Browse Health
Internist, Hematology Specialist, Oncology Specialist (cancer)
13 years of experience
Accepting new patients


Education ?

Medical School Score Rankings
Uniformed Services University (1999)
Top 50%

Awards & Distinctions ?

American Board of Internal Medicine
American Society of Clinical Oncology

Affiliations ?

Dr. Olnes is affiliated with 2 hospitals.

Hospital Affiliations



  • The Johns Hopkins Hospital
    Medical Oncology
    600 N Wolfe St, Baltimore, MD 21287
    Top 25%
  • Johns Hopkins Bayview Medical Center
    4940 Eastern Ave, Baltimore, MD 21224
    Top 25%
  • Publications & Research

    Dr. Olnes has contributed to 13 publications.
    Title Alemtuzumab Treatment of Intermediate-1 Myelodysplasia Patients is Associated with Sustained Improvement in Blood Counts and Cytogenetic Remissions.
    Date January 2011
    Journal Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

    Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis and progression to leukemia. Clinical and experimental evidence suggests an immune-mediated pathophysiology in some patients, in whom immunosuppressive therapy (IST) with horse antithymocyte globulin (h-ATG) and cyclosporine (CsA) can be effective. Because of the toxicities associated with h-ATG/CsA, we investigated an alternative regimen with alemtuzumab in MDS.

    Title Long-term Follow-up of Patients with Moderate Aplastic Anemia and Pure Red Cell Aplasia Treated with Daclizumab.
    Date July 2010
    Journal Haematologica

    Pure red cell aplasia and moderate aplastic anemia are marrow failure states with an immune pathogenesis. Previously, we described short-term improvements in blood counts in two pilot studies treating moderate aplastic anemia (mAA) and pure red cell aplasia (PRCA) patients with daclizumab, a humanized monoclonal antibody to the interleukin-2 receptor; we now report our long-term experience with a larger cohort of patients.

    Title A Review and Update on Cholangiocarcinoma.
    Date July 2004
    Journal Oncology

    Cholangiocarcinoma is a malignant neoplasm arising from the biliary epithelium that was first described by Durand-Fardel in 1840. Today, it continues to defy diagnosis and treatment. It is difficult to diagnose in part because of its relative rarity, and because it is clinically silent until it becomes advanced disease with obstructive symptoms. The worldwide incidence of cholangiocarcinoma has risen over the past three decades. There is marked geographic variability in the prevalence of this disease, due in large part to regional environmental risk factors. Surgical resection remains the only curative treatment, and high priorities are improving diagnostic methods, and clinical staging for resection once the disease is suspected. A recent trend towards aggressive surgical management has improved outcomes. Chemotherapy, palliative stenting, and radiation are reserved for patients who are not resectable, those with recurrence after surgery, and those who decline surgical intervention. Recent trials using combination systemic chemotherapy and neoadjuvant chemoradiation are promising, but require further study. Over the past five years, several important studies have yielded new insights into the molecular mechanisms of cholangiocarcinoma tumorigenesis. In this review we discuss epidemiology, etiologic factors, molecular pathogenesis, diagnosis, staging, and treatment of cholangiocarcinoma. Particular focus is on recent studies into the cellular and molecular pathogenesis of the disease, recent chemotherapy trials, and newer methods of staging and screening for this devastating malignancy.

    Title Nonconvulsive Status Epilepticus Resulting from Benzodiazepine Withdrawal.
    Date December 2003
    Journal Annals of Internal Medicine
    Title Interdigitating Dendritic Cell Sarcoma: a Rare Malignancy Responsive to Abvd Chemotherapy.
    Date November 2002
    Journal Leukemia & Lymphoma

    Interdigitating dendritic cell sarcoma (IDCS) is an aggressive neoplasm of which fewer than 25 cases have been reported in the world literature. This malignancy is difficult to diagnose because of its rarity, and because of the subtle histopathologic features that distinguish IDCS from similar tumors arising from reticular cells. To date, there exists no consensus on a standard chemotherapeutic regimen for IDCS. Patients with this malignancy have been treated with chemotherapy regimens used against non-Hodgkin's lymphomas. Responses to these regimens have been variable, but mostly unsuccessful. In this article we describe a case of IDCS occurring in a 44 year old female who presented with abdominal pain and inguinal adenopathy. Staging of the tumor with CT scan, PET scan, and bone marrow biopsy demonstrated inguinal and abdominal lymphadenopathies, a large mass encasing the small bowel, and extensive liver infiltration. Morphologic and cytochemical analysis of biopsies from the abdominal mass and inguinal node were consistent with a diagnosis of IDCS, and immunohistochemical stains of the lymph node were positive for CLA, Kp-1, S-100, while negative for CD1a, CD3, CD20, CKER, and HMB45. Treatment of this patient with ABVD chemotherapy resulted in rapid clinical improvement with a marked decrease in tumor burden after two cycles of ABVD, and a complete response after six cycles of therapy.

    Title Promoter of the Canine Tracheobronchial Mucin Gene.
    Date February 1997
    Journal Glycoconjugate Journal

    The mucin gene is up-regulated in diseases such as cystic fibrosis (CF) and asthma. To understand the mechanisms involved in transcriptional regulation of mucin gene expression we have characterized the region of the mucin gene up-stream of the transcriptional start site and analysed the cis-acting elements required for mucin promoter activity. We isolated clones from a dog genomic library containing the promoter region for the tracheobronchial mucin gene (TBM). The authenticity of the promoter was tested by nucleotide sequencing, primer extension analysis, electrophoretic mobility shift assay (EMSA) and reporter gene expression analysis. The canine TBM promoter is different from housekeeping gene promoters (as it is not rich in GC content and contains TATA- and CAAT-like sequences) and different from that of regulatory genes (because it contains many TATA- and CAAT-like sequences and multiple transcriptional initiation sites). Reporter gene analysis using canine TBM promoter-chloramphenicol acetyltransferase (CAT) fusion plasmids established the regions responsible for promoter activity and verified the positions of the major mucin transcriptional initiation sites. Reporter gene analysis also established that a region of the canine TBM promoter and first exon containing all of the transcriptional initiation sites is more active in mucin expressing cells (e.g. CT1 cells-immortalized canine tracheal epithelial cells, human CFT1 cells-immortalized tracheal epithelial cells from a CF subject, or HBE1 cells-immortalized tracheal epithelial cells from non-CF subject) than in mucin non-expressing cells (COS7, 3T3), suggesting cell specificity. The promoter region contained cAMP response element (CRE) sequences, and the TBM gene transcription was enhanced when cAMP analogs were added to transfected cells. EMSA indicated the presence of at least two DNA binding proteins in CT1 cells. This is the first report describing the characterization of a TBM gene promoter. The information obtained in the present studies will be valuable in understanding mucin gene regulation in normal and pathological conditions.

    Title 2,3,7,8-tetrachlorodibenzo-p-dioxin Modulates Expression of the Prostaglandin G/h Synthase-2 Gene in Rat Thymocytes.
    Date January 1997
    Journal The Journal of Pharmacology and Experimental Therapeutics

    As an approach to understanding the molecular mechanism(s) of thymic gene expression mediated by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), we investigated the effect of TCDD on expression of prostaglandin G/H synthase-2 (PGHS-2) in rat thymocytes by reverse transcription-polymerase chain reaction. Incubation of thymocytes with increasing doses of TCDD resulted in inhibition of PGHS-2 gene expression in a concentration-dependent manner, with an IC50 of 10 nM. In contrast, TCDD had no appreciable effect on expression of glyceraldehyde phosphate dehydrogenase. Because the xenobiotic-responsive element is conserved in the PGHS-2 promoter from several animal species, it seems likely that inhibition of PGHS-2 expression by TCDD may occur at the level of transcription. To test this hypothesis in cultured thymocytes, we characterized the Ah receptor in the thymoma cell line WEHI 7.1. Reverse transcription-polymerase chain reaction experiments indicated that TCDD inhibited PGHS-2 expression in this cell line. Sucrose density gradient centrifugation experiments indicated that WEHI 7.1 cytosol exhibited 9 to 10S ligand-binding activity characteristic of the Ah receptor. The viability of WEHI 7.1 cells incubated with TCDD was comparable to that of control cells, whereas dexamethasone induced toxicity in a concentration-dependent manner. Transient transfection experiments using PGHS-2 promoter fragments ligated into a chloramphenicol acetyltransferase reporter plasmid suggested that TCDD inhibits PGHS-2 transcription, and deletion of the xenobiotic-responsive element failed to exhibit this repression. These results demonstrate that TCDD is a potent inhibitor of PGHS-2 gene expression, and they represent the first mechanistic evidence for TCDD-dependent inhibition of transcription in thymocytes.

    Title Primary Structure of the Canine U1 Snrna.
    Date April 1995
    Journal Gene

    The nucleotide (nt) sequence of the canine U1 snRNA was determined. It exhibited significant homology (90-98%) with known U1 sequences. The RNA can be folded according to the secondary structure previously proposed for the U1 snRNA. It contained the conserved sequence UUACCUG in loop A (nt 6-12), required for the recognition of the 5' splice site, and the sequence UGCACU in loop B (nt 68-73), required for recognition of the U1-70K protein. The U1 snRNA was localized in the nucleus and its transcription was sensitive to alpha-amanitin, suggesting that it is transcribed by RNA polymerase II. Southern analysis revealed that the canine genome possesses 5-10 copies of U1 snRNA-encoding genes.

    Title 2,3,7,8-tetrachlorodibenzo-p-dioxin-mediated Gene Expression in the Immature Rat Thymus.
    Date February 1995
    Journal Experimental and Clinical Immunogenetics

    To examine the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on thymic gene expression in vitro, freshly isolated rat thymocytes were incubated with 10 nM TCDD, and reverse transcriptase polymerase chain reaction experiments were performed using primers specific for prostaglandin G/H synthase (PGHS) and glyceraldehyde 3-phosphate dehydrogenase. TCDD selectively repressed PGHS gene expression, with maximal inhibition occurring within 60 min. Gel retardation assays demonstrated that dioxin transiently induced binding of the ubiquitous transcription factor NF kappa B to its cognate response element at early time points. However, TCDD had little ability to induce transformation of the Ah receptor to the xenobiotic responsive element in thymic cytosol. These results indicate that TCDD exerts changes in thymocyte gene expression prior to inducing toxicity.

    Title Inhibition of Ah (dioxin) Receptor Transformation by 9-hydroxy Ellipticine. Involvement of Protein Kinase C?
    Date November 1993
    Journal Biochemical Pharmacology

    9-Hydroxy ellipticine (9-OHE), a metabolite of the anti-neoplastic agent ellipticine, is known to bind the aryl hydrocarbon (Ah) receptor in rat lung cytosol and to inhibit aryl hydrocarbon hydroxylase activity (AHH) in rat hepatic microsomes. In this study, the effects of 9-OHE on the transformation of the rat hepatic cytosolic Ah receptor to a form that binds the xenobiotic responsive enhancer element-3 (XRE-3) of the cytochrome P4501A1 gene was investigated. Sucrose density gradient analysis of [3H]-2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) binding in rat hepatic cytosol indicated that 9-OHE inhibited binding of the radiolabeled ligand to the Ah receptor with an IC50 of 90 microM. Gel retardation assays revealed that at low concentrations of 9-OHE the Ah receptor bound to XRE-3, as was the case with the TCDD-liganded receptor. However, in the presence of high concentrations of 9-OHE, the Ah receptor failed to transform to a form that could bind to XRE-3. In vitro studies indicated that incubation of rat hepatic cytosol with TCDD resulted in concentration-dependent increases in levels of protein kinase C (PKC) mediated phosphorylation as compared to vehicle-treated extracts. Furthermore, 9-OHE concentrations that exhibited agonist activity with respect to Ah receptor transformation did not alter PKC phosphorylation in hepatic cytosol, whereas higher concentrations exhibited significant concentration-dependent decrease in PKC-mediated phosphorylation. These results demonstrate that the antagonistic effect of 9-OHE observed at high concentrations is due to inhibition of Ah receptor-XRE complex formation, a phenomenon that correlates with alterations in PKC activity.

    Title Early Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (tcdd) on Rat Thymocytes in Vitro.
    Date March 1993
    Journal Toxicology

    TCDD is known to induce thymic atrophy in several mammalian species through activation of programmed cell death, or apoptosis. To investigate the time course of events which precede TCDD-induced thymic apoptosis in vitro, experiments were performed with thymocytes isolated from immature rats. Peak accumulation of both total and specifically bound [3H]TCDD was observed at 60 min post incubation. Incubation of cells with 10 nM TCDD resulted in significant increases in RNA polymerase activity and incorporation of [3H]uridine at 30 min, indicating increased RNA synthesis in response to TCDD. TCDD-induced stimulation of [3H]uridine incorporation was not significantly altered in the presence of cycloheximide, while this effect was abrogated in the presence of actinomycin D. Incubation of thymocytes with 10 nM TCDD also stimulated the activity of poly(A)polymerase, the enzyme catalyzing mRNA polyadenylation, at time points beyond 30 min. No significant increases in [35S] incorporation were observed in cells treated with 10 nM TCDD, although analysis of detergent and high salt extracted nuclear proteins by SDS-PAGE and coomassie blue staining revealed the increased abundance of at least two proteins with molecular masses of 52,000 and 42,000 Da, respectively. These studies reveal that thymocyte nuclei rapidly accumulated TCDD in vitro, leading to increased RNA synthesis, poly(A)polymerase activity and protein synthesis. These events correlate closely with the process of programmed cell death.

    Title A Non-atp-competitive Dual Inhibitor of Jak2 and Bcr-abl Kinases: Elucidation of a Novel Therapeutic Spectrum Based on Substrate Competitive Inhibition.
    Journal Genes & Cancer

    Here we report the discovery of ON044580, an alpha-benzoyl styryl benzyl sulfide that possesses potent inhibitory activity against two unrelated kinases, JAK2 and BCR-ABL, and exhibits cytotoxicity to human tumor cells derived from chronic myelogenous leukemia (CML) and myelodysplasia (MDS) patients or cells harboring a mutant JAK2 kinase. This novel spectrum of activity is explained by the non-ATP-competitive inhibition of JAK2 and BCR-ABL kinases. ON044580 inhibits mutant JAK2 kinase and the proliferation of JAK2(V617F)-positive leukemic cells and blocks the IL-3-mediated phosphorylation of JAK2 and STAT5. Interestingly, this compound also directly inhibits the kinase activity of both wild-type and imatinib-resistant (T315I) forms of the BCR-ABL kinase. Finally, ON044580 effectively induces apoptosis of imatinib-resistant CML patient cells. The apparently unrelated JAK2 and BCR-ABL kinases share a common substrate, STAT5, and such substrate competitive inhibitors represent an alternative therapeutic strategy for development of new inhibitors. The novel mechanism of kinase inhibition exhibited by ON044580 renders it effective against mutant forms of kinases such as the BCR-ABL(T315I) and JAK2(V617F). Importantly, ON044580 selectively reduces the number of aneuploid cells in primary bone marrow samples from monosomy 7 MDS patients, suggesting another regulatory cascade amenable to this agent in these aberrant cells. Data presented suggest that this compound could have multiple therapeutic applications including monosomy 7 MDS, imatinib-resistant CML, and myeloproliferative neoplasms that develop resistance to ATP-competitive agents.

    Title T Cell Immune Responses to Wilms Tumor 1 Protein in Myelodysplasia Responsive to Immunosuppressive Therapy.
    Journal Blood

    Clinical observations and laboratory evidence link bone marrow failure in myelodysplastic syndrome (MDS) to a T cell-mediated immune process that is responsive to immunosuppressive treatment (IST) in some patients. We previously reported that trisomy 8 MDS was more likely to respond to IST and was associated with skewed T cell receptor Vβ profiles with clonally expanded CD8+ T cells capable of suppressing the growth of aneuploid progenitor cells in vitro. Furthermore, microarray analyses showed that Wilms tumor protein (WT1) was over-expressed by trisomy 8 hematopoietic progenitor (CD34+) cells as compared to CD34+ cells from healthy donors. Here, we show that WT1 mRNA expression is upregulated in the bone marrow mononuclear cells of MDS patients with trisomy 8 compared to healthy controls (p = 0.001) and to non-trisomy 8 MDS (p=0.04); WT1 protein levels were also significantly elevated. In addition, using a combination of physical and functional assays to detect the presence and biological reactivity of specific T cells respectively, we demonstrate that IST-responsive MDS patients exhibit significant CD4+ and CD8+ T cell responses directed against WT1. Finally, WT1-specific CD8+ T cells were present within expanded Vβ subfamilies and inhibited hematopoiesis when added to autologous patient bone marrow cells in culture. Thus, our results strongly implicate WT1 as one of the antigens that triggers T cell-mediated myelosuppression in MDS. This study is registered at as NCT00217594.

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