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Sato L, Iwamoto N, Kakumoto Y, Tsuzuki S, Togano T, Ishikane M, Okumura N, Yamada G, Inada M, Suzuki T, Hojo M, Takasaki J, Sasaki R, Kimura A, Teruya K, Okamoto T, Hayakawa K, Hara H, Iseki K, Ohmagari N. Unfractionated Heparin Safety in COVID-19: Incidence and Risks of Bleeding Complications in Japan. J Atheroscler Thromb 2024:64448. [PMID: 38355124 DOI: 10.5551/jat.64448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
AIM Several studies have shown the efficacy and safety of low-molecular-weight heparin use in coronavirus disease 2019 (COVID-19), but that of unfractionated heparin (UFH) has not been investigated. We investigated the prevalence of bleeding complications during UFH administration, its impact on mortality, and the risk factors of bleeding outcomes associated with UFH. METHODS This retrospective cohort study was conducted at a single-center tertiary care hospital, including hospitalized patients with COVID-19. The primary outcomes were measured as the prevalence of bleeding complications during hospitalization, and the secondary outcomes were thromboembolic events and 60-day mortality rates. Logistic regression analysis and propensity score matching were used to assess risk factors for bleeding complications and their impact on mortality. RESULTS Among 1035 included patients, 516 patients were treated with UFH. Twelve (2.3%) patients in the UFH group experienced major bleeding. The prevalence of major bleeding in patients treated with therapeutic-dose UFH was 9.2%. Logistic regression analysis showed that age ≥ 60 years (adjusted odds ratio [aOR], 3.89; 95% confidence interval [CI], 1.01-15.0; P<.05) and COVID-19 severity (aOR, 35.9; 95% CI, 4.57-282; P <.05) were associated with major bleeding complications. After propensity score matching, 11 major and 11 non-major bleeding cases (including minor bleeding) were matched. The 60-day cumulative mortality rate between the two groups did not differ significantly (P=.13, log-rank test). CONCLUSIONS The incidence of major bleeding in COVID-19 patients using therapeutic-dose UFH was relatively high. Critical COVID-19 and older age were risk factors for bleeding complications.
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Affiliation(s)
- Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Yuko Kakumoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Nobumasa Okumura
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine
| | - Ryo Sasaki
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine
| | - Katsuji Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Hisao Hara
- Department of Cardiology, National Center for Global Health and Medicine
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
- AMR Clinical Reference Center, National Center for Global Health and Medicine
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2
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Kamegai K, Iwamoto N, Ishikane M, Yamamoto K, Horii K, Kubota S, Hangaishi A, Shimazu H, Togano T, Yamashita H, Yamada Y, Ohmagari N. A novel protocol for de-isolating moderately and severely immunocompromised COVID-19 patients. Glob Health Med 2023; 5:366-371. [PMID: 38162429 PMCID: PMC10730921 DOI: 10.35772/ghm.2023.01053] [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: 04/28/2023] [Revised: 09/19/2023] [Accepted: 10/30/2023] [Indexed: 01/03/2024]
Abstract
Immunocompromised coronavirus disease 2019 patients are at a higher risk of prolonged viral shedding than immunocompetent patients. However, as of August 2023, there is no clear international standard for de-isolating vulnerable patients. A comprehensive assessment is advisable based on various information, such as the increase in immune escape of specific mutant strains as well as the patient's innate immunity and vaccination status; therefore, consultation with an infectious disease specialist is recommended. The patient population defined as moderately or severely immunocompromised by the Centers for Disease Control and Prevention and the European Centre for Disease Prevention and Control is significantly broad. A boundary between the two remains to be delineated, and the existing protocols allow the release of patients based on their symptoms alone. This may lead to an unnecessary extension or premature termination of isolation. In this study, we searched for studies, particularly those that used real-world data, discussed the results with experts in our hospital, and proposed new isolation criteria based on both testing and clinical symptoms. We classified patients into three groups namely severely, moderately, and mildly immunocompromised, defined by their background and the administration of immunosuppressive drugs. A separate flowchart for ending isolation is indicated for each group. This standard may be a useful support material, especially for non-specialists. Nevertheless, our criteria must be revised and added continuously; accumulating real-world data to support revision of and addition to the list is becoming increasingly important.
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Affiliation(s)
- Kohei Kamegai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kei Yamamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Horii
- Infection Control Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shiho Kubota
- Infection Control Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Shimazu
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Yamashita
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasuhide Yamada
- Comprehensive Cancer Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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3
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Terada M, Saito S, Kutsuna S, Kinoshita-Iwamoto N, Togano T, Hangaishi A, Shiratori K, Takamatsu Y, Maeda K, Ishizaka Y, Ohtsu H, Satake M, Mitsuya H, Ohmagari N. Efficacy and Safety of Treatment with Plasma from COVID-19-Recovered Individuals. Life (Basel) 2023; 13:2184. [PMID: 38004324 PMCID: PMC10671928 DOI: 10.3390/life13112184] [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: 08/29/2023] [Revised: 10/14/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Convalescent plasma therapy, which involves administering plasma from recovered coronavirus disease 2019 (COVID-19) patients to infected individuals, is being explored as a potential treatment for severe cases of COVID-19. This study aims to evaluate the efficacy and safety of convalescent plasma therapy in COVID-19 patients with moderate to severe illness. An open-label, single-arm intervention study was conducted without a control group. Plasma collected from recovered COVID-19 patients was administered to eligible participants. The primary endpoint was the proportion of patients who were placed on artificial ventilation or died within 14 days of transfusion. Secondary endpoints included clinical improvement, viral load measurements, and adverse event monitoring. A total of 59 cases were included in the study. The primary endpoint was evaluated by comparing the rate obtained in the study to an existing rate of 25%. The study also assessed clinical improvement, viral load changes, and safety endpoints through adverse event monitoring. Convalescent plasma therapy shows potential as a treatment option for COVID-19. This study aimed to provide evidence for the efficacy and safety of this therapy and may contribute to its future use in treating severe cases of COVID-19.
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Affiliation(s)
- Mari Terada
- Center for Clinical Sciences, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan (S.K.)
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan (S.K.)
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan (S.K.)
| | - Noriko Kinoshita-Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan (S.K.)
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Katsuyuki Shiratori
- Laboratory Testing Department, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Kenji Maeda
- Division of Antiviral Therapy Joint Research Center for Human Retrovirus Infection, Kagoshima University, Sakuragaoka, Kagoshima 890-8544, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Hiroshi Ohtsu
- Faculty of Health Data Science, Juntendo, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Masahiro Satake
- Central Blood Institute, Japanese Red Cross, Tatsumi, Koto-ku, Tokyo 135-8521, Japan
| | - Hiroaki Mitsuya
- Department of Intractable Diseases, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan (S.K.)
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4
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Suzuki T, Asai Y, Takahashi K, Sanada M, Shimanishi Y, Terada M, Sato L, Inada M, Yamada G, Akiyama Y, Oshiro Y, Shiratori K, Togano T, Takamatsu Y, Kenji M, Matsunaga A, Ishizaka Y, Nomoto H, Iwamoto N, Saito S, Kutsuna S, Morioka S, Ohmagari N. Trends of participants in convalescent plasma donation for COVID-19 in Japan as the pandemic evolved. Heliyon 2023; 9:e20568. [PMID: 37842585 PMCID: PMC10568336 DOI: 10.1016/j.heliyon.2023.e20568] [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: 02/26/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/17/2023] Open
Abstract
Background We aimed to investigate chronological changes in the characteristics of participants in a coronavirus disease 2019 convalescent plasma donation study that may benefit optimal collection methods in the future. Methods Data from a convalescent plasma donation study from April 30, 2020 to November 5, 2021 were collected and analyzed. After August 23, 2021, an interim analysis of factors linked to higher antibody titers led us to restrict our participant recruitment criteria to participants who were within 4 months of disease onset and to patients who were otherwise most likely to have sufficiently high antibody titers. Overall, 1299 samples from 1179 patients were analyzed. Results Over the duration of the study, 35.9% of the samples were deemed eligible for convalescent plasma collection. The overall eligibility rate initially declined, dipping to <20% after one year. During this period, the proportion of enrolled samples from patients who had severe illness also declined, and the proportion of samples from participants who were >120 days post disease onset increased. After the addition of days from onset and vaccination status to our participant recruitment criteria, the eligibility rate improved significantly. Conclusions As outbreaks of emerging infectious disease occur, it is desirable to construct and implement a scheme for convalescent plasma donation promptly and to monitor the eligibility rate over time. If it declines, promptly analyze and resolve the associated factors. Additionally, vaccine development and infection prevalence are likely to influence the effective recruitment of participants with high antibody titers.
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Affiliation(s)
- Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yusuke Asai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kozue Takahashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - Mio Sanada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Shimanishi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Oshiro
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuyuki Shiratori
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maeda Kenji
- Department of Refractory Viral Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
- Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Infection Control, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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5
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Saito S, Kutsuna S, Akifumi I, Hase R, Oda R, Terada J, Shimizu Y, Uemura Y, Takamatsu Y, Yasuhara A, Shiratori K, Satake M, Sakamoto N, Miyazaki Y, Shimizu H, Togano T, Matsunaga A, Okuma K, Hamaguchi I, Fujisawa K, Nagashima M, Ashida S, Terada M, Kimura A, Morioka S, Matsubayashi K, Tsuno NH, Kojima M, Kuramitsu M, Tezuka K, Ikebe E, Ishizaka Y, Kenji M, Hangaishi A, Mikami A, Sugiura W, Ohmagari N, Mitsuya H. Efficacy of convalescent plasma therapy for COVID-19 in Japan: An open-label, randomized, controlled trial. J Infect Chemother 2023:S1341-321X(23)00122-8. [PMID: 37178973 PMCID: PMC10174342 DOI: 10.1016/j.jiac.2023.05.012] [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: 02/19/2023] [Revised: 04/13/2023] [Accepted: 05/10/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Convalescent plasma is a potential therapeutic option for patients with coronavirus disease 2019 (COVID-19). Despite its use for treating several viral infections, we lack comprehensive data on its efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS We conducted a multicenter, open-label, randomized controlled trial of convalescent plasma therapy with high neutralizing activity against SARS-CoV-2 in high-risk patients within five days after the onset of COVID-19 symptoms. The primary endpoint was the time-weighted average change in the SARS-CoV-2 viral load in nasopharyngeal swabs from days 0-5. RESULTS Between February 24, 2021, and November 30, 2021, 25 patients were randomly assigned to either convalescent plasma (n = 14) or standard of care (n = 11) groups. Four patients discontinued their allocated convalescent plasma, and 21 were included in the modified intention-to-treat analysis. The median interval between the symptom onset and plasma administration was 4.5 days (interquartile range, 3-5 days). The primary outcome of the time-weighted average change in the SARS-CoV-2 viral load in nasopharyngeal swabs did not significantly differ between days 0-5 (1.2 log10 copies/mL in the convalescent plasma vs. 1.2 log10 copies/mL in the standard of care (effect estimate, 0.0 [95% confidence interval, -0.8-0.7]; P = 0.94)). No deaths were observed in either group. CONCLUSIONS The early administration of convalescent plasma with high neutralizing activity did not contribute to a decrease in the viral load within five days compared with the standard of care alone.
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Affiliation(s)
- Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infection Control, Graduate School of Medicine Faculty of Medicine, Osaka University, Japan
| | - Imamura Akifumi
- Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Ryota Hase
- Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Rentaro Oda
- Division of Infectious Diseases, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Junko Terada
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yosuke Shimizu
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukari Uemura
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Akemi Yasuhara
- Joint Center for Researchers, Associates and Clinicians Data Center, Department of Data Science, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuyuki Shiratori
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Naoya Sakamoto
- Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Yasunari Miyazaki
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidefumi Shimizu
- Department of Respiratory Medicine, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazu Okuma
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan; Department of Microbiology, Faculty of Medicine, Kansai Medical University, Osaka, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kyoko Fujisawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Nagashima
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinobu Ashida
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Kimura
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Makiko Kojima
- Japanese Red Cross Central Blood Institute, Tokyo, Japan; Japanese Red Cross Kanto-Koshin-etsu Block Blood Center, Tokyo, Japan
| | - Madoka Kuramitsu
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenta Tezuka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Emi Ikebe
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukihito Ishizaka
- Department of Intractable Diseases, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maeda Kenji
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ayako Mikami
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Science, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
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6
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Kamo-Imai A, Togano T, Sato M, Kawakami Y, Inaba K, Shimazu H, Igarashi S, Tanaka K, Terada M, Kinoshita-Iwamoto N, Saito S, Kutsuna S, Hangaishi A, Morioka S, Takahashi K, Miyata S, Ohmagari N. The safety of plasma apheresis from donors recovering from COVID-19 infection in Japan. Transfus Apher Sci 2023:103687. [PMID: 36964059 PMCID: PMC10027293 DOI: 10.1016/j.transci.2023.103687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE Since 2020, the novel coronavirus infection (COVID-19) has spread globally. A few studies have investigated the safety of COVID-19 convalescent plasma (CCP) apheresis from COVID-19. This study was the first retrospective observational study of CCP in Japan. METHODS We recruit donors from April 2020 to November 2021 and plasmapheresis in our center (NCGM: national center for global health and medicine). We set the primary endpoint as the Donors Adverse Event (DAE) occurrence at the time of the CCP collection. Variable selection was used to explore the determinants of DAE. RESULTS Mean and SD age was 50.5 (10.6) years old. Seventy-three (42.2 %) were female, and 87 (33.3 %) were multiple-times donors. Twelve (6.97 % by donors and 4.6 % in total collections) adverse events occurred. The DAEs were VVR (Vaso Vagal Reaction), paresthesia, hypotension, agitation, dizziness, malaise, and hearing impairment/paresthesia. Half of them were VVR during apheresis. DAE occurred only in first-time donors and more in severe illnesses such as using ventilation and ECMO. From the donor characteristics and variable selection, the risk factors are as follows: younger age, female, the severity of disease at the time of the disease, and lower SBP before initiation. Our DAE incidence did not differ from previous studies. DAEs were more likely to occur in CCP apheresis than in healthy donors. CONCLUSION We confirm the safety of CCP apheresis in this study, although DAEs were more than healthy donors. More caution should be exercised in the plasma collection for future outbreaks of emerging infectious diseases.
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Affiliation(s)
- Ayumi Kamo-Imai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.
| | - Motohiko Sato
- Department of Clinical Engineering, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuiko Kawakami
- Department of Clinical Engineering, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Inaba
- Department of Clinical Engineering, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Shimazu
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Saori Igarashi
- Department of Nursing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiko Tanaka
- Department of Nursing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita-Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infection Control, Graduate School of Medicine, Osaka University, Japan
| | - Akira Hangaishi
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenzo Takahashi
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Satoshi Miyata
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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7
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Inada M, Togano T, Terada M, Shiratori K, Tsuzuki S, Takamatsu Y, Saito S, Hangaishi A, Morioka S, Kutsuna S, Maeda K, Mitsuya H, Ohmagari N. Preserved SARS-CoV-2 neutralizing IgG activity of in-house manufactured COVID-19 convalescent plasma. Transfus Apher Sci 2022:103638. [PMID: 36610860 PMCID: PMC9797217 DOI: 10.1016/j.transci.2022.103638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE In the current study, we aimed to evaluate the neutralizing IgG activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as the coagulation factors of convalescent plasmas which we manufactured in-house without a fast-freezing technique. METHODS We collected plasmas from eligible participants who had confirmed certain titers of neutralizing antibodies. The plasmas were frozen and stored in the ordinary biofreezer without a fast-freezing function. The purified-IgG neutralizing activity of 20 samples from 19 participants and the coagulation factors of 49 samples from 40 participants were evaluated before and after freezing. RESULTS Purified-IgG maintained its neutralizing activities, with the median 50 % inhibitory concentration (IC50) of 10.11 mg/ml (IQR 6.53-18.19) before freezing and 8.90 m g/ml (IQR 6.92-28.27) after thawing (p = 0.956). On the contrary, fibrinogen and factor Ⅷ decreased significantly after freezing and thawing in our environment. No significant temperature deviation was observed during the storage period. CONCLUSION Neutralizing IgG activity, which largely contributes to the antiviral activity of convalescent plasma, did not change through our in-house manufacturing, without fastfreezing and storage conditions for more than 200 days. Ordinary freezers without the fast-freezing function are suitable enough to manufacture and store convalescent plasmas. Hospitals or facilities without specified resources could easily collect and store convalescent plasmas in case of upcoming emerging or re-emerging infectious diseases on-demand with appropriate neutralizing antibody levels measurements.
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Affiliation(s)
- Makoto Inada
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan,Corresponding author
| | - Mari Terada
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan,Center for Clinical Sciences, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Katsuyuki Shiratori
- Department of Clinical Laboratory, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Shinya Tsuzuki
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Sho Saito
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan,Department of Infection Control, Graduate School of Medicine, Osaka University, 2–15 Yamadagaoka, Suita City, Osaka, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan,Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, 8–35-1 Sakuragaoka, Kagoshima City, Kagoshima, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
| | - Norio Ohmagari
- Disease Prevention and Control Center, National Center for Global Health and Medicine, 1–21-1 Toyama, Shinjuku-ku, Tokyo, Japan
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8
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Togano T, Andoh S, Komuro M, Mitsui Y, Itoi S, Hirai R, Nakamura M, Tanimura A, Sekine R, Takeshita M, Miwa A, Hagiwara S. Bortezomib-thalidomide-dexamethasone-cisplatin-doxorubicin-cyclophosphamide-etoposide as a Salvage and Bridging Regimen before Hematopoietic Stem Cell Transplantation for Relapsed or Refractory Multiple Myeloma. Intern Med 2022; 61:3329-3334. [PMID: 35466165 PMCID: PMC9751732 DOI: 10.2169/internalmedicine.9097-21] [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: 12/24/2022] Open
Abstract
Objective Currently, treatment of relapsed or refractory multiple myeloma is challenging. Although bortezomib-thalidomide-dexamethasone-cisplatin-doxorubicin-cyclophosphamide-etoposide (VTD-PACE), a potent combination of a proteasome inhibitor, immunomodulatory drug, and conventional chemotherapeutics, is a widely used regimen, its efficacy and safety are unclear. Methods We retrospectively analyzed the clinical data of 35 patients treated with VTD-PACE. Results The overall response rate was 65.7% (complete response, 5.7%). The median progression-free survival (PFS) and overall survival (OS) were 8.0 [95% confidence interval (CI), 0.9-15.0] and 20.0 (95% CI, 17.5-22.5) months, respectively. Twenty-two (62.9%) patients developed grade 3-4 infections, and no therapy-related deaths occurred. Sixteen of 25 patients (64%) underwent stem cell harvest successfully with more than 2.0×106/kg of CD34 cells after VTD-PACE. Twenty-two patients underwent autologous or allogeneic stem cell transplantation (SCT). The response and survival durations were short in patients without SCT after VTD-PACE [median PFS: 4.0 (95% CI, 2.7-5.3) months; OS: 14.0 (6.9-21.0) months]; however, these responses significantly improved with SCT following VTD-PACE. The PFS was 8.0 (NA) months (p=0.024), and the OS was 21.0 (19.1-22.8) months (p=0.019). Conclusion VTD-PACE is an effective and tolerable salvage regimen and feasible bridging therapy for SCT.
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Affiliation(s)
- Tomiteru Togano
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Japan
| | - Shohei Andoh
- Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Japan
| | - Masato Komuro
- Department of Pharmacy, Center Hospital of the National Center for Global Health and Medicine, Japan
| | - Yurika Mitsui
- Division of Hematology and Oncology, Toho University Omori Medical Center, Japan
| | - Satoru Itoi
- Department of Hematology, Tokyo Women's Medical University, Japan
| | - Risen Hirai
- Department of Hematology, Tokyo-Kita Medical Center, Japan
| | - Miki Nakamura
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Japan
| | - Akira Tanimura
- Department of Hematology, Tokyo-Kita Medical Center, Japan
| | - Rieko Sekine
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Japan
| | | | - Akiyoshi Miwa
- Department of Hematology, Tokyo-Kita Medical Center, Japan
| | - Shotaro Hagiwara
- Department of Hematology, Tsukuba University Hospital Mito Clinical Education and Training Center, Japan
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9
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Tomita N, Saito S, Terada-Hirashima J, Mikami A, Uemura Y, Kutsuna S, Nomoto H, Fujisawa K, Nagashima M, Terada M, Ashida S, Morioka S, Satake M, Hangaishi A, Togano T, Shiratori K, Takamatsu Y, Maeda K, Ohmagari N, Sugiura W, Mitsuya H. A Multi-Center, Open-Label, Randomized Controlled Trial to Evaluate the Efficacy of Convalescent Plasma Therapy for Coronavirus Disease 2019: A Trial Protocol (COVIPLA-RCT). Life (Basel) 2022; 12:life12060856. [PMID: 35743887 PMCID: PMC9225318 DOI: 10.3390/life12060856] [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] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 12/15/2022]
Abstract
Background: Coronavirus disease 2019 is a global public health concern. As of December 2020, the therapeutic agents approved for coronavirus disease 2019 in Japan were limited to two drugs: remdesivir, an antiviral drug, granted a Special Approval for Emergency on 7 May 2020, and dexamethasone, which has an anti-inflammatory effect. The aim of this study is to evaluate the efficacy of convalescent plasma collected from donors who recovered from coronavirus disease 2019. Methods: This is an open-label, randomized controlled trial comprising two groups: a convalescent plasma and a standard-of-care group. Plasma administered to patients with coronavirus disease 2019 randomized in the convalescent plasma group of this trial will be plasma that has been collected and stored in an associated study. Patients with a diagnosis of mild coronavirus disease 2019 will be included in this trial. The efficacy of convalescent plasma transfusion will be evaluated by comparing the convalescent plasma group to the standard-of-care group (without convalescent plasma transfusion) with respect to changes in the viral load and other measures. The primary endpoint will be time-weighted average changes in the SARS-CoV-2 virus load in nasopharyngeal swabs from day 0 to days 3 and 5. It is hypothesized that the intervention should result in a decrease in the viral load in the convalescent plasma group until day 5. This endpoint has been used as a change in viral load has and been used as an index of therapeutic effect in several previous studies. Discussion: The proposed trial has the potential to prevent patients with mild COVID-19 from developing a more severe illness. Several RCTs of convalescent plasma therapy have already been conducted in countries outside of Japan, but no conclusion has been reached with respect to the efficacy of convalescent plasma therapy, which is likely in part because of the heterogeneity of the types of target patients, interventions, and endpoints among trials. Actually, previous clinical trials on plasma therapy have shown inconsistent efficacy and are sometimes ineffective in COVID-19 patients with severe disease, which is due to unmeasured neutralizing antibody titer in the COVID-19 convalescent plasma. To improve this issue, in this study, we measure neutralizing activity of convalescent plasma before administration and provide the plasma with high neutralizing activity to the subjects. It is hoped that this study will further evidence to support the role of convalescent plasma therapy in COVID-19.
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Affiliation(s)
- Noriko Tomita
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
| | - Sho Saito
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Junko Terada-Hirashima
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
- Correspondence: ; Tel.: +81-3-3202-7181; Fax: +81-3-5273-6941
| | - Ayako Mikami
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
| | - Yukari Uemura
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
- Department of Infection Control and Prevention, Osaka University Hospital, Osaka 565-0871, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Kyoko Fujisawa
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Maki Nagashima
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Mari Terada
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Shinobu Ashida
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Shinichiro Morioka
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Masahiro Satake
- Central Blood Institute, Japanese Red Cross Society, Tokyo 135-8521, Japan;
| | - Akira Hangaishi
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (A.H.); (T.T.)
| | - Tomiteru Togano
- Department of Hematology, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (A.H.); (T.T.)
| | - Katsuyuki Shiratori
- Labotatory Testing Department, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan;
| | - Yuki Takamatsu
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo 162-8655, Japan; (Y.T.); (K.M.); (H.M.)
| | - Kenji Maeda
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo 162-8655, Japan; (Y.T.); (K.M.); (H.M.)
| | - Norio Ohmagari
- Disease Control and Prevention Center, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (S.S.); (S.K.); (H.N.); (K.F.); (M.N.); (S.A.); (S.M.); (N.O.)
| | - Wataru Sugiura
- Center for Clinical Sciences, Center Hospital of the National Center for Global Health and Medicine, Tokyo 162-8655, Japan; (N.T.); (A.M.); (Y.U.); (M.T.); (W.S.)
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infections, National Center for Global Health and Medicine Research Institute, Tokyo 162-8655, Japan; (Y.T.); (K.M.); (H.M.)
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10
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Kamegai K, Iwamoto N, Togano T, Maeda K, Takamatsu Y, Miyazato Y, Ishikane M, Mizokami M, Sugiyama M, Iida S, Miyamoto S, Suzuki T, Ohmagari N. A Fatal Breakthrough Coronavirus Disease 2019 Case Following Bendamustine-Rituximab Therapy. Int J Infect Dis 2022; 121:85-88. [PMID: 35500795 PMCID: PMC9054701 DOI: 10.1016/j.ijid.2022.04.058] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 11/27/2022] Open
Abstract
Although messenger ribonucleic acid vaccines are substantially effective toward SARS-CoV-2 infection, patients with hematologic malignancies are still prone to the virus. Herein, we report a fatal case of breakthrough SARS-CoV-2 Delta variant infection in a patient with mucosa-associated lymphoid tissue lymphoma with remission by bendamustine-rituximab (BR) therapy completed a year ago. The serologic study revealed impaired responsiveness toward vaccines and prolonged high viral load after infection. BR therapy seemingly induced an immune escape. Prevention and treatment strategies for such vulnerable patients should be clarified immediately.
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Affiliation(s)
- Kohei Kamegai
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Noriko Iwamoto
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Tomiteru Togano
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Kenji Maeda
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Yuki Takamatsu
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Yusuke Miyazato
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Masahiro Ishikane
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Masashi Mizokami
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Masaya Sugiyama
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan
| | - Shun Iida
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Sho Miyamoto
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Norio Ohmagari
- National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Tokyo, Japan.
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11
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Suzuki T, Asai Y, Ide S, Fukuda S, Tanaka A, Shimanishi Y, Takahashi K, Terada M, Sato L, Sato M, Inada M, Yamada G, Miyazato Y, Akiyama Y, Nomoto H, Nakamoto T, Nakamura K, Togano T, Morioka S, Kinoshita-Iwamoto N, Saito S, Kutsuna S, Ohmagari N. Factors associated with high antibody titer following coronavirus disease among 581 convalescent plasma donors: A single-center cross-sectional study in Japan. J Infect Chemother 2021; 28:206-210. [PMID: 34756573 PMCID: PMC8526427 DOI: 10.1016/j.jiac.2021.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/23/2021] [Accepted: 10/16/2021] [Indexed: 12/15/2022]
Abstract
Introduction The ability to predict which patients with a history of coronavirus disease (COVID-19) will exhibit a high antibody titer is necessary for more efficient screening of potential convalescent plasma donors. We aimed to identify factors associated with a high immunoglobulin G (IgG) titer in Japanese convalescent plasma donors after COVID-19. Methods This cross-sectional study included volunteers undergoing screening for convalescent plasma donation after COVID-19. Serum anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S-protein IgG antibodies were measured using a high-sensitivity chemiluminescence enzyme immunoassay. Results IgG antibodies were measured in 581 patients, 534 of whom had full information of selected independent variables. Multiple linear regression analysis revealed that increasing age (1.037 [1,025, 1.048]), days from symptom onset to sampling (0.997 [0.995, 0.998]), fever (1.664 [1.226, 2.259]), systemic corticosteroid use during SARS-CoV-2 infection (2.382 [1.576, 3.601]), and blood type AB (1.478 [1.032, 2.117]) predict antibody titer. Conclusion Older participants, those who experienced fever during infection, those treated with systemic corticosteroids during infection, those from whom samples were obtained earlier after symptom onset, and those with blood type AB are the best candidates for convalescent plasma donation. Therefore, these factors should be incorporated into the screening criteria for convalescent plasma donation after SARS-CoV-2 infection.
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Affiliation(s)
- Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Saori Fukuda
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihito Tanaka
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Shimanishi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kozue Takahashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuhiro Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Gen Yamada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Noriko Kinoshita-Iwamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Department of Infection Control, Graduate School of Medicine, Osaka University, Japan.
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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12
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Hara H, Uemura Y, Hayakawa K, Togano T, Asai Y, Matsunaga N, Terada M, Ohtsu H, Kitajima K, Shimizu Y, Sato L, Ishikane M, Kinoshita-Iwamoto N, Shibata T, Kondo M, Izumi K, Sugiura W, Ohmagari N. Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan. Int J Infect Dis 2021; 112:111-116. [PMID: 34517044 PMCID: PMC8432973 DOI: 10.1016/j.ijid.2021.09.014] [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: 05/14/2021] [Revised: 08/04/2021] [Accepted: 09/06/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease 2019 (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts. Methods The efficacy of anticoagulation therapy in hospitalized patients with COVID-19 was evaluated using a nationwide registry: the COVID-19 Registry Japan. The inverse probability of weight treatment method was used to adjust for baseline confounders in the anticoagulation and non-anticoagulation groups. Results Of the 1748 patients included, anticoagulants were used in 367 patients (treatment group). The patients in the anticoagulant group were older, predominantly male, and often presented with obesity, hyperlipidaemia, hypertension, diabetes and elevated D-dimer levels. Twenty-nine-day mortality was 7.6% in the whole cohort (treatment group, 11.2%; no treatment group, 6.6%), 6% in patients who were not treated with steroids (treatment group, 12.3%; no treatment group, 5.2%), and 11.2% in patients treated with steroids (treatment group, 10.5%; no treatment group, 11.8%). Mortality in the whole cohort was similar between the treatment and no treatment groups (P=0.99), and an insignificant decreasing trend in mortality was observed in patients treated with steroids (P=0.075). Conclusions Anticoagulants may be beneficial in Asians, in whom comorbidities and risk of thrombosis may differ from other ethnic groups.
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Affiliation(s)
- Hisao Hara
- Department of Cardiology, National Centre for Global Health and Medicine, Tokyo, Japan.
| | - Yukari Uemura
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Haematology, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Nobuaki Matsunaga
- AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Mari Terada
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan; Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Hiroshi Ohtsu
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Koji Kitajima
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Yousuke Shimizu
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita-Iwamoto
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Taro Shibata
- Biostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, Japan
| | - Masashi Kondo
- Centre for Clinical Trial and Research Support, Fujita Health University, Aichi, Japan
| | - Kazuo Izumi
- Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Biostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, Japan
| | - Norio Ohmagari
- Department of Haematology, National Centre for Global Health and Medicine, Tokyo, Japan; Biostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, Japan
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13
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Togano T, Suzuki Y, Nakamura F, Tse W, Kume H. Epidemiology of visceral mycoses in patients with acute leukemia and myelodysplastic syndrome: Analyzing the national autopsy database in Japan. Med Mycol 2021; 59:50-57. [PMID: 32400871 DOI: 10.1093/mmy/myaa029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 11/15/2022] Open
Abstract
Visceral mycoses (VM) are a deadly common infection in patients with acute leukemia and myelodysplastic syndrome (MDS). We retrospectively analyzed the data from the centralized "Annual Report of Autopsy Cases in Japan" that archives the national autopsy cases since 1989. Among the total of 175,615 archived autopsy cases, 7183 cases (4.1%) were acute leukemia and MDS patients. While VM was only found in 7756 cases (4.4% in total cases), we found VM had a disproportionally high prevalence among acute leukemia and MDS patients: 1562 VM cases (21.7%) and nearly sixfold higher in prevalence. Aspergillus spp. was the most predominant causative agent (45.0%), and Candida spp. was the second (22.7%) among confirmed single pathogen involved cases. The prevalence of Candida spp. infection decreased about 50% due to the widely use of fluconazole prophylaxis, which may skew toward doubling of the Mucormycetes incidence compared to 30 years ago. Complicated fungal infection (> one pathogen) was 11.0% in acute leukemia and MDS in 2015. It was 14.7 times higher than in other populations. Among 937 patients who received allogeneic hematopoietic cell transplantation (HCT), the prevalence of VM was 28.3% and 23.3% with GVHD. Aspergillus spp. was less prevalent, but Candida spp. was more associated with GVHD. Its prevalence remains stable. Although Aspergillus spp. was the primary causative agent, non-albicans Candida spp. was increasing as a breakthrough infection especially in GVHD cases. Complicated pathogen cases were more common in acute leukemia and MDS.
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Affiliation(s)
- Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan.,Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Fumihiko Nakamura
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - William Tse
- Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - Hikaru Kume
- Department of Pathology, Kitasato University, School of Medicine, Sagamihara, Japan
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14
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Terada M, Kutsuna S, Togano T, Saito S, Kinoshita N, Shimanishi Y, Suzuki T, Miyazato Y, Inada M, Nakamoto T, Nomoto H, Ide S, Sato M, Maeda K, Matsunaga A, Satake M, Matsubayashi K, Tsuno H, Kojima M, Kuramistu M, Tezuka K, Ikebe E, Okuma K, Hamaguchi I, Shiratori K, Sato M, Kawakami Y, Inaba K, Igarashi S, Yamauchi R, Matsumura M, Ishimaru K, Zhang B, Kuge C, Ishihara M, Gouda M, Tanaka K, Ishizaka Y, Ohmagari N. How we secured a COVID-19 convalescent plasma procurement scheme in Japan. Transfusion 2021; 61:1998-2007. [PMID: 34096059 PMCID: PMC8242376 DOI: 10.1111/trf.16541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022]
Abstract
Background In order to tackle the COVID‐19 pandemic, a COVID‐19 convalescent plasma (CCP) procurement program was initiated in Japan in April 2020. The program was a collaboration between a government‐managed national hospital, an infectious disease research institute, and a blood banking organization. Each party assumed different responsibilities: recruitment, SARS‐CoV‐2 antibody profiling, and plasmapheresis; conduction of screening tests; and SARS‐CoV‐2 blood testing, respectively. Methods We adopted a two‐point screening approach before the collected CCP was labeled as a CCP product for investigational use, for which we mainly tested anti‐SARS‐CoV‐2 antibody eligibility and blood product eligibility. Anti‐SARS‐CoV‐2 spike protein titer was measured using enzyme‐linked immunosorbent assay, and the IC50 value was denoted as the neutralizing activity. Blood donor eligibility was extended beyond the normal blood donation guidelines to include a broader range of participants. After both eligibility criteria were confirmed, participants were asked to revisit the hospital for blood donation, which is a unique aspect of the Japanese CCP program, as most donations are taking place in normal blood donation venues in other countries. Some donors were re‐scheduled for repeat plasma donations. As public interest in anti‐SARS‐CoV‐2 antibodies increased, test results were given to the participants. Results As of September 17, 2020, our collection of CCP products was sufficient to treat more than 100 patients. As a result, projects for administration and distribution are also being conducted. Conclusions We successfully implemented a CCP procurement scheme with the goal to expand to other parts of the country to improve treatment options for COVID‐19.
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Affiliation(s)
- Mari Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yumiko Shimanishi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makoto Inada
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahito Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsuhiro Sato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kenji Maeda
- Department of Refractory Viral Infections, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akihiro Matsunaga
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Hirokazu Tsuno
- Japanese Red Cross, Kanto-Koshin-etsu Block Blood Center, Tokyo, Japan
| | - Makiko Kojima
- Japanese Red Cross, Kanto-Koshin-etsu Block Blood Center, Tokyo, Japan
| | - Madoka Kuramistu
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenta Tezuka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Emi Ikebe
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazu Okuma
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Katsuyuki Shiratori
- Clinical Laboratory Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Motohiko Sato
- Department of Clinical Engineering, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yuiko Kawakami
- Department of Clinical Engineering, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Inaba
- Department of Clinical Engineering, National Center for Global Health and Medicine, Tokyo, Japan
| | - Saori Igarashi
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Reina Yamauchi
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mina Matsumura
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiko Ishimaru
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Bijuan Zhang
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chika Kuge
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maiko Ishihara
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Miho Gouda
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiko Tanaka
- Nursing Department, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yukihito Ishizaka
- Research Institute, National Medical Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.,Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan.,Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
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15
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Katagiri D, Ishikane M, Asai Y, Izumi S, Takasaki J, Katsuoka H, Kondo I, Ide S, Nakamura K, Nakamoto T, Nomoto H, Akiyama Y, Miyazato Y, Suzuki T, Kinoshita N, Ogawa T, Togano T, Suzuki M, Hashimoto M, Sakamoto K, Kusaba Y, Katsuno T, Fukaya T, Hojo M, Sugiyama M, Mizokami M, Okamoto T, Kimura A, Noiri E, Ohmagari N, Hinoshita F, Sugiyama H. Direct hemoperfusion using a polymyxin B-immobilized polystyrene column for COVID-19. J Clin Apher 2020; 36:313-321. [PMID: 33325084 PMCID: PMC8246724 DOI: 10.1002/jca.21861] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/09/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022]
Abstract
Objective To evaluate the efficacy and safety of direct hemoperfusion using a polymyxin B‐immobilized polystyrene column (PMX‐DHP) in severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2)‐positive pneumonia patients. Methods This study was a case series conducted at a designated infectious diseases hospital. Twelve SARS‐CoV‐2‐positive patients with partial pressure of arterial oxygen/percentage of inspired oxygen (P/F) ratio < 300 were treated with PMX‐DHP on two consecutive days each during hospitalization. We defined day 1 as the first day when PMX‐DHP was performed. PMX‐DHP efficacy was assessed on days 7 and 14 after the first treatment based on eight categories. Subsequently, improvement in P/F ratio and urinary biomarkers on days 4 and 8, malfunctions, and ventilator and extracorporeal membrane oxygenation avoidance rates were also evaluated. Results On day 14 after the first treatment, disease severity decreased in 58.3% of the patients. P/F ratio increased while urine β2‐microglobulin decreased on days 4 and 8. Cytokine measurement pre‐ and post‐PMX‐DHP revealed decreased levels of interleukin‐6 and the factors involved in vascular endothelial injury, including vascular endothelial growth factor. Twenty‐two PMX‐DHPs were performed, of which seven and five PMX‐DHPs led to increased inlet pressure and membrane coagulation, respectively. When the membranes coagulated, the circuitry needed to be reconfigured. Circuit problems were usually observed when D‐dimer and fibrin degradation product levels were high before PMX‐DHP. Conclusions Future studies are expected to determine the therapeutic effect of PMX‐DHP on COVID‐19. Because of the relatively high risk of circuit coagulation, coagulation capacity should be assessed beforehand.
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Affiliation(s)
- Daisuke Katagiri
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Asai
- Antimicrobial Resistance Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinyu Izumi
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiyori Katsuoka
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Isao Kondo
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Ide
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiji Nakamura
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takato Nakamoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yutaro Akiyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusuke Miyazato
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Kinoshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tatsunori Ogawa
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Manabu Suzuki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masao Hashimoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keita Sakamoto
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yusaku Kusaba
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Katsuno
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takashi Fukaya
- Medical Equipment Management Office, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayuki Hojo
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masaya Sugiyama
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, Research Institute, National Center for Global Health and Medicine, Ichikawa, Japan
| | - Tatsuya Okamoto
- Department of Intensive Care Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akio Kimura
- Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo, Japan
| | - Eisei Noiri
- National Center Biobank Network, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fumihiko Hinoshita
- Department of Nephrology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- National Center Biobank Network, National Center for Global Health and Medicine, Tokyo, Japan
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16
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Tanimura A, Hirai R, Nakamura M, Takeshita M, Togano T, Sekine R, Hagiwara S, Miwa A. Efficacy of VRD(Bortezomib, Lenalidomide, and Dexamethasone) Consolidation Therapy and Maintenance Therapy with Immunomodulatory Drugs(Thalidomide or Lenalidomide) after Autologous Peripheral Blood Stem Cell Transplantation in the Era of Bortezomib-Containing Induction Therapy-A Single Institution Experience. Gan To Kagaku Ryoho 2020; 47:789-796. [PMID: 32408321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Autologous stem cell transplantation(ASCT)for newly-diagnosed multiple myeloma(NDMM)has underwent recent improvements in combination with novel agents-containing induction and post-ASCT therapy. Since the approval of bortezomib for NDMM in Japan, we conducted the following regimen(BD arm)in transplant-eligible patients with NDMM: BD (bortezomib and dexamethasone)induction, ASCT, VRD consolidation, and maintenance therapy with immunomodulatory drugs(IMIDs). The efficacy and safety of the BD arm were compared to those of patients treated with vincristine, doxorubicin, and dexamethasone(VAD)induction followed by ASCT(VAD arm)retrospectively. Thirty-three patients were treated with the BD arm, and 92 patients with the VAD arm. Thirty-one patients in the BD arm proceeded to ASCT. Thereafter, 23 and 17 patients received VRD consolidation and IMIDs maintenance therapy, respectively. The rates of complete response/Bvery good partial response after ASCT, consolidation, and maintenance therapy were 43%/61%, 76%/90% and 87%/93%, respectively. The response rates after ASCT did not differ between BD and VAD arms. The median PFS was 46.2 months(BD arm)and 30.6 months(VAD arm)(HR 0.48[0.27-0.85], p=0.0106). The median OS was not-reached(BD arm)and 90.6 months(VAD arm)(HR 0.21[0.05-0.87], p=0.0172). VRD consolidation and IMIDs maintenance therapies improved disease status after ASCT and prolonged PFS and OS.
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17
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Togano T, Kim N, Kim N, Park GS, Park AK, Bennet M, Park J. The evaluation of Cannabidiol's effect on the immunotherapy of Burkitt lymphoma. Biochem Biophys Res Commun 2019; 520:225-230. [PMID: 31587870 DOI: 10.1016/j.bbrc.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 09/13/2019] [Accepted: 10/01/2019] [Indexed: 01/19/2023]
Abstract
AIM AF1q has a precise oncogenic function. The purpose of this study is to investigate whether CBD has an effect on the AF1q/ICAM-1 regulatory axis in Burkitt's lymphoma (BL), and thus has potential to enhance immunotherapy and reduce side effects. METHODS We established BL cell lines with altered AF1q expression using lentivirus. After confirmation of gene expression by RT-PCR, cells were treated with CBD followed by co-culture of killing assay. RESULTS AF1q increased oncogenic growth and colony formation, and induced resistance against cell-mediated cytotoxic chemotherapy through attenuation of ICAM-1 expression in BL. CBD was able to reverse the acquired resistance mediated by AF1q/ICAM-1 regulatory axis. CONCLUSION CBD holds potential to enhance the efficacy of immunotherapy for BL with hyperactive AF1q/ICAM-1 regulatory axis, and warrants further study.
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Affiliation(s)
- Tomiteru Togano
- Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA; Division of Haematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naomi Kim
- Dupont Manual High School, Louisville, KY, USA
| | - Natalie Kim
- Dupont Manual High School, Louisville, KY, USA
| | | | - Alex K Park
- Dupont Manual High School, Louisville, KY, USA
| | - Maura Bennet
- Northern Kentucky University, Highland Heights, KY, USA
| | - Jino Park
- Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
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18
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Park J, Hwang JY, Thore A, Kim S, Togano T, Hagiwara S, Park JW, Tse W. AF1q inhibited T cell attachment to breast cancer cell by attenuating Intracellular Adhesion Molecule-1 expression. ACTA ACUST UNITED AC 2019; 5. [PMID: 31297450 PMCID: PMC6623974 DOI: 10.20517/2394-4722.2018.84] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Indexed: 01/06/2023]
Abstract
Aim: To investigate whether AF1q, overexpressed in metastatic cells compared with the primary tumor cells, plays a pivotal role in breast cancer metastasis. Methods: To investigate whether AF1q has a responsibility in the acquisition of a metastatic phenotype, we performed RNA-sequencing (RNA-Seq) to identify the gene signature and applied the Metacore direct interactions network building algorithm with the top 40 amplicons of RNA-Seq. Results: Most genes were directly linked with intercellular adhesion molecule-1 (ICAM-1). Likewise, we identified that ICAM-1 expression is attenuated in metastatic cells compared to primary tumor cells. Moreover, overexpression of AF1q attenuated ICAM-1 expression, whereas suppression of AF1q elicited the opposite effect. AF1q had an effect on ICAM-1 promoter region and regulated its transcription. Decreased ICAM-1 expression affected the attachment of T cells to a breast cancer cell monolayer. We confirmed the finding by performing the analysis on Burkitt’s lymphoma. Conclusion: Attenuation of ICAM-1 by AF1q on tumor cells disadvantages host anti-tumor defenses through the trafficking of lymphocytes, which affects tumor progression and metastasis.
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Affiliation(s)
- Jino Park
- James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Jae Yeon Hwang
- Department of Computer Science and Computer Engineering, University of Louisville, Louisville, KY 40292, USA
| | - Alexandra Thore
- James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Soojin Kim
- James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
| | - Tomiteru Togano
- Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Division of Haematology, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Shotaro Hagiwara
- Division of Haematology, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Juw Won Park
- Department of Computer Science and Computer Engineering, University of Louisville, Louisville, KY 40292, USA
| | - William Tse
- James Graham Brown Cancer Center, University of Louisville School of Medicine, Louisville, KY 40202, USA.,Division of Blood and Bone Marrow Transplantation, Department of Medicine, University of Louisville School of Medicine, Louisville, KY 40202, USA
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19
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Nakamura F, Hirai R, Higo T, Togano T, Sekine R. [Osteonecrosis developing after rituximab-containing chemotherapy for Waldenström macroglobulinemia]. Rinsho Ketsueki 2018; 59:305-309. [PMID: 29618689 DOI: 10.11406/rinketsu.59.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 71-year-old woman presented with fever, weight loss, and anemia because of recurrent Waldenström macroglobulinemia (WM) with cryoglobulinemia. Treatment with five cycles of doxorubicin, vincristine, cyclophosphamide, and prednisolone (CHOP) therapy was initiated, which resulted in insufficient improvement in anemia. Hence, a combination of rituximab and CHOP therapy was subsequently initiated. The patient complained of lumbago and lower leg pain on day 4 of the chemoimmunotherapy. X-ray findings for the affected sites were unremarkable, and the patient's symptoms gradually and spontaneously subsided. Rituximab monotherapy was then administered, which resulted in the deterioration of her symptoms. Magnetic resonance imaging revealed osteonecrosis of the bilateral distal ends of the femur, and proximal and distal ends of the tibia. This is the first case of lower leg osteonecrosis complicating chemoimmunotherapy for WM. Osteonecrosis may be an unusual adverse effect of rituximab therapy for WM. Tumor lysis by rituximab may have contributed to the pathogenesis of this complication. MRI assessment should be considered when WM patients complain of bone pain following rituximab-containing chemotherapy.
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Affiliation(s)
- Fumihiko Nakamura
- Department of Hematology, National Center for Global Health and Medicine
| | - Risen Hirai
- Department of Hematology, National Center for Global Health and Medicine
| | - Takashi Higo
- Department of Hematology, National Center for Global Health and Medicine
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Rieko Sekine
- Department of Hematology, National Center for Global Health and Medicine
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20
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Affiliation(s)
- Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University
| | - Hikaru Kume
- Department of Pathology, Kitasato University School of Medicine
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21
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Suzuki Y, Kenjo A, Togano T, Yamamoto N, Ohto H, Kume H. Infectious diseases in solid organ transplant recipients: Analysis of autopsied cases in Japan. J Infect Chemother 2017. [PMID: 28647177 DOI: 10.1016/j.jiac.2017.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND With the improvements in immunosuppressive agents and graft survival, infections such as mycoses have become major complications after solid organ transplantation (SOT). METHODS Our group has continuously updated an epidemiological database of visceral mycoses (VM) among autopsy cases in Japan since 1989. Data on infectious agents and clinical information were complied using similar procedures. RESULTS Among the all autopsied cases studied, 356 undergone SOT. Of these, 214 (60.1%) suffered from one or more types of infections, including 51 (14.3%) with VM. Thus, the incidence of VM was higher in SOT recipients than in non-transplanted cases (P < 0.0001). Aspergillus spp. (Asp) was the most predominant agent and Candida spp. was second. Specifically, among SOT recipients, Asp was the most predominant in liver and lung transplant recipients. Among the 217 autopsied liver transplants cases, the incidence of VM was highest in those with fulminant hepatitis (FH, P = 0.01). The incidence of cytomegalovirus infection tended to be higher in cases with mycosis (P = 0.06). Multivariate logistic regression analysis identified FH (odds ratio, 3.61, 95% confidence interval 1.34-9.75; P = 0.03) as an independent risk factor for mycosis in liver transplant recipients. CONCLUSION This epidemiological analysis of autopsied cases provides a strong incentive to intensify efforts to diagnose and treat post-SOT infectious diseases.
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Affiliation(s)
- Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Fukushima, Japan.
| | - Akira Kenjo
- Department of Regenerative Surgery, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Tomiteru Togano
- Department of Hematology, National Center for Global Health and Medicine, Shinjyuku, Tokyo, Japan
| | - Natsuo Yamamoto
- Department of Infection Control, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Hikaru Kume
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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Suzuki Y, Kume H, Togano T, Ohto H. Epidemiology of Zygomycosis: Analysis of National Data from Pathological Autopsy Cases in Japan. Med Mycol J 2017; 58:E89-E95. [DOI: 10.3314/mmj.16-00028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, School of Medicine
- Both authors contributed equally to this work
| | - Hikaru Kume
- Department of Pathology, Kitasato University, School of Medicine
- Both authors contributed equally to this work
| | - Tomiteru Togano
- Department of Hematology, Kitasato University, School of Medicine
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, School of Medicine
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23
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Affiliation(s)
- Yuhko Suzuki
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine
| | - Tomiteru Togano
- Department of Hematology, Kitasato University School of Medicine
| | - Hikaru Kume
- Department of Pathology, Kitasato University School of Medicine
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24
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Togano T, Watanabe M, Itoh K, Umezawa K, Masuda N, Higashihara M, Horie R. Activation of Akt involves resistance to NF-κB inhibition and abrogation of both triggers synergistic apoptosis in lung adenocarcinoma cells. Lung Cancer 2014; 83:139-45. [DOI: 10.1016/j.lungcan.2013.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 09/14/2013] [Accepted: 10/30/2013] [Indexed: 10/26/2022]
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25
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Maejima H, Katsuoka K, Togano T. Multiple primary cutaneous plasmacytoma. Acta Dermatovenerol Croat 2014; 22:308-310. [PMID: 25580795] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Hideki Maejima
- Hideki Maejima, MD, Department of Dermatology, Kitasato University School of Medicine, 1-15 Kitasato, Sagamihara 228-8885, Japan;
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26
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Togano T, Nakashima M, Watanabe M, Umezawa K, Watanabe T, Higashihara M, Horie R. Synergistic effect of 5-azacytidine and NF-κB inhibitor DHMEQ on apoptosis induction in myeloid leukemia cells. Oncol Res 2013; 20:571-7. [PMID: 24139415 DOI: 10.3727/096504013x13775486749371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Constitutive NF-κB activation characterizes a subset of myeloid leukemia (ML) cells. Recent reports have indicated that DNA methyltransferase (DNMT) inhibitors are alternative candidates for the treatment of ML. However, the optimal use of DNMT as a chemotherapeutic agent against ML has yet to be established. In this report, we examined the effect of the NF-κB inhibitor dehydroxymethylepoxyquinomicin (DHMEQ) and its combinational use with the DNMT inhibitor 5-azacytidine (AZA) in ML cell lines. DHMEQ alone induced cell death in ML cell lines with NF-κB activation, although the response varied among the cell lines. The addition of DHMEQ enhanced the effect of AZA on the viability and apoptosis induction of ML cell lines. The treatment of ML cell lines with AZA marginally induced NF-κB binding activity, although the treatment induced NF-κB protein. These results indicate the potential usefulness of DHMEQ and its combinational use with AZA in the treatment of ML, although the molecular effect by AZA on the NF-κB pathway awaits further study.
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Affiliation(s)
- Tomiteru Togano
- Department of Hematology, School of Medicine, Kitasato University, Minami-ku, Sagamihara, Kanagawa, Japan
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27
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Suzuki Y, Kume H, Togano T, Kanoh Y, Ohto H. Epidemiology of visceral mycoses in autopsy cases in Japan: the data from 1989 to 2009 in the Annual of Pathological Autopsy Cases in Japan. Med Mycol 2013; 51:522-6. [DOI: 10.3109/13693786.2012.755574] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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28
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Suzuki Y, Togano T, Ohto H, Kume H. P261 Epidemiology of visceral mycoses in autopsy cases in Japan: leukemia cases from 1989 to 2009. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Suzuki Y, Yoshida T, Wang G, Togano T, Miyamoto S, Miyazaki K, Iwabuchi K, Nakayama M, Horie R, Niitsu N, Sato Y, Nakamura N. Association of CD20 levels with clinicopathological parameters and its prognostic significance for patients with DLBCL. Ann Hematol 2012; 91:997-1005. [DOI: 10.1007/s00277-012-1407-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 01/04/2012] [Indexed: 12/01/2022]
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30
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Kume H, Yamazaki T, Togano T, Abe M, Tanuma H, Kawana S, Okudaira M. Epidemiology of visceral mycoses in autopsy cases in Japan: comparison of the data from 1989, 1993, 1997, 2001, 2005 and 2007 in Annual of Pathological Autopsy Cases in Japan. Med Mycol J 2012; 52:117-27. [PMID: 21788723 DOI: 10.3314/jjmm.52.117] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The data on visceral mycoses reported in the " Annual of Pathological Autopsy Cases in Japan " were analyzed epidemiologically every four years from 1989 to 2005, and in 2007. The frequency rates of visceral mycoses dropped sharply between 1989 (4.5%) and 1994 (3.2%), but by 2001 had risen again and have remained (4.4-4.6%) generally stable since then. The predominant causative agents were Candida and Aspergillus. Although the rate of candidosis showed a gradual decrease, the rate of aspergillosis showed an increase by degrees. Furthermore, the rate of aspergillosis exceeded that of candidosis in 1994, and the difference in the rates between the two conditions apparently further increased until 2001. After 2005, however no changes in this difference were observed. For complicated infections, the incidence of coinfection with Aspergillus and Candida showed a decreasing, and that with Aspergillus and Zygomycetes showed an increasing tendency. Severe infections with Zygomycetes showed a clear increase from 57.4% in 1989 to 88.9% in 2007. Comparing underlying diseases with mycoses in 1989 and 2007, leukemia (including myelodysplastic syndrome) decreased from 26.1% to 18.8% and bacterial infections (including interstitial pneumonia) increased from 11.1% to 22.1%. By age, the highest frequency rate of mycoses was observed in the range of 60-79 years, and the frequency rate of exogenous fungal infections such as aspergillosis, cryptococcosis, zygomycosis and trichosporonosis showed an increasing trend in the less than one-year old group.
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Affiliation(s)
- Hikaru Kume
- Department of Pathology, School of Medicine, Kitasato University, Japan
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31
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Togano T, Shibuya K, Kume H. Estimated Numbers of Visceral Mycoses in Case of Leukemia and MDS in Japan : Analysis of the data from the Annual of the pathological autopsy cases and vital statics in Japan. Med Mycol J 2012; 53:53-8. [DOI: 10.3314/mmj.53.53] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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32
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Watanabe M, Itoh K, Togano T, Kadin ME, Watanabe T, Higashihara M, Horie R. Ets-1 activates overexpression of JunB and CD30 in Hodgkin's lymphoma and anaplastic large-cell lymphoma. Am J Pathol 2011; 180:831-8. [PMID: 22107829 DOI: 10.1016/j.ajpath.2011.10.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 09/23/2011] [Accepted: 10/13/2011] [Indexed: 01/20/2023]
Abstract
Overexpression of CD30 and JunB is a hallmark of tumor cells in Hodgkin's lymphoma (HL) and anaplastic large-cell lymphoma (ALCL). We reported that CD30-extracellular signal-regulated kinase (ERK)1/2 mitogen-activated protein kinase (MAPK) signaling induces JunB, which maintains constitutive activation of the CD30 promoter. Herein, we localize a cis-acting enhancer in the JunB promoter that is regulated by Ets-1. We show that E26 transformation-specific-1 (Ets-1) (-146 to -137) enhances JunB promoter activation in a manner that is dependent on CD30 or the nucleophosmin-anaplastic lymphoma kinase (NPM-ALK)-ERK1/2 MAPK pathway. Ets-1 knockdown reduces the expression of both JunB and CD30, and CD30 knockdown significantly reduces JunB expression in HL and ALCL cell lines. NPM-ALK knockdown also reduces JunB expression in ALCL cell lines expressing NPM-ALK. Collectively, these results indicate that CD30 and NPM-ALK cooperate to activate the ERK1/2 MAPK-Ets-1 pathway. Ets-1, constitutively activated by ERK1/2-MAPK, plays a central role in the overexpression of JunB and CD30, which are both involved in the pathogenesis of HL and ALCL.
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Affiliation(s)
- Mariko Watanabe
- Department of Hematology, School of Medicine, Kitasato University, Kanagawa, Japan
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33
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Watanabe M, Nakano K, Togano T, Nakashima M, Higashihara M, Kadin ME, Watanabe T, Horie R. Targeted Repression of Overexpressed CD30 Downregulates NF-κB and ERK1/2 Pathway in Hodgkin Lymphoma Cell Lines. Oncol Res 2011; 19:463-9. [DOI: 10.3727/096504012x13285365944292] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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34
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Nakashima M, Ishii Y, Watanabe M, Togano T, Umezawa K, Higashihara M, Watanabe T, Horie R. The side population, as a precursor of Hodgkin and Reed-Sternberg cells and a target for nuclear factor-κB inhibitors in Hodgkin’s lymphoma. Cancer Sci 2010; 101:2490-6. [DOI: 10.1111/j.1349-7006.2010.01693.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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35
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Suzuki Y, Nakamura T, Tokoro M, Togano T, Ohsaka M, Kohri M, Hirata Y, Miyazaki K, Danbara M, Horie R, Miura I, Sunakawa K, Higashihara M. A case of giardiasis expressing severe systemic symptoms and marked hypereosinophilia. Parasitol Int 2010; 59:487-9. [PMID: 20601107 DOI: 10.1016/j.parint.2010.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 06/07/2010] [Accepted: 06/15/2010] [Indexed: 11/18/2022]
Abstract
An 88-year-old Japanese woman was referred to our hospital due to a one-month history of face edema, aphagia, shortness of breath, and skin rush over almost her entire skin. She had no abdominal symptoms. Her peripheral blood count showed a white blood cell (WBC) count of 27.1x10(9)/L with 82.1% eosinophils. Serum non-specific Immunoglobulin E was within a normal range. Soluble interleukin-2 receptor was elevated to 4200U/mL. At first, her eosinophil count was so high that we suspected she had an eosinophilic leukemia or hypereosinophilic syndrome. After admission, cysts of Giardia duodenalis (G. duodenalis) were detected in the patient's feces by microscopic analysis, then she was diagnosed with giardiasis, and 750mg per day of metronidazole was administered for seven days. Her WBC count decreased to 6.0x10(9)/L with 10% eosinophils, and her systemic symptoms improved. At that time her serum IL-5 was within a normal range. A few months later, the patient again complained of skin rush, and G. duodenalis was once again found in her feces. Her serum IL-5 was elevated to 751pg/mL. Metronidazole was administered for two weeks, and her eosinophil count decreased. G. duodenalis is a protozoan parasite, and it is one of the most common waterborne transmission gastrointestinal parasites in the world. G. duodenalis rarely causes hypereosinophilia. To our knowledge, this is the first case report of giardiasis with extreme hypereosinophilia and severe systemic symptoms.
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Affiliation(s)
- Yuhko Suzuki
- Department of Hematology, Kitasato University School of Medicine, Kitasato, Sagamihara, Japan.
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36
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Suzuki Y, Yoshida T, Horie R, Tsuruta T, Togano T, Ohsaka M, Miyazaki K, Danbara M, Ohtani S, Okayasu I, Higashihara M. Constitutive Activity of Nuclear Transcription Factor κB is Observed in Follicular Lymphoma. J Clin Exp Hematop 2010; 50:45-50. [DOI: 10.3960/jslrt.50.45] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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37
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Togano T, Sasaki M, Watanabe M, Nakashima M, Tsuruo T, Umezawa K, Higashihara M, Watanabe T, Horie R. Induction of oncogene addiction shift to NF-kappaB by camptothecin in solid tumor cells. Biochem Biophys Res Commun 2009; 390:60-4. [PMID: 19778522 DOI: 10.1016/j.bbrc.2009.09.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Accepted: 09/18/2009] [Indexed: 12/31/2022]
Abstract
The biological basis of the resistance of solid tumor cells to chemotherapy is not well understood. While addressing this problem, we found that gastric cancer cell line St-4/CPT, lung cancer cell line A549/CPT, and colon cancer cell line HT-29/CPT, all of which are resistant to camptothecin (CPT), showed strong and constitutive nuclear factor (NF)-kappaB activity driven by IkappaB kinase compared with their parental cell lines St-4, A549, and HT-29. A new NF-kappaB inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ), reduced viability and induced apoptosis in St-4/CPT, A549/CPT, and HT-29/CPT cell lines, while their parental cell lines were resistant to DHMEQ. The results in this study present an example of the shift in signals that support the survival of solid tumor cells to NF-kappaB during the acquisition of resistance to CPT. The results also indicate that solid tumor cells that become resistant to chemotherapy may be more easily treated by NF-kappaB inhibitors.
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Affiliation(s)
- Tomiteru Togano
- Department of Hematology, School of Medicine, Kitasato University, Sagamihara, Kanagawa 228-8555, Japan
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Watanabe M, Nakashima M, Togano T, Higashihara M, Watanabe T, Umezawa K, Horie R. Identification of the RelA domain responsible for action of a new NF-kappaB inhibitor DHMEQ. Biochem Biophys Res Commun 2008; 376:310-4. [PMID: 18782563 DOI: 10.1016/j.bbrc.2008.08.148] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 08/26/2008] [Indexed: 11/26/2022]
Abstract
A new NF-kappaB inhibitor dehydroxymethylepoxyquinomicin (DHMEQ) has a potential to be applied to clinical medicine as an anti-cancer and anti-inflammatory agent. DHMEQ inhibits localization of NF-kappaB in the nucleus and the inhibitory effect by DHMEQ is more potent on p50/RelA than on p50 homodimer. However, a molecular target of DHMEQ is unknown. In this study, we identified residues CEGRSAGSI, which appear in RelA (amino acids 38-46), c-Rel (28-36), and RelB (144-152), but not in p50 and p52, as a target of DHMEQ. As a possible mechanism, we propose that DHMEQ accesses CEGRSAGSI domain recognizing RSAGSI structure and directly binds to cysteine. This target domain appears to be unique among mammalian proteins. The results obtained in this study may provide better understanding of the action of DHMEQ and a key for developing a new NF-kappaB inhibitor with more potent activity.
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Affiliation(s)
- Mariko Watanabe
- Department of Hematology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan
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Suzuki Y, Shichishima T, Mukae M, Ohsaka M, Hayama M, Horie R, Togano T, Miyazaki K, Ichinoe M, Iwabuchi K, Fujii H, Higashihara M. Splenic infarction after Epstein-Barr virus infection in a patient with hereditary spherocytosis. Int J Hematol 2007; 85:380-3. [PMID: 17562611 DOI: 10.1532/ijh97.07208] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We describe the first patient with hereditary spherocytosis (HS) known to have developed splenic infarction following infectious mononucleosis (IM). An 18-year-old Japanese man was referred to our hospital in November 2004 because of continuous fever and icterus. He had undergone cholecystectomy at the age of 14 years. On patient admission in November 2004, a physical examination showed marked hepatosplenomegaly, icterus, and jaundice. He had a white blood cell count of 14.9 x 10(9)/L with 9.5% atypical lymphocytes, a red blood cell count of 2.93 x 10(12)/L, and a hemoglobin concentration of 7.8 g/dL. Microspherocytes were observed in the patient's peripheral blood smear, and immunoglobulin M antibody to Epstein-Barr virus (EBV) viral capsid antigen was detected. The patient's diagnosis was HS with IM. On day 4 of admission, the patient complained of severe abdominal pain. Abdominal computed tomography scanning revealed findings of splenic infarction. Two months after the occurrence of splenic infarction, a splenectomy was performed. A pathohistologic examination of the resected spleen revealed no evidence of thrombosis or arterial occlusion. We assume that the cause of splenic infarction was insufficient blood flow to oxygenate the entire spleen during the acute enlargement of the spleen.
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Affiliation(s)
- Yuhko Suzuki
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan.
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40
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Suzuki Y, Danbara M, Hayama M, Togano T, Ohsaka M, Miyazaki K, Horie R, Higashihara M. Phase II: Combination of cladribine, cyclophosphamide, mitoxantrone, rituximab (R-CCM) in patients with relapsed and refractory follicular and mantle cell lymphoma, results of a prospective study at Kitasato University. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18542 Background: Indolent non-Hodgkin’s lymphoma (I-NHL) account for 20% of all of NHL in Japan, and they are increasing in number. More than 80% of the patients who achieve a complete remission with the initial treatment, will require salvage therapy. Recently, cladribine (2-CdA), a purine analogue is receiving much attention, because, even as a single agent, it has shown a high efficacy for I-NHL. The aim of our study was to determine the effectiveness and toxicity of combined chemotherapy consisting of 2-CdA, cyclophosphamide (CYP), mitoxantrone (MIT), rituximab (R-CCM) in the treatment of refractory or relapsed I-NHL. Methods: Patient eligibility criteria were: Previously treated patients with I-NHL, refractory or relapsed disease, no chemotherapy or irradiation within 4 weeks prior to the study, life expectancy of at least 3 months, age: 20–75, perfomance status of 0–3, adequate function ( bone marrow, liver, kidney, lung, heart) and written informed consent. The treatment regimen was: 2-CdA given at a dose of 0.09 mg/kg/day in a 2-h intravenous infusion from day 2–4, CYP 200 mg/m2/day from day 2–4, MIT 8 mg/m2/day on day 2 and rituximab 375 mg/m2/day on day .Primary end point was overall response rate. Results: 9 patients were enrolled, 7 (2 with mantle cell lymphoma, MCL; and 5 with follicular lymphoma, FL) were eligible. Mean Age was 63(51–72). The mean observation time was 121 days(47–314). Overall response rate (complete and partial) just after this therapy was 85.7%, one was progressive disease. One of PR one relapsed and died ten months after this regimen. The major toxicity was myelosuppression. Grade-III and -IV neutropenia was seen in 7 patients, grade-III thrombocytopenia in one and grade-III hemorrhagic cystitis in one, but all of them recovered from these toxicity. After the treatment, Grade-IV pneumonia and grade-III left-ventricular diastolic dysfunction was seen in the PD patient and passed away. Conclusions: the R-CCM is effective and safe in a combined regimen for relapsed and refractory I-NHL patients. We have just begun this new regimen, therefore, further investigations with larger population are warranted. No significant financial relationships to disclose.
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Affiliation(s)
- Y. Suzuki
- Kitasato University, Sagamihara, Japan
| | | | - M. Hayama
- Kitasato University, Sagamihara, Japan
| | - T. Togano
- Kitasato University, Sagamihara, Japan
| | - M. Ohsaka
- Kitasato University, Sagamihara, Japan
| | | | - R. Horie
- Kitasato University, Sagamihara, Japan
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Miyazaki K, Kon S, Watanabe T, Togano T, Ohsaka M, Suzuki Y, Danbara M, Horie R, Kanda Y, Maruta A, Higashihara M. [Early blastic transformation within a year of imatinib treatment in 2 cases of chronic myeloid leukemia]. Rinsho Ketsueki 2007; 48:297-304. [PMID: 17515120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
We report herein on two rare cases of newly diagnosed chronic myeloid leukemia, which developed early blastic transformation within a year of imatinib treatment. Case 1 is a 22-year-old Japanese female, who underwent gradual blastic transformation with the increase of a resistant clone, which cytogenetically evolved right after she reached complete hematologic remission. Case 2 is a 24-year-old Japanese male, who underwent sudden transformation after 8 months treatment with imatinib mesylate following complete cytogenetic response. Although a sudden blastic transformation is extremely rare, the occurrence of such events even among the low-risk, good responding patients highlights the need for continued, rigorous monitoring by sensitive analysis, such as quantitative PCR. In order to accomplish the early eradication of minimal residual disease, the therapeutic strategy for chronic myeloid leukemia has to be defined in the era of imatinib, considering the application of allogeneic stem cell transplantation, which is currently the only curative treatment.
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MESH Headings
- Adult
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Benzamides
- Drug Resistance, Neoplasm
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Lymphocyte Activation
- Male
- Monitoring, Physiologic
- Piperazines/administration & dosage
- Piperazines/adverse effects
- Polymerase Chain Reaction
- Pyrimidines/administration & dosage
- Pyrimidines/adverse effects
- Remission Induction
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Affiliation(s)
- Koji Miyazaki
- Department of Hematology, Kitasato University School of Medicine
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42
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Seki M, Tanaka T, Matsuda H, Togano T, Hashimoto K, Ueda J, Fukuchi T, Abe H. Topically administered timolol and dorzolamide reduce intraocular pressure and protect retinal ganglion cells in a rat experimental glaucoma model. Br J Ophthalmol 2005; 89:504-7. [PMID: 15774933 PMCID: PMC1772601 DOI: 10.1136/bjo.2004.052860] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS This study sought to elucidate the effects of timolol and dorzolamide on intraocular pressure (IOP) and retinal ganglion cell (RGC) death in an experimental model of glaucoma in rat. METHODS Mild elevation of IOP was induced in rats by intracameral injection of India ink and subsequent laser trabecular photocoagulation. IOP was measured before the surgical procedures and weekly thereafter. Timolol (0.5%), timolol XE (0.5%), dorzolamide (1%), and artificial tears (vehicle) were topically applied daily. Retinal sections were prepared for histology to determine RGC number. RESULTS Timolol, timolol XE, and dorzolamide induced a significant reduction in IOP (p<0.05) and counteracted the reduction in RGC number that occurred in vehicle treated glaucomatous eyes (p<0.05). The coefficient of correlation between RGC number and IOP was significant in the dorzolamide treated group (r = -0.908, p<0.005), but not in other groups (p>0.05). CONCLUSIONS Both timolol formulation and dorzolamide reduced IOP and protected RGCs in a rat model of experimental glaucoma. It cannot be ruled out that timolol might protect RGCs by additional mechanisms other than simply lowering of IOP.
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Affiliation(s)
- M Seki
- Division of Ophthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi, Niigata, Niigata 951-8585, Japan
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Niitsu N, Kohri M, Togano T, Nakamine H, Nakamura S, Iwabuchi KI, Higashihara M. Development of hepatosplenic γδ T-cell lymphoma with pancytopenia during early pregnancy: a case report and review of the literature. Eur J Haematol 2004; 73:367-71. [PMID: 15458516 DOI: 10.1111/j.1600-0609.2004.00300.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Lymphomas rarely develop during pregnancy, but hepatosplenic gammadelta T-cell lymphoma (HSgammadeltaTCL) is extremely rare. We encountered a case of T-cell intracellular antigen-1 (TIA-1) positive and granzyme B-positive HSgammadeltaTCL that developed early during the course of pregnancy. The patient was a 31-yr-old female who was referred to our hospital because of pancytopenia and splenomegaly at the time of the14th week of her gestation. Her pancytopenia and hepatosplenomegaly worsened and she became fibril at the 27th week of gestation and Cesarean section was performed at the 29th week. Histopathological examination of the spleen, which was resected 28 d after delivery for a diagnostic purpose, revealed medium to large-sized nodules composed of dense proliferation of lymphoid cells having round to oval-shaped nuclei and abundant weakly eosinophilic cytoplasm. They were CD3epsilon+, mCD3+, CD4-, CD8-, CD56+, CD79a-, T-cell receptor (TCR)-gammadelta protein+, TIA-1+, and granzyme B+ by either immunohistochemistry or flow cytometry. Clonal rearrangement of TCR-gamma genes without such rearrangement of TCR-delta and TCR-beta genes was confirmed by Southern blot hybridization. Thus, the patient was diagnosed as having HSgammadeltaTCL, and combination chemotherapy was initiated. She is currently in partial remission. To our knowledge, this is the first case report of HSgammadeltaTCL that developed during pregnancy. Pathogenesis of pregnancy-associated lymphoma is not known, but it is possible that maternal immunity during pregnancy or a hormonal imbalance, such as a change in the progesterone level, induces the development of lymphoma. Pregnancy-associated lymphoma is resistant to standard chemotherapy and is associated with poor prognosis. Therefore, it is important to accumulate clinicopathologic data of such cases for the development of a treatment modality.
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Affiliation(s)
- Nozomi Niitsu
- Department of Internal Medicine IV, Kitasato University School of Medicine, Kanagawa, Japan.
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Sawada H, Fukuchi T, Ohta A, Suda K, Togano T, Nakatsue T, Funaki S, Hara H, Shirakashi M, Abe H. [Persistent hyperplastic primary vitreous--a case report of adult onset acute angle-closure glaucoma]. Nippon Ganka Gakkai Zasshi 2001; 105:711-5. [PMID: 11692619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND We report a patient with persistent hyperplastic primary vitreous(PHPV) who presented with acute angle-closure glaucoma in his adult life. CASE A 30-year-old man had an attack of acute angle-closure glaucoma associated with retrolenticular fibrous tissue, atrophic retina, and elongated cilliary process in his right eye. RESULT Ultrasound biomicroscopy(UBM) study showed iris bowing, shallow anterior chamber, and elongated cilliary body which were being pulled by the retrolenticular mass. The posterior chamber was normal. CONCLUSION Although the mechanisms of secondary angle-closure glaucoma in PHPV are complicated, we suspected pupillary block resulting from constriction by the retrolenticular mass in this case.
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Affiliation(s)
- H Sawada
- Department of Ophthalmology, Niigata University School of Medicine, 1-757 Asahi-machi, Niigata 951-8510, Japan
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Hagiwara S, Togano T, Kajiwara K, Otake H, Owada A, Hayama M, Akiyama N, Horie R, Higashihara M. [Role of ultrasonography in diagnosis of neutropenic enteritis: a study of 4 cases]. Rinsho Ketsueki 2001; 42:81-8. [PMID: 11280921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Neutropenic enteritis is a septic or inflammatory disease of the colon. It is usually encountered in patients with hematological malignancy who have undergone chemotherapy, and it presents as fever, diarrhea, and abdominal pain, although the symptoms are not always specific. The diagnostic features of neutropenic enteritis revealed by barium enema, CT and ultrasonography have been reported previously. Here we report 4 cases of neutropenic enteritis in which ultrasound was used for diagnosis, and also for monitoring the clinical course of the disease. Because neutropenic enteritis is rapidly progressive, early diagnosis and therapeutic intervention are required. We believe that ultrasonography is a useful method for examining patients with neutropenic enteritis, being noninvasive, mobile, and providing rapid results in real time, thus aiding early diagnosis and clinical follow-up.
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Affiliation(s)
- S Hagiwara
- Fourth Department of Internal Medicine, Kitasato University School of Medicine
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