Publications by authors named "Almuth M A Merz"
Myelodysplastic neoplasms (MDS) involve clonal hematopoiesis and cellular dysplasia, driven by genetic and epigenetic alterations. Spliceosome mutations and epigenetic dysregulation underscore the intricate pathogenesis of MDS. The bone marrow microenvironment, stromal dysfunction, chronic inflammation, and immune dysregulation contribute to disease progression.
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- - Recent advancements in the treatment of high-risk Myelodysplastic Neoplasms (HR MDS) face obstacles due to changing drug combinations with Hypomethylating Agents (HMAs) and a shift from the IPSS to IPSS-M scoring system.
- - The introduction of MDS/AML overlap and the inclusion of chronic myelomonocytic leukemia (CMML) add further complexity to study classifications and trial designs.
- - Emphasizing the need for precise trial methodologies, the text discusses the importance of accurately reporting adverse events and reviewing negative clinical trials to improve future research in HR MDS.
Management of myelodysplastic neoplasms (MDS) requires a personalized approach, with a focus on improving quality of life and extending lifespan. The International Prognostic Scoring System-Revised and the molecular International Prognostic Scoring System are key tools for risk stratification and management of MDS. They provide a framework for predicting survival and the risk of transformation to acute myeloid leukemia.
View Article and Find Full Text PDFSpatial heterogeneity is a common phenomenon in metastatic solid tumors and an evolving concept in multiple myeloma (MM). The interplay between malignant plasma cells (PCs) and the microenvironment has not yet been analyzed in MM. For this purpose, we performed bone marrow aspirates and imaging-guided biopsies of corresponding lesions in newly diagnosed MM (NDMM) and relapsed/refractory MM (RRMM) patients.
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- Osteolytic lesions (OL) in multiple myeloma are influenced by malignant plasma cells (PC), but the reasons for varying bone destruction in different regions remain unclear.
- A study using single-cell RNA sequencing analyzed 148,630 PC from various sites in 10 patients, revealing significant inter- and intra-patient variability.
- Findings indicate that PC from OL express different genes compared to those from bone marrow, highlighting specific gene changes related to bone disease and showing transcriptional shifts post-induction therapy.
Revaccination after autologous hematopoietic cell transplantation (AHCT) is recommended in post-HCT survivorship guidelines to restore humoral immunity. Data on seroconversion after AHCT and vaccination in multiple myeloma (MM) patients are limited. We investigated the feasibility and effectiveness of vaccination post-AHCT and analyzed the restoration of humoral immunity and patient prognosis.
View Article and Find Full Text PDF: Maintenance therapy after autologous transplantation is a standard of care in newly diagnosed myeloma. However, there is no universal answer to the question of which maintenance strategy should be pursued after ASCT? : We conducted a MEDLINE search using the medical subject headings 'multiple myeloma', 'autologous transplantation' and 'maintenance' to identify available data from clinical trials on the role of different maintenance strategies after autologous transplantation for the newly diagnosed disease. : A large meta-analysis demonstrated that lenalidomide prolongs progression-free and overall survival after autologous transplantation compared to observation/placebo.
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