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Guare EG, Hale CM, Sivik J, Lehman E, Inoue Y, Rakszawski K, Songdej N, Nickolich M, Zheng H, Naik S, Claxton D, Rybka W, Hohl R, Mineishi S, Minagawa K, Paules CI. The addition of doxycycline to fluoroquinolones for bacterial prophylaxis in autologous stem cell transplantation for multiple myeloma. Transpl Infect Dis 2024; 26:e14241. [PMID: 38269469 DOI: 10.1111/tid.14241] [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: 12/01/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Bacterial prophylaxis with a fluoroquinolone (FQ) during autologous stem cell transplant (ASCT) is common, although not standardized among transplant centers. The addition of doxycycline (doxy) to FQ prophylaxis was previously linked to reduced neutropenic fever and bacteremia in multiple myeloma (MM) patients undergoing ASCT although several confounders were present. We compared the incidence of neutropenic fever and bacteremia between MM patients variably receiving prophylaxis with FQ alone and FQ-doxy during ASCT. METHODS Systematic retrospective chart review of MM patients who underwent ASCT between January 2016 and December 2021. The primary objective was to determine the effect of bacterial prophylaxis on neutropenic fever and bacteremia within 30 days of ASCT. Multivariable logistic regression for neutropenic fever and univariate logistic regression for bacteremia accounted for differences in subject characteristics between groups. RESULTS Among 341 subjects, 121 received FQ and 220 received FQ-doxy for prophylaxis. Neutropenic fever developed in 67 (55.4%) and 87 (39.5%) subjects in the FQ and FQ-doxy groups, respectively (p = .005). Bacteremia was infrequent, with 5 (4.1%) and 5 (2.3%) cases developing in the FQ and FQ-doxy groups, respectively (p = .337). Among Gram-negative bacteremia events, 7/7 Escherichia coli strains were FQ-resistant, and 5/7 were ceftriaxone-resistant. CONCLUSION The FQ-doxy prophylaxis group had fewer cases of neutropenic fever than the FQ group, however, there was no significant difference in bacteremia. High rates of antibiotic resistance were observed. An updated randomized controlled trial investigating appropriate prophylaxis for ASCT in the context of current oncology standards and changing antimicrobial resistance rates is warranted.
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Affiliation(s)
- Emma G Guare
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Cory M Hale
- Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Jeffrey Sivik
- Department of Pharmacy, Penn State Health Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Erik Lehman
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Yoshika Inoue
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Kevin Rakszawski
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Natthapol Songdej
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Myles Nickolich
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Hong Zheng
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Seema Naik
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - David Claxton
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Witold Rybka
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Raymond Hohl
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Shin Mineishi
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Kentaro Minagawa
- Blood and Marrow Transplant Program, Division of Hematology and Oncology, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Catharine I Paules
- Division of Infectious Diseases, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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Naik S, Rakszawski K, Zheng H, Claxton D, Minagawa K, Mineishi S. Clofarabine Preconditioning followed by Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia. Int J Mol Sci 2024; 25:957. [PMID: 38256031 PMCID: PMC10815844 DOI: 10.3390/ijms25020957] [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: 12/01/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Acute myeloid leukemia patients with induction failure or relapsed refractory disease have minimal chance of achieving remission with subsequent treatments. Several trials have shown the feasibility of clofarabine-based conditioning in allogeneic stem cell transplants (allo-HSCT) for non-remission AML patients. Pre-transplant conditioning with clofarabine followed by reduced-intensity allo-HSCT has also demonstrated a potential benefit in those patients with human leukocyte antigen (HLA)-identical donors, but it is not commonly used in haploidentical and mismatched transplants. In this case report, we describe our experience of seven cases of non-remission AML who received clofarabine preconditioning followed by an allo-HSCT with PTCy. The 2-year overall survival and disease-free survival was 83.3% (95% confidence interval (CI): 27.3-97.9%) and 85.7% (95% CI: 33.4-97.9%). Median days of neutrophil and platelet recovery were 16 (range of 13-23) and 28 (range of 17-75), respectively. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) at day 100 and chronic GVHD at 1-year showed 28.6% (95% CI: 8-74.2%) and 28.6% (95% CI: 3-63.9%), respectively. The two-year relapse rate was 14.3% (95% CI: 2.14-66.6%). One-year GVHD-free relapse-free survival (GFRS) at 1-year was 71.4% (95% CI: 25.8-92%). Our patients showed successful outcomes with clofarabine preconditioning to reduce the leukemic burden at the pre-transplant period followed by PTCy to reduce GVHD resulting in lower relapsed rate and better GFRS in these patients.
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Affiliation(s)
- Seema Naik
- Department of Medicine, Penn State Cancer Institute, 500 University Dr. Hershey, Hershey, PA 17033, USA; (K.R.); (H.Z.); (D.C.); (K.M.); (S.M.)
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3
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Jia B, Zhao C, Minagawa K, Shike H, Claxton DF, Ehmann WC, Rybka WB, Mineishi S, Wang M, Schell TD, Prabhu KS, Paulson RF, Zhang Y, Shultz LD, Zheng H. Acute Myeloid Leukemia Causes T Cell Exhaustion and Depletion in a Humanized Graft-versus-Leukemia Model. J Immunol 2023; 211:1426-1437. [PMID: 37712758 DOI: 10.4049/jimmunol.2300111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (alloSCT) is, in many clinical settings, the only curative treatment for acute myeloid leukemia (AML). The clinical benefit of alloSCT greatly relies on the graft-versus-leukemia (GVL) effect. However, AML relapse remains the top cause of posttransplant death; this highlights the urgent need to enhance GVL. Studies of human GVL have been hindered by the lack of optimal clinically relevant models. In this article, we report, the successful establishment of a novel (to our knowledge) humanized GVL model system by transplanting clinically paired donor PBMCs and patient AML into MHC class I/II knockout NSG mice. We observed significantly reduced leukemia growth in humanized mice compared with mice that received AML alone, demonstrating a functional GVL effect. Using this model system, we studied human GVL responses against human AML cells in vivo and discovered that AML induced T cell depletion, likely because of increased T cell apoptosis. In addition, AML caused T cell exhaustion manifested by upregulation of inhibitory receptors, increased expression of exhaustion-related transcription factors, and decreased T cell function. Importantly, combined blockade of human T cell-inhibitory pathways effectively reduced leukemia burden and reinvigorated CD8 T cell function in this model system. These data, generated in a highly clinically relevant humanized GVL model, not only demonstrate AML-induced inhibition of alloreactive T cells but also identify promising therapeutic strategies targeting T cell depletion and exhaustion for overcoming GVL failure and treating AML relapse after alloSCT.
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Affiliation(s)
- Bei Jia
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Chenchen Zhao
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Kentaro Minagawa
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Hiroko Shike
- Department of Pathology, Penn State University College of Medicine, Hershey, PA
| | - David F Claxton
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - W Christopher Ehmann
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Witold B Rybka
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Shin Mineishi
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
| | - Ming Wang
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Todd D Schell
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
- Department of Microbiology and Immunology, Penn State University College of Medicine, Hershey, PA
| | - K Sandeep Prabhu
- Department of Veterinary and Biomedical Sciences, Penn State University, University Park, PA
| | - Robert F Paulson
- Department of Veterinary and Biomedical Sciences, Penn State University, University Park, PA
| | - Yi Zhang
- Center for Discovery and Innovation, Hackensack Meridian Health, Edison, NJ
| | - Leonard D Shultz
- Department of Immunology, The Jackson Laboratory, Bar Harbor, ME
| | - Hong Zheng
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA
- Department of Microbiology and Immunology, Penn State University College of Medicine, Hershey, PA
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Zhou H, Jia B, Annageldiyev C, Minagawa K, Zhao C, Mineishi S, Ehmann WC, Naik SG, Cioccio J, Wirk B, Songdej N, Rakszawski KL, Nickolich MS, Shen J, Zheng H. CD26 lowPD-1 + CD8 T cells are terminally exhausted and associated with leukemia progression in acute myeloid leukemia. Front Immunol 2023; 14:1169144. [PMID: 37457737 PMCID: PMC10338956 DOI: 10.3389/fimmu.2023.1169144] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Acute myeloid leukemia (AML) is a devastating blood cancer with poor prognosis. Novel effective treatment is an urgent unmet need. Immunotherapy targeting T cell exhaustion by blocking inhibitory pathways, such as PD-1, is promising in cancer treatment. However, results from clinical studies applying PD-1 blockade to AML patients are largely disappointing. AML is highly heterogeneous. Identification of additional immune regulatory pathways and defining predictive biomarkers for treatment response are crucial to optimize the strategy. CD26 is a marker of T cell activation and involved in multiple immune processes. Here, we performed comprehensive phenotypic and functional analyses on the blood samples collected from AML patients and discovered that CD26lowPD-1+ CD8 T cells were associated with AML progression. Specifically, the percentage of this cell fraction was significantly higher in patients with newly diagnosed AML compared to that in patients achieved completed remission or healthy controls. Our subsequent studies on CD26lowPD-1+ CD8 T cells from AML patients at initial diagnosis demonstrated that this cell population highly expressed inhibitory receptors and displayed impaired cytokine production, indicating an exhaustion status. Importantly, CD26lowPD-1+ CD8 T cells carried features of terminal exhaustion, manifested by higher frequency of TEMRA differentiation, increased expression of transcription factors that are observed in terminally exhausted T cells, and high level of intracellular expression of granzyme B and perforin. Our findings suggest a prognostic and predictive value of CD26 in AML, providing pivotal information to optimize the immunotherapy for this devastating cancer.
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Affiliation(s)
- Huarong Zhou
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fujian Medical Center of Hematology, Fuzhou, China
| | - Bei Jia
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Charyguly Annageldiyev
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Kentaro Minagawa
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Chenchen Zhao
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Shin Mineishi
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - W Christopher Ehmann
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Seema G. Naik
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Joseph Cioccio
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Baldeep Wirk
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Natthapol Songdej
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Kevin L. Rakszawski
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Myles S. Nickolich
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
| | - Jianzhen Shen
- Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fujian Medical Center of Hematology, Fuzhou, China
| | - Hong Zheng
- Penn State Cancer Institute, Penn State University College of Medicine, Hershey, PA, United States
- Department of Microbiology and Immunology, Penn State University College of Medicine, Hershey, PA, United States
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Minagawa K, Wakahashi K, Fukui C, Kawano Y, Kawano H, Suzuki T, Ishii S, Sada A, Nishikawa S, Asada N, Katayama Y, Matsui T. Tfl deletion induces extraordinary Cxcl13 secretion and cachexia in VavP- Bcl2 transgenic mice. Front Immunol 2023; 14:1197112. [PMID: 37304286 PMCID: PMC10250710 DOI: 10.3389/fimmu.2023.1197112] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/16/2023] [Indexed: 06/13/2023] Open
Abstract
STATEMENT OF SIGNIFICANCE Loss of TFL, found in several types of lymphoma, induces excessive CXCL13 secretion through RNA dysregulation contributing to body weight loss and early death in lymphoma model mice. Follicular lymphoma (FL) is associated with overexpressed BCL-2 and other genetic aberrations, including 6q-. We identified a novel gene on 6q25, "Transformed follicular lymphoma (TFL)," from a transformed FL. TFL regulates several cytokines via mRNA degradation, which has been suggested to underlie resolving inflammation. Fluorescence in situ hybridization revealed a deletion of TFL occurred in 13.6% of various B-cell lymphoma samples. We developed VavP-bcl2 transgenic, TFL deficit mice (Bcl2-Tg/Tfl -/-) to seek how TFL affects disease progression in this lymphoma model. While Bcl2-Tg mice developed lymphadenopathy and died around 50 weeks, Bcl2-Tg/Tfl -/- mice lost body weight around 30 weeks and died about 20 weeks earlier than Bcl2-Tg mice. Furthermore, we found a unique B220-IgM+ cell population in the bone marrow of Bcl2-Tg mice. cDNA array in this population revealed that Cxcl13 mRNA in Bcl2-Tg/Tfl -/- mice expressed significantly higher than Bcl2-Tg mice. In addition, bone marrow extracellular fluid and serum showed an extremely high Cxcl13 concentration in Bcl2-Tg/Tfl -/- mice. Among bone marrow cells, the B220-IgM+ fraction was the main producer of Cxcl13 in culture. A reporter assay demonstrated TFL regulates CXCL-13 via induction of 3'UTR mRNA degradation in B lineage cells. These data suggest Tfl regulates Cxcl13 in B220-IgM+ cells in the bone marrow, and a very high concentration of serum Cxcl13 arising from these cells may contribute to early death in lymphoma-bearing mice. Since several reports have suggested the association of CXCL13 expression with lymphoma, these findings provide new insights into cytokine regulation via TFL in lymphoma.
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Affiliation(s)
- Kentaro Minagawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Hematology & Oncology Division, Penn State College of Medicine, Hershey, PA, United States
| | - Kanako Wakahashi
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chie Fukui
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuko Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohide Suzuki
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichi Ishii
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Sada
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Nishikawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noboru Asada
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshio Katayama
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Nishiwaki, Japan
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Naik S, Zheng H, Minagawa K, Mineishi S. Clofarabine Preconditioning Followed By Allogeneic Transplant Using TBI and Post-Transplant Cyclophosphamide for Relapsed Refractory Leukemia. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00293-2] [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: 02/07/2023]
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Shah N, Cioccio J, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann C, Silar B, Vajdic C, Mierski J, Zhou S, Shike H, Greiner R, Brown V, Hohl R, Claxton D, Mineishi S, Minagawa K, Tuanquin L. Low-dose total body irradiation promotes T-cells donor chimerism in reduced-intensity/non-myeloablative allogeneic stem cell transplant with post-transplant cyclophosphamide. Leuk Res 2022; 123:106969. [DOI: 10.1016/j.leukres.2022.106969] [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] [Received: 08/09/2022] [Revised: 09/20/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022]
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Falcon C, Smith L, Al-Obaidi M, Abu Zaanona M, Purvis K, Minagawa K, Athar M, Salzman D, Bhatia R, Goldman F, Di Stasi A. Combinatorial suicide gene strategies for the safety of cell therapies. Front Immunol 2022; 13:975233. [PMID: 36189285 PMCID: PMC9515659 DOI: 10.3389/fimmu.2022.975233] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Gene-modified cellular therapies carry inherent risks of severe and potentially fatal adverse events, including the expansion of alloreactive cells or malignant transformation due to insertional mutagenesis. Strategies to mitigate uncontrolled proliferation of gene-modified cells include co-transfection of a suicide gene, such as the inducible caspase 9 safety switch (ΔiC9). However, the activation of the ΔiC9 fails to completely eliminate all gene-modified cells. Therefore, we tested a two suicide gene system used independently or together, with the goal of complete cell elimination. The first approach combined the ΔiC9 with an inducible caspase 8, ΔiC8, which lacks the endogenous prodomain. The rationale was to use a second caspase with an alternative and complementary mechanism of action. Jurkat cells co-transduced to co-express the ΔiC8, activatable by a BB homodimerizer, and the ΔiC9 activatable by the rapamycin analog sirolimus were used in a model to estimate the degree of inducible cell elimination. We found that both agents could activate each caspase independently, with enhanced elimination with superior reduction in cell regrowth of gene-modified cells when both systems were activated simultaneously. A second approach was employed in parallel, combining the ΔiC9 with the RQR8 compact suicide gene. RQR8 incorporates a CD20 mimotope, targeted by the anti-CD20 monoclonal antibody rituxan, and the QBend10, a ΔCD34 selectable marker. Likewise, enhanced cell elimination with superior reduction in cell regrowth was observed when both systems were activated together. A dose-titration effect was also noted utilizing the BB homodimerizer, whereas sirolimus remained very potent at minimal concentrations. Further in vivo studies are needed to validate these novel combination systems, which may play a role in future cancer therapies or regenerative medicine.
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Pizzola CJ, Cioccio J, Rakszawski KL, Nickolich M, Ehmann WC, Rybka WB, Wirk B, Naik S, Zheng H, Silar B, Shike H, Zhou S, Mineishi S, Minagawa K, Claxton DF. Non-myeloablative allogeneic stem cell transplant with fludarabine and reduced dose cyclophosphamide in acute myeloid leukemia for older adults with comorbidities. Bone Marrow Transplant 2022; 57:1743-1745. [PMID: 36097041 DOI: 10.1038/s41409-022-01821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | - Joseph Cioccio
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | | | - Myles Nickolich
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | | | - Witold B Rybka
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Baldeep Wirk
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Seema Naik
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Hong Zheng
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Brooke Silar
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Hiroko Shike
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Shouhao Zhou
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA.,Division of Biostatistics and Bioinformatics, Penn State College of Medicine, 700 HMC Crescent Road, Hershey, PA, 17033, USA
| | - Shin Mineishi
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
| | - Kentaro Minagawa
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA.
| | - David F Claxton
- Penn State Cancer Institute, 500 University Dr, Hershey, PA, 17033, USA
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Jamy O, Arora S, Salzman D, Di Stasi A, Minagawa K, Mineishi S, Saad A. A Phase II Study of Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Acute Lymphoblastic Leukemia in Older Patients Using Fludarabine and Total Body Irradiation. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00466-3] [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: 11/17/2022]
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Zulch E, Cioccio J, Rakszawski K, Nickolich M, Ehmann WC, Wirk B, Naik S, Rybka W, Zheng H, Shike H, Sivik J, Mierski J, Silar B, Greiner R, Brown V, Tuanquin L, Claxton DF, Mineishi S, Minagawa K. Splenomegaly Predisposes Graft Failure in Ptcy Transplant. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00339-6] [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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Jamy O, Innis‐Shelton R, Bal S, Paluri R, Salzman D, Di Stasi A, Costa L, Meredith R, Lamb L, Minagawa K, Mineishi S, Saad A. Phase II clinical trial of one dose of post-transplant cyclophosphamide for graft versus host disease prevention following myeloablative, peripheral blood stem cell, matched-unrelated donor transplantation. Am J Hematol 2021; 96:E396-E398. [PMID: 34288026 DOI: 10.1002/ajh.26296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022]
Affiliation(s)
- Omer Jamy
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Raquel Innis‐Shelton
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Susan Bal
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Ravi Paluri
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Donna Salzman
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Antonio Di Stasi
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Luciano Costa
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Ruby Meredith
- Department of Radiation Oncology University of Alabama at Birmingham Birmingham Alabama USA
| | - Lawrence Lamb
- Division of Hematology and Oncology, Department of Medicine University of Alabama at Birmingham Birmingham Alabama USA
| | - Kentaro Minagawa
- Division of Hematology and Oncology, Department of Medicine Pennsylvania State University University Park Pennsylvania USA
| | - Shin Mineishi
- Division of Hematology and Oncology, Department of Medicine Pennsylvania State University University Park Pennsylvania USA
| | - Ayman Saad
- Division of Hematology and Oncology, Department of Medicine Ohio State University Columbus Ohio USA
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Minagawa K, Mineishi S. [The coronavirus disease 2019 (COVID-19) and hematologic oncology or BMT practice at our center in US]. Rinsho Ketsueki 2021; 62:998-1003. [PMID: 34497240 DOI: 10.11406/rinketsu.62.998] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has exerted a considerable impact in our region; thus, we have been performing only emergency transplants in March 2020. At present, all inpatients and surgical patients are being tested and screened for COVID-19. If they are found to be positive, they are transferred to the COVID-19 ward, where a specialized team manages them. Team-based care allows the hematology/oncology teams to perform their regular duties. In particular, for post-transplant patients, treatment decisions are made through discussion with infectious disease specialists, and in principle, the patients are treated using the same protocol as that used for the general COVID-19 infected patients. Currently, vaccination is being promoted at a rapid pace based on the Centers for Disease Control and Prevention Guidelines (CDC) guidelines. At our institution, when a situation of suspected nosocomial COVID-19 infection occurred, all healthcare workers were tested. Thereafter, all hospitalized patients were tested every week for COVID-19, and we were able to overcome the situation. Although definitive measures for COVID-19 are yet to be established, signs of an end to the infection are beginning to appear with a wider availability of vaccines.
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Affiliation(s)
- Kentaro Minagawa
- Penn State Hershey Medical Center, Blood and Marrow Transplant Program
| | - Shin Mineishi
- Penn State Hershey Medical Center, Blood and Marrow Transplant Program
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14
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Tomita T, Kato M, Mishima T, Matsunaga Y, Sanjo H, Ito KI, Minagawa K, Matsui T, Oikawa H, Takahashi S, Takao T, Iwai N, Mino T, Takeuchi O, Maru Y, Hiratsuka S. Extracellular mRNA transported to the nucleus exerts translation-independent function. Nat Commun 2021; 12:3655. [PMID: 34135341 PMCID: PMC8208975 DOI: 10.1038/s41467-021-23969-1] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/27/2021] [Indexed: 12/19/2022] Open
Abstract
RNA in extracellular vesicles (EVs) are uptaken by cells, where they regulate fundamental cellular functions. EV-derived mRNA in recipient cells can be translated. However, it is still elusive whether “naked nonvesicular extracellular mRNA” (nex-mRNA) that are not packed in EVs can be uptaken by cells and, if so, whether they have any functions in recipient cells. Here, we show the entrance of nex-mRNA in the nucleus, where they exert a translation-independent function. Human nex-interleukin-1β (IL1β)-mRNA outside cells proved to be captured by RNA-binding zinc finger CCCH domain containing protein 12D (ZC3H12D)-expressing human natural killer (NK) cells. ZC3H12D recruited to the cell membrane binds to the 3′-untranslated region of nex-IL1β-mRNA and transports it to the nucleus. The nex-IL1β-mRNA in the NK cell nucleus upregulates antiapoptotic gene expression, migration activity, and interferon-γ production, leading to the killing of cancer cells and antimetastasis in mice. These results implicate the diverse actions of mRNA. Nonvesicular extracellular RNA (nex-RNA) that are not packed in extracellular vesicles is detected outside the cell, but it is poorly understood. Here the authors report that nex-RNA is captured by a zinc finger protein and transported to the nucleus to enhance antimetastatic characters of the cell.
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Affiliation(s)
- Takeshi Tomita
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan.,Department of Biochemistry and Molecular Biology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan
| | - Masayoshi Kato
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan.,Department of Biochemistry and Molecular Biology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan
| | - Taishi Mishima
- Department of Pharmacology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Yuta Matsunaga
- Department of Pharmacology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Hideki Sanjo
- Department of Molecular and Cellular Immunology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan
| | - Ken-Ichi Ito
- Division of Breast, Endocrine and Respiratory Surgery, Department of Surgery, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan
| | - Kentaro Minagawa
- Department of Hematology/Oncology, Penn State College of Medicine, Hershey, PA, USA
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Nishiwaki, Hyogo, Japan
| | - Hiroyuki Oikawa
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Japan
| | - Satoshi Takahashi
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Sendai, Japan
| | - Toshifumi Takao
- Institute for Protein Research, Osaka University, Suita, Osaka, Japan
| | - Noriki Iwai
- Department of Medical Chemistry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Mino
- Department of Medical Chemistry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Osamu Takeuchi
- Department of Medical Chemistry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshiro Maru
- Department of Pharmacology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
| | - Sachie Hiratsuka
- Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan. .,Department of Biochemistry and Molecular Biology, Shinshu University, School of Medicine, Matsumoto, Nagano, Japan.
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15
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Suzuki T, Ishii S, Shinohara M, Kawano Y, Wakahashi K, Kawano H, Sada A, Minagawa K, Hamada M, Takahashi S, Furuyashiki T, Tan NS, Matsui T, Katayama Y. Mobilization efficiency is critically regulated by fat via marrow PPARδ. Haematologica 2021; 106:1671-1683. [PMID: 33538151 PMCID: PMC8168511 DOI: 10.3324/haematol.2020.265751] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 07/03/2020] [Indexed: 12/21/2022] Open
Abstract
The mobilization efficiency of hematopoietic stem/progenitor cells from bone marrow (BM) to circulation by granulocyte colony-stimulating factor (G-CSF) is dramatically dispersed in humans and mice with no mechanistic lead for poor mobilizers. The regulatory mechanism for mobilization efficiency by dietary fat was assessed in mice. Fat-free diet (FFD) for 2 weeks greatly increased mobilization compared to normal diet (ND). The BM mRNA level of peroxisome proliferator-activated receptor δ (PPARδ), a receptor for lipid mediators, was markedly up-regulated by G-CSF in mice fed with ND and displayed strong positive correlation with widely scattered mobilization efficiency. It was hypothesized that BM fat ligand for PPARδ might inhibit mobilization. The PPARδ agonist inhibited mobilization in mice fed with ND and enhanced mobilization by FFD. Treatment with the PPARδ antagonist and chimeric mice with PPARδ+/- BM showed enhanced mobilization. Immunohistochemical staining and flow cytometry revealed that BM PPARδ expression was enhanced by G-CSF mainly in mature/immature neutrophils. BM lipid mediator analysis revealed that G-CSF treatment and FFD resulted in the exhaustion of ω3-polyunsaturated fatty acids such as eicosapentaenoic acid (EPA). EPA induced the up-regulation of genes downstream of PPARδ, such as carnitine palmitoyltransferase-1α and angiopoietin-like protein 4 (Angptl4), in mature/immature neutrophils in vitro and inhibited enhanced mobilization in mice fed with FFD in vivo. Treatment of wild-type mice with the anti-Angptl4 antibody enhanced mobilization together with BM vascular permeability. Collectively, PPARδ signaling in BM mature/immature neutrophils induced by dietary fatty acids negatively regulates mobilization, at least partially, via Angptl4 production.
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Affiliation(s)
- Tomohide Suzuki
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Shinichi Ishii
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Masakazu Shinohara
- Division of Epidemiology; The Integrated Center for Mass Spectrometry, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Yuko Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Kanako Wakahashi
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Akiko Sada
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Kentaro Minagawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Michito Hamada
- Department of Anatomy and Embryology, Faculty of Medicine,
| | - Satoru Takahashi
- Department of Anatomy and Embryology, Faculty of Medicine; Transborder Medical Research Center (TMRC),; International Institute for Integrative Sleep Medicine (WPI-IIIS); Life Science Center, Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8576
| | - Tomoyuki Furuyashiki
- Division of Pharmacology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017
| | - Nguan Soon Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232; School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, Singapore 637551
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, 652-1 Shimotoda, Nishiwaki 677-0043
| | - Yoshio Katayama
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017.
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16
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Ishii S, Suzuki T, Wakahashi K, Asada N, Kawano Y, Kawano H, Sada A, Minagawa K, Nakamura Y, Mizuno S, Takahashi S, Matsui T, Katayama Y. FGF-23 from erythroblasts promotes hematopoietic progenitor mobilization. Blood 2021; 137:1457-1467. [PMID: 33512467 DOI: 10.1182/blood.2020007172] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/20/2020] [Accepted: 12/15/2020] [Indexed: 12/26/2022] Open
Abstract
Fibroblast growth factor 23 (FGF-23) hormone is produced by bone-embedded osteocytes and regulates phosphate homeostasis in kidneys. We found that administration of granulocyte colony-stimulating factor (G-CSF) to mice induced a rapid, substantial increase in FGF-23 messenger RNA in bone marrow (BM) cells. This increase originated mainly from CD45-Ter119+CD71+ erythroblasts. FGF-23 protein in BM extracellular fluid was markedly increased during G-CSF-induced hematopoietic progenitor cell (HPC) mobilization, but remained stable in the blood, with no change in the phosphate level. Consistent with the BM hypoxia induced by G-CSF, low oxygen concentration induced FGF-23 release from human erythroblast HUDEP-2 cells in vitro. The efficient mobilization induced by G-CSF decreased drastically in both FGF-23-/- and chimeric mice with FGF-23 deficiency, only in hematopoietic cells, but increased in osteocyte-specific FGF-23-/- mice. This finding suggests that erythroblast-derived, but not bone-derived, FGF-23 is needed to release HPCs from BM into the circulation. Mechanistically, FGF-23 did not influence CXCL-12 binding to CXCR-4 on progenitors but interfered with their transwell migration toward CXCL-12, which was canceled by FGF receptor inhibitors. These results suggest that BM erythroblasts facilitate G-CSF-induced HPC mobilization via FGF-23 production as an intrinsic suppressor of chemoattraction.
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Affiliation(s)
- Shinichi Ishii
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohide Suzuki
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kanako Wakahashi
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noboru Asada
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuko Kawano
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Kawano
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Sada
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kentaro Minagawa
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukio Nakamura
- Cell Engineering Division, RIKEN BioResource Research Center, Ibaraki, Japan
| | | | - Satoru Takahashi
- Transborder Medical Research Center (TMRC)
- Department of Anatomy and Embryology, Faculty of Medicine
- International Institute for Integrative Sleep Medicine (WPI-IIIS), and
- Life Science Center, Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, Tsukuba, Japan; and
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Nishiwaki, Japan
| | - Yoshio Katayama
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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17
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Naik S, Shah N, Rakszawski K, Minagawa K, Mineishi S. Unusual Extra Nodal Patterns of Relapse Post CAR-T Therapy for High Grade B Cell Lymphoma. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00541-8] [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: 12/01/2022]
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18
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Shah N, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann WC, Silar B, Vajdic C, Mackey G, Zhou S, Cioccio J, Bartock M, Shike H, Greiner RJ, Brown V, Hohl R, Claxton DF, Mineishi S, Minagawa K, Tuanquin L. Low Dose Total Body Irradiation (TBI) Plus Post-Transplant Cyclophosphamide As Graft-Versus-Host Disease (GVHD) Prophylaxis Facilitates Early Chimerism Achievement and a Tendency Towards Improved Disease-Free Survival in Alternative Donor Allogeneic Stem Cell Transplant. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00425-5] [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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19
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Cioccio J, Rakszawski K, Zheng H, Nickolich M, Naik S, Wirk B, Rybka W, Ehmann WC, Silar B, Vajdic C, Mackey G, Shah N, Bartock M, Shike H, Tuanquin L, Greiner RJ, Brown V, Hohl R, Claxton DF, Mineishi S, Minagawa K. Post-Transplant Cyclophosphamide As GVHD Prophylaxis Eliminates GVHD Mortality and Improves Overall Survival in Alternative Donor Allogeneic Stem Cell Transplant. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00301-8] [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: 10/22/2022]
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20
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Shah N, Rakszawski K, Nickolich M, Ehmann WC, Wirk B, Naik S, Rybka W, Zheng H, Mierski J, Silar B, Mackey G, Greiner RJ, Brown V, Claxton DF, Mineishi S, Minagawa K. Improved Outcome for AML Relapse after Allogeneic Transplant with High Intensity Chemotherapy Followed By 2nd Allogeneic Stem Cell Transplant or Donor Lymphocyte Infusion; A Retrospective Analysis. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.601] [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: 10/25/2022]
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21
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Abstract
Chimeric antigen receptor (CAR)-redirected T-cells are a powerful tool for the treatment of several type of cancers; however, they can cause several adverse effects including cytokine release syndrome, off-target effects resulting in potentially fatal organ damage or even death. Particularly, for CAR T-cells redirected toward acute myeloid leukemia (AML) antigens myelosuppression can be a challenge. The previously validated inducible Caspase9 (iC9) suicide gene system is one of the approaches to control the infused cells in vivo through its activation with a nontherapeutic chemical inducer of dimerizer (CID). We performed a preclinical validation using a model of CD33+ AML, and generated iC9 CAR T-cells co-expressing a CAR targeting the AML-associated antigen CD33 and a selectable marker (ΔCD19). ΔCD19 selected (sel.) iC9-CAR.CD33 T-cells were effective in controlling leukemia growth in vitro, and could be partially eliminated (76%) using a chemical inducer of dimerization that activates iC9. Moreover, to completely eliminate residual cells, a second targeted agent was added. Future plans with these methods are to investigate the utility of iC9-CAR.CD33 T-cells as part of the conditioning therapy for an allogeneic hematopoietic stem cell transplant. Additional strategies that we are currently validating include (1) the modulation of the suicide gene activation, using different concentrations of the inducing agent(s), to be able to eliminate CAR T-cells modified by a regulatable gene, ideally aiming at preserving a proportion of the infused cells (and their antitumor activity) for mild to moderate toxicities, or (2) the co-expression of an inhibitory CAR aiming at sparing normal cells co-expressing an antigen not shared with the tumor.
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Affiliation(s)
- Kentaro Minagawa
- Department of Hematology/Oncology, Bone Marrow Transplantation and Cell Therapy Unit, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mustafa Al-Obaidi
- Department of Hematology/Oncology, Bone Marrow Transplantation and Cell Therapy Unit, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Antonio Di Stasi
- Department of Hematology/Oncology, Bone Marrow Transplantation and Cell Therapy Unit, University of Alabama at Birmingham, Birmingham, AL, USA.
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22
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Wakahashi S, Kawakami F, Wakahashi K, Minagawa K, Matsuo K, Katayama Y, Yamada H, Matsui T, Sudo T. Transformed Follicular Lymphoma (TFL) Predicts Outcome in Advanced Endometrial Cancer. Cancer Epidemiol Biomarkers Prev 2018; 27:963-969. [PMID: 29784731 DOI: 10.1158/1055-9965.epi-17-0762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 02/13/2018] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Transformed follicular lymphoma (TFL, ZC3H12D) was identified as a candidate tumor suppressor gene that contributes to cell-cycle arrest through regulation of Rb phosphorylation, but the clinical impact of TFL is unknown. The goal of this study was to evaluate the prognostic significance of TFL expression in advanced endometrial cancer.Methods: Tissue samples were obtained from 103 patients with Federation Internationale des Gynaecologistes et Obstetristes stage III-IV endometrial cancer. Associations between TFL expression and outcomes were evaluated using the Kaplan-Meier method and multivariate Cox proportional hazards regression models.Results: There were 24 TFL-low cases (23.3%) and the 10-year progression-free survival (PFS) and overall survival (OS) in these cases were lower than those for patients with normal TFL expression in univariate analysis (PFS, P = 0.003; OS, P = 0.106). In multivariate analysis, TFL status was a significant predictor for PFS [HR = 2.76; 95% confidence interval (CI), 1.45-5.28; P = 0.002] and OS (HR = 1.94; 95% CI, 0.91-4.11; P = 0.085), adjusted for covariates. The TFL gene maps to human chromosome 6q25.1, where estrogen receptor alpha (ERα) gene ESR1 is also located. Lack of ERα expression is a poor prognostic factor in early endometrial cancer. Among 41 ERα-low patients, 10-year PFS was significantly lower in 15 TFL-low cases (univariate analysis, P = 0.055; multivariate analysis, HR = 4.70; 95% CI, 1.68-13.20; P = 0.003).Conclusions: We identified TFL as a strong independent prognostic factor, regardless of ERα status.Impact: An investigation of the mechanism underlying tumor suppression by TFL may lead to new therapies for patients with advanced endometrial cancer. Cancer Epidemiol Biomarkers Prev; 27(8); 963-9. ©2018 AACR.
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Affiliation(s)
- Senn Wakahashi
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Fumi Kawakami
- Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan
| | - Kanako Wakahashi
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kentaro Minagawa
- Department of Hematology/Oncology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yoshio Katayama
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideto Yamada
- Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Department of Hematology, Nishiwaki Municipal Hospital, Nishiwaki, Hyogo, Japan
| | - Tamotsu Sudo
- Section of Translational Research, Hyogo Cancer Center, Akashi, Japan
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23
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Iwasaki M, Yoshihara A, Sato N, Sato M, Minagawa K, Shimada M, Nishimuta M, Ansai T, Yoshitake Y, Ono T, Miyazaki H. A 5-year longitudinal study of association of maximum bite force with development of frailty in community-dwelling older adults. J Oral Rehabil 2017; 45:17-24. [PMID: 28965370 DOI: 10.1111/joor.12578] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Abstract
To determine whether maximum bite force (MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios (HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively (P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women.
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Affiliation(s)
- M Iwasaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.,Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | - A Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - N Sato
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Sato
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Minagawa
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Shimada
- Chiba Prefectural University of Health Sciences, Chiba, Japan
| | | | - T Ansai
- Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan
| | - Y Yoshitake
- Institute of Fitness and Sports in Kanoya, Kanoya, Japan
| | - T Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - H Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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24
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Ube T, Minagawa K, Ikeda T. Interpenetrating polymer networks of liquid-crystalline azobenzene polymers and poly(dimethylsiloxane) as photomobile materials. Soft Matter 2017; 13:5820-5823. [PMID: 28848977 DOI: 10.1039/c7sm01412k] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We developed photomobile polymer materials with interpenetrating polymer network (IPN) structures composed of crosslinked liquid-crystalline azobenzene polymer (PAzo) and poly(dimethylsiloxane) (PDMS). By introducing PDMS into a PAzo template network, IPN was formed without disturbing the alignment of mesogens in the PAzo network. The films showed macroscopic bending behavior upon irradiation with UV and visible light. Although the IPN film showed a phase separated structure, the bending speed was significantly enhanced compared with the pristine film of PAzo, thanks to the soft nature of PDMS. The present method of preparing IPNs can be a promising approach to combine PAzo with various polymers and enhance the mechanical and photoresponsive properties.
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Affiliation(s)
- T Ube
- Research and Development Initiative, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo 112-8551, Japan.
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25
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Minagawa K, Falcon CP, Matsui T. Very-Low-Dose Lenalidomide for Elderly and/or Frail Multiple Myeloma Patients: Lower Might Be Better. Acta Haematol 2017; 138:52-54. [PMID: 28723683 DOI: 10.1159/000478691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/14/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Kentaro Minagawa
- Bone Marrow Transplantation and Cell Therapy Unit, Department of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
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Minagawa K, Jamil MO, AL-Obaidi M, Pereboeva L, Salzman D, Erba HP, Lamb LS, Bhatia R, Mineishi S, Di Stasi A. In Vitro Pre-Clinical Validation of Suicide Gene Modified Anti-CD33 Redirected Chimeric Antigen Receptor T-Cells for Acute Myeloid Leukemia. PLoS One 2016; 11:e0166891. [PMID: 27907031 PMCID: PMC5132227 DOI: 10.1371/journal.pone.0166891] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/04/2016] [Indexed: 12/20/2022] Open
Abstract
Background Approximately fifty percent of patients with acute myeloid leukemia can be cured with current therapeutic strategies which include, standard dose chemotherapy for patients at standard risk of relapse as assessed by cytogenetic and molecular analysis, or high-dose chemotherapy with allogeneic hematopoietic stem cell transplant for high-risk patients. Despite allogeneic hematopoietic stem cell transplant about 25% of patients still succumb to disease relapse, therefore, novel strategies are needed to improve the outcome of patients with acute myeloid leukemia. Methods and findings We developed an immunotherapeutic strategy targeting the CD33 myeloid antigen, expressed in ~ 85–90% of patients with acute myeloid leukemia, using chimeric antigen receptor redirected T-cells. Considering that administration of CAR T-cells has been associated with cytokine release syndrome and other potential off-tumor effects in patients, safety measures were here investigated and reported. We genetically modified human activated T-cells from healthy donors or patients with acute myeloid leukemia with retroviral supernatant encoding the inducible Caspase9 suicide gene, a ΔCD19 selectable marker, and a humanized third generation chimeric antigen receptor recognizing human CD33. ΔCD19 selected inducible Caspase9-CAR.CD33 T-cells had a 75±3.8% (average ± standard error of the mean) chimeric antigen receptor expression, were able to specifically lyse CD33+ targets in vitro, including freshly isolated leukemic blasts from patients, produce significant amount of tumor-necrosis-factor-alpha and interferon-gamma, express the CD107a degranulation marker, and proliferate upon antigen specific stimulation. Challenging ΔCD19 selected inducible Caspase9-CAR.CD33 T-cells with programmed-death-ligand-1 enriched leukemia blasts resulted in significant killing like observed for the programmed-death-ligand-1 negative leukemic blasts fraction. Since the administration of 10 nanomolar of a non-therapeutic dimerizer to activate the suicide gene resulted in the elimination of only 76.4±2.0% gene modified cells in vitro, we found that co-administration of the dimerizer with either the BCL-2 inhibitor ABT-199, the pan-BCL inhibitor ABT-737, or mafosfamide, resulted in an additive effect up to complete cell elimination. Conclusions This strategy could be investigated for the safety of CAR T-cell applications, and targeting CD33 could be used as a ‘bridge” therapy for patients coming to allogeneic hematopoietic stem cell transplant, as anti-leukemia activity from infusing CAR.CD33 T-cells has been demonstrated in an ongoing clinical trial. Albeit never performed in the clinical setting, our future plan is to investigate the utility of iC9-CAR.CD33 T-cells as part of the conditioning therapy for an allogeneic hematopoietic stem cell transplant for acute myeloid leukemia, together with other myelosuppressive agents, whilst the activation of the inducible Caspase9 suicide gene would grant elimination of the infused gene modified T-cells prior to stem cell infusion to reduce the risk of engraftment failure as the CD33 is also expressed on a proportion of the donor stem cell graft.
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MESH Headings
- B7-H1 Antigen/pharmacology
- Biphenyl Compounds/pharmacology
- Bridged Bicyclo Compounds, Heterocyclic/pharmacology
- Caspase 9/genetics
- Caspase 9/immunology
- Cell Engineering
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Cellular Reprogramming
- Clinical Trials as Topic
- Cyclophosphamide/analogs & derivatives
- Cyclophosphamide/pharmacology
- Cytotoxicity, Immunologic
- Genetic Vectors
- Humans
- Interferon-gamma/biosynthesis
- Interferon-gamma/immunology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Lysosomal-Associated Membrane Protein 1/genetics
- Lysosomal-Associated Membrane Protein 1/immunology
- Myeloid Cells/drug effects
- Myeloid Cells/immunology
- Myeloid Cells/pathology
- Nitrophenols/pharmacology
- Piperazines/pharmacology
- Primary Cell Culture
- Receptors, Antigen, T-Cell/genetics
- Receptors, Antigen, T-Cell/immunology
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/immunology
- Sialic Acid Binding Ig-like Lectin 3/antagonists & inhibitors
- Sialic Acid Binding Ig-like Lectin 3/genetics
- Sialic Acid Binding Ig-like Lectin 3/immunology
- Sulfonamides/pharmacology
- T-Lymphocytes/cytology
- T-Lymphocytes/drug effects
- T-Lymphocytes/immunology
- Tumor Necrosis Factor-alpha/biosynthesis
- Tumor Necrosis Factor-alpha/immunology
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Affiliation(s)
- Kentaro Minagawa
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Muhammad O. Jamil
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Mustafa AL-Obaidi
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Larisa Pereboeva
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Donna Salzman
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Harry P. Erba
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Lawrence S. Lamb
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Ravi Bhatia
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Shin Mineishi
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Antonio Di Stasi
- Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, United States of America
- * E-mail:
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Yamaguchi Y, Torisu H, Kira R, Ishizaki Y, Sakai Y, Sanefuji M, Ichiyama T, Oka A, Kishi T, Kimura S, Kubota M, Takanashi J, Takahashi Y, Tamai H, Natsume J, Hamano S, Hirabayashi S, Maegaki Y, Mizuguchi M, Minagawa K, Yoshikawa H, Kira J, Kusunoki S, Hara T. A nationwide survey of pediatric acquired demyelinating syndromes in Japan. Neurology 2016; 87:2006-2015. [PMID: 27742816 PMCID: PMC5109945 DOI: 10.1212/wnl.0000000000003318] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 07/28/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the clinical and epidemiologic features of pediatric acquired demyelinating syndromes (ADS) of the CNS in Japan. METHODS We conducted a nationwide survey and collected clinical data on children with ADS aged 15 years or younger, who visited hospitals between 2005 and 2007. RESULTS Among 977 hospitals enrolled, 723 (74.0%) responded to our inquiries and reported a total of 439 patients as follows: 244 with acute disseminated encephalomyelitis (ADEM), 117 with multiple sclerosis (MS), 14 with neuromyelitis optica (NMO), and 64 with other ADS. We collected and analyzed detailed data from 204 cases, including those with ADEM (66), MS (58), and NMO (10). We observed the following: (1) the estimated annual incidence rate of pediatric ADEM in Japan was 0.40 per 100,000 children (95% confidence interval [CI], 0.34-0.46), with the lowest prevalence in the north; (2) the estimated prevalence rate of MS was 0.69 per 100,000 children (95% CI, 0.58-0.80), with the lowest prevalence in the south; (3) NMO in Japan was rare, with an estimated prevalence of 0.06 per 100,000 children (95% CI, 0.04-0.08); and (4) the sex ratio and mean age at onset varied by ADS type, and (5) male/female ratios correlated with ages at onset in each ADS group. CONCLUSIONS Our results clarify the characteristic clinical features of pediatric ADS in the Japanese population.
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Affiliation(s)
- Y Yamaguchi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Torisu
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
| | - R Kira
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Ishizaki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Sakai
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Sanefuji
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Ichiyama
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - A Oka
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Kimura
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Kubota
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Takanashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Takahashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Tamai
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Natsume
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Hamano
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Hirabayashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Maegaki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Mizuguchi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - K Minagawa
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Yoshikawa
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Kira
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Kusunoki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Hara
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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Minagawa K, Zhou X, Mineishi S, Di Stasi A. Seatbelts in CAR therapy: How Safe Are CARS? Pharmaceuticals (Basel) 2015; 8:230-49. [PMID: 26110321 PMCID: PMC4491658 DOI: 10.3390/ph8020230] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 04/29/2015] [Accepted: 05/04/2015] [Indexed: 12/29/2022] Open
Abstract
T-cells genetically redirected with a chimeric antigen receptor (CAR) to recognize tumor antigens and kill tumor cells have been infused in several phase 1 clinical trials with success. Due to safety concerns related to on-target/off-tumor effects or cytokine release syndrome, however, strategies to prevent or abate serious adverse events are required. Pharmacologic therapies; suicide genes; or novel strategies to limit the cytotoxic effect only to malignant cells are under active investigations. In this review, we summarize results and toxicities of investigations employing CAR redirected T-cells, with a focus on published strategies to grant safety of this promising cellular application.
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Affiliation(s)
- Kentaro Minagawa
- Bone Marrow Transplantation and Cellular Therapy, University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA.
| | - Xiaoou Zhou
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX 77030-2399, USA.
| | - Shin Mineishi
- Bone Marrow Transplantation and Cellular Therapy, University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA.
| | - Antonio Di Stasi
- Bone Marrow Transplantation and Cellular Therapy, University of Alabama at Birmingham, Birmingham, AL 35294-3300, USA.
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Di Stasi A, Jimenez AM, Minagawa K, Al-Obaidi M, Rezvani K. Review of the Results of WT1 Peptide Vaccination Strategies for Myelodysplastic Syndromes and Acute Myeloid Leukemia from Nine Different Studies. Front Immunol 2015; 6:36. [PMID: 25699052 PMCID: PMC4316779 DOI: 10.3389/fimmu.2015.00036] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
We performed a systematic review of data from nine clinical trials of WT1 peptide vaccination in patients with myelodysplastic syndromes and/or acute myeloid leukemia (MDS/AML), published between 2004 and 2012. A total of 51 patients were eligible for analysis. Vaccination with WT1 peptides proved safe and feasible in patients with MDS/AML, in studies from different institutions. Additionally, clinical responses and clinical benefit were observed, with some patients achieving and maintaining remission long-term (more than 8 years). A significant correlation between induction of WT1-specific T cells and normalization/reduction of WT1 mRNA levels and progression-free survival was noted in a number of studies. However, larger studies are warranted to confirm these results. Interestingly, the majority of trials reported the presence of WT1-specific T cells with limited or absent functionality prior to vaccination, which increased in frequency and function after vaccination. In conclusion, WT1 peptide vaccination strategies were safe in this heterogeneous group of patient with MDS/AML. Larger and more homogeneous studies or randomized clinical trials are needed to quantify the contribution of WT1 peptide vaccines to clinical responses and long-term survival.
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Affiliation(s)
- Antonio Di Stasi
- Stem Cell Transplantation and Cell Therapy Unit, The University of Alabama at Birmingham , Birmingham, AL , USA
| | - Antonio M Jimenez
- Stem Cell Transplantation and Cell Therapy Unit, Rush University Medical Center , Chicago, IL , USA
| | - Kentaro Minagawa
- Stem Cell Transplantation and Cell Therapy Unit, The University of Alabama at Birmingham , Birmingham, AL , USA
| | - Mustafa Al-Obaidi
- Stem Cell Transplantation and Cell Therapy Unit, The University of Alabama at Birmingham , Birmingham, AL , USA
| | - Katayoun Rezvani
- Stem Cell Transplantation and Cell Therapy Unit, The University of Texas MD Anderson Cancer Center , Houston, TX , USA
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Iida M, Fukuda T, Uchida N, Murata M, Aotsuka N, Minagawa K, Oohashi K, Fukushima K, Kondo T, Eto T, Miyamoto T, Morishima Y, Nagamura T, Atsuta Y, Suzuki R. Mycophenolate mofetil use after unrelated hematopoietic stem cell transplantation for prophylaxis and treatment of graft-vs.-host disease in adult patients in Japan. Clin Transplant 2014; 28:980-9. [PMID: 24943923 DOI: 10.1111/ctr.12405] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2014] [Indexed: 01/08/2023]
Abstract
Our previous study of 301 patients who received hematopoietic stem cell transplantation (HSCT) from related donors demonstrated the efficacy of mycophenolate mofetil (MMF) for prophylaxis and treatment of graft-vs.-host disease (GVHD). In this study, we investigated the safety and efficacy of MMF in 716 adult patients who received unrelated HSCT. The incidences of Grade II-IV and III-IV acute GVHD in the prophylactic administration group were 38.3% and 14.3%, respectively. These rates were not statistically significant when evaluating the MMF dosage and graft source. The incidences of limited and extensive chronic GVHD were 16.6% and 11.1%, respectively. In the therapeutic administration group, 69.1% of the subjective symptoms for both acute and chronic GVHD improved. With respect to the adverse events, 75 infections and 50 cases of diarrhea were observed, and the frequency of these events increased with increasing MMF dose. The overall survival rate was 36.4% after a median follow-up period of three yr. This study shows that MMF is safe and effective for the prevention and treatment of GVHD in patients who have received HSCT from unrelated donors.
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Affiliation(s)
- Minako Iida
- Department of HSCT Data Management and Biostatistics, Nagoya University School of Medicine, Nagoya, Japan; Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University School of Medicine, Aichi, Japan
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Kawano H, Suzuki T, Ishii S, Wakahashi K, Kawano Y, Sada A, Minagawa K, Takaya T, Yamashita T, Hirata KI, Koriyama K, Nagamatsu Y, Matsui T, Katayama Y. [Thrombopoietin receptor agonists administration for acute exacerbation of chronic idiopathic thrombocytopenic purpura and subsequent anticoagulant therapy for accompanying deep venous thrombosis of the lower limbs]. Rinsho Ketsueki 2014; 55:697-702. [PMID: 24975340] [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: 06/03/2023]
Abstract
We report two patients (70- and 49-year-old Japanese men) with acute exacerbation of chronic idiopathic thrombocytopenic purpura (ITP) and deep venous thrombosis of the lower extremities. Both were successfully managed with thrombopoietin receptor agonist (TPO-RA) administration. Both had ITP refractory to steroid treatment. Their immature platelet fraction (absolute-IPF) counts were increased and paralleled the platelet recoveries after TPO-RA (eltrombopag and romiplostim, respectively) without progression of thrombosis. Although ITP has recently been evaluated as a thrombophilic disorder, reports on acute exacerbation of ITP with newly diagnosed thrombosis are limited, and the pathophysiology and association between ITP and thrombosis remain to be elucidated. Moreover, the influences of TPO-RA on thrombosis are still controversial. To our knowledge, this is the first case report describing patients with exacerbation of ITP who developed thrombosis and were treated with TPO-RA. The outcomes of our cases underscore the importance of monitoring thrombosis and not delaying the initiation of anticoagulation treatment during the use of TPO-RA.
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Affiliation(s)
- Hiroki Kawano
- Department of Hematology, Kobe University Graduate School of Medicine
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Minagawa K, Iwasaki M, Ogawa H, Yoshihara A, Miyazaki H. Relationship between metabolic syndrome and periodontitis in 80-year-old Japanese subjects. J Periodontal Res 2014; 50:173-9. [DOI: 10.1111/jre.12190] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 01/22/2023]
Affiliation(s)
- K. Minagawa
- Division of Preventive Dentistry; Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - M. Iwasaki
- Division of Preventive Dentistry; Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - H. Ogawa
- Division of Preventive Dentistry; Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - A. Yoshihara
- Division of Oral Science for Health Promotion; Department of Oral Health and Welfare; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - H. Miyazaki
- Division of Preventive Dentistry; Department of Oral Health Science; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Minagawa K, Wakahashi K, Kawano H, Nishikawa S, Fukui C, Kawano Y, Asada N, Sato M, Sada A, Katayama Y, Matsui T. Posttranscriptional modulation of cytokine production in T cells for the regulation of excessive inflammation by TFL. J Immunol 2014; 192:1512-24. [PMID: 24415781 DOI: 10.4049/jimmunol.1301619] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Posttranscriptional machinery regulates inflammation and is associated with autoimmunity as well as tumorigenesis in collaboration with transcription factors. We previously identified the tumor suppressor gene transformed follicular lymphoma (TFL) on 6q25 in a patient with follicular lymphoma, which transformed into diffuse large B cell lymphoma. TFL families have a common RNase domain that governs macrophage-mediated inflammation. In human peripheral blood, TFL is dominantly expressed at the glycine- and tryptophan-rich cytoplasmic processing bodies of T lymphocytes, and it is persistently upregulated in activated T cells. To address its physiological role, we established TFL(-/-) mice in which TFL(-/-) lymphocytes proliferated more rapidly than TFL(+/+) upon stimulation with inappropriate cytokine secretion, including IL-2, IL-6, and IL-10. Moreover, TFL inhibited the synthesis of cytokines such as IL-2, IL-6, IL-10, TNF-α, and IL-17a by 3' untranslated region RNA degradation. Experimental autoimmune encephalitis induced in TFL(-/-) mice demonstrated persistent severe paralysis. CNS-infiltrated CD4(+) T cells in TFL(-/-) mice contained a higher proportion of Th17 cells than did those in TFL(+/+) mice during the resolution phase, and IL-17a mRNA levels were markedly increased in TFL(-/-) cells. These results suggest that TFL may play an important role in attenuating local inflammation by suppressing the infiltration of Th17 cells in the CNS during the resolution phase of experimental autoimmune encephalitis. TFL is a novel gradual and persistent posttranscriptional regulator, and the TFL-driven attenuation of excessive inflammation could contribute to recovery from T cell-mediated autoimmune diseases.
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Affiliation(s)
- Kentaro Minagawa
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Kawano H, Suzuki T, Ishii S, Wakahashi K, Kawano Y, Sada A, Minagawa K, Ueno D, Yamasaki T, Itoh T, Yokozaki H, Katayama Y. Recurrence of abdominal large-vessel vasculitis and development of severe Sweet syndrome after a single cycle of 5-azacytidine in a patient with myelodysplastic syndrome. Eur J Haematol 2014; 92:362-4. [DOI: 10.1111/ejh.12249] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hiroki Kawano
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Tomohide Suzuki
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Shinichi Ishii
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Kanako Wakahashi
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Yuko Kawano
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Akiko Sada
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Kentaro Minagawa
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Daisuke Ueno
- Diagnostic Pathology; Kobe University Hospital; Chuo-ku Kobe Japan
| | - Takashi Yamasaki
- Diagnostic Pathology; Kobe University Hospital; Chuo-ku Kobe Japan
| | - Tomoo Itoh
- Diagnostic Pathology; Kobe University Hospital; Chuo-ku Kobe Japan
| | - Hiroshi Yokozaki
- Pathology; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
| | - Yoshio Katayama
- Hematology; Department of Medicine; Kobe University Graduate School of Medicine; Chuo-ku Kobe Japan
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Kanamori H, Mizuta S, Kako S, Kato H, Nishiwaki S, Imai K, Shigematsu A, Nakamae H, Tanaka M, Ikegame K, Yujiri T, Fukuda T, Minagawa K, Eto T, Nagamura-Inoue T, Morishima Y, Suzuki R, Sakamaki H, Tanaka J. Reduced-intensity allogeneic stem cell transplantation for patients aged 50 years or older with B-cell ALL in remission: a retrospective study by the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation. Bone Marrow Transplant 2013; 48:1513-8. [DOI: 10.1038/bmt.2013.140] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 07/18/2013] [Accepted: 07/29/2013] [Indexed: 11/12/2022]
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Koeda M, Takizawa Y, Minagawa K, Yamamoto M, Ichimiya T, Tateno A, Belin P, Okubo Y. A CASE OF ORGANIC AMNESIC DISORDER SYNDROME DIAGNOSED WITH FMRI. J Neurol Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306103.27] [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: 11/04/2022]
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38
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Kawano H, Wakahashi K, Ebara S, Ishii S, Suzuki T, Kawano Y, Sada A, Minagawa K, Matsui T, Kawakami F, Hayashi Y, Itoh T, Katayama Y. Unusual hepatic involvement with significant fibrosis in adult T cell leukemia. Ann Hematol 2013; 93:897-8. [PMID: 23942637 DOI: 10.1007/s00277-013-1875-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 08/01/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan,
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Asada N, Katayama Y, Sato M, Minagawa K, Wakahashi K, Kawano H, Kawano Y, Sada A, Ikeda K, Matsui T, Tanimoto M. Matrix-Embedded Osteocytes Regulate Mobilization of Hematopoietic Stem/Progenitor Cells. Cell Stem Cell 2013; 12:737-47. [DOI: 10.1016/j.stem.2013.05.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Revised: 03/28/2013] [Accepted: 05/01/2013] [Indexed: 10/26/2022]
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Abstract
Abstract
We studied in detail the effects of pressure and shear stress on the crystallization behaviors during injection molding process. Crystallization of isotactic-polypropylene (iPP) was simulated for various injection flow rates. The crystallization started during the filling stage under long filling condition. Moreover, the crystallization in some layers showed two -step growth behavior, while in other layers the crystallization does not progress during the packing -cooling stage. Since pressure becomes very high during molding process under long filling time condition, the change of pressure is the most important factor governing the crystallization.
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Affiliation(s)
- H. Ito
- Department of Material and Biological Engineering, Tsuruoka National College of Technology, Tsuruoka, Japan
| | - K. Minagawa
- Department of Chemical Science and Technology, The University of Tokushima, Tokushima, Japan
| | - J. Takimoto
- Department of Materials Science and Engineering, Yamagata University, Yonezawa, Japan
| | - K. Tada
- Plamedia Research Corporation, Tokyo, Japan
| | - K. Koyama
- Department of Materials Science and Engineering, Yamagata University, Yonezawa, Japan
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Tanaka J, Kanamori H, Nishiwaki S, Ohashi K, Taniguchi S, Eto T, Nakamae H, Minagawa K, Miyamura K, Sakamaki H, Morishima Y, Kato K, Suzuki R, Nishimoto N, Oba K, Masauzi N. Reduced-intensity vs myeloablative conditioning allogeneic hematopoietic SCT for patients aged over 45 years with ALL in remission: a study from the Adult ALL Working Group of the Japan Society for Hematopoietic Cell Transplantation (JSHCT). Bone Marrow Transplant 2013; 48:1389-94. [PMID: 23665820 DOI: 10.1038/bmt.2013.68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 03/05/2013] [Accepted: 04/08/2013] [Indexed: 11/09/2022]
Abstract
In this study, outcomes for 575 adult ALL patients aged ≥45 years who underwent first allo-SCT in CR were analyzed according to the type of conditioning regimen (myeloablative conditioning (MAC) for 369 patients vs reduced-intensity conditioning (RIC) for 206 patients). Patients in the RIC group were older (median age, 58 vs 51 years, P<0.0001). There were no statistically significant differences in 3-year OS, disease-free survival (DFS) and non-relapse mortality (NRM): 51% vs 53%, 47% vs 39% and 38% vs 36%, respectively. Multivariate analysis showed that CR2 and HLA mismatching were associated with poor OS (P=0.002 and P=0.019, respectively). HLA mismatching was associated with lower rate of relapse (P=0.016), but was associated with higher rate of NRM (P=0.001). RIC was associated with good OS and DFS in patients who received HLA-mismatch transplantation and were aged ≥55 years compared with MAC by multivariate analysis for each event with interaction (hazard ratio (HR) and 95% confidence interval 0.35 and 0.15-0.81, P=0.014 for OS and 0.36 and 0.16-0.81, P=0.013 for DFS). Therefore, patients ≥55 years of age with HLA-mismatch transplantation should be candidates for RIC rather than MAC.
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Affiliation(s)
- J Tanaka
- Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Minagawa K, Kawano H, Suzuki T, Inagaki T, Kishi M, Hirata T, Kimura S, Takechi M, Koide T, Iwai M, Katayama Y, Matsui T. [Very low-dose lenalidomide therapy for elderly multiple myeloma patients]. Rinsho Ketsueki 2013; 54:457-462. [PMID: 23727684] [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: 06/02/2023]
Abstract
Lenalidomide treatment for refractory or relapsed multiple myeloma in elderly patients may be feasible in an outpatient setting. However, difficulties have been associated with the management of adverse effects. Therefore, a dose reduction in lenalidomide has been recommended in some cases. In this report, we encountered the successful treatment of myeloma in 6 elderly patients (aged above 70 years) with very low-dose lenalidomide (5 mg daily). Four patients exhibited more than a partial response with an 8.6 months median follow-up period, which was comparable with previous findings. The major adverse effect observed was infection, which occurred during the first several cycles. Others were less toxic, especially the absence of grade 3/4 toxicities for hematological adverse effects.Although a dose reduction in lenalidomide therapy for elderly patients is controversial, a very low dose could be safe and effective. Our group is currently conducting a multi-center prospective trial to evaluate the efficacy of low-dose lenalidomide therapy.
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Affiliation(s)
- Kentaro Minagawa
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine
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Kawano H, Minagawa K, Wakahashi K, Kawano Y, Sada A, Matsui T, Katayama Y. [Diminished expression of CD5 and/or CD7 surface antigens as the first clue of diagnosis for monoclonal T lymphocytosis]. Rinsho Ketsueki 2012; 53:785-787. [PMID: 22975821] [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: 06/01/2023]
Abstract
The significance of precursor status for mature T-cell neoplasms has not been elucidated. Diagnosis of T-cell neoplasms is often challenging and sometimes overlooked when leukocytosis is not evident and neoplastic cell morphology is hardly distinguishable. Here, we report two cases of monoclonal T lymphocytosis (MTL) without evident lymphocytosis and lymphadenopathies that show slightly diminished CD5 and/or CD7 surface antigens as the first clue of diagnosis. Recently, some reports have demonstrated the possibility that monoclonal lymphocytosis precedes leukemia/lymphoma. Although its clinical significance is unknown, flow cytometric analysis of peripheral blood is useful for detection of occult MTL and careful follow-up is required.
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Kawano H, Katayama Y, Minagawa K, Shimoyama M, Henkemeyer M, Matsui T. A novel feedback mechanism by Ephrin-B1/B2 in T-cell activation involves a concentration-dependent switch from costimulation to inhibition. Eur J Immunol 2012; 42:1562-72. [PMID: 22622783 DOI: 10.1002/eji.201142175] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/25/2012] [Accepted: 02/16/2012] [Indexed: 11/10/2022]
Abstract
Bidirectional signals via Eph receptors/ephrins have been recognized as major forms of contact-dependent cell communications such as cell attraction and repulsion. T cells express EphBs, and their ligands, the ephrin-Bs, have been known as costimulatory molecules for T-cell proliferation. Recently, another remarkable feature of ephrin-As has emerged in the form of a concentration-dependent transition from promotion to inhibition in axon growth. Here we examined whether this modification plays a role in ephrin-B costimulation in murine primary T cells. Low doses of ephrin-B1 and ephrin-B2 costimulated T-cell proliferation induced by anti-CD3, but high concentrations strongly inhibited it. In contrast, ephrin-B3 showed a steadily increasing stimulatory effect. This modulation was virtually preserved in T cells from mice simultaneously lacking four genes, EphB1, EphB2, EphB3, and EphB6. High concentrations of ephrin-B1/B2, but not ephrin-B3, inhibited the anti-CD3-induced phosphorylation of Lck and its downstream signals such as Erk and Akt. Additionally, high doses of any ephrin-Bs could phosphorylate EphB4. However, only ephrin-B1/B2 but not ephrin-B3 recruited SHP1, a phosphatase to suppress the phosphorylation of Lck. These data suggest that EphB4 signaling could engage in negative feedback to TCR signals. T-cell activation may be finely adjusted by the combination and concentration of ephrin-Bs expressed in the immunological microenvironment.
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Affiliation(s)
- Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
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45
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Kawano H, Minagawa K, Wakahashi K, Kawano Y, Sada A, Matsui T, Hirano H, Shiomi H, Ku Y, Katayama Y. Successful management of obstructive jaundice due to gallstones with eculizumab in a patient with paroxysmal nocturnal hemoglobinuria. Intern Med 2012; 51:2613-6. [PMID: 22989836 DOI: 10.2169/internalmedicine.51.8202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) makes patients susceptible to intravascular hemolysis and thrombosis, and it can be life-threatening in stressful situations. Eculizumab, a humanized monoclonal antibody that inhibits the complement protein C5, has been evaluated as a novel therapy for PNH. We herein describe the case of a 59-year-old Japanese woman with classic PNH, who had been successfully treated with eculizumab, but who later developed acute cholecystitis/cholangitis from gallstones. Although the severe obstructive jaundice requiring endoscopic therapy following cholecystectomy was complicated, critical intravascular hemolysis and thrombosis were not observed. Therefore, utilizing eculizumab during the peri-operative management of PNH patients should be carefully taken into consideration.
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Affiliation(s)
- Hiroki Kawano
- Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
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46
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Huang S, Qi D, Liang J, Miao R, Minagawa K, Quinn T, Matsui T, Fan D, Liu J, Fu M. The putative tumor suppressor Zc3h12d modulates toll-like receptor signaling in macrophages. Cell Signal 2011; 24:569-576. [PMID: 22036805 DOI: 10.1016/j.cellsig.2011.10.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 09/27/2011] [Accepted: 10/11/2011] [Indexed: 01/17/2023]
Abstract
Toll-like receptors (TLR) are pivotal in macrophage activation. The molecular mechanisms controlling TLR signaling and macrophage activation are not completely understood. Zc3h12d is originally identified as a possible tumor suppressor gene. However, its function remains unknown. We here report that Zc3h12d negatively regulates TLR signaling and macrophage activation. Zc3h12d was enriched in spleen, lung and lymph node. In macrophages, the expression of Zc3h12d was remarkably induced by TLR ligands through JNK and NF-κB signal pathways. On the other hand, overexpression of Zc3h12d significantly inhibited TLR2 and TLR4 activation-induced JNK, ERK and NF-κB signaling as well as macrophage inflammation. Similar to Zc3h12a/MCPIP1, Zc3h12d also decreased the global cellular protein ubiquitination. These findings suggest that Zc3h12d is a novel negative feedback regulator of TLR signaling and macrophage activation and thus may play a role in host immunity and inflammatory diseases.
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Affiliation(s)
- Shengping Huang
- Shock/Trauma Research Center & Department of Basic Medical Science, School of Medicine, University of Missouri Kansas City, MO 64108, United States
| | - Dongfei Qi
- Shock/Trauma Research Center & Department of Basic Medical Science, School of Medicine, University of Missouri Kansas City, MO 64108, United States
| | - Jian Liang
- Burnett School of Biological Science, College of Medicine, University of Central Florida, Orlando, FL 32816, United States
| | - Ruidong Miao
- Shock/Trauma Research Center & Department of Basic Medical Science, School of Medicine, University of Missouri Kansas City, MO 64108, United States
| | | | - Tim Quinn
- Shock/Trauma Research Center & Department of Basic Medical Science, School of Medicine, University of Missouri Kansas City, MO 64108, United States
| | | | - Daping Fan
- Department of Cell Biology and Anatomy, University of South Carolina, Columbia, SC 29209, United States
| | - Jianguo Liu
- Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, United States
| | - Mingui Fu
- Shock/Trauma Research Center & Department of Basic Medical Science, School of Medicine, University of Missouri Kansas City, MO 64108, United States.
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Taniguchi K, Okada M, Yoshihara S, Sawada A, Tokugawa T, Ishii S, Kaida K, Ikegame K, Minagawa K, Matsui T, Ogawa H. Strategy for bone marrow transplantation in eculizumab-treated paroxysmal nocturnal hemoglobinuria. Int J Hematol 2011; 94:403-407. [PMID: 21927799 DOI: 10.1007/s12185-011-0931-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 08/25/2011] [Accepted: 08/26/2011] [Indexed: 11/28/2022]
Abstract
Although the recent introduction of eculizumab has had a significant impact on the management of paroxysmal nocturnal hemoglobinuria (PNH), bone marrow transplantation (BMT) remains the only therapeutic option for patients who develop severe aplasia in the clinical course of PNH. However, information regarding BMT for eculizumab-treated PNH patients is scarce, and two major points-the optimal duration of eculizumab therapy, and the optimal BMT conditioning regimen-remain unclear. Here, we describe the clinical course of a PNH patient who was successfully treated with unrelated reduced-intensity BMT. Eculizumab was discontinued 2 weeks prior to the initiation of the conditioning regimen, which consisted of fludarabine 180 mg/m(2), cyclophosphamide 100 mg/kg, rabbit anti-thymocyte globulin 2 mg/kg, and TBI 3 Gy. Complete donor chimerism was rapidly achieved in association with a rapid decrease in the proportion of PNH erythrocytes. The patient became transfusion-free immediately after BMT, and had no recurrence of hemolysis. The present case suggests that discontinuation of eculizumab before BMT and the use of a highly lymphoablative conditioning regimen may act as a successful treatment strategy in BMT for PNH. Further studies are warranted to evaluate the efficacy and safety of this treatment strategy.
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Affiliation(s)
- Kyoko Taniguchi
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Masaya Okada
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Satoshi Yoshihara
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| | - Akihiro Sawada
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Tazuko Tokugawa
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Shinichi Ishii
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Katsuji Kaida
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kazuhiro Ikegame
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Kentaro Minagawa
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Division of Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyasu Ogawa
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
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48
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Wakahashi K, Yamamori M, Minagawa K, Ishii S, Nishikawa S, Shimoyama M, Kawano H, Kawano Y, Kawamori Y, Sada A, Matsui T, Katayama Y. Pharmacokinetics-based optimal dose prediction of donor source-dependent response to mycophenolate mofetil in unrelated hematopoietic cell transplantation. Int J Hematol 2011; 94:193-202. [DOI: 10.1007/s12185-011-0888-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 06/14/2011] [Accepted: 06/14/2011] [Indexed: 11/28/2022]
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49
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Okamura A, Shimoyama M, Ishii S, Wakahashi K, Asada N, Kawano H, Kawamori Y, Nishikawa S, Minagawa K, Katayama Y, Matsui T. Delayed neutrophil engraftment in cord blood transplantation with intensive administration of mycophenolate mofetil for GVHD prophylaxis. Bone Marrow Transplant 2010; 46:148-9. [PMID: 20228852 DOI: 10.1038/bmt.2010.59] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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50
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Minagawa K, Matsui T. p58TFL Does Not Localize to Messenger RNA Processing Bodies - Response. Mol Cancer Res 2010. [DOI: 10.1158/1541-7786.mcr-09-0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kentaro Minagawa
- Hematology/Oncology, Department of Medicine, Kobe University, Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Hematology/Oncology, Department of Medicine, Kobe University, Graduate School of Medicine, Kobe, Japan
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