently has no standard treatment. Triplet therapy with lenalidomide, bortezomib, and dexamethasone can be an effective therapy for scleromyxedema, especially in patients with refractory or relapsed disease.
- Gowin, K., & Win, H. (2019). Treatment of scleromyxedema with Bortezomib, Lenalidomide and Dexamethasone: A case report and review of literature.. American Journal of Hematology, 94, S22-S23.
- Huberty, J., Eckert, R., Dueck, A., Kosiorek, H., Larkey, L., Gowin, K., & Mesa, R. (2019). Online yoga in myeloproliferative neoplasm patients: results of a randomized pilot trial to inform future research. BMC complementary and alternative medicine, 19(1), 121.More infoMyeloproliferative neoplasm (MPN) patients suffer from significant symptoms, inflammation and reduced quality of life. Yoga improves these outcomes in other cancers, but this hasn't been demonstrated in MPNs. The purpose of this study was to: (1) explore the limited efficacy (does the program show promise of success) of a 12-week online yoga intervention among MPN patients on symptom burden and quality of life and (2) determine feasibility (practicality: to what extent a measure can be carried out) of remotely collecting inflammatory biomarkers.
- Okolo, O. N., & Gowin, K. (2019). Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers. Current hematologic malignancy reports, 14(4), 328-336.More infoThis review discusses the emerging role of integrative hematology. It reinforces the growing interest of CAM among patients, and the importance of provider knowledge and participation in discussions with patients about the subject. The main question asked in this review, "Is there evidence for the use of integrative medicine practices in the field of malignant hematology?" is answered by examining current research and providing relevant summaries.
- Huberty, J., Eckert, R., Larkey, L., Gowin, K., Mitchell, J., & Mesa, R. (2018). Perceptions of Myeloproliferative Neoplasm Patients Participating in an Online Yoga Intervention: A Qualitative Study. Integrative cancer therapies, 17(4), 1150-1162.More infoMyeloproliferative neoplasms (MPNs) are rare hematological malignancies with a significant symptom burden often left unresolved despite recent advances in pharmacological therapy. Yoga is a nonpharmacological strategy that has been shown to improve symptoms in other cancers and may be effective for improving symptoms in MPN patients. Online yoga helps address many of the commonly reported barriers of cancer patients to in-person interventions and may make yoga more accessible to MPNs. An exploration of MPN patient perceptions of participation in online yoga is needed to tailor interventions to patient needs and inform future studies. The purpose of this study was to explore the perceptions of MPN patients participating in a 12-week online yoga intervention. This article represents the combined qualitative interview data from two studies. Participants were asked to complete 60 min/wk of online, home-based yoga and were asked to participate in a 15- to 20-minute phone interview postintervention. The qualitative data was coded in NVivo 11 for content analysis. The total sample included 39 MPN patients. Online yoga was well accepted and liked among these patients. They reported physical (eg, improved sleep, reduced fatigue) and mental (eg, reduced stress) health benefits and liked the convenience of being able to do yoga at home. Online yoga provides a feasible and attractive format through which to deliver a nonpharmacological intervention among MPN patients. Randomized controlled trials are needed to confirm the effects of online yoga on MPN patient symptoms. The qualitative findings presented here help inform the development of these future trials.