Publications by authors named "Reinhold Munker"

Small cell lung cancer (SCLC) is an aggressive form of neuroendocrine neoplasm known for its striking initial response to treatment, followed by fast relapse and refractoriness in response to additional lines of therapy. New advances in immunotherapy are paving the way for more effective treatment strategies and have promising results with early clinical trial data. While SCLC rarely harbors actionable mutations, the receptor DLL3 is extensively present in SCLC, making it a potential target for immunotherapy.

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  • This study analyzes the role of genetic mutations in Chronic Myelomonocytic Leukemia (CMML) and their effect on treatment responses among 51 patients treated at a single institution, compared to a statewide dataset from Kentucky.
  • Key mutations in genes like TET2, ASXL1, and SRSF2 were identified as significant prognostic indicators that influence patient survival outcomes.
  • The research highlights the importance of targeted genetic profiling for understanding CMML progression and emphasizes the need for advanced screening to personalize treatment strategies for better patient care.
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  • The study examined the genetic features of acute myeloid leukemia (AML) in obese patients compared to non-obese patients, using data from 185 individuals diagnosed with AML between 2017 and 2023.
  • Obese patients (BMI > 30 kg/m²) were found to be younger and more likely female, and they displayed different mutation rates in specific genes associated with AML.
  • The results indicate that the molecular characteristics of AML in obese individuals may involve distinct mechanisms of disease development, even though overall survival rates were similar across both groups.
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We report a distinctive case of sequential lymphomas in a 72-year-old male, initially diagnosed with Epstein-Barr virus (EBV)-positive rectal classic Hodgkin lymphoma (cHL), followed by the development of diffuse large B cell lymphoma (DLBCL) in the lung. This rare progression underscores the complexity of lymphomas associated with EBV infection and their unpredictable clinical courses. The patient's journey began with symptoms of intractable diarrhea, low appetite, and significant weight loss, leading to the diagnosis of stage 4B cHL, managed initially with brentuximab/doxorubicin, vinblastine, dacarbazine (AVD) chemotherapy.

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  • There has been an increase in the number of hematopoietic cell transplants (HCT) and improvement in overall survival after these procedures for blood disorders, but the impact on racial/ethnic minorities is unclear.
  • A study examined transplant rates and survival trends among non-Hispanic Whites, non-Hispanic African Americans, and Hispanics from 2009 to 2018, revealing that Hispanics and non-Hispanic African Americans experienced higher rates of transplant than non-Hispanic Whites.
  • Despite overall improvements in survival rates across groups, non-Hispanic African Americans faced greater mortality risks after allogeneic transplants, indicating ongoing disparities that need to be addressed.
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Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only curative treatment for myelofibrosis. However, the optimal conditioning regimen either with reduced-intensity conditioning (RIC) or myeloablative conditioning (MAC) is not well known. Using the Center for International Blood and Marrow Transplant Research database, we identified adults aged ≥18 years with myelofibrosis undergoing allo-HCT between 2008-2019 and analyzed the outcomes separately in the RIC and MAC cohorts based on the conditioning regimens used.

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Primary central nervous system lymphoma (PCNSL) occurs primarily in older patients and has a worse prognosis than other extranodal lymphomas. Contemporary treatment is based on high-dose methotrexate (HD-MTX), which crosses the blood-brain barrier. Secondary CNS lymphoma (SCNSL) can occur concomitantly with systemic lymphoma or later at relapse and generally has a dismal outcome.

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  • * A study analyzed 313 adult CMML patients who underwent HCT from 2001 to 2017, finding that higher prognostic scoring (CPSS and CPSS-Mol) correlated with poorer overall survival rates.
  • * Common mutations like ASXL1, TET2, and TP53 were linked to adverse outcomes, with TP53 mutations specifically showing an increase in relapse rates, though their impact should be viewed cautiously due to their infrequency in CMML cases.
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  • T cell prolymphocytic leukemia (T-PLL) is a rare and aggressive cancer with limited treatment options and poor survival rates, prompting this study to evaluate allogeneic hematopoietic cell transplantation (alloHCT) outcomes in affected patients.* -
  • The analysis utilized data from 266 T-PLL patients who underwent alloHCT from 2008 to 2018, revealing a 4-year overall survival rate of 30% and highlighting significant factors affecting survival, including the conditioning regimen and patient age.* -
  • Findings indicated that myeloablative conditioning and poor performance status lead to worse survival and increased treatment-related mortality, while stable disease or progression correlated with a higher relapse risk, suggesting
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  • - The study analyzed the outcomes of haploidentical hematopoietic cell transplantation (HCT) using posttransplant cyclophosphamide (PTCy) for adults with acute lymphoblastic leukemia (ALL) in remission, comparing it with other donor types like HLA-matched sibling, unrelated, and umbilical cord blood.
  • - Results showed that overall survival (OS), leukemia-free survival (LFS), and relapse rates were generally similar across donor types; however, haploidentical HCT had lower rates of chronic graft-versus-host disease (cGVHD) than matched donors.
  • - The findings suggest that haploidentical HCT with PTCy is a preferable alternative for adults with
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Acute myeloid leukemia (AML) patients often undergo allogeneic hematopoietic cell transplantation (alloHCT) in first complete remission (CR). We examined the effect of depth of clinical response, including incomplete count recovery (CRi) and/or measurable residual disease (MRD), in patients from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry. We identified 2492 adult patients (1799 CR and 693 CRi) who underwent alloHCT between January 1, 2007 and December 31, 2015.

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  • The study analyzed 2,528 patients who underwent autologous haematopoietic cell transplantation for multiple myeloma from 2008 to 2017 to create a prognostic model for predicting patient outcomes.
  • High-risk cytogenetic factors, such as specific genetic abnormalities and the level of bone marrow plasma cells before treatment, were found to significantly influence relapse and progression rates.
  • The developed scoring system categorizes patients into low, intermediate, and high-risk groups, demonstrating distinct differences in 3-year progression-free survival and overall survival rates among these categories.
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  • Myeloablative conditioning (MAC) generally leads to lower relapse rates than reduced-intensity conditioning (RIC) for patients with acute myelogenous leukemia (AML) and myelodysplastic syndromes (MDS) after allogeneic hematopoietic cell transplantation (HCT).
  • In patients classified with low/intermediate-risk Disease Risk Index (DRI), RIC resulted in lower nonrelapse mortality but higher relapse rates, resulting in worse disease-free survival compared to MAC.
  • For high/very high-risk DRI patients, both RIC and MAC showed similar disease-free survival outcomes, indicating that MAC is preferred for low/intermediate-risk patients, while new, less toxic MAC options are needed for high-risk patients
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  • This study explores how the t(11;14) genetic translocation affects clinical outcomes in African American and White multiple myeloma patients during autologous hematopoietic cell transplantation (autoHCT).
  • It analyzed data from 3,538 patients and found that African Americans with t(11;14) were generally younger and had more advanced disease than their White counterparts.
  • Despite these factors, African Americans with t(11;14) showed better overall survival rates compared to Whites with the same translocation, suggesting that race may influence outcomes in multiple myeloma patients, warranting further investigation.
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Background: Prolyl hydroxylase inhibitors (PHI) promote stabilization of hypoxia-inducible factor-1 alpha and affect signaling cascades of inflammation and cell death. Their beneficial use in experimental models of ulcerative colitis and lung allograft rejection led us to test the effect of the PHI dimethyl oxalyl glycine (DMOG) in the pathophysiology of graft versus host disease (GVHD).

Methods: Acute GVHD was induced in lethally irradiated BALB/c mice.

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Mixed phenotype acute leukemia (MPAL) is thought to have poor outcome, and presence of the Philadelphia chromosome (Ph+) has been considered to be an adverse prognostic marker. However, most of these reports were in the pre-tyrosine kinase inhibitors (TKIs) era. Recent limited reports indicate improved outcomes for MPAL with the addition of TKIs.

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The outcomes of patients with primary plasma cell leukemia (pPCL) after undergoing hematopoietic cell transplantation (HCT) in the novel agent era are unknown. We report outcomes of 348 patients with pPCL receiving autologous (auto-) HCT (n = 277) and allogeneic (allo-) HCT (n = 71) between 2008 and 2015. Median age was 60 years and 56 years for auto- and allo-HCT respectively.

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Acute undifferentiated leukemia (AUL) is rare and defined by the absence of bona fide myeloid and lymphoid markers. Little is known about its incidence, survival and optimal management in the recent time period. Based on a case observed in our clinic, we queried the Surveillance, Epidemiology, and End Results database between 2000 and 2016.

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