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Fujikawa T, Uemura S, Hasegawa D, Morisada N, Nakamura S, Kozaki A, Saito A, Kishimoto K, Ishida T, Mori T, Yakushijin K, Katayama Y, Yamashita D, Wakamatsu M, Hamada M, Muramatsu H, Takahashi Y, Kosaka Y. Novel mutation in KIF23 causing congenital dyserythropoietic anemia type III in patients who underwent allogeneic hematopoietic stem cell transplantation. Pediatr Blood Cancer 2024; 71:e30736. [PMID: 38523246 DOI: 10.1002/pbc.30736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 03/26/2024]
Affiliation(s)
- Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Naoya Morisada
- Department of Clinical Genetics, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | | | - Daiki Yamashita
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Manabu Wakamatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Motoharu Hamada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
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Horikawa S, Kishimoto K, Uemura S, Hyodo S, Kozaki A, Saito A, Ishida T, Mori T, Hasegawa D, Kosaka Y. Impact of prophylactic echinocandin on the development of neurological complications in patients receiving busulfan-containing conditioning regimens for stem cell transplantation: A single-center retrospective study. Pediatr Transplant 2024; 28:e14728. [PMID: 38600717 DOI: 10.1111/petr.14728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/18/2023] [Accepted: 02/16/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Although neurotoxicity is a major adverse event associated with busulfan, little information is available regarding the association between drug interactions and neurological symptoms during busulfan-based regimens. This study evaluated the association between prophylactic echinocandins and neurological complications in patients receiving busulfan-containing conditioning regimens for stem cell transplantation. METHODS We retrospectively included consecutive patients who administered intravenous busulfan as a conditioning regimen at our facility between 2007 and 2022. Prophylactic echinocandin use was defined as the use of an echinocandin antifungal drug to prevent invasive fungal disease in SCT recipients. The primary outcome was the incidence of neurological complications within 7 days of busulfan initiation and was compared between the echinocandin group (patients received prophylactic echinocandin) and nonechinocandin group (patients received prophylactic antifungal drugs other than echinocandin and those without antifungal prophylaxis). RESULTS Among the 59 patients included in this study, the incidence of neurological complications in the echinocandin (n = 26) and nonechinocandin groups (n = 33) was 30.8% and 63.6%, respectively. We observed a negative association between prophylactic echinocandin use and the development of neurological complications after adjusting for the propensity score for receiving prophylactic echinocandins (adjusted odds ratio 0.294, 95% confidence interval 0.090 to 0.959). We observed a lower incidence of neurological complications in the echinocandin group than in the nonechinocandin group. CONCLUSION Our results suggested that the choice of antifungal prophylaxis is associated with busulfan neurotoxicity.
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Affiliation(s)
- Shogo Horikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Hyodo
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
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Nakatani N, Tamura A, Hanafusa H, Nino N, Yamamoto N, Awano H, Tanaka Y, Morisada N, Uemura S, Saito A, Hasegawa D, Nozu K, Kosaka Y. A novel NFKB1 variant in a Japanese pedigree with common variable immunodeficiency. Hum Genome Var 2024; 11:15. [PMID: 38514645 PMCID: PMC10957891 DOI: 10.1038/s41439-024-00271-2] [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: 07/11/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
Recently, heterozygous loss-of-function NFKB1 variants were identified as the primary cause of common variable immunodeficiency (CVID) in the European population. However, pathogenic NFKB1 variants have never been reported in the Japanese population. We present a 29-year-old Japanese woman with CVID. A novel variant, c.136 C > T, p.(Gln46*), was identified in NFKB1. Her mother and daughter carried the same variant, demonstrating the first Japanese pedigree with an NFKB1 pathogenic variant.
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Affiliation(s)
- Naoko Nakatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hiroaki Hanafusa
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Pediatrics, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Awano
- Research Initiative Center, Organization for Research Initiative and Promotion, Tottori University, Tottori, Japan
| | | | - Naoya Morisada
- Department of Clinical Genetics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
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4
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Ishida H, Arakawa Y, Hasegawa D, Usami I, Hashii Y, Arai Y, Nishiwaki S, Keino D, Kato K, Sato M, Yoshida N, Ozawa Y, Okada K, Hidaka M, Yuza Y, Tanaka M, Watanabe K, Takita J, Kosaka Y, Fujita N, Tanaka J, Sato A, Atsuta Y, Imamura T. Reduced-intensity allogenic transplantation for children and adolescents with Philadelphia chromosome-positive acute lymphoblastic leukemia. Ann Hematol 2024; 103:843-854. [PMID: 38006571 DOI: 10.1007/s00277-023-05557-z] [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: 01/04/2023] [Accepted: 11/18/2023] [Indexed: 11/27/2023]
Abstract
Survival rates of patients with Philadelphia chromosome-positive ALL (Ph+ALL) have improved considerably with the introduction of tyrosine kinase inhibitors (TKI); however, hematopoietic stem cell transplantation (HSCT) continues to play an important role. Reduced-intensity conditioning (RIC) regimens have been widely applied particularly for older patients, but their validity for children and adolescents with Ph+ALL has not been investigated. In this study, data from patients receiving HSCT for de novo Ph+ALL in first or second remission at ages younger than 25 years and with a history of pre-HSCT TKI therapy were retrospectively collected through the nationwide registry in Japan. In 265 patients who received myeloablative conditioning (MAC) and 33 patients receiving RIC, 5-year leukemia-free survival (LFS) rates were 67.3% and 79.8%, respectively (p = 0.142). Multivariate analysis of LFS, focusing on patients with good performance status, identified RIC as a significant prognostic factor for LFS (hazard ratio 0.32, p = 0.032), as well as older age, higher leukocyte count at diagnosis, and disease with additional chromosomal abnormalities. These trends were similar when we focused on patients who received prophylactic post-HSCT TKI treatment, as 5-year LFS was 81.0% for MAC and 84.4% for RIC (p = 0.748). In summary, HSCT with RIC regimen showed at least comparable LFS to HSCT with MAC regimen, and RIC was an independent favorable prognostic factor on multivariate analysis adjusting potential prognostic factors. While patient numbers were limited, our data suggest that RIC may be safely applied in this group, particularly combined with prophylactic post-HSCT TKI maintenance therapy.
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Affiliation(s)
- Hisashi Ishida
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Yuki Arakawa
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Ikuya Usami
- Department of Pediatric Hematology and Oncology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka International Cancer Institute, Osaka, Japan
| | - Yasuyuki Arai
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Nishiwaki
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Dai Keino
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Keisuke Kato
- Division of Pediatric Hematology and Oncology, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Maho Sato
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Nao Yoshida
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Aichi Medical Center Nagoya First Hospital, Nagoya, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya First Hospital, Nagoya, Japan
| | - Keiko Okada
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Moe Hidaka
- Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Yuza
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Junko Takita
- Department of Pediatrics, Kyoto University Hospital, Kyoto, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Sato
- Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai, 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
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajiichou, Hirokouji Kawaramachidori, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Hidaka M, Inokuchi K, Uoshima N, Takahashi N, Yoshida N, Ota S, Nakamae H, Iwasaki H, Watanabe K, Kosaka Y, Komatsu N, Meguro K, Najima Y, Eto T, Kondo T, Kimura S, Yoshida C, Ishikawa Y, Sawa M, Hata T, Horibe K, Iida H, Shimomura T, Dobashi N, Sugiura I, Makiyama J, Miyagawa N, Sato A, Ito R, Matsumura I, Kanakura Y, Naoe T. Development and evaluation of a rapid one-step high sensitivity real-time quantitative PCR system for minor BCR-ABL (e1a2) test in Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). Jpn J Clin Oncol 2024; 54:153-159. [PMID: 37986553 PMCID: PMC10849185 DOI: 10.1093/jjco/hyad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE Minimal residual disease assessment of BCR-ABL messenger ribonucleic acid levels is crucial in Philadelphia chromosome-positive acute lymphoblastic leukemia for prognosis and treatment planning. However, accurately quantifying minor BCR-ABL transcripts, which comprise 70% of Philadelphia chromosome-positive acute lymphoblastic leukemia cases, lacks a national-approved method. METHODS We developed the "Otsuka" minor BCR-ABLmessenger ribonucleic acid assay kit with exceptional precision (0.00151%). Minor BCR-ABL messenger ribonucleic acid levels were analyzed in 175 adults, 36 children with acute lymphoblastic leukemia and 25 healthy individuals to evaluate the kit's performance. RESULTS The "Otsuka" kit showed high concordance with a commonly used chimeric gene screening method, indicating reliable detection of positive cases. Quantitative results demonstrated a robust correlation with both a laboratory-developed test and a diagnostic research product. The "Otsuka" kit performs comparably or even surpass to conventional products, providing valuable insights into Philadelphia chromosome-positive acute lymphoblastic leukemia pathology. CONCLUSIONS The 'Otsuka" minor BCR-ABL messenger ribonucleic acid assay kit exhibits excellent performance in quantifying minor BCR-ABL transcripts in Philadelphia chromosome-positive acute lymphoblastic leukemia patients. Our results align well with established screening methods and show a strong correlation with laboratory-developed tests and diagnostic research products. The "Otsuka" kit holds great promise as a valuable tool for understanding Philadelphia chromosome-positive acute lymphoblastic leukemia pathology and guiding effective treatment strategies.
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Affiliation(s)
- Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Naoto Takahashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Nao Yoshida
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Aichi Medical Center Nagoya First Hospital, Aichi, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kuniaki Meguro
- Department of Hematology, National Hospital Organization Sendai Medical Center, Miyagi, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Hokkaido, Japan
| | - Shinya Kimura
- Department of Hematology, Respiratory Medicine and Oncology, Saga University, Saga, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Aichi, Japan
| | - Tomoko Hata
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Takeshi Shimomura
- Department of Hematology, National Hospital Organization Hiroshimanishi Medical Center, Hiroshima, Japan
| | - Nobuaki Dobashi
- Department of Clinical Oncology and Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Isamu Sugiura
- Department of Hematology and Oncology, Toyohashi Municipal Hospital, Aichi, Japan
| | - Junya Makiyama
- Department of Hematology/Oncology, Institute of Medical Science, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoyuki Miyagawa
- Division of Hematology/Oncology, Kanagawa Children’s Medical Center, Kanagawa, Japan
| | - Asuka Sato
- Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan
| | - Ryuta Ito
- Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | - Tomoki Naoe
- National Hospital Organization Nagoya Medical Center, Aichi, Japan
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Fukumitsu N, Kubota H, Demizu Y, Suzuki T, Hasegawa D, Kosaka Y, Kawamura A, Soejima T. Comparison of passive-scattered and intensity-modulated proton beam therapy of craniospinal irradiation with proton beams for pediatric and young adult patients with brain tumors. Jpn J Radiol 2024; 42:182-189. [PMID: 37874526 PMCID: PMC10811119 DOI: 10.1007/s11604-023-01499-8] [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: 05/29/2023] [Accepted: 09/06/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE To investigate the dose stability of craniospinal irradiation based on irradiation method of proton beam therapy (PBT). METHODS AND MATERIALS Twenty-four pediatric and young adult brain tumor patients (age: 1-24 years) were examined. Treatment method was passive-scattered PBT (PSPT) in 8 patients and intensity-modulated PBT (IMPT) in 16 patients. The whole vertebral body (WVB) technique was used in 13 patients whose ages were younger than 10, and vertebral body sparing (VBS) technique was used for the remaining 11 patients aged 10 and above. Dose stability of planning target volume (PTV) against set-up error was investigated. RESULTS The minimum dose (Dmin) of IMPT was higher than that of PSPT (p = 0.01). Inhomogeneity index (INH) of IMPT was lower than that of PSPT (p = 0.004). When the irradiation field of the cervical spinal cord level (C level) was shifted, the maximum dose (Dmax) was lower in IMPT, and mean dose (Dmean) was higher than PSPT as movement became greater to the cranial-caudal direction (p = 0.000-0.043). Dmin was higher and INH was lower in IMPT in all directions (p = 0.000-0.034). When the irradiation field of the lumber spinal cord level (L level) was shifted, Dmax was lower in IMPT as movement became greater to the cranial direction (p = 0.000-0.028). Dmin was higher and INH was lower in IMPT in all directions (p = 0.000-0.022). CONCLUSIONS The PTV doses of IMPT and PSPT are robust and stable in both anterior-posterior and lateral directions at both C level and L level, but IMPT is more robust and stable than PSPT for cranial-caudal movements. TRIAL REGISTRY Clinical Trial Registration number: No. 04-03.
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Affiliation(s)
- Nobuyoshi Fukumitsu
- Department of Radiation Oncology, Kobe Proton Center, 1-6-8, Minatojima-Minamimachi, Kobe, 650-0047, Japan.
| | - Hikaru Kubota
- Department of Radiation Oncology, Kobe Proton Center, 1-6-8, Minatojima-Minamimachi, Kobe, 650-0047, Japan
| | - Yusuke Demizu
- Department of Radiation Oncology, Kobe Proton Center, 1-6-8, Minatojima-Minamimachi, Kobe, 650-0047, Japan
| | - Takeshi Suzuki
- Department of Anesthesiology, Kobe Proton Center, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Hyogo Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Children's Hospital, Kobe, Japan
| | | | - Toshinori Soejima
- Department of Radiation Oncology, Kobe Proton Center, 1-6-8, Minatojima-Minamimachi, Kobe, 650-0047, Japan
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Mizuno S, Tsukamura Y, Nishio S, Ishida T, Hasegawa D, Kosaka Y, Ooka T, Nishi J, Kasai M. Catheter-related bloodstream infection caused by Tsukamurella tyrosinosolvens identified by secA1sequencing in an immunocompromised child: a case report. Ann Clin Microbiol Antimicrob 2023; 22:97. [PMID: 37940983 PMCID: PMC10633952 DOI: 10.1186/s12941-023-00651-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Tsukamurella spp. are obligate aerobic, gram-positive, non-motile, and slightly acid-fast bacilli belonging to the Actinomycetes family. They share many characteristics with Nocardia, Rhodococcus, Gordonia, and the rapidly growing Mycobacterium species. Therefore, standard testing may misidentify Tsukamurella spp. as another species. Accurate and rapid diagnosis is critical for proper infection management, but identification of this bacterium is difficult in the standard laboratory setting. CASE PRESENTATION A bloodstream infection caused by a gram-positive bacterium and related to a central venous catheter was identified in an immunocompromised 2-year-old girl. Tsukamurella tyrosinosolvens was identified by modified secA1 sequencing. Antibiotic treatment and removal of the central venous catheter resolved the infection. Inappropriate management of the catheter during an overnight stay outside of the hospital was considered as a possible source of infection. CONCLUSIONS SecA1 sequencing may be a useful diagnostic tool in the identification of T. tyrosinosolvens. Providing proper central venous catheter care instructions to patients, their families, and medical staff is important for infection prevention.
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Affiliation(s)
- Shinsuke Mizuno
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children hospital, Kobe City, 6500047, Hyogo, Japan.
| | - Yoshiyuki Tsukamura
- Department of Inspection unit, Hyogo Prefectural Kobe Children hospital, Kobe City, Hyogo, Japan
| | - Shuro Nishio
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Tadasuke Ooka
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Junichiro Nishi
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masashi Kasai
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children hospital, Kobe City, 6500047, Hyogo, Japan
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8
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Inoue S, Win KHN, Mon CY, Fujikawa T, Hyodo S, Uemura S, Ishida T, Mori T, Hasegawa D, Kosaka Y, Nishimura A, Nakatani N, Nino N, Tamura A, Yamamoto N, Nozu K, Nishimura N. Higher levels of minimal residual disease in peripheral blood than bone marrow before 1st and 2nd relapse/regrowth in a patient with high‑risk neuroblastoma: A case report. Oncol Lett 2023; 26:369. [PMID: 37559575 PMCID: PMC10407720 DOI: 10.3892/ol.2023.13955] [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: 01/15/2023] [Accepted: 04/26/2023] [Indexed: 08/11/2023] Open
Abstract
More than half of patients with high-risk neuroblastoma (HR-NB) experience relapse/regrowth due to the activation of chemoresistant minimal residual disease (MRD). MRD in patients with HR-NB can be evaluated by quantitating neuroblastoma-associated mRNAs (NB-mRNAs) in bone marrow (BM) and peripheral blood (PB) samples. Although several sets of NB-mRNAs have been shown to possess a prognostic value for MRD in BM samples (BM-MRD), MRD in PB samples (PB-MRD) is considered to be low and difficult to evaluate. The present report describes an HR-NB case presenting higher PB-MRD than BM-MRD before 1st and 2nd relapse/regrowth. A 3-year-old female presented with an abdominal mass, was diagnosed with HR-NB, and treated according to the nationwide standard protocol for HR-NB. Following systemic induction and consolidation therapy with local therapy, the patient achieved complete remission but experienced a 1st relapse/regrowth 6 months after maintenance therapy. The patient partially responded to salvage chemotherapy and anti-GD2 immunotherapy but had a 2nd relapse/regrowth 14 months after the 1st relapse/regrowth. Consecutive PB-MRD and BM-MRD monitoring revealed that PB-MRD was lower than BM-MRD at diagnosis (100 times) and 1st and 2nd relapse/regrowth (1,000 and 3 times) but became higher than BM-MRD before 1st and 2nd relapse/regrowth. The present case highlights that PB-MRD can become higher than BM-MRD before relapse/regrowth of patients with HR-NB.
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Affiliation(s)
- Shotaro Inoue
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Kaung Htet Nay Win
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Hyogo 654-0142, Japan
| | - Cho Yee Mon
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Hyogo 654-0142, Japan
| | - Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Sayaka Hyodo
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Akihiro Nishimura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Naoko Nakatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Noriyuki Nishimura
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Hyogo 654-0142, Japan
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Fukumitsu N, Kubota H, Mima M, Demizu Y, Suzuki T, Hasegawa D, Kosaka Y, Kawamura A, Soejima T. Comparison of Craniospinal Irradiation Using Proton Beams According to Irradiation Method and Initial Experience Treating Pediatric Patients. Adv Radiat Oncol 2023; 8:101251. [PMID: 37408669 PMCID: PMC10318217 DOI: 10.1016/j.adro.2023.101251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/11/2023] [Indexed: 07/07/2023] Open
Abstract
Purpose This study compared craniospinal irradiation using proton beam therapy (PBT) according to irradiation method and investigated the initial effects. Methods and Materials Twenty-four pediatric patients (1-24 years old) who received proton craniospinal irradiation were examined. Passive scattered PBT (PSPT) and intensity modulated PBT (IMPT) were used in 8 and 16 patients, respectively. The whole vertebral body technique was used for 13 patients <10 years old, and the vertebral body sparing (VBS) technique was used for the remaining 11 patients aged ≥10 years. The follow-up period was 17 to 44 (median, 27) months. Organ-at-risk and planning target volume (PTV) doses and other clinical data were examined. Results The maximum lens dose using IMPT was lower than that using PSPT (P = .008). The mean thyroid, lung, esophagus, and kidney doses were lower in patients treated using the VBS technique compared with the whole vertebral body technique (all P < .001). The minimum PTV dose of IMPT was higher than that of PSPT (P = .01). The inhomogeneity index of IMPT was lower than that of PSPT (P = .004). Conclusions IMPT is better than PSPT at reducing the dose to the lens. The VBS technique can decrease the doses to neck-chest-abdomen organs. The PTV coverage of IMPT is superior to that of PSPT.
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Affiliation(s)
| | | | | | | | | | | | | | - Atsufumi Kawamura
- Neurosurgery, Hyogo Prefectual Kobe Children's Hospital, Kobe, Japan
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10
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Uemura S, Hasegawa D, Kishimoto K, Fujikawa T, Nakamura S, Kozaki A, Saito A, Ishida T, Mori T, Ozaki K, Kosaka Y. Association between conditioning intensity and height growth after allogeneic hematopoietic stem cell transplantation in children. Cancer Med 2023; 12:17018-17027. [PMID: 37434385 PMCID: PMC10501226 DOI: 10.1002/cam4.6336] [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: 04/21/2023] [Revised: 06/15/2023] [Accepted: 07/02/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND The present study aimed to examine the association between the conditioning intensity and height growth in pediatric patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS We reviewed the clinical records of 89 children with malignant diseases who underwent initial allo-HSCT between 2003 and 2021. Height measurements were standardized using standard height charts prepared by the Japanese Society for Pediatric Endocrinology to calculate standard deviation score (SDS). We defined short stature as a height SDS less than -2.0 in that reference. Myeloablative conditioning (MAC) comprised total-body irradiation at more than 8 Gy and busulfan administration at more than 8 mg/kg (more than 280 mg/m2 ). Other conditioning regimens were defined as reduced intensity conditioning (RIC). RESULTS A total of 58 patients underwent allo-HSCT with MAC, and 31 patients received allo-HSCT with RIC. There were significant differences in the height SDS at 2 and 3 years after allo-HSCT between MAC and RIC group (-1.33 ± 1.20 vs. -0.76 ± 1.12, p = 0.047, -1.55 ± 1.28 vs. -0.75 ± 1.11, p = 0.022, respectively). Multivariate logistic regression analysis with the adjustments for potential confounding factors of patients less than 10 years of age at allo-HSCT and chronic graft-versus host disease demonstrated that MAC regimen was associated with a markedly increased risk of a short stature at 3 years after allo-HSCT (adjusted odds ratio, 5.61; 95% confidence interval, 1.07-29.4; p = 0.041). CONCLUSION The intensity of conditioning regimen may be associated with short statures after allo-HSCT.
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Affiliation(s)
- Suguru Uemura
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | | | - Kenji Kishimoto
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Tomoko Fujikawa
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Sayaka Nakamura
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Aiko Kozaki
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Atsuro Saito
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Toshiaki Ishida
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Takeshi Mori
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
| | - Kayo Ozaki
- Department of Endocrinology and MetabolismKobe Children's HospitalKobeJapan
| | - Yoshiyuki Kosaka
- Department of Hematology and OncologyKobe Children's HospitalKobeJapan
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11
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Yoshida M, Saito A, Hasegawa D, Kosaka Y, Koyama J, Kawamura A, Akasaka Y, Soejima T. Focal glioneuronal differentiation in an atypical teratoid/rhabdoid tumor after chemoradiotherapy. Pathol Int 2023; 73:377-379. [PMID: 37493103 DOI: 10.1111/pin.13354] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Makiko Yoshida
- Departments of Pathology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Departments of Pediatric Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Departments of Pediatric Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Departments of Pediatric Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Junji Koyama
- Departments of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Atsufumi Kawamura
- Departments of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yoshinobu Akasaka
- Departments of Diagnostic Radiology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
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12
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Sato A, Hatta Y, Imai C, Oshima K, Okamoto Y, Deguchi T, Hashii Y, Fukushima T, Hori T, Kiyokawa N, Kato M, Saito S, Anami K, Sakamoto T, Kosaka Y, Suenobu S, Imamura T, Kada A, Saito AM, Manabe A, Kiyoi H, Matsumura I, Koh K, Watanabe A, Miyazaki Y, Horibe K. Nelarabine, intensive L-asparaginase, and protracted intrathecal therapy for newly diagnosed T-cell acute lymphoblastic leukaemia in children and young adults (ALL-T11): a nationwide, multicenter, phase 2 trial including randomisation in the very high-risk group. Lancet Haematol 2023:S2352-3026(23)00072-8. [PMID: 37167992 DOI: 10.1016/s2352-3026(23)00072-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND T-cell acute lymphoblastic leukaemia has distinct biological characteristics and a poorer prognosis than B-cell precursor acute lymphoblastic leukaemia. This trial aimed to reduce the rate of radiation and haematopoietic stem-cell transplantation (HSCT) while improving outcomes by adding nelarabine, intensified L-asparaginase, and protracted intrathecal therapy in the Berlin-Frankfurt-Münster (BFM)-type treatment. METHODS In this nationwide, multicenter, phase 2 trial, we enrolled patients with newly diagnosed T-cell acute lymphoblastic leukaemia (age <25 years at diagnosis) conducted by Japan Children's Cancer Group and Japan Adult Leukemia Study Group. Patients were stratified into standard-risk, high-risk, and very-high-risk groups according to prednisolone response, CNS status, and end-of-consolidation minimal residual disease. We used the Associazione Italiana di Ematologia Oncologia Pediatrica (AIEOP)-BFM-ALL 2000-backbone chemotherapy. Nelarabine (650 mg/m2 per day for 5 days) was given to high-risk and very high-risk patients. All patients received, until the measurement of end-of-consolidation minimal residual disease, an identical therapy schedule, which included the prednisolone pre-phase remission induction therapy with dexamethasone (10 mg/m2 per day, for 3 weeks [for patients <10 years] or for 2 weeks including a 7-day off interval [for patients ≥10 years]) instead of prednisolone, and consolidation therapy added with Escherichia coli-derived L-asparaginase. On the basis of the stratification, patients received different intensities of treatment; L-asparaginase-intensified standard BFM-type therapy for standard risk and nelarabine-added high risk BFM-type therapy for high risk. In the very high-risk group, patients were randomly assigned (1:1) to group A (BFM-based block therapy) and group B (another block therapy, including high-dose dexamethasone) stratified by hospital, age (≥18 years or <18 years), and end-of-induction bone marrow blast percentage of M1 (<5%) or M2 (≥5%, <25%)+M3 (≥25%). Cranial radiotherapy was limited to patients with overt CNS disease at diagnosis (CNS3; >5 white blood cells per μL with blasts) and patients with no evidence of CNS disease received protracted triple intrathecal therapy. Only very high-risk patients were scheduled to receive HSCT. The primary endpoint was 3-year event-free survival for the entire cohort and the proportion of patients with disappearance of minimal residual disease between randomly assigned groups A and B in the very high-risk group. Secondary endpoints were overall survival, remission induction rate, and occurrence of adverse events. 3 years after the completion of patient accrual, a primary efficacy analysis was performed in the full analysis set and the per-protocol set. This study is registered with the Japan Registry of Clinical Trials, jRCTs041180145. FINDINGS Between Dec 1, 2011, and Nov 30, 2017, of 349 eligible patients (median age 9 years [IQR 6-13]), 238 (68%) were male, and 28 (8%) patients had CNS3 status. 168 (48%) patients were stratified as standard risk, 103 (30%) as high risk, 39 (11%) as very high risk, and 39 (11%) as no risk (patients who had off protocol treatment before risk assessment. The composite complete remission (complete remission plus complete remission in suppression) rate after remission induction therapy was 89% (298 of 335 patients). HSCT was performed in 35 (10%) of 333 patients. With a median follow-up of 5·2 years (IQR 3·6-6·7), 3-year event-free survival was 86·4% (95% CI 82·3-89·7%) and 3-year overall survival was 91·3% (87·7-93·8%). The proportion of minimal residual disease disappearance was 0·86 (12 of 14 patients; 95% CI 0·57-0·98) in group A and 0·50 (6 of 12 patients, 0·21-0·79) in group B. Grade 3 peripheral motor neuropathy was seen in 11 (3%) of 349 patients and sensory neuropathy was seen in 6 (2%) patients. The most common grade 3 or worse adverse event was febrile neutropenia (294 [84%] of 349 patients). Treatment-related death occurred in three patients due to sepsis, gastric perforation, or intracranial haemorrhage during remission induction. INTERPRETATION The ALL-T11 protocol produced encouraging outcomes with acceptable toxicities despite limited cranial radiotherapy and HSCT use. FUNDING Ministry of Health, Labor and Welfare of Japan, and Japan Agency for Medical Research and Development. TRANSLATION For the Japanese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Atsushi Sato
- Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai, Japan.
| | - Yoshihiro Hatta
- Department of Hematology and Rheumatology, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Koichi Oshima
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Yasuhiro Okamoto
- Department of Pediatrics, Kagoshima University Hospital, Kagoshima, Japan
| | - Takao Deguchi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University, Osaka, Japan
| | - Takashi Fukushima
- Department of Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Toshinori Hori
- Department of Pediatrics, Aichi Medical University Hospital, Aich, Japan
| | - Nobutaka Kiyokawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatrics, The University of Tokyo, Tokyo, Japan
| | - Shoji Saito
- Department of Pediatrics, Shinshu University Hospital, Matsumoto, Japan
| | - Kenichi Anami
- Department of Medical Oncology, Hematology, and Infectious Diseases, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tatsuhiro Sakamoto
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Souichi Suenobu
- Department of Pediatrics, Oita University Hospital, Oita, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, University Hospital Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Akiko Kada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Arata Watanabe
- Department of Pediatrics, Nakadori General Hospital, Akita, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Miyagawa N, Goto H, Ogawa A, Kikuta A, Kosaka Y, Sekimizu M, Tomizawa D, Toyoda H, Hiramatsu H, Hara J, Mochizuki S, Nakayama H, Yoshimura K, Iijima-Yamashita Y, Sanada M, Ogawa C. Phase 2 study of combination chemotherapy with bortezomib in children with relapsed and refractory acute lymphoblastic leukemia. Int J Hematol 2023:10.1007/s12185-023-03609-8. [PMID: 37127801 DOI: 10.1007/s12185-023-03609-8] [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: 01/23/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Abstract
Treatment outcomes for children with relapsed and refractory acute lymphoblastic leukemia (R/R-ALL) remain poor, and the optimal induction therapy has not been determined. Bortezomib is a proteasome inhibitor that acts synergistically and additively with standard chemotherapy for ALL. We evaluated the efficacy and safety of combination chemotherapy with bortezomib in children with R/R-ALL. This single-arm, multicenter, phase 2 study was conducted in Japan between 2016 and 2020. Eligible patients were divided into two cohorts: a high-risk first-relapse cohort of untreated patients with high-risk first-relapsed ALL and an expansion cohort of patients with refractory ALL, including multiple relapses, relapse after allogeneic hematopoietic cell transplantation, and induction failure. All patients received a single course of chemotherapy as induction therapy. Sixteen patients (10 in the high-risk first-relapse cohort, six in the expansion cohort) were evaluable. The overall remission rate after induction therapy was 60% in the high-risk first-relapse cohort and 16.7% in the expansion cohort. All patients had minimal residual disease. Adverse events were acceptable except for interstitial lung disease and hypoxia in a patient in the expansion cohort, but addition of bortezomib to conventional chemotherapy did not produce obvious improvement in children with R/R-ALL.
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Affiliation(s)
- Naoyuki Miyagawa
- Division of Hematology and Oncology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-Ku, Yokohama, Kanagawa, 232-8555, Japan.
| | - Hiroaki Goto
- Division of Hematology and Oncology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-Ku, Yokohama, Kanagawa, 232-8555, Japan
| | - Atsushi Ogawa
- Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Masahiro Sekimizu
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Daisuke Tomizawa
- Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hidemi Toyoda
- Department of Pediatrics, Mie University Graduate School of Medicine, Mie, Japan
| | - Hidefumi Hiramatsu
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Shinji Mochizuki
- Department of Pediatrics, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Nakayama
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kenichi Yoshimura
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuka Iijima-Yamashita
- Department of Advanced Diagnosis, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masashi Sanada
- Department of Advanced Diagnosis, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
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14
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Mizuno S, Koyama J, Horikawa S, Kishimoto K, Hasegawa D, Kosaka Y, Kasai M. Cerebral venous sinus thrombosis after a third dose of mRNA COVID-19 vaccine in an adolescent. Pediatr Blood Cancer 2023:e30376. [PMID: 37101363 DOI: 10.1002/pbc.30376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Affiliation(s)
- Shinsuke Mizuno
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Junji Koyama
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Shogo Horikawa
- Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Kenji Kishimoto
- Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Daiichiro Hasegawa
- Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Yoshiyuki Kosaka
- Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
| | - Masashi Kasai
- Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe City, Hyogo, Japan
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Nakayama H, Ogawa C, Sekimizu M, Fujisaki H, Kosaka Y, Hashimoto H, Saito AM, Horibe K. Correction to: A phase I study of inotuzumab ozogamicin as a single agent in pediatric patients in Japan with relapsed/refractory CD22-positive acute lymphoblastic leukemia (INO-Ped-ALL-1). Int J Hematol 2023; 117:786. [PMID: 36943610 DOI: 10.1007/s12185-023-03584-0] [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: 03/23/2023]
Affiliation(s)
- Hideki Nakayama
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Sekimizu
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyuki Fujisaki
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Hiroya Hashimoto
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Core Laboratory, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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16
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Morimoto A, Shioda Y, Kudo K, Kanegane H, Imamura T, Koh K, Kosaka Y, Yuza Y, Nakazawa A, Saito AM, Watanabe T, Nakazawa Y. Intensification of treatment with vinca alkaloid does not improve outcomes in pediatric patients with Langerhans cell histiocytosis: results from the JPLSG LCH-12 study. Int J Hematol 2023:10.1007/s12185-023-03568-0. [PMID: 36871086 DOI: 10.1007/s12185-023-03568-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
Chemotherapy with cytarabine, vincristine (VCR), and prednisolone has achieved low mortality rates in pediatric patients with Langerhans cell histiocytosis (LCH). However, relapse rates remain high, making event-free survival (EFS) rates unsatisfactory. A nationwide clinical trial, LCH-12, tested a modified protocol in which the early maintenance phase was intensified with increasing dosages of VCR. Patients newly diagnosed with multifocal bone (MFB) or multisystem (MS) LCH and aged < 20 years at diagnosis were enrolled between June 2012 and November 2017. Of the 150 eligible patients, 43 with MFB were treated for 30 weeks and 107 with MS LCH were treated for 54 weeks. One patient with MS LCH died of sepsis during the induction phase. The 3-year EFS rates among patients with MFB LCH, risk organ (RO)-negative MS LCH, and RO-positive MS LCH were 66.7% (95% confidential interval [CI], 56.5-77.0%), 66.1% (95% CI 52.9-76.4%), and 51.1% (95% CI 35.8-64.5%), respectively, similar to previously observed rates. EFS rates were significantly lower in patients with disease activity scores > 6 than in those with scores ≤ 6. The strategy that included more intense treatment with VCR was not effective. Other strategies are required to improve outcomes in patients with pediatric LCH.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan. .,Department of Pediatrics, Showa Inan General Hospital, 3230, Akaho, Komagane, Nagano, 399-4117, Japan.
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuki Yuza
- Departments of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Tomoyuki Watanabe
- Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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17
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Okamoto T, Murata Y, Hasegawa D, Yoshida M, Tanaka D, Ueda T, Hazama D, Oduori OS, Komori S, Takai T, Saito Y, Kotani T, Kosaka Y, Maniwa Y, Matozaki T. Targeting of SIRPα as a potential therapy for Langerhans cell histiocytosis. Cancer Sci 2023; 114:1871-1881. [PMID: 36788737 PMCID: PMC10154843 DOI: 10.1111/cas.15758] [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: 11/11/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare neoplastic disorder characterized by inflammatory lesions arising from the anomalous accumulation of pathogenic CD1a+ CD207+ dendritic cells (DCs). SIRPα is a transmembrane protein highly expressed in myeloid cells such as DCs and macrophages. Here we show that SIRPα is a potential therapeutic target for LCH. We found that SIRPα is expressed in CD1a+ cells of human LCH lesions as well as in CD11c+ DCs in the spleen, liver, and lung of a mouse model of LCH (BRAFV600ECD11c mouse), in which an LCH-associated active form of human BRAF is expressed in a manner dependent on the mouse Cd11c promoter. BRAFV600ECD11c mice manifested markedly increased numbers of CD4+ T cells, regulatory T cells, and macrophages as well as of CD11c+ MHCII+ DCs in the spleen. Monotherapy with a mAb to SIRPα greatly reduced the percentage of CD11c+ MHCII+ DCs in peripheral blood, LCH-like lesion size in the liver, and the number of CD11c+ MHCII+ DCs in the spleen of the mutant mice. Moreover, this mAb promoted macrophage-mediated phagocytosis of CD11c+ DCs from BRAFV600ECD11c mice, whereas it had no effects on the viability or CCL19-dependent migration of such CD11c+ DCs or on their expression of the chemokine genes Ccl5, Ccl20, Cxcl11, and Cxcl12. Our results thus suggest that anti-SIRPα monotherapy is a promising approach to the treatment of LCH that is dependent in part on the promotion of the macrophage-mediated killing of LCH cells.
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Affiliation(s)
- Takeshi Okamoto
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoji Murata
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology & Oncology, Children's Cancer Center, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Makiko Yoshida
- Department of Pathology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Daisuke Tanaka
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takashi Ueda
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hazama
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Okechi S Oduori
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satomi Komori
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoko Takai
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takenori Kotani
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology & Oncology, Children's Cancer Center, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takashi Matozaki
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
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18
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Mizuno S, Fujikawa T, Uemura S, Hasegawa D, Kosaka Y, Kasai M. Nosocomial meningitis caused by Staphylococcus haemolyticus in a child with neutropenia in the absence of intracranial devices: a case report. BMC Infect Dis 2023; 23:95. [PMID: 36788492 PMCID: PMC9930307 DOI: 10.1186/s12879-023-08059-5] [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: 11/14/2022] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Coagulase-negative staphylococci can cause hospital-acquired infections, especially in immunocompromised hosts. Bacterial meningitis is a potentially fatal infection of the central nervous system, causing high mortality and morbidity. In general, the causative agents of meningitis, coagulase-negative staphylococci, are associated with direct implantation of a foreign body and the presence of a cerebrospinal fluid (CSF) shunt. Here, we describe a case of nosocomial meningitis caused by Staphylococcus haemolyticus in a child with neutropenia who had no intracranial foreign devices. CASE PRESENTATION A 15-year-old boy with relapsed acute myeloid leukemia undergoing chemotherapy through a central venous catheter developed fever on Day 13 post-initiation of chemotherapy. There was no history of implantation of neurosurgical devices. Two blood cultures obtained on Day 14 were positive for Staphylococcus haemolyticus. Clinical improvement was noted, and treatment with vancomycin and removal of the central venous catheter resulted in negative repeat blood cultures on Day 18. However, the patient developed a tendency for somnolence and improper speech, along with persistent fever on Day 26. A lumber puncture was performed on Day 27, resulting in positive culture of Staphylococcus haemolyticus. He was diagnosed with meningitis and the dosage of vancomycin was increased. A repeat CSF culture was positive for Staphylococcus haemolyticus on Day 40, so oral rifampicin was added. CSF findings on Day 46 revealed a low concentration of vancomycin, and treatment was switched from vancomycin plus rifampicin to linezolid. After Day 46, four subsequent cerebrospinal fluid tests of the CSF showed no growth of Staphylococcus haemolyticus. The patient's symptoms were improved on Day 52. Brain and spinal magnetic resonance images was taken and it showed no abnormalities. Linezolid was continued until Day 72. The patient was discharged without any complications on Day 72. CONCLUSIONS To the best of our knowledge, this is the first reported case of Staphylococcus haemolyticus meningitis in a patient without a neurosurgical device. Typical symptoms or signs may be absent in a patient with meningitis who also has neutropenia. Repeated tests of the CSF, and prolonged duration of antibiotics should be considered if atypical pathogens are detected in immunocompromised hosts.
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Affiliation(s)
- Shinsuke Mizuno
- Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan. .,Department of Pediatrics Infectious Disease, Hyogo Prefectural Kobe Children's Hospital, 1-6-7 Minamimachi, Minatojima, Chuoku, Kobe, Hyogo, 6500047, Japan.
| | - Tomoko Fujikawa
- grid.415413.60000 0000 9074 6789Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo Japan
| | - Suguru Uemura
- grid.415413.60000 0000 9074 6789Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo Japan
| | - Daiichiro Hasegawa
- grid.415413.60000 0000 9074 6789Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo Japan
| | - Yoshiyuki Kosaka
- grid.415413.60000 0000 9074 6789Division of Hematology and Oncology, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo Japan
| | - Masashi Kasai
- grid.415413.60000 0000 9074 6789Division of Infectious Disease, Department of Pediatrics, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo Japan
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19
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Fujikawa T, Kishimoto K, Inoue S, Nishimura A, Tojo R, Uemura S, Nakamura S, Saito A, Kozaki A, Ishida T, Mori T, Higashino M, Koyama J, Kawamura A, Hasegawa D, Kosaka Y. Epidural Spinal Cord Compression as the Presenting Manifestation of Acute Myeloid Leukemia: A Case Report and Literature Review. Intern Med 2023; 62:453-457. [PMID: 35793962 PMCID: PMC9970809 DOI: 10.2169/internalmedicine.9580-22] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We herein report a rare case of spinal cord compression due to epidural involvement of acute myeloid leukemia (AML). A 14-year-old boy presented with a 7-day history of back pain, paraplegia and hypoesthesia. Contrast-enhanced computed tomography revealed an epidural mass. Emergency laminectomy and resection of the mass were performed. Histopathologically, the resected mass was comparable to an extramedullary mass of AML. Chemotherapy was initiated, and complete remission was achieved. Neurological sequelae remained after the treatment. Based on the present and previous reports, spinal cord compression from epidural AML involvement may progress rapidly.
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Affiliation(s)
- Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Shotaro Inoue
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Akihiro Nishimura
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Ryunosuke Tojo
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
| | | | - Junji Koyama
- Department of Neurosurgery, Kobe Children's Hospital, Japan
| | | | | | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Japan
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20
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Yasue S, Ozeki M, Endo S, Kanayama T, Suzui N, Nakamura S, Kishimoto K, Kosaka Y, Miyazaki T, Demizu Y, Soejima T, Kawamura A, Ohnishi H. Poorly Differentiated Chordoma of the Clivus With Loss of SMARCB1 Expression in a Pediatric Patient: A Case Report. J Pediatr Hematol Oncol 2022; 44:465-470. [PMID: 35091519 DOI: 10.1097/mph.0000000000002402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/04/2021] [Indexed: 11/25/2022]
Abstract
Poorly differentiated chordoma (PDC) is a rare, aggressive subtype of chordoma. A two-year-old girl presented with cervical pain, limb paralysis and respiratory failure. Magnetic resonance imaging and positron emission tomography-computed tomography revealed a tumor compressing the pons at the clivus and osteoblastic metastatic lesions of the left upper arm and right iliac bone. Her tumors shrank substantially after treatment with chemotherapy and proton beam therapy. Our initial diagnosis was an atypical teratoma/rhabdoid tumor, but final diagnosis of PDC was made on the basis of the immunohistochemical expression of brachyury. In addition, the detection of SMARCB1/INI1 mutation confirmed the diagnosis of PDC.
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Affiliation(s)
- Shiho Yasue
- Department of Pediatrics, Gifu University Graduate School of Medicine
| | - Michio Ozeki
- Department of Pediatrics, Gifu University Graduate School of Medicine
| | - Saori Endo
- Department of Pediatrics, Gifu University Graduate School of Medicine
| | | | - Natsuko Suzui
- Department of Pathology, Gifu University Hospital, Gifu
| | - Sayaka Nakamura
- Depertment of Hematology and Oncology, Children's Cancer Center
| | - Kenji Kishimoto
- Depertment of Hematology and Oncology, Children's Cancer Center
| | | | | | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Japan
| | - Atsufumi Kawamura
- Depertment of Neurosurgery, Childhood Cancer Medical Center, Hyogo Prefectural Kobe Children's Hospital
| | - Hidenori Ohnishi
- Department of Pediatrics, Gifu University Graduate School of Medicine
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21
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Fujikawa T, Uemura S, Yoshida M, Hyodo S, Kozaki A, Saito A, Kishimoto K, Ishida T, Mori T, Uematsu A, Morita K, Hatakeyama T, Tamura A, Yamamoto N, Komatsu M, Soejima T, Hasegawa D, Kosaka Y. Spindle cell sarcoma with KIAA1549-BRAF resembling infantile fibrosarcoma morphologically: A case report and literature review. Oncol Lett 2022; 24:452. [PMID: 36380878 PMCID: PMC9650595 DOI: 10.3892/ol.2022.13572] [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: 09/07/2022] [Accepted: 10/18/2022] [Indexed: 11/24/2022] Open
Abstract
Infantile fibrosarcoma (IFS) commonly harbors ETS variant transcription factor 6 (ETV6)-neurotrophic receptor tyrosine kinase 3 (NTRK3) fusion. However, the recent accessibility to clinical next-generation sequencing (NGS) has revealed ETV6-NTRK3 negative spindle cell sarcomas resembling IFS morphologically, involving NTRK1/2, MET, RET and BRAF. The present report describes a pediatric case of spindle cell sarcoma with KIAA1549-BRAF resembling IFS morphologically. A 20-month-old female patient was referred to Kobe Children's Hospital (Kobe, Japan) for the treatment of intrathoracic spindle cell sarcoma. Pathologically, the intrathoracic tumor cells were composed of spindle cells with focal hemagiopericytomatous pattern. In immunohistochemistry analysis, the intrathoracic tumor cells focally expressed desmin and WT-1 and were negative for pan-tropomyosin receptor kinase (TRK), S-100 and CD34. Fluorescence in situ hybridization analysis for ETV6 and capicua transcriptional repressor revealed negative split signals. Although the patient was initially diagnosed with IFS morphologically, KIAA1549-BRAF fusion transcript was detected by comprehensive genomic profiling with NGS using intrathoracic tumor tissues and confirmed by reverse transcription-PCR. Chemotherapy induced a reduction in the tumor size. At present, the patient is alive with the disease and has been receiving therapy for 8 months since the initiation of chemotherapy. Review of BRAF-altered spindle cell sarcomas resembling IFS morphologically revealed the inconsistency in immunohistochemical expression patterns and the diversity of BRAF fusion genes and mutations. Therefore, the elucidation of genomic profiling by NGS may assist in making an appropriate diagnosis and selecting novel alternative therapies in ETV6-NTRK3-negative spindle cell sarcomas resembling IFS morphologically.
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Affiliation(s)
- Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan,Correspondence to: Dr Suguru Uemura, Department of Hematology and Oncology, Kobe Children's Hospital, Minatojima-minanimachi 1-6-7, Chuo-ku, Kobe, Hyogo 650-0047, Japan, E-mail:
| | - Makiko Yoshida
- Department of Pathology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Sayaka Hyodo
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Ayano Uematsu
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Keiichi Morita
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Tadashi Hatakeyama
- Department of Surgery, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Masato Komatsu
- Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Kobe Proton Center, Kobe, Hyogo 650-0047, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
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22
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Nino N, Ishida T, Nakatani N, Lin KS, Win KHN, Mon CY, Nishimura A, Inoue S, Tamura A, Yamamoto N, Uemura S, Saito A, Mori T, Hasegawa D, Kosaka Y, Nozu K, Nishimura N. Minimal residual disease detected by droplet digital PCR in peripheral blood stem cell grafts has a prognostic impact on high-risk neuroblastoma patients. Heliyon 2022; 8:e10978. [PMID: 36276741 PMCID: PMC9578974 DOI: 10.1016/j.heliyon.2022.e10978] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
More than half of high-risk neuroblastoma (NB) patients have experienced relapse due to the activation of chemoresistant minimal residual disease (MRD) even though they are treated by high-dose chemotherapy with autologous peripheral blood stem cell (PBSC) transplantation. Although MRD in high-risk NB patients can be evaluated by quantitative PCR with several sets of neuroblastoma-associated mRNAs (NB-mRNAs), the prognostic significance of MRD in PBSC grafts (PBSC-MRD) is unclear. In the present study, we collected 20 PBSC grafts from 20 high-risk NB patients and evaluated PBSC-MRD detected by droplet digital PCR (ddPCR) with 7NB-mRNAs (CRMP1, DBH, DDC, GAP43, ISL1, PHOX2B, and TH mRNA). PBSC-MRD in 11 relapsed patients was significantly higher than that in 9 non-relapsed patients. Patients with a higher PBSC-MRD had a lower 3-year event-free survival (P = 0.0148). The present study suggests that PBSC-MRD detected by ddPCR with 7NB-mRNAs has a prognostic impact on high-risk NB patients.
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Affiliation(s)
- Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Naoko Nakatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kyaw San Lin
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kaung Htet Nay Win
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | - Cho Yee Mon
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan
| | - Akihiro Nishimura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shotaro Inoue
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriyuki Nishimura
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan,Corresponding author.
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23
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Nakayama H, Ogawa C, Sekimizu M, Fujisaki H, Kosaka Y, Hashimoto H, Saito AM, Horibe K. A phase I study of inotuzumab ozogamicin as a single agent in pediatric patients in Japan with relapsed/refractory CD22-positive acute lymphoblastic leukemia (INO-Ped-ALL-1). Int J Hematol 2022; 116:612-621. [PMID: 35635686 DOI: 10.1007/s12185-022-03388-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
Inotuzumab ozogamicin (InO) is a CD22-directed antibody conjugated with calicheamicin approved for adult relapsed or refractory CD22-positive acute lymphoblastic leukemia (ALL). This phase 1 study primarily aimed to determine the pediatric recommended doses of InO through the standard 3 + 3 design, and to evaluate the safety, tolerability, pharmacokinetic (PK) profile, immunogenicity and efficacy of InO. Dose level 1 (DL1) was 1.8 mg/m2 (days 1, 8, and 15: 0.8, 0.5, and 0.5 mg/m2, respectively). Six of the seven registered patients were eligible [median age, 7.5 (2-17) years]. Although all six patients started DL1, only five completed the dose. No dose-limiting toxicity was observed. All patients experienced adverse events (AEs), including increased alanine aminotransferase and aspartate aminotransferase in four patients. Three patients experienced serious AEs, which were hepatic veno-occlusive disease (VOD), ALL, and fever. Five patients achieved complete remission (CR) or CR with incomplete blood cell recovery (CRi), among whom 3 (60%) were negative for minimal residual disease. PK findings were similar to those in adults. No patient had anti-drug antibodies to InO. In conclusion, InO was well tolerated in children and promoted similar antileukemic efficacy as in adults. Nonetheless, the risk for VOD requires attention.
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Affiliation(s)
- Hideki Nakayama
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Sekimizu
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiroyuki Fujisaki
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Hiroya Hashimoto
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Core Laboratory, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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24
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Kobayashi T, Otake S, Mori T, Hasegawa D, Kosaka Y, Ohkusu K, Kasai M. A pediatric case of Gordonia otitidis bacteremia detected by long-term blood culture. J Infect Chemother 2022; 28:1427-1429. [PMID: 35724915 DOI: 10.1016/j.jiac.2022.06.008] [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: 03/27/2022] [Revised: 06/11/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
For immunocompromised patients receiving chemotherapy or bone mallow transplantation, slow-growing bacteria should also be considered one of the pathogenic microorganisms. However, there is no evidence pertaining to the microbiological tests associated with a patient with febrile neutropenia before peripheral blood stem cell harvest (PBSCH). We report a case of a 4-year-old cancer-bearing female presenting with a catheter-related bloodstream infection due to Gordonia otitidis. We detected G. otitidis from long-term blood cultures for approximately 6 days and prevented iatrogenic bacteremia by identifying the same organism from the culture of the PBSC sample and postponing the scheduled PBSCH. If febrile neutropenia occurs before PBSCH, we should collect multiple sets of blood cultures and culture them for a longer period.
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Affiliation(s)
- Takao Kobayashi
- Division of Infectious Diseases, Department of Pediatrics, Kobe Children's Hospital, Hyogo, Japan
| | - Shogo Otake
- Division of Infectious Diseases, Department of Pediatrics, Kobe Children's Hospital, Hyogo, Japan.
| | - Takeshi Mori
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Hyogo, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Hyogo, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Hyogo, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, Tokyo Medical University, Hyogo, Japan
| | - Masashi Kasai
- Division of Infectious Diseases, Department of Pediatrics, Kobe Children's Hospital, Hyogo, Japan
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25
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Carvajal LA, Robinson B, Kosaka Y, Jacob T, Lee J, Hood T, Baker K, Kaempf A, Amara SNA, Pucilowska J, Lind E, Tognon C, Tyner J, Kumar P, Vu T, DiMartino J. P392: PHARMACOLOGICAL INHIBITION OF SYK CONFERS ANTI-PROLIFERATIVE AND NOVEL ANTI-TUMOR IMMUNE RESPONSES IN AML. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000844456.64162.e9] [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: 11/25/2022] Open
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26
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Kishimoto K, Hasegawa D, Uemura S, Nakamura S, Kozaki A, Saito A, Ishida T, Mori T, Kosaka Y. Association between muscle mass evaluated by computed tomography and the serum creatinine-cystatin C ratio in children with cancer: A cross-sectional study. Nutrition 2022; 99-100:111679. [DOI: 10.1016/j.nut.2022.111679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
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27
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Takahashi Y, Ishida H, Imamura T, Tamefusa K, Suenobu S, Usami I, Yumura-Yagi K, Hasegawa D, Nishimura S, Suzuki N, Hashii Y, Deguchi T, Moriya-Saito A, Kosaka Y, Kato K, Kobayashi R, Kawasaki H, Hori H, Sato A, Kudo T, Nakahata T, Oda M, Hara J, Horibe K. JACLS ALL-02 SR protocol reduced-intensity chemotherapy produces excellent outcomes in patients with low-risk childhood acute lymphoblastic leukemia. Int J Hematol 2022; 115:890-897. [PMID: 35258855 DOI: 10.1007/s12185-022-03315-x] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 10/18/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. As overall cure rates of childhood ALL have improved, reduction of overall treatment intensity while still ensuring excellent outcomes is imperative for low-risk patients. We report the outcomes of patients treated following the standard-risk protocol from the prospective Japan Association of Childhood Leukemia Study (JACLS) ALL-02 study, which was conducted between 2002 and 2008 for patients with newly diagnosed ALL aged 1-18 years. Of 1138 patients with B-cell precursor ALL, 388 (34.1%) were allocated to this protocol. Excellent outcomes were achieved despite the overall treatment intensity being lower than that of most contemporary protocols: 4 years event-free survival (EFS) was 92.3% and 4 years overall survival 98.2%. Patients with high hyperdiploidy (HHD) involving triple trisomy (trisomy of chromosomes 4, 10, and 17) or ETV6-RUNX1 had even better outcomes (4 years EFS 97.6% and 100%, respectively). Unique characteristics of this protocol include a selection of low-risk patients with a low initial WBC count and good early treatment response and reduction of cumulative doses of chemotherapeutic agents while maintaining dose density. In Japan, we are currently investigating the feasibility of this protocol while incorporating minimal residual disease into the patient stratification strategy.
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Affiliation(s)
- Yoshihiro Takahashi
- Department of Pediatrics, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Hisashi Ishida
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465, Kajiichou, Hirokouji Kawaramachidori, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Kosuke Tamefusa
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Souichi Suenobu
- Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of Medicine, Oita, Japan
| | - Ikuya Usami
- Department of Pediatric Hematology and Oncology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | | | - Daiichiro Hasegawa
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | | | - Nobuhiro Suzuki
- Department of Pediatrics, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University, Suita, Japan
| | - Takao Deguchi
- Department of Pediatrics, Mie University, Tsu, Japan
| | - Akiko Moriya-Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Koji Kato
- Department of Hematology Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Ryoji Kobayashi
- Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Hirohide Kawasaki
- Department of Pediatrics, Kansai Medical University, Hirakata, Japan
| | - Hiroki Hori
- Department of Pediatrics, Mie University, Tsu, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Toru Kudo
- Saiseikai Nishiotaru Hospital, Otaru, Japan
| | - Tatsutoshi Nakahata
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Megumi Oda
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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28
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Uemura S, Demizu Y, Hasegawa D, Fujikawa T, Inoue S, Nishimura A, Tojyo R, Nakamura S, Kozaki A, Saito A, Kishimoto K, Ishida T, Mori T, Koyama J, Kawamura A, Akasaka Y, Yoshida M, Fukumitsu N, Soejima T, Kosaka Y. The comparison of acute toxicities associated with craniospinal irradiation between photon beam therapy and proton beam therapy in children with brain tumors. Cancer Med 2022; 11:1502-1510. [PMID: 35137555 PMCID: PMC8921900 DOI: 10.1002/cam4.4553] [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: 10/14/2021] [Revised: 11/24/2021] [Accepted: 11/27/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction This study aimed to evaluate acute toxicities associated with irradiation between the X‐CSI (photon beam craniospinal irradiation) and P‐CSI (proton beam craniospinal irradiation) groups in children with brain tumors. Methods Sixty‐two consecutive patients who received initial craniospinal irradiation (CSI) for brain tumors in our center between January 1, 2011 and May 31, 2021, were included in the study. Acute toxicities were retrospectively evaluated during CSI using Common Terminology Criteria for Adverse Events version 5.0. Maximum grades of fatigue, headache, insomnia, nausea, vomiting, dermatitis, constipation, abdominal pain, oropharyngeal mucositis, and hematological toxicities were evaluated. Results Thirty‐six patients received X‐CSI, and 26 patients received P‐CSI. The median dose of CSI was 18.0 Gy in the X‐CSI group and 23.4 Gy (relative biological effectiveness) in the P‐CSI group (p < 0.001). The P‐CSI group had a lower incidence of more than grade 2 nausea (11.5% vs. 69.4%, p = 0.008) and vomiting (7.7% vs. 38.8%, p < 0.001), compared with the X‐CSI group. Multivariate logistic regression analysis with adjustments for potential confounding factors of doses of CSI showed that proton radiation therapy was associated with a marked reduced risk of more than grade 2 nausea and vomiting during CSI (adjusted odds ratio, 0.050; 95% confidential interval, 0.011–0.24; p < 0.001). Conclusion The present study suggests that P‐CSI reduces the acute gastrointestinal toxicities associated with irradiation.
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Affiliation(s)
- Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Yusuke Demizu
- Department of Radiation Oncology, Kobe Proton Center, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Shotaro Inoue
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Akihiro Nishimura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Ryunosuke Tojyo
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Jyunji Koyama
- Department of Neurosurgery, Kobe Children's Hospital, Kobe, Japan
| | | | | | - Makiko Yoshida
- Department of Pathology, Kobe Children's Hospital, Kobe, Japan
| | | | | | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
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29
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Hara J, Nitani C, Shichino H, Kuroda T, Hishiki T, Soejima T, Mori T, Matsumoto K, Sasahara Y, Iehara T, Miyamura T, Kosaka Y, Takimoto T, Nakagawara A, Tajiri T. Outcome of children with relapsed high-risk neuroblastoma in Japan and analysis of the role of allogeneic hematopoietic stem cell transplantation. Jpn J Clin Oncol 2022; 52:486-492. [PMID: 35137156 DOI: 10.1093/jjco/hyac007] [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: 09/10/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In Japan, allogeneic hematopoietic stem cell transplantation is widely performed for recurrent neuroblastomas. This retrospective study aimed to investigate the prognosis of recurrent neuroblastoma in Japan and explore the effectiveness of allogeneic hematopoietic stem cell transplantation. METHODS Clinical characteristics and data on the treatment of patients with high-risk neuroblastoma who experienced first progression between 2003 and 2010 after attaining complete remission or partial remission were collected from hospitals participating in the Japanese Neuroblastoma Research Group. RESULTS Data from 61 patients who fulfilled these criteria were collected. The median interval from disease onset to first progression was 19 months (range, 7-65 months), whereas the median observation time of the surviving patients was 18 months (range, 1-69 months). All patients were treated with chemotherapy, where 22 and 3 patients received allogeneic and autologous hematopoietic stem cell transplantation, respectively. Seven patients were alive in second complete remission, and 39 died, including two in complete remission. The 3-year progression-free survival and overall survival rates were 15.3% (SE: 6.1%) and 16.9% (SE: 6.5%), respectively. For patients with allogeneic hematopoietic stem cell transplantation, the 3-year progression-free survival and overall survival were 28.3% (standard error, 12.0%) and 24.3% (standard error, 11.5%), respectively, and for patients without allogeneic hematopoietic stem cell transplantation, the 3-year progression-free survival and overall survival were 6.0% (standard error 5.5%) and 12.0% (standard error 7.6%), respectively. The duration of initial remission (≥ 18 months) and implementation of allogeneic hematopoietic stem cell transplantation were independently predictive of progression-free survival (P = 0.002 and P = 0.017), whereas for overall survival, only allogeneic hematopoietic stem cell transplantation was predictive (P = 0.012). CONCLUSION Although allogeneic hematopoietic stem cell transplantation contributed to some improvement in prognosis, it was insufficient.
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Affiliation(s)
- Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Chika Nitani
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Hiroyuki Shichino
- Department of Pediatrics, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomoro Hishiki
- Department of Pediatric Surgery, Chiba University, Chiba, Japan
| | | | - Tetsuya Mori
- Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takako Miyamura
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Tetsuya Takimoto
- Department of Childhood Cancer Data Management, National Center for Child Health and Development, Tokyo, Japan
| | | | - Tatsuro Tajiri
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.,Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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30
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Kishimoto K, Hasegawa D, Uemura S, Nakamura S, Kozaki A, Saito A, Ishida T, Mori T, Kosaka Y. Effect of Monoammonium Glycyrrhizinate on the Development of Hepatotoxicity After Initial Intrathecal Chemotherapy for Leukemia. Anticancer Res 2021; 41:6231-6236. [PMID: 34848478 DOI: 10.21873/anticanres.15443] [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: 08/09/2021] [Revised: 08/28/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Chemotherapy for acute leukemia includes agents known to cause hepatotoxicity. This study evaluated the role of monoammonium glycyrrhizinate for the prevention of hepatotoxicity after the first methotrexate-containing intrathecal chemotherapy (ITC) in children and adolescents with leukemia. PATIENTS AND METHODS Patients with newly diagnosed acute leukemia (age 0-18 years) who received ITC during the first week of induction therapy at our hospital between April 2016 and March 2021 were enrolled. Intravenous monoammonium glycyrrhizinate (IVMG) was defined as the intravenous administration of monoammonium glycyrrhizinate initiated on the day before or the day of the first ITC. RESULTS Overall, 39 of 118 patients (33%) developed grade 3-4 hepatotoxicity. The inverse probability of treatment weighting logistic regression model showed that IVMG was not associated with the development of grade 3-4 hepatotoxicity (OR=1.9, 95%CI=0.808-4.468). CONCLUSION IVMG did not protect against the development of grade 3-4 hepatotoxicity after the first methotrexate-containing ITC for leukemia.
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Affiliation(s)
- Kenji Kishimoto
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
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31
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Kishimoto K, Kasai M, Kawamura N, Otake S, Hasegawa D, Kosaka Y. Clinical characteristics and risk factors for mortality in children with Pseudomonas aeruginosa bacteraemia: A retrospective review at a paediatric tertiary centre. J Paediatr Child Health 2021; 57:1976-1980. [PMID: 34169605 DOI: 10.1111/jpc.15634] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/08/2021] [Accepted: 06/16/2021] [Indexed: 11/29/2022]
Abstract
AIM The objective of this study was to describe clinical features and to assess the risk factors associated with mortality in Pseudomonas aeruginosa bacteraemia in a tertiary Japanese paediatric care hospital. METHODS Patients diagnosed with P. aeruginosa bacteraemia at our hospital between 2007 and 2018 were analysed in a retrospective case series. Inadequate initial therapy for P. aeruginosa bacteraemia was defined as initial treatment without antipseudomonal antibiotics or an administration of antipseudomonal agent to which the causative strain was resistant. Bacteraemia-related death was defined as all deaths occurring within 7 days after the onset of bacteraemia. RESULTS Overall, 41 patients with 42 P. aeruginosa bacteraemia episodes were identified. The most common underlying condition was malignancy (27%), followed by congenital heart disease (20%) and preterm birth (17%). Among the 42 P. aeruginosa clinical isolates, 24% were resistant to at least one of the antipseudomonal agents and 10% were resistant to more than one agent. The susceptibility levels for piperacillin, fourth-generation cephalosporins and ciprofloxacin were higher than that for carbapenems. Bacteraemia-related death was observed in 43% of episodes. The 30-day all-cause mortality was 50% (standard error 8%). Neonates, intensive care, mechanical ventilation, afebrile episodes, septic shock, hypoxia, renal injury and inadequate initial therapy were associated with bacteraemia-related death episodes. CONCLUSIONS We found that childhood P. aeruginosa bacteraemia is still a high mortality disease. Our results imply the importance of the identification of high-risk patients and the establishment of adequate empirical antibiotic therapy.
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Affiliation(s)
- Kenji Kishimoto
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Masashi Kasai
- Department of Infectious Disease, Kobe Children's Hospital, Kobe, Japan
| | - Noriko Kawamura
- Department of Clinical Laboratory, Kobe Children's Hospital, Kobe, Japan
| | - Shogo Otake
- Department of Infectious Disease, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
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32
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Hama A, Hasegawa D, Manabe A, Nozawa K, Narita A, Muramatsu H, Kosaka Y, Kobayashi M, Koh K, Takahashi Y, Watanabe K, Ohara A, Ito M, Kojima S. Prospective validation of the provisional entity of refractory cytopenia of childhood, proposed by the World Health Organization. Br J Haematol 2021; 196:1031-1039. [PMID: 34729770 DOI: 10.1111/bjh.17921] [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: 08/02/2021] [Revised: 09/28/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
In 2008, the World Health Organization proposed a new entity of childhood myelodysplastic syndrome (MDS), which was referred to as refractory cytopenia of childhood (RCC). However, whether this morphological classification reflects clinical outcomes remains unclear. We performed a prospective evaluation of bone marrow morphology in 252 children with acquired bone marrow failure between 2009 and 2013. Of 252 patients, 63 were diagnosed with aplastic anaemia (AA), 131 with RCC without multilineage dysplasia (RCC-w/o-MLD) and 58 with RCC with MLD (RCC-MLD). One patient with AA, three with RCC-w/o-MLD and nine with RCC-MLD presented with chromosomal abnormalities at diagnosis (P = 0·001). The response rates to immunosuppressive therapy (IST) at 6 months and the cumulative incidence of clonal evolution at 5 years did not significantly differ among the three groups. A multivariate analysis revealed that the morphological classification of RCC-MLD was a significant risk factor for secondary graft failure after haematopoietic cell transplantation (HCT) (P = 0·003). In view of these findings, RCC could be divided into two categories, RCC-w/o-MLD and RCC-MLD, because children with this condition exhibited a distinct morphology, frequent chromosomal abnormalities at diagnosis and a high frequency of secondary graft failure after HCT.
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Affiliation(s)
- Asahito Hama
- Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Haematology and Oncology, Children's Medical Centre, Japanese Red Cross Aichi Medical Centre Nagoya First Hospital, Nagoya, Japan
| | - Daisuke Hasegawa
- Department of Paediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Atsushi Manabe
- Department of Paediatrics, St. Luke's International Hospital, Tokyo, Japan.,Department of Paediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kazue Nozawa
- Department of Laboratory Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Atsushi Narita
- Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Muramatsu
- Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Kosaka
- Department of Haematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Masao Kobayashi
- Department of Paediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Katsuyoshi Koh
- Department of Haematology/Oncology, Saitama Children's Medical Centre, Saitama, Japan
| | - Yoshiyuki Takahashi
- Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kenichiro Watanabe
- Department of Haematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Akira Ohara
- Department of Paediatrics, Toho University School of Medicine, Tokyo, Japan
| | - Masafumi Ito
- Department of Pathology, Japanese Red Cross Aichi Medical Centre Nagoya First Hospital, Nagoya, Japan
| | - Seiji Kojima
- Department of Paediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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33
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Nakamura N, Kishimoto K, Ishida T, Nakamura S, Tamura A, Kozaki A, Saito A, Hasegawa D, Kosaka Y. Muscle mass change during chemotherapy in children with high-risk neuroblastoma: a retrospective case series of 24 patients. Eur J Pediatr 2021; 180:3265-3271. [PMID: 33970314 DOI: 10.1007/s00431-021-04106-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/17/2022]
Abstract
The clinical characteristics, cause, and risk factors of sarcopenia are unclear in children. The aim of this study was to describe the course of and identify the factors related to muscle mass change during chemotherapy in children with neuroblastoma. A total of 24 consecutive patients aged below 18 years with newly diagnosed high-risk neuroblastoma between 2010 and 2018 in our hospital were enrolled in a case-series study. The psoas muscle index (PMI) was calculated as a parameter of muscle mass based on computer tomography (CT) images of the psoas muscle. PMIs were evaluated at 4 time points (TPs): TP1, at the diagnosis of neuroblastoma; TP2, after the first cycle of chemotherapy; TP3, after the third cycle of chemotherapy; and TP4, at the end of the induction chemotherapy. PMI recovery was defined as an increase in PMI between TP2 and TP4. The mean PMI decreased by 15% between TP1 and TP2 (TP1 7.09 ± 0.99 vs. TP2 6.01 ± 0.98, P < 0.001) and by 10% between TP1 and TP4 (TP1 7.09 vs. TP4 6.35, P = 0.004). PMI recovery between TP1 and TP2 was observed in 7 (29%) patients. The median age of patients with PMI recovery was significantly lower (2 vs. 4 years, P = 0.028), and the proportion of boys was significantly higher in patients with PMI recovery (100% vs. 41%, P = 0.017).Conclusion: This study demonstrated that prominent PMI reduction occurs during the early time of chemotherapy, and a younger age and male sex may be predictive factors for PMI recovery. What is Known: • Sarcopenia is a common disorder in elderly people. • Several causes and risk factors have been reported in adults. • Children with previous hematological malignancies have decreased physical activity. What is New: • Prominent muscle mass loss was observed early in children with high-risk neuroblastoma during chemotherapy. • Age and sex were found to be potentially associated with muscle mass recovery.
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Affiliation(s)
- Natsumi Nakamura
- Pediatric Emergency Department, Hyogo Prefectural Amagasaki General Medical Center, Higashi-Naniwacho 2-17-77, Amagasaki, 660-8550, Japan
| | - Kenji Kishimoto
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan.
| | - Toshiaki Ishida
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Sayaka Nakamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Akihiro Tamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Aiko Kozaki
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Atsuro Saito
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Daiichiro Hasegawa
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Minatojima-Minamimachi 1-6-7, Chuo-ku, Kobe, 650-0047, Japan
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Yamamoto S, Kato M, Watanabe K, Ishimaru S, Hasegawa D, Noguchi M, Hama A, Sato M, Koike T, Iwasaki F, Yagasaki H, Takahashi Y, Kosaka Y, Hashii Y, Morimoto A, Atsuta Y, Hasegawa D, Yoshida N. Prognostic value of the revised International Prognostic Scoring System five-group cytogenetic abnormality classification for the outcome prediction of hematopoietic stem cell transplantation in pediatric myelodysplastic syndrome. Bone Marrow Transplant 2021; 56:3016-3023. [PMID: 34508178 DOI: 10.1038/s41409-021-01446-z] [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] [Received: 06/03/2021] [Revised: 08/10/2021] [Accepted: 08/19/2021] [Indexed: 11/09/2022]
Abstract
Cytogenetic abnormalities are a major risk factor for relapse after hematopoietic stem cell transplantation (HSCT) for myelodysplastic syndrome (MDS). We aimed to evaluate the value of the five-group cytogenetic classification according to the revised International Prognostic Scoring System (R-IPSS) for predicting the outcome after HSCT in pediatric patients with MDS. We retrospectively analyzed the Japanese registration data of 242 pediatric patients with MDS. According to the R-IPSS classification, 112 (45.5%) patients had good, 55 (22.7%) had intermediate, 64 (26.4%) had poor, and 11 (4.6%) had very poor cytogenetics. The 5-year overall survival (5yOS) was 72%, 69%, 59%, and 30% in the good, intermediate, poor, and very poor cytogenetic subgroups (p = 0.026), respectively. The very good, good, and intermediate subgroups were grouped into a "standard" subgroup and reclassified into three subgroups (standard, poor, and very poor). Patients with very poor risk had worse 5yOS (hazard ratio 2.17, 95% confidence interval (CI) 1.02-4.61; p = 0.04) and a much higher 5yCIR (hazard ratio 2.52, 95% CI 1.05-6.04; p = 0.04) than those of patients in the standard group in the multivariate analysis, indicating that very poor risk cytogenetic characteristics independently predicted worse outcome after HSCT in pediatric patients with MDS.
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Affiliation(s)
- Shohei Yamamoto
- Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan. .,Department of Pediatrics, Showa University Fujigaoka Hospital, Kanagawa, Japan.
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Sae Ishimaru
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St Luke's International Hospital, Tokyo, Japan
| | - Maiko Noguchi
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Asahito Hama
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
| | - Maho Sato
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takashi Koike
- Division of Cell Transplantation, Tokai University School of Medicine, Kanagawa, Japan
| | - Fuminori Iwasaki
- Division of Hemato-Oncology/Regenerative Medicine, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Hiroshi Yagasaki
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Yoshiko Hashii
- Cancer Immunotherapy/Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Yoshiko Atsuta
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan
| | - Nao Yoshida
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Aichi, Japan
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35
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Saito Y, Urashima M, Takahashi Y, Ogawa A, Kiyotani C, Yuza Y, Koh K, Watanabe K, Kosaka Y, Goto H, Kikuta A, Okada K, Koga Y, Fujimura J, Inoue M, Sato A, Atsuta Y, Matsumoto K. Effect of high-dose chemotherapy plus stem cell rescue on the survival of patients with neuroblastoma modified by MYCN gene gain/amplification and remission status: a nationwide registration study in Japan. Bone Marrow Transplant 2021; 56:2173-2182. [PMID: 33911201 DOI: 10.1038/s41409-021-01303-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 02/05/2023]
Abstract
In high-risk neuroblastoma, the presence of an MYCN gain/amplification (MYCN-GA) is not always a risk factor of cancer-specific death. We herein examined the effect modification of high-dose chemotherapy with autologous hematopoietic stem cell rescue (HDC-autoSCR) in terms of the interaction between MYCN status and remission status (complete remission or very good partial remission [CR/VGPR] vs. partial remission or less [≤PR]). The present study recruited patient data from 1992 to 2017 in the Japan Society of Hematopoietic Cell Transplantation's national registry. The MYCN status was known in 586 of 950 patients with a single course of HDC-autoSCR. Cumulative hazard curves for neuroblastoma-specific death showed that a subgroup with MYCN-GA and ≤PR had a significantly poorer prognosis than three other subgroups, namely, the MYCN-NGA/ ≤ PR, MYCN-NGA/CR/VGPR, and MYCN-GA/CR/VGPR subgroups even after adjusting for non-infants and stage IV disease (hazard ratio: 2.79; 95% confidence interval: 1.91-4.09; P < 0.001). The interaction between MYCN-GA and ≤PR was significant (pinteraction = 0.006). Hence, the patients with MYCN-GA with non-remission status at HDC-autoSCR had a significantly poorer prognosis than the other subgroups, suggesting that HDC-autoSCR may be effective in patients with CR/VGPR regardless of MYCN gene status and in patients with MYCN-NGA regardless of remission status.
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Affiliation(s)
- Yuya Saito
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. .,Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan.
| | - Mitsuyoshi Urashima
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsushi Ogawa
- Department of Pediatrics, Niigata Cancer Center Hospital, Niigata, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yuki Yuza
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Keiko Okada
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yuhki Koga
- Department of Pediatrics, Kyushu University Hospital, Fukuoka, Japan
| | - Junya Fujimura
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Atsushi Sato
- Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Yoshiko Atsuta
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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36
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Koga Y, Kosaka Y, Koh K, Matsumoto K, Kumamoto T, Fujisaki H, Ishida Y, Suzuki R, Mochizuki S, Goto H, Yuza Y, Hara J. PS3-5 Phase III study of palonosetron for preventing chemotherapy-induced nausea and vomiting in pediatric patients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.520] [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: 11/26/2022] Open
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37
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Hara J, Kosaka Y, Koh K, Matsumoto K, Kumamoto T, Fujisaki H, Ishida Y, Suzuki R, Mochizuki S, Goto H, Yuza Y, Koga Y. Phase III study of palonosetron for prevention of chemotherapy-induced nausea and vomiting in pediatric patients. Jpn J Clin Oncol 2021; 51:1204-1211. [PMID: 34021341 DOI: 10.1093/jjco/hyab079] [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: 02/17/2021] [Accepted: 05/04/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Palonosetron has demonstrated non-inferiority to ondansetron for prevention of chemotherapy-induced nausea and vomiting in pediatric patients in the United States and Europe. We conducted a single-arm registration study to evaluate the efficacy, safety and pharmacokinetics of palonosetron in pediatric patients in Japan. METHODS Key inclusion criteria were age of 28 days to 18 years and malignant disease for which initial highly emetogenic chemotherapy or moderately emetogenic chemotherapy was planned. Patients received palonosetron at 20 μg/kg over at least 30 s intravenously before the start of highly emetogenic chemotherapy or moderately emetogenic chemotherapy and received dexamethasone on Days 1-3. The primary endpoint was the proportion of patients achieving a complete response in the overall phase (0-120 h) in Course 1, and its threshold was set at 30%. RESULTS From December 2016 to June 2019, 60 patients were enrolled, and 58 received at least one dose of palonosetron. The proportion of patients achieving a complete response during the overall phase was 58.6% (95% confidence interval, 44.9%-71.4%), showing the primary endpoint was met (P < 0.0001). Treatment-related adverse events occurred in two patients (3.4%). Regarding the pharmacokinetics of palonosetron, neither the plasma concentration immediately after administration nor the area under the plasma concentration-time curve from time 0 to infinity differed significantly among the age groups. CONCLUSION We demonstrated the efficacy of palonosetron in pediatric patients receiving highly emetogenic chemotherapy or moderately emetogenic chemotherapy and confirmed the appropriateness of the 20 μg/kg dose, regardless of age, considering the safety and pharmacokinetic profiles. TRIAL REGISTRATION JapicCTI-163305, registered 6 June 2016.
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Affiliation(s)
- Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tadashi Kumamoto
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Fujisaki
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Yuji Ishida
- Department of Pediatric Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Ryoko Suzuki
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shinji Mochizuki
- Department of Pediatrics, Graduate School of Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuki Yuza
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yuhki Koga
- Department of Pediatrics, Kyushu University, Fukuoka, Japan
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38
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Uemura S, Lin KS, Mon Thwin KK, Nakatani N, Ishida T, Yamamoto N, Tamura A, Saito A, Mori T, Hasegawa D, Kosaka Y, Nino N, Nagano C, Takafuji S, Iijima K, Nishimura N. Limited correlation between tumor markers and minimal residual disease detected by seven neuroblastoma-associated mRNAs in high-risk neuroblastoma patients. Mol Clin Oncol 2021; 15:137. [PMID: 34055352 DOI: 10.3892/mco.2021.2299] [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: 08/03/2020] [Accepted: 12/18/2020] [Indexed: 01/23/2023] Open
Abstract
Vanillylmandelic acid (VMA), homovanillic acid (HVA), neuron-specific enolase (NSE) and lactate dehydrogenase (LDH) are classical tumor markers and are used as standard clinical evaluations for patients with neuroblastoma (NB). Minimal residual disease (MRD) can be monitored by quantifying several sets of NB-associated mRNAs in the bone marrow (BM) and peripheral blood (PB) of patients with NB. Although MRD in BM and PB has been revealed to be a strong prognostic factor that is independent of standard clinical evaluations, its interrelation with tumor markers remains uncharacterized. The present study determined the levels of tumor markers (VMA, HVA, NSE and LDH) and MRD (BM-MRD and PB-MRD) in 133 pairs of concurrently collected BM, PB and urine samples from 19 patients with high-risk NB. The patients were evaluated during the entire course of treatment, which included 10 diagnoses, 32 treatments, 36 post-treatment, 9 relapses and 46 post-relapse sample pairs. The level of BM-MRD and PB-MRD was determined by quantifying 7 NB-mRNAs (collapsin response mediator protein 1, dopamine beta-hydroxylase, dopa decarboxylase, growth-associated protein 43, ISL LIM homeobox 1, pairedlike homeobox 2b and tyrosine hydroxylase) using droplet digital PCR. In overall sample pairs, tumor markers (VMA, HVA, NSE and LDH) demonstrated weak but significant correlations (P<0.011) with BM-MRD and PB-MRD. In subgroups according to each patient evaluation, the degree of correlation between tumor markers and MRD became stronger in patients with adrenal gland tumors, BM metastasis at diagnosis and relapse/regrowth compared with overall sample pairs. In contrast, tumor markers demonstrated variable correlations with MRD in subgroups according to each sample evaluation (BM infiltration at sampling, collection time point and disease status). The results suggested that tumor markers may demonstrate limited correlation with MRD in patients with high-risk NB.
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Affiliation(s)
- Suguru Uemura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kyaw San Lin
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Khin Kyae Mon Thwin
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Naoko Nakatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Akihiro Tamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Hyogo 650-0047, Japan
| | - Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Satoru Takafuji
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
| | - Noriyuki Nishimura
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Hyogo 654-0142, Japan
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Lin KS, Uemura S, Thwin KKM, Nakatani N, Ishida T, Yamamoto N, Tamura A, Saito A, Mori T, Hasegawa D, Kosaka Y, Nino N, Nagano C, Takafuji S, Iijima K, Nishimura N. Minimal residual disease in high-risk neuroblastoma shows a dynamic and disease burden-dependent correlation between bone marrow and peripheral blood. Transl Oncol 2021; 14:101019. [PMID: 33993097 PMCID: PMC8138775 DOI: 10.1016/j.tranon.2021.101019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/20/2020] [Accepted: 01/12/2021] [Indexed: 11/04/2022] Open
Abstract
Bone marrow is the most frequent site of metastasis and relapse for neuroblastoma. Minimal residual disease has been identified in bone marrow and peripheral blood (BM-MRD and PB-MRD) by quantifying several sets of neuroblastoma-associated mRNAs. BM-MRD has significant prognostic information for high-risk neuroblastoma. BM-MRD and PB-MRD show a dynamic and disease burden-dependent correlation in high-risk neuroblastoma.
Neuroblastoma (NB) is the most common extracranial solid tumor in children and originates from sympathoadrenal or Schwann cell precursors derived from neural crest. These neural crest derivatives also constitute the hematopoietic and mesenchymal stem cells in bone marrow (BM) that is the most frequent site of NB metastasis and relapse. In NB patients, NB cells have been pathologically detected in BM and peripheral blood (PB), and minimal residual disease (MRD) in BM and PB (BM-MRD and PB-MRD) can be monitored by quantitating several sets of NB-associated mRNAs (NB-mRNAs). Although previous studies have shown varying degrees of correlation between BM-MRD and PB-MRD, the underlying factors and/or mechanisms remains unknown. In the present study, we determined the levels of BM-MRD and PB-MRD by quantitating seven NB-mRNAs in 133 pairs of concurrently collected BM and PB samples from 19 high-risk NB patients with clinical disease evaluation, and examined their correlation in overall and subgroups of sample pairs. The levels of BM-MRD and PB-MRD were moderately (r = 0.418, p < 0.001) correlated with each other in overall sample pairs. The correlation became strong (r = 0.725, p < 0.001), weak (r = 0.284, p = 0.008), and insignificant (p = 0.194) in progression, stable, and remission subgroups of sample pairs, respectively. It also became stronger in subgroups of sample pairs with poor treatment responses and poor prognostic factors. Present study suggests that MRD in high-risk NB shows a dynamic and disease burden-dependent correlation between BM and PB.
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Affiliation(s)
- Kyaw San Lin
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Suguru Uemura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Khin Kyae Mon Thwin
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Naoko Nakatani
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihiro Tamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Nanako Nino
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satoru Takafuji
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriyuki Nishimura
- Department of Public Health, Kobe University Graduate School of Health Science, Kobe, Japan.
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40
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Mizumoto M, Fuji H, Miyachi M, Soejima T, Yamamoto T, Aibe N, Demizu Y, Iwata H, Hashimoto T, Motegi A, Kawamura A, Terashima K, Fukushima T, Nakao T, Takada A, Sumi M, Oshima J, Moriwaki K, Nozaki M, Ishida Y, Kosaka Y, Ae K, Hosono A, Harada H, Ogo E, Akimoto T, Saito T, Fukushima H, Suzuki R, Takahashi M, Matsuo T, Matsumura A, Masaki H, Hosoi H, Shigematsu N, Sakurai H. Proton beam therapy for children and adolescents and young adults (AYAs): JASTRO and JSPHO Guidelines. Cancer Treat Rev 2021; 98:102209. [PMID: 33984606 DOI: 10.1016/j.ctrv.2021.102209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/02/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022]
Abstract
Children and adolescents and young adults (AYAs) with cancer are often treated with a multidisciplinary approach. This includes use of radiotherapy, which is important for local control, but may also cause adverse events in the long term, including second cancer. The risks for limited growth and development, endocrine dysfunction, reduced fertility and second cancer in children and AYAs are reduced by proton beam therapy (PBT), which has a dose distribution that decreases irradiation of normal organs while still targeting the tumor. To define the outcomes and characteristics of PBT in cancer treatment in pediatric and AYA patients, this document was developed by the Japanese Society for Radiation Oncology (JASTRO) and the Japanese Society of Pediatric Hematology/Oncology (JSPHO).
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Affiliation(s)
- Masashi Mizumoto
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroshi Fuji
- Department of Radiology and National Center for Child Health and Development, Tokyo, Japan
| | - Mitsuru Miyachi
- Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Norihiro Aibe
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Hiromitsu Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Aichi, Japan
| | - Takayuki Hashimoto
- Department of Radiation Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Atsufumi Kawamura
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Fukushima
- Department of Pediatric Hematology and Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Tomohei Nakao
- Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Akinori Takada
- Department of Radiology, Mie University Hospital, Tsu-shi, Mie, Japan
| | - Minako Sumi
- Department of Radiation Oncology and Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Radiation Oncology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | | | - Kensuke Moriwaki
- Department of Medical Statistics, Kobe Pharmaceutical University, Kobe, Hyogo, Japan
| | - Miwako Nozaki
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Yuji Ishida
- Department of Pediatrics, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Keisuke Ae
- Department of Orthopaedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ako Hosono
- Department of Pediatric Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Hideyuki Harada
- Division of Radiation Therapy, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Etsuyo Ogo
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Takashi Saito
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroko Fukushima
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryoko Suzuki
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Mitsuru Takahashi
- Department of Orthopaedic Oncology, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Takayuki Matsuo
- Department of Neurosurgery, Nagasaki University Graduate School of Medicine, Nagasaki, Japan
| | - Akira Matsumura
- Departments of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hidekazu Masaki
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Nagano, Japan
| | - Hajime Hosoi
- Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Sakurai
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Sakaguchi H, Miyamura T, Tomizawa D, Taga T, Ishida H, Okamoto Y, Koh K, Yokosuka T, Yoshida N, Sato M, Noguchi M, Okada K, Hori T, Takeuchi M, Kosaka Y, Inoue M, Hashii Y, Atsuta Y. Effect of extramedullary disease on allogeneic hematopoietic cell transplantation for pediatric acute myeloid leukemia: a nationwide retrospective study. Bone Marrow Transplant 2021; 56:1859-1865. [PMID: 33692532 DOI: 10.1038/s41409-021-01250-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 01/27/2021] [Accepted: 02/17/2021] [Indexed: 11/09/2022]
Abstract
Children with acute myeloid leukemia (AML) commonly develop extramedullary disease (EMD), which comprises central nervous system (CNS) lesions and myeloid sarcoma (MS). In this retrospective analysis, we aimed to determine the effect of EMD on the outcomes of allogeneic hematopoietic cell transplantation (HCT) in 678 pediatric patients with de novo AML (median age, 7 years; range, 0.3-15 years) between 2006 and 2016. We compared the outcomes between patients with (EMD group, n = 158; CNS lesion, n = 47, CNS lesion + MS, n = 9, and MS, n = 102) and without EMD at diagnosis (non-EMD group, n = 520). Survivors were followed for a median of 4.5 years, and the 4-year overall survival (OS) rates were 60.6% and 56.4% in the EMD and non-EMD groups, respectively (P = 0.60). No significant differences in OS were observed with respect to the EMD site, except bone lesions, which were associated with poor OS after HCT in a non-remission status. A multivariate analysis revealed that EMD did not affect the outcomes of HCT. In conclusion, the study findings suggest that EMD should not be considered a poor prognostic factor in HCT for children with AML.
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Affiliation(s)
- Hirotoshi Sakaguchi
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan. .,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
| | - Takako Miyamura
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Taga
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
| | | | - Yasuhiro Okamoto
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Tomoko Yokosuka
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Nao Yoshida
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Maho Sato
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Maiko Noguchi
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Keiko Okada
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Tsukasa Hori
- Department of Pediatrics, Sapporo Medical University Hospital, Sapporo, Japan
| | - Masanobu Takeuchi
- Department of Pediatrics, Yokohama City University Hospital, Yokohama, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Cancer Immunotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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42
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Furukawa K, Arii J, Nishimura M, Tjan LH, Lystia Poetranto A, Ren Z, Aktar S, Huang JR, Sutandhio S, Kurahashi Y, Nishino A, Shigekuni S, Takeda Y, Uto K, Matsui K, Sato I, Inui Y, Endo K, Kosaka Y, Oota T, Saegusa J, Mori Y. Seroepidemiological Survey of the Antibody for Severe Acute Respiratory Syndrome Coronavirus 2 with Neutralizing Activity at Hospitals: A Cross-sectional Study in Hyogo Prefecture, Japan. JMA J 2021; 4:41-49. [PMID: 33575502 PMCID: PMC7872787 DOI: 10.31662/jmaj.2020-0094] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/04/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic is spreading rapidly all over the world. The Japanese government lifted the state of emergency, announced in April 2020, on May 25, but there are still sporadic clusters. Asymptomatic patients who can transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause some of these clusters. It is thus urgent to investigate the seroprevalence of antibodies against SARS-CoV-2 and their neutralizing activity. We conducted a cross-sectional study of >10,000 samples at hospitals in Hyogo Prefecture, Japan. Methods: Between August 6 and October 1, 2020, we collected samples of residual blood from the patients who visited or were admitted to five hospitals and a foundation in Hyogo. We tested the samples for antibodies against SARS-CoV-2 by electrochemiluminescence immunoassay (ECLIA) and chemiluminescent enzyme immunoassay (CLEIA). Sera that were positive by ECLIA or CLEIA were analyzed by an immunochromatographic (IC) test and neutralizing activity assay. Results: We tested 10,377 samples from patients aged between 0 and 99 years old; 27 cases (0.26%) were positive on the ECLIA, and 51 cases (0.49%) were positive on CLEIA. In the 14 cases that tested positive on both ECLIA and CLEIA, the positive rates on the IC test and for neutralizing activity were high (85% and 92%, respectively). In 50 cases (0.48%) that were positive by either ECLIA or CLEIA, the corresponding rates were low (20% and 6%, respectively). The positive rate of neutralizing antibody was 0.15%. Conclusions: These results indicate that most Hyogo Prefecture residents still do not have antibodies and should avoid the risk of incurring a SARS-CoV-2 infection. Two or more antibody tests should be required for seroepidemiological studies of the antibody for SARS-CoV-2, and a neutralizing activity assay is also essential.
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Affiliation(s)
- Koichi Furukawa
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Arii
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mitsuhiro Nishimura
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Lidya Handayani Tjan
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Anna Lystia Poetranto
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Zhenxiao Ren
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Salma Aktar
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jing Rin Huang
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Silvia Sutandhio
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukiya Kurahashi
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Arisa Nishino
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shiho Shigekuni
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichiro Takeda
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kenichi Uto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Keiji Matsui
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Itsuko Sato
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Yoshiaki Inui
- Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan
| | - Kazuo Endo
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | - Toshiaki Oota
- Hyogo Prefecture Health Promotion Association, Kobe, Japan
| | - Jun Saegusa
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Yasuko Mori
- Division of Clinical Virology, Center for Infectious Disease, Kobe University Graduate School of Medicine, Kobe, Japan
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43
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Tamura A, Shinozawa K, Uemura S, Nakamura S, Fujiwara T, Tahara T, Yamamoto N, Saito A, Kozaki A, Kishimoto K, Ishida T, Hasegawa D, Muramatsu T, Amano K, Fukutake K, Kosaka Y. Early elevation of factor IX level in japanese brothers with Haemophilia B Leyden who are carrying c. -35 g > a mutations in the promoter region of F9. Haemophilia 2021; 27:e510-e512. [PMID: 33427373 DOI: 10.1111/hae.14248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Akihiro Tamura
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Keiko Shinozawa
- Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Suguru Uemura
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan.,Department of Paediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sayaka Nakamura
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takahiro Fujiwara
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Teppei Tahara
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan.,Department of Paediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsuro Saito
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kenji Kishimoto
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takashi Muramatsu
- Department of Paediatrics, Kawanishi City Hospital, Kawanishi, Japan
| | - Kagehiro Amano
- Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Katsuyuki Fukutake
- Department of Laboratory Medicine, Tokyo Medical University, Tokyo, Japan
| | - Yoshiyuki Kosaka
- Department of Haematology and Oncology, Kobe Children's Hospital, Kobe, Japan
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44
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Soejima T, Fukumitsu N, Demizu Y, Mima M, Suzuki T, Kawamura A, Kosaka Y. RONC-04. RE-IRRADIATION AFTER TREATMENT OF MEDULLOBLASTOMA; RELAPSED CASES AND SECOND CANCER CASES. Neuro Oncol 2020. [PMCID: PMC7715112 DOI: 10.1093/neuonc/noaa222.777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Late complications such as brainstem necrosis are great concern of re-irradiation for brain tumor. Proton beam therapy can reduce radiation dose of organs at risk such as brainstem, so is expected to reduce late complications. PATIENTS AND METHODS Patients with medulloblastoma treated with re-irradiation from January 2015 to February 2019 at the Kobe Children’s Hospital and the Kobe Proton Center were reviewed. There were three cases of relapsed medulloblastoma and three cases of second cancer (glioblastomas). RESULTS In relapsed cases, all three cases treated with 12 Gy in 8 fractions cranio-spinal irradiation followed by gamma knife radiosurgery (one) or 28.8 Gy (RBE) in 16 fractions of proton beam therapy (two). Follow-up periods were 8 to 19 months (median 12 months) and all three cases survived without relapse. In second cancer cases, all three cases were treated with 40.05 Gy per 15 fractions of radiation therapy (2 cases were treated with photon and one case with proton). However, all cases relapsed and two cases died of disease. CONCLUSION Twelve Gy in 8 fractions cranio-spinal irradiation followed by 28.8 Gy (RBE) in 16 fractions of proton beam therapy is thought to be useful for the relapsed case. Re-irradiation for second cancer was disappointing and further study is warranted.
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45
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Kawamura A, Koyama J, Akutsu N, Demizu Y, Fukumitsu N, Soejima T, Kosaka Y. RONC-01. PROTON BEAM THERAPY IN THE MULTIDISCIPLINARY THERAPY FOR PEDIATRIC BRAIN AND SPINAL TUMOR AT KOBE CHILDREN’S HOSPITAL WITH KOBE PROTON CENTER. Neuro Oncol 2020. [PMCID: PMC7715491 DOI: 10.1093/neuonc/noaa222.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
It could be remarked that Radiotherapy (RT) has the important role for the multidisciplinary therapy to Malignant Pediatric Central Nervous System tumor. And recently among RT, Proton Beam Therapy (PBT) is expected to be effective and decrease serious late effects after RT in malignant pediatric tumor. PBT could be controlled precisely the dose and depth and spare the normal structures outside the target. Thus, PBT becomes applicable for pediatric solid tumor to insurance in April, 2016 in Japan. We have worked in closer cooperation with Hyogo Prefectural Ion Beam Medical Center and started PBT from April 2015. And from December 2017, our PBT has transferred to adjacent new medical center (Kobe Proton Center) which has the only institute that equipped the exclusive gantry for children in our country. The treated cases are 28 boys and 35 girls (age average 8.2 years oid). They are 15 Germ cell tumor, 14 Ependymoma, 13 Medulloblastoma, 4 Chordoma, 4 Atypical teratoid/rhabdoid tumor, 2 Craniopharyngioma and others. We have simulated the applications of not only broad beam but also scanned beam to limit the dose distribution and prepare for the cranio-spinal irradiation. All cases underwent magnetic resonance imaging to evaluate the results at out clinic and also the complications are assessed after treatments. The effect of PBT in this series is similar to our experience of traditional RT. There are a few controllable complications such as conventional RT. Farther more follow up is necessary to evaluate the advantage of PBT which could reduce delayed complications of RT.
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Affiliation(s)
- Atsufumi Kawamura
- Department of Neurosurgery Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
| | - Junji Koyama
- Department of Neurosurgery Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
| | - Nobuyuki Akutsu
- Department of Neurosurgery Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
| | - Yuske Demizu
- Department of Radiation Oncology Hyogo Prefectural Ion Beam Medical Center Kobe Proton, Kobe, Hyogo, Japan
| | - Nobuyoshi Fukumitsu
- Department of Radiation Oncology Hyogo Prefectural Ion Beam Medical Center Kobe Proton, Kobe, Hyogo, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology Hyogo Prefectural Ion Beam Medical Center Kobe Proton, Kobe, Hyogo, Japan
| | - Yoshiyuki Kosaka
- Department of Hemato-oncology Hyogo Prefectural Kobe Children’s Hospital, Kobe, Hyogo, Japan
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46
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Hasegawa D, Tawa A, Tomizawa D, Watanabe T, Saito AM, Kudo K, Taga T, Iwamoto S, Shimada A, Terui K, Moritake H, Kinoshita A, Takahashi H, Nakayama H, Koh K, Goto H, Kosaka Y, Miyachi H, Horibe K, Nakahata T, Adachi S. Attempts to optimize postinduction treatment in childhood acute myeloid leukemia without core-binding factors: A report from the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG). Pediatr Blood Cancer 2020; 67:e28692. [PMID: 32886449 DOI: 10.1002/pbc.28692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 08/08/2020] [Accepted: 08/23/2020] [Indexed: 01/08/2023]
Abstract
We previously reported that risk-stratified therapy and intensive postremission chemotherapy (PRC) contributed to the improved survival of childhood acute myeloid leukemia (AML) in the AML99 study, which led us to consider a reduction in the number of PRC courses with more restrictive indications for stem cell transplantation (SCT) in the successor AML-05 study. We here report the outcome of AML patients without core-binding factor mutation (non-CBF AML) in the AML-05 study. Two-hundred eighty-nine children (age < 18 years old) with non-CBF AML were eligible. Patients with unfavorable cytogenetics and/or poor bone marrow response to the first induction course were candidates for SCT in the AML-05 study. After two courses of induction, a further three courses of PRC were given in AML-05, while four courses were given in the AML99 study. The 3-year event-free survival (EFS) rate in the AML-05 study (46.7%, 95% CI: 40.6-52.6%) was comparable to that of non-CBF AML in the AML99 study (51.5%, 95% CI: 42.7-59.6%) (P = .16). However, the 3-year overall survival (OS) rate in the AML-05 study (62.9%, 95% CI: 56.3-68.8%) was slightly lower than that in the AML99 study (71.6%, 95% CI: 63.2-78.5%) (P = .060), mainly due to decreased remission induction rate and increased nonrelapsed mortality. In conclusion, reductions in the number of PRC courses from four to three, together with repetitive cycles of high-dose cytarabine, were acceptable for non-CBF childhood AML.
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Affiliation(s)
- Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Hyogo, Japan
| | - Akio Tawa
- Higashiosaka Aramoto Heiwa Clinic, Osaka, Japan
| | - Daisuke Tomizawa
- Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoyuki Watanabe
- Department of Nutritional Science, Faculty of Psychological and Physical Science, Aichi Gakuin University, Aichi, Japan
| | - Akiko Moriya Saito
- Laboratory of Clinical, Epidemiological and Health Services Research, National Hospital Organization, Nagoya Medical Center Clinical Research Center, Nagoya, Aichi, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Takashi Taga
- Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan
| | - Shotaro Iwamoto
- Department of Pediatrics, Mie University Graduate School of Medicine, Mie, Japan
| | - Akira Shimada
- Department of Pediatrics, Okayama University, Okayama, Japan
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Hiroshi Moritake
- Division of Pediatrics, Department of Reproductive and Developmental Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Akitoshi Kinoshita
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Hideki Nakayama
- Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Hiroaki Goto
- Department of Hematology/Oncology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Hyogo, Japan
| | - Hayato Miyachi
- Department of Laboratory Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Keizo Horibe
- Clinical Research Center, National Nagoya Hospital, Aichi, Japan
| | - Tatsutoshi Nakahata
- Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
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47
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Tamura A, Inoue S, Mori T, Noguchi J, Nakamura S, Saito A, Kozaki A, Ishida T, Sadaoka K, Hasegawa D, Kosaka Y, Miyanishi M. Low Multiplication Value of Absolute Monocyte Count and Absolute Lymphocyte Count at Diagnosis May Predict Poor Prognosis in Neuroblastoma. Front Oncol 2020; 10:572413. [PMID: 33123478 PMCID: PMC7566172 DOI: 10.3389/fonc.2020.572413] [Citation(s) in RCA: 4] [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: 07/13/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022] Open
Abstract
Despite the growing evidences that immune dysfunction contributes to tumor progression, the prognostic value in patients with neuroblastoma regarding circulating immune blood cell counts has not been well characterized. To answer this, we conducted a retrospective study to evaluate the prognostic value of the circulating immune cell counts at diagnosis in a cohort of 55 patients with neuroblastoma. Based on a novel index by multiplying the absolute monocyte count (AMC)/μl and absolute lymphocyte count (ALC)/μl, we sub-grouped patients with AMC × ALC ≥ 1 × 106 (/μl)2 as high group and patients with AMC × ALC < 1 × 106 (/μl)2 as low group. In the entire cohort, the 4-year progression-free survival (PFS), and overall survival (OS) for high group (n = 38) vs low group (n = 17) was 81.7% (95%CI; 63.6-91.3%) and 90.7% (95%CI; 73.8-96.9%) vs 31.7% (11.6-54.1%) and 56.5% (29.7-76.4%; p < 0.001 for PFS and p = 0.015 for OS), respectively, suggesting that a low AMC × ALC is associated with poor prognosis. In the subgroup analysis for high-risk patients, the 4-year PFS and OS for high group (n = 17) vs low group (n = 13) was 59.8% (31.2-79.7%) and 79.8% (49.4-93.0%) vs 8.5% (0.5-31.7%) and 42.0% (15.4-66.8%; p < 0.001 for PFS and p = 0.089 for OS), respectively. Our data demonstrate that AMC × ALC at diagnosis is a cost-effective and easily measurable biomarker for predicting prognosis in neuroblastoma.
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Affiliation(s)
- Akihiro Tamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan.,Laboratory for Organismal Patterning, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Shotaro Inoue
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Jun Noguchi
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kay Sadaoka
- Laboratory for Organismal Patterning, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Masanori Miyanishi
- Laboratory for Organismal Patterning, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
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48
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Kishimoto K, Hasegawa D, Irie K, Okada A, Nakamura S, Tamura A, Yamamoto N, Kozaki A, Saito A, Ishida T, Fukushima S, Kosaka Y. Pharmacokinetic analysis for model-supported therapeutic drug monitoring of busulfan in Japanese pediatric hematopoietic stem cell transplantation recipients. Pediatr Transplant 2020; 24:e13696. [PMID: 32196880 DOI: 10.1111/petr.13696] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/09/2020] [Accepted: 02/21/2020] [Indexed: 12/22/2022]
Abstract
This prospective observational study analyzed the pharmacokinetics of busulfan in Japanese children and evaluated the predicting accuracy of previous pediatric PPK models of busulfan. This study enrolled five patients (aged 2-12 years, BW 14-48 kg) receiving a busulfan-based conditioning regimen for hematopoietic stem cell transplantation at our hospital between January 2017 and December 2018. All patients received a 2-hour intravenous busulfan infusion four times daily for a total of 16 doses. After the infusions, 51 plasma samples were collected with the plasma busulfan concentration measured by liquid chromatography-tandem mass spectrometry. PPK model fitting was analyzed using the (%MPE) and the (%MAPE). Limited sampling strategies for estimating busulfan AUC were also evaluated. High interpatient variability was observed in the PK parameters. The most suitable PPK model that reflected our data was McCune's two-compartment model (%MPE -8.7, %MAPE 19.3). A combination sampling method using the busulfan concentration at 2 and 6 hours after the start of the first busulfan dose was found to be able to estimate AUC4 day . These results provide useful information on busulfan therapeutic drug monitoring in the Japanese pediatric population.
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Affiliation(s)
- Kenji Kishimoto
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Kei Irie
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan.,Department of Pharmacy, Kobe City Hospital Organization Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akira Okada
- Department of Regulatory Science, Faculty of Pharmacy, Musashino University, Tokyo, Japan
| | - Sayaka Nakamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Akihiro Tamura
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Nobuyuki Yamamoto
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
| | - Shoji Fukushima
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, Kobe Gakuin University, Kobe, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology & Oncology, Children's Cancer Center, Kobe Children's Hospital, Kobe, Japan
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49
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Aoki T, Takahashi H, Tanaka S, Shiba N, Hasegawa D, Iwamoto S, Terui K, Moritake H, Nakayama H, Shimada A, Koh K, Goto H, Kosaka Y, Saito AM, Horibe K, Kinoshita A, Tawa A, Taga T, Adachi S, Tomizawa D. Predisposition to prolonged neutropenia after chemotherapy for paediatric acute myeloid leukaemia is associated with better prognosis in the Japanese Paediatric Leukaemia/Lymphoma Study Group AML-05 study. Br J Haematol 2020; 193:176-180. [PMID: 32337716 DOI: 10.1111/bjh.16656] [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: 01/15/2020] [Revised: 03/17/2020] [Accepted: 03/20/2020] [Indexed: 11/28/2022]
Abstract
The variability in myelosuppression after chemotherapy for acute myeloid leukaemia (AML) can affect its prognosis; however, the underlying mechanism remains controversial. In the Japanese Paediatric Leukaemia/Lymphoma Study Group AML-05 study, we showed that prolonged neutropenia was associated with high overall survival (P = 0·011) and low frequency of relapse (P = 0·042) in patients without granulocyte-colony stimulating factor (G-CSF) who completed the indicated treatment protocol. Our data indicate that predisposition to prolonged neutropenia after chemotherapy is correlated with a better outcome of AML treatment. Our results promote the usage of individualised drug dosing strategies to improve the therapeutic outcome in AML patients.
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Affiliation(s)
- Takahiro Aoki
- Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Shiro Tanaka
- Department of Clinical Biostatistics/Clinical Biostatistics Course, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Norio Shiba
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University Hospital, Yokohama, Japan
| | - Daiichiro Hasegawa
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | | | - Kiminori Terui
- Department of Pediatrics, Hirosaki University, Hirosaki, Japan
| | - Hiroshi Moritake
- Division of Pediatrics, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hideki Nakayama
- Department of Pediatrics, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Akira Shimada
- Department of Pediatric Hematology/Oncology, Okayama University Hospital, Okayama, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Centre, Saitama, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Centre, Yokohama, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Akiko M Saito
- Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Keizo Horibe
- Clinical Research Centre, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Akitoshi Kinoshita
- Department of Pediatrics, School of Medicine, St. Marianna University, Kawasaki, Japan
| | - Akio Tawa
- Higashiosaka Aramoto Heiwa Clinic, Higashiosaka, Japan
| | - Takashi Taga
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
| | - Souichi Adachi
- Department of Human Health Science, Kyoto University, Kyoto, Japan
| | - Daisuke Tomizawa
- Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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50
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Hasegawa D, Imamura T, Yumura-Yagi K, Takahashi Y, Usami I, Suenobu SI, Nishimura S, Suzuki N, Hashii Y, Deguchi T, Moriya-Saito A, Kato K, Kosaka Y, Hirayama M, Iguchi A, Kawasaki H, Hori H, Sato A, Kudoh T, Nakahata T, Oda M, Hara J, Horibe K. Risk-adjusted therapy for pediatric non-T cell ALL improves outcomes for standard risk patients: results of JACLS ALL-02. Blood Cancer J 2020; 10:23. [PMID: 32107374 PMCID: PMC7046744 DOI: 10.1038/s41408-020-0287-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/01/2020] [Accepted: 02/07/2020] [Indexed: 11/14/2022] Open
Abstract
This study was a second multicenter trial on childhood ALL by the Japan Childhood Leukemia Study Group (JACLS) to improve outcomes in non-T ALL. Between April 2002 and March 2008, 1138 children with non-T ALL were enrolled in the JACLS ALL-02 trial. Patients were stratified into three groups using age, white blood cell count, unfavorable genetic abnormalities, and treatment response: standard risk (SR), high risk (HR), and extremely high risk (ER). Prophylactic cranial radiation therapy (PCRT) was abolished except for CNS leukemia. Four-year event-free survival (4yr-EFS) and 4-year overall survival (4yr-OS) rates for all patients were 85.4% ± 1.1% and 91.2% ± 0.9%, respectively. Risk-adjusted therapy resulted in 4yr-EFS rates of 90.4% ± 1.4% for SR, 84.9% ± 1.6% for HR, and 66.5% ± 4.0% for ER. Based on NCI risk classification, 4yr-EFS rates were 88.2% in NCI-SR and 76.4% in NCI-HR patients, respectively. Compared to previous trial ALL-97, 4yr-EFS of NCI-SR patients was significantly improved (88.2% vs 81.2%, log rank p = 0.0004). The 4-year cumulative incidence of isolated (0.9%) and total (1.5%) CNS relapse were significantly lower than those reported previously. In conclusion, improved EFS in NCI-SR patients and abolish of PCRT was achieved in ALL-02.
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Affiliation(s)
- Daiichiro Hasegawa
- Department of Hematology/Oncology, Hyogo Prefectural Children's Hospital, Kobe, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. .,Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
| | | | - Yoshihiro Takahashi
- Department of Pediatrics, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Ikuya Usami
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.,Department of Pediatric Hematology and Oncology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
| | - So-Ichi Suenobu
- Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University, Oita, Japan
| | | | - Nobuhiro Suzuki
- Department of Pediatrics, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University, Suita, Japan
| | - Takao Deguchi
- Department of Pediatrics, Mie University, Tsu, Japan
| | - Akiko Moriya-Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koji Kato
- Department of Hematology Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Children's Hospital, Kobe, Japan
| | | | - Akihiro Iguchi
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan
| | | | - Hiroki Hori
- Department of Pediatrics, Mie University, Tsu, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | | | - Tatsutoshi Nakahata
- Department of Clinical Application, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, Japan
| | - Megumi Oda
- Department of Pediatrics, Okayama University, Okayama, Japan
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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