Meet the Speakers
Terri Lynn Shigle, PharmD, is a clinical pharmacy specialist at The University of Texas MD Anderson Cancer Center in Houston, Texas.
J. Ryan Shaw, PharmD, BCPS, BCOP, CPP, is a clinical pharmacist practitioner of bone marrow transplant and cellular therapy at the University of North Carolina (UNC) Medical Center and an adjunct assistant professor of clinical education at UNC Eshelman School of Pharmacy in Chapel Hill, North Carolina.
Andrew Lin, PharmD, BCOP, is the clinical pharmacy manager for the adult BMT and cellular therapy services at Memorial Sloan Kettering Cancer Center in New York, New York.
Breana K. Goscicki, PharmD, BCPPS, is a pharmacist and information tech, electronic health record transformation, at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania.
In this episode, Terri Lynn Shigle, PharmD; J. Ryan Shaw, PharmD, BCPS, BCOP, CPP; Andrew Lin, PharmD, BCOP; and Breana K. Goscicki, PharmD, BCPPS, gather to discuss their contributions to the most recent wave of American Society for Transplantation and Cellular Therapy (ASTCT) infectious disease practice guidelines—a collaborative series designed to break down and periodically update the landmark Tomblyn guidelines, last published in 2009. The group reflects on the value of including pharmacists in guideline development, noting that of the 11 guidelines published so far, a pharmacist is either an author or acknowledged in 7.
The panelists walk through the specific guidelines they worked on—cytomegalovirus (CMV) prophylaxis and treatment updates, non-Aspergillus mold management, and human herpesvirus 6 (HHV-6) after hematopoietic cell transplant and chimeric antigen receptor T-cell therapy—and highlight key contributions, including comprehensive drug interaction tables, updated dosing references for newer agents, and a deliberate, evidence-based decision to omit a numeric treatment threshold for HHV-6 in favor of clinical judgment. They also discuss institutional variation in antifungal prophylaxis approaches, the clinical nuances of the interaction between letermovir and voriconazole, and the ongoing challenge of extrapolating data to pediatric populations, including the off-label use of maribavir in patients outside FDA-approved parameters.
The conversation turns candid as the group discusses what did not make the final cut and why—including a more expansive review of chromosomal integration in HHV-6 and a more explicit call-out of rifamycin interactions—as well as the deliberate shift from comprehensive review documents toward targeted FAQ-style guidance. Looking ahead, the panelists share anticipation for upcoming guidelines on vaccines, rare yeasts, and tuberculosis, and underscore the growing importance of infectious disease guidance as cellular therapy expands beyond hematologic malignancies into autoimmune disease, solid tumors, and nonmalignant indications.
