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Oiwa K, Lee S, Fujita K, Ueda T, Yamauchi T. Clinical Features of Clonal Cytogenetic Abnormalities in Philadelphia-negative Cells Developed During Tyrosine Kinase Inhibitor Treatment. Intern Med 2024; 63:729-732. [PMID: 37468240 PMCID: PMC10982022 DOI: 10.2169/internalmedicine.2182-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/11/2023] [Indexed: 07/21/2023] Open
Abstract
Most clonal cytogenetic abnormalities of Philadelphia-negative cells (CCA/Ph-) occurring during tyrosine kinase inhibitor (TKI) treatment are transient, and the development of secondary myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) is rare, but the frequency and clinical significance in Japanese patients are still unknown. We herein report four patients who developed CCA/Ph- during TKI therapy and were diagnosed with secondary MDS/AML. The duration from TKI therapy initiation to MDS/AML onset ranged from 3 to 48 months, and the survival ranged from 5 to 84 months. The occurrence of CCA/Ph- with MDS/AML may be associated with a poor prognosis, and careful follow-up is recommended for patients who receive TKI therapy.
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MESH Headings
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Tyrosine Kinase Inhibitors
- Chromosome Aberrations
- Protein Kinase Inhibitors/adverse effects
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
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Affiliation(s)
- Kana Oiwa
- Division of Hematology and Oncology, University of Fukui, Japan
- Division of Internal Medicine, Osu Hospital, Japan
| | - Shin Lee
- Division of Hematology and Oncology, University of Fukui, Japan
- Department of Hematology, Matsunami General Hospital, Japan
| | - Kei Fujita
- Division of Hematology and Oncology, University of Fukui, Japan
- Department of Hematology, Matsunami General Hospital, Japan
| | - Takanori Ueda
- Division of Hematology and Oncology, University of Fukui, Japan
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Hirade K, Kusumoto S, Hashimoto H, Shiraga K, Hagiwara S, Oiwa K, Suzuki T, Kinoshita S, Ri M, Komatsu H, Iida S. Low-dose fluconazole as a useful and safe prophylactic option in patients receiving allogeneic hematopoietic stem cell transplantation. Cancer Med 2024; 13:e6815. [PMID: 38213090 PMCID: PMC10905229 DOI: 10.1002/cam4.6815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/22/2023] [Accepted: 12/03/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Invasive fungal infections (IFIs) represent a potentially fatal complication in patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) if the initiation of therapy is delayed. Some guidelines recommend antifungal prophylaxis or preemptive therapy for these patients depending on the risk of IFIs following allogeneic HSCT. This retrospective study aimed to identify the group of patients who safely undergo allogeneic HSCT with low-dose fluconazole (FLCZ) prophylaxis (100 mg/day). METHODS We retrospectively reviewed 107 patients who underwent their first allogeneic HSCT at Nagoya City University Hospital from January 1, 2010, to December 31, 2019. We analyzed the efficacy of low-dose FLCZ prophylaxis and investigated the relationship between major risk factors and antifungal prophylaxis failure (APF) within 100 days post-transplant. RESULTS Of the 107 patients, 70 received low-dose FLCZ prophylaxis, showing a cumulative incidence of APF of 37.1% and a proven/probable IFI rate of 4.3%. There were no fungal infection-related deaths, including Aspergillus infections, in the FLCZ prophylaxis group. In a multivariable analysis, cord blood transplantation (CBT) (subdistribution hazard ratio (SHR), 3.55; 95% confidence interval (CI), 1.44-8.77; p = 0.006) and abnormal findings on lung CT before transplantation (SHR, 2.24; 95% CI, 1.02-4.92; p = 0.044) were independent risk factors for APF in the FLCZ prophylaxis group. CONCLUSION Low-dose FLCZ prophylaxis is a useful and safe option for patients receiving allogeneic HSCT, except in those undergoing CBT or having any fungal risk features including history of fungal infections, positive fungal markers, and abnormal findings on lung CT before transplantation.
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Affiliation(s)
- Kentaro Hirade
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Shigeru Kusumoto
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
- Department of Hematology and Cell TherapyAichi Cancer Center HospitalNagoyaJapan
| | - Hiroya Hashimoto
- Clinical Research Management Center of Nagoya City University HospitalNagoyaJapan
| | - Kazuhide Shiraga
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Shinya Hagiwara
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Kana Oiwa
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Tomotaka Suzuki
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Shiori Kinoshita
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Masaki Ri
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Hirokazu Komatsu
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
| | - Shinsuke Iida
- Department of Hematology and OncologyNagoya City University Institute of Medical and Pharmaceutical SciencesNagoyaJapan
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Nakano K, Kohno M, Onozawa H, Hashimoto R, Oiwa K, Masuda R, Yamaguchi M, Hato T, Watanabe M, Horinouchi H, Sakai H, Kobayashi K, Iwazaki M. Using hemoglobin vesicles to treat operative hemorrhagic shock after pneu- monectomy in dog models: an experimental study. Biomed Res 2024; 45:91-101. [PMID: 38556266 DOI: 10.2220/biomedres.45.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Hemoglobin vesicles (HbVs), considered as red blood cell substitutes, are liposomes encapsulating purified hemoglobin, with a phospholipid bilayer membrane (diameter: 250 nm; P50, 28 Torr). In this study, we aimed to investigate HbV function during hemorrhagic shock in lung resection and analyze the details of oxygen delivery. Left pneumonectomy was performed in dogs under mechanical ventilation, followed by rapid exsanguination of approximately 30% of the total circulating blood volume, which led to shock, reducing the mean arterial pressure (MAP) by approximately 60% of baseline. Subsequently, either 5% human serum albumin (HSA) or HbVs suspended in 5% HSA were infused for resuscitation. The MAP only recovered to 75% of baseline after HSA administration, but fully recovered (100%) after HbV administration, with significant differences between the groups (P < 0.005). Oxygen delivery was restored in the HbV group and was significantly higher than that in the HSA group (P < 0.0001). The infusion of HbVs dispersed in a 5% HSA solution compensated for the rapid loss of approximately 30% of the total circulating blood volume in a dog pneumonectomy model, even with impaired lung function. Thus, HbVs can be used for resuscitation from hemorrhagic shock during thoracic surgery.
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Affiliation(s)
- Kei Nakano
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Mitsutomo Kohno
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hiroto Onozawa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Ryo Hashimoto
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kana Oiwa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Ryota Masuda
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Masatoshi Yamaguchi
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Tai Hato
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Masazumi Watanabe
- Department of General Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Hiromi Sakai
- Department of Chemistry, Nara Medical University, Kashihara, Nara, Japan
| | - Koichi Kobayashi
- Department of General Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
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Lee S, Fujita K, Morishita T, Negoro E, Tsukasaki H, Oiwa K, Hara T, Tsurumi H, Ueda T, Yamauchi T. The Relative Dose Intensity Changes during Cycles of Standard Regimens in Patients with Diffuse Large B-Cell Lymphoma. Cancers (Basel) 2023; 15:4458. [PMID: 37760427 PMCID: PMC10526837 DOI: 10.3390/cancers15184458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/01/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
No studies have focused on the trajectory of the average relative dose intensity (ARDI) during cycles of first-line chemotherapy for patients with diffuse large B-cell lymphoma. To evaluate the impact of attenuating ARDI during cycles on overall survival, we conducted a multi-centre, longitudinal, observational retrospective study. A total of 307 analysable patients were enrolled. Multivariate Cox hazards modelling with restricted cubic spline models revealed prognostic benefits of higher ARDI up to, but not after, cycle 6. According to group-based trajectory modelling, patients were classified into five groups depending on the pattern of ARDI changes. Among these, two groups in which ARDI had fallen significantly to less than 50% by cycles 4-6 displayed significantly poorer prognosis, despite increased ARDI in the second half of the treatment period (log-rank p = 0.02). The Geriatric Nutritional Risk Index offered significant prediction of unfavourable ARDI changes (odds ratio 2.540, 95% confidence interval 1.020-6.310; p = 0.044). Up to cycle 6, maintenance of ARDI in all cycles (but particularly in the early cycles) is important for prognosis. Malnutrition is a significant factor that lets patients trace patterns of ARDI changes during cycles of chemotherapy associated with untoward prognosis.
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Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Tetsuji Morishita
- Department of Internal Medicine, Matsunami General Hospital, Gifu 501-6062, Japan;
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Cancer Care Promotion Center, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hikaru Tsukasaki
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Hematology, Fukui Red Cross Hospital, Fukui 918-8501, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
- Department of Internal Medicine, Osu Hospital, Nagoya 460-0017, Japan
| | - Takeshi Hara
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501-6062, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan; (S.L.); (K.F.)
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Fujita K, Lee S, Morishita T, Negoro E, Oiwa K, Hara T, Tsurumi H, Ueda T, Yamauchi T. Prognostic significance of the Geriatric 8 score alone and included with genetic risk group in older adults with acute myeloid leukemia. J Geriatr Oncol 2023; 14:101582. [PMID: 37429106 DOI: 10.1016/j.jgo.2023.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/01/2023] [Accepted: 06/29/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION As the numbers of older adult patients with acute myeloid leukemia (AML) continue to increase, the establishment of a simple geriatric assessment specifically for AML represents an unmet need. This study aimed to assess the impact of the Geriatric 8 (G8) score on overall survival (OS). MATERIALS AND METHODS We retrospectively analyzed 100 patients ≥60 years old with newly diagnosed AML. RESULTS Multivariate Cox modeling identified G8 score as a significant prognostic factor for OS (hazard ratio 0.891, 95% confidence interval [CI] 0.808-0.983). A linear association between G8 score and mortality risk was confirmed in a Cox model with restricted cubic spline. Multivariate receiver operating characteristic curves demonstrated a significant improvement in prediction ability when G8 score was added to cytogenetic risk group. The combination of G8 score and cytogenetic risk group yielded a significant continuous net reclassification improvement (0.718; 95%CI 0.353-1.082; P < 0.001). Decision curve analysis showed a clinical net benefit associated with adding G8 score to cytogenetic risk group. DISCUSSION G8 score not only offered a strong prognostic factor for OS, but also markedly improved prediction accuracy for mortality when incorporated with cytogenetic risk group.
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Affiliation(s)
- Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Hematology and Oncology, Matsunami General Hospital, Gifu, Japan
| | - Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Hematology and Oncology, Matsunami General Hospital, Gifu, Japan.
| | - Tetsuji Morishita
- Department of Internal Medicine, Matsunami General Hospital, Gifu, Japan; Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Kyoto, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Cancer Care Promotion Center, University of Fukui, Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan; Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Takeshi Hara
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Oncology, Matsunami General Hospital, Gifu, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Suzuki T, Kusumoto S, Kamezaki Y, Hashimoto H, Nishitarumizu N, Nakanishi Y, Kato Y, Kawai A, Matsunaga N, Ebina T, Nakamura T, Marumo Y, Oiwa K, Kinoshita S, Narita T, Ito A, Inagaki A, Ri M, Komatsu H, Aritsu T, Iida S. Humoral and cellular immune response to second and third severe acute respiratory syndrome coronavirus 2 mRNA vaccine in patients with plasma cell dyscrasia. Cancer Med 2023. [PMID: 37102222 DOI: 10.1002/cam4.5996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/18/2023] [Accepted: 04/14/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The recently developed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine has a short history of use and further information is needed regarding its efficacy, especially in immunocompromised conditions, such as plasma cell dyscrasia (PCD). METHODS We retrospectively measured serum SARS-CoV-2 antibodies against the spike protein (S-IgG) after the second and third mRNA vaccine doses (doses 2 and 3, respectively) in 109 patients with PCD. We evaluated the proportion of patients with an adequate humoral response (defined as S-IgG titers ≥300 antibody units/mL). RESULTS Although active anti-myeloma treatments prior to vaccination had a significantly negative impact on adequate humoral response, specific drug subclasses including immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies were not negatively associated, except for B-cell maturation antigen-targeted therapy. Dose 3 (booster vaccination) led to significantly higher S-IgG titers and more patients acquired an adequate humoral response. Furthermore, evaluation of vaccine-induced cellular immune response in patients using T-spot Discovery SARS-CoV-2 kit, revealed an enhanced cellular immune response after Dose 3. CONCLUSIONS This study highlighted the significance of booster SARS-CoV-2 mRNA vaccination in patients with PCD with respect to humoral and cellular immunity. Moreover, this study highlighted the potential impact of certain drug subclasses on vaccine-induced humoral immune response.
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Affiliation(s)
- Tomotaka Suzuki
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Hiroya Hashimoto
- Clinical Research Management Center, Nagoya City University Hospital, Nagoya, Japan
| | - Nozomi Nishitarumizu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoko Nakanishi
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yukiyasu Kato
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Akimi Kawai
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naohiro Matsunaga
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toru Ebina
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomoyuki Nakamura
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yoshiaki Marumo
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shiori Kinoshita
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomoko Narita
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Asahi Ito
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Atsushi Inagaki
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Oiwa K, Fujita K, Lee S, Morishita T, Tsujikawa T, Negoro E, Hara T, Tsurumi H, Ueda T, Yamauchi T. Prognostic value of metabolic tumor volume of extranodal involvement in diffuse large B cell lymphoma. Ann Hematol 2023; 102:1141-1148. [PMID: 36951966 PMCID: PMC10102098 DOI: 10.1007/s00277-023-05165-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/15/2022] [Indexed: 03/24/2023]
Abstract
Extranodal involvement predicts poor outcomes of diffuse large B cell lymphoma (DLBCL), but the impact of the metabolic tumor burden (MTV) of extranodal sites using positron emission tomography has not been clarified. This study aimed to assess the impact of extranodal MTV on overall survival (OS). We retrospectively analyzed 145 newly diagnosed DLBCL patients and verified the prognostic impact of each extranodal and nodal MTV. Multivariate Cox hazards modelling using both extranodal and nodal MTV as covariables identified extranodal MTV as a significant factor for OS (hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.019-1.129, P = 0.008), but not nodal MTV. Multivariate Cox modelling using restricted cubic splines demonstrated that the impact of total MTV depends on the MTV of extranodal sites, not of nodal sites. When both the number and MTV of extranodal involvements were used as covariables, extranodal MTV remained a significant predictor of OS (HR 1.070, 95%CI 1.017-1.127, P = 0.009), but the number of extranodal sites did not. Extranodal MTV potentially had a more significant role on prognosis than nodal MTV. When considering prognostic impacts, the MTV of extranodal involvement is significantly more important than the number.
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Affiliation(s)
- Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Hematology and Oncology, Matsunami General Hospital, Dendai 185-1 Kasamatsu-Cho, Hashima-Gun, Gifu, 501-6062, Japan
| | - Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
- Department of Hematology and Oncology, Matsunami General Hospital, Dendai 185-1 Kasamatsu-Cho, Hashima-Gun, Gifu, 501-6062, Japan.
| | - Tetsuji Morishita
- Department of Internal Medicine, Matsunami General Hospital, Gifu, Japan
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-Cho, Kyoto, Japan
| | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
- Department of Cancer Care Promotion Center, University of Fukui, Fukui, Japan
| | - Takeshi Hara
- Department of Hematology and Oncology, Matsunami General Hospital, Dendai 185-1 Kasamatsu-Cho, Hashima-Gun, Gifu, 501-6062, Japan
| | - Hisashi Tsurumi
- Department of Hematology and Oncology, Matsunami General Hospital, Dendai 185-1 Kasamatsu-Cho, Hashima-Gun, Gifu, 501-6062, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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8
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Suzuki T, Kusumoto S, Kamezaki Y, Hashimoto H, Nishitarumizu N, Nakanishi Y, Kato Y, Kawai A, Matsunaga N, Ebina T, Nakamura T, Marumo Y, Oiwa K, Kinoshita S, Narita T, Ito A, Inagaki A, Ri M, Komatsu H, Aritsu T, Iida S. A comprehensive evaluation of humoral immune response to second and third SARS-CoV-2 mRNA vaccination in patients with malignant lymphoma. Int J Hematol 2023; 117:900-909. [PMID: 36790667 PMCID: PMC9930006 DOI: 10.1007/s12185-023-03550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/16/2023]
Abstract
More information is needed regarding the efficacy of SARS-CoV-2 mRNA vaccines in immunocompromised populations, including patients with malignant lymphoma. This study aimed to evaluate humoral responses to the second and third mRNA vaccine doses in 165 lymphoma patients by retrospective analysis of serum SARS-CoV-2 spike protein antibody (S-IgG) titers. Patients with S-IgG titers ≥ 300, 10-300, and ≤ 10 binding antibody units (BAU)/mL were defined as adequate responders, low responders, and non-responders, respectively. S-IgG titers > 10 BAU/mL were considered to indicate seroconversion. After the second dose, 56%, 16%, and 28% of patients were adequate responders, low responders and non-responders, respectively. Multivariate analysis revealed that being an adequate responder after the second dose was associated with receiving the vaccine > 12 months after last chemotherapy, total peripheral lymphocyte count of ≥ 1000/µL, estimated glomerular filtration rate of ≥ 50 mL/min/1.73 m2, and vaccine type (mRNA-1273). After the third dose, patients had significantly higher S-IgG titers and a greater proportion achieved seroconversion. With this third dose, 26% of second-dose non-responders achieved seroconversion and 68% of second-dose low responders became adequate responders. Subsequent SARS-CoV-2 mRNA vaccinations may elicit an immune response in immunocompromised patients who do not initially respond to vaccination.
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Affiliation(s)
- Tomotaka Suzuki
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, Japan.
| | - Yoshiko Kamezaki
- grid.419812.70000 0004 1777 4627Scientific Information, Scientific Affairs, Sysmex Corporation, Kobe, Hyogo Japan
| | - Hiroya Hashimoto
- grid.411885.10000 0004 0469 6607Clinical Research Management Center, Nagoya City University Hospital, Nagoya, Japan
| | - Nozomi Nishitarumizu
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Yoko Nakanishi
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Yukiyasu Kato
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Akimi Kawai
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Naohiro Matsunaga
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Toru Ebina
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Tomoyuki Nakamura
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Yoshiaki Marumo
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Kana Oiwa
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Shiori Kinoshita
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Tomoko Narita
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Asahi Ito
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Atsushi Inagaki
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Masaki Ri
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Hirokazu Komatsu
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
| | - Takashi Aritsu
- grid.419812.70000 0004 1777 4627Scientific Information, Scientific Affairs, Sysmex Corporation, Kobe, Hyogo Japan
| | - Shinsuke Iida
- grid.260433.00000 0001 0728 1069Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi Japan
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9
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Kinoshita S, Tanida S, Kawai A, Shiraga K, Nakamura T, Oiwa K, Suzuki T, Ito A, Ri M, Kusumoto S, Komatsu H, Iida S. Acute Promyelocytic Leukemia in a Patient With Chronic Continuous Type of Crohn’s Disease. J Clin Med Res 2022; 14:136-141. [PMID: 35464606 PMCID: PMC8993430 DOI: 10.14740/jocmr4675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/26/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic inflammation can induce leukemogenic mutations in hematopoietic stem cells (HSCs). We report a case of acute promyelocytic leukemia (APL) in a patient with chronic continuous type of Crohn’s disease. The patient had been diagnosed with Crohn’s disease at the age of 28 years and had received conventional treatments with biologics, but not azathioprine. At the age of 51, he was diagnosed with APL with ider(17). Long-term exposure to chronic continuous inflammation from Crohn’s disease might be a factor inducing genomic instability in HSCs, which lead to the subsequent development of APL. APL is a rare hematological manifestation that required attention in Crohn’s disease patients.
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Affiliation(s)
- Shiori Kinoshita
- Department of Hematology, Toyokawa City Hospital, Toyokawa City, Aichi Prefecture, Japan
| | - Satoshi Tanida
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
- Corresponding Author: Satoshi Tanida, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan.
| | - Akimi Kawai
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Kazuhide Shiraga
- Department of Hematology, Toyokawa City Hospital, Toyokawa City, Aichi Prefecture, Japan
| | - Tomoyuki Nakamura
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Tomotaka Suzuki
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Asahi Ito
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Aichi Prefecture, Japan
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10
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Oiwa K, Hosono N, Nishi R, Scotto L, O'Connor OA, Yamauchi T. Characterization of newly established Pralatrexate-resistant cell lines and the mechanisms of resistance. BMC Cancer 2021; 21:879. [PMID: 34332580 PMCID: PMC8325835 DOI: 10.1186/s12885-021-08607-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/16/2021] [Indexed: 11/20/2022] Open
Abstract
Background Pralatrexate (PDX) is a novel antifolate approved for the treatment of patients with relapsed/refractory peripheral T-cell lymphoma, but some patients exhibit intrinsic resistance or develop acquired resistance. Here, we evaluated the mechanisms underlying acquired resistance to PDX and explored potential therapeutic strategies to overcome PDX resistance. Methods To investigate PDX resistance, we established two PDX-resistant T-lymphoblastic leukemia cell lines (CEM and MOLT4) through continuous exposure to increasing doses of PDX. The resistance mechanisms were evaluated by measuring PDX uptake, apoptosis induction and folate metabolism-related protein expression. We also applied gene expression analysis and methylation profiling to identify the mechanisms of resistance. We then explored rational drug combinations using a spheroid (3D)-culture assay. Results Compared with their parental cells, PDX-resistant cells exhibited a 30-fold increase in half-maximal inhibitory concentration values. Induction of apoptosis by PDX was significantly decreased in both PDX-resistant cell lines. Intracellular uptake of [14C]-PDX decreased in PDX-resistant CEM cells but not in PDX-resistant MOLT4 cells. There was no significant change in expression of dihydrofolate reductase (DHFR) or folylpolyglutamate synthetase (FPGS). Gene expression array analysis revealed that DNA-methyltransferase 3β (DNMT3B) expression was significantly elevated in both cell lines. Gene set enrichment analysis revealed that adipogenesis and mTORC1 signaling pathways were commonly upregulated in both resistant cell lines. Moreover, CpG island hypermethylation was observed in both PDX resistant cells lines. In the 3D-culture assay, decitabine (DAC) plus PDX showed synergistic effects in PDX-resistant cell lines compared with parental lines. Conclusions The resistance mechanisms of PDX were associated with reduced cellular uptake of PDX and/or overexpression of DNMT3B. Epigenetic alterations were also considered to play a role in the resistance mechanism. The combination of DAC and PDX exhibited synergistic activity, and thus, this approach might improve the clinical efficacy of PDX. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08607-9.
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Affiliation(s)
- Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Naoko Hosono
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Rie Nishi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Luigi Scotto
- The Center of Lymphoid Malignancy, Columbia University Medical Center, College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA
| | - Owen A O'Connor
- The Center of Lymphoid Malignancy, Columbia University Medical Center, College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA.,Department of Medicine, Division of Hematology and Oncology, University of Virginia, 1215 Lee Street, Charlottesville, VA, 22903, USA
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
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11
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Oiwa K, Fujita K, Lee S, Morishita T, Tsukasaki H, Negoro E, Hara T, Tsurumi H, Ueda T, Yamauchi T. Prognostic impact of six versus eight cycles of standard regimen in patients with diffuse large B-cell lymphoma: propensity score-matching analysis. ESMO Open 2021; 6:100210. [PMID: 34271313 PMCID: PMC8287142 DOI: 10.1016/j.esmoop.2021.100210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Background R-CHOP-21 has been the standard treatment for diffuse large B-cell lymphoma (DLBCL), but there is a paucity of evidence focusing on the number of cycles of regimens. Patients and methods We conducted a retrospective study to compare the effectiveness of six cycles of standard regimens versus eight cycles for overall survival (OS) in DLBCL patients using propensity score matching, in consideration of relative dose intensity (RDI). Results A total of 685 patients with newly diagnosed DLBCL were identified in three institutions from 2007 to 2017. Patients treated using six cycles of standard regimens were matched by propensity scores with those treated using eight cycles. A 1 : 1 propensity score matching yielded 138 patient pairs. Eight cycles did not significantly improve OS in the conventional Cox proportional hazards model (hazard ratio 0.849, 95% confidence interval 0.453-1.588, P = 0.608). Restricted cubic spline Cox models for OS confirmed that the effect of the number of cycles was not modified by total average RDI, the International Prognostic Index, and age. Occurrence of adverse events did not differ between six and eight cycles. Conclusion Even considering the impact of RDI, six cycles of the initial standard regimen for DLBCL is not inferior to eight cycles. The optimal number of cycles of standard regimens including R-CHOP-21 for newly diagnosed DLBCL has not been determined. This study was conducted to verify whether six cycles or eight cycles of standard regimen improved the prognosis of DLBCL. Propensity score matching and a Cox hazards model with restricted cubic spline were used in this study. No survival benefit of eight cycles compared with six cycles was seen, even taking into account RDI. Prognosis was no better with eight cycles of (R-)CHOP-21 or THP-COP-21 than with six cycles, after age and IPI modifications.
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Affiliation(s)
- K Oiwa
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan; Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - K Fujita
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan; Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - S Lee
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan; Department of Hematology, Matsunami General Hospital, Gifu, Japan.
| | - T Morishita
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Kyoto, Japan
| | - H Tsukasaki
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan; Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - E Negoro
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - T Hara
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - H Tsurumi
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - T Ueda
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - T Yamauchi
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
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12
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Lee S, Fujita K, Morishita T, Negoro E, Oiwa K, Tsukasaki H, Hara T, Tsurumi H, Ueda T, Yamauchi T. MO12-3 Association between relative dose intensity and prognosis in patients aged 80 years and older with DLBCL. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Lee S, Fujita K, Morishita T, Oiwa K, Tsukasaki H, Negoro E, Hara T, Tsurumi H, Ueda T, Yamauchi T. Association of the Geriatric 8 with treatment intensity and prognosis in older patients with diffuse large B-cell lymphoma. Br J Haematol 2021; 194:325-335. [PMID: 34041751 DOI: 10.1111/bjh.17554] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/23/2021] [Indexed: 01/12/2023]
Abstract
Because of the heterogeneity among older patients with diffuse large B-cell lymphoma (DLBCL), the establishment of an easy-to-use geriatric assessment tool is an unmet need. We verified the impact of the Geriatric 8 (G8) on treatment stratification and overall survival (OS). We conducted a retrospective, multicentre analysis of older patients (≥65 years) with DLBCL. The primary endpoint was OS. The total average relative dose intensity (tARDI) was defined as the average delivered dose intensity divided by the planned dose intensity through all cycles. A total of 451 patients were diagnosed with DLBCL from 2007 to 2017, and 388 patients received standard regimens. A multivariate Cox model confirmed that the G8 was a significant predictor of OS (hazard ratio 0·88, 95% confidence interval 0·828-0·935). A Cox model with restricted cubic spline showed a linear association between the G8 and the mortality risk. The G8 had a significant impact on OS in elderly patients with DLBCL. The upper limit of tARDI for standard regimens to improve OS might be appropriate at ≥80% for patients with high G8 scores and 60% for patients with low G8 scores. However, the standard regimens should be given to all patients regardless of the G8 score to improve OS.
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Affiliation(s)
- Shin Lee
- Department of Hematology, Matsunami General Hospital, Gifu, Japan.,Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kei Fujita
- Department of Hematology, Matsunami General Hospital, Gifu, Japan.,Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Morishita
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Kyoto, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Hikaru Tsukasaki
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takeshi Hara
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Hisashi Tsurumi
- Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Takanori Ueda
- Department of Hematology, Matsunami General Hospital, Gifu, Japan.,Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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14
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Hagiwara S, Kusumoto S, Ito A, Masaki A, Shiraga K, Tachita T, Hirade K, Oiwa K, Suzuki T, Kinoshita S, Ri M, Ito Y, Komatsu H, Inagaki H, Iida S. Volunteer unrelated donor cell‐derived acute myeloid leukemia with
RUNX1‐RUNX1T1. eJHaem 2021; 2:285-290. [PMID: 35845276 PMCID: PMC9175994 DOI: 10.1002/jha2.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
A 15‐year‐old male was diagnosed with acute myeloid leukemia with t(6;9)(p23;q34), a chimeric DEK‐NUP214 fusion gene. He underwent allogeneic bone marrow transplantation (allo‐BMT) from an unrelated volunteer donor at first molecular remission. Approximately 5 years after allo‐BMT, multiple bone marrow aspirations showed increased blasts to 63%, which were positive for myeloperoxidase, CD13, CD33, CD56, and CD34. Surprisingly, t(8;21)(q22;q22.1), a chimeric RUNX1‐RUNX1T1 (not DEK‐NUP214) fusion gene, was detected with full donor chimerism. To our best knowledge, this is the first case of a volunteer unrelated donor cell‐derived acute myeloid leukemia harboring a chimeric RUNX1‐RUNX1T1 fusion gene.
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Affiliation(s)
- Shinya Hagiwara
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Asahi Ito
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Ayako Masaki
- Department of Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Kazuhide Shiraga
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Takuto Tachita
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
- Department of Gastroenterology and Hematology Hirosaki University Graduate School of Medicine Hirosaki Japan
| | - Kentaro Hirade
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Kana Oiwa
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Tomotaka Suzuki
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shiori Kinoshita
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Masaki Ri
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Yasuhiko Ito
- Department of Pediatrics and Neonatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
- Nagoya City West Medical Center Pediatrics Nagoya Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular Diagnostics Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya Japan
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15
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Oiwa K, Fujita K, Lee S, Morishita T, Tsukasaki H, Negoro E, Ueda T, Yamauchi T. Utility of the Geriatric 8 for the Prediction of Therapy-Related Toxicity in Older Adults with Diffuse Large B-Cell Lymphoma. Oncologist 2020; 26:215-223. [PMID: 33320984 DOI: 10.1002/onco.13641] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The management of severe adverse events (AEs) is important in safely and effectively providing chemotherapy to older adults with diffuse large B-cell lymphoma (DLBCL). However, reports on simple and DLBCL-specific predictive models for treatment-related toxicity in elderly individuals are scarce. The aim of this study was to examine the usefulness of Geriatric 8 (G8) in predicting treatment-related severe AEs, nonhematological toxicity, and febrile neutropenia in older adults with DLBCL in real-world practice. MATERIALS AND METHODS We conducted a multicenter, retrospective study on 398 consecutive patients with DLBCL (aged ≥65 years) who received standard therapy at three centers in Japan (University of Fukui Hospital, the Fukui Prefectural Hospital, and the Japanese Red Cross Fukui Hospital), between 2007 and 2017. RESULT Multivariate logistic analysis demonstrated that the G8 score was an independent predictive factor for severe AEs. Moreover, a logistic regression model with restricted cubic spline showed a nonlinear association between the incidence of severe AEs and the G8 score. According to receiver operating characteristic analysis, the most discriminative cutoff value of the G8 for the incidence of severe AEs was 11, with an area under the curve value of 0.670. AEs occurred most often in the first course of chemotherapy and decreased as the course progressed. CONCLUSION The G8 score, an easy-to-use geriatric assessment tool, can be a useful prediction model of treatment-related severe AEs during standard therapy in older adults with DLBCL. IMPLICATIONS FOR PRACTICE In older patients with diffuse large B-cell lymphoma (DLBCL), to accurately predict the risk of severe adverse events (AEs) in advance is essential for safe and effective treatment. This study demonstrated that the Geriatric 8 score, a simple and established geriatric assessment tool, indicated a high predictive ability for occurrence of therapy-related severe AEs in elderly patients with DLBCL who were treated with standard treatment.
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Affiliation(s)
- Kana Oiwa
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan.,Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Shin Lee
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, University of Fukui, Fukui, Japan.,Department Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Hikaru Tsukasaki
- Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
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16
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Hashimoto R, Kohno M, Oiwa K, Onozawa H, Watanabe M, Horinouchi H, Sakai H, Kobayashi K, Iwazaki M. Immediate effects of systemic administration of normal and high O 2-affinity haemoglobin vesicles as a transfusion alternative in a rat pneumonectomy model. BMJ Open Respir Res 2020; 7:7/1/e000476. [PMID: 32527871 PMCID: PMC7292042 DOI: 10.1136/bmjresp-2019-000476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/10/2019] [Accepted: 12/30/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Haemoglobin vesicles (HbVs) are red blood cell (RBC) substitutes with a phospholipid bilayer membrane and a polyethylene modified surface (diameter=250 nm; P50=28 Torr). They can be preserved for years and can be used in patients of all blood types without the risk of infection. Their oxygen affinity can be modified by changing the allosteric effectors. METHODS Left pneumonectomy was performed under mechanical ventilation on rats, followed by rapid exsanguination of ~30% of the total circulating blood volume. Rat RBCs shed in 5% human serum albumin (HSA) solution (rat RBC), HbV with high oxygen affinity in 5% albumin solution (low-P50 HbV, P50=9 Torr), normal HbV suspended in 5% albumin (HbV, P50=28 Torr) or 5% HSA was infused for resuscitation. Haemodynamics and oxygenation were evaluated. RESULTS Systemic arterial blood pressure significantly decreased after exsanguination and increased after each infusion. In the HbV, low-P50 HbV and rat RBC groups, all rats were liberated from mechanical ventilation and blood pressure was stabilised, whereas 50% of the rats in the HSA group died within 1 hour after weaning from mechanical ventilation. The PaO2 in arterial blood for 1 hour after liberation from mechanical ventilation in the rat RBC, HbV and low-P50 HbV groups was 59.4±12.5, 58.3±10.1 and 70.5±14.5 mm Hg, respectively. The PaO2 in the low-P50 HbV group was significantly higher than those in the rat RBC and HbV groups (p=0.05 for both). Serum lactate elevations due to hypoxic damage were minimised by HbV, low-P50 HbV as well as rat RBCs. CONCLUSIONS The oxygen-carrying ability of HbV was comparable to that of rat RBCs, even under impaired lung function after pneumonectomy. HbVs with high oxygen affinity may have more beneficial effects on oxygenation in pulmonary resection.
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Affiliation(s)
- Ryo Hashimoto
- Division of General Thoracic Surgery, Department of Surgery, Tokai University-Isehara Campus, Isehara, Kanagawa, Japan
| | - Mitsutomo Kohno
- Division of General Thoracic Surgery, Department of Surgery, Tokai University-Isehara Campus, Isehara, Kanagawa, Japan
| | - Kana Oiwa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University-Isehara Campus, Isehara, Kanagawa, Japan
| | - Hiroto Onozawa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University-Isehara Campus, Isehara, Kanagawa, Japan
| | - Masazumi Watanabe
- General Thoracic Surgery, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Tokyo, Japan
| | | | - Hiromi Sakai
- Chemistry, Nara Medical University, Kashihara, Nara, Japan
| | - Koichi Kobayashi
- General Thoracic Surgery, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University-Isehara Campus, Isehara, Kanagawa, Japan
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17
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Hidehiko Y, Kohno M, Nito M, Aruga N, Oiwa K, Nakagawa T, Masuda R, Iwazaki M. Postintubation tracheal stenosis 35 years after neonatal resuscitation. Int J Surg Case Rep 2020; 71:378-381. [PMID: 32487473 PMCID: PMC7322740 DOI: 10.1016/j.ijscr.2020.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 12/21/2019] [Accepted: 02/12/2020] [Indexed: 11/12/2022] Open
Abstract
Granulation or cicatrization on the tracheal lumen increases after injury or ischemia caused by tubes or cuffs, results in narrowing of the trachea within a few months after extubation. We have described a case of tracheal stenosis that manifested 35 years after endotracheal intubation for neonatal resuscitation. The scar tissue was ablated using argon plasma coagulation, and no recurrence has been observed for more than 3 years. Delayed postintubation tracheal stenosis should be taken into consideration, when a patient suffers from suffocating tracheal stenosis.
Introduction Postintubation tracheal stenosis involves granulation or cicatrization of the tracheal epithelium. It is progressive and can become life-threatening within a few months after extubation. Presentation of case We here report a case of tracheal stenosis with a delayed manifestation, presenting 35 years after endotracheal intubation for neonatal resuscitation. A female patient complained of dyspnea during pregnancy. Bronchoscopy revealed 75% constriction of the tracheal lumen by cicatrization, from the 2nd to 4th tracheal rings. After child-birth, the scar tissue was ablated using argon plasma coagulation. Discussion The patient had no significant medical history, such as severe airway infection or cervical/chest trauma, which might have caused the circumferential cicatricial tracheal stenosis, other than the endotracheal intubation she had undergone for neonatal resuscitation. Therefore, we considered this to reflect postintubation tracheal stenosis with delayed manifestation. Conclusion Delayed postintubation tracheal stenosis should be taken into consideration, when a patient suffers from suffocating tracheal stenosis.
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Affiliation(s)
- Yagasaki Hidehiko
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Mitsutomo Kohno
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan.
| | - Madoka Nito
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Naohiro Aruga
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kana Oiwa
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Tomoki Nakagawa
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Ryota Masuda
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Masayuki Iwazaki
- Division of Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
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18
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Lee S, Fujita K, Morishita T, Negoro E, Oiwa K, Tsukasaki H, Yamamura O, Ueda T, Yamauchi T. Prognostic utility of a geriatric nutritional risk index in combination with a comorbidity index in elderly patients with diffuse large B cell lymphoma. Br J Haematol 2020; 192:100-109. [PMID: 32410224 DOI: 10.1111/bjh.16743] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
Reflecting the increasing risk in elderly patients with diffuse large B cell lymphoma (DLBCL), prognostic predictors other than the International Prognostic Index have attracted more attention. This study presents the first analysis of the prognostic utility of the Geriatric Nutritional Risk Index (GNRI) in combination with the Charlson Comorbidity Index (CCI) for overall survival (OS) in elderly DLBCL patients. A multicentre retrospective was conducted on a cohort of 451 patients (≥65 years). The GNRI and CCI were independent predictors in a multivariate Cox proportional hazard model. There was a nonlinear correlation between the GNRI and OS in a Cox model with restricted cubic spline. Multivariate receiver operating characteristic curves showed a significant improvement in prediction accuracy when the GNRI was added to CCI. Adding the GNRI to CCI yielded a significant category-free net reclassification improvement (0·556; 95% CI: 0·378-0·736, P < 0·001) and integrated discrimination improvement (0·094; 95% CI: 0·067-0·122, P < 0·001). The decision curve analysis demonstrated the clinical net benefit associated with the adoption of the GNRI. The GNRI was not only a predictor of OS but also remarkably improved the prognosis prediction accuracy when incorporated with the CCI, having the ability to stratify the prognosis of elderly DLBCL patients.
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Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology, Matsunami General Hospital, Gifu, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Cardiovascular Medicine, National Hospital Organization Awara Hospital, Fukui, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.,Department of Hematology and Oncology, Nagoya City University, Aichi, Japan
| | - Hikaru Tsukasaki
- Department of Hematology, Fukui Red Cross Hospital, Fukui, Japan
| | - Osamu Yamamura
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Lee S, Fujita K, Negoro E, Morishita T, Oiwa K, Tsukasaki H, Kinoshita K, Kawai Y, Ueda T, Yamauchi T. Impact of relative dose intensity of standard regimens on survival in elderly patients aged 80 years and older with diffuse large B-cell lymphoma. Haematologica 2020; 105:e415-e418. [PMID: 31919079 DOI: 10.3324/haematol.2019.234435] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui.,Department of Cancer Care Promotion Centre, Faculty of Medical Sciences, University of Fukui
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui .,Department of Cancer Care Promotion Centre, Faculty of Medical Sciences, University of Fukui
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui.,Department Cardiovascular Medicine, National Hospital Organization Awara Hospital
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | | | | | - Yasukazu Kawai
- Department of Hematology and Oncology, Fukui Prefectural Hospital, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui
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20
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Lee S, Fujita K, Negoro E, Morishita T, Yamauchi H, Oiwa K, Ueda T, Yamauchi T. The impact of diagnostic wait time on the survival of patients with diffuse large B-cell lymphoma: effect modification by the International Prognostic Index. Br J Haematol 2019; 187:195-205. [PMID: 31247676 DOI: 10.1111/bjh.16078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/11/2019] [Indexed: 12/09/2022]
Abstract
Despite the importance of a prompt diagnosis to improve cancer patients' survival, little has been reported on diagnostic delay in diffuse large B-cell lymphoma (DLBCL). A single-centre, retrospective study was conducted to examine the association between diagnostic wait time (DWT), the interval from the initial hospital visit to diagnosis, and survival in patients with DLBCL. A total of 193 patients were enrolled from 2007 to 2017 in our institution. A covariate-adjusted Cox proportional hazards model with restricted cubic spline was used to evaluate the impact of DWT on survival, with a subgroup analysis according to the International Prognostic Index (IPI). DWT was not associated with survival in the entire DLBCL population, but the impact of DWT on survival differed between IPI < 3 and ≥ 3; prolongation of DWT steadily exacerbated the prognosis in patients with IPI ≥ 3, whereas there was a patient population with IPI < 3 who had a high mortality rate despite rather early diagnosis. The opposite trend in the effect of DWT on survival between patients with IPI < 3 and ≥ 3 offset survival in all DLBCL patients. DWT had no observable impact on outcomes in the entire DLBCL population, but longer DWT worsened the prognosis, particularly in patients with IPI ≥ 3.
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Affiliation(s)
- Shin Lee
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kei Fujita
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Eiju Negoro
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuji Morishita
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hideaki Yamauchi
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Kana Oiwa
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Haematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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Kohno M, Hashimoto R, Oiwa K, Yashiro H, Nakatsuka S, Kawamura M, Iwazaki M. Initial experience with transbronchial cryoablation as a novel local treatment for malignant peripheral lung lesions. BMJ Open Respir Res 2018; 5:e000315. [PMID: 30622715 PMCID: PMC6307616 DOI: 10.1136/bmjresp-2018-000315] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 12/22/2022] Open
Abstract
Introduction Percutaneous cryoablation has been adopted for small, malignant peripheral pulmonary lesions and has yielded favourable results as a less invasive local treatment. A transbronchial approach may reduce the risks of complications, such as pneumothorax and pleural haemorrhage. A fundamental animal experiment on transbronchial cryoablation was performed to examine its immediate safety and effectiveness. Methods Experimental cryoablation was performed on swine lungs using a rigid cryoprobe, 2.4 mm in diameter. The probe was introduced from the right main bronchus into the distal bronchus via thoracotomy, perforated the end of the conducting bronchus and reached the lung parenchyma. The temperature of the cryoprobe tip reaches approximately −130°C during freezing and approximately 20°C during thawing. After three freeze-thaw cycles, the cryoprobe was removed. Results No significant haemorrhage was bronchoscopically observed in the airways throughout the experiment. The chronological changes and spatial distribution of the temperature of the pulmonary tissue circumferential to the point of the cryoprobe were similar to those seen with transpleural cryoablation and the less than −20°C thermal zone seemed to be established within a radius of at least 12 mm. The central destruction zone of alveolar structures was histologically similar to the thermal zone, while the conducting bronchus structure and the accompanying pulmonary artery were not severely affected. Conclusion Experimental transbronchial cryoablation with a rigid cryoprobe could effectively freeze and destroy peripheral lung alveoli without any significant immediate adverse effects. This may suggest the potential clinical application of transbronchial cryoablation for peripheral malignant lung lesions.
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Affiliation(s)
- Mitsutomo Kohno
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Ryo Hashimoto
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Kana Oiwa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Hideki Yashiro
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Seishi Nakatsuka
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masafumi Kawamura
- Department of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Japan
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22
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Ookura M, Hosono N, Tasaki T, Oiwa K, Fujita K, Ito K, Lee S, Matsuda Y, Morita M, Tai K, Negoro E, Kishi S, Iwasaki H, Ueda T, Yamauchi T. Successful treatment of disseminated intravascular coagulation by recombinant human soluble thrombomodulin in patients with acute myeloid leukemia. Medicine (Baltimore) 2018; 97:e12981. [PMID: 30383650 PMCID: PMC6221668 DOI: 10.1097/md.0000000000012981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Disseminated intravascular coagulation (DIC) is a life-threatening condition that frequently occurs in patients with hematologic malignancies. Currently, recombinant human soluble thrombomodulin (rTM) is a therapeutic DIC drug that is manufactured and sold in Japan only. We evaluated the efficacy of rTM compared to that of gabexate mesilate (GM), which was previously used routinely for treating DIC in Japan, in patients with acute myeloid leukemia (AML). This retrospective study enrolled 43 AML patients, including 17 with acute promyelocytic leukemia (APL), that was complicated with DIC. DIC resolution rates in non-APL AML and rTM-treated APL patients were 68.4% and 81.8%, respectively. In non-APL AML patients, the duration of rTM administration was significantly shorter than that of GM (7 vs 11 days), suggesting that rTM could improve DIC earlier than GM, although rTM was used in patients with more severe DIC. Moreover, treatment with rTM significantly improved DIC score, fibrinogen, fibrin/fibrinogen degradation product (FDP), and prothrombin time (PT) ratio. Conversely, treatment with GM only improved the DIC score and FDP. In APL patients, the duration of rTM administration was also significantly shorter than that of GM. No severe side effects associated with the progression of bleeding were observed during rTM administration. These findings suggest that rTM is safe, and its anti-DIC effects are more prompt than GM for treating AML patients with DIC.
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Affiliation(s)
- Miyuki Ookura
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Naoko Hosono
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Toshiki Tasaki
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Kana Oiwa
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Kei Fujita
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Kazuhiro Ito
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Shin Lee
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Yasufumi Matsuda
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Mihoko Morita
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Katsunori Tai
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
| | - Shinji Kishi
- Department of Health and Nutrition, Jin-ai University
| | | | | | - Takahiro Yamauchi
- Department of Hematology and Oncology, Faculty of Medical Science, University of Fukui
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23
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Lee S, Negoro E, Oiwa K, Fujita K, Ookura M, Matsuda Y, Tai K, Hosono N, Ueda T, Yamauchi T. Analysis of clinical presentation and prognosis of diffuse large B-cell lymphoma in patients over 80 years of age. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy374.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Oiwa K, Hosono N, Itoh K, Ookura M, Matsuda Y, Tai K, Ueda T, Yamauchi T. [Evaluation of Chemotherapy-Induced Nausea and Vomiting in Patients with Hematological Malignancies Using MASCC Antiemesis Tool(MAT)]. Gan To Kagaku Ryoho 2018; 45:45-50. [PMID: 29362306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Chemotherapy-induced nausea and vomiting(CINV)were prospectively evaluated using MASCC Antiemesis Tool(MAT) in patients with hematological malignancies in our institution. A total of 33 patients receiving 46 chemotherapy courses were evaluated. Although vomiting was not observed in the acute phase, nausea was seen in 22.6% and 32.3% of the patients in the acute and delayed phases, respectively. Thirty percent(25 cases)of the patients receiving highly emetogenic chemotherapy presented nausea in both the phases, while 40%(18 cases)of the patients receiving moderately emetogenic chemotherapy presented nausea in the delayed phase. The oral intake was quantitated retrospectively in 31 patients with non- Hodgkin's lymphoma, who were hospitalized and received CHOP±R. Prior to the initiation of the chemotherapy, 13 patients received the first generation 5-HT3 receptor antagonist granisetron, while 18 patients received the second generation palonosetron. Oral intake was greater in the patients who were administered palonosetron. Thus, the present study suggested that antiemetic treatment could be improved at our institution.
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Affiliation(s)
- Kana Oiwa
- Dept. of Hematology and Oncology, University of Fukui Hospital
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25
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Wada A, Kohno M, Oiwa K, Hashimoto R, Koizumi T, Nakamura Y, Nakagawa T, Masuda R, Kaga K, Iwazaki M. Temporal Changes of Inflammatory Cytokine Profiles in Epithelial Lining Fluid in a Canine Lung Transplant Model. Tokai J Exp Clin Med 2017; 42:165-175. [PMID: 29228414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Ischemia-reperfusion injury resulting in post-transplant lung dysfunction involves a complicated network of cytokines that has yet to be fully investigated. We analyzed temporal changes in cytokine levels in epithelial lining fluid (ELF) from the distal airways of a canine lung transplantation model. METHODS Ischemic time was set to 18 hours to enhance lung injury in a left single-lung transplantation model. ELF was collected via bronchoscopic microsampling, a minimally-invasive technique allowing repeated sampling, hourly up to 5 hours after reperfusion started. We compared levels of pro-inflammatory cytokines in ELF with those at baseline (time zero), and with a sham-operated control group. RESULTS Concentrations of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) significantly increased immediately after the start of lung reperfusion in the transplant group relative to the sham group (P < 0.005 and P < 0.05, respectively); both were sustained through the 5 hours. Interferon gamma (IFN-γ levels were significantly reduced 3 h after reperfusion started (P < 0.05). CONCLUSIONS We found time- and cytokine-dependent changes in TNF-α, IL-6, and IFN-γ in ELF from the lung transplantation model. These specific changes in the cytokine profile may relate to the mechanism underlying post-transplant lung dysfunction.
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Affiliation(s)
| | - Mitsutomo Kohno
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Watanabe H, Masuda R, Matsuzaki T, Hamanaka R, Ikoma Y, Nakano T, Oiwa K, Kohno M, Iwazaki M. A surgical case of methotrexate-associated lymphomatoid granuloma. Gen Thorac Cardiovasc Surg 2017; 66:435-438. [DOI: 10.1007/s11748-017-0871-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/18/2017] [Indexed: 01/19/2023]
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27
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Hashimoto R, Kohno M, Tsuboi T, Matsuzaki T, Oiwa K, Hamamoto A, Nakagawa T, Masuda R, Iwazaki M. P-136ANALYSIS OF CYTOKINES IN EPITHELIAL LINING FLUID SERIALLY COLLECTED USING BRONCHOSCOPIC MICROSAMPLING TECHNIQUE IN A CANINE LUNG TRANSPLANT MODEL. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Morozumi S, Kondo A, Huang Y, Kawakami Y, Uematsu T, Oiwa K, Miyajima M, Kato S, Yasui K. Diagnosis and prognosis of esus in a municipal emergency hospital in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Uematsu T, Huang Y, Kondo A, Kawakami Y, Oiwa K, Miyajima M, Morozumi S, Kato S, Yasui K. The characteristics of in-hospital ischemic strokes in a municipal emergency hospital in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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Araie H, Sakamaki I, Matsuda Y, Tai K, Ikegaya S, Itoh K, Kishi S, Oiwa K, Okura M, Tasaki T, Hosono N, Ueda T, Yamauchi T. 3A Comparison between R-THP-COP and R-CHOP Regimens for the Treatment of Diffuse Large B-cell Lymphoma in Old Patients: A Single-institution Analysis. Intern Med 2017; 56:2407-2413. [PMID: 28824057 PMCID: PMC5643166 DOI: 10.2169/internalmedicine.8291-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective We retrospectively compared the clinical efficacy and toxicity of rituximab (R)-THP-COP (pirarubicin, cyclophosphamide, vincristine, and prednisolone) with that of R-CHOP (rituximab, adriamicin, cyclophosphamide, vincristine, and prednisolone) in previously untreated old patients with diffuse large B-cell lymphoma (DLBCL). Patients and Methods Patients admitted to our institution between 2004 and 2013 were examined. The patients received either R (375 mg/m2, day 1)-THP-COP (pirarubicin 50 mg/m2 day 1, cyclophosphamide 750 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5) or R-CHOP (adriamicin 50 mg/m2 day 1, cyclophosphamide 750 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, and prednisolone 100 mg day 1-5). The doses of chemotherapeutic agents were adjusted depending on the patient's age and associated complications. The treatment was performed for 6 to 8 cycles. Results Among 74 patients with DLBCL (median 76, range 65-90 years; male 39, female 35), 29 received R-THP-COP, while 45 received R-CHOP. The overall response rates were 94.6% (complete response 86.4%, partial response 8.1%). The 2-year overall and progression-free survival rates were 77.6% and 68.5% for the R-THP-COP regimen and 79.2% and 78.9% for R-CHOP, respectively. No significant differences were found between these two regimens regarding the clinical efficacies. The most frequent adverse event was neutropenia (72.4% for the R-THP-COP regimen, 88.9% for the R-CHOP regimen). The cardiac function as evaluated by ejection fraction values was not impaired in either regimen. Conclusion R-THP-COP was effective and safe as an alternative to R-CHOP.
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Affiliation(s)
- Hiroaki Araie
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Ippei Sakamaki
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Yasufumi Matsuda
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Katsunori Tai
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Satoshi Ikegaya
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Kazuhiro Itoh
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Shinji Kishi
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Kana Oiwa
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Miyuki Okura
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Toshiki Tasaki
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Naoko Hosono
- Department of Hematology and Oncology, University of Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, University of Fukui, Japan
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Oiwa K, Morita M, Kishi S, Okura M, Tasaki T, Matsuda Y, Tai K, Hosono N, Ueda T, Yamauchi T. High Risk of Tumor Lysis Syndrome in Symptomatic Patients with Multiple Myeloma with Renal Dysfunction Treated with Bortezomib. Anticancer Res 2017; 36:6655-6662. [PMID: 27919998 DOI: 10.21873/anticanres.11274] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Tumor lysis syndrome (TLS) is a life-threatening complication associated with cancer chemotherapy. We retrospectively evaluated the risk of developing TLS in patients with symptomatic multiple myeloma undergoing chemotherapy. PATIENTS AND METHODS Sixty-four patients (median age=71 years, range=48-87 years, 35 males/29 females) who were treated at our Institution between April 2006 and December 2015 were evaluated. RESULTS A total of 124 chemotherapy courses were administered, of which 63 courses were bortezomib-based regimens and 34 courses were immunomodulatory drug (IMiD)-based regimens. TLS occurred in 13 (10.5%) out of 124 chemotherapy courses with five (4.0%) cases of laboratory TLS and eight (6.5%) cases of clinical TLS. The incidences of TLS were 17.5% for bortezomib-containing regimens and 3.2% for non-bortezomib-based regimens. No TLS occurred in the patients treated with IMiD-containing regimens. TLS occurred more frequently in the patients with elevated uric acid, creatinine, or beta-2-microglobulin levels at baseline. The patients with disease classified as advanced International Staging System also developed TLS more frequently. All the patients who developed clinical TLS received bortezomib-containing regimens (8/63, 12.7%). Among them, patients with elevated values of uric acid or creatinine developed clinical TLS more often than those without such elevation. The incidence of clinical TLS was 33.3% if the patients had renal dysfunction at baseline and were subsequently treated with bortezomib-based regimens (8/24 cases). CONCLUSION Patients with renal dysfunction or a high uric acid level receiving bortezomib-based chemotherapy have a high risk of developing TLS.
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Affiliation(s)
- Kana Oiwa
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Mihoko Morita
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Shinji Kishi
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan .,Department of Health and Nutrition, Faculty of Human Life Studies, Jin-ai University, Fukui, Japan
| | - Miyuki Okura
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Toshiki Tasaki
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Yasufumi Matsuda
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Katsunori Tai
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Naoko Hosono
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Takanori Ueda
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui, Fukui, Japan
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Matsuoka S, Hosono N, Matsuda Y, Oiwa K, Ookura M, Tai K, Anzai M, Nemoto T, Ishizuka T, Nakamoto Y, Yamauchi T. [Recurrent multiple lung lesions synchronizing with the disease activity of multiple myeloma]. Rinsho Ketsueki 2017; 58:2406-2410. [PMID: 29332875 DOI: 10.11406/rinketsu.58.2406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 68-year-old male patient, who was diagnosed with MGUS (IgG-λ) 11 years ago, was referred to our hospital because of a progressing pancytopenia. He was diagnosed with multiple myeloma (MM) and was hospitalized because of fever and pneumonia. Although empiric antibiotic and antifungal therapies were promptly initiated, his pneumonia worsened. Chest CT images revealed diffuse interstitial pneumonia. Although bortezomib/dexamethasone therapy was initiated as a treatment for MM and pneumonia, he showed little response. His pneumonia worsened and progressed to acute respiratory distress syndrome. Using mPSL (500 mg/day), sivelestat, and MM treatment switching to lenalidomide/dexamethasone (Rd), his respiratory status and CT findings rapidly improved. He received Rd therapy as an outpatient; however, after the completion of six cycles of therapy, his MM progressed, with a recurrence of pneumonia and high fever again. The onset of pneumonia was closely associated with MM progression. His pneumonia improved by treatment with mPSL half-pulse and MM treatment switching to carfilzomib/Rd. In the present study, we report the case of a patient with myeloma, who presented with multiple interstitial pneumonia, resulting in respiratory failure twice in concordance with myeloma progression.
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Affiliation(s)
- Sae Matsuoka
- Department of Hematology and Oncology, University of Fukui
| | - Naoko Hosono
- Department of Hematology and Oncology, University of Fukui
| | | | - Kana Oiwa
- Department of Hematology and Oncology, University of Fukui
| | - Miyuki Ookura
- Department of Hematology and Oncology, University of Fukui
| | - Katsunori Tai
- Department of Hematology and Oncology, University of Fukui
| | - Masaki Anzai
- Division of Respiratory Medicine, University of Fukui
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Oiwa K, Kohno M, Hashimoto R, Nakagawa T, Masuda R, Nishiumi N, Kaga K, Iwazaki M. Serial Epithelial Lining Fluid Collection Using Bronchoscopic Microsampling in a Canine Lung Transplantation Model. Tokai J Exp Clin Med 2016; 41:218-226. [PMID: 27988921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 09/26/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES As a less invasive alternative to bronchoalveolar lavage (BAL), bronchoscopic microsampling (BMS) was developed to identify molecules present in the epithelial lining fluid (ELF) of the distal airways. Here, we evaluated the utility of BMS for serial collection of ELF in a canine lung transplant model. METHODS ELF was collected hourly by BMS up to 5 hours after reperfusion in a canine left lung transplant model. Tumor necrosis factor (TNF)-α levels in ELF were measured using an enzyme-linked immunosorbent assay and were compared with those in BAL fluid. RESULTS Serial collection of ELF by BMS in graft lungs was possible without adverse effects. However, the partial pressure of oxygen was markedly decreased because of ischemia-reperfusion lung injury. Probe ELF absorption ranged from 1-18 µL. TNF-α expression was significantly elevated and detected for 5 hours after reperfusion, whereas it was very low in the sham-operated group (p < 0.05). TNF-α concentration in BAL fluid was less than one-hundredth of that in ELF. CONCLUSIONS BMS was safe and effective for serial ELF collection in grafted lungs. Temporal changes in TNF-α corresponded with ischemia-reperfusion lung injury. This is the first study to adopt BMS to elucidate pulmonary function after lung transplantation.
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Affiliation(s)
| | - Mitsutomo Kohno
- Division of General Thoracic Surgery, Department of Surgery Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Nakagawa T, Tsuboi T, Wada A, Nito M, Aruga N, Oiwa K, Masuda R, Iwazaki M. Sternal Segment Dislocation in a Child Treated by Conservative Observation. Tokai J Exp Clin Med 2015; 40:27-28. [PMID: 26150179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/10/2015] [Indexed: 06/04/2023]
Abstract
Sternal segment dislocation is rare in children, with only eight cases appearing in the literature. Four of the six reports recommended surgical treatment such as excision or open reduction and fixation [1-4], while the remaining two reports recommended conservative observation. Therefore, it remains unclear whether surgical treatment is necessary. We report a case of sternal segment dislocation in a child. Although the segment had rotated 90°, it was remodeled. We now believe that surgical treatment is not necessary for this condition.
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Affiliation(s)
- Tomoki Nakagawa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, 143 Simokasuya, Isehara, Kanagawa 259-1193, Japan.
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Oiwa K, Shimazu K, Tamura N, Hienuki M, Kim HT, Yamamoto T, Hamaguchi K. Effect of aging on cerebral blood flow autoregulation--with special reference to the role of the prostaglandins. Monogr Neural Sci 2015; 11:210-5. [PMID: 6588291 DOI: 10.1159/000409213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Nakagawa T, Koizumi T, Oiwa K, Inomoto C, Ogura G, Masuda R, Yamashita T, Nakamura N, Iwazaki M. Sudden death of a 14-year-old girl with lymphangiomatosis. Gen Thorac Cardiovasc Surg 2014; 64:116-9. [PMID: 25047633 DOI: 10.1007/s11748-014-0450-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 06/27/2014] [Indexed: 10/25/2022]
Abstract
A 14-year-old girl presented with progressively worsening intermittent orthopnea. Imaging studies showed cardiomegaly, extensive pericardial effusion, and a mediastinal tumor. By pericardial drainage, approximately 8,000-mL fluid was collected over 10 days. Left thoracoscopic pericardial fenestration and mediastinal tumor biopsy were performed, revealing lymphangiomatosis. Chylous pleural effusion developed post-surgery. Although control was attempted, her condition worsened. Eight months later, she died of sudden cardiopulmonary arrest. Autopsy revealed systemic spread of the primary lesion from the hyperplastic lymph ducts to the parietal pleura and mediastinum confirming systemic lymphangiomatosis.
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Affiliation(s)
- Tomoki Nakagawa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan.
| | - Takahisa Koizumi
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Kana Oiwa
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Chie Inomoto
- Division of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Go Ogura
- Division of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Ryota Masuda
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Tomohiro Yamashita
- Division of Radiology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Naoya Nakamura
- Division of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
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Masuda R, Ikoma Y, Oiwa K, Nakazato K, Takeichi H, Iwazaki M. Delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury: a case report. Tokai J Exp Clin Med 2013; 38:97-102. [PMID: 24030485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/17/2013] [Indexed: 06/02/2023]
Abstract
We report a case showing delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury. The patient was a 56-year-old man with a medical history of alcoholic hepatopathy who presented with a chief complaint of dyspnea on exertion. One month prior to presentation, he had sustained a fall that had resulted in left simple rib fracture. A chest radiograph taken at the time of injury showed notable reduction in the permeability of the left lung field along with high pulmonary collapse as well as rightward deviation of the shadow of the inferior mediastinum. Chest CT images showed a region of low absorption in the thoracic cavity with septi. Thoracic drainage was performed (1,300 mL total) and hemothorax was diagnosed. Thoracoscopic examination was then performed. When the inside of the thorax was observed, what had been presumed to be the septi of a multilocular fluid collection was found to be actually the parietal pleura, and a hematoma was confirmed inside the extrapleural cavity. The hematoma inside the extrapleural cavity was managed with lavage and drainage, and drainage tubes were placed inside both the thoracic cavity and extrapleural cavity at the end of the procedure. The patient's postoperative course was uneventful, and he was discharged on postoperative day 4.
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Affiliation(s)
- Ryota Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193 Japan.
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Nakagawa T, Hamanaka R, Nakano T, Oiwa K, Nakazato K, Ogura G, Masuda R, Nakamura N, Iwazaki M. Case of adolescent lung cancer resectable by the microthoracoscopic one-port method. Tokai J Exp Clin Med 2013; 38:21-23. [PMID: 23564571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 11/28/2012] [Indexed: 06/02/2023]
Abstract
An abnormal shadow was detected in a 15-year-old male adolescent by routine chest radiography during a school medical examination. Further detailed examination demonstrated stage IA primary lung adenocarcinoma in the right inferior lobe. The patient then underwent surgery. The right inferior lobe was resected, and the mediastinal lymph node was dissected by the microthoracoscopic one-port method. Thoracoscopic surgery for stage IA primary adult lung cancer has been established. However, no report has been published on thoracoscopic surgery, particularly the one-port method, for rare primary lung cancer in an adolescent, as demonstrated in this case.
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Affiliation(s)
- Tomoki Nakagawa
- Division of General Thoracic Surgery, Department of Surgery Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Masuda R, Kijima H, Imamura N, Aruga N, Nakazato K, Oiwa K, Nakano T, Watanabe H, Ikoma Y, Tanaka M, Inokuchi S, Iwazaki M. Laminin-5γ2 chain expression is associated with tumor cell invasiveness and prognosis of lung squamous cell carcinoma. Biomed Res 2013; 33:309-17. [PMID: 23124251 DOI: 10.2220/biomedres.33.309] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Our previous study showed that tumor budding is a significant indicator of a poor prognosis in lung squamous cell carcinoma patients. Tumor budding-positive (Bud(+)) cases of lung squamous cell carcinoma (SqCC) showed locally aggressive growth, and the positivity was a useful indicator of the lymph node status and prognosis. The present study focused on the clinicopathologic significance of laminin-5γ2 chain expression for local aggressiveness in lung SqCC. Laminin-5γ2 chain immunohistochemical stains in tissue samples were divided into three distinct types: basement membrane (B type; laminin-5γ2 present in basement membrane), cytoplasmic (C type; laminin- 5γ2 present in intracellular matrix), and invasive front (F type; laminin-5γ2 present in cytoplasm, and strongly in part of peripheral nest). The F type was more common in Bud(+) cases than tumor budding-negative (Bud(-)) cases; B and C types were less common in Bud(+) cases (P 〈 0.001). The F type was more closely associated with decreased overall survival than the B and C types (P 〈 0.001 for both). Univariate analysis showed that the F type could be used to predict tumor size, lymph node metastasis, lymphatic invasion, tumor infiltrative patterns, tumor budding, and laminin-5γ2 chain staining. Multivariate analysis showed that laminin-5γ2 chain staining and tumor budding could be used to predict patient mortality (P 〈 0.001 and P = 0.005, respectively). The overall survival rate after curative resection was lower in patients with the F/Bud(+) type than in those with B+C/Bud(-) and B+C/Bud(+) types (P < 0.001 for both, log-rank test), and also lower with the F/Bud(-) type than the B+C/Bud(-) type. On the other hand, there was no significant difference between the F/Bud(+) and F/Bud(-) types. In conclusion, both laminin- 5γ2 chain staining and tumor budding are associated with tumor cell invasiveness and are independent predictors of mortality in lung SqCC patients.
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Affiliation(s)
- Ryota Masuda
- Department of General Thoracic Surgery Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
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Kojima H, Kikumoto M, Sakakibara H, Oiwa K. Mechanical Properties of a Single-Headed Processive Motor, Inner-Arm Dynein Subspecies-c of ChlamydomonasStudied at the Single Molecule Level. J Biol Phys 2013; 28:335-45. [PMID: 23345779 DOI: 10.1023/a:1020300319224] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dynein from inner arms of Chlamydomonasflagella contains sevendistinct subspecies, a through g. Several lines of evidence suggest thesesubspecies play important roles in generating flagellar beating and thatthe different subspecies are functionally diverse. To evaluate theirroles and diversity, the mechanical properties of subspecies-c, which isa single-headed motor, were examined using optical trap nanometry. Apolystyrene bead coated with a small number of subspecies-c moleculeswas captured with the optical trap and brought into contact with amicrotubule fixed to a coverslip. Movements of the bead were measured bya quadrant photodiode sensor with sub-nanometer- and millisecond-resolution.Beads carrying a single active subspecies-c molecule moved processivelyalong the microtubules in 8-nm steps but slipped backwards under highloads. Force-velocity relationships of single subspecies-c molecules werealmost linear and the shapes of the normalized curves at 5 μM and 100μM ATP were similar. These results indicate that dynein subspecies-cfunctions in a very different way from conventional motor proteins, suchas myosin and kinesin, and has properties that could produceself-oscillation in vivo.
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Affiliation(s)
- H Kojima
- Communications Research Laboratory, Kansai Advanced Research Center, Iwaoka, Kobe, 651-2492 Japan
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Nakano T, Hamanaka R, Oiwa K, Nakazato K, Masuda R, Iwazaki M. Localized malignant pleural mesothelioma. Gen Thorac Cardiovasc Surg 2012; 60:468-74. [DOI: 10.1007/s11748-012-0025-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 07/28/2011] [Indexed: 11/29/2022]
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Iwazaki M, Oiwa K, Nakazato K, Masuda R. [Surgical therapy focusing mainly on endoscopic treatment]. Nihon Rinsho 2010; 68:1015-1018. [PMID: 20535949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Endoscopic surgery was popularized at the beginning of the 1990s in Japan, along with the development of video optical instruments, and it was soon applied to the treatment of solid cancers. Less invasive surgical techniques were sought using various approaches in various fields in the 2000s, and now in 2010 three approaches are notable: (1) single incision laparoscopic surgery using a one window method, which is attracting considerable interest because of its low invasiveness; (2) natural orifice translumenal endoscopic surgery (NOTES); and (3) robotic surgery, which is being pursued as a new modality. Further improvements in all these methods are anticipated as a result of the development of new instruments and the mastery of surgical techniques. However, an assurance of the safety of surgical procedures and a good prognosis are requisites for all these methods, and a level of quality equivalent to that of surgical techniques such as traditional thoracic and abdominal surgery must be maintained. Although these methods seem to represent difference paths, investigations of the various surgical techniques pursued by surgeons reveal that the various paths merge to reach the same goal. Therefore, extensive studies of new surgical techniques in various fields are needed to ensure that these new techniques hold up to the expectations of surgeons.
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Affiliation(s)
- Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine
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Nishiumi N, Inokuchi S, Oiwa K, Masuda R, Iwazaki M, Inoue H. Diagnosis and treatment of deep pulmonary laceration with intrathoracic hemorrhage from blunt trauma. Ann Thorac Surg 2010; 89:232-8. [PMID: 20103242 DOI: 10.1016/j.athoracsur.2009.09.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Revised: 09/16/2009] [Accepted: 09/16/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Blunt chest trauma resulting in massive hemothorax requires immediate attention. We investigated the diagnostic and prognostic utility of various clinical factors in patients with deep pulmonary laceration caused by blunt chest trauma with a view toward interventional treatment. METHODS We reviewed 42 patients with deep pulmonary laceration resulting from blunt chest trauma who were treated between 1988 and 2008. Various clinical factors were compared between survivors and nonsurvivors. RESULTS Of the 42 patients, 29 (69%) survived. Median (25th, 75th percentile) systolic blood pressure at arrival was 102 (76, 121) mm Hg for survivors and 70 (60, 90) mm Hg for nonsurvivors (p = 0.015). The median heart rate at arrival was 107 (98, 120) beats/min for survivors and 130 (120, 140) beats/min for nonsurvivors (p = 0.014). Respiratory rate, Glasgow Coma Scale score, and arterial blood gas values did not affect prognosis. Blood loss through the chest tube at insertion was 500 (400, 700) mL for survivors and 700 (500, 1000) mL for nonsurvivors (p = 0.147) and within 2 hours of arrival was 850 (590, 1100) mm Hg and 1600 (1400, 2000) mL, respectively (p < 0.001). Blood loss during thoracotomy was 1170 (600, 1790) mL and 3500 (2000, 6690), respectively (p < 0.001). CONCLUSIONS In patients with deep pulmonary laceration, hemorrhagic shock with systolic blood pressure less than 80 mm Hg and heart rate more than 120 beats/min leads to a poor prognosis. Emergency thoracotomy and pulmonary lobectomy should be performed before the intrathoracic hemorrhage reaches 1200 mL.
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Affiliation(s)
- Noboru Nishiumi
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
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Chen Q, Li DY, Shitaka Y, Oiwa K. Behaviors of microtubules (MTs) driven by biological motors (dynein c) at collisions against micro-fabricated tracks and mts for potential nano-bio-machines. J Nanosci Nanotechnol 2009; 9:5123-5133. [PMID: 19928190 DOI: 10.1166/jnn.2009.1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In vitro motility assays, where protein motors (attached to a surface) move protein filaments, have been used for investigating protein motors' functions. In recent decades, these assays are extended to explore potential applications of motor proteins as biological motors in nano-bio-machine development. Recent attempts include fabricating micrometer-scale tracks on the surface to confine and guide the flow of bio-filaments as a power transfer medium driven by the motor proteins. Understanding the interaction between bio-filaments and fabricated tracks as well as the mutual interaction between bio-filaments is of importance to the design of potential nano-bio-machines. In this study, we investigate the behaviors of a microtubule driven by axonemal dynein at the collision against another microtubule and micro-fabricated walls, respectively. Based on experimental observations, we propose a model to study possible mechanisms for the microtubule-microtubule and microtubule-wall interactions, which involve bumping force, bending moment and torque generation.
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Affiliation(s)
- Q Chen
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, T6G 2V2, Canada
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Chen Q, Li DY, Oiwa K. The coordination of protein motors and the kinetic behavior of microtubule — A computational study. Biophys Chem 2007; 129:60-9. [PMID: 17566632 DOI: 10.1016/j.bpc.2007.05.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 05/09/2007] [Accepted: 05/11/2007] [Indexed: 11/20/2022]
Abstract
Utilizing the mechanical energy converted from chemical energy through hydrolysis of ATP, motor proteins drive cytoskeleton filaments to move in various biological systems. Recent technological advance has shown the potential of the motor proteins for powering future nano-bio-mechanical systems. In order to effectively use motor proteins as a biological motor, the interaction between the protein motors and bio-filaments needs to be well clarified, since such interaction is largely influenced by many factors, such as the coordination among the motors, their dynamic behavior, physical properties of microtubules, and the viscosity of solution involved, etc. In this study, a two-dimensional model was proposed to simulate the motion of a microtubule driven by protein motors based on a dissipative particle dynamics (DPD) method with attempt to correlate the microtubule's kinetic behavior to the coordination among protein motors.
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Affiliation(s)
- Q Chen
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2V2.
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Yamamoto Y, Akiguchi I, Oiwa K, Hayashi M, Ohara T, Ozasa K. The relationship between 24-hour blood pressure readings, subcortical ischemic lesions and vascular dementia. Cerebrovasc Dis 2005; 19:302-8. [PMID: 15775671 DOI: 10.1159/000084498] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2004] [Accepted: 11/25/2004] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Twenty-four-hour blood pressure (BP) readings have been found to correlate with hypertensive target organ damage. Lacunar infarcts (LI) and white matter lesions (WML) probably represent manifestations of cerebral hypertensive target organ damage. This study was conducted to better delineate the relationships between 24-hour BP measurements, LI/WML and small vessel disease cognitive impairment/vascular dementia (CI/VD). METHODS Two hundred patients with first-time symptomatic LI were examined with 24-hour BP monitoring. The degree of nocturnal BP dip, (daytime BP - nighttime BP)/daytime BP, was categorized into three groups: dippers (>0.1), nondippers (0-0.1) and reverse dippers (<0). WML were subdivided into periventricular hyperintensities (PVH) and subcortical hyperintensities. RESULTS The breakdown of patients was: 50% nondippers, 27.5% reverse dippers and 22.5% dippers. Forty-one patients (20.5%) were found to have CI and dementia. Male sex (OR 3.35; 95% CI 1.20-9.34), advanced PVH (OR 14.42; 95% CI 5.62-36.98) and absence of a dipping status (nondipper: OR 12.62; 95% CI 1.37-115.95; reverse dipper: OR 11.95; 95% CI 1.27-112.11) were independently associated with CIVD after multivariate analysis. High nighttime systolic BP (OR 3.93; 95% CI 1.38-11.17), high daytime (OR 2.06; 95% CI 1.03-4.04) and nighttime diastolic BP (OR 2.48; 95% CI 1.13-5.45) and absence of a dipping status (nondipper: OR 2.7; 95% CI 1.03-7.05; reverse dipper: OR 3.78; 95% CI 1.38-10.34) were significantly associated with PVH. CONCLUSIONS High prevalence of a nondipping status was found in the LI cohort. A nondipping status appears to be directly associated with CIVD independent of PVH. This study indicates the need for further studies to investigate whether or not controlling nighttime BP will help reduce the risk for CI/VD development.
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Affiliation(s)
- Y Yamamoto
- Department of Neurology, Kyoto Second Red Cross Hospital, Japan.
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48
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Burgess SA, Walker ML, Sakakibara H, Oiwa K, Knight PJ. The structure of dynein-c by negative stain electron microscopy. J Struct Biol 2004; 146:205-16. [PMID: 15037251 DOI: 10.1016/j.jsb.2003.10.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2003] [Revised: 10/01/2003] [Indexed: 12/01/2022]
Abstract
Dynein ATPases contain six concatenated AAA modules within the motor region of their heavy chains. Additional regions of sequence are required to form a functional ATPase, which a previous study suggested forms seven or eight subdomains arranged in either a ring or hollow sphere. A more recent homology model of the six AAA modules suggests that these form a ring. Therefore both the number and arrangement of subdomains remain uncertain. We show two-dimensional projection images of dynein-c in negative stain which reveal new details of its structure. Initial electron cryomicroscopy shows a similar overall morphology. The molecule consists of three domains: stem, head, and stalk. In the absence of nucleotide the head has seven lobes of density forming an asymmetric ring. An eighth lobe protrudes from one side of this heptameric ring and appears to join the elongated cargo-binding stem. The proximal stem is flexible, as is the stalk, suggesting that they act as compliant elements within the motor. A new analysis of pre- and post-power stroke conformations shows the combined effect of their flexibility on the spatial distribution of the microtubule-binding domain and therefore the potential range of power stroke sizes. We present and compare two alternative models of the structure of dynein.
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Affiliation(s)
- S A Burgess
- Astbury Centre for Structural Molecular Biology and School of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK.
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Yamamoto J, Taka T, Yamada K, Ijiri Y, Murakami M, Hirata Y, Naemura A, Hashimoto M, Yamashita T, Oiwa K, Seki J, Suganuma H, Inakuma T, Yoshida T. Tomatoes have natural anti-thrombotic effects. Br J Nutr 2003; 90:1031-8. [PMID: 14641962 DOI: 10.1079/bjn2003994] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The prevention of arterial thrombotic diseases has a high priority in developed countries. An inappropriate diet may be an important risk factor for thrombotic events. The daily intake of an anti-thrombotic diet may offer a convenient and effective way of prevention. The aim of the present study was to test tomato extracts for anti-thrombotic effects and to identify those varieties that have such an effect. A shear-induced platelet-function test (haemostatometry) was used to test anti-thrombotic potential in vitro. Extracts from those tomato varieties that showed a significant anti-thrombotic activity in vitro were further assessed in vivo, using a laser-induced thrombosis test in mice. One tomato variety (KG99-4) showed significant anti-thrombotic activity both in vitro and in vivo. KG99-4 inhibited not only platelet-rich thrombus formation but also had a thrombolytic effect. It is concluded that haemostatometry can detect and classify the anti-thrombotic potential of fruits and vegetables and offers a simple way of screening for such effects.
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Affiliation(s)
- J Yamamoto
- Laboratory of Physiology, Faculty of Nutrition and High Technology Research Centre, Kobe Gakuin University, Kobe, Japan.
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Ijiri Y, Miura M, Hashimoto M, Fukunaga C, Watanabe S, Kubota A, Oiwa K, Okuda T, Yamamoto J. A new model to evaluate the diet-induced prothrombotic state, using He-Ne laser-induced thrombogenesis in the carotid artery of apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice. Blood Coagul Fibrinolysis 2002; 13:497-504. [PMID: 12192301 DOI: 10.1097/00001721-200209000-00004] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Epidemiological studies suggest the high fat content of the Western diet to be responsible for atherosclerosis and its thrombotic complications. Despite such a prevailing view, few animal experiments have so far succeeded in demonstrating enhanced thrombogenicity due to a high fat diet. Even a high fat and a very high cholesterol (1%) diet has failed to demonstrate an enhanced thrombotic reaction in rodents and rabbits. The aim of the present study was twofold. First, we wanted to establish a new, sensitive and specific thrombosis model in mice, which can then be used to study the effect of diets. Second, we intended to employ such a thrombosis model in investigations into the effect of high or low fat diets on thrombosis. The technique described uses a laser to induce thrombus formation in the exposed carotid artery of apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice. Thrombus formation was recorded on video, analysed by computer, and the size of thrombus was calculated by image analysis software. Thrombotic status was evaluated by analysing a total of 61 individual images of the thrombotic reaction, which were taken over 600 s. The severity of atherosclerosis was assessed by image analysis of the stained elastic fibers. Two kinds of diets were used: the Western type, high fat diet contained 20% fat (w/w) and 0.05% cholesterol (w/w); the low fat diet contained 7% fat, without cholesterol. These diets were on the basis of AIN93G and were given to mice for 4 or 8 weeks. The high fat diet significantly enhanced both the thrombotic reaction and the development of atherosclerosis as compared with the low fat diet.
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Affiliation(s)
- Y Ijiri
- Laboratory of Physiology, Faculty of Nutrition, and High Technology Research Center, Kobe Gakuin University, Japan
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