Knight Biobehavioral Oncology Lab
Dr. Knight’s research program aims to investigate biological risk and interventions – both pharmacologic and behavioral – for social health disparities in cancer, specifically among hematopoietic stem cell transplant (HCT) and cellular therapy recipients. Our lab does this by investigating how variations in immune function based on socioeconomic status (SES) – among other social health variables including depression, stress, sleep quality, and anxiety – contribute to differential patient responses and outcomes following HCT and cellular therapy. Reciprocally, we also investigate how these cancer therapies affect central nervous system function.
To accomplish these goals, we study biobehavioral mechanisms of cancer progression. Candidate mechanisms include the conserved transcriptional response to adversity (CTRA) transcriptome profile and associated molecular changes, inflammation, sympathetic nervous system activation, neurotoxic metabolites, and the endocannabinoid system, among others. These pathways are investigated as potential mediators of social health disparities among HCT recipients.
Dr. Knight’s group has identified a potential effective candidate pharmacologic intervention for such social health disparities – propranolol. They have identified propranolol as an effective pharmacologic mitigator of CTRA gene expression among a cohort of patients with multiple myeloma undergoing HCT. Subsequent future research goals involve investigating whether propranolol is effective in ameliorating adverse clinical outcomes associated with reduced expression of these potential biomarkers. We have also recently confirmed preliminary findings that these CTRA-related transcriptome dynamics are associated with adverse clinical outcomes among HCT recipients. Examples of ongoing and future work include investigating the following:
- Bidirectional neuroimmune effects of tocilizumab, an IL-6 antagonist used to treat
- Biobehavioral implications of chimeric antigen receptor (CAR) T cell therapy
- Mindfulness to improve sleep and related symptomatology and inflammatory markers among hospitalized HCT recipients
- Effect of donor SES on recipient HCT outcomes
- Propranolol as an intervention to reduce cancer progression
Our research program continues to inform the clinical field of Psycho-Oncology as we increasingly understand how the central nervous system regulates cancer disease and progression.
- Knight, J. M., Lyness, J. M., Sahler, O. J. Z., Liesveld, J. L., & Moynihan, J. A. (2013). Psychosocial factors and hematopoietic stem cell transplantation: potential biobehavioral pathways. Psychoneuroendocrinology, 38(11), 2383-2393.
Clinical Cancer Research (2016)
- Knight, J. M., Rizzo, J. D., Logan, B. R., Wang, T., Arevalo, J. M., Ma, J., & Cole, S. W. (2016). Low Socioeconomic Status, Adverse Gene Expression Profiles, and Clinical Outcomes in Hematopoietic Stem Cell Transplant Recipients Low SES, Gene Expression, and Outcomes in HCT. Clinical Cancer Research, 22(1), 69-78.
Blood Advances (2020)
- Knight, J. M., Rizzo, J. D., Hari, P., Pasquini, M. C., Giles, K. E., D’Souza, A., ... & Cole, S. W. (2020). Propranolol inhibits molecular risk markers in HCT recipients: a phase 2 randomized controlled biomarker trial. Blood advances, 4(3), 467-476.
Transplantation and Cellular Therapy (2021)
- Kelly, D. L., Syrjala, K., Taylor, M., Rentscher, K. E., Hashmi, S., Wood, W. A., ... & Knight, J. M. (2021). Biobehavioral research and hematopoietic stem cell transplantation: expert review from the Biobehavioral Research Special Interest Group of the American Society for Transplantation and Cellular Therapy. Transplantation and cellular therapy, 27(9), 747-757.
Rap1A, Rap1B, and β-Adrenergic Signaling in Autologous HCT: A Randomized Controlled Trial of Propranolol. (Johnson AK, Lorimer EL, Szabo A, Wu R, Shah NN, D'Souza A, Chhabra S, Hamadani M, Dhakal B, Hari P, Rao S, Carlson K, Williams CL, Knight JM) Yale J Biol Med 2022 03;95(1):45-56 PMID: 35370486 PMCID: PMC8961707 SCOPUS ID: 2-s2.0-85127524780 04/05/2022
Impact of the COVID-19 pandemic on cancer patients and psycho-oncology providers: Perspectives, observations, and experiences of the American Psychosocial Oncology Society membership. (McAndrew NS, Strong Y, Morris KJ, Sannes TS, Pirl WF, Cole S, Mohanraj L, Knight JM) Psychooncology 2022 06;31(6):1031-1040 PMID: 35102653 SCOPUS ID: 2-s2.0-85124553620 02/02/2022
The impact of beta-blocker use at the time of hematopoietic cell transplantation on the development of acute and chronic graft-versus-host disease. (Patel A, Subramanian Guru Murthy G, Hamadani M, Szabo A, Knight JM) Hematol Oncol Stem Cell Ther 2021 Nov 05 PMID: 34780786 SCOPUS ID: 2-s2.0-85119520781 11/16/2021
Donor socioeconomic status affects hematopoietic stem cell transplant outcomes
Healio News | April 26, 2022
War of Nerves: An emerging relationship between the nervous system and tumor growth suggests new therapies
Preclinical research shows that stress-induced activation of the sympathetic nervous system can promote hematopoietic malignancies via β-adrenoreceptor–mediated molecular pathways.
Meet the Director | Jennifer M. Knight, MD, MS, FACLP
Dr. Knight is an Associate Professor of Psychiatry, Medicine, and Microbiology & Immunology. She completed her undergraduate training at the University of Wisconsin-Madison in 1999 and her medical training at the Medical College of Wisconsin in 2004. Dr. Knight completed her residency in a combined Internal Medicine and Psychiatry program at Rush University in Chicago in 2009, and is dual board certified in both specialties. She finished a post-doctoral T32 research fellowship in Psychoneuroimmunology at the University of Rochester Medical Center in 2011.
Dr. Knight joined MCW in 2011 as an Assistant Professor of Psychiatry and Behavioral Medicine. She is currently an Associate Professor of Psychiatry, Medicine, and Microbiology & Immunology and Medical Director of the MCW Psycho-Oncology Program. Dr. Knight is an NIH funded researcher (R01CA238562) and is the elected Director of Research for the American Psychosocial Oncology Society, Co-Founder and -Director of the American Society for Transplantation and Cellular Therapy (ASTCT) Biobehavioral Oncology Research Special Interest Group, and elected fellow of the Academy of Behavioral Medicine Research. Locally she is the Co-Founder and -Chair of the MCW Biobehavioral Oncology Group and Chair of the MCW Cancer Center Population Sciences and Behavioral Health Disease Oriented Team (DOT). She mentors numerous students, residents, fellows, and junior faculty members both locally and nationally. Dr. Knight is a nationally and internationally recognized expert in biobehavioral HCT mechanisms.
The goal of this research study is to evaluate whether mindfulness techniques are helpful and easy for allogeneic hematopoietic stem cell transplant (HCT) recipients. We want to find out if behavioral techniques such as the Mindfulness Awareness Practices for Insomnia (MAP-I) and Sleep Health Education (SHE) are easy to learn and practice and help with sleep.
The goal of this research study is to determine whether donor immunologic characteristics associated with socioeconomic factors worsen hematopoietic cell transplant recipient outcomes. We will also look to see whether donor and recipient SES factors will impact genetic expression statuses among these patients.
The purpose of this research is to examine associations between socioeconomic status and CAR T-cell therapy changes in neurotoxicity biomarkers, clinical outcomes, and quality of life with the goal of further understanding the biological basis of cancer disparities.
The purpose of this research is to understand financial toxicity (distress from out-of-pocket expenses, opportunity costs, treatment compliance, and survivorship) among CAR-T cell therapy patients with relapsed and refractory B cell lymphoma. Using interviews and questionnaires through multiple time points, we hope to understand how financial stressors play a part in CAR-T cell therapy clinical outcomes.
This goal of this research study is to determine whether the anti-interleukin (IL)-6 receptor antibody Tocilizumab improves quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HCT). The study compares two groups of patients; the intervention group received Tocilizumab with HCT while the comparison group underwent standard of care HCT treatment and did not receive Tocilizumab. Patient reported outcome (PRO) measures will inform us of any quality of life changes patients experienced over the course of treatment until 180 days following treatment completion.
Knight Biobehavioral Oncology Lab Partner Organizations
Resident, PGY 4
Internal Medicine/Psychiatry Resident
Research Technologist I
(Taylor MR, Cole SW, Strom J, Brazauskas R, Baker KS, Phelan R, Buchbinder D, Hamilton B, Schoemans H, Shaw BE, Sharma A, Bhatt NS, Badawy SM, Winestone LE, Preussler JM, Mayo S, Jamani K, Nishihori T, Lee MA, Knight JM.) Blood Adv. 2023 Nov 28;7(22):6830-6838 PMID: 37773924 09/29/2023
(Blue BJ, Brazauskas R, Chen K, Patel J, Zeidan AM, Steinberg A, Ballen K, Kwok J, Rotz SJ, Perez MAD, Kelkar AH, Ganguly S, Wingard JR, Lad D, Sharma A, Badawy SM, Lazarus HM, Hashem H, Szwajcer D, Knight JM, Bhatt NS, Page K, Beattie S, Arai Y, Liu H, Arnold SD, Freytes CO, Abid MB, Beitinjaneh A, Farhadfar N, Wirk B, Winestone LE, Agrawal V, Preussler JM, Seo S, Hashmi S, Lehmann L, Wood WA, Rangarajan HG, Saber W, Majhail NS.) Transplant Cell Ther. 2023 Nov;29(11):709.e1-709.e11 PMID: 37482244 SCOPUS ID: 2-s2.0-85173143416 07/24/2023
(Kleman A, Singavi A, Pommert L, Mathison AJ, Hari P, Dhakal B, Mohan M, Janz S, Knight JM, Shah MV, Schinke C, Burns R, Steinhardt GF, Rao S, Carlson K.) Blood Adv. 2023 Sep 26;7(18):5549-5553 PMID: 36724511 PMCID: PMC10514068 SCOPUS ID: 2-s2.0-85164933174 02/02/2023
(Nelson AM, Erdmann AA, Coe CL, Juckett MB, Morris K, Knight JM, Hematti P, Costanzo ES.) Brain Behav Immun. 2023 Aug;112:11-17 PMID: 37236325 PMCID: PMC10524437 SCOPUS ID: 2-s2.0-85160562513 05/27/2023
(Ogunsanya ME, Sifat M, Bamidele OO, Ezenwankwo EF, Clifton S, Ton C, Knight JM, Odedina FT, Greer JA, Dwyer K, Kendzor DE.) J Cancer Surviv. 2023 Jun;17(3):557-568 PMID: 36627464 SCOPUS ID: 2-s2.0-85145983150 01/11/2023
(Cusatis R, Ibrahim A, Knight JM, D'Souza A, Shaw BE.) Hematol Oncol Stem Cell Ther. 2023 May 23;16(4):366-369 PMID: 37363976 SCOPUS ID: 2-s2.0-85163346266 06/26/2023
(Patel A, Murthy GSG, Hamadani M, Szabo A, Knight JM.) Hematol Oncol Stem Cell Ther. 2023 Apr 04;16(3):209-216 PMID: 34780786 SCOPUS ID: 2-s2.0-85119520781 11/16/2021
(Applebaum AJ, Sannes T, Mitchell HR, McAndrew NS, Wiener L, Knight JM, Nelson AJ, Gray TF, Fank PM, Lahijani SC, Pozo-Kaderman C, Rueda-Lara M, Miran DM, Landau H, Amonoo HL.) Transplant Cell Ther. 2023 Mar;29(3):143-150 PMID: 36572386 PMCID: PMC9780643 SCOPUS ID: 2-s2.0-85146470226 12/27/2022
(Drom C, Schenheit K, Matzke M, Obeidat AZ, Molinaro J, Charlson J, Knight JM.) Brain Behav Immun Health. 2023 Feb;27:100570 PMID: 36578920 PMCID: PMC9791578 12/30/2022
(Knight JM, Hackett E, Szabo A, Wu R, Sauber G, Johnson B, Cusatis RN, Aughey E, Cole SW, Hillard CJ, Shah NN.) Haematologica. 2023 Feb 01;108(2):588-593 PMID: 36200427 PMCID: PMC9890001 SCOPUS ID: 2-s2.0-85147234722 10/07/2022
(Satilmis H, Verheye E, Vlummens P, Oudaert I, Vandewalle N, Fan R, Knight JM, De Beule N, Ates G, Massie A, Moreaux J, Maes A, De Bruyne E, Vanderkerken K, Menu E, Sloan EK, De Veirman K.) J Pathol. 2023 Jan;259(1):69-80 PMID: 36245401 SCOPUS ID: 2-s2.0-85143222266 10/18/2022
(Taylor MR, Steineck A, Lahijani S, Hall AG, Jim HSL, Phelan R, Knight JM.) Transplant Cell Ther. 2023 Jan;29(1):19-26 PMID: 36208728 SCOPUS ID: 2-s2.0-85143519815 10/09/2022
(Molinaro J, DeVries P, Ha J, Knight JM.) Ann Gen Psychiatry. 2022 Aug 24;21(1):34 PMID: 36002899 PMCID: PMC9400302 SCOPUS ID: 2-s2.0-85137030748 08/25/2022
(Taylor MR, Hillard CJ, Drobyski WR, Szabo A, Johnson BD, Zhu F, Raison CL, Cole SW, Knight JM.) Brain Behav Immun Health. 2022 Aug;23:100480 PMID: 35757656 PMCID: PMC9213229 SCOPUS ID: 2-s2.0-85133379996 06/28/2022
(Mohanraj L, Elswick RK Jr, Buch M, Knight JM, Guidry J.) Semin Oncol Nurs. 2022 Aug;38(4):151257 PMID: 35379527 PMCID: PMC8907028 SCOPUS ID: 2-s2.0-85127530657 04/06/2022
(McAndrew NS, Strong Y, Morris KJ, Sannes TS, Pirl WF, Cole S, Mohanraj L, Knight JM.) Psychooncology. 2022 Jun;31(6):1031-1040 PMID: 35102653 SCOPUS ID: 2-s2.0-85124553620 02/02/2022
(Johnson AK, Lorimer EL, Szabo A, Wu R, Shah NN, D'Souza A, Chhabra S, Hamadani M, Dhakal B, Hari P, Rao S, Carlson K, Williams CL, Knight JM.) Yale J Biol Med. 2022 Mar;95(1):45-56 PMID: 35370486 PMCID: PMC8961707 SCOPUS ID: 2-s2.0-85127524780 04/05/2022
(Knight JM, Taylor MR, Rentscher KE, Henley EC, Uttley HA, Nelson AM, Turcotte LM, McAndrew NS, Amonoo HL, Mohanraj L, Kelly DL, Costanzo ES.) Front Immunol. 2022;13:877558 PMID: 35865530 PMCID: PMC9295749 SCOPUS ID: 2-s2.0-85134257906 07/23/2022
(Knight JM, Szabo A, Arapi I, Wu R, Emmrich A, Hackett E, Sauber G, Yim S, Johnson B, Hari P, Schneider D, Dropulic B, Cusatis RN, Cole SW, Hillard CJ, Shah NN.) Commun Med (Lond). 2022;2(1):49 PMID: 35603278 PMCID: PMC9098435 05/24/2022
(Chang A, Sloan EK, Antoni MH, Knight JM, Telles R, Lutgendorf SK.) Integr Cancer Ther. 2022;21:15347354221096081 PMID: 35579197 PMCID: PMC9118395 SCOPUS ID: 2-s2.0-85130183860 05/18/2022
(Knight JM, Cole SW.) Psychological Aspects of Cancer: a Guide to Emotional and Psychological Consequences of Cancer, their Causes, and their Management, Second Edition. 1 January 2022:345-357 SCOPUS ID: 2-s2.0-85169408174 01/01/2022
(Taylor MR, Knight JM, Rosenberg AR.) Brain Behav Immun Health. 2021 Nov;17:100321 PMID: 34589815 PMCID: PMC8474169 10/01/2021
Biobehavioral Research and Hematopoietic Stem Cell Transplantation: Expert Review from the Biobehavioral Research Special Interest Group of the American Society for Transplantation and Cellular Therapy.
(Kelly DL, Syrjala K, Taylor M, Rentscher KE, Hashmi S, Wood WA, Jim H, Barata A, Flynn KE, Burns LJ, Shaw BE, Petersdorf E, Yero AC, Emmrich AD, Morris KE, Costanzo ES, Knight JM.) Transplant Cell Ther. 2021 Sep;27(9):747-757 PMID: 34139388 PMCID: PMC8428782 SCOPUS ID: 2-s2.0-85110419978 06/18/2021
(Alabdaljabar MS, Muhsen IN, Knight JM, Syrjala KL, Hashmi SK.) Blood Reviews. July 2021;48 SCOPUS ID: 2-s2.0-85099517313 07/01/2021
(Pisano M, Cheng Y, Sun F, Dhakal B, D'Souza A, Chhabra S, Knight JM, Rao S, Zhan F, Hari P, Janz S.) Front Immunol. 2021;12:667054 PMID: 34149703 PMCID: PMC8206561 SCOPUS ID: 2-s2.0-85108140164 06/22/2021