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Manabe M, Inano N, Hagiwara Y, Sogabe N, Nanno S, Mazaki T, Koh K. Cancer-related thrombotic microangiopathy and disseminated intravascular coagulation in a patient with bone marrow carcinomatosis of unknown primary origin: A case report. Cancer Rep (Hoboken) 2024; 7:e2036. [PMID: 38517451 PMCID: PMC10959179 DOI: 10.1002/cnr2.2036] [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: 09/15/2023] [Revised: 02/13/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Cancer-related thrombotic microangiopathy (CR-TMA) is a rare type of Coombs-negative hemolytic anemia, which is caused by malignancy and has a poor prognosis. CASE A 76-year-old female was referred to our hospital due to Coombs-negative hemolytic anemia, which was causing fatigue and dyspnea on exertion, accompanied by schistocytosis. A bone marrow examination demonstrated bone marrow carcinomatosis, and the tumor cells were morphologically suspected to be signet-ring cell carcinoma cells. As we failed to find the primary tumor site before the patient died, she was diagnosed with CR-TMA due to bone marrow carcinomatosis of unknown primary origin. Thrombotic thrombocytopenic purpura (TTP) was rapidly ruled out based on her PLASMIC score. In addition, immunohistochemical staining of a clot section of the bone marrow and tumor marker data were useful for narrowing down the likely primary tumor site. CONCLUSION Although CR-TMA is an extremely rare phenomenon, clinicians who suspect CR-TMA should quickly rule out TTP and decide whether to provide appropriate chemotherapy or plan for palliative care.
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Affiliation(s)
- Masahiro Manabe
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Naoyuki Inano
- Department of Clinical LaboratoryOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Yuuji Hagiwara
- Department of Clinical LaboratoryOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Nobuhiro Sogabe
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Satoru Nanno
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Takeshi Mazaki
- Department of PathologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Ki‐Ryang Koh
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
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Manabe M, Tani Y, Inano N, Hagiwara Y, Sogabe N, Nanno S, Koh KR. Acute myeloid leukemia post‑cytotoxic therapy following chemotherapy for thymoma: A case report. Med Int (Lond) 2024; 4:9. [PMID: 38283133 PMCID: PMC10811442 DOI: 10.3892/mi.2024.133] [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] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
The present study reports the case of a patient with acute myeloid leukemia post-cytotoxic therapy (AML-pCT) that developed following chemotherapy for thymoma. A 64-year-old female patient underwent surgical resection for a mediastinal tumor and was diagnosed with stage IVa thymoma. She received chemotherapy, including carboplatin/etoposide, carboplatin/paclitaxel and amrubicin monotherapy. At 56 months following surgery, she developed blastosis and was diagnosed with AML-pCT. As demonstrated herein, although treatment for thymoma is associated with a markedly lower frequency of myeloid neoplasms post-cytotoxic therapy (MN-pCT) than treatment for other malignancies, such as breast carcinoma, it is important to be aware that MN-pCT may occur as a late complication of thymoma treatment.
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Affiliation(s)
- Masahiro Manabe
- Department of Hematology, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
| | - Yoko Tani
- Department of Clinical Oncology, Osaka Metropolitan University Graduate School of Medicine, Osaka 545-8585, Japan
| | - Naoyuki Inano
- Department of Clinical Laboratory, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
| | - Yuuji Hagiwara
- Department of Clinical Laboratory, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
| | - Nobuhiro Sogabe
- Department of Hematology, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
| | - Satoru Nanno
- Department of Hematology, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
| | - Ki-Rhang Koh
- Department of Hematology, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, Japan
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Kin A, Manabe M, Sogabe N, Nanno S, Hatanaka S, Morimoto K, Yoneda Y, Mazaki T, Koh KR. [Onset of Testicular Plasmacytoma in a Patient with Refractory Multiple Myeloma]. Gan To Kagaku Ryoho 2023; 50:1347-1349. [PMID: 38247079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
A 72-year-old male patient, who had been on chemotherapy for the treatment of IgG-λ multiple myeloma, presented an enlargement of the testis 3 years and 5 months after the diagnosis. High orchiectomy was then performed, leading to the diagnosis of plasmacytoma. Due to residual disease, treatment with a combination of isatuximab and dexamethasone was initiated. The patient is currently under follow-up without recurrence. While testicular tumors are difficult to diagnose by imaging studies alone and extramedullary plasmacytomas rarely occur in the testis, pathological assessment is critical for treatment planning.
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Affiliation(s)
- Akiko Kin
- Dept. of Hematology, Osaka General Hospital of West Japan Railway Company
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Manabe M, Sogabe N, Nanno S, Hagiwara Y, Asada R, Koh K. Dutcher bodies in an IgA-myeloma patient harbouring the FGFR3/ IGH fusion. EJHaem 2023; 4:528-529. [PMID: 37206264 PMCID: PMC10188451 DOI: 10.1002/jha2.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Masahiro Manabe
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Nobuhiro Sogabe
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Satoru Nanno
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Yuuji Hagiwara
- Department of Clinical LaboratoryOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Reiko Asada
- Department of Clinical LaboratoryOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Ki‐Ryang Koh
- Department of HematologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
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Nishimoto M, Sogabe N, Hino M. Visceral disseminated varicella zoster virus infection following COVID-19 vaccination in an allogeneic stem cell transplant recipient. Transpl Infect Dis 2022; 24:e13810. [PMID: 35213772 PMCID: PMC9115351 DOI: 10.1111/tid.13810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mitsutaka Nishimoto
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Nobuhiro Sogabe
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masayuki Hino
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Sogabe N, Kuno M, Nakagama Y, Makuuchi Y, Harada N, Takakuwa T, Okamura H, Hirose A, Nishimoto M, Nakashima Y, Koh H, Nakamae M, Kido Y, Nakamae H, Hino M. [Warm autoimmune hemolytic anemia and IgM-monoclonal gammopathy following BNT162b2 COVID-19 vaccine in a patient with splenic marginal zone lymphoma]. Rinsho Ketsueki 2022; 63:1379-1385. [PMID: 36351643 DOI: 10.11406/rinketsu.63.1379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
There is currently no evidence that a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine might be associated with the development of autoimmune hemolytic anemia or disease progression in patients with mature B-cell neoplasm. Our patient was a 71-year-old man with indolent mature B-cell neoplasm who had been monitored for many years without treatment. After receiving the second dose of the BNT162b2 mRNA COVID-19 vaccine, he developed severe warm autoimmune hemolytic anemia. Although steroid therapy improved his anemia, he continued to develop IgM-monoclonal gammopathy, renal insufficiency, and splenomegaly. He was diagnosed with splenic marginal zone lymphoma after undergoing splenectomy. The splenectomy improved the patient's symptoms. We assessed his SARS-CoV-2 specific antibody response, but the patient's serologic response to the vaccine was impaired. In patients with mature B-cell neoplasm, a non-specific immune response after vaccination might be associated with paraneoplastic syndromes.
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Affiliation(s)
- Nobuhiro Sogabe
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Masatomo Kuno
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Yu Nakagama
- Department of Parasitology & Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University
| | - Yosuke Makuuchi
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Naonori Harada
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Teruhito Takakuwa
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Hiroshi Okamura
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Asao Hirose
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Mitsutaka Nishimoto
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Yasuhiro Nakashima
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Hideo Koh
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Mika Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Yasutoshi Kido
- Department of Parasitology & Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka City University
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University
| | - Masayuki Hino
- Department of Hematology, Graduate School of Medicine, Osaka City University
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Takakuwa T, Ohta K, Sogabe N, Nishimoto M, Kuno M, Makuuchi Y, Okamura H, Nakashima Y, Koh H, Nakamae H, Hino M. Isatuximab plus Pomalidomide and Dexamethasone in a Patient with Dialysis-Dependent Multiple Myeloma. Chemotherapy 2021; 66:192-195. [PMID: 34710867 DOI: 10.1159/000519783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/18/2021] [Indexed: 11/19/2022]
Abstract
The phase 3 ICARIA-MM trial showed that the addition of isatuximab improved the progression-free survival compared with pomalidomide/dexamethasone. However, the safety and efficacy of isatuximab for end-stage renal failure remains unclear. A 67-year-old man who started hemodialysis 5 years ago for diabetic nephropathy was diagnosed with International Staging System stage III multiple myeloma (MM) of IgD-λ type 3 years ago. After receiving a total of 7 treatment regimens, his free light chain (FLC) λ level increased from 419 to 2,070 mg/L, indicating progressive disease. Twelve days after starting isatuximab plus pomalidomide (3 mg daily) and dexamethasone (IsaPd), his FLC λ level rapidly decreased to 412 mg/L. The patient has now completed 7 courses of IsaPd with no adverse events, including infusion reactions and neutropenia. Isatuximab requires a lower dilution volume than daratumumab and can be safely and effectively administered to hemodialysis-dependent MM patients.
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Affiliation(s)
- Teruhito Takakuwa
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | | | - Nobuhiro Sogabe
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Mitsutaka Nishimoto
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masatomo Kuno
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yosuke Makuuchi
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiroshi Okamura
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hideo Koh
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masayuki Hino
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
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Sogabe N, Sawada SS, Lee IM, Kawakami R, Ishikawa-Takata K, Nakata Y, Mitomi M, Noguchi J, Tsukamoto K, Miyachi M, Blair SN. Weight change after 20 years of age and the incidence of dyslipidemia: a cohort study of Japanese male workers. J Public Health (Oxf) 2015. [PMID: 26199305 DOI: 10.1093/pubmed/fdv089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While heavier weight is known to increase the incidence of dyslipidemia, limited data are available on the relationship between weight gain and its development. METHODS A total of 2647 males were categorized into the following four groups according to the difference between their self-reported weight at 20 years of age and their measured weight in 1994-95: a loss of ≥5% (decrease), loss of <5% or gain of <5% (no change), gain of ≥5 to <15% (increase) and gain of ≥15% (sizable increase). They were followed up until their 2002-03 health examination. Using the 'no change' group as reference, the multivariable-adjusted odds ratio (adjusted for age, body mass index at 20 years of age, physical activity, smoking and alcohol intake) and 95% confidence interval (95% CI) for the incidence of dyslipidemia were determined using logistic regression models. RESULTS A total of 1342 participants developed dyslipidemia during the follow-up period. The 'increase' and 'sizable increase' groups had odds ratios for the incidence of dyslipidemia of 1.97 (95% CI, 1.59-2.45) and 2.68 (2.15-3.34), respectively, demonstrating that there was a significant dose-response association between weight gain since 20 years of age and the incidence of dyslipidemia (P < 0.001 for trend). CONCLUSION These results suggest that dyslipidemia could be prevented by avoiding weight gain in adulthood.
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Affiliation(s)
- N Sogabe
- Department of Health and Nutrition Sciences, Faculty of Human Health, Komazawa Women's University, Tokyo, Japan
| | - S S Sawada
- Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan
| | - I-M Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - R Kawakami
- Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - K Ishikawa-Takata
- Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo, Japan
| | - Y Nakata
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - M Mitomi
- Department of Safety and Health, Tokyo Gas Co. Ltd., Tokyo, Japan
| | - J Noguchi
- Department of Safety and Health, Tokyo Gas Co. Ltd., Tokyo, Japan
| | - K Tsukamoto
- Department of Safety and Health, Tokyo Gas Co. Ltd., Tokyo, Japan
| | - M Miyachi
- Department of Health Promotion and Exercise, National Institute of Health and Nutrition, Tokyo, Japan
| | - S N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Sugano T, Nishimura K, Sogabe N, Shiota M, Oyama N, Noda S, Ohta M. Ca2+-dependent activation of the malate-aspartate shuttle by norepinephrine and vasopressin in perfused rat liver. Arch Biochem Biophys 1988; 264:144-54. [PMID: 2899418 DOI: 10.1016/0003-9861(88)90579-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The role of Ca2+ in stimulation of the malate-aspartate shuttle by norepinephrine and vasopressin was studied in perfused rat liver. Shuttle capacity was indexed by measuring the changes in both the rate of production of glucose from sorbitol and the ratio of lactate to pyruvate during the oxidation of ethanol. (T. Sugano et al. (1986) Amer. J. Physiol. 251, E385-E392). Asparagine (0.5 mM), but not alanine (0.5 mM) decreased the ethanol-induced responses. Norepinephrine and vasopressin had no effect on the ethanol-induced responses when the liver was perfused with sorbitol or glycerol. In the presence of 0.25 mM alanine, norepinephrine, vasopressin, and A23187 decreased the ethanol-induced responses that occurred with the increase of flux of Ca2+. In liver perfused with Ca2+-free medium, asparagine also decreased the ethanol-induced responses, but norepinephrine and vasopressin had no effect. Aminooxyacetate inhibited the effects of norepinephrine, A23187, and asparagine. Regardless of the presence or absence of perfusate Ca2+, the combination of glucagon and alanine had no effect on the ethanol-induced responses. Norepinephrine caused a decrease in levels of alpha-ketoglutarate, aspartate, and glutamate in hepatocytes incubated with Ca2+. The present data suggest that the redistribution of cellular Ca2+ may activate the efflux of aspartate from mitochondria in rat liver, resulting in an increase in the capacity of the malate-aspartate shuttle.
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Affiliation(s)
- T Sugano
- Department of Veterinary Physiology, College of Agriculture, University of Osaka, Japan
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