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Kurosawa S, Yokota T, Takada Y, Okubo S, Masuda M, Nakayama H, Sakurai A, Ito C, Aisa Y, Nakazato T. Effective treatment of pleural effusion in chronic lymphocytic leukemia with acalabrutinib: a case report. Ann Hematol 2024; 103:1779-1781. [PMID: 38512464 DOI: 10.1007/s00277-024-05721-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/19/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Shuhei Kurosawa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan.
| | - Takako Yokota
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Yusuke Takada
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - So Okubo
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Moe Masuda
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Hitomi Nakayama
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawa Nishimachi, Kanagawa-Ku, Yokohama, Kanagawa, 221-0855, Japan
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Iriyama N, Iwanaga E, Kimura Y, Watanabe N, Ishikawa M, Nakayama H, Sato E, Tabayashi T, Mitsumori T, Takaku T, Nakazato T, Tokuhira M, Fujita H, Ando M, Hatta Y, Kawaguchi T. Changes in chronic myeloid leukemia treatment modalities and outcomes after introduction of second-generation tyrosine kinase inhibitors as first-line therapy: a multi-institutional retrospective study by the CML Cooperative Study Group. Int J Hematol 2024:10.1007/s12185-024-03758-4. [PMID: 38587692 DOI: 10.1007/s12185-024-03758-4] [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: 10/19/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
This study investigated changes in treatment modalities and outcomes of chronic myeloid leukemia in the chronic phase (CP-CML) after the approval of second-generation tyrosine kinase inhibitors (2G-TKIs) for first-line therapy. Patients were grouped into those who underwent TKI therapy up to December 2010 (imatinib era group, n = 185) and after January 2011 (2G-TKI era group, n = 425). All patients in the imatinib era group were initially treated with imatinib, whereas patients in the 2G-TKI era group were mostly treated with dasatinib (55%) or nilotinib (36%). However, outcomes including progression-free survival, overall survival, and CML-related death (CRD) did not differ significantly between groups. When stratified by risk scores, the prognostic performance of the ELTS score was superior to that of the Sokal score. Even though both scoring systems predicted CRD in the imatinib era, only the ELTS score predicted CRD in the 2G-TKI era. Notably, the outcome of patients classified as high-risk by ELTS score was more favorable in the 2G-TKI era group than in the imatinib era group. Thus, expanding treatment options may have improved patient outcomes in CP-CML, particularly in patients classified as high-risk by ELTS score.
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Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Eisaku Iwanaga
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
| | - Yuta Kimura
- Department of Hematology, Japan Community Health Care Organization, Saitama Medical Center, Saitama, Japan
| | - Naoki Watanabe
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hitomi Nakayama
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Takayuki Tabayashi
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Toru Mitsumori
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Michihide Tokuhira
- Department of Hematology, Japan Community Health Care Organization, Saitama Medical Center, Saitama, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
- Department of Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
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Okubo S, Shinmura K, Kadota S, Nakayasu M, Kurosawa S, Nakayama H, Sakurai A, Ito C, Aisa Y, Nakazato T. Evaluation of the cachexia index using a bioelectrical impedance analysis in elderly patients with non-Hodgkin's lymphoma: A single-center prospective study. Ann Hematol 2024; 103:823-831. [PMID: 38010408 DOI: 10.1007/s00277-023-05548-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/11/2023] [Indexed: 11/29/2023]
Abstract
Cancer cachexia is a disorder that affects patient outcomes. The present study prospectively evaluated the prognostic value of the cachexia index (CXI) in elderly patients with non-Hodgkin's lymphoma (NHL). We prospectively analyzed 51 elderly patients who were diagnosed with NHL at our institution. CXI was calculated as follows: CXI = SMI × Alb/NLR (SMI: skeletal muscle index, Alb: serum albumin, NLR: neutrophil-to-lymphocyte ratio). SMI was measured by a bioelectrical impedance analysis (BIA) using the InBody 720. We determined the sex-specific cutoff values of the CXI by a receiver operating characteristic curve analysis and divided all patients into low- and high-CXI groups. The median age at the diagnosis was 78 years (60-93 years), and 28 (55%) were male. The histologic subtypes were B-cell lymphoma in 49 patients and T-cell lymphoma in 2. Twenty-eight (55%) patients were categorized into the high-CXI group, and 23 (45%) were categorized into the low-CXI group. The overall survival (OS) in the low-CXI group was significantly shorter than that in the high-CXI group (3-year OS, 70.4% vs. 95.7%, p = 0.007). Among 23 patients with DLBCL, patients with low-CXI had shorter OS than those with high-CXI (3-year OS, 55.6% vs. 92.9%, p = 0.008). On the other hand, sarcopenia had less impact on the clinical outcome of DLBCL patients. Low-CXI was associated with poor outcomes in elderly NHL and the CXI may be a clinical useful index for predicting prognosis. Further large prospective studies are needed to verify this conclusion.
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Affiliation(s)
- So Okubo
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Kohei Shinmura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Saori Kadota
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Misa Nakayasu
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Shuhei Kurosawa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Hitomi Nakayama
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 1-1 Mitsuzawanishi-Cho, Kanagawa-Ku, Yokohama, 221-0855, Japan.
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Kurosawa S, Hamakawa Y, Yoshimura Y, Hayashi H, Nakazato T, Okamoto H. When cancer disguises: small-cell lung cancer masquerading as HIV-associated lymphoma in leukaemic phase. Lancet Haematol 2024; 11:e168. [PMID: 38302224 DOI: 10.1016/s2352-3026(23)00369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/17/2023] [Accepted: 11/30/2023] [Indexed: 02/03/2024]
Affiliation(s)
- Shuhei Kurosawa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
| | - Yusuke Hamakawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yukihiro Yoshimura
- Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Hiroaki Okamoto
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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Tsuchiya S, Takaku T, Watanabe N, Iriyama N, Kimura Y, Iwanaga E, Sugimoto KJ, Mitsumori T, Ishikawa M, Nakazato T, Fujita H, Sato E, Hatta Y, Asou N, Kizaki M, Tokuhira M, Ando M, Kawaguchi T. Management and Risk Factors for Pleural Effusion in Japanese Patients with Chronic Myeloid Leukemia Treated with First-line Dasatinib in Real-world Clinical Practice. Intern Med 2023; 62:3299-3303. [PMID: 37005261 DOI: 10.2169/internalmedicine.1611-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Objective Pleural effusion (PE) is a common adverse event that occurs during dasatinib therapy for chronic myeloid leukemia (CML). However, the pathomechanism of PE and appropriate management of Asian patients with CML have not been elucidated. This study investigated the incidence rate, risk, and appropriate management of PE in Asian patients with CML treated with dasatinib. Methods We retrospectively collected data on patients in the chronic phase of CML who received first-line dasatinib therapy and were registered in the CML-Cooperative Study Group database. Patients We identified 44 cases of PE in a series of 89 patients and analyzed previously reported risk factors and effective management of PE. Results A univariate analysis revealed that age, diabetes mellitus, chronic renal failure, hypertension, the history of cardiovascular events, and dasatinib dose were significantly associated with PE. A multivariate analysis revealed that age ≥65 years old was the only independent risk factor for PE. Dasatinib dose reduction and switching to a tyrosine kinase inhibitor showed a statistically significant difference in effectively reducing PE volume compared to single diuretic use. Conclusion Although further studies are warranted, our observations showed that advanced age is a significant risk factor for PE, and tyrosine kinase inhibitor dose reduction or replacement of dasatinib may be an effective management strategy for PE in Asian CML patients who received first-line treatment with dasatinib in real-world clinical practice.
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Affiliation(s)
- Shun Tsuchiya
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Naoki Watanabe
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Japan
| | - Yuta Kimura
- Department of Hematology, Japan Community Health Care Organization Saitama Medical Center, Japan
| | - Eisaku Iwanaga
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Japan
| | - Kei-Ji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Japan
| | - Toru Mitsumori
- Department of Hematology, Juntendo University Urayasu Hospital, Japan
| | - Maho Ishikawa
- Department of Hemato-oncology, Saitama Medical University International Medical Center, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Japan
| | - Norio Asou
- Department of Hemato-oncology, Saitama Medical University International Medical Center, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Japan
| | - Michihide Tokuhira
- Department of Hematology, Japan Community Health Care Organization Saitama Medical Center, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Japan
- Department of Medical Technology, Kumamoto Health Science University, Japan
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Tokuhira M, Kimura Y, Tabayashi T, Watanabe N, Tsuchiya S, Takaku T, Iriyama N, Sato E, Nakazato T, Mitsumori T, Ishikawa M, Fujita H, Kizaki M, Ando M, Hatta Y, Iwanaga E, Kawaguchi T. Clinical management of second-generation tyrosine kinase inhibitor therapy in patients with newly diagnosed chronic myeloid leukemia in the chronic phase, focusing on age and dose effects. Int J Hematol 2023:10.1007/s12185-023-03606-x. [PMID: 37129800 DOI: 10.1007/s12185-023-03606-x] [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: 02/03/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
ABL1-tyrosine kinase inhibitors (TKIs) are an established treatment choice for patients with chronic myeloid leukemia in the chronic phase (CML-CP). However, effects of TKI dose modification have not been well investigated. In this study, we retrospectively analyzed 178 patients with newly diagnosed CML-CP who were treated with dasatinib or nilotinib, focusing on age and dose effects. Efficacy as measured by cumulative major molecular response (MMR) and molecular response 4.5 rates did not differ significantly between the younger group and elderly group. Elderly patients who started nilotinib at a reduced dose had similar or better efficacy outcomes (including cumulative MMR and continuation ratios) than other groups, and elderly patients who started dasatinib at a reduced dose had the lowest MMR ratio and longest MMR duration. Effects of dose modification based on age and TKI selection can be attributed to flexible management of TKI therapy in real-world practice, but further studies are required to validate the findings of this study.
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Affiliation(s)
- Michihide Tokuhira
- Department of Hematology, Japan Community Health Care Organization Saitama Medical Center, Saitama, 330-0074, Japan.
| | - Yuta Kimura
- Department of Hematology, Japan Community Health Care Organization Saitama Medical Center, Saitama, 330-0074, Japan
| | - Takayuki Tabayashi
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Naoki Watanabe
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shun Tsuchiya
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Toru Mitsumori
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Eisaku Iwanaga
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
- Department of Medical Technology, Faculty of Health Sciences, Kumamoto Health Science University, Kumamoto, Japan
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Nishiyama-Fujita Y, Nakazato T, Iriyama N, Tokuhira M, Ishikawa M, Sato E, Takaku T, Sugimoto K, Fujita H, Fujioka I, Tsuchiya S, Kimura Y, Iwanaga E, Komatsu N, Asou N, Kizaki M, Hatta Y, Kawaguchi T. Outcomes of adolescents and young adults with chronic-phase chronic myeloid leukaemia treated with tyrosine kinase inhibitors. Ann Med 2022; 54:1244-1254. [PMID: 35486442 PMCID: PMC9126594 DOI: 10.1080/07853890.2022.2069280] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Few studies have reported the outcomes of adolescents and young adults (AYAs) with chronic-phase chronic myeloid leukaemia (CML-CP) on tyrosine kinase inhibitors (TKIs). MATERIALS AND METHODS We retrospectively analysed the clinical features, treatment response, and long-term outcomes of 42 AYA patients, in comparison to older patients. The initial therapies of AYA patients between 2001 and 2016 included imatinib (n = 24), dasatinib (n = 13) and nilotinib (n = 5). RESULTS In AYA patients, the peripheral blood (PB) white blood cell count and percentage of blasts at the diagnosis were significantly higher, haemoglobin levels were lower and the spleen size was larger. The major molecular response (MMR), event-free survival (EFS) and overall survival (OS) rates were comparable. A sub-analysis comparing imatinib to second-generation TKIs as the initial therapy also showed that their prognosis was comparable. DISCUSSION In conclusion, the tumour burden at the diagnosis of CML-CP is higher in AYA patients; however, their prognosis was not worse in comparison to older patients treated with TKIs. KEY MESSAGESFew studies have reported the outcomes of adolescents and young adults (AYAs) with chronic-phase chronic myeloid leukaemia (CML-CP) on tyrosine kinase inhibitors (TKIs). This study showed the tumour burden at the diagnosis of CML-CP is higher in AYA pa tients; however, their prognosis was not worse in comparison to older patients treated with TKIs. Understanding the biological and non-biological features of AYA patients with CML-CP on TKI therapy is essential for better management and to improve the outcomes.
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Affiliation(s)
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Noriyoshi Iriyama
- Department of Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shun Tsuchiya
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuta Kimura
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Eisaku Iwanaga
- Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Asou
- Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yoshihiro Hatta
- Department of Medicine, Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Tatsuya Kawaguchi
- Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
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Ueda Y, Usuki K, Fujita J, Matsumura I, Aotsuka N, Sekiguchi N, Nakazato T, Iwasaki H, Takahara-Matsubara M, Sugimoto S, Goto M, Naoe T, Kizaki M, Miyazaki Y, Aakashi K. Phase 1/2 Study Evaluating the Safety and Efficacy of DSP-7888 Dosing Emulsion in Myelodysplastic Syndromes. Cancer Sci 2021; 113:1377-1392. [PMID: 34932235 PMCID: PMC8990724 DOI: 10.1111/cas.15245] [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: 08/06/2021] [Revised: 11/11/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
DSP‐7888 is an immunotherapeutic cancer vaccine derived from the Wilms’ tumor gene 1 (WT1) protein. This phase 1/2 open‐label study evaluated the safety and efficacy of DSP‐7888 dosing emulsion in patients with myelodysplastic syndromes (MDS). DSP‐7888 was administered intradermally (3.5 or 10.5 mg) every 2 weeks for 6 months and then every 2‐4 weeks until lack of benefit. Twelve patients were treated in phase 1 (3.5 mg, n = 6; 10.5 mg, n = 6), with no dose‐limiting toxicities reported. Thus, the 10.5 mg dose was selected as the recommended phase 2 dose, and 35 patients were treated in phase 2. Forty‐seven patients received ≥1 dose of the study drug and comprised the safety analysis set. The most common adverse drug reaction (ADR) was injection site reactions (ISR; 91.5%). Grade 3 ISR were common (58.8%) in phase 1 but occurred less frequently in 2 (22.9%) following implementation of risk minimization strategies. Other common ADR were pyrexia (10.6%) and febrile neutropenia (8.5%). In the efficacy analysis set, comprising patients with higher‐risk MDS after azacitidine failure in phases 1 and 2 (n = 42), the disease control rate was 19.0%, and the median overall survival (OS) was 8.6 (90% confidence interval [CI], 6.8‐10.3) months. Median OS was 10.0 (90% CI, 7.6‐11.4) months in patients with a WT1‐specific immune response (IR; n = 33) versus 4.1 (90% CI, 2.3‐8.1) months in those without a WT1‐specific IR (n = 9; P = .0034). The acceptable safety and clinical activity findings observed support the continued development of DSP‐7888 dosing emulsion.
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Affiliation(s)
- Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Jiro Fujita
- Department of Hematology and Oncology, Osaka University Hospital, Osaka, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Hospital, Osaka, Japan
| | - Nobuyuki Aotsuka
- Department of Hematology Oncology, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Naohiro Sekiguchi
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | | | | | - Masashi Goto
- Sumitomo Dainippon Pharma Co., Ltd, Osaka, Japan
| | - Tomoki Naoe
- National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Koichi Aakashi
- Department of Medicine and Biosystemic Science Faculty of Medicine, Kyushu University, Fukuoka, Japan
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9
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Akimoto M, Sakurai A, Nishiyama-Fujita Y, Ito C, Aisa Y, Nakazato T. The prognostic value of the Fibrinogen-Albumin Ratio Index in patients with myelodysplastic syndrome and acute myeloid leukemia with myelodysplasia-related changes treated with azacitidine. Ann Hematol 2021; 100:953-957. [PMID: 33521864 DOI: 10.1007/s00277-021-04440-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
Inflammation is a major hallmark of several cancers. The present study evaluated the prognostic value of the Fibrinogen-Albumin Ratio Index (FARI) at the diagnosis in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) treated with azacitidine (AZA). A retrospective study was conducted in a single cohort of 99 patients with de novo MDS and AML-MRC who were treated with AZA between May 2011 and June 2019 in our hospital. Plasma fibrinogen and serum albumin levels were measured before the start of AZA treatment. A total of 99 patients were included in the analysis. The optimal cut-off value of FARI for predicting the 1-year overall survival (OS) was determined by a receiver operating characteristic (ROC) analysis to be 0.079. A total of 59 (60%) and 40 (40%) patients had an FARI ≥0.079 (high-FARI group) and < 0.079 (low-FARI group), respectively. The high-FARI patients had a significantly shorter OS than low-FARI patients (1-year OS, 35.6% vs. 77.5%, p < 0.001). In a multivariate analysis, parameters with independent adverse significance for the OS were a high FARI (≥0.079) (hazard ratio (HR) 2.41, 95% confidence interval (CI), 1.36-4.29; p = 0.006), and Revised-International Prognostic Scoring System (IPSS-R) very high (HR 1.483, 95% CI, 1.12-1.963, p = 0.006). A high FARI was found to be associated with a poor outcome in MDS and AML-MRC patients treated with AZA, and FARI was an independent prognostic factor for the OS in these patients. Further internal and external validations are needed to clarify the prognostic role of the FARI for MDS and AML-MRC patients.
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Affiliation(s)
- Masahiro Akimoto
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuriko Nishiyama-Fujita
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
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10
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Amikura T, Kikuchi T, Kato J, Koda Y, Sakurai M, Yamazaki R, Mikita K, Saburi M, Nakazato T, Mori T. Toxoplasmosis after allogeneic hematopoietic stem cell transplantation: Impact of serostatus-based management. Transpl Infect Dis 2020; 23:e13506. [PMID: 33174304 DOI: 10.1111/tid.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/03/2020] [Accepted: 10/22/2020] [Indexed: 12/01/2022]
Abstract
Toxoplasmosis caused by Toxoplasma gondii (T. gondii) is a serious infectious complication after allogeneic hematopoietic stem cell transplantation (HSCT). The incidence of toxoplasmosis varies widely because of the variabilities of seroprevalence among patient populations. The incidence and the optimal management of toxoplasmosis after allogeneic HSCT in a patient population with a low seroprevalence have not been fully evaluated. We conducted a single-center retrospective study evaluating toxoplasmosis in Japanese patients who underwent allogeneic HSCT. Of the 728 evaluable patients, only 5 developed toxoplasmosis with a median onset of day 60 post-transplant (range, day 55-393). The cumulative incidence was 0.7% (95% CI: 0.3%-1.5%) at day 500 post-transplant. Four of the five patients succumbed due to toxoplasmosis. The more recently treated 220 patients (not the earlier 508 patients) were screened for the T. gondii serostatus, and prophylactic treatment with trimethoprim/sulfamethoxazole was applied. All five patients with toxoplasmosis were in the unscreened group, and there was no case of toxoplasmosis after the introduction of the screening and prophylactic treatment. Our results suggest that toxoplasmosis after allogeneic HST is rare but can develop as a life-threatening complication even in the populations with low seroprevalence, and that prophylactic treatment for seropositive patients could effectively prevent toxoplasmosis.
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Affiliation(s)
- Takahito Amikura
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Taku Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yuya Koda
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Rie Yamazaki
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kei Mikita
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Masuho Saburi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - Tomonori Nakazato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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11
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Nakazato T, Miyagawa S, Uemura T, Liu L, Li J, Sasai M, Harada A, Toda K, Sawa Y. Functional engineered heart tissue cultured in a rotating wall vessel bioreactor improve cardiac function in the distressed rat heart. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
How to construct massive cardiac tissue and culture it with functional improvement may be crucial as cardiomyogenesis in failed heart. We previously presented that dynamic culture in a rotating wall vessel (RWV) bioreactor could provide a better culture environment for maintenance of the engineered 3D cardiac tissue. However, it is unknown about the effect of the tissue cultured in a RWV bioreactor on engraftment and improvement of function in the distressed rat heart.
Hypothesis
We hypothesized that the engineered 3D cardiac tissue cultured in a RWV bioreactor could improve its engraftment and lead recovery of cardiac function in rat infarction model.
Methods
We made engineered cardiac tissue by seeding 2.0 × 106 human induced pluripotent stem cell derived cardiomyocytes on the PLGA fiber sheet. It was cultured in the RWV bioreactor for seven days (RWV group). For the control, static culture has been done. After in vitro assessment, these tissues were transplanted to myocardial infarction model nude rats (sham, control, and RWV group, n=10, respectively) and cardiac performance was evaluated by ultrasonography. Four weeks after transplantation, we evaluated their hearts by histological analysis.
Results
The RWV group demonstrated maturation of cardiomyocytes evidenced by significantly higher expression of Troponin T (TnT), sarcomeric α actinin (SAA), connexin 43 (Cx43) and myosin heavy chain 7 (MYH7) than the control by Western blots (TnT; 2.7±1.0 vs. 1.0±0.4, p<0.01, SAA; 2.1±0.7 vs. 1.0±0.2, p<0.01, Cx 43; 2.0±0.6 vs. 1.0±0.1, p<0.05, MYH7; 10.9±2.7 vs. 1.0±0.1, p<0.01). In the culture supernatant, the concentration of cytokines related to angiogenesis was significantly higher in the RWV group than in the control (VEGF; 29.6±7.4 vs. 12.2±4.3pg/ml, p<0.01, HGF; 72.7±9.9 vs. 42.6±5.9pg/ml, p<0.01). Four weeks after transplantation, the left ventricular ejection fraction was significantly improved in the RWV group than in the control (RWV vs. control; 47±4.9 vs. 38±6.9%, p<0.01). On histological analysis, more engineered cardiac tissue survived in the RWV group than in the control (RWV vs. control; 7/10 vs. 3/10, p=0.18). A vascular-like structure double-stained with isolectin B4 and smooth muscle actin was partially observed in the transplanted tissue. LV remodeling exhibiting extracellular collagen deposition (fibrotic area, RWV vs. control; 17±4.3 vs. 24±5.2%, p<0.05) and cardiomyocyte hypertrophy (RWV vs. control; 16±1.7 vs. 18±2.1μm, p<0.05) was significantly attenuated in RWV group than in the control. Neovascularization was significantly noted in the RWV group compared with the control (capillary density, RWV vs. control; 545±113 vs. 356±92, p<0.01).
Conclusion
Functional engineered 3D cardiac tissue cultured in a RWV bioreactor could induce angiogenesis and improved its engraftment, leading significant improvement of cardiac function in rat infarction model.
Dynamic culture in a RWV bioreactor
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Japan Society for the Promotion of Science
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Affiliation(s)
- T Nakazato
- Osaka University Graduate School of Medicine, Suita, Japan
| | - S Miyagawa
- Osaka University Graduate School of Medicine, Suita, Japan
| | - T Uemura
- JTEC CORPORATION, Ibaraki, Japan
| | - L Liu
- Osaka University Graduate School of Medicine, Suita, Japan
| | - J Li
- Osaka University Graduate School of Medicine, Suita, Japan
| | - M Sasai
- Osaka University Graduate School of Medicine, Suita, Japan
| | - A Harada
- Osaka University Graduate School of Medicine, Suita, Japan
| | - K Toda
- Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Sawa
- Osaka University Graduate School of Medicine, Suita, Japan
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12
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Sato E, Iriyama N, Tokuhira M, Takaku T, Ishikawa M, Nakazato T, Sugimoto KJ, Fujita H, Kimura Y, Fujioka I, Asou N, Komatsu N, Kizaki M, Hatta Y, Kawaguchi T. The EUTOS long-term survival score predicts disease-specific mortality and molecular responses among patients with chronic myeloid leukemia in a practice-based cohort. Cancer Med 2020; 9:8931-8939. [PMID: 33037866 PMCID: PMC7724301 DOI: 10.1002/cam4.3516] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/25/2020] [Accepted: 09/12/2020] [Indexed: 01/17/2023] Open
Abstract
The European Treatment and Outcome Study (EUTOS) long‐term survival (ELTS) score predicts disease‐specific death in patients with chronic myeloid leukemia (CML) being treated with imatinib during the chronic phase (CP) of the disease. However, it is unclear whether the ELTS score predicts CML‐related events or treatment responses. This study evaluated the predictive value of the ELTS score regarding prognosis and treatment response in patients with CML‐CP. Clinical data were retrospectively obtained from patients enrolled in the CML Cooperative Study Group (CML‐CSG), which included patients diagnosed with CML‐CP from April 2001 to January 2016, and treated with any tyrosine kinase inhibitor (TKI) as first‐line therapy. Among 342 eligible patients, the ELTS scores indicated low‐, intermediate‐, and high‐risk in 74%, 21%, and 5% of patients, respectively. Patients with high ELTS scores had significantly higher disease‐specific mortality and worse event‐free survival, progression‐free survival, and overall survival. Among four risk scores, including the Sokal, Hasford, EUTOS, and ELTS scores, risk stratification by the ELTS score had the highest predictive value in assessing patient prognosis, and also in treatment responses. In fact, the EUTOS and ELTS scores were able to predict the major molecular response within 12 months. Most importantly, the ELTS score was the only scoring system that predicted deep molecular response at any time, regardless of risk level (65.0%, 43.7%, and 23.5% in low‐, intermediate‐, and high‐risk groups, respectively). Compared to other risk scores, the ELTS score was the most sensitive risk classification tool for the four endpoints of interest in this study, as well as molecular responses in patients with CML‐CP.
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Affiliation(s)
- Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Kei-Ji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Yuta Kimura
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Asou
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan.,Department of Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
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13
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Matsuda S, Suzuki R, Takahashi T, Suehiro Y, Tomita N, Izutsu K, Fukuhara N, Imaizumi Y, Shimada K, Nakazato T, Yoshida I, Miyazaki K, Yamaguchi M, Suzumiya J. Dose-adjusted EPOCH with or without rituximab for aggressive lymphoma patients: real world data. Int J Hematol 2020; 112:807-816. [PMID: 32880824 DOI: 10.1007/s12185-020-02984-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/11/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) -/+ rituximab (R) is the standard chemotherapeutic regimen for aggressive lymphoma, but is insufficient for aggressive lymphoma with adverse prognostic factors. Dose-adjusted (DA)-EPOCH (etoposide, doxorubicin, cyclophosphamide, vincristine, and prednisolone) -/+ R demonstrates excellent efficacy against some aggressive lymphoma. Thus, we conducted a retrospective study to evaluate the feasibility and efficacy of this therapy in clinical practice. We enrolled 149 patients from 17 institutions diagnosed between 2007 and 2015. The median follow-up period for survivors was 27 months (range 0.2-123). The complete response (CR) rate of newly diagnosed patients was 79% (95% CI 68-87%). All patients were hospitalized to receive this therapy and 94% of patients also received granulocyte-colony-stimulating factor support. There were no treatment-related deaths. Febrile neutropenia (FN) and grade 3 or 4 infection occurred in 55% and 28% of patients, respectively. There were no significant differences in FN or infection between young (≤ 65 years) and elderly patients (> 65 years). In newly diagnosed diffuse large B-cell lymphoma-not otherwise specified patients (n = 46), the CR rate was 80% (95% CI 64-91%) and the 2-year OS rate was 81% (95% CI 66-90%). In the present study, DA-EPOCH -/+ R exhibited excellent efficacy and feasibility for aggressive lymphoma.
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Affiliation(s)
- Shinichiro Matsuda
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan
| | - Ritsuro Suzuki
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan
| | - Tsutomu Takahashi
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan
| | - Youko Suehiro
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Naoto Tomita
- Department of Hematology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Koji Izutsu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Noriko Fukuhara
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | | | - Kazuyuki Shimada
- Department of Hematology, Nagoya University Hospital, Nagoya, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizens Hospital, Yokohama, Japan
| | - Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoko Yamaguchi
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junji Suzumiya
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan.
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14
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Sakurai A, Nakazato T. The prognostic value of the controlling nutritional status score in patients with myelodysplastic syndrome and acute myeloid leukemia with myelodysplasia related changes treated with azacitidine. Leuk Lymphoma 2020; 61:2995-2997. [PMID: 32654579 DOI: 10.1080/10428194.2020.1791847] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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15
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Nishiyama‐Fujita Y, Nakazato T, Kamiya T, Mizuno K, Ito C, Ogura S, Sakurai A, Tanigawa T, Akimoto M, Aisa Y. The geriatric nutritional risk index predicts the early death and survival in patients with myelodysplastic syndrome and acute myeloid leukemia with myelodysplasia‐related changes treated with azacitidine. Hematol Oncol 2020; 38:611-613. [DOI: 10.1002/hon.2760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 11/06/2022]
Affiliation(s)
| | - Tomonori Nakazato
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Takahiro Kamiya
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Kota Mizuno
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Chisako Ito
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Shinji Ogura
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Aki Sakurai
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Tomohiko Tanigawa
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Masahiro Akimoto
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
| | - Yoshinobu Aisa
- Department of Hematology Yokohama Municipal Citizen's Hospital Yokohama Japan
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16
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Ogura S, Nakazato T. The Prognostic Significance of Pretransplant Plasma Fibrinogen Levels in Autologous Hematopoietic Stem Cell Transplantation. Transplant Proc 2020; 53:405-407. [PMID: 32505504 DOI: 10.1016/j.transproceed.2020.02.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 02/07/2020] [Accepted: 02/15/2020] [Indexed: 11/29/2022]
Abstract
Elevated plasma fibrinogen is associated with tumor progression and poor outcomes in several cancers. However, no studies have demonstrated the prognostic value of hyperfibrinogenemia in the setting of autologous hematopoietic stem cell transplantation (ASCT). We retrospectively reviewed 104 patients who were diagnosed with malignant lymphoma (ML) or multiple myeloma (MM) and underwent ASCT in our institution between 2007 and 2018. The patients included 63 men and 41 women with a median age of 58 years (range, 24-70 years). Forty-seven patients were diagnosed with ML, and 57 patients were diagnosed with MM. The median follow-up period was 59 months. The median pretransplant plasma fibrinogen levels were 336 mg/dL in ML patients and 320 mg/dL in MM patients. The Kaplan-Meier method revealed that patients with pretransplant hyperfibrinogenemia had a significantly shorter 5-year overall survival (OS) than those without hyperfibrinogenemia (5-year OS: 34.3% vs 81.0%, P < .001). Among 27 patients with diffuse large B cell lymphoma, patients with pretransplant hyperfibrinogenemia (n = 12) had a significantly shorter OS than those without hyperfibrinogenemia (n = 15) (5-year OS: 40.0% vs 80.2%, P = .006). Among 57 MM patients, there was no significant difference in the 5-year OS between the high-fibrinogen group and the low-fibrinogen group (5-year OS: 77.1% vs 50.4%, P = .17). Our study suggested that pretransplant hyperfibrinogenemia was associated with a poor survival in patients with lymphoma who underwent ASCT. Because our results are based on a small-sized analysis, further large-scale prospective studies are warranted to verify this conclusion.
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Affiliation(s)
- Shinji Ogura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
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17
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Ogura S, Nakazato T. Prognostic significance of the modified Barthel index in elderly patients with diffuse large B-cell lymphoma. Eur J Intern Med 2020; 75:110-111. [PMID: 32044179 DOI: 10.1016/j.ejim.2020.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 01/19/2020] [Accepted: 01/29/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Shinji Ogura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, Japan.
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18
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Kamiya T, Ito C, Fujita Y, Ogura S, Mizuno K, Sakurai A, Aisa Y, Nakazato T. The prognostic value of the controlling nutritional status score in patients with multiple myeloma. Leuk Lymphoma 2020; 61:1894-1900. [PMID: 32306801 DOI: 10.1080/10428194.2020.1749608] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The Controlling Nutritional Status (CONUT) score predicts the prognosis in several tumors. However, its prognostic significance in multiple myeloma (MM) remains unclear. The present study investigated the correlation between the CONUT score and the survival outcomes of MM patients. A total of 178 patients newly diagnosed with MM were retrospectively enrolled. Patients with a high CONUT score (≥5) had a significantly shorter median overall survival (OS) than those with a low CONUT score (≤4) (33 vs. 57 months, p < .001). In a multivariate analysis among patients with International Staging System (ISS) score of ≤2, a high CONUT score was an independent prognostic covariate for the OS after adjusting for other significant factors (hazard ratio 2.364; 95% confidence interval 1.324-4.220, p = .004). Our results suggest that the CONUT score is a predictor of a poor outcome in patients with MM, particularly in low-ISS-score cases.
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Affiliation(s)
- Takahiro Kamiya
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.,Division of Hematology, Keio University School of Medicine, Tokyo, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yuriko Fujita
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Shinji Ogura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Kota Mizuno
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.,Division of Hematology, Keio University School of Medicine, Tokyo, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
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19
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Osada Y, Ito C, Nishiyama-Fujita Y, Ogura S, Sakurai A, Akimoto M, Aisa Y, Nakazato T. Prognostic Impact of ABO Blood Group on Survival in Patients With Malignant Lymphoma. Clinical Lymphoma Myeloma and Leukemia 2020; 20:122-129. [DOI: 10.1016/j.clml.2019.09.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/09/2019] [Accepted: 09/21/2019] [Indexed: 11/26/2022]
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20
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Masuda K, Nakazato T, Nishiyama‐Fujita Y, Ito C, Ogura S, Mizuno K, Kamiya T, Aisa Y, Mori T. Successful treatment with ponatinib for central nervous system relapse of Philadelphia chromosome‐positive B‐cell acute lymphoblastic leukaemia. Intern Med J 2019; 49:1332-1334. [DOI: 10.1111/imj.14451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/30/2019] [Accepted: 06/30/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Kyoko Masuda
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Tomonori Nakazato
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | | | - Chisako Ito
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Shinji Ogura
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Kota Mizuno
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Takahiro Kamiya
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Yoshinobu Aisa
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Takehiko Mori
- Division of HematologyKeio University School of Medicine Tokyo Japan
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21
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Ishikawa M, Iriyama N, Tokuhira M, Takaku T, Sato E, Sugimoto KJ, Nakazato T, Fujita H, Kimura Y, Fujioka I, Komatsu N, Asou N, Kizaki M, Hatta Y, Kawaguchi T. Potential role for second‑generation tyrosine kinase inhibitors in patients with chronic myeloid leukemia harboring additional clonal chromosome abnormalities: A retrospective CML Cooperative Study Group analysis. Oncol Rep 2019; 42:2836-2843. [PMID: 31578586 DOI: 10.3892/or.2019.7339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/29/2019] [Indexed: 11/06/2022] Open
Abstract
Tyrosine kinase inhibitor (TKI) treatment is the standard of care for patients with chronic myeloid leukemia (CML). Even in the imatinib era, the presence of 'clonal chromosomal abnormalities' in the Philadelphia chromosome (CCA/Ph+) at diagnosis reportedly increased the risk of disease progression and predicted shorter survival. However, it remains unclear whether CCA/Ph+ is a poor prognostic marker in the era of new‑generation TKIs. The data of patients with CML in the chronic phase (CP) that were extracted from the CML Cooperative Study Group database were retrospectively analyzed. Of the 328 eligible patients, 33 (10.1%) had CCA/Ph+, including 9 major route and 24 minor route aberrations. The characteristics of patients with and without CCA/Ph+ were similar; however, the proportion of blasts was higher among patients with CCA/Ph+. Notably, the survival rate of patients with CCA/Ph+ was not inferior to that of patients without CCA/Ph+, and there were no differences in responses to TKIs. All 9 patients with major route CCA/Ph+ attained a major molecular response (MMR) with no disease progression, and 8 ultimately achieved a deep molecular response. In particular, the median interval between TKI initiation and achievement of MMR was shorter in patients initially treated with a second‑generation TKI than in those treated with imatinib (5 vs. 10 months). The present retrospective study, thus, revealed favorable treatment outcomes in CML‑CP patients with CCA/Ph+ treated with second‑generation TKIs. The data indicated that administering second‑generation TKIs as first‑line treatments is preferable in CML‑CP patients with CCA/Ph+.
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Affiliation(s)
- Maho Ishikawa
- Department of Hemato‑Oncology, Saitama Medical University International Medical Center, Saitama 350‑1298, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173‑8610, Japan
| | - Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350‑8550, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113‑8431, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo 177‑8521, Japan
| | - Kei-Ji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Chiba 279‑0021, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Kanagawa 240‑8555, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Kanagawa 234‑0054, Japan
| | - Yuta Kimura
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350‑8550, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113‑8431, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo 113‑8431, Japan
| | - Norio Asou
- Department of Hemato‑Oncology, Saitama Medical University International Medical Center, Saitama 350‑1298, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350‑8550, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo 173‑8610, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto 860‑8556, Japan
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Nishiyama‐Fujita Y, Nakazato T, Ito C, Ogura S, Mizuno K, Kamiya T, Aisa Y, Mori T. Rare case of ocular adnexal relapse with mantle cell lymphoma treated with ibrutinib monotherapy. Intern Med J 2019; 49:1187-1189. [DOI: 10.1111/imj.14432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/11/2019] [Accepted: 05/18/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Tomonori Nakazato
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Chisako Ito
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Shinji Ogura
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Kota Mizuno
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Takahiro Kamiya
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Yoshinobu Aisa
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Takehiko Mori
- Division of HematologyKeio University School of Medicine Tokyo Japan
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Iriyama N, Tokuhira M, Sato E, Sugimoto K, Takaku T, Ishikawa M, Nakazato T, Fujita H, Kimura Y, Fujioka I, Asou N, Komatsu N, Kizaki M, Hatta Y, Kawaguchi T. Smoking influences the outcomes of patients receiving tyrosine kinase inhibitors for chronic myeloid leukemia in the chronic phase: A retrospective analysis. Hematol Oncol 2019; 37:323-325. [DOI: 10.1002/hon.2617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 03/29/2019] [Accepted: 03/29/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of MedicineNihon University School of Medicine Tokyo Japan
| | - Michihide Tokuhira
- Department of Hematology, Saitama Medical CenterSaitama Medical University Saitama Japan
| | - Eriko Sato
- Department of HematologyJuntendo University Nerima Hospital Tokyo Japan
| | - Kei‐Ji Sugimoto
- Department of HematologyJuntendo University Urayasu Hospital Urayasu Japan
| | - Tomoiku Takaku
- Department of HematologyJuntendo University School of Medicine Tokyo Japan
| | - Maho Ishikawa
- Department of Hemato‐Oncology, Comprehensive Cancer CenterSaitama Medical University International Medical Center Saitama Japan
| | - Tomonori Nakazato
- Department of HematologyYokohama Municipal Citizen's Hospital Yokohama Japan
| | - Hiroyuki Fujita
- Department of HematologySaiseikai Yokohama Nanbu Hospital Yokohama Japan
| | - Yuta Kimura
- Department of Hematology, Saitama Medical CenterSaitama Medical University Saitama Japan
| | - Isao Fujioka
- Department of HematologyJuntendo University School of Medicine Tokyo Japan
| | - Norio Asou
- Department of Hemato‐Oncology, Comprehensive Cancer CenterSaitama Medical University International Medical Center Saitama Japan
| | - Norio Komatsu
- Department of HematologyJuntendo University School of Medicine Tokyo Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical CenterSaitama Medical University Saitama Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of MedicineNihon University School of Medicine Tokyo Japan
| | - Tatsuya Kawaguchi
- Department of Medical TechnologyKumamoto Health Science University Kumamoto Japan
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Usuki K, Ueda Y, Fujita J, Matsumura I, Aotsuka N, Sekiguchi N, Nakazato T, Iwasaki H, Watanabe A, Sugimoto S, Koga-Yamakawa E, Naoe T, Kizaki M, Heike Y, Miyazaki Y, Akashi K. PS1344 PHASE 1/2 STUDY OF DSP-7888 IN PATIENTS WITH HIGHER-RISK (HR) MYELODYSPLASTIC SYNDROMES (MDS) AFTER FAILURE OF AZACITIDINE (AZA) THERAPY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563656.45660.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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25
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Mizuno K, Nakazato T, Ito C, Fujita Y, Ogura S, Kamiya T, Sakurai A, Aisa Y, Mori T. The prognostic value of geriatric nutritional risk index in patients with follicular lymphoma. Ann Hematol 2019; 98:1777-1779. [PMID: 31041513 DOI: 10.1007/s00277-019-03703-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/21/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Kota Mizuno
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuriko Fujita
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Shinji Ogura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Takahiro Kamiya
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Aki Sakurai
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Takehiko Mori
- Division of Hematology, Keio University School of Medicine, Tokyo, Japan
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26
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Sunami K, Matsumoto M, Fuchida SI, Omoto E, Takamatsu H, Adachi Y, Choi I, Fujishima N, Kiguchi T, Miyamoto T, Maeda A, Suzumiya J, Yamamura R, Nagafuji K, Nakazato T, Kuroda Y, Yujiri T, Takamatsu Y, Harada M, Akashi K. Bortezomib-based strategy with autologous stem cell transplantation for newly diagnosed multiple myeloma: a phase II study by the Japan Study Group for Cell Therapy and Transplantation (JSCT-MM12). Int J Clin Oncol 2019; 24:966-975. [PMID: 30937622 DOI: 10.1007/s10147-019-01436-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/25/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Japan Study Group for Cell Therapy and Transplantation (JSCT) organized a phase II study to evaluate the efficacy and safety of a treatment protocol (JSCT-MM12) for multiple myeloma (MM) patients who were previously untreated and transplantation-eligible. Since bortezomib-based therapy is known to be effective for MM, the protocol is intensified more than the previous protocol (JSCT-MM10) and comprised the subsequent treatments: bortezomib + cyclophosphamide + dexamethasone (VCD) induction; bortezomib + high-dose-melphalan (B-HDM) conditioning with autologous stem cell transplantation (ASCT); bortezomib + thalidomide + dexamethasone (VTD) consolidation; and lenalidomide (LEN) maintenance. METHODS Sixty-four symptomatic patients aged between 20 and 65 years were enrolled for treatment and received three cycles of VCD, followed by cyclophosphamide administration for autologous stem cell harvest and B-HDM/ASCT, and subsequently two cycles of VTD, after that LEN for 1 year. RESULTS Complete response (CR)/stringent CR (sCR) rates for induction, ASCT, consolidation, and maintenance therapies were 20, 39, 52, and 56%, respectively. The grade 3/4 toxicities (≥ 10%) with VCD treatment included neutropenia (27%), anemia (19%), and thrombocytopenia (11%). There was no treatment-related mortality. After median follow-up of 41 months, estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 64% and 88%, respectively. The high-risk group revealed lower CR/sCR, PFS, and OS than the standard-risk group. CONCLUSIONS The study revealed that the treatment protocol consisting of VCD induction, B-HDM/ASCT followed by VTD consolidation, and LEN maintenance could produce highly beneficial responses and favorable tolerability in newly diagnosed MM. However, future study is required for improving treatment in the high-risk group.
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Affiliation(s)
- Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
| | - Morio Matsumoto
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shirai, Shibukawa, Gunma, 377-0280, Japan
| | - Shin-Ichi Fuchida
- Department of Hematology, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center, 27 Shimofusa-cho, Koyama, Kita-ku, Kyoto, 603-8151, Japan
| | - Eijiro Omoto
- Department of Hematology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata, 990-2292, Japan
| | - Hiroyuki Takamatsu
- Department of Hematology/Respiratory Medicine, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Yoko Adachi
- Department of Internal Medicine, Japan Community Health Care Organization Kobe Central Hospital, 2-1-1 Soyama-cho, Kita-ku, Kobe, Hyogo, 651-1145, Japan
| | - Ilsong Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, 3-1-1, Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Naohito Fujishima
- Division of Blood Transfusion, Akita University Hospital, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Toru Kiguchi
- Department of Hematology, Chugoku Central Hospital, 148-13 Kamiiwanari, Miyuki-cho, Fukuyama, Hiroshima, 720-0001, Japan
| | - Toshihiro Miyamoto
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akio Maeda
- Department of Hematology, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, Hyogo, 673-8558, Japan
| | - Junji Suzumiya
- Innovative Cancer Center/Oncology-Hematology, Shimane University Hospital, 89-1 Enya, Izumo, Shimane, 693-8501, Japan
| | - Ryosuke Yamamura
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, 2-10-39 Shibata, Kitaku, Osaka, 530-0012, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, 67 Asahicho, Kurume, Fukuoka, 830-0011, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, Kanagawa, 240-8555, Japan
| | - Yoshiaki Kuroda
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Toshiaki Yujiri
- Third Department of Internal Medicine, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0006, Japan
| | - Mine Harada
- Karatsu Higashimatsuura Medical Association, 2566-11 Chiyodacho, Karatsu, Saga, 847-0041, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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27
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Kamiya T, Nakazato T. The prognostic value of circulating myeloblasts in patients with myelodysplastic syndromes treated with azacitidine. Med Oncol 2019; 36:25. [DOI: 10.1007/s12032-019-1247-3] [Citation(s) in RCA: 1] [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: 11/17/2018] [Accepted: 01/21/2019] [Indexed: 11/29/2022]
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Sakurai M, Watanuki S, Kato J, Hashida R, Yamane Y, Karigane D, Mitsuhashi T, Murata M, Ueno H, Nakazato T, Okamoto S, Mori T. Very Late Relapse of Acute Promyelocytic Leukemia 17 Years after Continuous Remission. Intern Med 2018; 57:3299-3302. [PMID: 29984744 PMCID: PMC6287980 DOI: 10.2169/internalmedicine.0807-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/26/2022] Open
Abstract
The prognosis of acute promyelocytic leukemia (APL) has been improved by the combination of all-trans retinoic acid (ATRA) with chemotherapy. Nonetheless, relapse occurs in a certain proportion of patients, mostly within three to four years after treatment. We herein report a patient treated with ATRA and chemotherapy achieving remission who relapsed approximately 17 years after the treatment. A literature review identified 5 additional reported cases of APL relapse after more than 10 years. None of them presented with generally established risk factors for relapse, such as a high leukocyte count. The potential for late relapse of APL occurring more than 10 years after treatment should be recognized.
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Affiliation(s)
- Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Shintaro Watanuki
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Risa Hashida
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Yusuke Yamane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Daiki Karigane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | | | - Mitsuru Murata
- Laboratory Medicine, Keio University School of Medicine, Japan
| | - Hironori Ueno
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
- Division of Hematology, Department of Internal Medicine, National Hospital Organization, Tokyo Medical Center, Japan
| | - Tomonori Nakazato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Japan
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Iriyama N, Sugimoto KJ, Sato E, Takaku T, Tokuhira M, Nakazato T, Ishikawa M, Fujita H, Fujioka I, Kimura Y, Asou N, Kizaki M, Komatsu N, Hatta Y, Kawaguchi T. Comparison of the clinical outcomes of nilotinib and dasatinib therapies in newly diagnosed patients in the chronic phase of chronic myeloid leukemia: a retrospective analysis. Med Oncol 2018; 35:142. [PMID: 30194496 DOI: 10.1007/s12032-018-1203-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 09/05/2018] [Indexed: 12/14/2022]
Abstract
Treatment with a tyrosine kinase inhibitor (TKI) is the standard of care for patients with chronic myeloid leukemia (CML). The new-generation TKIs, nilotinib and dasatinib, are found to have deeper and faster treatment response rates compared to imatinib in the first-line setting. However, a direct comparison between nilotinib and dasatinib has never been reported previously. Our study aims to compare the outcomes and molecular responses achieved following the first-line use of these two agents in patients with CML-CP. The database of the CML Cooperative Study Group was reviewed and patients with CML in the chronic phase (CP) who were given nilotinib or dasatinib as first-line therapy were identified. Out of 361 patients with CML-CP enrolled in our database, 58 and 63 had been treated with conventional doses of nilotinib (300 mg twice daily) and dasatinib (100 mg once daily), respectively, as first-line therapy. The patient demographics did not show significant differences between the groups. The event-free survival rates did not differ between these two groups. The major molecular response (MMR) and the deep molecular response (DMR) rates by 6, 12, 18, and 24 months did not differ between groups. Among the three scoring systems, only the Hasford score could predict the achievement of DMR, and all of them failed to predict the achievement of MMR in the entire cohort. Our data suggest that both nilotinib and dasatinib have comparable efficacies and promising outcomes.
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Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Kei-Ji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Eriko Sato
- Department of Hematology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Michihide Tokuhira
- Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuta Kimura
- Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Asou
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masahiro Kizaki
- Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Tatsuya Kawaguchi
- Department of Medical Technology, Kumamoto Health Science University, Kumamoto, Japan
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Camacho G, Nakazato T. Looking at the smartphone screen for a prolonged time is associated with chronic neck pain, specially in young adults. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.244] [Citation(s) in RCA: 1] [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] [Indexed: 10/28/2022]
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31
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Camacho G, Nakazato T. Chronic neck pain and its relationship with stress symptoms: Regular physical exercise could be a protective factor? Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.240] [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: 10/28/2022]
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32
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Fujita Y, Nakazato T, Ito C, Masuda K, Osada Y, Aisa Y, Mori T. A rare case of an acquired factor V inhibitor in a patient with myelodysplastic syndrome during azacitidine treatment. Ann Hematol 2018; 97:2009-2010. [PMID: 29713749 DOI: 10.1007/s00277-018-3348-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/23/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Yuriko Fujita
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Kyoko Masuda
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuki Osada
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Takehiko Mori
- Division of Hematology, Keio University School of Medicine, Tokyo, Japan
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Nakazato T, Takanashi S, Hirano M, Ito C, Fujita Y, Osada Y, Aisa Y, Mori T. Brentuximab vedotin is effective for rheumatoid arthritis in a patient with relapsed methotrexate-associated Hodgkin lymphoma. Ann Hematol 2018; 97:1489-1491. [PMID: 29455236 DOI: 10.1007/s00277-018-3279-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 02/10/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
| | - Satoshi Takanashi
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.,Department of Rheumatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Motoharu Hirano
- Department of Rheumatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuriko Fujita
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuki Osada
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Takehiko Mori
- Division of Hematology, Keio University School of Medicine, Tokyo, Japan
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Tokuhira M, Kimura Y, Sugimoto K, Nakazato T, Ishikawa M, Fujioka I, Takaku T, Iriyama N, Sato E, Fujita H, Hatta Y, Komatsu N, Asou N, Kizaki M, Kawaguchi T. Efficacy and safety of nilotinib therapy in patients with newly diagnosed chronic myeloid leukemia in the chronic phase. Med Oncol 2018; 35:38. [PMID: 29442179 DOI: 10.1007/s12032-018-1093-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 01/31/2018] [Indexed: 01/28/2023]
Abstract
ABL1-tyrosine kinase inhibitors (TKIs) have led to dramatic changes in treatment strategies for chronic myeloid leukemia in the chronic phase (CML-CP). However, clinical studies have highlighted increasing numbers of adverse events (AE) with TKIs. Although TKI modification plays a key role in AE management, this process is poorly understood, particularly in terms of the TKI nilotinib. In the present study, we retrospectively analyzed the records of 70 patients with newly diagnosed (ND)-CML-CP who were treated with nilotinib to investigate the drug potency of nilotinib and treatment management. During a median observation period of 3.4 years, 76% of patients continued nilotinib as a first-line treatment. The 1-year and overall major molecular response (MMR) rates and the overall molecular response (MR) 4.5 rate for all patients receiving first-line nilotinib therapy were 70, 84.2, and 50%, respectively. No case progressed to the accelerated or blast phase during the study. To avoid AEs during the early phase, nilotinib doses were reduced to < 600 mg/day in a third of patients (Reduced group); these patients experienced better therapeutic efficacy and a lower rate of AEs relative to those in Standard group (300 mg twice daily). Ten patients who received < 600 mg/day of nilotinib throughout the study had a 1-year MMR rate and overall MR4.5 rate of 90 and 60%, respectively. In summary, our findings indicate that careful management, including dose reduction, can yield better outcomes in patients with ND-CML-CP.
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Affiliation(s)
- Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
| | - Yuta Kimura
- Department of Hematology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Keiji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Eriko Sato
- Division of Hematology, Department of Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Asou
- Department of Hemato-Oncology, Comprehensive Cancer Center, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
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Abstract
Most patients diagnosed with acute myeloid leukemia (AML) are over the age of 60 years yet optimal treatment strategies for older adults remain unclear. Old age is associated with increased risk of treatment-related toxicity and worse survival compared to younger adults. It is widely recognized that chronological age does not capture the heterogeneous physiological and functional status of older adults. Thus, it is critically important to evaluate both disease-related (adverse cytogenetics, unfavorable gene mutations, secondary AML, etc.) and patient-related (age, PS, comorbidity, ADL, physical function, cognitive function, nutritional status, social situation, etc.) factors before making the treatment decision for elderly AML patients. The geriatric assessment (GA) can identify problems that may interfere with cancer treatment and predict chemotherapy toxicity and survival. Identification of the most efficient GA screening tools for detecting multiple patient-related factors is necessary to make optimal treatment decision and improve the outcomes for elderly AML patients.
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Kamijima S, Sekiya A, Takata M, Nakano H, Murakami M, Nakazato T, Asakura H, Morishita E. Gene analysis of inherited antithrombin deficiency and functional analysis of abnormal antithrombin protein (N87D). Int J Hematol 2017; 107:490-494. [PMID: 29071478 DOI: 10.1007/s12185-017-2352-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/27/2017] [Accepted: 10/09/2017] [Indexed: 11/24/2022]
Abstract
Inherited antithrombin (AT) deficiency is one of the most clinically significant forms of congenital thrombophilia and follows an autosomal dominant mode of inheritance. We analyzed SERPINC1 in a patient who developed deep-vein thrombosis and low AT activity during pregnancy, and identified a novel missense mutation c.259A>G (p.Asn87Asp; N87D). Surprisingly, analysis of the parents' DNA showed that they did not possess this mutant, and thus, it may have been due to a de novo mutation. We also expressed this mutant AT protein in COS-1 cells and compared its intracellular localization and intracellular and extracellular antigen levels with that of wild-type AT. The expression experiment did not reveal a significant difference in the antigen levels of the mutant and wild-type AT in the cell lysate, but the mutant AT antigen level was markedly lower than that of its wild-type counterpart in the COS-1 cell supernatant. Immunofluorescence did not indicate any difference between the mutant and wild-type AT in terms of cytoplasmic localization of fluorescence signals. Our findings suggest that the patient's AT deficiency may have been caused by impaired extracellular secretion of mutant AT protein p.Asn87Asp.
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Affiliation(s)
- Sayaka Kamijima
- Division of Health Sciences, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Akiko Sekiya
- Division of Health Sciences, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Mao Takata
- Department of Central Clinical Laboratory, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan
| | - Haruka Nakano
- Division of Health Sciences, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Morika Murakami
- Division of Health Sciences, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okasawa, Hotogaya, Yokohama, Kanagawa, 240-8555, Japan
| | - Hidesaku Asakura
- Department of Internal Medicine (III), Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Eriko Morishita
- Division of Health Sciences, Kanazawa University Graduate School of Medical Science, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan. .,Department of Internal Medicine (III), Kanazawa University School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
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37
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Sakurai M, Toyama T, Kikuchi T, Kato J, Shimizu T, Koda Y, Karigane D, Yamane Y, Abe R, Yamazaki R, Nakazato T, Nakahara T, Jinzaki M, Okamoto S, Mori T. Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography with gallium-67 scintigraphy in the initial clinical staging of diffuse large B-cell lymphoma. Int J Hematol 2017; 107:194-200. [PMID: 28994017 DOI: 10.1007/s12185-017-2337-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been recommended as a complementary tool for the staging of various malignancies, including malignant lymphoma. PET findings often shift patients to higher stages and may affect treatment outcomes. In this study, we retrospectively compared staging and treatment outcomes of newly diagnosed diffuse large B-cell lymphoma (DLBCL) assessed by PET (n = 153) or gallium-67 scintigraphy (Ga) (n = 95). In total, Ga upstaged two (2.1%) of 95 patients, whereas PET upstaged 13 (8.5%) of 153 patients. Bone/bone marrow (15 vs. 4%, P = 0.01) and muscle lesion (5 vs. 0%, P = 0.03) were identified more frequently in the PET group than in the Ga group. The estimated 3-year overall and progression-free survival rates did not differ significantly in the two groups at any stage. However, patients with stage III disease tended to have better progression-free survival in the PET group than in the Ga group [92.3 (95% CI 56.6-98.9%) vs. 58.3% (95% CI 27.0-80.1%), P = 0.086]. These results suggest that PET has a greater potential in detecting musculoskeletal lesions of DLBCL as extranodal lesions than Ga, and may contribute to the optimal staging.
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Affiliation(s)
- Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takaaki Toyama
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Taku Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takayuki Shimizu
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuya Koda
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Daiki Karigane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yusuke Yamane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryohei Abe
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Rie Yamazaki
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomonori Nakazato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tadaki Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Sugano K, Yoshino H, Nakazato T, Imai H. Half of the patients with amyotrophic lateral sclerosis after ventilation had apparent frontotemporal lobar atrophy: A Quantitative survey of 92 patients by CT imaging. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Kanai K, Yokota T, Shibuya K, Nakazato T, Kanouchi T, Iwai Y, Oyama G, Shimo Y, Shimizu T, Hattori N, Kuwabara S. Increased motor axonal persistent sodium currents is associated with rapid regional spreading in amyotrophic lateral sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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40
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Maruyama D, Nagai H, Maeda Y, Nakane T, Shimoyama T, Nakazato T, Sakai R, Ishikawa T, Izutsu K, Ueda R, Tobinai K. Phase I/II study of pralatrexate in Japanese patients with relapsed or refractory peripheral T-cell lymphoma. Cancer Sci 2017; 108:2061-2068. [PMID: 28771889 PMCID: PMC5623731 DOI: 10.1111/cas.13340] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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] [Received: 05/19/2017] [Revised: 07/03/2017] [Accepted: 07/31/2017] [Indexed: 12/02/2022] Open
Abstract
Pralatrexate is a novel antifolate approved in the USA for the treatment of relapsed or refractory peripheral T‐cell lymphoma. To assess its safety, efficacy, and pharmacokinetics in Japanese patients with this disease, we undertook a phase I/II study. Pralatrexate was given i.v. weekly for 6 weeks of a 7‐week cycle. All patients received concurrent vitamin B12 and folic acid. In phase I, three patients received pralatrexate 30 mg/m2 and none experienced a dose‐limiting toxicity. In phase II, we treated 22 additional patients with that dose. The median number of treatment cycles was 1 (range, 1–9). Nine of 20 evaluable patients (45%) achieved an objective response by central review, including two complete responses. All responses occurred within the first treatment cycle. At the time of data cut‐off, median progression‐free survival was 150 days. Median overall survival was not reached. In the total population, the most commonly reported adverse events included mucositis (88%), thrombocytopenia (68%), liver function test abnormality (64%), anemia (60%), and lymphopenia (56%). Grade 3/4 adverse events included lymphopenia (52%), thrombocytopenia (40%), leukopenia (28%), neutropenia (24%), anemia (20%), and mucositis (20%). The pharmacokinetic profile showed no drug accumulation with repeat dosing. These results indicate that pralatrexate is generally well tolerated and effective in Japanese patients with relapsed or refractory peripheral T‐cell lymphoma. This trial was registered with ClinicalTrials.gov (NCT02013362).
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Affiliation(s)
- Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Takahiko Nakane
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tatsu Shimoyama
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Rika Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan.,Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Ryuzo Ueda
- Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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Sato E, Iriyama N, Tokuhira M, Takaku T, Ishikawa M, Nakazato T, Sugimoto KJ, Fujita H, Fujioka I, Asou N, Komatsu N, Kizaki M, Hatta Y, Kawaguchi T. Introduction of second-generation tyrosine kinase inhibitors may reduce the prognostic impact of high-risk patients, according to the European treatment and outcome study (EUTOS) score. Leuk Lymphoma 2017; 59:1105-1112. [PMID: 28838287 DOI: 10.1080/10428194.2017.1365858] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Our study aims to highlight the critical role of the introduction of second generation tyrosine kinase inhibitors (2nd TKIs) on the prognosis of patients with chronic myeloid leukemia (CML) in chronic phase (CML-CP), as determined by European Treatment and Outcome Study (EUTOS) system. Patients who were diagnosed with CML-CP before March 2009 were classified into the imatinib group, and those diagnosed after April 2009 were classified into the 2nd TKI group. EUTOS high-risk patients exhibited significantly worse outcomes in terms of event-free survival (EFS), progression-free survival (PFS), and CML-associated death than those considered to be low-risk. Risk stratification by EUTOS score was predictive of risk-associated clinical outcomes in patients classified into the imatinib group; however, the EUTOS score failed to predict the outcomes of patients classified into the 2nd TKI group. Our data suggest that the introduction of 2nd TKIs might have improved treatment outcomes, particularly in EUTOS high-risk patients.
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Affiliation(s)
- Eriko Sato
- a Department of Medicine, Division of Hematology , Juntendo University Nerima Hospital , Tokyo , Japan
| | - Noriyoshi Iriyama
- b Division of Hematology and Rheumatology, Department of Medicine , Nihon University School of Medicine , Tokyo , Japan
| | - Michihide Tokuhira
- c Department of Hematology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Tomoiku Takaku
- d Department of Hematology , Juntendo University School of Medicine , Tokyo , Japan
| | - Maho Ishikawa
- e Department of Hemato-Oncology , Saitama Medical University International Medical Center , Saitama , Japan
| | - Tomonori Nakazato
- f Department of Hematology , Yokohama Municipal Citizen's Hospital , Yokohama , Japan
| | - Kei-Ji Sugimoto
- g Department of Hematology , Juntendo University Urayasu Hospital , Urayasu , Japan
| | - Hiroyuki Fujita
- h Department of Hematology , Saiseikai Yokohama Nanbu Hospital , Yokohama , Japan
| | - Isao Fujioka
- d Department of Hematology , Juntendo University School of Medicine , Tokyo , Japan
| | - Norio Asou
- e Department of Hemato-Oncology , Saitama Medical University International Medical Center , Saitama , Japan
| | - Norio Komatsu
- d Department of Hematology , Juntendo University School of Medicine , Tokyo , Japan
| | - Masahiro Kizaki
- c Department of Hematology , Saitama Medical Center, Saitama Medical University , Saitama , Japan
| | - Yoshihiro Hatta
- b Division of Hematology and Rheumatology, Department of Medicine , Nihon University School of Medicine , Tokyo , Japan
| | - Tatsuya Kawaguchi
- i Department of Hematology and Infectious Diseases , Kumamoto University Hospital , Kumamoto , Japan
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Takanashi S, Aisa Y, Ito C, Arakaki H, Osada Y, Amano Y, Hirano M, Nakazato T. Clinical characteristics of methotrexate-associated lymphoproliferative disorders: relationship between absolute lymphocyte count recovery and spontaneous regression. Rheumatol Int 2017; 37:1629-1633. [PMID: 28676912 DOI: 10.1007/s00296-017-3764-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/28/2017] [Indexed: 12/19/2022]
Abstract
Several reports have shown that patients with rheumatoid arthritis (RA) are at increased risk of developing lymphoproliferative disorders (LPD). Methotrexate (MTX) has been recognized as a major cause of LPD. Sometimes spontaneous regression (SR) occurs after withdrawal of MTX. Recent studies suggest that the early recovery of the absolute lymphocyte count (ALC) after withdrawal of MTX is associated with the spontaneous regression of MTX-LPD. We retrospectively analyzed 26 patients with MTX-LPD to identify predictive factors for spontaneous regression. The spontaneous regression after withdrawal of MTX occurred in 13 of 26 (50%) cases. We assessed the ALC at the time of MTX cessation and 1 month after cessation in 23 evaluable cases. The spontaneous regression was observed in 3 of 11 in the ALC recovery group (27%) and in 8 of the 12 in the ALC non-recovery group (67%). Thus, we could not detect any relationship between the recovery of ALC after withdrawal of MTX and the spontaneous regression. The patients in the ALC recovery group had a poorer prognosis than those in the ALC non-recovery group (2-year overall survival: 65.6 vs. 100%, p = 0.05). According to these results, the recovery of the ALC might not be useful as a predictor of the spontaneous regression. Furthermore, the existence of extranodal sites and advanced-stage were associated with non-SR. It is suspected that MTX-LPD patients with high disease activity at the time of their diagnosis might have little hope of spontaneous regression. This result indicated the importance of the early detection of MTX-LPD.
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Affiliation(s)
- Satoshi Takanashi
- Department of Rheumatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Chisako Ito
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Hideki Arakaki
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuki Osada
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan
| | - Yuichiro Amano
- Department of Rheumatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Motoharu Hirano
- Department of Rheumatology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, 56 Okazawacho, Hodogaya-ku, Yokohama, 240-8555, Japan.
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Saburi M, Kohashi S, Kato J, Koda Y, Sakurai M, Toyama T, Kikuchi T, Karigane D, Yuda S, Yamane Y, Hashida R, Abe R, Nakazato T, Hirahashi J, Ogata M, Okamoto S, Mori T. Effects of calcineurin inhibitors on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation. Int J Hematol 2017; 106:431-435. [PMID: 28516402 DOI: 10.1007/s12185-017-2253-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
Abstract
Calcineurin inhibitors (CIs) such as cyclosporine A (CSA) and tacrolimus often cause renal dysfunction, resulting in increased serum creatinine, hyperkalemia, and hyperuricemia. However, the effects of CIs on sodium excretion have not been fully elucidated. We retrospectively evaluated the effects of CI administration on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation (HSCT). Fifty consecutive recipients each of allogeneic HSCT receiving either CSA or tacrolimus (100 patients in total) with available data for weekly fractional excretion of sodium (FENa) for a 4-week period after transplantation were enrolled in this retrospective analysis. No significant differences in patient characteristics were observed between CSA and tacrolimus groups except for the type of donor. FENa was significantly higher at the 3rd (1.25 ± 0.80) and 4th weeks (1.53 ± 1.06) after transplantation as compared with that at the 1st week (0.93 ± 0.51; P < 0.01, P < 0.001, respectively) in the tacrolimus group, but not at any time point in the CSA group. In addition, FENa was significantly higher in the tacrolimus group than the CSA group at the 4th week (1.53 ± 1.06 vs. 1.13 ± 0.80; P < 0.05). These results suggest that tacrolimus increases sodium excretion after allogeneic HSCT, and that this effect is minimal with CSA.
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Affiliation(s)
- Masuho Saburi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - Sumiko Kohashi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuya Koda
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masatoshi Sakurai
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takaaki Toyama
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Taku Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Daiki Karigane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Sayako Yuda
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yusuke Yamane
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Risa Hashida
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryohei Abe
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomonori Nakazato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Junichi Hirahashi
- Department of General Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masao Ogata
- Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Iriyama N, Tokuhira M, Takaku T, Sato E, Ishikawa M, Nakazato T, Sugimoto KJ, Fujita H, Fujioka I, Hatta Y, Kizaki M, Komatsu N, Asou N, Kawaguchi T. Incidences and outcomes of therapy-related chronic myeloid leukemia in the era of tyrosine kinase inhibitors: Surveillance of the CML Cooperative Study Group. Leuk Res 2017; 54:55-58. [PMID: 28109974 DOI: 10.1016/j.leukres.2017.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/24/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023]
Abstract
This study was performed to investigate the features and outcome of patients with therapy-related chronic myeloid leukemia (TR-CML) who were treated with tyrosine kinase inhibitors (TKIs). The analysis included 308 patients with CML in the chronic phase who were extracted from the CML Cooperative Study Group database. Of these patients, 11 (3.6%) were identified as having TR-CML. No differences in age, sex, white blood cell count, hemoglobin level, platelet count, or European Treatment and Outcome Study risk were observed between patients with TR-CML vs. de novo CML. However, the responses of TR-CML patients to TKIs (6, 3, and 2 received imatinib, nilotinib, and dasatinib, respectively) were excellent; all achieved major or deep molecular response. Furthermore, the outcomes of TR-CML patients were relatively favorable; the 3-year event-free survival rates in the TR-CML and de novo CML patients were 100% and 94%, respectively; the difference was not statistically significant. In conclusion, our study showed that TR-CML patients could achieve a good clinical course with TKI therapy. Detailed investigations of TR-CML may provide new insights into CML biology.
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Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Michihide Tokuhira
- Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomoiku Takaku
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Eriko Sato
- Division of Hematology, Department of Medicine, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Maho Ishikawa
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Kei-Ji Sugimoto
- Department of Hematology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Isao Fujioka
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Kizaki
- Departments of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Asou
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tatsuya Kawaguchi
- Department of Hematology and Infectious Diseases, Kumamoto University Hospital, Kumamoto, Japan
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Kikuchi T, Mori T, Koda Y, Kohashi S, Kato J, Toyama T, Nakazato T, Aisa Y, Shimizu T, Okamoto S. Outcome of reduced-intensity allogeneic hematopoietic stem cell transplantation for multiple myeloma. Int J Hematol 2015; 102:670-7. [PMID: 26440970 DOI: 10.1007/s12185-015-1873-2] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/09/2015] [Accepted: 09/25/2015] [Indexed: 10/23/2022]
Abstract
We retrospectively evaluated single-institute outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with a reduced-intensity conditioning regimen consisting of fludarabine (125 mg/m²) and melphalan (140 mg/m²) for multiple myeloma. Twenty-three patients (median age: 46 years) were evaluated. Stem cell sources were bone marrow or peripheral blood stem cells from siblings (n = 4) and bone marrow from unrelated donors (n = 19). For graft-versus-host disease prophylaxis, cyclosporine A or tacrolimus with short-term methotrexate was given. Disease status at time of transplant was complete response in four patients, very good partial or partial response in 13, and stable or progressive disease in six. The median follow-up period of 7 survivors at analysis was 73.2 months (range 46.0-158.9 months). During the follow-up, disease recurrence or progression was observed in 21 patients, and was primary causes of death in 88% of the patients. The 5-year overall survival and progression-free survival rates were 38.6% (95% CI 19.3-57.7%) and 5.4% (95% CI 0.4-21.6%), respectively. Although allo-HSCT with this conditioning could be safely performed, further refinement of this approach aiming at more effective eradication of myeloma cells is clearly warranted.
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Affiliation(s)
- Taku Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Yuya Koda
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Sumiko Kohashi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Jun Kato
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takaaki Toyama
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Yoshinobu Aisa
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Takayuki Shimizu
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Hasegawa T, Aisa Y, Shimazaki K, Ito C, Nakazato T. Cytomegalovirus reactivation in patients with multiple myeloma. Eur J Haematol 2015; 96:78-82. [DOI: 10.1111/ejh.12551] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Tetsuo Hasegawa
- Department of Hematology; Yokohama Municipal Citizen's Hospital; Yokohama Japan
| | - Yoshinobu Aisa
- Department of Hematology; Yokohama Municipal Citizen's Hospital; Yokohama Japan
| | - Kengo Shimazaki
- Department of Hematology; Yokohama Municipal Citizen's Hospital; Yokohama Japan
| | - Chisako Ito
- Department of Hematology; Yokohama Municipal Citizen's Hospital; Yokohama Japan
| | - Tomonori Nakazato
- Department of Hematology; Yokohama Municipal Citizen's Hospital; Yokohama Japan
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Sadahira K, Sagawa M, Nakazato T, Uchida H, Ikeda Y, Okamoto S, Nakajima H, Kizaki M. Gossypol induces apoptosis in multiple myeloma cells by inhibition of interleukin-6 signaling and Bcl-2/Mcl-1 pathway. Int J Oncol 2014; 45:2278-86. [PMID: 25231749 PMCID: PMC4215583 DOI: 10.3892/ijo.2014.2652] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 08/22/2014] [Indexed: 12/02/2022] Open
Abstract
Multiple myeloma (MM) is a clonal plasma cell disorder affecting the immune system with various systemic symptoms. MM remains incurable even with high dose chemotherapy using conventional drugs, thus necessitating development of novel therapeutic strategies. Gossypol (Gos) is a natural polyphenolic compound extracted from cotton plants, and has been shown to possess anti-neoplastic activity against various tumors. Recent studies have shown that Gos is an inhibitor for Bcl-2 or Bcl-XL acting as BH3 mimetics that interfere interaction between pro-apoptotic BH3-only proteins and Bcl-2/Bcl-XL. Since most of the patients with MM overexpress Bcl-2 protein, we considered Gos might be a promising therapeutic agent for MM. We herein show that Gos efficiently induced apoptosis and inhibited proliferation of the OPM2 MM cell line, in a dose- and time-dependent manner. Gos induced activation of caspase-3 and cytochrome c release from mitochondria, showing mitochondrial dysfunction pathway is operational during apoptosis. Further investigation revealed that phosphorylation of Bcl-2 at serine-70 was attenuated by Gos treatment, while protein levels were not affected. In addition, Mcl-1 was downregulated by Gos. Interestingly, phosphorylation of JAK2, STAT3, ERK1/2 and p38MAPK was inhibited by Gos-treatment, indicating that Gos globally suppressed interleukin-6 (IL-6) signals. Moreover, JAK2 inhibition mimicked the effect of Gos in OPM2 cells including Bcl-2 dephosphorylation and Mcl-1 downregulation. These results demonstrated that Gos induces apoptosis in MM cells not only through displacing BH3-only proteins from Bcl-2, but also through inhibiting IL-6 signaling, which leads to Bcl-2 dephosphorylation and Mcl-1 downregulation.
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Affiliation(s)
- Ken Sadahira
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Morihiko Sagawa
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Hospital, Kanagawa 240-8555, Japan
| | - Hideo Uchida
- Department of Laboratory Medicine, Tokyo Electric Power Company Hospital, Tokyo 160-0016, Japan
| | - Yasuo Ikeda
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hideaki Nakajima
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan
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Nakazato T, Sagawa M, Kizaki M. Triptolide induces apoptotic cell death of multiple myeloma cells via transcriptional repression of Mcl-1. Int J Oncol 2014; 44:1131-8. [PMID: 24481531 DOI: 10.3892/ijo.2014.2280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 12/27/2013] [Indexed: 11/06/2022] Open
Abstract
Triptolide, a diterpenoid trioxide purified from the Chinese herb Tripterygium wilfordii Hook F, has been used as a natural medicine in China for hundreds of years. Several reports have demonstrated that triptolide inhibits the proliferation of cancer cells in vitro and reduces the growth of several types of tumors in vivo. To address the potential of triptolide as a novel therapeutic agent for patients with multiple myeloma, we investigated the effects of triptolide on the induction of apoptosis in human multiple myeloma cells in vitro. Triptolide rapidly induces apoptotic cell death in various myeloma cell lines. Triptolide-induced apoptosis in myeloma cells is associated with the loss of mitochondrial transmembrane potential (∆ψm), the release of cytochrome c and Smac/DIABLO from mitochondria into the cytosol, and the activation of caspase-3 and caspase-9. Furthermore, triptolide induces a rapid decline in the levels of Mcl-1 protein that correlates with caspase activation and induction of apoptosis. Inhibition of Mcl-1 synthesis by triptolide occurs at the level of mRNA transcription and is associated with an inhibition of phosphorylation of RNA polymerase II CTD. These results indicate that Mcl-1 is an important target for triptolide-induced apoptosis in myeloma cells that occurs via inhibition of Mcl-1 mRNA transcription coupled with rapid protein degradation through the ubiquitin-proteasome pathway.
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Affiliation(s)
- Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Kanagawa 240-8550, Japan
| | - Morihiko Sagawa
- Division of Hematology, Keio University School of Medicine, Tokyo 160-0001, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan
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Yanagawa Y, Nagayama M, Hashimoto T, Nakazato T. Spinal cord concussion induced by neck massage. Ann Phys Rehabil Med 2013; 56:687-9. [DOI: 10.1016/j.rehab.2013.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/19/2013] [Accepted: 08/20/2013] [Indexed: 10/26/2022]
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Nakazato T, Rieseberg LH, Wood TE. The genetic basis of speciation in the Giliopsis lineage of Ipomopsis (Polemoniaceae). Heredity (Edinb) 2013; 111:227-37. [PMID: 23652565 DOI: 10.1038/hdy.2013.41] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 03/27/2013] [Accepted: 04/02/2013] [Indexed: 12/29/2022] Open
Abstract
One of the most powerful drivers of speciation in plants is pollinator-mediated disruptive selection, which leads to the divergence of floral traits adapted to the morphology and behavior of different pollinators. Despite the widespread importance of this speciation mechanism, its genetic basis has been explored in only a few groups. Here, we characterize the genetic basis of pollinator-mediated divergence of two species in genus Ipomopsis, I. guttata and I. tenuifolia, using quantitative trait locus (QTL) analyses of floral traits and other variable phenotypes. We detected one to six QTLs per trait, with each QTL generally explaining small to modest amounts of the phenotypic variance of a backcross hybrid population. In contrast, flowering time and anthocyanin abundance (a metric of color variation) were controlled by a few QTLs of relatively large effect. QTLs were strongly clustered within linkage groups, with 26 of 37 QTLs localized to six marker-interval 'hotspots,' all of which harbored pleiotropic QTLs. In contrast to other studies that have examined the genetic basis of pollinator shifts, our results indicate that, in general, mutations of small to modest effect on phenotype were involved. Thus, the evolutionary transition between the distinct pollination modes of I. guttata and I. tenuifolia likely proceeded incrementally, rather than saltationally.
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Affiliation(s)
- T Nakazato
- Department of Biological Sciences, University of Memphis, Memphis, TN, USA
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