About

Dr. Michael W Schuster is a Clinical Professor of Medicine specializing in Hematology and Hematology Oncology at Stony Brook University. His work involves the development and clinical application of revolutionary treatments for blood cancers, including therapies such as bi-specific antibodies, CAR T cells, and other antibody conjugates with chemotherapy drugs, which have produced unprecedented results. He has been involved in clinical trials that help bring these innovative drugs into clinical practice, emphasizing continued research in targeted therapies and immune-based treatments. His research also encompasses understanding the growth and signaling mechanisms inside cancer cells, contributing to the development of targeted drugs that have led to what he describes as 'miraculous' treatments. Dr. Schuster's extensive publication record reflects his focus on clinical trials, transplantation outcomes, and supportive care in hematologic malignancies, with particular attention to multiple myeloma, lymphoma, and leukemia. His contributions aim to improve therapeutic strategies and patient outcomes in hematologic cancers.

Research topics

• Internal medicine
• Medicine
• Immunology
• Gastroenterology
• Biology
• Virology
• Emergency medicine
• Oncology
• Surgery
• Intensive care medicine
• Endocrinology

Selected publications

• P18-68 InSilify DrugTox – a computational retrospective analysis of herg potassium channel inhibition and QT prolongation data from pharmaceutical scientific advice and authorization procedures

  Toxicology Letters · 2025-09-01

  article
  PublisherDOI

• Unveiling Cardiac Complications: A Case of Amisulpride Overdose Leading to Bradycardia, QT-Prolongation, and Torsade de Pointes Tachycardia

  Therapeutic Drug Monitoring · 2025-03-05 · 2 citations

  article

  ABSTRACT: Suicide attempts involving self-poisoning with benzodiazepines, antipsychotic drugs, or antidepressants are prevalent in emergency departments and intensive care units. Managing these patients is often complex and relies predominantly on local expertise and experience. Treatment options for overdose of orally ingested substances include gastroscopy with gastric lavage and activated charcoal therapy. However, there are limited data regarding the effectiveness of delayed treatment initiation and associated clinical benefits. Overdose with antipsychotic drugs, such as amisulpride, can lead to severe cardiac side effects, including bradycardia, QT prolongation, and subsequent torsade de point tachycardia. This report describes a 65-year-old woman who ingested of 40g amisulpride with suicidal intent. The patient presented with bradycardia necessitating temporary pacing and QT prolongation, which resulted in torsade de point tachycardia. Due to the severe cardiac, hemodynamic, and central nervous system complications of the intoxication, the authors opted for gastroscopy with gastric lavage and activated charcoal therapy, despite the intake taking place >7 hours ago. Amisulpride plasma concentrations were measured using liquid chromatography coupled with high-resolution mass spectrometry at various time points, including before and after gastroscopy. In addition, a qualitative measurement of amisulpride in stomach contents was performed. Drawing insights from this case, the authors explored optimal approaches for managing cardiac side effects and assessed the value of gastric lavage and activated charcoal therapy in contemporary intensive care medicine. Why should physicians and toxicologists be aware of this issue? (1) To detect and treat possible cardiac side effects, such as torsade de point tachycardia, and (2) To understand the role of gastric lavage and activated charcoal therapy in patients with poisoning.

  PublisherDOI

• A Relapsed AML Case Featuring MYC and MECOM Rearrangements

  Diagnostics · 2025-09-22

  articleOpen access

  Background/Objectives: Relapsed acute myeloid leukemia (AML) is often characterized by clonal evolution and acquired genomic abnormalities, which can inform prognosis and direct therapeutic decisions. The emergence of high-risk chromosomal rearrangements during relapse is of particular significance, yet the impact of rare and complex events remains poorly understood. This report details a case of relapsed AML that demonstrated rare MYC and MECOM rearrangements and additional features that were not observed at initial diagnosis, emphasizing the clinical relevance of serial cytogenetic assessments. Case Description: A 70-year-old man was initially diagnosed with AML, exhibiting monocytic differentiation, an 11q23 deletion involving KMT2A loss, and a U2AF1 mutation. After achieving remission with azacitidine and venetoclax, the patient relapsed within ten months, necessitating reevaluation and modification of therapy. Repeat cytogenetic analysis at relapse revealed a distinct t(3;8)(q26.2;q24.3) exhibiting MYC and MECOM rearrangements, features that were absent at initial diagnosis. Conclusions: This case underscores the importance of serial cytogenetic and molecular profiling in relapsed AML. The emergence of new abnormalities upon relapse suggested underlying genomic instability and clonal evolution. MYC rearrangements are notably rare in AML, especially with concurrent MECOM rearrangements, highlighting a unique feature of this case. The identification of novel abnormalities at relapse may carry prognostic and therapeutic significance and may be used to refine risk stratification. Thus, ongoing cytogenetic monitoring is essential to adapt management approaches in evolving disease contexts.

  PublisherOA PDFDOI

• Advantages of less frequent doing of BCMA-directed bispecific antibodies

  Blood · 2025-11-03

  article1st authorCorresponding

  Abstract The use of bispecific antibodies to treat relapsed/refractory myeloma has increased dramatically over the past several years. The reasons for this include their “off-the-shelf” availability and their efficacy even in triple class refractory myeloma and in patients who have already been treated with 5 prior lines of therapy, including prior stem cell transplant. Alternative schedules and fixed duration of treatment are being explored as a way to decrease toxicity, including infections, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) as well as to address the issues of maintaining long-term effectiveness by decreasing T cell exhaustion. An additional burden of these treatments are their expense and requirement that patients have to go to clinic weekly or every other week. We report a single institution experience of 10 patients with relapsed/refractory multiple myeloma, who were treated with BCMA-directed bispecific antibodies and who have gone on to monthly dosing. The median age of the patients was 68. All of the patients were triple class refractory with a median of 3.5 prior lines of therapy and with 8/10 patients having had a prior transplant. Half of the patients were treated with teclistamab and half with elranatamab. The median time from diagnosis for these patients was 7 years (range 1-15 years). Patients were taken through the prescribed step up dosing and then advanced to every other week dosing. During this period, toxicity included infections, low-grade CRS and 1 case of low-grade ICANS. All of the patients achieved a CR or better by the time they reached every other week dosing. The decision to go to monthly dosing was highly variable, including patient preference, physician preference, intercurrent medical procedures and insurance problems. The median time to go to monthly dosing from every other week dosing was 8 weeks. All ten patients maintained their complete response with monthly dosing. As of the time of this report, the median time on monthly dosing was less than 6 months (range 3-28 weeks). No case of CRS or ICANS was reported during monthly dosing. All of the patients were begun on monthly IVIG after starting treatment with the bispecific antibodies. 2 patients who had frequent upper respiratory tract infections (URI's) prior to treatment with the bispecific antibodies had additional episodes of viral URI's during the monthly treatment. In the other patients, no new infections were reported; however, 1 patient was noted to have CMV reactivation. Our experience similarly reflects that of a recent FDA approval of monthly dosing of elranatamab after at least 24 weeks of the bi-weekly (every two weeks) dosing regimen based upon the long-term update from the phase 2 Magnetis MM study. In a post-hoc analysis from that study, 96.2% of patients maintained their response and infections were reduced from 17.9% to 10.7%. As more experience and data are collected, we believe that less frequent dosing will become the norm.

  PublisherDOI

• POSTER: AML-732 Ziftomenib Combined With Intensive Induction Chemotherapy (7+3) in Newly Diagnosed NPM1-m or KMT2A-r Acute Myeloid Leukemia (AML): Updated Phase 1a/b Results From KOMET-007

  Clinical Lymphoma Myeloma & Leukemia · 2025-08-28

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  PublisherDOI

• AML-732: Ziftomenib Combined With Intensive Induction Chemotherapy (7+3) in Newly Diagnosed NPM1-m or KMT2A-r Acute Myeloid Leukemia (AML): Updated Phase 1a/b Results From KOMET-007

  Clinical Lymphoma Myeloma & Leukemia · 2025-08-28 · 3 citations

  article
  PublisherDOI

• Tolerability and long-term survival of fragile or older patients with diffuse large B cell lymphoma (DLBCL) not otherwise specified by R-CDOP

  Blood · 2025-11-03

  article

  Abstract Introduction: According to Surveillance, Epidemiology, and End Results data, Diffuse Large B-Cell Lymphoma (DLBCL) is diagnosed at the median age of 67. Treatment decisions amongst older patients, especially over 75-year-old are challenging due to the poor tolerability of standard R-CHOP and the compromised efficacy of R-mini-CHOP. Patients and Methods: We retrospectively analyzed data from patients with DLBCL not otherwise specified (NOS) who were treated with frontline R-CDOP. The regimen included Rituximab 375mg/m2, Cyclophosphamide 750mg/m2, liposomal doxorubicin 30mg/m2 on day 1 and prednisone 100mg day 1-5, every 21 days a cycle, followed by granulocyte colony stimulating factor and preventive antibiotics support. Patients with transformed or other entities of DLBCL, or RCDOP as second line were excluded from this study. Clinical data included complete blood counts with differential, chemistry and clinical signs of cardiac failure, transfusion requirement, hospitalizations, positron emission tomography scans and clinical signs and symptoms of disease were analyzed. Deaths without evidence of disease relapse were counted as events Results: Ten patients' data (2 females, 8 males; 1 diagnosed at age of 47 with heart failure, the other 9, age from 71-86) were analyzed, 1 patients completed 4 cycles, one 5 cycles and the other 8 completed 6 cycles, none was given dose reduction. There was no worsening of cardiac congestion noted or events that compromised treatment. One showed partial response, the other 9 showed durable complete response. Three patients died without evidence of disease relapse (one from demenitia and 2 from secondary malignancies), 2 died from disease relapse. Overall survival and relapse-free survival at 5 years are both 50%. No patient died from the treatment. Conclusions: RCDOP as frontline appears tolerable for olderly with DLBCL NOS and gives durable response and long-term survival.

  PublisherDOI

• P18-70 Insilify Drugtox – A Computational Retrospective Analysis of Genotoxicity Data from Pharmaceutical Scientific Advice and Authorization Procedures

  Toxicology Letters · 2025-09-01

  article
  PublisherDOI

• Randomized Phase III SIERRA Trial of ¹³¹ I-Apamistamab Before Allogeneic Hematopoietic Cell Transplantation Versus Conventional Care for Relapsed/Refractory AML

  Journal of Clinical Oncology · 2024-09-19 · 14 citations

  articleOpen access

  PURPOSE Older patients with relapsed or refractory AML (RR AML) have dismal prognoses without allogeneic hematopoietic cell transplantation (alloHCT). SIERRA compared a targeted pretransplant regimen involving the anti-CD45 radioconjugate 131 I-apamistamab with conventional care. METHODS SIERRA (ClinicalTrials.gov identifier: NCT02665065 ) was a phase III open-label trial. Patients age ≥55 years with active RR AML were randomly assigned 1:1 to either an 131 I-apamistamab–led regimen before alloHCT or conventional care followed by alloHCT if initial complete remission (CR)/CR with incomplete platelet recovery (CRp) occurred. Initial response was assessed 28-56 days after alloHCT in the 131 I-apamistamab group and 28-42 days after salvage chemotherapy initiation; patients without CR/CRp or with AML progression could cross over to receive 131 I-apamistamab followed by alloHCT. The primary end point was durable complete remission (dCR) lasting 180 days after initial CR/CRp. Secondary end points were overall survival (OS) and event-free survival (EFS), assessed hierarchically in the intention-to-treat (ITT) population. RESULTS The ITT population included 153 patients ( 131 I-apamistamab [n = 76]; conventional care [n = 77]). In total, 44/77 conventional care arm patients crossed over and 40/77 (52%) received 131 I-apamistamab and alloHCT, with six patients (13.6%) experiencing a dCR. In the ITT population, the dCR rate was significantly higher with 131 I-apamistamab (17.1% [95% CI, 9.4 to 27.5]) than conventional care (0% [95% CI, 0 to 4.7]; P < .0001). The OS hazard ratio (HR) was 0.99 (95% CI, 0.70 to 1.41; P = .96), and the EFS HR was 0.23 (95% CI, 0.15 to 0.34), with HR <1 favoring 131 I-apamistamab. Grade ≥3 treatment-related adverse events occurred in 59.7% and 59.2% of the 131 I-apamistamab and conventional care groups, respectively. CONCLUSION The 131 I-apamistamab–led regimen was associated with a higher dCR rate than conventional care in older patients with RR AML. 131 I-apamistamab was well tolerated and could address an unmet need in this population.

  PublisherDOI

• Nuclear receptor corepressor 1 controls regulatory T cell subset differentiation and effector function

  eLife · 2024-09-26 · 3 citations

  articleOpen access

  FOXP3 + regulatory T cells (Treg cells) are key for immune homeostasis. Here, we reveal that nuclear receptor corepressor 1 (NCOR1) controls naïve and effector Treg cell states. Upon NCOR1 deletion in T cells, effector Treg cell frequencies were elevated in mice and in in vitro-generated human Treg cells. NCOR1-deficient Treg cells failed to protect mice from severe weight loss and intestinal inflammation associated with CD4 + T cell transfer colitis, indicating impaired suppressive function. NCOR1 controls the transcriptional integrity of Treg cells, since effector gene signatures were already upregulated in naïve NCOR1-deficient Treg cells while effector NCOR1-deficient Treg cells failed to repress genes associated with naïve Treg cells. Moreover, genes related to cholesterol homeostasis including targets of liver X receptor (LXR) were dysregulated in NCOR1-deficient Treg cells. However, genetic ablation of LXRβ in T cells did not revert the effects of NCOR1 deficiency, indicating that NCOR1 controls naïve and effector Treg cell subset composition independent from its ability to repress LXRβ-induced gene expression. Thus, our study reveals that NCOR1 maintains naïve and effector Treg cell states via regulating their transcriptional integrity. We also reveal a critical role for this epigenetic regulator in supporting the suppressive functions of Treg cells in vivo.

  PublisherDOI

Frequent coauthors

• Christoph Bock

  213 shared

• Bertrand Guidet

  105 shared

• C. G. Gibson

  Fairfield Medical Center

  73 shared

• Michele Galietta

  73 shared

• Alexis Tomarken

  Memorial Sloan Kettering Cancer Center

  73 shared

• Hayley Pessin

  Memorial Sloan Kettering Cancer Center

  73 shared

• Christian J. Nelson

  73 shared

• William Breitbart

  Memorial Sloan Kettering Cancer Center

  73 shared