Publications by authors named "Denai Milton"

Autologous transplantation remains the standard of care for eligible multiple myeloma (MM) patients, yet optimal CD34 cell dose remains unclear. We conducted a retrospective study on MM patients undergoing upfront transplant between 2005 and 2021 and divided them into low (≤2.5 × 10 cells/kg) and high (>2.

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  • This study investigates the outcomes of newly diagnosed multiple myeloma (NDMM) patients with a specific genetic marker (del(17p)) who underwent an upfront autologous hematopoietic stem cell transplantation at MD Anderson Cancer Center from 2008 to 2018.
  • Out of 115 patients analyzed, those with del(17p) displayed poor prognosis, with primary measures showing a median progression-free survival (PFS) of 19.9 months and overall survival (OS) of 71.5 months.
  • Additionally, patients with both del(17p) and another genetic abnormality (t(4;14)) had the worst
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  • Melanoma leptomeningeal disease (LMD) has a low survival rate and this study looked at patients from MD Anderson to understand survival factors over a five-year period.
  • A total of 172 patients were examined, showing a median age of 53, with many having prior treatments and high levels of lactate dehydrogenase (LDH) during diagnosis.
  • While the overall median survival was only 4.9 months, those treated with intrathecal therapy or systemic immunotherapy showed better outcomes, indicating that targeted treatments can be beneficial for some patients.
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Background And Methods: Although signet ring cell (SRC) histology is associated with resistance to neoadjuvant chemoradiotherapy and worse overall survival (OS) in esophageal adenocarcinoma (EAC), its prognostic relationship among patients who survive the early period following resection is unknown. EAC patients who underwent trimodality therapy at a single institution (2006-2018) were identified. Bayesian multivariable regression (BMR) analyses of OS and additional OS from a 3-year landmark were performed.

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Upfront autologous stem cell transplantation (auto-SCT) remains standard of care for eligible patients with newly diagnosed multiple myeloma (NDMM), although recently its role has been questioned. The aim of the study was to evaluate trends in patient characteristics, treatment, and outcomes of NDMM who underwent upfront auto-SCT over three decades. We conducted a single-center retrospective analysis of patients with NDMM who underwent upfront auto-SCT at MD Anderson Cancer Center between 1988 to 2021.

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  • Autologous stem cell transplantation (autoHCT) is a common treatment for newly diagnosed multiple myeloma (MM), but only 15% of patients show a long-term response with over 8 years of progression-free survival (PFS).
  • The study analyzed 1,576 patients, finding that long-term responders (LTR) tend to be younger, have fewer high-risk genetic factors, and are more likely to undergo post-transplant maintenance therapy.
  • LTR patients had better treatment responses compared to non-LTR patients, with a median PFS of 169.3 months, although the primary cause of death in this group was progression of the disease.
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The second revision of the International Staging System (R2-ISS) is a simple tool to risk-stratify newly diagnosed multiple myeloma (NDMM) patients. Here, we completed a retrospective analysis to evaluate the utility of R2-ISS in NDMM patients who underwent up-front autologous haematopoietic stem cell transplantation (auto-HCT). A total of 1291 patients were included, with a median age of 62 years (range 29-83).

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  • Enfortumab vedotin (EV) is a targeted therapy for urothelial carcinoma, and this study evaluates its effectiveness for treating certain skin tumors by assessing Nectin-4 expression.
  • Researchers analyzed various skin adnexal carcinomas and benign tumors through immunohistochemical staining, finding that malignant tumors had significantly higher Nectin-4 expression than benign ones.
  • The study concludes that since many cutaneous adnexal carcinomas, particularly sebaceous carcinomas, exhibit high Nectin-4 levels, EV could be a viable treatment option for these cancers.
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The prognostic impact of additional copies of chromosome 1q (1q + ) on outcomes of newly-diagnosed multiple myeloma (NDMM) patients undergoing autologous transplantation (autoSCT) is unclear. We conducted a retrospective single-center analysis of NDMM patients with 1q21 gain/amplification (3 or ≥4 copies of 1q, respectively) that received autoSCT between 2008-2018. 213 patients were included (79% 1q gain; 21% 1q amplification).

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Background: Breast cancer (BC) with germline BRCA1/2 mutations and their association with triple-negative BC has been thoroughly investigated. However, some carriers of BRCA1/2 mutations have human epidermal growth factor receptor 2 (HER2/neu)-positive BC, which has a different targeted therapy approach, and data are scarce for this patient population. The authors sought to characterize the clinical characteristics and outcomes of patients with HER2/neu-positive BC who had germline BRCA1/2 mutations.

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Context.—: Transition from pathology trainee to independent pathologist is stressful. No study has examined junior pathologists' challenges and concerns during this transition.

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Context.—: In the United States, review of digital whole slide images (WSIs) using specific systems is approved for primary diagnosis but has not been implemented for intraoperative consultation.

Objective.

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Outcomes of myelofibrosis (MF) with allogeneic stem cell transplantation (allo-SCT) have improved over the past decade, related in part to advances in supportive treatments and conditioning regimens. Several factors are known to predict transplantation outcomes. However, most studies lack homogeneity in conditioning regimens used, limiting their ability to assess prognostic factors on transplantation outcomes.

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Multiple myeloma (MM) patients with high-risk cytogenetic abnormalities have inferior survival outcomes and are underrepresented in clinical trials. There is scarce data on MM patients with more than one high-risk cytogenetic aberration (ie, ultra- high-risk MM). This study was conducted to evaluate outcomes of newly diagnosed MM patients with ultra-high-risk MM who underwent autologous hematopoietic stem cell transplantation (autoHCT).

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Context: To provide high-quality, safe training during the COVID-19 pandemic, our anatomic pathology fellowship program implemented a hybrid virtual/in-person training model with supplemental digital material.

Objective: To evaluate the impact of this model.

Design: We examined Accreditation Council for Graduate Medical Education survey results and board pass rates for fellows before the pandemic (group 1); during the pandemic peak (group 2); and early and late after the pandemic peak (groups 3 and 4).

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The optimal duration of lenalidomide (Len) maintenance for patients with multiple myeloma (MM) after autologous stem cell transplantation (autoHCT) is unknown. We conducted a retrospective single-center analysis of adult MM patients that received upfront autoHCT between 2005 and 2021, followed by single-agent Len maintenance. A total of 1167 patients were included with a median age of 61.

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Patients with multiple myeloma (MM) who undergo high-dose chemotherapy and autologous hematopoietic cell transplantation (Auto-HCT) have an increased risk of developing therapy-related myelodysplastic syndrome and acute myeloid leukemia (t-MDS/AML). We retrospectively reviewed the medical records of all MM patients who underwent an Auto-HCT at our institution between 1 January and 31 December 2018 and later developed t-MDS/AML. Among the 2982 patients who underwent at least 1 Auto-HCT, 55 (2%) developed t-MDS/AML (MDS, n = 52; AML, n = 3).

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Multiple myeloma (MM) primarily affects older patients. There are scarce data on the outcomes of young adults undergoing autologous transplantation (auto-HCT). In this single-centre analysis, we included 117 younger patients, with a median age of 37 years (range 22-40) at transplant.

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Dual expression of MYC and BCL2 proteins (double-expressor lymphoma [DEL]) as well as cell of origin (COO) are important prognostic factors in patients with diffuse large B-cell lymphoma (DLBCL) after conventional chemotherapy. We studied the prognostic impact of DEL and COO in patients with relapsed DLBCL treated with autologous stem cell transplant (ASCT). Three-hundred and three patients with stored tissue samples were identified.

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  • Immune checkpoint inhibitor therapies can lead to skin-related immune issues, specifically a condition known as bullous pemphigoid (BP), but the exact causes of these reactions are not well understood.
  • A study compared biopsy samples from patients with BP related to immune therapy and those with regular BP, analyzing their gene expression and immune cell presence.
  • Findings showed that BP-irAE had increased levels of specific immune response genes and a higher presence of certain T-cells, while showing fewer regulatory T-cells, suggesting a distinct immune response mechanism in these cases.
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Most patients with multiple myeloma (MM) undergoing autologous hematopoietic stem cell transplantation (autoHCT) eventually relapse, perhaps due to the presence of clonal plasma cells (CPC) in the autograft. We conducted a retrospective analysis to evaluate the impact of CPC in the autograft on the outcomes of high-risk chromosomal abnormalities (HRMM) patients undergoing autoHCT between 2008 and 2018. Patients were divided into CPC+ or CPC- in the autograft by next-generation flow cytometry (NGF).

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Background: In lung cancer, overexpression of nuclear export proteins can result in inactivation of critical tumor suppressor proteins and cell-cycle regulators. Selective suppression of nuclear export proteins has immunomodulatory activities. Here, clinical safety and early efficacy data are presented on the combination of pembrolizumab and an oral selective nuclear export inhibitor, selinexor, for the treatment of metastatic non-small cell lung cancer (mNSCLC).

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