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Yvonne A Efebera MD

Yvonne A Efebera MD
Asst ProfessorCollege of MedicineYvonne.Efebera@osumc.edu
B302 Starling Loving Hall 320 W 10th Avenue Columbus OH 43210
Phone:614-293-2268Fax: 614-366-5970
  • Innate Immunity

General Research Interest

: Dr. Efebera’s clinical and research interests include the treatment of patients with B-cell lymphoid malignancies including multiple myeloma, amyloidosis and Waldenstrom’s disease. In addition, her interests include blood and marrow transplantation and the prevention of graft versus host disease.

Research Description

The development of osteolytic bone disease in Multiple Myeloma (MM) is the result of increased osteoclastic bone resorption and impairment of osteoblastic bone formation. The Wnt signaling pathway is important for osteoblastic differentiation. Dickkopf (DKK1), a Wnt inhibitor, inhibits osteoblast activity, and its serum level directly correlates with increased bone lesions in newly diagnosed MM. BHQ880, an IgG1 anti DKK1 monoclonal antibody that has been shown in vitro to neutralize DKK1 and activate the Wnt pathway, thus enhancing osteoblastic activity and differentiation and improving bone disease. BHQ880 may also inhibit myeloma cell growth. We propose to perform a phase I dose determination study followed by a randomized, placebo controlled, double blind phase II study of BHQ880 with/without zoledronic acid in multiple myeloma patients undergoing autologous and allogeneic transplant. To determine effect of BHQ880 on prevention of progression of bone disease. We plan to assess: A: The maximum tolerated dose and to characterize Dose limiting toxicity of escalating doses of BHQ880 in combination with zoledronic acid. B: to characterize the binding kinetics of DKK-1/BHQ880 complex in serum and characterize serum DKK1 levels during treatment. C: The pharmacodynamics of BHQ880 by measuring biochemical markers of bone formation (osteocalcin, bone specific alkaline phosphatase, P1NP, DEXA scan) resorption (serum CTX, urine NTX, Trap 5b) and metabolism (RANKL, OPG) in serum and urine D: Assess the effect of BHQ880 on calcium and phosphate metabolism Hypothesis: We hypothesize that the combination of BHQ880 with zoledronic acid will be well tolerated, will enhance osteoblast activity and differentiation improving or preventing further bone disease, will increase bone formation markers and will decrease DKK-1 expression.

Current Publications

  • Dunavin NC, Wei L, Elder P, Phillips GS, Benson DM Jr, Hofmeister CC, Penza S, Greenfield C, Rose KS, Rieser G, Merritt L, Ketcham J, Heerema N, Byrd JC, Devine SM, Efebera YAEarly versus delayed autologous stem cell transplant in patients receiving novel therapies for multiple myeloma.Leuk Lymphoma in press 12/31/2012
  • Mori S, Crawford BS, Roddy JV, Phillips G, Elder P, Hofmeister CC, Efebera Y, Benson DM JrSerum free light chains in myeloma patients with an intact M protein by immunofixation: potential roles for response assessment and prognosis during induction therapy with novel agents.Hematol Oncol 30(3) 156-62 9/1/2012
  • Benson DM Jr, Bakan CE, Zhang S, Collins SM, Liang J, Srivastava S, Hofmeister CC, Efebera Y, Andre P, Romagne F, Bléry M, Bonnafous C, Zhang J, Clever D, Caligiuri MA, Farag SSIPH2101, a novel anti-inhibitory KIR antibody, and lenalidomide combine to enhance the natural killer cell versus multiple myeloma effect.Blood 118(24) 6387-91 12/8/2011
  • Hamadani M, Craig M, Phillips GS, Abraham J, Tse W, Cumpston A, Gibson L, Remick SC, Bunner P, Leadmon S, Elder P, Hofmeister C, Penza S, Efebera Y, Andritsos L, Garzon R, Benson DM Jr, Blum W, Devine SMHigher busulfan dose intensity does not improve outcomes of patients undergoing allogeneic haematopoietic cell transplantation following fludarabine, busulfan-based reduced toxicity conditioning.Hematol Oncol 29(4) 202-10 12/1/2011