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Rokutan H, Arai Y, Kunita A, Yamasaki S, Nakamura H, Hama N, Nakayama A, Hosoda F, Totoki Y, Fujishiro M, Seto Y, Shibata T, Ushiku T. Genomic and Pathologic Profiling of Very Well-Differentiated Gastric Adenocarcinoma of Intestinal Type: A Study With Emphasis on Diffuse-Type Transformation. Am J Surg Pathol 2024:00000478-990000000-00326. [PMID: 38584451 DOI: 10.1097/pas.0000000000002222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Very well-differentiated adenocarcinoma of intestinal type is a distinct subtype of gastric cancer characterized by anastomosing glands with a hand-in-hand pattern and low-grade cytologic atypia resembling intestinal metaplasia. This is a slow-growing neoplasm with an indolent clinical course; however, a subset demonstrates transformation into adenocarcinoma with higher-grade histology, typically diffuse-type carcinoma, and behaves aggressively. This study aimed to better characterize the genomic and pathologic features, with a focus on factors associated with diffuse-type transformation. A total of 58 cases with (n=31) and without (n=27) diffuse-type transformation were analyzed for molecular and pathologic features. First, comprehensive deep DNA sequencing was conducted in 18 cases (discovery cohort), followed by a digital droplet polymerase chain reaction of hot spot RHOA mutations in 40 cases (validation cohort). In total, RHOA mutations were the most common alteration (34%), followed by loss of ARID1A (12%), p53 alterations (10%), and CLDN18::ARHGAP26/6 fusions (3.4%). FGFR2 amplification was identified in an advanced case with a p53 alteration. Altered p53 expression was recognized only in higher-grade components and was significantly associated with advanced disease (P=0.0015) and diffuse-type transformation (P=0.026). A mixed mucin phenotype was also strongly correlated with advanced disease (P<0.001) and diffuse-type transformation (P<0.001). Decreased E-cadherin expression was frequently observed (74%) in poorly cohesive components. This study demonstrated that a subset of RHOA-mutant diffuse-type gastric cancers develops through the transformation of very well-differentiated adenocarcinoma of intestinal type. Our observations suggest a mixed mucin phenotype as a risk factor and alterations in p53 and E-cadherin as drivers of diffuse-type transformation.
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Affiliation(s)
| | - Yasuhito Arai
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
| | | | - Satoshi Yamasaki
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo
| | - Hiromi Nakamura
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
| | - Natsuko Hama
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
| | | | - Fumie Hosoda
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
| | - Yasushi Totoki
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
- Department of Cancer Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Tokyo, Japan
| | | | | | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo
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Notoh H, Yamasaki S, Suzuki N, Suzuki A, Okamoto S, Kanematsu T, Suzuki N, Katsumi A, Kojima T, Matsushita T, Tamura S. Basement membrane extract potentiates the endochondral ossification phenotype of bone marrow-derived mesenchymal stem cell-based cartilage organoids. Biochem Biophys Res Commun 2024; 701:149583. [PMID: 38330731 DOI: 10.1016/j.bbrc.2024.149583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
Endochondral ossification is a developmental process in the skeletal system and bone marrow of vertebrates. During endochondral ossification, primitive cartilaginous anlages derived from mesenchymal stem cells (MSCs) undergo vascular invasion and ossification. In vitro regeneration of endochondral ossification is beneficial for research on the skeletal system and bone marrow development as well as their clinical aspects. However, to achieve the regeneration of endochondral ossification, a stem cell-based artificial cartilage (cartilage organoid, Cart-Org) that possesses an endochondral ossification phenotype is required. Here, we modified a conventional 3D culture method to create stem cell-based Cart-Org by mixing it with a basement membrane extract (BME) and further characterized its chondrogenic and ossification properties. BME enlarged and matured the bone marrow MSC-based Cart-Orgs without any shape abnormalities. Histological analysis using Alcian blue staining showed that the production of cartilaginous extracellular matrices was enhanced in Cart-Org treated with BME. Transcriptome analysis using RNA sequencing revealed that BME altered the gene expression pattern of Cart-Org to a dominant chondrogenic state. BME triggered the activation of the SMAD pathway and inhibition of the NK-κB pathway, which resulted in the upregulation of SOX9, COL2A1, and ACAN in Cart-Org. BME also facilitated the upregulation of genes associated with hypertrophic chondrocytes (IHH, PTH1R, and COL10A1) and ossification (SP7, ALPL, and MMP13). Our findings indicate that BME promotes cartilaginous maturation and further ossification of bone marrow MSC-based Cart-Org, suggesting that Cart-Org treated with BME possesses the phenotype of endochondral ossification.
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Affiliation(s)
- Hinako Notoh
- Graduate School of Health Sciences, Hokkaido University, Japan
| | | | - Nobuaki Suzuki
- Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Atsuo Suzuki
- Department of Medical Technique, Nagoya University Hospital, Japan
| | - Shuichi Okamoto
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Kanematsu
- Department of Clinical Laboratory, Nagoya University Hospital, Nagoya, Japan
| | - Naruko Suzuki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, Obu City, Japan
| | - Tetsuhito Kojima
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan; Aichi Health Promotion Foundation, Nagoya, Japan
| | - Tadashi Matsushita
- Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Clinical Laboratory, Nagoya University Hospital, Nagoya, Japan
| | - Shogo Tamura
- Department of Transfusion Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Clinical Laboratory Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
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Yanada M, Yamasaki S, Kondo T, Kawata T, Harada K, Uchida N, Doki N, Yoshihara S, Katayama Y, Eto T, Tanaka M, Takada S, Kawakita T, Nishida T, Ota S, Serizawa K, Onizuka M, Kanda Y, Fukuda T, Atsuta Y, Konuma T. Allogeneic hematopoietic cell transplantation for patients with acute myeloid leukemia not in remission. Leukemia 2024; 38:513-520. [PMID: 38129514 DOI: 10.1038/s41375-023-02119-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is the last option for long-term survival for patients with chemotherapy-refractory acute myeloid leukemia (AML). By using the Japanese nationwide registry data, we analyzed 6927 adults with AML having undergone first allogeneic HCT while not in complete remission (CR) between 2001 and 2020. The 5-year overall survival (OS), relapse, and non-relapse mortality (NRM) rates were 23%, 53%, and 27%, respectively. Multivariate analysis identified several factors predictive of OS mainly through their effects on relapse (cytogenetics, percentage of blasts in the peripheral blood, and transplantation year) and NRM (age, sex, and performance status). As regards disease status, relapsed disease was associated with a higher risk of overall mortality than primary induction failure (PIF). The shorter duration of the first CR increased the risks of relapse and overall mortality for the relapsed group, and the longer time from diagnosis to transplantation did so for the PIF group. Our experience compiled over the past two decades demonstrated that >20% of patients still enjoy long-term survival with allogeneic HCT performed during non-CR and identified those less likely to benefit from allogeneic HCT. Future efforts are needed to reduce the risk of posttransplant relapse in these patients.
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Affiliation(s)
- Masamitsu Yanada
- Nagoya City University East Medical Center, Nagoya, Japan.
- Aichi Cancer Center, Nagoya, Japan.
| | | | | | - Takahito Kawata
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kaito Harada
- Tokai University School of Medicine, Isehara, Japan
| | | | - Noriko Doki
- Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | | | - Yuta Katayama
- Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | | | | | | | - Toshiro Kawakita
- National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Tetsuya Nishida
- Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | | | | | | | | | | | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
- Aichi Medical University, Nagakute, Japan
| | - Takaaki Konuma
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Shibata S, Arai Y, Kondo T, Mizuno S, Yamasaki S, Akasaka T, Doki N, Ota S, Maruyama Y, Matsuoka KI, Nagafuji K, Eto T, Tanaka T, Ohigashi H, Nakamae H, Onizuka M, Fukuda T, Atsuta Y, Yanada M. Prognostic factors in haploidentical transplantation with post-transplant cyclophosphamide for acute myeloid leukemia. Cytotherapy 2024:S1465-3249(24)00057-4. [PMID: 38466265 DOI: 10.1016/j.jcyt.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/02/2024] [Accepted: 02/16/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND AIMS Haploidentical hematopoietic stem cell transplantation (haplo-HCT) is an appropriate option when an HLA-matched related or unrelated donor is not available. Haplo-HCT using post-transplant cyclophosphamide (PTCy) is being increasingly performed worldwide due to its effective suppression of GVHD and its safety. METHODS We conducted a large nationwide cohort study to retrospectively analyze 366 patients with acute myeloid leukemia undergoing haplo-HCT with PTCy between 2010 and 2019 and to identify prognostic factors. RESULTS A multivariate Cox analysis revealed that an older recipient age (≥60 years), a male donor to a male recipient, a cytomegalovirus IgG-negative donor to a cytomegalovirus IgG-positive recipient, a poor cytogenetic risk, a noncomplete remission status at the time of transplantation, and a history of HCT were independently associated with worse overall survival (OS). Based on each hazard ratio, these factors were scored (1-2 points) and stratified by their total score into three groups: favorable (0-1 points), intermediate (2-3 points), and poor (4 points or more) groups, and 2-year OS rates were 79.9%, 49.2%, and 25.1%, respectively (P < 0.001). CONCLUSIONS The present study revealed significant prognostic factors in haplo-HCT with PTCy, and a scoring system based on these factors may be used to predict outcomes.
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Affiliation(s)
- Sho Shibata
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuyuki Arai
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Center for Research and Application of Cellular Therapy, Kyoto University Hospital, Kyoto, Japan.
| | - Tadakazu Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | | | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Kurume, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Ohigashi
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Osaka Metropolitan University Hospital, Osaka, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Masamitsu Yanada
- Department of Hematology and Oncology, Nagoya City University East Medical Center, Nagoya, Japan
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Konuma T, Yamasaki S, Ishiyama K, Mizuno S, Hayashi H, Uchida N, Shimabukuro M, Tanaka M, Kuriyama T, Onizuka M, Ishiwata K, Sawa M, Tanaka T, Ohigashi H, Fujiwara SI, Matsuoka KI, Ota S, Nishida T, Kanda Y, Fukuda T, Atsuta Y, Nakasone H, Yanada M. Comparison of Allogeneic Transplant Outcomes Between Matched Sibling Donors and Alternative Donors in Patients Over 50 Years of Age with Acute Myeloid Leukemia: 8/8 Allele-Matched Unrelated Donors and Unrelated Cord Blood Provide Better Leukemia-Free Survival Compared with Matched Sibling Donors During Nonremission Status. Transplant Cell Ther 2024; 30:215.e1-215.e18. [PMID: 38081415 DOI: 10.1016/j.jtct.2023.12.002] [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: 10/17/2023] [Revised: 11/11/2023] [Accepted: 12/06/2023] [Indexed: 01/01/2024]
Abstract
Acute myeloid leukemia (AML) is the most common indication for allogeneic hematopoietic cell transplantation (HCT). The increased availability of alternative donor sources has broadened donor types for older patients without HLA-matched sibling donors (MSD). It is uncertain if an MSD should be the first option for allogeneic HCT in patients with AML over 50 years of age. The objective of this study was to compare survival and other post-transplant outcomes between MSDs, 8/8 allele-matched unrelated donors (MUDs), 7/8 allele-MUDs, unrelated cord blood (UCB), and haploidentical donors for patients with AML over 50 years of age. We conducted a retrospective study to compare outcomes in 5704 patients with AML over 50 years of age and receiving allogeneic HCT between 2013 and 2021, using either MSD, 8/8 allele-MUD, 7/8 allele-MUD, UCB, or haploidentical donors in Japan. Complete remission (CR) and nonremission at HCT were analyzed separately for all analyses. In total, 3041 patients were CR, and 2663 patients were nonremission at the time of HCT. In multivariate analysis, donor type did not determine overall survival, irrespective of disease status at HCT. Leukemia-free survival (LFS) was significantly better for 8/8 allele-MUD (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.64 to 0.93; P = .005) and UCB (HR, 0.76; 95% CI, 0.65 to 0.88; P < .001), but not for 7/8 allele-MUD (HR, 0.97; 95% CI, 0.79 to 1.19; P = .794), and haploidentical donor (HR, 0.86; 95% CI, 0.70 to 1.05; P = .146) compared to the MSD group in nonremission status. However, donor type did not determine LFS among CR status. Relapse rates were significantly lower for 8/8 allele-MUD and UCB, whereas nonrelapse mortality was higher for UCB compared to the MSD group among both CR and nonremission status. Our registry-based study demonstrated that MSDs do not lead to superior survival compared to alternative donors for patients with AML over 50 years of age. Furthermore, 8/8 allele-MUDs and UCB provide better LFS compared with MSDs during nonremission status. Therefore, MSD is not necessarily the best donor option for allogeneic HCT in this population.
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Affiliation(s)
- Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
| | - Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - Ken Ishiyama
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Hiromi Hayashi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Masashi Shimabukuro
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takuro Kuriyama
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Ohigashi
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | | | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Tetsuya Nishida
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan
| | - Masamitsu Yanada
- Department of Hematology and Oncology, Nagoya City University East Medical Center, Nagoya, Japan
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Yamasaki S. Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study. Hematol Rep 2023; 16:1-10. [PMID: 38247991 PMCID: PMC10801517 DOI: 10.3390/hematolrep16010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/19/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Quality of life (QOL) must be carefully monitored in older patients with lymphoma who are suitable for chemotherapy, but few reports have assessed QOL in older patients who received reduced-intensity chemotherapy. This study investigated QOL in patients with lymphoma aged ≥80 years to clarify the feasibility of such assessments following reduced-intensity chemotherapy. QOL was prospectively analyzed (using the QOL Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL-ACD)] and the SF-36®, a comprehensive survey of patient health) among 13 patients (seven women) aged ≥80 years with lymphoma who received reduced-intensity chemotherapy at 4-week intervals at Kyushu University Beppu Hospital between June 2022 and August 2023. Patients were assessed at baseline, in the middle of the protocol, at the end of the protocol, and 6 months after the end of the protocol. The overall response rate was 69%. Almost all severe adverse events (10 patients) occurred during early cycles (cycles 1-2). Common adverse events included hematological toxicities such as neutropenia (10 patients). The daily activity (p = 0.048) and social attitude (p = 0.027) scores of the QOL-ACD and the general health perception (p = 0.044) and social functioning (p = 0.030) scores of the SF-36® were significantly improved during and after chemotherapy. Reduced-dose chemotherapy, if implemented before treatment selection, might permit evaluations of QOL in older patients aged ≥80 years; further investigation is warranted.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan; or ; Tel.: +81-977-27-1600; Fax: +81-977-27-1641
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu 874-0838, Japan
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Yamasaki S, Tokunou T, Maeda T, Horiuchi T. Night-Time Hot Spring Bathing Is Associated with a Lower Systolic Blood Pressure among Japanese Older Adults: A Single-Institution Retrospective Cohort Study. Geriatrics (Basel) 2023; 9:2. [PMID: 38392101 PMCID: PMC10888263 DOI: 10.3390/geriatrics9010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 02/24/2024] Open
Abstract
Hot spring bathing is practiced to help manage hypertension. We retrospectively investigated the effects of hot spring bathing on hypertension with the aim of identifying a novel approach to prevent and manage hypertension. The study cohort comprised 99 patients aged ≥65 years admitted to Kyushu University Beppu Hospital between 1 December 2021 and 30 November 2022 who could walk by themselves and who used hot springs for ≥3 days during their hospital stay. The changes in both systolic and diastolic blood pressure were significantly decreased in the night-time bathing group (n = 21) compared with the noontime (n = 26) and afternoon (n = 52) groups. Night-time hot spring bathing was significantly associated with reduced systolic blood pressure the next morning in older adults. Although prospective randomized controlled trials on night-time hot spring bathing as a hypertension treatment are warranted to investigate whether the practice can prevent hypertension among adults aged ≥65 years, we have initiated a single-center, phase II study on the relationship between sleep quality and quality of life in hypertensive patients after night-time hot spring bathing.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan
| | - Tomotake Tokunou
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
- Division of Basic Medical Science and Fundamental Nursing, Department of Nursing, Fukuoka Nursing College, Fukuoka 814-0193, Japan
| | - Toyoki Maeda
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu 874-0838, Japan
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8
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Rizq O, Mimura N, Oshima M, Momose S, Takayama N, Itokawa N, Koide S, Shibamiya A, Miyamoto-Nagai Y, Rizk M, Nakajima-Takagi Y, Aoyama K, Wang C, Saraya A, Ito R, Seimiya M, Watanabe M, Yamasaki S, Shibata T, Yamaguchi K, Furukawa Y, Chiba T, Sakaida E, Nakaseko C, Tamaru JI, Tai YT, Anderson KC, Honda H, Iwama A. UTX inactivation in germinal center B cells promotes the development of multiple myeloma with extramedullary disease. Leukemia 2023; 37:1895-1907. [PMID: 37198323 PMCID: PMC10457198 DOI: 10.1038/s41375-023-01928-7] [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: 05/25/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
UTX/KDM6A, a histone H3K27 demethylase and a key component of the COMPASS complex, is frequently lost or mutated in cancer; however, its tumor suppressor function remains largely uncharacterized in multiple myeloma (MM). Here, we show that the conditional deletion of the X-linked Utx in germinal center (GC) derived cells collaborates with the activating BrafV600E mutation and promotes induction of lethal GC/post-GC B cell malignancies with MM-like plasma cell neoplasms being the most frequent. Mice that developed MM-like neoplasms showed expansion of clonal plasma cells in the bone marrow and extramedullary organs, serum M proteins, and anemia. Add-back of either wild-type UTX or a series of mutants revealed that cIDR domain, that forms phase-separated liquid condensates, is largely responsible for the catalytic activity-independent tumor suppressor function of UTX in MM cells. Utx loss in concert with BrafV600E only slightly induced MM-like profiles of transcriptome, chromatin accessibility, and H3K27 acetylation, however, it allowed plasma cells to gradually undergo full transformation through activation of transcriptional networks specific to MM that induce high levels of Myc expression. Our results reveal a tumor suppressor function of UTX in MM and implicate its insufficiency in the transcriptional reprogramming of plasma cells in the pathogenesis of MM.
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Affiliation(s)
- Ola Rizq
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Hematology, Chiba University Hospital, Chiba, Japan
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Naoya Mimura
- Department of Hematology, Chiba University Hospital, Chiba, Japan.
- Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan.
| | - Motohiko Oshima
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shuji Momose
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Naoya Takayama
- Department of Regenerative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Itokawa
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Shuhei Koide
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Asuka Shibamiya
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | | | - Mohamed Rizk
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yaeko Nakajima-Takagi
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazumasa Aoyama
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Changshan Wang
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, China
| | - Atsunori Saraya
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryoji Ito
- Central Institute for Experimental Animals, Kanagawa, Japan
| | - Masanori Seimiya
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Mariko Watanabe
- Department of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Satoshi Yamasaki
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kiyoshi Yamaguchi
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tetsuhiro Chiba
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
- Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan
| | - Chiaki Nakaseko
- Department of Hematology, International University of Health and Welfare, Narita, Japan
| | - Jun-Ichi Tamaru
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yu-Tzu Tai
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kenneth C Anderson
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Hiroaki Honda
- Field of Human Disease Models, Major in Advanced Life Sciences and Medicine, Institute of Laboratory Animals, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Iwama
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
- Laboratoty of Cellular and Molecular Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
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9
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Rizq O, Mimura N, Oshima M, Momose S, Takayama N, Itokawa N, Koide S, Shibamiya A, Miyamoto-Nagai Y, Rizk M, Nakajima-Takagi Y, Aoyama K, Wang C, Saraya A, Ito R, Seimiya M, Watanabe M, Yamasaki S, Shibata T, Yamaguchi K, Furukawa Y, Chiba T, Sakaida E, Nakaseko C, Tamaru JI, Tai YT, Anderson KC, Honda H, Iwama A. Correction: UTX inactivation in germinal center B cells promotes the development of multiple myeloma with extramedullary disease. Leukemia 2023; 37:1952. [PMID: 37464071 PMCID: PMC10457190 DOI: 10.1038/s41375-023-01969-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Ola Rizq
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Hematology, Chiba University Hospital, Chiba, Japan
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Naoya Mimura
- Department of Hematology, Chiba University Hospital, Chiba, Japan.
- Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan.
| | - Motohiko Oshima
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shuji Momose
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Naoya Takayama
- Department of Regenerative Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Itokawa
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Shuhei Koide
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Asuka Shibamiya
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | | | - Mohamed Rizk
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yaeko Nakajima-Takagi
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazumasa Aoyama
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Changshan Wang
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- The State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, School of Life Sciences, Inner Mongolia University, Hohhot, China
| | - Atsunori Saraya
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryoji Ito
- Central Institute for Experimental Animals, Kanagawa, Japan
| | - Masanori Seimiya
- Department of Medical Technology and Sciences, School of Health Sciences at Narita, International University of Health and Welfare, Narita, Japan
| | - Mariko Watanabe
- Department of Clinical Laboratory, Chiba University Hospital, Chiba, Japan
| | - Satoshi Yamasaki
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kiyoshi Yamaguchi
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tetsuhiro Chiba
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
- Department of Transfusion Medicine and Cell Therapy, Chiba University Hospital, Chiba, Japan
| | - Chiaki Nakaseko
- Department of Hematology, International University of Health and Welfare, Narita, Japan
| | - Jun-Ichi Tamaru
- Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Yu-Tzu Tai
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kenneth C Anderson
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Hiroaki Honda
- Field of Human Disease Models, Major in Advanced Life Sciences and Medicine, Institute of Laboratory Animals, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Iwama
- Division of Stem Cell and Molecular Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
- Laboratoty of Cellular and Molecular Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
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10
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Yanagihara A, Yamasaki S, Hashimoto K, Taguchi R, Umesaki T, Imai H, Kaira K, Nitanda H, Sakaguchi H, Ishida H, Kobayashi K, Horimoto K, Kagamu H. A Th1-like CD4 + T-cell Cluster That Predicts Disease-free Survival in Early-stage Lung Cancer. Cancer Res Commun 2023; 3:1277-1285. [PMID: 37476074 PMCID: PMC10355164 DOI: 10.1158/2767-9764.crc-23-0167] [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] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/22/2023]
Abstract
Perioperative immune checkpoint inhibitors have been shown to improve prognosis in early-stage lung cancer. However, no biomarkers are known to indicate the requirement for treatment. This study aimed to identify T-cell clusters responsible for antitumor immunity in patients with early-stage lung cancer. Preoperative blood samples from 50 consecutive patients with lung cancer who were diagnosed as operable and underwent complete resection were analyzed by mass cytometry. Patients were divided into two groups: no recurrence at a minimum observation period of 851 days (median observation period: 1,031.5 days) and recurrence by the last observation date. Mass cytometry and single-cell RNA sequencing analysis of lymph nodes (LN) and tumor-infiltrating T cells were also performed. CCR4-CCR6+ Th7R showed discriminative ability between recurrence and non-recurrence patients with lung cancer. Patients with more than 3.04% Th7R showed significantly favorable disease-free survival. Th7R was a major component of CD4+ T cells in tumor microenvironments and LNs adjacent to lung cancer tissues and was the only cluster that decreased in peripheral blood after the removal of cancer tissues, suggesting that Th7R was primed and proliferated in tumor-draining LNs in the presence of cancer tissues. Th7R had the kinetics that antitumor T cells should have, as indicated by the cancer immunity cycle; thus, peripheral blood Th7R could represent the potency of tumor immunity by reflecting priming and proliferation in tumor-draining LNs and Th7R in the tumor microenvironment. Prediction using peripheral Th7R before surgery could allow the selection of patients who require perioperative drug therapy and optimize therapeutic interventions with clinical implications. Significance Peripheral Th7R, a Th1-like CD4+ T-cell cluster reflecting priming status in draining LNs and immune status in the tumor microenvironment, predicts disease-free survival after complete resection and has significant clinical relevance in selecting appropriate therapeutic interventions in patients with early-stage lung cancer.
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Affiliation(s)
- Akitoshi Yanagihara
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Satoshi Yamasaki
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Department of Clinical Cancer Genomics, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kosuke Hashimoto
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Ryo Taguchi
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Tetsuya Umesaki
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hisao Imai
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kyoichi Kaira
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hiroyuki Nitanda
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hirozo Sakaguchi
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hironori Ishida
- Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kunihiko Kobayashi
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Katsuhisa Horimoto
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Koto-ku, Tokyo, Japan
| | - Hiroshi Kagamu
- Department of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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11
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Akahoshi Y, Nakasone H, Takenaka K, Yamasaki S, Nakamura M, Doki N, Tanaka M, Ozawa Y, Uchida N, Ara T, Nakamae H, Ota S, Onizuka M, Yano S, Tanaka J, Fukuda T, Kanda Y, Atsuta Y, Kako S, Yanada M, Arai Y. CMV reactivation after allogeneic HCT is associated with a reduced risk of relapse in acute lymphoblastic leukemia. Blood Adv 2023; 7:2699-2708. [PMID: 36661335 PMCID: PMC10333743 DOI: 10.1182/bloodadvances.2022009376] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/21/2023] Open
Abstract
Cytomegalovirus reactivation (CMVR) after allogeneic hematopoietic cell transplantation (HCT) is a frequent complication related to survival outcomes; however, its impact on relapse remains unclear, especially in acute lymphoblastic leukemia (ALL). In this nationwide retrospective study, we included patients with acute myeloid leukemia (AML) and ALL in the first or second complete remission who underwent their first HCT using a pre-emptive strategy for CMVR. Because 90% of cases with CMVR had occurred by day 64 and 90% of cases with grades 2 to 4 acute graft-versus-host disease (GVHD) had occurred by day 58, a landmark point was set at day 65. In landmark analyses, 3793 patients with AML and 2213 patients with ALL who survived without relapse for at least 65 days were analyzed. Multivariate analyses showed that CMVR was associated with a lower incidence of relapse in both AML (hazard ratio [HR], 0.81; 95% confidence interval [CI], 0.69-0.95; P = .009) and ALL (HR, 0.81; 95% CI, 0.66-0.99; P = .045). These findings were confirmed when CMVR was used as the time-dependent covariate. Moreover, our study suggests that the protective effect of CMVR on relapse was independent of acute GVHD. A post-hoc subgroup analysis of combined AML and ALL showed that CMVR had a mild antileukemia effect without effect modification, in contrast to the impact of CMVR on NRM. Our findings may provide important implications for strategies used for CMV prophylaxis after HCT.
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Affiliation(s)
- Yu Akahoshi
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | - Momoko Nakamura
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Takahide Ara
- Department of Hematology, Hokkaido University Faculty of Medicine, Hokkaido, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan
| | - Shingo Yano
- Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Takahiro Fukuda
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Aichi, Japan
| | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masamitsu Yanada
- Department of Haematology and Cell Therapy, Aichi Cancer Centre, Aichi, Japan
| | - Yasuyuki Arai
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Clinical Laboratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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12
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Shida D, Kuchiba A, Shibata T, Hamaguchi T, Yamasaki S, Ito M, Kobatake T, Tonooka T, Masaki T, Shiozawa M, Takii Y, Uetake H, Okamura S, Ojima H, Kazama S, Takeyama H, Kanato K, Shimada Y, Murakami Y, Kanemitsu Y. Genomic landscape and its prognostic significance in stage III colorectal cancer: JCOG1506A1, an ancillary of JCOG0910. Cancer Sci 2023. [PMID: 37189003 PMCID: PMC10394152 DOI: 10.1111/cas.15834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
Large-scale genomic sequencing of colorectal cancers has been reported mainly for Western populations. Differences by stage and ethnicity in the genomic landscape and their prognostic impact remain poorly understood. We investigated 534 Japanese stage III colorectal cancer samples from the Phase III trial, JCOG0910. Targeted-capture sequencing of 171 potentially colorectal cancer-associated genes was performed, and somatic single-nucleotide variants and insertion-deletions were determined. Hypermutated tumors were defined as tumors with MSIsensor score >7 and ultra-mutated tumors with POLE mutations. Genes with alterations associated with relapse-free survival were analyzed using multivariable Cox regression models. In all patients (184 right-sided, 350 left-sided), mutation frequencies were TP53, 75.3%; APC, 75.1%; KRAS, 43.6%; PIK3CA, 19.7%; FBXW7, 18.5%; SOX9, 11.8%; COL6A3, 8.2%; NOTCH3, 4.5%; NRAS, 4.1%; and RNF43, 3.7%. Thirty-one tumors were hypermutated (5.8%; 14.1% right-sided, 1.4% left-sided). Modest associations were observed: poorer relapse-free survival was seen with mutant KRAS (hazard ratio 1.66; p = 0.011) and mutant RNF43 (2.17; p = 0.055), whereas better relapse-free survival was seen with mutant COL6A3 (0.35; p = 0.040) and mutant NOTCH3 (0.18; p = 0.093). Relapse-free survival tended to be better for hypermutated tumors (0.53; p = 0.229). In conclusion, the overall spectrum of mutations in our Japanese stage III colorectal cancer cohort was similar to that in Western populations, but the frequencies of mutation for TP53, SOX9, and FBXW7 were higher, and the proportion of hypermutated tumors was lower. Multiple gene mutations appeared to impact relapse-free survival, suggesting that tumor genomic profiling can support precision medicine for colorectal cancer.
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Affiliation(s)
- Dai Shida
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Aya Kuchiba
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Satoshi Yamasaki
- Laboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Takaya Kobatake
- Department of Gastroenterological Surgery, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Toru Tonooka
- Department of Gastroenterological Surgery, Chiba Cancer Center, Chiba, Japan
| | - Tadahiko Masaki
- Department of Surgery, Kyorin University, Mitaka City, Japan
| | - Manabu Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yasumasa Takii
- Department of Gastroenterological Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hiroyuki Uetake
- Department of Specialized Surgeries, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shu Okamura
- Department of Surgery, Suita Municipal Hospital, Osaka, Japan
| | - Hitoshi Ojima
- Department of Gastroenterological Surgery, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Shinsuke Kazama
- Division of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | | | - Keisuke Kanato
- Research Management Division, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Shimada
- Gastrointestinal Medical Oncology Division, Kochi Health Sciences Center, Kochi, Japan
| | - Yoshinori Murakami
- Division of Molecular Pathology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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13
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Yamasaki S. Bisphosphonate use for glucocorticoid-induced osteoporosis in older patients with immune thrombocytopenia: a clinical perspective. Ann Hematol 2023:10.1007/s00277-023-05266-7. [PMID: 37171596 PMCID: PMC10175903 DOI: 10.1007/s00277-023-05266-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/06/2023] [Indexed: 05/13/2023]
Abstract
Prednisolone, used as a standard initial treatment for immune thrombocytopenia (ITP), is an important risk factor for osteoporosis. Recently, we found that prescription of bisphosphonate during initial loading of prednisolone may prevent reduction in bone mineral density and development of glucocorticoid-induced osteoporosis (GIO) in older patients with ITP receiving prolonged steroid therapy. In this review, I describe the treatment options for older patients with ITP, and present the best practices for screening, evaluating, and diagnosing ITP. I also summarize the literature from 2017 to 2022 on the treatment options for ITP, including discussions on the contraindications and side effects, with an emphasis on GIO, and the relative merits of bisphosphonates as a co-treatment for prevention of GIO. Finally, I present a perspective and an expert recommendation on how older patients with ITP would best be served in the future.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Oita, 874-0838, Japan.
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, 810-0065, Japan.
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14
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Yamasaki S, Mizuno S, Iwasaki M, Seo S, Uchida N, Shigesaburo M, Nakano N, Ishiwata K, Uehara Y, Eto T, Takase K, Kawakita T, Tanaka M, Sawa M, Katayama Y, Nawa Y, Makoto O, Ichinohe T, Atsuta Y, Kanda J, Yanada M. Efficacy and safety of allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients aged > 65 years with unfavorable cytogenetics. Ann Hematol 2023; 102:1549-1559. [PMID: 37126115 DOI: 10.1007/s00277-023-05243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
Unrelated donor bone marrow transplantation (UR-BMT), unrelated donor cord blood stem cell transplantation (UR-CBT), and haploidentical peripheral blood stem cell transplantation (Haplo-PBSCT) are the main alternative stem cell sources for allogeneic hematopoietic cell transplantation (HCT) in Japan. The present study aimed to identify factors associated with the outcomes of UR-BMT, UR-CBT, and Haplo-PBSCT in older patients with acute myeloid leukemia (AML) and intermediate- or poor-risk cytogenetics to improve the clinical efficacy and safety of allogeneic HCT. We retrospectively analyzed data for 448 AML patients aged > 65 years who received UR-BMT (n = 102), UR-CBT (n = 250), or Haplo-PBSCT (n = 96) between 2014 and 2020. Overall survival (OS) in the UR-BMT group was superior (P = 0.033) to that in the other groups. However, all patients without complete remission (non-CR) who had Karnofsky performance status (KPS) < 80 at HCT and poor-risk cytogenetics died within 1 year after HCT. Multivariate Cox regression analysis identified KPS <80 at HCT and poor-risk cytogenetics as independent predictors of worse OS in non-CR patients. KPS < 80 may be an alternative indicator for non-CR AML patients with poor-risk cytogenetics during the selection of HCT, alternative treatments, or best supportive therapy, and the optimal KPS is important for the success of HCT.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Makoto Iwasaki
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Mibu, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | | | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kawasaki, Japan
| | - Yasufumi Uehara
- Department of Hematology, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yuichiro Nawa
- Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Onizuka Makoto
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Tatsuo Ichinohe
- Department of Hematology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
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15
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Edahiro Y, Ochiai T, Hashimoto Y, Morishita S, Shirane S, Inano T, Furuya C, Koike M, Noguchi M, Usuki K, Shiratsuchi M, Nakajima K, Ohtsuka E, Tanaka H, Kawata E, Nakamae M, Ueda Y, Aota Y, Sugita Y, Ohara S, Yamasaki S, Asagoe K, Yoshida S, Yamanouchi J, Suzuki S, Kondo T, Kanisawa Y, Toyama K, Omura H, Mizuchi D, Sakamaki S, Ando M, Komatsu N. Clinical characteristics of Japanese patients with myelodysplastic/myeloproliferative neoplasm with ring sideroblasts and thrombocytosis. Int J Hematol 2023:10.1007/s12185-023-03592-0. [PMID: 37058247 DOI: 10.1007/s12185-023-03592-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/26/2023] [Accepted: 03/27/2023] [Indexed: 04/15/2023]
Abstract
Myelodysplastic/myeloproliferative neoplasm with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T) is a rare disease, which presents with features of myelodysplastic syndromes with ring sideroblasts and essential thrombocythemia, as well as anemia and marked thrombocytosis. SF3B1 and JAK2 mutations are often found in patients, and are associated with their specific clinical features. This study was a retrospective analysis of 34 Japanese patients with MDS/MPN-RS-T. Median age at diagnosis was 77 (range, 51-88) years, and patients had anemia (median hemoglobin: 9.0 g/dL) and thrombocytosis (median platelet count: 642 × 109/L). Median overall survival was 70 (95% confidence interval: 68-not applicable) months during the median follow-up period of 26 (range: 0-91) months. A JAK2V617F mutation was detected in 46.2% (n = 12) of analyzed patients (n = 26), while an SF3B1 mutation was detected in 87.5% (n = 7) of analyzed patients (n = 8). Like those with myelodysplastic syndromes or myeloproliferative neoplasms, patients often received erythropoiesis-stimulating agents and aspirin to improve anemia and prevent thrombosis. This study, which was the largest to describe the real-world characteristics of Japanese patients with MDS/MPN-RS-T, showed that the patients had similar characteristics to those in western countries.
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Affiliation(s)
- Yoko Edahiro
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan.
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan.
- Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Tomonori Ochiai
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
- Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshinori Hashimoto
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan
- Department of Hematology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Soji Morishita
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan
- Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuichi Shirane
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
- Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tadaaki Inano
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Chiho Furuya
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Michiaki Koike
- Department of Hematology, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Masaaki Noguchi
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Kei Nakajima
- Department of Hematology/Oncology, University of Yamanashi, Kofu, Japan
| | - Eiichi Ohtsuka
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Hiroaki Tanaka
- Department of Hematology, Asahi General Hospital, Asahi, Japan
| | - Eri Kawata
- Department of Hematology, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Mika Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yasuo Aota
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Kohsei Chuo General Hospital, Tokyo, Japan
| | - Yasumasa Sugita
- Department of Hematology, Oami Municipal Hospital, Oamishirasato, Japan
| | - Shin Ohara
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - Kohsuke Asagoe
- Department of Hematology & Oncology, Shiga General Hospital, Moriyama, Japan
| | - Shuro Yoshida
- Department of Hematology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Jun Yamanouchi
- Division of Blood Transfusion and Cell Therapy, Ehime University Hospital, Toon, Japan
| | - Sayaka Suzuki
- Department of Hematology, Tottori University Hospital, Yonago, Japan
| | - Toshinori Kondo
- Department of Hematology, Kawasaki Medical School, Kurashiki, Japan
| | - Yuji Kanisawa
- Department of Hematology and Oncology, Oji General Hospital, Tomakomai, Japan
| | - Kohtaro Toyama
- Department of Hematology, Fujioka General Hospital, Fujioka, Japan
| | - Hiromi Omura
- Department of Hematology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Daisuke Mizuchi
- Department of Hematology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Sumio Sakamaki
- Department of Hematology, Hokuou Hospital, Sapporo, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Komatsu
- Department of Advanced Hematology, Juntendo University Graduate School of Medicine, 2-1-1 Hongou, Bunkyo-Ku, Tokyo, Japan
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
- Laboratory for the Development of Therapies Against MPN, Juntendo University Graduate School of Medicine, Tokyo, Japan
- PharmaEssentia Japan KK, Tokyo, Japan
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16
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Yamasaki S, Maeda T, Horiuchi T. Association between habitual hot spring bathing and depression in Japanese older adults: A retrospective study in Beppu. Complement Ther Med 2023; 72:102909. [PMID: 36526152 DOI: 10.1016/j.ctim.2022.102909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Thermal therapy is used to manage various psychological diseases, such as depression. We investigated the relationship between hot spring bathing and depression in older adults using questionnaire responses. DESIGN AND SETTING We comprehensively evaluated the preventive effects of long-term hot spring bathing in 10429 adults aged ≥ 65 years in Beppu, Japan, by conducting a questionnaire study on the prevalence of depression (n = 219). MAIN OUTCOME MEASURES Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a multivariable logistic regression model for history of depression. RESULTS A separate multivariable logistic regression model for inference showed that female sex (OR, 1.56; 95 % CI, 1.17-2.08; p = 0.002), arrhythmia (OR, 1.73; 95 % CI, 1.18-2.52; p = 0.004), hyperlipidemia (OR, 1.63; 95 % CI, 1.14-2.32; p = 0.006), renal disease (OR, 2.26; 95 % CI, 1.36-3.75; p = 0.001), collagen disease (OR, 2.72; 95 % CI, 1.48-5.02; p = 0.001), allergy (OR, 1.97; 95 % CI, 1.27-3.04; p = 0.002), and habitual daily hot spring bathing (OR, 0.63; 95 % CI, 0.41-0.94; p = 0.027) were independently significantly associated with a history of depression. CONCLUSIONS We found an inverse relationship between habitual daily hot spring bathing and history of depression. Prospective randomized controlled trials on habitual daily hot spring bathing as a treatment for depression are warranted to investigate whether the use of hot springs can provide relief to those with psychiatric and mental health disorders.
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Affiliation(s)
- S Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan; Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
| | - T Maeda
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - T Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
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17
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Yanada M, Yamasaki S, Konuma T, Mizuno S, Uchida N, Onai D, Fukuda T, Tanaka M, Ozawa Y, Eto T, Ikegame K, Sawa M, Katayama Y, Kawakita T, Onizuka M, Kanda Y, Ichinohe T, Atsuta Y, Yano S. Age and allogeneic hematopoietic cell transplantation outcomes in acute myeloid leukemia. Int J Hematol 2023; 117:398-408. [PMID: 36335534 DOI: 10.1007/s12185-022-03486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
Although several studies have reported significant effects of patient age on outcomes of allogeneic hematopoietic cell transplantation (HCT), the prognostic relevance of age must be determined separately for myeloablative conditioning (MAC) and reduced-intensity conditioning (RIC). We analyzed Japanese nationwide transplantation registry data of patients aged 20-79 years with acute myeloid leukemia who underwent allogeneic HCT using MAC (n = 7525) or RIC (n = 3154) between 2008 and 2019. Patient were divided into six groups by age, with each group representing a decade, and overall survival (OS), relapse, and non-relapse mortality (NRM) were compared between adjacent age groups. The adverse impact of age on OS increased each decade starting at age 40 among patients receiving MAC, but only differed significantly between patients in their 50s and 60s among those receiving RIC. In patients receiving both MAC and RIC, the detrimental effect of advanced age on OS was accompanied by an increased risk of NRM. These findings show that age affects NRM and OS significantly, but differs depending on conditioning intensity. RIC mitigates the adverse prognostic impact of older age and is thus considered a reasonable option for older patients.
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Affiliation(s)
- Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
| | | | - Takaaki Konuma
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | | | | | - Daishi Onai
- Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | | | | | - Yukiyasu Ozawa
- Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | | | | | | | - Yuta Katayama
- Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Toshiro Kawakita
- National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | | | | | - Tatsuo Ichinohe
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Aichi Medical University, Nagakute, Japan.,Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
| | - Shingo Yano
- The Jikei University School of Medicine, Tokyo, Japan
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18
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Iwasaki H, Yamasaki S, Kadowaki M, Minami M, Nukada T, Takase K. [Safety and feasibility of outpatient management in relapsed/refractory lymphoma treated with pegfilgrastim after multi-agent salvage therapy: a single-center, open-label, non-randomized, prospective interventional study]. Rinsho Ketsueki 2023; 64:596-607. [PMID: 37544718 DOI: 10.11406/rinketsu.64.596] [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: 08/08/2023]
Abstract
OBJECTIVE We sought to assess the safety and feasibility of outpatient management in Japanese patients with relapsed/refractory lymphoma who had received pegfilgrastim after salvage therapy. METHOD This was a single-center, open-label, non-randomized, prospective interventional analysis. Patients were completely hospitalized for cycle 1 of chemotherapy. Those who met the outpatient management criteria (outpatient group) were subsequently admitted to the hospital for chemotherapy cycles but were discharged after each cycle was completed. The inpatient group was discharged when white blood cell and platelet counts improved. Pegfilgrastim was given as a single 3.6 mg dose by subcutaneous injection 2 days after the completion of each chemotherapy cycle. RESULTS The percentage of outpatient management days (primary endpoint) ranged from 68.2%-75.0% in the outpatient group and 28.6%-50.0% in the inpatient group. According to the secondary endpoints, there were no hospitalizations due to febrile neutropenia during the outpatient period. There were no major safety concerns raised. CONCLUSIONS For patients with relapsed/refractory lymphoma, pegfilgrastim administration after salvage therapy in an outpatient setting was feasible and safe for those who satisfied the outpatient management criteria.
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Affiliation(s)
- Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Mariko Minami
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | | | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
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19
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Yamasaki S, Tokunou T, Maeda T, Horiuchi T. Author Correction: Hot spring bathing is associated with a lower prevalence of hypertension among Japanese older adults: a cross-sectional study in Beppu. Sci Rep 2022; 12:22172. [PMID: 36550143 PMCID: PMC9780199 DOI: 10.1038/s41598-022-26365-x] [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: 12/24/2022] Open
Affiliation(s)
- Satoshi Yamasaki
- grid.459691.60000 0004 0642 121XDepartment of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita 874-0838 Japan ,grid.415613.4Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tomotake Tokunou
- grid.459691.60000 0004 0642 121XDepartment of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita 874-0838 Japan
| | - Toyoki Maeda
- grid.459691.60000 0004 0642 121XDepartment of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita 874-0838 Japan
| | - Takahiko Horiuchi
- grid.459691.60000 0004 0642 121XDepartment of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita 874-0838 Japan
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20
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Kagamu H, Yamasaki S, Kitano S, Yamaguchi O, Mouri A, Shiono A, Nishihara F, Miura Y, Hashimoto K, Imai H, Kaira K, Kobayashi K, Kanai Y, Shibata T, Horimoto K. Single-Cell Analysis Reveals a CD4+ T-cell Cluster That Correlates with PD-1 Blockade Efficacy. Cancer Res 2022; 82:4641-4653. [PMID: 36219677 PMCID: PMC9755963 DOI: 10.1158/0008-5472.can-22-0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/30/2022] [Accepted: 10/06/2022] [Indexed: 01/24/2023]
Abstract
CD4+ T-cell immunity helps clonal proliferation, migration, and cancer cell killing activity of CD8+ T cells and is essential in antitumor immune responses. To identify CD4+ T-cell clusters responsible for antitumor immunity, we simultaneously analyzed the naïve-effector state, Th polarization, and T-cell receptor clonotype based on single-cell RNA-sequencing data. Unsupervised clustering analysis uncovered the presence of a new CD4+ T-cell metacluster in the CD62Llow CD4+ T-cell subpopulation, which contained multicellular clonotypes associated with efficacy of programmed death-ligand 1 (PD-1) blockade therapy. The CD4+ T-cell metacluster consisted of CXCR3+CCR4-CCR6+ and CXCR3-CCR4-CCR6+ cells and was characterized by high expression of IL7 receptor and TCF7. The frequency of these cells in the peripheral blood significantly correlated with progression-free survival and overall survival of patients with lung cancer after PD-1 blockade therapy. In addition, the CD4+ metacluster in the peripheral blood correlated with CD4+ T-cell infiltration in the tumor microenvironment, whereas peripheral Th1 correlated with local CD8+ T-cell infiltration. Together, these findings suggest that CD62Llow CCR4-CCR6+ CD4+ T cells form a novel metacluster with predictive potential of the immune status and sensitivity to PD-1 blockade, which may pave the way for personalized antitumor immunotherapy strategies for patients. SIGNIFICANCE The identification of a new CD4+ T-cell metacluster that corresponds with immune status could guide effective tumor treatment by predicting response to immunotherapy using peripheral blood samples from patients.
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Affiliation(s)
- Hiroshi Kagamu
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.,Corresponding Author: Hiroshi Kagamu, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City 350-1298, Japan. Phone: 814-2984-4581; Fax: 814-2984-4581; E-mail:
| | - Satoshi Yamasaki
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.,Department of Clinical Cancer Genomics, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Shigehisa Kitano
- Division of Cancer Immunotherapy Development, Advanced Medical Development Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ou Yamaguchi
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Atsuto Mouri
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Ayako Shiono
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Fuyumi Nishihara
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Yu Miura
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kosuke Hashimoto
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hisao Imai
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kyoichi Kaira
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Kunihiko Kobayashi
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Yae Kanai
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Division of Cancer Genomics, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan
| | - Katsuhisa Horimoto
- Division of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.,Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
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21
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Liu X, Sato N, Yabushita T, Li J, Jia Y, Tamura M, Asada S, Fujino T, Fukushima T, Yonezawa T, Tanaka Y, Fukuyama T, Tsuchiya A, Shikata S, Iwamura H, Kinouchi C, Komatsu K, Yamasaki S, Shibata T, Sasaki AT, Schibler J, Wunderlich M, O'Brien E, Mizukawa B, Mulloy JC, Sugiura Y, Takizawa H, Shibata T, Miyake K, Kitamura T, Goyama S. IMPDH inhibition activates TLR-VCAM1 pathway and suppresses the development of MLL-fusion leukemia. EMBO Mol Med 2022; 15:e15631. [PMID: 36453131 PMCID: PMC9832838 DOI: 10.15252/emmm.202115631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/22/2021] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
Inosine monophosphate dehydrogenase (IMPDH) is a rate-limiting enzyme in de novo guanine nucleotide synthesis pathway. Although IMPDH inhibitors are widely used as effective immunosuppressants, their antitumor effects have not been proven in the clinical setting. Here, we found that acute myeloid leukemias (AMLs) with MLL-fusions are susceptible to IMPDH inhibitors in vitro. We also showed that alternate-day administration of IMPDH inhibitors suppressed the development of MLL-AF9-driven AML in vivo without having a devastating effect on immune function. Mechanistically, IMPDH inhibition induced overactivation of Toll-like receptor (TLR)-TRAF6-NF-κB signaling and upregulation of an adhesion molecule VCAM1, which contribute to the antileukemia effect of IMPDH inhibitors. Consequently, combined treatment with IMPDH inhibitors and the TLR1/2 agonist effectively inhibited the development of MLL-fusion AML. These findings provide a rational basis for clinical testing of IMPDH inhibitors against MLL-fusion AMLs and potentially other aggressive tumors with active TLR signaling.
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Affiliation(s)
- Xiaoxiao Liu
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
| | - Naru Sato
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Tomohiro Yabushita
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Jingmei Li
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
| | - Yuhan Jia
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
| | - Moe Tamura
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
| | - Shuhei Asada
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan,The Institute of Laboratory Animals, Tokyo Women's Medical UniversityTokyoJapan
| | - Takeshi Fujino
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Tsuyoshi Fukushima
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Taishi Yonezawa
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
| | - Yosuke Tanaka
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Tomofusa Fukuyama
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Akiho Tsuchiya
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Shiori Shikata
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Hiroyuki Iwamura
- FUJIFILM Corporation: Pharmaceutical Products DivisionTokyoJapan
| | - Chieko Kinouchi
- FUJIFILM Corporation: Bio Science & Engineering LaboratoriesKanagawaJapan
| | - Kensuke Komatsu
- FUJIFILM Corporation: Bio Science & Engineering LaboratoriesKanagawaJapan
| | - Satoshi Yamasaki
- Laboratory of Molecular Medicine, Human Genome Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Tatsuhiro Shibata
- Laboratory of Molecular Medicine, Human Genome Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Atsuo T Sasaki
- Division of Hematology and Oncology, Department of Internal MedicineUniversity of CincinnatiCincinnatiOHUSA
| | - Janet Schibler
- Division of Experimental Hematology and Cancer BiologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Mark Wunderlich
- Division of Experimental Hematology and Cancer BiologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Eric O'Brien
- Division of Oncology, Department of Pediatrics, University of CincinnatiCincinnatiOHUSA
| | - Benjamin Mizukawa
- Division of Experimental Hematology and Cancer BiologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - James C Mulloy
- Division of Experimental Hematology and Cancer BiologyCincinnati Children's Hospital Medical CenterCincinnatiOHUSA
| | - Yuki Sugiura
- Department of BiochemistryKeio University School of MedicineTokyoJapan
| | - Hitoshi Takizawa
- Laboratory of Stem Cell Stress, International Research Center for Medical SciencesKumamoto UniversityKumamotoJapan
| | - Takuma Shibata
- Division of Innate Immunity, Department of Microbiology and ImmunologyThe Institute of Medical Science, The University of TokyoTokyoJapan
| | - Kensuke Miyake
- Division of Innate Immunity, Department of Microbiology and ImmunologyThe Institute of Medical Science, The University of TokyoTokyoJapan
| | - Toshio Kitamura
- Division of Cellular Therapy, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Susumu Goyama
- Division of Molecular Oncology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier SciencesThe University of TokyoTokyoJapan
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22
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Suga T, Hidaka Y, Hori M, Yamasaki H, Wakasugi D, Yamasaki S, Yamaguchi R, Ida H, Nakashima M. Successful treatment of a patient with Takayasu's arteritis complicated with Crohn's disease with ustekinumab: A case report. Mod Rheumatol Case Rep 2022:rxac090. [PMID: 36445313 DOI: 10.1093/mrcr/rxac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/05/2022] [Accepted: 11/27/2022] [Indexed: 06/16/2023]
Abstract
A 17-year-old woman was referred to our department with fever, general malaise, and weight loss. She was diagnosed with Takayasu arteritis (TAK) and Crohn's disease (CD) following positron emission tomography-computed tomography (PET-CT) and colonoscopy, respectively. Serological human leukocyte antigen (HLA) typing revealed HLA-B52 positivity. Initial treatment with prednisolone (0.5mg/kg) was insufficient; therefore, ustekinumab and 5-aminosalicylic acid were added. This treatment achieved prednisolone free remission for both diseases, as confirmed by PET-CT and colonoscopy. Although treatment guidelines for TAK and CD have been previously established, treatment of patients with TAK with coexisting CD is controversial. Our case suggests that ustekinumab has the ability to achieve TAK remission in addition to its therapeutic effect on CD.
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Affiliation(s)
- Takeshi Suga
- Division of Rheumatology
- Department of Rheumatology Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | | | - Maisa Hori
- Division of Gastroenterology
- Naito Hospital, Kurume, Japan
| | | | | | | | - Rin Yamaguchi
- Division of Pathology, Kurume University Medical Center. Kurume, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka Japan
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23
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Sakatoku K, Kim SW, Okamura H, Kanaya M, Kato K, Yamasaki S, Uchida N, Kobayashi H, Fukuda T, Takayama N, Ishikawa J, Nakazawa H, Sakurai M, Ikeda T, Kondo T, Yoshioka S, Miyamoto T, Kimura T, Ichinohe T, Atsuta Y, Kondo E. Improved survival after single-unit cord blood transplantation using fludarabine and melphalan-based reduced-intensity conditioning for malignant lymphoma: impact of melphalan dose and graft-versus-host disease prophylaxis with mycophenolate mofetil. Ann Hematol 2022; 101:2743-2757. [PMID: 36195679 DOI: 10.1007/s00277-022-04990-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/23/2022] [Indexed: 11/01/2022]
Abstract
We evaluated 413 adult patients with lymphoma who underwent unrelated cord blood transplantation (UCBT) with fludarabine and melphalan (FM)-based reduced-intensity conditioning between 2002 and 2017 to investigate longitudinal changes in outcomes and the optimal melphalan dose and graft-versus-host disease (GVHD) prophylaxis regimen. Outcomes were compared between FM80/100 (melphalan dose: 80 or 100 mg/m2) and FM140 (melphalan dose: 140 mg/m2), as well as between calcineurin inhibitor (CNI) plus methotrexate (MTX), CNI plus mycophenolate mofetil (MMF), and CNI alone. The 3-year overall survival (OS) and non-relapse mortality (NRM) rates improved over time (OS: 27% in 2000s vs. 42% in 2010s, p < 0.001; NRM: 43% in 2000s vs. 26% in 2010s, p < 0.001). Multivariable analysis showed that in the 2000s, melphalan dose and GVHD prophylaxis regimen did not affect any outcomes. In the 2010s, FM80/100 (vs. FM140) related to better OS (hazard ratio [HR] 0.62, p = 0.01) and NRM (HR 0.52, p = 0.016). MTX + CNI and CNI alone (vs. CNI + MMF) related to worse OS (CNI + MTX, HR 2.01, p < 0.001; CNI alone, HR 2.65, p < 0.001) and relapse/progression (CNI + MTX, HR 2.40, p < 0.001; CNI alone, HR 2.13, p = 0.023). In recent years, the use of FM80/100 and CNI + MMF significantly reduced the risk of NRM and relapse/progression, respectively, and resulted in better OS after UCBT for lymphoma.
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Affiliation(s)
- Kazuki Sakatoku
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Sung-Won Kim
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Hiroshi Okamura
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Minoru Kanaya
- Department of Cancer Immunology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Koji Kato
- Hematology, Oncology & Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Hikaru Kobayashi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Nobuyuki Takayama
- Department of Hematology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Hideyuki Nakazawa
- Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tadakazu Kondo
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshihiro Miyamoto
- Hematology, Oncology & Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takafumi Kimura
- Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Eisei Kondo
- Department of Hematology, Kawasaki Medical School, Kurashiki, Japan
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24
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Yamasaki S, Kamezaki K, Ito Y, Horiuchi T. Bisphosphonate Use for Glucocorticoid-Induced Osteoporosis in Elderly Patients with Immune Thrombocytopenia Receiving Prolonged Steroid Therapy: A Single Institute Retrospective Study. Hematol Rep 2022; 14:276-285. [PMID: 36135323 PMCID: PMC9498807 DOI: 10.3390/hematolrep14030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/12/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Prednisolone, used as a standard initial treatment for immune thrombocytopenia (ITP), is an important risk factor for osteoporosis. To investigate the prevention of glucocorticoid-induced osteoporosis (GIO) in elderly ITP patients receiving prolonged steroid therapy, associations between GIO prevention and the real-world data of score changes of a dual-energy X-ray absorptiometry (DXA) scan, FRAX® and the Garvan tool during the initial loading of prednisolone were examined. In our institute, 22 ITP patients aged ≥ 70 years received 0.5−1.0 mg/kg prednisolone for 2−3 weeks as the initial ITP treatment between 2014 and 2021. The femoral neck bone mineral density (BMD) measured by DXA scan was entered into FRAX® to define the risk-adapted approach to bisphosphonate during the initial loading of prednisolone. Bisphosphonate was administered according to <−1.0 femoral neck BMD T-score measured by DXA scan. Worse scores of FRAX® and the Garvan tool were associated with bisphosphonate use for short-term fracture prevention in primary GIO; however, there were no incidents of fracture or significant differences in probabilities determined by FRAX® and the Garvan tool. During the initial loading of prednisolone, prescribing bisphosphonate might prevent the reduction in BMD in elderly patients with ITP receiving prolonged steroid therapy.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan
- Correspondence: ; Tel.: +81-977-27-1600; Fax: +81-977-27-1641
| | - Kenjiro Kamezaki
- Department of Hematology, National Hospital Organization, Fukuoka Higashi Medical Center, Fukuoka 811-3195, Japan
| | - Yoshikiyo Ito
- Department of Hematology, Imamura General Hospital, Kagoshima 890-0064, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan
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25
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Kagamu H, Yamasaki S, Horimoto K, Kitano S, Yamaguchi O, Mouri A, Shiono A, Miura Y, Hashimoto K, Imai H, Kaira K, Kobayashi K. 1067P Discovery of a new CD4+ T cell cluster that correlates PD-1 blockade efficacy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1193] [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: 11/30/2022] Open
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26
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Maruyama D, Iida S, Machida R, Kusumoto S, Fukuhara N, Yamauchi N, Miyazaki K, Yoshimitsu M, Kuroda J, Tsukamoto N, Tsujimura H, Usuki K, Yamauchi T, Utsumi T, Mizuno I, Takamatsu Y, Nagata Y, Ota S, Ohtsuka E, Hanamura I, Suzuki Y, Yoshida S, Yamasaki S, Suehiro Y, Kamiyama Y, Fukuhara S, Tsukasaki K, Nagai H. Final analysis of randomized phase II study optimizing melphalan, prednisolone, bortezomib in multiple myeloma (
JCOG1105
). Cancer Sci 2022; 113:3267-3270. [PMID: 35909244 PMCID: PMC9459263 DOI: 10.1111/cas.15484] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Dai Maruyama
- Department of Hematology Oncology, Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology Nagoya City University Hospital Nagoya Japan
| | | | - Shigeru Kusumoto
- Department of Hematology and Oncology Nagoya City University Hospital Nagoya Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology Tohoku University Hospital Sendai Japan
| | - Nobuhiko Yamauchi
- Department of Hematology National Cancer Center Hospital East Kashiwa Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology Mie University School of Medicine Tsu Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology Kagoshima University Hospital Kagoshima Japan
| | - Junya Kuroda
- Division of Hematology and Oncology Kyoto Prefectural University of Medicine Kyoto Japan
| | | | | | - Kensuke Usuki
- Department of Hematology NTT Medical Center Tokyo Tokyo Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology University of Fukui Fukui Japan
| | - Takahiko Utsumi
- Department of Hematology Shiga General Hospital Moriyama Japan
| | | | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases Fukuoka University Hospital Fukuoka Japan
| | - Yasuyuki Nagata
- Department of Internal Medicine III Hamamatsu University School of Medicine Hamamatsu Japan
| | - Shuichi Ota
- Department of Hematology Sapporo Hokuyu Hospital Sapporo Japan
| | - Eiichi Ohtsuka
- Department of Hematology Oita Prefectural Hospital Oita Japan
| | - Ichiro Hanamura
- Division of Hematology Aichi Medical University Nagakute Japan
| | - Yasuhiro Suzuki
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Shinichiro Yoshida
- Department of Hematology National Hospital Organization Nagasaki Medical Center Ohmura Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Youko Suehiro
- Department of Hematology National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Yutaro Kamiyama
- Department of Clinical Oncology and Hematology The Jikei University Hospital Tokyo Japan
| | - Suguru Fukuhara
- Department of Hematology National Cancer Center Hospital Tokyo Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, International Medical Centre Saitama Medical University Saitama Japan
| | - Hirokazu Nagai
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
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27
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Kuno M, Yamasaki S, Fujii N, Ishida Y, Fukuda T, Kataoka K, Uchida N, Katayama Y, Sato M, Onai D, Miyamoto T, Ota S, Yoshioka S, Ara T, Hangaishi A, Hashii Y, Onizuka M, Ichinohe T, Atsuta Y, Inamoto Y. Characterization of myeloid neoplasms following allogeneic hematopoietic cell transplantation. Am J Hematol 2022; 97:185-193. [PMID: 34738245 DOI: 10.1002/ajh.26401] [Citation(s) in RCA: 1] [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: 09/27/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022]
Abstract
We compared characteristics of myeloid neoplasms (MNs) following allogeneic hematopoietic cell transplantation (HCT) versus autologous HCT using a Japanese HCT registry database. Among 43 788 patients who underwent allogeneic (n = 18 874) or autologous HCT (n = 24 914) for non-myeloid malignancies or non-malignant diseases, 352 developed MNs. The cumulative incidence of MNs was lower after allogeneic HCT than after autologous HCT (0.3% vs. 1.8% at 10 years, respectively, p < .001). Compared with autologous HCT, MNs following allogeneic HCT developed in younger patients (median, 42 vs. 57 years old, respectively) and sooner after HCT (median, 16 vs. 33 months, respectively). Approximately half of MNs following allogeneic HCT were donor-derived and occurred later than recipient-derived MNs (median, 26 vs. 6 months, respectively, p = .003). In multivariate analysis, reduced-intensity conditioning and cord blood transplantation were associated with MN development after allogeneic HCT. Overall survival was similar in patients who developed MNs following allogeneic versus autologous HCT (18% vs. 22% at 5 years, respectively, p = .48). Patient age ≥ 55 years, the presence of previous HCT, AML subtype, and chromosome 5 or 7 abnormalities were adverse factors for overall survival after MN diagnosis. Further research is warranted to elucidate the mechanisms of MN development following allogeneic HCT.
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Affiliation(s)
- Masatomo Kuno
- Department of Hematology, Graduate School of Medicine Osaka City University Osaka Japan
| | - Satoshi Yamasaki
- Department of Internal Medicine Kyushu University Beppu Hospital Beppu Japan
| | - Nobuharu Fujii
- Division of Blood Transfusion Okayama University Hospital Okayama Japan
| | - Yasushi Ishida
- Pediatric Medical Center Ehime Prefectural Central Hospital Ehime Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital Tokyo Japan
| | - Keisuke Kataoka
- Division of Hematology, Department of Medicine Keio University School of Medicine Tokyo Japan
- Division of Molecular Oncology National Cancer Center Research Institute Tokyo Japan
| | | | - Yuta Katayama
- Department of Hematology Hiroshima Red Cross Hospital & Atomic‐bomb Survivors Hospital Hiroshima Japan
| | - Maho Sato
- Department of Hematology/Oncology Osaka Women's and Children's Hospital Osaka Japan
| | - Daishi Onai
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Shuichi Ota
- Department of Hematology Sapporo Hokuyu Hospital Hokkaido Japan
| | - Satoshi Yoshioka
- Department of Hematology Kobe City Medical Center General Hospital Hyogo Japan
| | - Takahide Ara
- Department of Hematology Hokkaido University Hospital Hokkaido Japan
| | - Akira Hangaishi
- Department of Hematology National Center for Global Health and Medicine Tokyo Japan
| | - Yoshiko Hashii
- Department of Pediatrics Osaka International Cancer Institute Osaka Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology Tokai University School of Medicine Kanagawa Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine Hiroshima University Hiroshima Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation Aichi Japan
- Department of Registry Science for Transplant and Cellular Therapy Aichi Medical University School of Medicine Aichi Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital Tokyo Japan
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28
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Ishimoto K, Hatanaka N, Otani S, Maeda S, Xu B, Yasugi M, Moore JE, Suzuki M, Nakagawa S, Yamasaki S. Tea crude extracts effectively inactivate severe acute respiratory syndrome coronavirus 2. Lett Appl Microbiol 2021; 74:2-7. [PMID: 34695222 PMCID: PMC8661916 DOI: 10.1111/lam.13591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/03/2021] [Accepted: 10/19/2021] [Indexed: 12/29/2022]
Abstract
It is well known that black and green tea extracts, particularly polyphenols, have antimicrobial activity against various pathogenic microbes including viruses. However, there is limited data on the antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which emerged rapidly in China in late 2019 and which has been responsible for coronavirus disease 2019 (COVID‐19) pandemic globally. In this study, 20 compounds and three extracts were obtained from black and green tea and found that three tea extracts showed significant antiviral activity against SARS‐CoV‐2, whereby the viral titre decreased about 5 logs TCID50 per ml by 1·375 mg ml−1 black tea extract and two‐fold diluted tea bag infusion obtained from black tea when incubated at 25°C for 10 s. However, when concentrations of black and green tea extracts were equally adjusted to 344 µg ml−1, green tea extracts showed more antiviral activity against SARS‐CoV‐2. This simple and highly respected beverage may be a cheap and widely acceptable means to reduce SARS‐CoV‐2 viral burden in the mouth and upper gastrointestinal and respiratory tracts in developed as well as developing countries.
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Affiliation(s)
- K Ishimoto
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,Global Center for Medical Engineering and Informatic, Osaka University, Osaka, Japan
| | - N Hatanaka
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - S Otani
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - S Maeda
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - B Xu
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - M Yasugi
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
| | - J E Moore
- Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK
| | - M Suzuki
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,R&D Group, Mitsui Norin Co. Ltd, Fujieda, Shizuoka, Japan
| | - S Nakagawa
- Laboratory of Innovative Food Science, Graduate School of Pharmaceutical Sciences, Osaka University, Suita, Osaka, Japan.,Global Center for Medical Engineering and Informatic, Osaka University, Osaka, Japan.,Laboratory of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan
| | - S Yamasaki
- Department of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano, Osaka, Japan.,Asian Health Science Research Institute, Osaka Prefecture University, Izumisano, Osaka, Japan.,Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Izumisano, Osaka, Japan
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29
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Hatanaka N, Xu B, Yasugi M, Morino H, Tagishi H, Miura T, Shibata T, Yamasaki S. Chlorine dioxide is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite. J Hosp Infect 2021; 118:20-26. [PMID: 34536532 PMCID: PMC8442261 DOI: 10.1016/j.jhin.2021.09.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A new coronavirus (SARS-CoV-2) abruptly emerged in Wuhan, China, in 2019 and rapidly spread globally to cause the COVID-19 pandemic. AIM To examine the anti-SARS-CoV-2 activity of the potent disinfectant Cleverin, the major disinfecting component of which is chlorine dioxide (ClO2); and to compare the results with that of sodium hypochlorite in the presence or absence of 0.5% or 1.0% foetal bovine serum (FBS). METHODS Concentrated SARS-CoV-2 viruses were treated with various concentrations of ClO2 and sodium hypochlorite and 50% tissue culture infective dose was calcurated to evaluate the antiviral activity of each chemical. FINDINGS When SARS-CoV-2 viruses were treated with 0.8 ppm ClO2 or sodium hypochlorite, viral titre was decreased only by 1 log10 TCID50/mL in 3 min. However, the viral titre was decreased by more than 4 log10 TCID50/mL when treated with 80 ppm of each chemical for 10 s regardless of presence or absence of FBS. It should be emphasized that treatment with 24 ppm of ClO2 inactivated more than 99.99% SARS-CoV-2 within 10 s or 99.99% SARS-CoV-2 in 1 min in the presence of 0.5% or 1.0% FBS, respectively. By contrast, 24 ppm of sodium hypochlorite inactivated only 99% or 90% SARS-CoV-2 in 3 min under similar conditions. Notably, except for ClO2, the other components of Cleverin such as sodium chlorite, decaglycerol monolaurate, and silicone showed no significant antiviral activity. CONCLUSION Altogether, the results strongly suggest that although ClO2 and sodium hypochlorite are strong antiviral agents in absence of organic matter but in presence of organic matter, ClO2 is a more potent antiviral agent against SARS-CoV-2 than sodium hypochlorite.
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Affiliation(s)
- N Hatanaka
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - B Xu
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - M Yasugi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan
| | - H Morino
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - H Tagishi
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Miura
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - T Shibata
- Research and Development Center, Taiko Pharmaceutical Co. Ltd, Kyoto, Japan
| | - S Yamasaki
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan; Asian Health Science Research Institute, Osaka Prefecture University, Osaka, Japan; Osaka International Research Center for Infectious Diseases, Osaka Prefecture University, Osaka, Japan.
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30
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Yanada M, Konuma T, Yamasaki S, Mizuno S, Hirabayashi S, Nishiwaki S, Uchida N, Doki N, Tanaka M, Ozawa Y, Sawa M, Eto T, Kawakita T, Ota S, Fukuda T, Onizuka M, Kimura T, Atsuta Y, Kako S, Yano S. The differential effect of disease status at allogeneic hematopoietic cell transplantation on outcomes in acute myeloid and lymphoblastic leukemia. Ann Hematol 2021; 100:3017-3027. [PMID: 34477952 DOI: 10.1007/s00277-021-04661-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to compare the effect of disease status at the time of allogeneic hematopoietic cell transplantation (HCT) on post-transplant outcomes between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Japanese nationwide registry data for 6901 patients with AML and 2469 patients with ALL were analyzed. In this study, 2850 (41%), 937 (14%), 62 (1%), and 3052 (44%) AML patients and 1751 (71%), 265 (11%), 23 (1%), and 430 (17%) ALL patients underwent transplantation in first complete remission (CR1), second CR (CR2), third or subsequent CR (CR3 +), and non-CR, respectively. The probabilities of overall survival at 5 years for patients transplanted in CR1, CR2, CR3 + , and non-CR were 58%, 61%, 41%, and 26% for AML patients and 67%, 45%, 20%, and 21% for ALL patients, respectively. Multivariate analyses revealed that the risks of relapse and overall mortality were similar for AML patients transplanted in CR1 and CR2 (P = 0.672 and P = 0.703), whereas they were higher for ALL patients transplanted in CR2 than for those transplanted in CR1 (P < 0.001 for both). The risks of relapse and overall mortality for those transplanted in CR3 + and non-CR increased in a stepwise manner for both diseases, with the relevance being stronger for ALL than for AML patients. These results suggest a significant difference in the effect of disease status at HCT on post-transplant outcomes in AML and ALL. Further investigation to incorporate measurable residual disease data is warranted.
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Affiliation(s)
- Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
| | - Takaaki Konuma
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | | | | | | | | | | | - Noriko Doki
- Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | | | | | | | | | - Toshiro Kawakita
- National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | | | | | | | | | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichi Kako
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Shingo Yano
- The Jikei University School of Medicine, Tokyo, Japan
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31
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Yanada M, Mizuno S, Yamasaki S, Harada K, Konuma T, Tamaki H, Shingai N, Uchida N, Ozawa Y, Tanaka M, Onizuka M, Sawa M, Nakamae H, Shiratori S, Matsuoka KI, Eto T, Kawakita T, Maruyama Y, Ichinohe T, Kanda Y, Atsuta Y, Aoki J, Yano S. Difference in outcomes following allogeneic hematopoietic cell transplantation for patients with acute myeloid leukemia and myelodysplastic syndromes. Leuk Lymphoma 2021; 62:3411-3419. [PMID: 34348554 DOI: 10.1080/10428194.2021.1961242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To evaluate whether outcomes following allogeneic hematopoietic cell transplantation differ according to disease type, a three-way comparison for patients with de novo acute myeloid leukemia (AML) (n = 3318), AML evolving from myelodysplastic syndromes (MDS) (n = 208), and MDS with excess blasts (MDS-EB) (n = 994) was performed. The 5-year probabilities of overall survival (OS) for de novo AML, AML evolving from MDS, and MDS-EB were 60%, 42%, and 41% (p < 0.001), respectively. Multivariate analysis revealed that, compared to de novo AML, AML evolving from MDS was associated with a higher risk of NRM (p = 0.030) and MDS-EB with a higher risk of relapse (p < 0.001), both leading to lower OS (p = 0.010 and p < 0.001, respectively). These findings demonstrate inter-disease differences in post-transplant outcomes and highlight the needs to reduce NRM for AML evolving from MDS and to reduce relapse for MDS-EB.
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Affiliation(s)
| | | | | | - Kaito Harada
- Tokai University School of Medicine, Isehara, Japan
| | - Takaaki Konuma
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | | | - Naoki Shingai
- Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | | | | | | | | | | | - Hirohisa Nakamae
- Graduate School of Medicine, Osaka City University, Osaka, Japan
| | | | | | | | - Toshiro Kawakita
- National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | | | - Tatsuo Ichinohe
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | | | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jun Aoki
- National Cancer Center Hospital, Tokyo, Japan
| | - Shingo Yano
- The Jikei University School of Medicine, Tokyo, Japan
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32
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Tanaka T, Nakamae H, Ito A, Fuji S, Hirose A, Eto T, Henzan H, Takase K, Yamasaki S, Makiyama J, Moriuchi Y, Choi I, Nakano N, Hiramoto N, Kato K, Sato T, Sawayama Y, Kim SW, Inoue Y, Inamoto Y, Fukuda T. A Phase I/II Multicenter Trial of HLA-Haploidentical PBSCT with PTCy for Aggressive Adult T Cell Leukemia/Lymphoma. Transplant Cell Ther 2021; 27:928.e1-928.e7. [PMID: 34274491 DOI: 10.1016/j.jtct.2021.07.010] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
Adult T cell leukemia/lymphoma (ATL) is a highly aggressive hematologic malignancy with a very poor prognosis, and most patients with ATL are elderly. Although post-transplantation cyclophosphamide (PTCy) has yielded promising results in various diseases, available data are limited regarding its outcomes in ATL. The aim of this study was to determine the safety and efficacy of reduced-intensity peripheral blood stem cell transplantation (PBSCT) from a human leukocyte antigen (HLA)-haploidentical donor using PTCy as graft-versus-host disease (GVHD) prophylaxis. This was a prospective, multicenter phase I/II study (UMIN000021783) conducted at 16 hospitals in Japan. The primary endpoint was the probability of survival with engraftment and without grade III/IV acute GVHD at day 60 after PBSCT. The expected probability of the primary endpoint was estimated to be 60%, and the threshold probability was set at 30% on the basis of previous studies. The conditioning regimen consisted of fludarabine (30 mg/m2/d from day -7 to -2), melphalan (40 mg/m2/d on days -3 and -2), and total body irradiation (2 Gy on day -1). GVHD prophylaxis consisted of tacrolimus starting at 0.02 mg/kg/d on day -1, PTCy (50 mg/kg/d on days +3 and +5), and mycophenolate mofetil 2000 mg/d starting on day +6. Eighteen ATL patients underwent PBSCT. The probability of patients who met the primary endpoint was 89% (95% confidence interval, 65% to 99%). The cumulative incidences of grade II to IV acute GVHD, III/IV acute GVHD, and moderate-to-severe chronic GVHD were 39%, 11%, and 17%, respectively. The probabilities of overall survival were 83% at 1 year and 73% at 2 years. The cumulative incidences of non-relapse mortality and disease progression at 1 year were 11% and 28%, respectively. HLA-haploidentical PBSCT with PTCy as GVHD prophylaxis is a valid option for patients with aggressive ATL.
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Affiliation(s)
- Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hirohisa Nakamae
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Ayumu Ito
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Asao Hirose
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Yamasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junya Makiyama
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | | | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Koji Kato
- Department of Hematology, Oncology & Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takahiko Sato
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Yasushi Sawayama
- Department of Hematology, Sasebo University Hospital, Sasebo, Japan
| | - Sung-Won Kim
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Inoue
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
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33
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Yamasaki S, Matsushima T, Minami M, Kadowaki M, Takase K, Iwasaki H. Clinical impact of comprehensive geriatric assessment in patients aged 80 years and older with diffuse large B-cell lymphoma receiving rituximab-mini-CHOP: a single-institute retrospective study. Eur Geriatr Med 2021; 13:195-201. [PMID: 34254266 DOI: 10.1007/s41999-021-00539-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/25/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Comprehensive geriatric assessment (CGA) has been used to help identify elderly patients with diffuse large B-cell lymphoma (DLBCL) who were suitable for rituximab combined with CHOP therapy (cyclophosphamide, Adriamycin, vincristine, and prednisolone), but there are few reports of CGA for elderly patients with DLBCL who received R-mini-CHOP. METHODS We retrospectively analyzed the risk factors for outcomes among 142 patients aged 80 years and older (≤ 85 years, n = 102; > 85 years, n = 40) with DLBCL who received R-mini-CHOP at 4-week intervals at our institute between 2008 and 2019. We performed a comparison between CGA and treatment outcomes. RESULTS There were significant differences in progression-free survival between patients with international prognostic index (IPI) scores of > 3 and ≤ 3 at diagnosis and in overall survival between patients with instrumental activities of daily living (IADL) scores of ≥ 5 and IADL < 5 before the initial treatment and patients aged ≤ 85 years and > 85 years. CONCLUSION Strategies that carefully select elderly patients aged 80 years and older with DLBCL using CGA may help to identify individuals suitable for novel therapies.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. .,Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
| | - Takumi Matsushima
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Mariko Minami
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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34
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Fujino T, Goyama S, Sugiura Y, Inoue D, Asada S, Yamasaki S, Matsumoto A, Yamaguchi K, Isobe Y, Tsuchiya A, Shikata S, Sato N, Morinaga H, Fukuyama T, Tanaka Y, Fukushima T, Takeda R, Yamamoto K, Honda H, Nishimura EK, Furukawa Y, Shibata T, Abdel-Wahab O, Suematsu M, Kitamura T. Mutant ASXL1 induces age-related expansion of phenotypic hematopoietic stem cells through activation of Akt/mTOR pathway. Nat Commun 2021; 12:1826. [PMID: 33758188 PMCID: PMC7988019 DOI: 10.1038/s41467-021-22053-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/23/2021] [Indexed: 01/31/2023] Open
Abstract
Somatic mutations of ASXL1 are frequently detected in age-related clonal hematopoiesis (CH). However, how ASXL1 mutations drive CH remains elusive. Using knockin (KI) mice expressing a C-terminally truncated form of ASXL1-mutant (ASXL1-MT), we examined the influence of ASXL1-MT on physiological aging in hematopoietic stem cells (HSCs). HSCs expressing ASXL1-MT display competitive disadvantage after transplantation. Nevertheless, in genetic mosaic mouse model, they acquire clonal advantage during aging, recapitulating CH in humans. Mechanistically, ASXL1-MT cooperates with BAP1 to deubiquitinate and activate AKT. Overactive Akt/mTOR signaling induced by ASXL1-MT results in aberrant proliferation and dysfunction of HSCs associated with age-related accumulation of DNA damage. Treatment with an mTOR inhibitor rapamycin ameliorates aberrant expansion of the HSC compartment as well as dysregulated hematopoiesis in aged ASXL1-MT KI mice. Our findings suggest that ASXL1-MT provokes dysfunction of HSCs, whereas it confers clonal advantage on HSCs over time, leading to the development of CH.
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Affiliation(s)
- Takeshi Fujino
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Susumu Goyama
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Yuki Sugiura
- Department of Biochemistry, Keio University School of Medicine, and Japan Science and Technology Agency (JST), Exploratory Research for Advanced Technology (ERATO), Suematsu Gas Biology Project, Shinjuku-ku, Tokyo Japan
| | - Daichi Inoue
- grid.51462.340000 0001 2171 9952Human Oncology and Pathogenesis Program, Memorial Sloan−Kettering Cancer Center and Weill Cornell Medical College, New York, USA ,grid.417982.10000 0004 0623 246XDepartment of Hematology-Oncology, Institute of Biomedical Research and Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe City, Hyogo Japan
| | - Shuhei Asada
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan ,grid.410818.40000 0001 0720 6587Field of Human Disease Models, Major in Advanced Life Sciences and Medicine, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo Japan
| | - Satoshi Yamasaki
- grid.26999.3d0000 0001 2151 536XLaboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Akiko Matsumoto
- grid.26999.3d0000 0001 2151 536XLaboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Kiyoshi Yamaguchi
- grid.26999.3d0000 0001 2151 536XDivision of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Yumiko Isobe
- grid.26999.3d0000 0001 2151 536XDivision of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Akiho Tsuchiya
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Shiori Shikata
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Naru Sato
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Hironobu Morinaga
- grid.265073.50000 0001 1014 9130Department of Stem Cell Biology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo Japan
| | - Tomofusa Fukuyama
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Yosuke Tanaka
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Tsuyoshi Fukushima
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Reina Takeda
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Keita Yamamoto
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Hiroaki Honda
- grid.410818.40000 0001 0720 6587Field of Human Disease Models, Major in Advanced Life Sciences and Medicine, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo Japan
| | - Emi K. Nishimura
- grid.265073.50000 0001 1014 9130Department of Stem Cell Biology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo Japan
| | - Yoichi Furukawa
- grid.26999.3d0000 0001 2151 536XDivision of Clinical Genome Research, Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Tatsuhiro Shibata
- grid.26999.3d0000 0001 2151 536XLaboratory of Molecular Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
| | - Omar Abdel-Wahab
- grid.51462.340000 0001 2171 9952Human Oncology and Pathogenesis Program, Memorial Sloan−Kettering Cancer Center and Weill Cornell Medical College, New York, USA
| | - Makoto Suematsu
- Department of Biochemistry, Keio University School of Medicine, and Japan Science and Technology Agency (JST), Exploratory Research for Advanced Technology (ERATO), Suematsu Gas Biology Project, Shinjuku-ku, Tokyo Japan
| | - Toshio Kitamura
- grid.26999.3d0000 0001 2151 536XDivision of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Minato-ku, Tokyo Japan
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Fujimoto K, Hidaka Y, Koga T, Kaieda S, Yamasaki S, Nakashima M, Hoshino T, Yamamoto K, Nishikomori R, Ida H. MEFV E148Q variant is more associated with familial Mediterranean fever when combined with other non-exon 10 MEFV variants in Japanese patients with recurrent fever. Mod Rheumatol 2021; 31:1208-1214. [PMID: 33497256 DOI: 10.1080/14397595.2021.1880534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the genetic characteristics of one of the MEFV gene variants, p.Glu148Gln (E148Q), in patients with familial Mediterranean fever (FMF) and examine its significance in Japanese patients with recurrent fever. METHODS The clinical phenotype and genomic variants of systemic autoinflammatory diseases (SAIDs), including MEFV, were analyzed in 211 Japanese patients with recurrent fever. Genetic analysis was performed via next-generation sequencing of exons, including exon-intron boundaries. RESULTS Twelve patients met the diagnostic criteria for SAIDs other than FMF. Considering 199 patients with recurrent fever, 137 cases (68.8%) were clinically diagnosed with FMF. Although Bonferroni-adjusted p-value did not reach significance level, the group containing heterozygous E148Q and other variants tended to be at higher risk of developing the FMF phenotype (nominal p = .036) than the group with heterozygous E148Q only. Comparison between the group with heterozygous E148Q and other variants and the heterozygous group containing non-E148Q showed no statistically significant difference in FMF phenotype expression (nominal p = 1.00). CONCLUSION Patients with heterozygous E148Q and other variants exhibited higher expression of FMF phenotype than those with heterozygous E148Q only, and suggested that other variants than E148Q as well as exon 10 variants might contribute to the FMF phenotype.
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Affiliation(s)
- Kyoko Fujimoto
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yukiko Hidaka
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuma Koga
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shinjiro Kaieda
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Yamasaki
- Center for Rheumatic Diseases, Kurume University Medical Center, Kurume, Japan
| | - Munetoshi Nakashima
- Center for Rheumatic Diseases, Kurume University Medical Center, Kurume, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ken Yamamoto
- Department of Medical Biochemistry, Kurume University School of Medicine, Kurume, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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36
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Konuma T, Kanda J, Yamasaki S, Harada K, Shimomura Y, Terakura S, Mizuno S, Uchida N, Tanaka M, Doki N, Ozawa Y, Nakamae H, Sawa M, Matsuoka KI, Morishige S, Maruyama Y, Ikegame K, Kimura T, Kanda Y, Ichinohe T, Atsuta Y, Yanada M. Single Cord Blood Transplantation Versus Unmanipulated Haploidentical Transplantation for Adults with Acute Myeloid Leukemia in Complete Remission. Transplant Cell Ther 2021; 27:334.e1-334.e11. [PMID: 33836881 DOI: 10.1016/j.jtct.2021.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 12/30/2020] [Revised: 01/18/2021] [Accepted: 01/23/2021] [Indexed: 02/07/2023]
Abstract
Allogeneic hematopoietic cell transplantation (HCT) is a potentially curative post-remission therapy for adult patients with acute myeloid leukemia (AML) in complete remission (CR). The availability of alternative human leukocyte antigen (HLA)-mismatched donors, such as cord blood and haploidentical related donors, could allow patients to receive allogeneic HCT who are without an HLA-matched sibling or unrelated donor. The use of these alternative donors is preferable for patients with advanced disease due to the rapid availability. However, comparative data for cord blood transplantation (CBT) and haploidentical related donor transplantation (haplo-HCT) are limited for adult patients with AML in CR. We sought to compare overall survival (OS); leukemia-free survival (LFS); graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS); and chronic GVHD-free, relapse-free survival (CRFS) between single-unit CBT (SCBT) and haplo-HCT recipients for adult patients with intermediate- or poor-risk AML in CR. We retrospectively analyzed and compared the results of allogeneic hematopoietic cell transplantation in 1313 adult patients with intermediate- or poor-risk AML in CR who received either SCBT (n = 1102) or unmanipulated haplo-HCT (n = 211) between 2007 and 2018 in Japan. Among the whole cohort, the cumulative incidences of neutrophil and platelet recovery were significantly lower in SCBT recipients compared with those in haplo-HCT recipients (P < .001 for neutrophil, P < .001 for platelet). SCBT was significantly associated with a higher incidence of grade II to IV acute GVHD and lower incidence of extensive chronic GVHD compared to haplo-HCT (P = .013 for grades II to IV acute GVHD; P = .006 for extensive chronic GVHD). Haplo-HCT recipients developed a higher incidence of cytomegalovirus (CMV) antigenemia compared to SCBT recipients (P = .004). In the multivariate analysis, there were no significant differences for grades III or IV acute GVHD (hazard ratio [HR], 1.17; 95% confidence interval [CI], .88 to 1.57; P = .26), relapse incidence (HR, 1.09; 95% CI, .76 to 1.58; P = .61), non-relapse mortality (HR, .83; 95% CI, .58 to 1.18; P = .32), OS (HR, .92; 95% CI, .70 to 1.20; P = .56), LFS (HR, .94; 95% CI, .73 to 1.21; P = .67), GRFS (HR, 1.12; 95% CI, .90 to 1.40; P = .27), or CRFS (HR, 1.15; 95% CI, .92 to 1.44; P = .19) between the two donor types. In the propensity score matching analysis, which identified 180 patients in each cohort, there were no significant differences in transplant outcomes between the two donor types, except for delayed neutrophil (P < .001) and platelet recovery (P < .001) and a higher incidence of grades II to IV acute GVHD (P = .052) in SCBT. SCBT and unmanipulated haplo-HCT had similar survival outcomes for adult patients with AML in CR despite the lower hematopoietic recovery and higher grade II to IV acute GVHD in SCBT recipients and the higher CMV antigenemia in haplo-HCT recipients.
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Affiliation(s)
- Takaaki Konuma
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kaito Harada
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Hospital Organization, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Seitaro Terakura
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Hirohisa Nakamae
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Satoshi Morishige
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazuhiro Ikegame
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takafumi Kimura
- Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
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37
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Yamasaki S, Iida H, Yoshida I, Komeno T, Sawamura M, Matsumoto M, Sekiguchi N, Hishita T, Sunami K, Shimomura T, Takatsuki H, Yoshida S, Otsuka M, Kato T, Kuroda Y, Ooyama T, Suzuki Y, Ohshima K, Nagai H, Iwasaki H. Comparison of prognostic scores in transplant-ineligible patients with peripheral T-cell lymphoma not otherwise specified and angioimmunoblastic T-cell lymphoma: a retrospective study from the national hospital organization in Japan. Leuk Lymphoma 2020; 62:819-827. [PMID: 33167741 DOI: 10.1080/10428194.2020.1845336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We retrospectively analyzed the risk factors for outcomes among patients with peripheral T-cell lymphoma not otherwise specified (PTCL-NOS, n = 100) and angioimmunoblastic T-cell lymphoma (AITL, n = 128) who did not receive hematopoietic stem cell transplantation between 2008 and 2018. We designed a comparison of prognostic scores specifically for PTCL-NOS and AITL. The international prognostic index (IPI) was useful for investigating the risk factors associated with outcomes among transplant-ineligible patients with PTCL-NOS (Harrell's c-statistic 0.715) and AITL (c-statistic 0.615). The prognostic index for T-cell lymphoma (PIT), modified PIT, and the International Peripheral T Cell Lymphoma Project for overall survival (OS) seemed to identify separate prognostic groups, based on visual assessment of Kaplan-Meier curves. However, better c-statistics (>0.7) were only found for the IPI score for OS in PTCL-NOS. Strategies that carefully select PTCL patients with higher IPI scores may help to identify individuals suitable for novel therapies.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiroatsu Iida
- Department of Hematology and Oncology Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Morio Sawamura
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Morio Matsumoto
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Japan
| | - Naoshiro Sekiguchi
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tachikawa, Japan
| | - Terutoshi Hishita
- Department of Hematology, National Hospital Organization Himeji Medical Center, Himeji, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takeshi Shimomura
- Department of Hematology, National Hospital Organization Hiroshimanishi Medical Center, Otake, Japan
| | - Hiroshi Takatsuki
- Department of Hematology, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Maki Otsuka
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Yoshiaki Kuroda
- Department of Hematology, National Hospital Organization Hiroshimanishi Medical Center, Otake, Japan
| | - Tadashi Ooyama
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yasuhiro Suzuki
- Department of Hematology and Oncology Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Hirokazu Nagai
- Department of Hematology and Oncology Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Yamasaki S, Kada A, Choi I, Iida H, Sekiguchi N, Harada N, Sawamura M, Shimomura T, Komeno T, Yano T, Yoshida I, Yoshida S, Sunami K, Hishita T, Takatsuki H, Ohshima K, Takeshita M, Saito AM, Iwasaki H, Nagai H. Phase II study of dose‐adjusted gemcitabine, dexamethasone, cisplatin, and rituximab in elderly relapsed diffuse large B‐cell lymphoma patients. eJHaem 2020; 1:507-516. [PMID: 35844987 PMCID: PMC9176064 DOI: 10.1002/jha2.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
High‐dose chemotherapy and autologous stem cell transplantation (ASCT) are too toxic for elderly patients with relapsed or refractory diffuse large B‐cell lymphoma (DLBCL). Therefore, effective and tolerable regimens for elderly patients are urgently needed. The present phase II study assessed the efficacy and safety of dose‐adjusted therapy with gemcitabine, dexamethasone, cisplatin, and rituximab (GDP‐R) in this population. ASCT‐ineligible elderly patients with relapsed or refractory DLBCL received dose‐adjusted GDP‐R in each 28‐day cycle for up to six cycles. The primary endpoint was overall response rate (ORR), and secondary endpoints were complete response (CR) rate, progression‐free survival (PFS), and safety. Thirty‐three patients were enrolled and received dose‐adjusted GDP‐R. The median age was 75 years (range: 68‐87 years). The ORR was 82.8% (90% confidence interval [CI], 67.1‐93.0%), with a CR rate of 58.6% (90% CI, 41.7‐74.1%). At a median follow‐up of 20.9 months, the 2‐year PFS rate was 46.8% (90% CI, 30.7‐61.5%) and the 2‐year overall survival rate was 63.2% (90% CI, 45.8‐76.3%). The most frequently observed grade 4 adverse events were neutropenia (63.6%), thrombocytopenia (57.6%), and lymphocytopenia (39.4%). Dose‐adjusted GDP‐R is a promising salvage regimen for ASCT‐ineligible elderly patients with relapsed DLBCL after rituximab‐containing chemotherapy and warrants further investigation.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Akiko Kada
- Clinical Research Center National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Ilseung Choi
- Department of Hematology National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Hiroatsu Iida
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Naohiro Sekiguchi
- Department of Hematology National Hospital Organization Disaster Medical Center Tachikawa Japan
| | - Naoko Harada
- Department of Hematology National Hospital Organization Kumamoto Medical Center Kumamoto Japan
| | - Morio Sawamura
- Department of Hematology National Hospital Organization Shibukawa Medical Center Shibukawa Japan
| | - Takeshi Shimomura
- Department of Hematology National Hospital Organization Hiroshimanishi Medical Center Otake Japan
| | - Takuya Komeno
- Department of Hematology National Hospital Organization Mito Medical Center Ibaraki Japan
| | - Takahiro Yano
- Department of Hematology National Hospital Organization Tokyo Medical Center Tokyo Japan
| | - Isao Yoshida
- Department of Hematologic Oncology National Hospital Organization Shikoku Cancer Center Matsuyama Japan
| | - Shinichiro Yoshida
- Department of Hematology National Hospital Organization Nagasaki Medical Center Omura Japan
| | - Kazutaka Sunami
- Department of Hematology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Terutoshi Hishita
- Department of Hematology National Hospital Organization Himeji Medical Center Himeji Japan
| | - Hiroshi Takatsuki
- Department of Hematology National Hospital Organization Kokura Medical Center Kitakyushu Japan
| | - Koichi Ohshima
- Department of Pathology School of Medicine Kurume University Kurume Japan
| | - Morishige Takeshita
- Department of Pathology Faculty of Medicine Fukuoka University Fukuoka Japan
| | - Akiko M. Saito
- Clinical Research Center National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Hirokazu Nagai
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
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39
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Yamasaki S, Mori J, Kanda J, Imahashi N, Uchida N, Doki N, Tanaka M, Katayama Y, Eto T, Ozawa Y, Takada S, Onizuka M, Hino M, Kanda Y, Fukuda T, Atsuta Y, Yanada M. Effect of allogeneic HCT from unrelated donors in AML patients with intermediate- or poor-risk cytogenetics: a retrospective study from the Japanese Society for HCT. Ann Hematol 2020; 99:2927-2937. [PMID: 32940726 DOI: 10.1007/s00277-020-04261-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
This study aimed to analyze the factors associated with outcomes of bone marrow transplantation (UR-BMT) or cord blood stem cell transplantation from unrelated donors (UR-CBT). We assessed the time from diagnosis to transplantation among acute myeloid leukemia (AML) patients with intermediate- or poor-risk cytogenetics to identify the potential clinical efficacy of transplantation. We retrospectively analyzed 5331 patients who received UR-BMT or UR-CBT between 2008 and 2017. Patients were divided into four groups according to time from diagnosis to transplantation: (1) UR-BMT and > 5 months (n = 2353), (2) UR-BMT and ≤ 5 months (n = 379), (3) UR-CBT and > 5 months (n = 1494), and (4) UR-CBT and ≤ 5 months (n = 1106). There was no difference in overall survival (OS) for transplantation at ≤5 months and > 5 months in patients with first complete remission for both UR-BMT and UR-CBT, but OS in patients with primary induction failure (PIF) and transplantation at ≤ 5 months was significantly higher in the UR-CBT group compared with that at >5 months (P < 0.001). Multivariate Cox regression analysis also showed that transplantation at >5 months in patients with PIF was an independent predictor of poorer OS. Therefore, UR-CBT at ≤ 5 months after diagnosis is an alternative option for AML patients with PIF.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
| | - Jinichi Mori
- Department of Hematology, Jyoban Hospital, Iwaki, Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuhiko Imahashi
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Satoru Takada
- Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Masayuki Hino
- Department of Hematology, Osaka City University, Osaka, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Takahiro Fukuda
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
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Fujino T, Goyama S, Sugiura Y, Inoue D, Asada S, Yamasaki S, Matsumoto A, Tsuchiya A, Shikata S, Sato N, Morinaga H, Fukuyama T, Tanaka Y, Fukushima T, Takeda R, Yamamoto K, Honda H, Nishimura E, Shibata T, Abdel-Wahab O, Suematsu M, Kitamura T. 3011 – MUTANT ASXL1 INDUCES EXPANSION OF HEMATOPOIETIC STEM CELLS THROUGH ACTIVATION OF AKT/MTOR PATHWAY. Exp Hematol 2020. [DOI: 10.1016/j.exphem.2020.09.032] [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: 11/16/2022]
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Hidaka Y, Fujimoto K, Matsuo N, Koga T, Kaieda S, Yamasaki S, Nakashima M, Migita K, Nakayama M, Ohara O, Hoshino T, Nishikomori R, Ida H. Clinical phenotypes and genetic analyses for diagnosis of systemic autoinflammatory diseases in adult patients with unexplained fever. Mod Rheumatol 2020; 31:704-709. [PMID: 32552384 DOI: 10.1080/14397595.2020.1784542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To make an accurate diagnosis of systemic autoinflammatory diseases (SAIDs), clinical and genetic analyses were performed in patients with unexplained fever. METHODS The clinical phenotype and genomic variants of 11 genes responsible for SAIDs were analyzed in 179 Japanese patients with unexplained fever. Genetic analysis was performed by next generation sequencing (NGS) on exons including exon-intron boundaries. RESULTS Three cases met the diagnostic criteria for SAIDs other than familial Mediterranean fever (FMF). Considering 176 patients with unexplained fever, 43 cases (24.0%) were clinically diagnosed as FMF. Gene variants were found in 53 cases (30.1%) when searching for variants in the 10 disease genes other than the MEFV gene. Among them, the most frequently-identified genes were NLRP3, NOD2, NLRP12, NLRC4, and PLCG2, which accounted for 14, 7, 17, 7, and 6 cases, respectively. These variants were less than 1% of healthy individuals or novel variants, but not regarded as pathogenic since the patients did not meet the diagnostic criteria of SAIDs caused by their identified variants clinically. CONCLUSION Twenty four percent of Japanese patients with unexplained fever were clinically diagnosed as FMF in this study. Low frequency but not pathogenic variants in genes other than MEFV were identified in 30.1% of the cases. It is not clear how much these gene variants contribute to the inflammatory phenotypes; therefore, further analysis would uncover their autoinflammatory phenotypes that cause fever.
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Affiliation(s)
- Yukiko Hidaka
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kyoko Fujimoto
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Norikazu Matsuo
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takuma Koga
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shinjiro Kaieda
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoshi Yamasaki
- Division of Rheumatology, Kurume University Medical Center, Kurume, Japan
| | | | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | | | - Osamu Ohara
- Kazusa DNA Research Institute, Kisarazu, Japan
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Pediatrics, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Ida
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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Yamasaki S, Kada A, Nagai H, Yoshida I, Choi I, Miyata Y, Miyazawa Y, Saito A, Iwasaki H. Rituximab-Mediated Complement-Dependent Cytotoxicity Enhanced by Gemcitabine in Older Patients with Previously Rituximab-Treated Diffuse Large B-Cell Lymphoma: Study Protocol. Kurume Med J 2020; 66:37-42. [PMID: 31787704 DOI: 10.2739/kurumemedj.ms661001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
High-dose chemotherapy and autologous stem cell transplantation is too toxic for elderly patients with relapsed or refractory (DLBCL). Therefore, tolerable and efficient salvage regimens for elderly patients are greatly needed. In this study, therapy with rituximab, gemcitabine, dexamethasone, and cisplatin (R-GDP) will be performed every 4 weeks, and an interim evaluation will be performed after the completion of the 3rd course. If a complete response (CR) is achieved at the time of interim evaluation, 1 course of R-GDP therapy and 2 courses of monotherapy with rituximab will be additionally performed. If a partial response (PR) is achieved, 3 courses of R-GDP therapy will be additionally conducted. In patients without a PR or CR by the time of the interim evaluation, treatment will be discontinued. Treatment will also be discontinued at any point if disease progression is observed during protocol treatment. After the completion of the final course of R-GDP therapy, final effects of the regimen will be evaluated. A primary endpoint is the efficacy of R-GDP therapy (CR and response rates). This is the first multicenter phase II clinical study of R-GDP therapy to examine post-treatment activities of daily living in addition to the safety and efficacy of treatment in elderly patients with relapsed or refractory transplantineligible DLBCL.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center.,Clinical Research Center, National Hospital Organization Nagoya Medical Center
| | - Akiko Kada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center
| | - Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center
| | - Yasuhiko Miyata
- Department of Hematology, National Hospital Organization Nagoya Medical Center
| | - Yuri Miyazawa
- Department of Hematology, National Hospital Organization Nishigunma National Hospital
| | - Akiko Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
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Maruyama D, Iida S, Ogawa G, Fukuhara N, Seo S, Miyazaki K, Yoshimitsu M, Kuroda J, Tsukamoto N, Tsujimura H, Hangaishi A, Yamauchi T, Utsumi T, Mizuno I, Takamatsu Y, Nagata Y, Minauchi K, Ohtsuka E, Hanamura I, Yoshida S, Yamasaki S, Suehiro Y, Kamiyama Y, Tsukasaki K, Nagai H. Randomised phase II study to optimise melphalan, prednisolone, and bortezomib in untreated multiple myeloma (JCOG1105). Br J Haematol 2020; 192:531-541. [PMID: 32583431 PMCID: PMC7891591 DOI: 10.1111/bjh.16878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 01/04/2023]
Abstract
We conducted a randomised phase II study to determine the optimal dose and schedule of melphalan, prednisone, and bortezomib (MPB) (jRCTs031180097). Transplant‐ineligible untreated multiple myeloma patients were randomised to Arm A (twice weekly bortezomib in one six‐week cycle followed by eight five‐week cycles of four times once weekly bortezomib with melphalan and prednisolone on days 1–4) or Arm B (nine four‐week cycles of three times once weekly bortezomib with melphalan and prednisolone on days 1–4). The primary end‐point was complete response (CR) rate. Of 91 patients randomised to two arms, 88 were eligible. The median cumulative bortezomib doses were 45·8 and 35·1 mg/m2, CR rate was 18·6% [95% confidence interval (CI) 8·4–33·4] and 6·7% (95% CI 1·4–18·3), and the median progression‐free survival (PFS) was 2·5 and 1·4 years in Arms A and B [hazard ratio (HR) 1·93 (95% CI 1·09–3·42)], respectively. Frequent grade ≥3 haematologic toxicities in Arms A and B were neutropenia (64·4% vs. 28·3%) and thrombocytopenia (35·6% vs. 10·9%). Grade 2/3 peripheral neuropathy was observed in 24·4/2·2% in Arm A and 8·7/0% in Arm B. In conclusion, Arm A was the more promising regimen, suggesting that the twice weekly schedule of bortezomib in the first cycle and higher cumulative dose of both bortezomib and melphalan influences the efficacy of modified MPB.
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Affiliation(s)
- Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Gakuto Ogawa
- JCOG Data Center/Operating Office, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Sachiko Seo
- Department of Hematology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University School of Medicine, Tsu, Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Hideki Tsujimura
- Division of Hematology-Oncology, Chiba Cancer Center, Chiba, Japan
| | - Akira Hangaishi
- Division of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Japan
| | - Takahiko Utsumi
- Department of Hematology, Shiga General Hospital, Moriyama, Japan
| | | | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Fukuoka University Hospital, Fukuoka, Japan
| | - Yasuyuki Nagata
- Department of Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Eiichi Ohtsuka
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Ichiro Hanamura
- Division of Hematology, Aichi Medical University, Nagakute, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan
| | - Youko Suehiro
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yutaro Kamiyama
- Department of Clinical Oncology and Hematology, The Jikei University Hospital, Tokyo, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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44
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Inubushi T, Kosai A, Yanagisawa S, Chanbora C, Miyauchi M, Yamasaki S, Sugiyama E, Ishikado A, Makino T, Takata T. Bovine lactoferrin enhances osteogenesis through Smad2/3 and p38 MAPK activation. J Oral Biosci 2020; 62:147-154. [DOI: 10.1016/j.job.2020.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
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45
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Yoshida I, Saito AM, Tanaka S, Choi I, Hidaka M, Miyata Y, Inoue Y, Yamasaki S, Kagoo T, Iida H, Niimi H, Komeno T, Yoshida C, Tajima F, Yamamoto H, Takase K, Ueno H, Shimomura T, Sakai T, Nakashima Y, Yoshida C, Kubonishi S, Sunami K, Yoshida S, Sakurai A, Kaneko Y, Miyazaki Y, Nagai H. Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever. Mycoses 2020; 63:794-801. [PMID: 32391919 PMCID: PMC7497187 DOI: 10.1111/myc.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fungal infections are a major complication of neutropaenia following chemotherapy. Their early diagnosis is difficult, and empirical antifungal treatment is widely used, and uses of less toxic drugs that reduce breakthrough infection are required. OBJECTIVE We conducted a multicentre, open-label, randomised, non-inferiority trial to compare the safety and efficacy of intravenous itraconazole (ivITCZ) and liposomal amphotericin B (LAmB) as empirical antifungal therapy in patients with haematological malignancies with neutropaenia and persistent fever. METHODS Patients with haematological malignancies who developed fever refractory to broad-spectrum antibacterial agents under neutropaenia conditions were enrolled. Patients were randomised for treatment with LAmB (3.0 mg/kg/d) or ivITCZ (induction: 400 mg/d, maintenance: 200 mg/d). RESULTS Observed overall favourable response rates of 17/52 (32.7%) and 18/50 (36.0%) in the LAmB and ivITCZ groups, with a model-based estimate of a 4% difference (90% CI, -12% to 20%), did not fulfil the statistical non-inferiority criterion. In the LAmB group, there were two cases of breakthrough infection and five cases of probable invasive fungal disease, whereas in the itraconazole group, neither breakthrough infection nor probable invasive fungal disease occurred. Patients in the ivITCZ group had significantly fewer grade 3-4 hypokalaemia-related events than LAmB group patients (P < .01). The overall incidence of adverse events tended to be lower in the ivITCZ group (P = .07). CONCLUSION ivITCZ showed similar efficacy and safety as LAmB as empirical antifungal therapy in haematological malignancy patients with febrile neutropaenia, although the small sample size and various limitations prevented demonstration of its non-inferiority.
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Affiliation(s)
- Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiko Miyata
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoshiko Inoue
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Toshiya Kagoo
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiromasa Niimi
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Chikamasa Yoshida
- Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Fumihito Tajima
- Stem Cell Transplantation Center, National Hospital Organization Yonago Medical Center, Yonago, Japan
| | - Hideyuki Yamamoto
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hironori Ueno
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Shimomura
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Tatsunori Sakai
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Shiro Kubonishi
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Aki Sakurai
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yukihiro Kaneko
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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46
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Sakurai M, Mori T, Uchiyama H, Ago H, Iwato K, Eto T, Iwasaki H, Kawata T, Takamatsu H, Yamasaki S, Takanashi M, Ichinohe T, Atsuta Y, Suzuki R. Outcome of stem cell transplantation for Waldenström's macroglobulinemia: analysis of the Japan Society for Hematopoietic Cell Transplantation (JSHCT) Lymphoma Working Group. Ann Hematol 2020; 99:1635-1642. [PMID: 32424672 DOI: 10.1007/s00277-020-04078-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 05/04/2020] [Indexed: 11/24/2022]
Abstract
The role of stem cell transplantation (SCT) for patients with Waldenström's macroglobulinemia (WM) remains undetermined. Therefore, we retrospectively evaluated the outcome of autologous and allogeneic SCT for patients with WM using the registry database of the Japan Society for Hematopoietic Cell Transplantation. Forty-six patients receiving autologous and 31 receiving allogeneic SCT were analyzed. The allogeneic SCT group included more patients with advanced disease status at transplant and received more lines of chemotherapy. The cumulative incidences of non-relapse mortality (NRM) at 1 year were 30.0% (95% CI, 14.7-46.9%) in the allogeneic SCT and 0% in the autologous SCT group. The estimated 3-year overall (OS) and progression-free (PFS) survival rates were 84.5% (95% CI, 66.0-93.4%) and 70.8% (95% CI, 53.0-82.9%) in the autologous SCT group, and 52.2% (95% CI, 32.5-68.6%) and 45.0% (95% CI, 26.3-62.0%) in the allogeneic SCT group. No patients died after the first 2 years following allogeneic SCT. In univariate analyses, disease status at SCT was significantly associated with PFS in autologous SCT, and with OS and PFS in allogeneic SCT. These results suggest that both autologous and allogeneic SCT have each potential role in WM. Allogeneic SCT is more curative for WM, but is associated with high NRM.
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Affiliation(s)
- Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hiroatsu Ago
- Department of Hematology and Oncology, Shimane Prefectural Central Hospital, Izumo, Shimane, Japan
| | - Koji Iwato
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takahito Kawata
- Department of Hematology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan.,Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Takamatsu
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Minoko Takanashi
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital, Izumo, Shimane, Japan
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47
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Kojio K, Nozaki S, Takahara A, Yamasaki S. Influence of chemical structure of hard segments on physical properties of polyurethane elastomers: a review. J Polym Res 2020. [DOI: 10.1007/s10965-020-02090-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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48
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Yanada M, Takami A, Yamasaki S, Arai Y, Konuma T, Uchida N, Najima Y, Fukuda T, Tanaka M, Ozawa Y, Ikegame K, Takanashi M, Ichinohe T, Okamoto S, Atsuta Y, Yano S. Allogeneic hematopoietic cell transplantation for adults with acute myeloid leukemia conducted in Japan during the past quarter century. Ann Hematol 2020; 99:1351-1360. [DOI: 10.1007/s00277-020-04051-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
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49
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Fujimoto A, Hiramoto N, Yamasaki S, Inamoto Y, Ogata M, Sugio Y, Fukuda T, Uchida N, Ikegame K, Matsuoka KI, Shiratori S, Kondo T, Miyamoto T, Eto T, Ichinohe T, Kanda Y, Atsuta Y, Suzuki R. Low incidence of posttransplant lymphoproliferative disorder after allogeneic stem cell transplantation in patients with lymphoma treated with rituximab. Hematol Oncol 2020; 38:146-152. [PMID: 31953867 DOI: 10.1002/hon.2714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/28/2019] [Accepted: 01/12/2020] [Indexed: 11/06/2022]
Abstract
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Several studies of risk factors for PTLD have been reported; however, the probability of, and risk factors for, PTLD in patients with lymphoma is unknown. Japanese nationwide transplant registry data from 5270 patients with lymphoma after allogeneic HSCT were analyzed. Mature B-cell, T/NK-cell, and T-cell lymphoblastic subtypes accounted for 49%, 26%, and 9.6% of lymphoma cases, respectively. Rituximab was used in 1678 lymphoma patients, most of whom (89%) received HSCT for mature B-cell lymphoma. Thirty-one patients with lymphoma developed PTLD, representing a probability of 0.77% at 2 years post-HSCT, which did not differ significantly from that in patients with other diseases (P = .98). Year of HSCT after 2010 (hazard ratio [HR] = 5.6, 95% confidence interval [CI], 1.48-21.3), antithymocyte globulin (ATG) use in the conditioning regimen (HR = 4.5, 95% CI, 1.61-12.5), and no rituximab use before HSCT (HR = 3.2, 95% CI, 1.26-7.90) were identified as risk factors for PTLD. Probabilities of PTLD at 1 year post-HSCT according to rituximab and ATG use were 0.23% (rituximab+, ATG-), 0.75% (rituximab-, ATG-), 1.25% (rituximab+, ATG+), and 3.53% (rituximab-, ATG+). Regarding lymphoma subtypes, patients with mature B-cell lymphoma had the lowest incidence of PTLD (0.35% at 2 years). Among high-risk patients receiving ATG, the mortality rate due to infection was elevated in those previously treated with rituximab (22%) relative to those without (14%); however, the difference was not significant (P = .10). Rituximab use before HSCT significantly reduces the risk of PTLD. Adding rituximab to the conditioning regimen is potentially a good strategy to prevent the development of PTLD in high-risk patients.
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Affiliation(s)
- Ayumi Fujimoto
- Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan.,Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Masao Ogata
- Department of Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - Yasuhiro Sugio
- Department of Internal Medicine, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | - Kazuhiro Ikegame
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Souichi Shiratori
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Tadakazu Kondo
- Department of Hematology/Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiro Miyamoto
- Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan
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50
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Mori Y, Choi I, Yoshimoto G, Muta T, Yamasaki S, Tanimoto K, Kamimura T, Iwasaki H, Ogawa R, Akashi K, Miyamoto T. Phase I/II study of bortezomib, lenalidomide, and dexamethasone treatment for relapsed and refractory multiple myeloma. Int J Hematol 2020; 111:673-680. [PMID: 31981096 DOI: 10.1007/s12185-020-02833-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/06/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 02/06/2023]
Abstract
Use of novel agents, including proteasome inhibitors and immunomodulatory drugs, has markedly improved outcomes in multiple myeloma (MM) patients. However, most MM patients eventually relapse and require salvage treatments. We report herein the result of a phase I/II study, performed from 2014 to 2017 to assess the feasibility and efficacy of a maximum tolerated dose (MTD) of lenalidomide (Len) combined with a fixed dose of once weekly subcutaneous (sc) 1.3 mg/m2 of bortezomib plus 20 mg of dexamethasone (scVRd regimen) in relapsed/refractory MM patients in the Japanese population. In the phase I part, dose-limiting toxicities were observed in three of six patients treated with 20 mg of Len; the MTD was accordingly defined as 15 mg in our cohort. In the phase II part, the recommended dose of the scVRD regimen showed a 71.4% best overall response rate, with a median overall survival of 14.8 months and a median progression-free survival of 8 months. Severe adverse events (≥ grade 3) were observed in ~ 15% of the patients, indicating the tolerability and efficacy of the regimen. Less prior treatment was associated with higher probability of durable response. This scVRd regimen may thus be a better fit for MM patients in early-stage relapse.
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Affiliation(s)
- Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tsuyoshi Muta
- Department of Hematology/Oncology, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan
- Department of Transfusion Medicine, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kazuki Tanimoto
- Department of Hematology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ryosuke Ogawa
- Department of Hematology/Oncology, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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