1
|
Hidaka M, Inokuchi K, Uoshima N, Takahashi N, Yoshida N, Ota S, Nakamae H, Iwasaki H, Watanabe K, Kosaka Y, Komatsu N, Meguro K, Najima Y, Eto T, Kondo T, Kimura S, Yoshida C, Ishikawa Y, Sawa M, Hata T, Horibe K, Iida H, Shimomura T, Dobashi N, Sugiura I, Makiyama J, Miyagawa N, Sato A, Ito R, Matsumura I, Kanakura Y, Naoe T. Development and evaluation of a rapid one-step high sensitivity real-time quantitative PCR system for minor BCR-ABL (e1a2) test in Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). Jpn J Clin Oncol 2024; 54:153-159. [PMID: 37986553 PMCID: PMC10849185 DOI: 10.1093/jjco/hyad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE Minimal residual disease assessment of BCR-ABL messenger ribonucleic acid levels is crucial in Philadelphia chromosome-positive acute lymphoblastic leukemia for prognosis and treatment planning. However, accurately quantifying minor BCR-ABL transcripts, which comprise 70% of Philadelphia chromosome-positive acute lymphoblastic leukemia cases, lacks a national-approved method. METHODS We developed the "Otsuka" minor BCR-ABLmessenger ribonucleic acid assay kit with exceptional precision (0.00151%). Minor BCR-ABL messenger ribonucleic acid levels were analyzed in 175 adults, 36 children with acute lymphoblastic leukemia and 25 healthy individuals to evaluate the kit's performance. RESULTS The "Otsuka" kit showed high concordance with a commonly used chimeric gene screening method, indicating reliable detection of positive cases. Quantitative results demonstrated a robust correlation with both a laboratory-developed test and a diagnostic research product. The "Otsuka" kit performs comparably or even surpass to conventional products, providing valuable insights into Philadelphia chromosome-positive acute lymphoblastic leukemia pathology. CONCLUSIONS The 'Otsuka" minor BCR-ABL messenger ribonucleic acid assay kit exhibits excellent performance in quantifying minor BCR-ABL transcripts in Philadelphia chromosome-positive acute lymphoblastic leukemia patients. Our results align well with established screening methods and show a strong correlation with laboratory-developed tests and diagnostic research products. The "Otsuka" kit holds great promise as a valuable tool for understanding Philadelphia chromosome-positive acute lymphoblastic leukemia pathology and guiding effective treatment strategies.
Collapse
Affiliation(s)
- Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Naoto Takahashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Nao Yoshida
- Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Aichi Medical Center Nagoya First Hospital, Aichi, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Hokkaido, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Center of Childhood Cancer, Hyogo Prefectural Kobe Children’s Hospital, Hyogo, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kuniaki Meguro
- Department of Hematology, National Hospital Organization Sendai Medical Center, Miyagi, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Hokkaido, Japan
| | - Shinya Kimura
- Department of Hematology, Respiratory Medicine and Oncology, Saga University, Saga, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Aichi, Japan
| | - Tomoko Hata
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Keizo Horibe
- Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Takeshi Shimomura
- Department of Hematology, National Hospital Organization Hiroshimanishi Medical Center, Hiroshima, Japan
| | - Nobuaki Dobashi
- Department of Clinical Oncology and Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Isamu Sugiura
- Department of Hematology and Oncology, Toyohashi Municipal Hospital, Aichi, Japan
| | - Junya Makiyama
- Department of Hematology/Oncology, Institute of Medical Science, The University of Tokyo Hospital, Tokyo, Japan
| | - Naoyuki Miyagawa
- Division of Hematology/Oncology, Kanagawa Children’s Medical Center, Kanagawa, Japan
| | - Asuka Sato
- Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan
| | - Ryuta Ito
- Diagnostic Division, Otsuka Pharmaceutical Co. Ltd., Tokushima, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | | | - Tomoki Naoe
- National Hospital Organization Nagoya Medical Center, Aichi, Japan
| |
Collapse
|
2
|
Ogawa S, Sakamoto T, Matsuoka R, Ishitsuka K, Ogino Y, Sootome A, Makishima K, Yoshida C, Ito Y, Shimizu S, Suyama T, Shinagawa A, Ito T, Obara N, Kusakabe M, Sakata‐Yanagimoto M, Miyazaki Y, Nannya Y, Chiba S. Female and preserved platelet count subgroups of myelodysplastic syndrome patients benefit from standard-dose azacitidine. Cancer Rep (Hoboken) 2024; 7:e1938. [PMID: 38014499 PMCID: PMC10809187 DOI: 10.1002/cnr2.1938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/12/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Hypomethylating agents, including azacytidine (AZA), are standard therapeutics for patients with high-risk myelodysplastic syndromes (MDS), a group of myeloid neoplasms. However, treatment schedules are not unified in real-world practice; in addition to the standard 7-day (standard-dose) schedule, shortened (reduced-dose) schedules are also used. AIMS The aim of this study was to discover the patient group(s) which show differential efficacy between standard-and reduced-dose AZA to MDS. METHODS AND RESULTS The outcome of different AZA doses in a cohort of 151 MDS patients were retrospectively analyzed. Overall survival (OS) was not significantly different between standard- and reduced-dose AZA groups by multivariate analysis. However, an interaction was found between either the sex (female vs. male), the platelet counts (< 40 × 103 /μl vs. ≥ 40 × 103 /μl), or the karyotype risk (< poor vs. ≥ poor) and standard-dose AZA for longer OS. Subgroup analyses revealed better OS with standard- over reduced-dose AZA in female patients (HR, 0.27 [95% CI, 0.090-0.79]; p = 0.011), and those with platelet counts ≥ 40 × 103 /μl (HR, 0.51 [95% CI, 0.26-0.99]; p = 0.041). The union of female and preserved platelet count subgroups also benefited from standard-dose AZA. With this as a test cohort, we next analyzed patients registered in the JALSG MDS212 study, for whom 7-day and 5-day AZA treatment strategies were prospectively compared, as a validation cohort (N = 172). That cohort showed the same tendency as the retrospective results. CONCLUSION We identified the union of female and preserved platelet count subgroups which benefited from standard-dose AZA, imparting crucial information to physicians planning treatment regimens in MDS patients.
Collapse
Affiliation(s)
- Shinichi Ogawa
- Division of HematologyJA Toride General Medical CenterToride, IbarakiJapan
| | - Tatsuhiro Sakamoto
- Department of Hematology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| | - Ryota Matsuoka
- Department of Pathology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| | - Kantaro Ishitsuka
- Graduate School of Comprehensive Human SciencesUniversity of TsukubaTsukuba, IbarakiJapan
| | - Yasuko Ogino
- Division of HematologyJA Toride General Medical CenterToride, IbarakiJapan
| | - Ayano Sootome
- Department of Hematology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| | - Kenichi Makishima
- Graduate School of Comprehensive Human SciencesUniversity of TsukubaTsukuba, IbarakiJapan
| | - Chikashi Yoshida
- Division of HematologyNational Hospital Organization Mito Medical CenterMito, IbarakiJapan
| | - Yufu Ito
- Division of HematologyTsuchiura Kyoudou General HospitalTsuchiura, IbarakiJapan
| | - Seiichi Shimizu
- Division of HematologyTsuchiura Kyoudou General HospitalTsuchiura, IbarakiJapan
| | - Takuya Suyama
- Division of HematologyHitachi General HospitalHitachi, IbarakiJapan
| | | | - Takayoshi Ito
- Division of HematologyJA Toride General Medical CenterToride, IbarakiJapan
| | - Naoshi Obara
- Department of Hematology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| | - Manabu Kusakabe
- Department of Hematology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| | | | - Yasushi Miyazaki
- Department of HematologyAtomic Bomb Disease Institute, Nagasaki UniversityNagasakiJapan
| | - Yasuhito Nannya
- Department of HematologyInstitute of Medical Science, University of TokyoTokyoJapan
| | - Shigeru Chiba
- Department of Hematology, Faculty of MedicineUniversity of TsukubaTsukuba, IbarakiJapan
| |
Collapse
|
3
|
Yoshida C, Yamaguchi H, Doki N, Murai K, Iino M, Hatta Y, Onizuka M, Yokose N, Fujimaki K, Hagihara M, Oshikawa G, Murayama K, Kumagai T, Kimura S, Najima Y, Iriyama N, Tsutsumi I, Oba K, Kojima H, Sakamaki H, Inokuchi K. Importance of TKI treatment duration in treatment-free remission of chronic myeloid leukemia: results of the D-FREE study. Int J Hematol 2023; 117:694-705. [PMID: 36739328 PMCID: PMC10121524 DOI: 10.1007/s12185-023-03549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
Treatment-free remission (TFR) is a new goal for patients with chronic myeloid leukemia in chronic phase (CML-CP) with a sustained deep molecular response (DMR) to treatment with tyrosine kinase inhibitors (TKIs). However, optimal conditions for successful TFR in patients treated with second-generation (2G)-TKIs are not fully defined. In this D-FREE study, treatment discontinuation was attempted in newly diagnosed CML-CP patients treated with the 2G-TKI dasatinib who achieved BCR-ABL1 levels of ≤ 0.0032% (MR4.5) on the international scale (BCR-ABL1IS) and maintained these levels for exactly 1 year. Of the 173 patients who received dasatinib induction therapy for up to 2 years, 123 completed and 60 (48.8%) reached MR 4.5. Among the first 21 patients who maintained MR4.5 for 1 year and discontinued dasatinib, 17 experienced molecular relapse defined as loss of major molecular response (BCR-ABL1IS > 0.1%) confirmed once, or loss of MR4 (BCR-ABL1IS > 0.01%) confirmed on 2 consecutive assessments. The estimated molecular relapse-free survival rate was 16.7% at 12 months. This study was prematurely terminated according to the protocol's safety monitoring criteria. The conclusion was that sustained DMR for just 1 year is insufficient for TFR in CML-CP patients receiving dasatinib for less than a total of 3 years of treatment.
Collapse
Affiliation(s)
- Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193, Japan.
| | | | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kazunori Murai
- Department of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Norio Yokose
- Department of Hematology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | | | - Masao Hagihara
- Department of Hematology, EIJU General Hospital, Taito-Ku, Japan
| | - Gaku Oshikawa
- Japanese Red Cross Musashino Hospital, Musashino, Japan
| | - Kayoko Murayama
- Division of Hematology, Gunma Prefectural Cancer Center, Ohta, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Ome-Shi, Tokyo, Japan
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Ikuyo Tsutsumi
- Department of Hematology, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193, Japan
| | - Koji Oba
- Department of Biostatistics, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kojima
- Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Kasama, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
4
|
Asada N, Ando J, Takada S, Yoshida C, Usuki K, Shinagawa A, Ishizawa K, Miyamoto T, Iida H, Dobashi N, Okubo S, Honda H, Soshin T, Nishimura Y, Tsutsui A, Mukai H, Yamamoto K. Venetoclax plus low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia ineligible for intensive chemotherapy: an expanded access study in Japan. Jpn J Clin Oncol 2023:7103410. [PMID: 37017320 DOI: 10.1093/jjco/hyad027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/15/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND In a Phase 3 international clinical trial (VIALE-C), venetoclax plus low-dose cytarabine improved the response rate and overall survival versus placebo plus low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia who were ineligible for intensive chemotherapy. After the enrollment period of VIALE-C ended, we conducted an expanded access study to provide preapproval access to venetoclax in combination with low-dose cytarabine in Japan. METHODS Previously, untreated patients with acute myeloid leukemia who were ineligible for intensive chemotherapy were enrolled according to the VIALE-C criteria. Patients received venetoclax (600 mg, Days 1-28, 4-day ramp-up in Cycle 1) in 28-day cycles and low-dose cytarabine (20 mg/m2, Days 1-10). All patients took tumor lysis syndrome prophylactic agents and hydration. Safety endpoints were assessed. RESULTS Fourteen patients were enrolled in this study. The median age was 77.5 years (range = 61-84), with 78.6% over 75 years old. The most common grade ≥ 3 treatment-emergent adverse event was neutropenia (57.1%). Febrile neutropenia was the most frequent serious adverse event (21.4%). One patient developed treatment-related acute kidney injury, leading to discontinuation of treatment. Two patients died because of cardiac failure and disease progression that were judged not related to study treatment. No patients developed tumor lysis syndrome. CONCLUSIONS The safety outcomes were similar to those in VIALE-C without new safety signals and were well managed with standard medical care. In clinical practice, more patients with severe background disease are expected, in comparison with in VIALE-C, suggesting that it is important to carefully manage and prevent adverse events.
Collapse
Affiliation(s)
- Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Jun Ando
- Department of Hematology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Satoru Takada
- Leukemia Research Center, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki-machi, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Atsushi Shinagawa
- Department of Internal Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Kenichi Ishizawa
- Department of Internal Medicine III, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Nobuaki Dobashi
- Division of Clinical Oncology/Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Sumiko Okubo
- Department of Hematology and Cell Therapy, AbbVie GK, Osaka, Japan
| | - Hideyuki Honda
- Department of Hematology and Cell Therapy, AbbVie GK, Tokyo, Japan
| | - Tomomi Soshin
- Department of Hematology and Cell Therapy, AbbVie GK, Tokyo, Japan
| | - Yasuko Nishimura
- Department of Hematology and Cell Therapy, AbbVie GK, Tokyo, Japan
| | - Atsuko Tsutsui
- Department of Hematology and Cell Therapy, AbbVie GK, Tokyo, Japan
| | - Harumi Mukai
- Department of Hematology and Cell Therapy, Abbvie Inc., Singapore
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| |
Collapse
|
5
|
Nadon C, Croxen M, Knox N, Tanner J, Zetner A, Yoshida C, Van Domselaar G. Public health genomics capacity assessment: readiness for large-scale pathogen genomic surveillance in Canada’s public health laboratories. BMC Public Health 2022; 22:1817. [PMID: 36153510 PMCID: PMC9508744 DOI: 10.1186/s12889-022-14210-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Along with rapid diagnostic testing, contact tracing, and public health measures, an effective pandemic response incorporates genomics-based surveillance. Large-scale SARS-CoV-2 genome sequencing is a crucial component of the global response to COVID-19. Characterizing the state of genomics readiness among Canada’s public health laboratories was necessary to inform strategic planning and deployment of capacity-building resources in the early stages of the pandemic. Methods We used a qualitative study design and focus group discussions, encompassing both technical and leadership perspectives, to perform an in-depth evaluation of the state of pathogen genomics readiness in Canada. Results We found substantial diversity in the state of readiness for SARS-CoV-2 genomic surveillance across Canada. Despite this variability, we identified common barriers and needs in the areas of specimen access, data flow and sharing, computing infrastructure, and access to highly qualified bioinformatics personnel. Conclusions These findings enable the strategic prioritization and deployment of resources to increase Canada’s ability to perform effective public health genomic surveillance for COVID-19 and prepare for future emerging infectious diseases. They also provide a unique qualitative research model for use in capacity building. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14210-9.
Collapse
|
6
|
Yoshida C, Kondo T, Ito T, Kizaki M, Yamamoto K, Miyamoto T, Morita Y, Eto T, Katsuoka Y, Takezako N, Uoshima N, Imada K, Ando J, Komeno T, Mori A, Ishikawa Y, Satake A, Watanabe J, Kawakami Y, Morita T, Taneike I, Nakayama M, Duan Y, Garbayo Guijarro B, Delgado A, Llamas C, Kiyoi H. Real-world treatment patterns and clinical outcomes in patients with AML in Japan who were ineligible for first-line intensive chemotherapy. Int J Hematol 2022; 116:89-101. [PMID: 35394258 DOI: 10.1007/s12185-022-03334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
Acute myeloid leukemia (AML) predominantly affects elderly adults, and its prognosis worsens with age. Treatment options for patients in Japan ineligible for intensive chemotherapy include cytarabine/aclarubicin ± granulocyte colony-stimulating factor (CA ± G), azacitidine (AZA), low-dose cytarabine (LDAC), targeted therapy, and best supportive care (BSC). The country's aging population and the evolving treatment landscape are contributing to a need to understand treatment pathways and associated outcomes. This retrospective chart review evaluated outcomes in patients across Japan with primary/secondary AML who were ineligible for intensive chemotherapy and began first-line treatment or BSC between 01/01/2015 and 12/31/2018. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS) and healthcare resource utilization (HRU). Of 199 patients (58% > 75 years), 121 received systemic therapy (38 CA ± G, 37 AZA, 7 LDAC, 39 other) and 78 received BSC. Median OS was 5.4, 9.2, 2.2, 3.8, and 2.2 months for CA ± G, AZA, LDAC, other systemic therapy, and BSC, respectively; median PFS was 3.4, 7.7, 1.6, 2.3, and 2.1 months, respectively. HRU rates were uniformly high, with > 80% patients hospitalized in each cohort. The poor clinical outcomes and high HRU among Japanese AML patients who are ineligible for intensive chemotherapy highlight an unmet need for novel therapies.
Collapse
Affiliation(s)
- Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki-machi, Japan.
| | - Takeshi Kondo
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | - Tomoki Ito
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | - Toshihiro Miyamoto
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuyoshi Morita
- Division of Hematology and Rheumatology, Department of Internal Medicine, Kindai University, Osaka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yuna Katsuoka
- Department of Hematology, Sendai Medical Center, National Hospital Organization, Sendai, Japan
| | - Naoki Takezako
- Department of Hematology, Disaster Medical Center, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Kazunori Imada
- Department of Hematology, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Jun Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki-machi, Japan
| | - Akio Mori
- Blood Disorders Center, Aiiku Hospital, Sapporo, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsushi Satake
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Junichi Watanabe
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | | | | | | | | | | | | | | | | | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
7
|
De Paolis L, Bazzi M, Bosnar D, Bragadireanu M, Cargnelli M, Carminati M, Clozza A, Deda G, Del Grande R, Fabbietti L, Fiorini C, Friščić I, Guaraldo C, Iliescu M, Iwasaki M, Khreptak A, King P, Sandri PL, Manti S, Marton J, Miliucci M, Moskal P, Napolitano F, Niedźwiecki S, Ohnishi H, Piscicchia K, Sada Y, Scordo A, Sgaramella F, Shi H, Silarski M, Sirghi D, Sirghi F, Skurzok M, Spallone A, Toho K, Tüchler M, Doce OV, Yoshida C, Zmeskal J, Curceanu C. Trigger rejection factor in the first kaonic helium run with the complete SIDDHARTA-2 setup. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202227000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The SIDDHARTA-2 experiment aims to perform the first measurement of the kaonic deuterium 2p → 1s x-ray transition energy. Such measurement, together with the measurement of kaonic hydrogen 2p → 1s x-ray energy transition performed by the SIDDHARTA experiment in 2011, allows the determination of kaon proton and kaon neutron scattering lengths and represents a fundamental input for the low energies QCD in the strangeness sector theory. The SIDDHARTA-2 experiment is presently installed at the DAΦNE electronpositron collider at the National Laboratories of Frascati, in Italy. In May 2022, the kaonic 4He x-ray transitions measurement was performed by the complete SIDDHARTA-2 setup, by using a gaseous target. The result of this measurement is presented in this paper, with a specific focus on the background rejection performed by the kaon trigger system.
Collapse
|
8
|
Kurita N, Kato T, Nanmoku T, Maruyama Y, Suehara Y, Hattori K, Sakamoto T, Yokoyama Y, Yoshida C, Tsuboi Y, Obara N, Nishikii H, Sakata-Yanagimoto M, Chiba S. [Acute myeloid leukemia harboring NUP98::DDX10]. Rinsho Ketsueki 2022; 63:1397-1401. [PMID: 36351646 DOI: 10.11406/rinketsu.63.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
NUP98::DDX10 is a rare fusion gene associated with acute myeloid leukemia (AML), for which the prognosis and indication for allogeneic hematopoietic stem cell transplantation are unknown. A 48-year-old woman was diagnosed with AML harboring NUP98::DDX10. The results of quantitative RT-PCR of the fusion mRNA as a minimal residual disease (MRD) marker guided the treatment. In August 2019, the patient achieved hematological remission following standard remission induction therapy with idarubicin and cytarabine. After four cycles of consolidation therapies, MRD was detected, and she underwent allogeneic stem cell transplantation in May 2020. As MRD persisted in June, the immunosuppressant was stopped and three cycles of azacitidine were administered. Despite this, a hematological relapse occurred in January 2021 that was resistant to high-dose cytarabine and an investigational agent. She died as a result of the disease's progression. Thus, a second thought should be given to the timing of transplantation, the bridging, and the intervention for relapse after transplantation. The cases must be accumulated.
Collapse
Affiliation(s)
- Naoki Kurita
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Takayasu Kato
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Toru Nanmoku
- Department of Laboratory Medicine, University of Tsukuba Hospital
| | - Yumiko Maruyama
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Yasuhito Suehara
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Keiichiro Hattori
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | | | - Yasuhisa Yokoyama
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center
| | - Yuri Tsuboi
- Department of Hematology, National Hospital Organization Mito Medical Center
| | - Naoshi Obara
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Hidekazu Nishikii
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | | | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| |
Collapse
|
9
|
Kamura Y, Tsutsumi I, Miura Y, Seki M, Komeno T, Ohtani H, Inadome Y, Yoshida C. Primary Intramuscular Classic Hodgkin Lymphoma: A Rare Case Report. Intern Med 2021; 60:3789-3793. [PMID: 34092739 PMCID: PMC8710373 DOI: 10.2169/internalmedicine.7524-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hodgkin lymphoma (HL) is a hematologic malignancy that typically presents with lymphadenopathy. We herein report a patient with HL who presented with an intramuscular mass that required differentiation from an inflammatory lesion. A 65-year-old Japanese woman was referred to our hospital with a chief complaint of chronic and expanding tumor in her left thigh. By surgical resection, she was diagnosed with primary intramuscular, Epstein-Barr virus-positive, mixed-cellularity classic HL. She received combined modality therapy, resulting in a complete response. Primary intramuscular classic HL is extremely rare. It should be listed as a differential diagnosis of intramuscular tumors.
Collapse
Affiliation(s)
- Yuya Kamura
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | - Ikuyo Tsutsumi
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | - Yukiko Miura
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | - Masanori Seki
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | - Haruo Ohtani
- Department of Pathology, Mito Saiseikai General Hospital, Japan
| | - Yukinori Inadome
- Department of Pathology, National Hospital Organization Mito Medical Center, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| |
Collapse
|
10
|
Murai K, Ureshino H, Kumagai T, Tanaka H, Nishiwaki K, Wakita S, Inokuchi K, Fukushima T, Yoshida C, Uoshima N, Kiguchi T, Mita M, Aoki J, Kimura S, Karimata K, Usuki K, Shimono J, Chinen Y, Kuroda J, Matsuda Y, Nakao K, Ono T, Fujimaki K, Shibayama H, Mizumoto C, Takeoka T, Io K, Kondo T, Miura M, Minami Y, Ikezoe T, Imagawa J, Takamori A, Kawaguchi A, Sakamoto J, Kimura S. Low-dose dasatinib in older patients with chronic myeloid leukaemia in chronic phase (DAVLEC): a single-arm, multicentre, phase 2 trial. The Lancet Haematology 2021; 8:e902-e911. [DOI: 10.1016/s2352-3026(21)00333-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022]
|
11
|
Yamamoto K, Shinagawa A, DiNardo CD, Pratz KW, Ishizawa K, Miyamoto T, Komatsu N, Nakashima Y, Yoshida C, Fukuhara N, Usuki K, Yamauchi T, Asada N, Asou N, Choi I, Miyazaki Y, Honda H, Okubo S, Kurokawa M, Zhou Y, Zha J, Potluri J, Matsumura I. Venetoclax plus azacitidine in Japanese patients with untreated acute myeloid leukemia ineligible for intensive chemotherapy. Jpn J Clin Oncol 2021; 52:29-38. [PMID: 34739075 PMCID: PMC9242001 DOI: 10.1093/jjco/hyab170] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023] Open
Abstract
Background The phase 3 VIALE-A trial (NCT02993523) reported that venetoclax-azacitidine significantly prolonged overall survival compared with placebo-azacitidine in patients with newly diagnosed acute myeloid leukemia ineligible for intensive chemotherapy. Herein, efficacy and safety of venetoclax-azacitidine are analyzed in the Japanese subgroup of VIALE-A patients. Methods Eligible Japanese patients were randomized 2:1 to venetoclax-azacitidine (N = 24) or placebo-azacitidine (N = 13). Primary endpoints for Japan were overall survival and complete response (CR) + CR with incomplete hematologic recovery (CRi). Venetoclax (target dose 400 mg) was given orally once daily. Azacitidine (75 mg/m2) was administered subcutaneously or intravenously on Days 1–7 of each 28-day cycle. Results Median follow-up was 16.3 months (range, 1.0–20.3). Median overall survival was not reached with venetoclax-azacitidine (hazard ratio 0.409 and 95% confidence interval: 0.151, 1.109); overall survival estimate was higher with venetoclax-azacitidine than placebo-azacitidine at 12 (67 and 46%) and 18 months (57 and 31%), respectively. CR and CRi rates were 67% with venetoclax-azacitidine and 15% with placebo-azacitidine. Most common any-grade adverse events were febrile neutropenia (79 and 39%), thrombocytopenia (54 and 77%), constipation (54 and 54%) and decreased appetite (54 and 38%) in the venetoclax-azacitidine and placebo-azacitidine arms, respectively. Only 1 patient in the venetoclax-azacitidine arm, and no patients in the placebo-azacitidine arm, had grade 4 febrile neutropenia that led to treatment discontinuation. Conclusions This Japanese subgroup analysis of VIALE-A demonstrates comparable safety and efficacy outcomes compared with the global study and supports venetoclax-azacitidine as first-line standard-of-care for Japanese treatment-naive patients with acute myeloid leukemia who are ineligible for intensive chemotherapy.
Collapse
Affiliation(s)
- Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Aichi, Japan
| | - Atsushi Shinagawa
- Department of Internal Medicine, Hitachi General Hospital, Hitachi, Ibaraki, Japan
| | - Courtney D DiNardo
- Department of Leukemia, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keith W Pratz
- Leukemia Program, Division of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kenichi Ishizawa
- Department of Third Internal Medicine, Yamagata University Hospital, Yamagata, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization, Mito Medical Center, Ibaraki, Japan
| | - Noriko Fukuhara
- Department of Hematology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Japan
| | - Noboru Asada
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Norio Asou
- Department of Hematology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | | | | | | | - Ying Zhou
- AbbVie, Inc., North Chicago, IL, USA
| | | | | | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Hospital, Osaka, Japan
| |
Collapse
|
12
|
Tsutsumi I, Tsutsumi Y, Yoshida C, Komeno T, Imanaka Y. Impact of the Clinical Trials Act on noncommercial clinical research in Japan: An interrupted time-series analysis. J Epidemiol 2021; 32:27-33. [PMID: 34690242 PMCID: PMC8666319 DOI: 10.2188/jea.je20210051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The number of new noncommercial clinical studies conducted in Japan declined within the first year of the implementation of the Clinical Trials Act (CTA) on April 1, 2018. This study aimed to examine the impact of the CTA's enforcement on the number of new noncommercial clinical studies registered in the Japanese Clinical Trial Registry. METHODS An interrupted time-series design was used in the analysis, which was conducted from April 2015 to March 2019. We collected data for studies registered in the Clinical Trial Registry, managed by the University Hospital Medical Information Network. RESULTS In total, 35,811 studies were registered; of these, 16,455 fulfilled the eligibility criteria. The difference in the trend of monthly number of new studies after CTA enforcement decreased significantly by 15.0 (95% CI, -18.7 to -11.3), and the level decreased by 40.8 (95% CI, -68.2 to -13.3) from the pre-enforcement to the post-enforcement period. Multigroup analyses indicated that the act exerted a significant effect on the trend of new clinical studies, particularly those with smaller sample sizes, interventional study designs, and nonprofit funding sponsors. CONCLUSIONS The number of Japanese noncommercial clinical studies declined significantly following implementation of the CTA. It is necessary to establish a system to promote clinical studies in Japan while ensuring transparency and safety.
Collapse
Affiliation(s)
- Ikuyo Tsutsumi
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine.,Department of Hematology, National Hospital Organization Mito Medical Center
| | - Yusuke Tsutsumi
- Department of Emergency Medicine, National Hospital Organization Mito Medical Center.,Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Kyoto University Graduate School of Medicine
| |
Collapse
|
13
|
Yamauchi T, Yoshida C, Usuki K, Takada S, Matsumura I, Dobashi N, Miyazaki Y, Miyamoto T, Iida H, Asou N, Kuroda J, Ichikawa S, Komatsu N, Mendes W, Honda H, Okubo S, Kurokawa M, Jiang Q, Wei A, Ishizawa K. Venetoclax plus low-dose cytarabine in Japanese patients with untreated acute myeloid leukaemia ineligible for intensive chemotherapy. Jpn J Clin Oncol 2021; 51:1372-1382. [PMID: 34322703 PMCID: PMC8405845 DOI: 10.1093/jjco/hyab112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background In a multinational phase 3 trial (VIALE-C), venetoclax plus low-dose cytarabine prolonged overall survival vs placebo plus low-dose cytarabine in patients with newly diagnosed acute myeloid leukaemia ineligible for intensive chemotherapy, although it was not statistically significant. Herein, we assess the benefit of venetoclax plus low-dose cytarabine in the Japanese subgroup of VIALE-C patients (n = 27). Methods VIALE-C, a randomized (2:1), double-blind study (NCT03069352), enrolled untreated patients (≥18 years) with acute myeloid leukaemia. Patients received venetoclax (600 mg days 1–28, 4-day ramp-up in cycle 1) or placebo in 28-day cycles with low-dose cytarabine (20 mg/m2 days 1–10). The primary endpoint was median overall survival. Results In the Japanese subgroup, at a 6-month follow-up from the primary analysis, median overall survival for venetoclax (n = 18) and placebo (n = 9), plus low-dose cytarabine, was 4.7 and 8.1 months, respectively (hazard ratio, 0.928, 95% confidence intervals : 0.399, 2.156). The rate of complete remission plus complete remission with incomplete blood count recovery was higher with venetoclax plus low-dose cytarabine (44.4%) vs placebo plus low-dose cytarabine (11.1%). All patients experienced at least 1 adverse event. The most common grade ≥3 adverse events with venetoclax or placebo, plus low-dose cytarabine, were febrile neutropenia (50.0% vs 44.4%, respectively) and thrombocytopenia (27.8% vs 44.4%, respectively). Serious adverse events were reported in 50.0 and 33.3% of patients in the venetoclax and placebo, plus low-dose cytarabine arms, respectively; pneumonia was the most common (22.2% each). Conclusions Limited survival benefit in the Japanese subgroup can be attributed to small patient numbers and to baseline imbalances observed between treatment arms, with more patients in the venetoclax plus low-dose cytarabine arm presenting poor prognostic factors. Venetoclax plus low-dose cytarabine was well tolerated in Japanese patients with acute myeloid leukaemia ineligible for intensive chemotherapy.
Collapse
Affiliation(s)
- Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization, Mito Medical Center, Ibaraki, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Satoru Takada
- Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Hospital, Osaka, Japan
| | - Nobuaki Dobashi
- Division of Clinical Oncology/Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Toshihiro Miyamoto
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Norio Asou
- Department of Hematology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoshi Ichikawa
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | | | | | | | | | - Qi Jiang
- AbbVie Inc., North Chicago, IL, USA
| | - Andrew Wei
- Department of Clinical Haematology, The Alfred Hospital and Monash University, Melbourne, VIC, Australia
| | - Kenichi Ishizawa
- Department of Third Internal Medicine, Yamagata University Hospital, Yamagata, Japan
| |
Collapse
|
14
|
Momose H, Nishikii H, Kozuma Y, Ota-Tsutsumi I, Nannya Y, Yoshida C, Komeno T, Kusakabe M, Yokoyama Y, Kato T, Kurita N, Sootome A, Sakata-Yanagimoto M, Obara N, Hasegawa Y, Ogawa S, Chiba S. [Acquired platelet dysfunction with severe bleeding tendency in triple-negative myelofibrosis]. Rinsho Ketsueki 2021; 62:1406-1411. [PMID: 34615801 DOI: 10.11406/rinketsu.62.1406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 50-year-old man demonstrated markedly increased number of white blood cells, anemia, severe splenomegaly, and bleeding tendency. Bone marrow analysis revealed remarkable hypercellularity; dysplasia in multilineage cells, including megakaryocytes; and fibrosis. He was eventually diagnosed with triple-negative myelofibrosis. A massive hematoma developed at the bone marrow biopsy site. A similar episode recurred after the second bone marrow biopsy. The von Willebrand factor and other coagulation factor activities were within normal ranges. Platelet aggregation analyses demonstrated highly impaired aggregation induced by ADP, collagen, and epinephrine. Treatment with hydroxyurea and ruxolitinib, a JAK inhibitor, was ineffective, and he eventually died on day 144 after hospitalization. Acquired platelet dysfunction uncommonly occurs in patients with myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN), without precise elucidation of the frequency and underlying mechanism. The onset of bleeding tendency in the current patient suggested that platelet dysfunction may be caused by somatic genetic events. Here, we discuss the mechanisms of acquired platelet dysfunction in MDS or MPN with a literature review.
Collapse
Affiliation(s)
- Haruka Momose
- Department of Hematology, University of Tsukuba Hospital
| | - Hidekazu Nishikii
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Yukinori Kozuma
- Department of Medical Science, Faculty of Medicine, University of Tsukuba
| | | | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University
| | | | | | - Manabu Kusakabe
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Yasuhisa Yokoyama
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Takayasu Kato
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Naoki Kurita
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Ayano Sootome
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Mamiko Sakata-Yanagimoto
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Naoshi Obara
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Yuichi Hasegawa
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University
| | - Shigeru Chiba
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| |
Collapse
|
15
|
Kumagai T, Nakaseko C, Nishiwaki K, Yoshida C, Ohashi K, Takezako N, Takano H, Kouzai Y, Murase T, Matsue K, Morita S, Sakamoto J, Wakita H, Sakamaki H, Inokuchi K. Silent NK/T cell reactions to dasatinib during sustained deep molecular response before cessation are associated with longer treatment-free remission. Cancer Sci 2020; 111:2923-2934. [PMID: 32614159 PMCID: PMC7419041 DOI: 10.1111/cas.14518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022] Open
Abstract
This study presents the final report of the multicenter, prospective tyrosine kinase inhibitor discontinuation study, D-STOP, after a 3-year follow-up of 54 patients with chronic CML who discontinued dasatinib after a sustained deep molecular response (DMR) for ≥2 years with dasatinib treatment. Estimated treatment-free remission (TFR) rates at 12 and 36 months were 63.0% [95% confidence interval (CI): 48.7-74.3] and 59.3% (95% CI: 45.0-71.0), respectively. CD3- CD56+ NK, CD16+ CD56+ NK, and CD57+ CD56+ NK large granular lymphocyte (NK-LGL), CD8+ CD4- cytotoxic T cell, and CD57+ CD3+ T-LGL cell numbers were relatively elevated throughout the 24-month consolidation only in failed patients who molecularly relapsed within 12 months. In successful patients, these subsets elevated transiently after 12 months, but returned to basal levels after 24-month consolidation. Therefore, smaller changes in NK/T, particularly the NK subset throughout consolidation, reflected higher TFR rates. TFR rates of those patients exhibiting elevation in CD3- CD56+ NK >376 cells/μL, CD16+ CD56+ NK > 241 cells/μL, or CD57+ CD56+ NK-LGL >242 cells/μL during consolidation compared with others were 26.7% (8.3%-49.6%) vs 78.3% (55.4%-90.3%), HR 0.032 (0.0027-0.38; P = .0064), 31.2% (11.4%-53.6%) vs 85.0% (60.4%-94.9%), HR 0.039 (0.0031-0.48; P = .011), or 36.8% (16.5%-57.5%) vs 77.3% (53.7%-89.8%), HR 0.21 (0.065-0.69; P = .010), respectively. Therefore, silent responses of T/NK subsets to dasatinib throughout consolidation were significant for longer TFR. Elevated NK/T, particularly NK lymphocytes responsive to dasatinib, may be immunologically insufficient to maintain TFR. Their decline, subsequently replaced by altered lymphocyte population with less response to dasatinib during sustained DMR, might be immunologically significant. (D-STOP, NCT01627132).
Collapse
Affiliation(s)
- Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Tokyo, Japan
| | - Chiaki Nakaseko
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Kaichi Nishiwaki
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization, Mito Medical Center, Higashiibarakigun, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Naoki Takezako
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tachikawa, Japan
| | - Hina Takano
- Department of Hematology, Musashino Red Cross Hospital, Musashino, Japan
| | - Yasuji Kouzai
- Department of Hematology, Tokyo Metropolitan Tama Synthesis Medical Center, Tokyo, Japan
| | - Tadashi Murase
- Department of Laboratory Medicine, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Kosei Matsue
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Hisashi Wakita
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hosp, Narita, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | | |
Collapse
|
16
|
Yoshida I, Saito AM, Tanaka S, Choi I, Hidaka M, Miyata Y, Inoue Y, Yamasaki S, Kagoo T, Iida H, Niimi H, Komeno T, Yoshida C, Tajima F, Yamamoto H, Takase K, Ueno H, Shimomura T, Sakai T, Nakashima Y, Yoshida C, Kubonishi S, Sunami K, Yoshida S, Sakurai A, Kaneko Y, Miyazaki Y, Nagai H. Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever. Mycoses 2020; 63:794-801. [PMID: 32391919 PMCID: PMC7497187 DOI: 10.1111/myc.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fungal infections are a major complication of neutropaenia following chemotherapy. Their early diagnosis is difficult, and empirical antifungal treatment is widely used, and uses of less toxic drugs that reduce breakthrough infection are required. OBJECTIVE We conducted a multicentre, open-label, randomised, non-inferiority trial to compare the safety and efficacy of intravenous itraconazole (ivITCZ) and liposomal amphotericin B (LAmB) as empirical antifungal therapy in patients with haematological malignancies with neutropaenia and persistent fever. METHODS Patients with haematological malignancies who developed fever refractory to broad-spectrum antibacterial agents under neutropaenia conditions were enrolled. Patients were randomised for treatment with LAmB (3.0 mg/kg/d) or ivITCZ (induction: 400 mg/d, maintenance: 200 mg/d). RESULTS Observed overall favourable response rates of 17/52 (32.7%) and 18/50 (36.0%) in the LAmB and ivITCZ groups, with a model-based estimate of a 4% difference (90% CI, -12% to 20%), did not fulfil the statistical non-inferiority criterion. In the LAmB group, there were two cases of breakthrough infection and five cases of probable invasive fungal disease, whereas in the itraconazole group, neither breakthrough infection nor probable invasive fungal disease occurred. Patients in the ivITCZ group had significantly fewer grade 3-4 hypokalaemia-related events than LAmB group patients (P < .01). The overall incidence of adverse events tended to be lower in the ivITCZ group (P = .07). CONCLUSION ivITCZ showed similar efficacy and safety as LAmB as empirical antifungal therapy in haematological malignancy patients with febrile neutropaenia, although the small sample size and various limitations prevented demonstration of its non-inferiority.
Collapse
Affiliation(s)
- Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiko Miyata
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoshiko Inoue
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Toshiya Kagoo
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiromasa Niimi
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Chikamasa Yoshida
- Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Fumihito Tajima
- Stem Cell Transplantation Center, National Hospital Organization Yonago Medical Center, Yonago, Japan
| | - Hideyuki Yamamoto
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hironori Ueno
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Shimomura
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Tatsunori Sakai
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Shiro Kubonishi
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Aki Sakurai
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yukihiro Kaneko
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| |
Collapse
|
17
|
Tomida N, Muramatsu N, Niiyama M, Ahn JK, Chang WC, Chen JY, Chu ML, Daté S, Gogami T, Goto H, Hamano H, Hashimoto T, He QH, Hicks K, Hiraiwa T, Honda Y, Hotta T, Ikuno H, Inoue Y, Ishikawa T, Jaegle I, Jo JM, Kasamatsu Y, Katsuragawa H, Kido S, Kon Y, Maruyama T, Masumoto S, Matsumura Y, Miyabe M, Mizutani K, Nagahiro H, Nakamura T, Nakano T, Nam T, Ngan TNT, Nozawa Y, Ohashi Y, Ohnishi H, Ohta T, Ozawa K, Rangacharyulu C, Ryu SY, Sada Y, Sasagawa M, Shibukawa T, Shimizu H, Shirai R, Shiraishi K, Strokovsky EA, Sugaya Y, Sumihama M, Suzuki S, Tanaka S, Tokiyasu A, Tsuchikawa Y, Ueda T, Yamazaki H, Yamazaki R, Yanai Y, Yorita T, Yoshida C, Yosoi M. Search for η^{'} Bound Nuclei in the ^{12}C(γ,p) Reaction with Simultaneous Detection of Decay Products. Phys Rev Lett 2020; 124:202501. [PMID: 32501086 DOI: 10.1103/physrevlett.124.202501] [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] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
We measured missing mass spectrum of the ^{12}C(γ,p) reaction for the first time in coincidence with potential decay products from η^{'} bound nuclei. We tagged an (η+p) pair associated with the η^{'}N→ηN process in a nucleus. After applying kinematical selections to reduce backgrounds, no signal events were observed in the bound-state region. An upper limit of the signal cross section in the opening angle cosθ_{lab}^{ηp}<-0.9 was obtained to be 2.2 nb/sr at the 90% confidence level. It is compared with theoretical cross sections, whose normalization ambiguity is suppressed by measuring a quasifree η^{'} production rate. Our results indicate a small branching fraction of the η^{'}N→ηN process and/or a shallow η^{'}-nucleus potential.
Collapse
Affiliation(s)
- N Tomida
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Niiyama
- Department of Physics, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J Y Chen
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - M L Chu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S Daté
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - T Gogami
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Goto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Hamano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Hashimoto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Q H He
- Department of Nuclear Science & Engineering, College of Material Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - T Hiraiwa
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - Y Honda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ikuno
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Inoue
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - I Jaegle
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J M Jo
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - Y Kasamatsu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Katsuragawa
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Kido
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Institute for Radiation Sciences, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Maruyama
- College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa 252-8510, Japan
| | - S Masumoto
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - Y Matsumura
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Mizutani
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Nagahiro
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Nara Women's University, Nara 630-8506, Japan
| | - T Nakamura
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Nam
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T N T Ngan
- Nuclear Physics Department, University of Science, Vietnam National University, Ho Chi Minh City 72711, Vietnam
| | - Y Nozawa
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Y Ohashi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ohnishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ohta
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - K Ozawa
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon SK S7N 5E2, Canada
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Sada
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Sasagawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Shibukawa
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - R Shirai
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Shiraishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Laboratory of High Energy Physics, Joint Institute for Nuclear Research, Dubna, Moscow Region 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - S Suzuki
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - S Tanaka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - A Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Tsuchikawa
- J-PARC Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ueda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - H Yamazaki
- Radiation Science Center, High Energy Accelerator Research Organization (KEK), Tokai, Ibaraki 319-1195, Japan
| | - R Yamazaki
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Yorita
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - C Yoshida
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| |
Collapse
|
18
|
Tsutsumi I, Kunisawa S, Yoshida C, Seki M, Komeno T, Fushimi K, Morita S, Imanaka Y. Correction to: Impact of oral voriconazole during chemotherapy for acute myeloid leukemia and myelodysplastic syndrome: a Japanese nationwide retrospective cohort study. Int J Clin Oncol 2020; 25:782-783. [DOI: 10.1007/s10147-019-01601-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Yabuki A, Uehara Y, Ichii O, Yoshida C, Yamato O. Expression of Peroxisome Proliferator-activated Receptor-γ in the Kidneys of Cats with Chronic Kidney Disease. J Comp Pathol 2020; 176:81-85. [PMID: 32359640 DOI: 10.1016/j.jcpa.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 11/26/2022]
Abstract
Peroxisome proliferator-activated receptor (PPAR)-γ plays an important role in various cellular functions and its activation exerts protective effects in kidney diseases. In the present study, chronic kidney disease in cats was examined, and changes in renal expression of PPARγ were observed by use of immunohistochemistry. In normal kidneys, nuclei of the superficial cortical tubules, medullary tubules and glomerular cells expressed PPARγ. The vascular walls (tunica media) also showed positive expression. In diseased kidneys, the expression of PPARγ varied between the cases. Some cases showed strong expression, while others had weak expression. PPARγ expression in the nuclei of infiltrating mononuclear cells was also detected in over half of the cases. Although there was no significant relationship between the expression of renal PPARγ and the severity of kidney disease, the fact that there were many cases where the expression of renal PPARγ was reduced was an important finding, and might be one of the possible mechanisms underlying feline chronic kidney diseases.
Collapse
Affiliation(s)
- A Yabuki
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24, Korimoto, Kagoshima, Japan.
| | - Y Uehara
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24, Korimoto, Kagoshima, Japan
| | - O Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 8, Nishi 5, Kita-ku, Sapporo, Japan
| | - C Yoshida
- Boehringer Ingelheim Animal Health Japan, Osaki, 2-1-1, Shinagawa-ku, Tokyo, Japan
| | - O Yamato
- Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University, 1-21-24, Korimoto, Kagoshima, Japan
| |
Collapse
|
20
|
Yamaguchi H, Takezako N, Ohashi K, Oba K, Kumagai T, Kozai Y, Wakita H, Yamamoto K, Fujita A, Igarashi T, Yoshida C, Ohyashiki K, Okamoto S, Sakamoto J, Sakamaki H, Inokuchi K. Treatment-free remission after first-line dasatinib treatment in patients with chronic myeloid leukemia in the chronic phase: the D-NewS Study of the Kanto CML Study Group. Int J Hematol 2020; 111:401-408. [PMID: 31894533 DOI: 10.1007/s12185-019-02801-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/20/2022]
Abstract
Treatment outcomes for chronic myeloid leukemia (CML) have dramatically improved with the development of tyrosine kinase inhibitors (TKI). However, due to the improved prognosis for CML, problems have arisen from long-term administration of TKI. The present study sought to verify whether more patients could achieve treatment-free remission (TFR) after stopping the administration of dasatinib using dasatinib as frontline treatment. Treatment-naïve chronic phase CML cases were treated with dasatinib as frontline treatment. Dasatinib treatment was stopped for 26 patients who achieved deep molecular response (DMR) within 24 months and were able to maintain DMR for an additional 2 years. Ten patients (38.5%) achieved DMR maintenance after 12 months. Recurrence was confirmed in 16 patients, and the median recurrence-free survival time was 5.1 months. The cumulative DMR rates at six and 12 months after restarting treatment were 84.6% and 100%, respectively. The results of this study demonstrated that the DMR maintenance rate after 12 months was 38.5%, which was not significantly different from previous TKI stop trials. The 2-year dasatinib administration period after reaching DMR did not contribute to improve TFR rates. These results suggest that the type of TKI is not associated with better TFR rates.
Collapse
Affiliation(s)
- Hiroki Yamaguchi
- Department of Hematology Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
| | - Naoki Takezako
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tachikawa, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koji Oba
- Interfactulty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan.,Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Tokyo, Japan
| | - Yasuji Kozai
- Department of Hematology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Hisashi Wakita
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hospital, Narita, Japan
| | - Koh Yamamoto
- Department of Hematology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Akira Fujita
- Hematology Division, Showa General Hospital, Tokyo, Japan
| | - Tadahiko Igarashi
- Division of Hematology and Oncology, Gunma Prefectural Cancer Center, Ohta, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization, Mito Medical Center, Higashiibarakigun, Ibaraki, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | | | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Department of Hematology Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan
| |
Collapse
|
21
|
Ueki D, Yoshida C, Tsutsumi Oota I, Seki M, Komeno T, Ito H, Ide Y. [Successful Treatment of T-Cell Prolymphocytic Leukemia with Alemtuzumab]. Gan To Kagaku Ryoho 2019; 46:913-915. [PMID: 31189814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
T-cell prolymphocytic leukemia(T-PLL)is a highly aggressive hematopoietic malignancy with poor prognosis and is extremely rare in Japan. Since T-PLL cells usually express high levels of CD52, the anti-CD52 monoclonal antibody alemtuzumab is expected to exhibit an antitumor effect via its antibody-dependent cell cytotoxicity(ADCC)and complement-dependent cytotoxicity(CDC). However, the therapeutic efficiency of alemtuzumab for T-PLL has not been established in Japan. Furthermore, only a few patients have completed the treatment schedule because of adverse events. Here, we report a 64-yearold woman with multiple comorbidities who was successfully treated with alemtuzumab.
Collapse
Affiliation(s)
- Daisuke Ueki
- Dept. of Pharmacy, National Hospital Organization Mito Medical Center
| | | | | | | | | | | | | |
Collapse
|
22
|
Tanaka K, Toyota S, Akiyama M, Wakimoto N, Nakamura Y, Najima Y, Doki N, Kakihana K, Igarashi A, Kobayashi T, Ohashi K, Kudo D, Shinagawa A, Takano H, Fujio T, Okoshi Y, Hori M, Kumagai T, Saito T, Mukae J, Yamamoto K, Tsutsumi I, Komeno T, Yoshida C, Yamamoto M, Kojima H. Efficacy and Safety of a Weekly Cyclophosphamide-Bortezomib-Dexamethasone Regimen as Induction Therapy Prior to Autologous Stem Cell Transplantation in Japanese Patients with Newly Diagnosed Multiple Myeloma: A Phase 2 Multicenter Trial. Acta Haematol 2019; 141:111-118. [PMID: 30726834 DOI: 10.1159/000495338] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/30/2018] [Indexed: 01/07/2023]
Abstract
We assessed the efficacy and safety of weekly cyclophosphamide-bortezomib-dexamethasone (CBD) induction prior to autologous stem cell transplantation (ASCT) in newly diagnosed Japanese patients with multiple myeloma (MM). This regimen consisted of four 28-day cycles of once-weekly oral cyclophosphamide (300 mg/m2), subcutaneous bortezomib (1.3 mg/m2), and oral dexamethasone (40 mg). Responding patients underwent stem cell collection followed by ASCT. The primary endpoint was the postinduction rate of achieving a near complete response (nCR) or better. Among the 38 enrolled patients, a complete response (CR), an nCR, a very good partial response (VGPR), and a partial response (PR) were achieved in 10.5, 2.6, 23.7, and 36.8% of cases, respectively. A grade 4 hematological adverse event (AE) was observed in 1 patient. Grade 3-4 infection, including febrile neutropenia, was observed in 4 patients (10.5%). Although 2 patients dropped out due to AE, 94.7% of the patients completed the induction phase. However, because of a poor response to induction chemotherapy (<PR in 6 patients), poor stem cell mobilization (4 patients), and a protocol violation (1 patient), only 24 patients (63.2%) proceeded to ASCT. The 2-year progression-free and overall survivals were 55.3 and 82.7%, respectively. We thus believe that the therapeutic power of weekly CBD is not strong enough as a 3-drug induction regimen despite its feasibility for most Japanese patients.
Collapse
Affiliation(s)
- Keisuke Tanaka
- Department of Hematology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Shigeo Toyota
- Department of Hematology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Megumi Akiyama
- Department of Hematology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Naoki Wakimoto
- Department of Hematology, Saitama Medical University Hospital, Saitama, Japan
| | - Yuichi Nakamura
- Department of Hematology, Saitama Medical University Hospital, Saitama, Japan
| | - Yuho Najima
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Noriko Doki
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Kazuhiko Kakihana
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Aiko Igarashi
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Takeshi Kobayashi
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Kazuteru Ohashi
- Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Daisuke Kudo
- Department of Hematology, Hitachi General Hospital, Hitachi, Japan
| | | | - Hina Takano
- Department of Hematology, Japanese Red Cross Musashino Hospital, Musashino, Japan
| | - Takayuki Fujio
- Department of Hematology, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Yasushi Okoshi
- Department of Hematology, Ibaraki Prefectural Central Hospital, Kasama, Japan
- Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Tsukuba, Japan
| | - Mitsuo Hori
- Department of Hematology, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Takashi Kumagai
- Department of Hematology, Ohme Municipal General Hospital, Ohme, Japan
| | - Tatsuya Saito
- Department of Hematology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Junichi Mukae
- Department of Hematology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Koh Yamamoto
- Department of Hematology, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Ikuyo Tsutsumi
- Department of Hematology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Masahide Yamamoto
- Department of Hematology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Hiroshi Kojima
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Japan,
- Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Tsukuba, Japan,
| |
Collapse
|
23
|
Fujisawa S, Ueda Y, Usuki K, Kobayashi H, Kondo E, Doki N, Nakao T, Kanda Y, Kosugi N, Kosugi H, Kumagai T, Harada H, Shikami M, Maeda Y, Sakura T, Inokuchi K, Saito A, Nawa Y, Ogasawara M, Nishida J, Kondo T, Yoshida C, Kuroda H, Tabe Y, Maeda Y, Imajo K, Kojima K, Morita S, Komukai S, Kawaguchi A, Sakamoto J, Kimura S. Feasibility of the imatinib stop study in the Japanese clinical setting: delightedly overcome CML expert stop TKI trial (DOMEST Trial). Int J Clin Oncol 2018; 24:445-453. [PMID: 30421023 PMCID: PMC6438937 DOI: 10.1007/s10147-018-1368-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/05/2018] [Indexed: 11/24/2022]
Abstract
Background Treatment-free remission (TFR), the ability to maintain a molecular response (MR), occurs in approximately 50% of patients with chronic myelogenous leukemia (CML) treated with tyrosine kinase inhibitors (TKIs). Methods A multicenter phase 2 trial (Delightedly Overcome CML Expert Stop TKI Trial: DOMEST Trial) was conducted to test the safety and efficacy of discontinuing imatinib. Patients with CML with a sustained MR of 4.0 or MR4.0-equivalent for at least 2 years and confirmed MR4.0 at the beginning of the study were enrolled. In the TFR phase, the international scale (IS) was regularly monitored by IS-PCR testing. Molecular recurrence was defined as the loss of MR4.0. Recurrent patients were immediately treated with dasatinib or other TKIs including imatinib. Results Of 110 enrolled patients, 99 were evaluable. The median time from diagnosis to discontinuation of imatinib was 103 months, and the median duration of imatinib therapy was 100 months. Molecular recurrence-free survival rates were 69.6%, 68.6% and 64.3% at 6, 12, and 24 months, respectively. After discontinuation of imatinib therapy, 26 patients showed molecular recurrence, and 25 re-achieved deep MR after dasatinib treatment. Molecular response MR4.0 was achieved in 23 patients within 6 months and 25 patients within 12 months. Multivariate analysis revealed that a longer time from diagnosis to discontinuation of imatinib therapy (p = 0.0002) and long duration of imatinib therapy (p = 0.0029) predicted a favorable prognosis. Conclusions This DOMEST Trial showed the feasibility of TKI discontinuation in a Japanese clinical setting.
Collapse
Affiliation(s)
- Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center, Tokyo, Japan
| | - Hajime Kobayashi
- Department of Hematology, Obihiro Kosei Hospital, Obihiro, Japan
| | - Eisei Kondo
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Takafumi Nakao
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Yoshinobu Kanda
- Department of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Nobuharu Kosugi
- Department of Hematology, Numazu City Hospital, Numazu, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Ome, Japan
| | - Hiroshi Harada
- Division of Hematology, Department of Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Masato Shikami
- Department of Hematology, Daiyukai General Hospital, Ichinomiya, Japan
| | - Yasuhiro Maeda
- Department of Hematology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan
| | - Toru Sakura
- Department of Hematology, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Akio Saito
- Department of Hematology, Fujioka General Hospital, Fujioka, Japan
| | - Yuichiro Nawa
- Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | - Junji Nishida
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Takeshi Kondo
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Mito, Japan
| | - Hiroyuki Kuroda
- Department of Gastroenterology and Hematology/Clinical Oncology, Steel Muroran Memorial Hospital, Muroran, Japan
| | - Yoko Tabe
- Department of Next Generation Hematology Laboratory Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Kenji Imajo
- Department of Internal Medicine, Okayama Municipal Hospital, Okayama, Japan
| | - Kensuke Kojima
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sho Komukai
- Division of Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsushi Kawaguchi
- Division of Biomedical Statistics, Department of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
| |
Collapse
|
24
|
Kumagai T, Nakaseko C, Nishiwaki K, Yoshida C, Ohashi K, Takezako N, Takano H, Kouzai Y, Murase T, Matsue K, Morita S, Sakamoto J, Wakita H, Sakamaki H, Inokuchi K. Dasatinib cessation after deep molecular response exceeding 2 years and natural killer cell transition during dasatinib consolidation. Cancer Sci 2017; 109:182-192. [PMID: 29058817 PMCID: PMC5765311 DOI: 10.1111/cas.13430] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/12/2017] [Accepted: 10/17/2017] [Indexed: 01/12/2023] Open
Abstract
Tyrosine kinase inhibitors (TKI) improve the prognosis of patients with chronic myelogenous leukemia (CML) by inducing substantial deep molecular responses (DMR); some patients have successfully discontinued TKI therapy after maintaining DMR for ≥1 year. In this cessation study, we investigated the optimal conditions for dasatinib discontinuation in patients who maintained DMR for ≥2 years. This study included 54 patients with CML who were enrolled in a D‐STOP multicenter prospective trial, had achieved DMR, and had discontinued dasatinib after 2‐year consolidation. Peripheral lymphocyte profiles were analyzed by flow cytometry. The estimated 12‐month treatment‐free survival (TFS) was 62.9% (95% confidence interval: 48.5%‐74.2%). During dasatinib consolidation, the percentage of total lymphocytes and numbers of CD3− CD56+ natural killer (NK) cells, CD16+ CD56+ NK cells and CD56+ CD57+ NK‐large granular lymphocytes (LGL) were significantly higher in patients with molecular relapse after discontinuation but remained unchanged in patients without molecular relapse for >7 months. At the end of consolidation, patients whose total lymphocytes comprised <41% CD3− CD56+ NK cells, <35% CD16+ CD56+ NK cells, or <27% CD56+ CD57+ NK‐LGL cells had higher TFS relative to other patients (77% vs 18%; P < .0008; 76% vs 10%; P < .0001; 84% vs 46%; P = .0059, respectively). The increase in the number of these NK cells occurred only during dasatinib consolidation. In patients with DMR, dasatinib discontinuation after 2‐year consolidation can lead to high TFS. This outcome depends significantly on a smaller increase in NK cells during dasatinib consolidation.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/pharmacology
- Consolidation Chemotherapy
- Dasatinib/administration & dosage
- Dasatinib/pharmacology
- Disease-Free Survival
- Female
- Flow Cytometry
- Fusion Proteins, bcr-abl/genetics
- Humans
- Killer Cells, Natural/cytology
- Killer Cells, Natural/drug effects
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Prospective Studies
- Withholding Treatment
Collapse
Affiliation(s)
- Takashi Kumagai
- Department of HematologyOme Municipal General HospitalTokyoJapan
| | | | - Kaichi Nishiwaki
- Division of Clinical Oncology and HematologyDepartment of Internal MedicineJikei University School of MedicineKashiwa HospitalChibaJapan
| | - Chikashi Yoshida
- Department of HematologyNational Hospital OrganizationMito Medical CenterHigashiibarakigunJapan
| | - Kazuteru Ohashi
- Hematology DivisionTokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | - Naoki Takezako
- Department of HematologyNational Hospital Organization Disaster Medical CenterTachikawaJapan
| | - Hina Takano
- Department of HematologyMusashino Red Cross HospitalMusashinoJapan
| | - Yasuji Kouzai
- Department of HematologyTokyo Metropolitan Tama Synthesis Medical CenterTokyoJapan
| | - Tadashi Murase
- Department of Laboratory MedicineDokkyo Medical University Koshigaya HospitalSaitamaJapan
| | - Kosei Matsue
- Division of Hematology/OncologyDepartment of Internal MedicineKameda Medical CenterKamogawaJapan
| | - Satoshi Morita
- Department of Biomedical Statistics and BioinformaticsKyoto University Graduate School of MedicineKyotoJapan
| | | | - Hisashi Wakita
- Division of Hematology and OncologyJapanese Red Cross SocietyNarita Red Cross HospitalNaritaJapan
| | - Hisashi Sakamaki
- Hematology DivisionTokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyoJapan
| | | | | |
Collapse
|
25
|
Shiseki M, Yoshida C, Takezako N, Ohwada A, Kumagai T, Nishiwaki K, Horikoshi A, Fukuda T, Takano H, Kouzai Y, Tanaka J, Morita S, Sakamoto J, Sakamaki H, Inokuchi K. Dasatinib rapidly induces deep molecular response in chronic-phase chronic myeloid leukemia patients who achieved major molecular response with detectable levels of BCR-ABL1 transcripts by imatinib therapy. Int J Clin Oncol 2017; 22:972-979. [PMID: 28550414 PMCID: PMC5608785 DOI: 10.1007/s10147-017-1141-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 05/14/2017] [Indexed: 01/06/2023]
Abstract
Background With the introduction of imatinib, a first-generation tyrosine kinase inhibitor (TKI) to inhibit BCR-ABL1 kinase, the outcome of chronic-phase chronic myeloid leukemia (CP-CML) has improved dramatically. However, only a small proportion of CP-CML patients subsequently achieve a deep molecular response (DMR) with imatinib. Dasatinib, a second-generation TKI, is more potent than imatinib in the inhibition of BCR-ABL1 tyrosine kinase in vitro and more effective in CP-CML patients who do not achieve an optimal response with imatinib treatment. Methods In the present study, we attempted to investigate whether switching the treatment from imatinib to dasatinib can induce DMR in 16 CP-CML patients treated with imatinib for at least two years who achieved a major molecular response (MMR) with detectable levels of BCR-ABL1 transcripts. Results The rates of achievement of DMR at 1, 3, 6 and 12 months after switching to dasatinib treatment in the 16 patients were 44% (7/16), 56% (9/16), 63% (10/16) and 75% (12/16), respectively. The cumulative rate of achieving DMR at 12 months from initiation of dasatinib therapy was 93.8% (15/16). The proportion of natural killer cells and cytotoxic T cells in peripheral lymphocytes increased after switching to dasatinib. In contrast, the proportion of regulatory T cells decreased during treatment. The safety profile of dasatinib was consistent with previous studies. Conclusion Switching to dasatinib would be a therapeutic option for CP-CML patients who achieved MMR but not DMR by imatinib, especially for patients who wish to discontinue TKI therapy.
Collapse
Affiliation(s)
- Masayuki Shiseki
- Department of Hematology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Naoki Takezako
- Department of Hematology, National Disaster Medical Center, Tokyo, Japan
| | - Akira Ohwada
- Department of Hematology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Takashi Kumagai
- Department of Hematology, Ohme Municipal General Hospital, Tokyo, Japan
| | - Kaichi Nishiwaki
- Clinical Oncology and Hematology, Jikei University Kashiwa Hospital, Chiba, Japan
| | - Akira Horikoshi
- Department of General Internal Medicine, Nerima-Hikarigaoka Hospital, Tokyo, Japan
| | - Tetsuya Fukuda
- Department of Hematology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hina Takano
- Department of Hematology, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Yasuji Kouzai
- Hematology Department, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Junji Tanaka
- Department of Hematology, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
26
|
Kusakabe M, Kurita N, Nishikii H, Sato R, Yoshida C, Yokoyama Y, Sakata-Yanagimoto M, Obara N, Hasegawa Y, Chiba S. [Haploidentical transplantation using post-transplant high-dose cyclophosphamide for adult T-cell lymphoma after mogamulizumab treatment]. Rinsho Ketsueki 2017; 58:449-454. [PMID: 28592758 DOI: 10.11406/rinketsu.58.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 53-year-old man diagnosed with adult T-cell lymphoma (ATL) was treated with mLSG15 chemotherapy and achieved a first complete remission. Subsequently, a liver tumor emerged that was pathologically diagnosed as ATL (first relapse). A second remission was achieved after local irradiation and four cycles of mogamulizumab treatment. The patient received peripheral blood stem cell transplantation (HSCT) from a one haplotype HLA-mismatched daughter after total body irradiation and the administration of fludarabine as a myeloablative conditioning regimen, followed by post-transplant cyclophosphamide. While subsequent acute graft-versus-host disease (GVHD) was never more than Grade I, severe chronic GVHD (cGVHD) developed in the oral cavity and skin that was resistant to escalated doses of cyclosporine and prednisolone. The patient subsequently had a second relapse of ATL as a subcutaneous mass and eventually died of disease progression. Mogamulizumab is a humanized monoclonal IgG that targets CC chemokine receptor 4 (CCR4) and is a key treatment option for relapsed ATL. It reportedly increases the risk of acute GVHD after HSCT due to the depletion of CCR4-positive regulatory T-cells; however, information on its impact on cGVHD is unavailable. Here, we discuss the potential risks and benefits of mogamulizumab, particularly in a haploidentical donor setting during a HSCT for ATL.
Collapse
Affiliation(s)
| | - Naoki Kurita
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Hidekazu Nishikii
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Rie Sato
- Department of Hematology, University of Tsukuba Hospital
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center
| | - Yasuhisa Yokoyama
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Mamiko Sakata-Yanagimoto
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Naoshi Obara
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Yuichi Hasegawa
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| | - Shigeru Chiba
- Department of Hematology, University of Tsukuba Hospital
- Department of Hematology, Faculty of Medicine, University of Tsukuba
| |
Collapse
|
27
|
Hagihara M, Iriyama N, Yoshida C, Wakita H, Chiba S, Okamoto S, Kawakami K, Takezako N, Kumagai T, Inokuchi K, Ohyashiki K, Taguchi J, Yano S, Igarashi T, Kouzai Y, Morita S, Sakamoto J, Sakamaki H. Association of pleural effusion with an early molecular response in patients with newly diagnosed chronic-phase chronic myeloid leukemia receiving dasatinib: Results of a D-First study. Oncol Rep 2016; 36:2976-2982. [PMID: 27665844 DOI: 10.3892/or.2016.5110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 09/07/2016] [Indexed: 11/06/2022] Open
Abstract
Despite the efficacy and safety of dasatinib treatment for chronic-phase chronic myeloid leukemia (CML-CP), adverse effects such as pleural effusion (PE) are still a serious concern. We determined the clinical significance of PE incidence using patient data derived from the D-First clinical study. In the present study, chest radiography and quantification of specific lymphocyte subsets were performed routinely after initiation of dasatinib treatment. Among 52 patients with newly diagnosed CML-CP, 17 (33%) developed PE within 18 months after initial dasatinib administration, but all cases were moderate (Grade 1, 10 patients; Grade 2, 7 patients). CD56+ lymphocyte counts at 1 month correlated significantly with the incidence of PE, whereas lymphocytosis did not. The major molecular response (MMR) rate at 3 months (although not at later times) was significantly higher in PE-positive patients than PE-negative patients (59% versus 24%, respectively; P=0.013). Deep molecular response rates did not differ significantly between the PE groups at any time point during the observation period. Our results suggest that an immune-mediated mechanism involving natural killer cells underlies the development of PE in patients receiving dasatinib for 18 months. This mechanism likely promotes transient tumor regression in patients newly diagnosed with CML-CP.
Collapse
Affiliation(s)
- Maki Hagihara
- Department of Hematology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - Hisashi Wakita
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hospital, Chiba, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kimihiro Kawakami
- Department of Hematology and Clinical Oncology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Naoki Takezako
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Takashi Kumagai
- Department of Hematology, Ohme Municipal General Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Shingo Yano
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Tadahiko Igarashi
- Division of Hematology and Oncology, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Yasuji Kouzai
- Department of Hematology, Tokyo Metropolitan Tama Synthesis Medical Center, Tokyo, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| |
Collapse
|
28
|
Yoshida C, Nakamae H, Fletcher L, Koga D, Sogabe T, Matsumura I, Kanakura Y, Branford S, Naoe T. Validation of a rapid one-step high sensitivity real-time quantitative PCR system for detecting major BCR-ABL1 mRNA on an International Scale. Springerplus 2016; 5:569. [PMID: 27247866 PMCID: PMC4864793 DOI: 10.1186/s40064-016-2258-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/29/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Detection and quantitation of BCR-ABL1 transcripts are crucial for managing patients with chronic myeloid leukemia (CML). Although real-time quantitative polymerase chain reaction (RT-qPCR) can be measured on an International Scale (IS), this has not become fully universal. By using a WHO international standard panel established for calibrating secondary standards based on the IS, we have previously developed an RT-qPCR kit, ODK-1201, for quantification of major BCR-ABL1. RESULTS In this study, the reliability of kit-specific conversion factor 1.12 was validated by exchanging patients' samples between three local clinical laboratories and a reference laboratory. The mean bias of the local method after IS conversion was 1.6 fold lower than the reference method. The clinically-useful sensitivity of the kit was further evaluated for monitoring patients with deep molecular response. Based on the correlation of the IS values between ODK-1201 and the reference laboratory method, the detection level of the kit was estimated as 0.0032 % BCR-ABL1 (IS). CONCLUSIONS ODK-1201 is a highly sensitive one-step RT-qPCR system for detecting BCR-ABL1 on the IS in 2 h after RNA extraction, thus contributing to standardization of molecular monitoring in CML.
Collapse
Affiliation(s)
- Chikashi Yoshida
- />Department of Hematology, National Hospital Organization Mito Medical Center, 280, Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193 Japan
| | - Hirohisa Nakamae
- />Hematology, Department of Internal Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Linda Fletcher
- />Department of Genetic and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
| | - Daisuke Koga
- />Diagnostic Division, Otsuka Pharmaceutical, Tokushima, Japan
| | - Takayuki Sogabe
- />Diagnostic Division, Otsuka Pharmaceutical, Tokushima, Japan
| | - Itaru Matsumura
- />Hematology, Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan
| | - Yuzuru Kanakura
- />Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Susan Branford
- />Department of Genetic and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, Australia
- />School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia
- />School of Medicine, University of Adelaide, Adelaide, Australia
- />School of Molecular and Biomedical Science, University of Adelaide, Adelaide, Australia
| | - Tomoki Naoe
- />National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| |
Collapse
|
29
|
Iriyama N, Fujisawa S, Yoshida C, Wakita H, Chiba S, Okamoto S, Kawakami K, Takezako N, Kumagai T, Inokuchi K, Ohyashiki K, Taguchi J, Yano S, Igarashi T, Kouzai Y, Morita S, Sakamoto J, Sakamaki H. Early cytotoxic lymphocyte expansion contributes to a deep molecular response to dasatinib in patients with newly diagnosed chronic myeloid leukemia in the chronic phase: results of the D-first study. Am J Hematol 2015; 90:819-24. [PMID: 26103598 DOI: 10.1002/ajh.24096] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 06/17/2015] [Indexed: 01/24/2023]
Abstract
Dasatinib is one of the key treatment options for chronic myeloid leukemia (CML) patients. Increase in lymphocyte counts has been known to be predictive of a good treatment response under dasatinib treatment as a second line therapy. However, clinical significance of lymphocyte dynamics in the upfront setting has yet to be clarified. To investigate the significance of lymphocyte dynamics in newly diagnosed chronic phase (CP)-CML, patient data of D-First study (ClinicalTrials.gov NCT01464411) were analyzed. Fifty-two CML-CP patients enrolled to this study were treated with dasatinib (100 mg day(-1) ) and all were followed-up for 18 months. The incidence of lymphocyosis was observed in 14 (27%), but it was not associated with deep molecular response achievement. However, natural killer (NK) cell or cytotoxic T lymphocyte (CTL) counts at 1 month were significantly higher in patients with deep molecular response (DMR) by 18 months compared to those without DMR. When the patients were divided into two groups according to those calculated thresholds by receiver operating characteristic curve (407/μL for NK cells and 347/μL for CTLs), the cumulative DMR rates by 18 months were significantly better in higher value group compared to lower value group. In contrast, regulatory T cell counts were significantly lower at 12 and 15 months in patients achieved DMR. These results suggest the presence of dual effects of dasatinib on immune system through the cytotoxic lymphocytes activation and Treg deregulation in different periods in newly diagnosed CML-CP.
Collapse
MESH Headings
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antineoplastic Agents/therapeutic use
- Dasatinib
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/immunology
- Gene Expression
- Humans
- Immunophenotyping
- Killer Cells, Natural/drug effects
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Leukemia, Myeloid, Chronic-Phase/drug therapy
- Leukemia, Myeloid, Chronic-Phase/genetics
- Leukemia, Myeloid, Chronic-Phase/immunology
- Leukemia, Myeloid, Chronic-Phase/pathology
- Lymphocyte Count
- Lymphocytosis/chemically induced
- Lymphocytosis/genetics
- Lymphocytosis/immunology
- Lymphocytosis/pathology
- Prospective Studies
- Protein Kinase Inhibitors/therapeutic use
- Pyrimidines/therapeutic use
- ROC Curve
- Remission Induction
- T-Lymphocytes, Cytotoxic/drug effects
- T-Lymphocytes, Cytotoxic/immunology
- T-Lymphocytes, Cytotoxic/pathology
- T-Lymphocytes, Regulatory/drug effects
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/pathology
- Thiazoles/therapeutic use
Collapse
Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization, Mito Medical Center, Ibaraki, Japan
| | - Hisashi Wakita
- Division of Hematology and Oncology, Japanese Red Cross Society, Narita Red Cross Hospital, Narita, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kimihiro Kawakami
- Department of Hematology and Clinical Oncology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Naoki Takezako
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Takashi Kumagai
- Department of Hematology, Ohme Municipal General Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Shingo Yano
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Tadahiko Igarashi
- Division of Hematology and Oncology, Gunma Prefectural Cancer Center, Gunma, Japan
| | - Yasuji Kouzai
- Department of Hematology, Tokyo Metropolitan Tama Synthesis Medical Center, Tokyo, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| |
Collapse
|
30
|
Inokuchi K, Kumagai T, Matsuki E, Ohashi K, Shinagawa A, Hatta Y, Takeuchi J, Yoshida C, Wakita H, Kozai Y, Shirasugi Y, Fujisawa S, Iwase O, Yano S, Okamoto S, Oba K, Sakamoto J, Sakamaki H. Efficacy of molecular response at 1 or 3 months after the initiation of dasatinib treatment can predict an improved response to dasatinib in imatinib-resistant or imatinib-intolerant Japanese patients with chronic myelogenous leukemia during the chronic phase. J Clin Exp Hematop 2015; 54:197-204. [PMID: 25501110 DOI: 10.3960/jslrt.54.197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Dasatinib is a BCR-ABL kinase inhibitor with improved potency compared with imatinib, for which efficacy and safety in imatinib-resistant and imatinib-intolerant patients with chronic myelogenous leukemia (CML) have been established. Here, an open-label phase II study evaluated the efficacy and safety of dasatinib in 50 Japanese patients with imatinib-resistant or imatinib-intolerant CML during the chronic phase (CML-CP). Dasatinib was effective in imatinib-resistant and imatinib-intolerant patients. After 12 months of dasatinib therapy, 35 patients (70%) had achieved a major molecular response (MMR) and 16 patients (32%) had achieved a complete molecular response (CMR). Among the imatinib-resistant CML-CP cohort, 21 and 8 patients had achieved an MMR and a CMR after 12 months of dasatinib therapy, respectively. Among the imatinib-intolerant CML-CP cohort, 14 and 8 patients had achieved an MMR and a CMR after 12 months of dasatinib therapy, respectively. After 18 months of dasatinib therapy, 38 out of 50 patients (76.0%) had achieved an MMR and 19 patients (38.0%) had achieved a CMR. A lower level of BCR-ABL transcript at 1 or 3 months after the initiation of dasatinib treatment was more strongly correlated with the BCR-ABL transcript level at 12 and 18 months (p < 0.001) than a higher level of BCR-ABL. The T315I mutation was identified in two patients receiving dasatinib therapy. Dasatinib was generally well tolerated, with only 3 patients (5%) having treatment discontinuation as a result of adverse hematologic events (thrombocytopenia, anemia, neutropenia) and/or non-hematologic events at a 12-month follow-up evaluation. Dasatinib was a safe and effective treatment for Japanese patients with imatinib-resistant or imatinib-intolerant CML. In addition, the molecular response at 1 or 3 months predicted a response to dasatinib at 12 or 18 months.
Collapse
Affiliation(s)
- Koiti Inokuchi
- Division of Hematology, Department of Internal Medicine, Nippon Medical School
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Nakamae H, Yoshida C, Miyata Y, Hidaka M, Uike N, Koga D, Sogabe T, Matsumura I, Kanakura Y, Naoe T. A new diagnostic kit, ODK-1201, for the quantitation of low major BCR-ABL mRNA level in chronic myeloid leukemia: correlation of quantitation with major BCR-ABL mRNA kits. Int J Hematol 2015; 102:304-11. [DOI: 10.1007/s12185-015-1826-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/10/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
|
32
|
Cho Y, Hori M, Okoshi Y, Fujisawa F, Shinagawa A, Kudo D, Komeno T, Yoshida C, Katsura Y, Ota I, Shimizu S, Kamoshita M, Sasaki K, Tanaka K, Mukai HY, Kojima H. Measurement of Proteasome Activity in Peripheral Blood Mononuclear Cells as an Indicator of Susceptibility to Bortezomib-Induced Severe Neurological Adverse Events in Patients with Multiple Myeloma. Acta Haematol 2015; 134:25-31. [PMID: 25871926 DOI: 10.1159/000369445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 10/29/2014] [Indexed: 11/19/2022]
Abstract
AIMS To explore the biomarker for predicting the occurrence of adverse events in myeloma patients treated by intravenous bortezomib, we measured proteasome activity in peripheral blood mononuclear cells. METHODS Samples were obtained from 34 bortezomib-naïve patients. Proteasome activity was measured at pre- and postchemotherapy phase by using a synthetic substrate. RESULTS Bortezomib injection resulted in a dramatic decrease in proteasome activity, reaching 32.4 ± 18.79% (mean ± SD) of the pretreatment level at 1 h, but it generally recovered at the end of the first course. In total, 6 patients manifested with severe bortezomib-induced peripheral neuropathy (sBIPN) in the second-third course. There was a nonsignificant trend for these patients to have lower levels of the relative proteasome activity at the end of the first course than those without sBIPN (median: 74.03 vs. 103.2%, p = 0.052). Moreover, in all of them, proteasome activity did not recover to the pretreatment level, whereas no patients with complete recovery manifested with sBIPN. Analysis with Fisher's exact test demonstrated that incomplete recovery of proteasome activity is a significant risk factor for sBIPN (p = 0.014). CONCLUSION Patients with incomplete recovery of proteasome activity are at high risk for developing sBIPN, and the susceptible patients can be indicated by monitoring proteasome activity.
Collapse
Affiliation(s)
- Yukiko Cho
- Department of Medical Oncology, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Ito H, Shiwaku H, Yoshida C, Homma H, Luo H, Chen X, Fujita K, Musante L, Fischer U, Frints SGM, Romano C, Ikeuchi Y, Shimamura T, Imoto S, Miyano S, Muramatsu SI, Kawauchi T, Hoshino M, Sudol M, Arumughan A, Wanker EE, Rich T, Schwartz C, Matsuzaki F, Bonni A, Kalscheuer VM, Okazawa H. In utero gene therapy rescues microcephaly caused by Pqbp1-hypofunction in neural stem progenitor cells. Mol Psychiatry 2015; 20:459-71. [PMID: 25070536 PMCID: PMC4378255 DOI: 10.1038/mp.2014.69] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 04/10/2014] [Accepted: 05/12/2014] [Indexed: 12/21/2022]
Abstract
Human mutations in PQBP1, a molecule involved in transcription and splicing, result in a reduced but architecturally normal brain. Examination of a conditional Pqbp1-knockout (cKO) mouse with microcephaly failed to reveal either abnormal centrosomes or mitotic spindles, increased neurogenesis from the neural stem progenitor cell (NSPC) pool or increased cell death in vivo. Instead, we observed an increase in the length of the cell cycle, particularly for the M phase in NSPCs. Corresponding to the developmental expression of Pqbp1, the stem cell pool in vivo was decreased at E10 and remained at a low level during neurogenesis (E15) in Pqbp1-cKO mice. The expression profiles of NSPCs derived from the cKO mouse revealed significant changes in gene groups that control the M phase, including anaphase-promoting complex genes, via aberrant transcription and RNA splicing. Exogenous Apc4, a hub protein in the network of affected genes, recovered the cell cycle, proliferation, and cell phenotypes of NSPCs caused by Pqbp1-cKO. These data reveal a mechanism of brain size control based on the simple reduction of the NSPC pool by cell cycle time elongation. Finally, we demonstrated that in utero gene therapy for Pqbp1-cKO mice by intraperitoneal injection of the PQBP1-AAV vector at E10 successfully rescued microcephaly with preserved cortical structures and improved behavioral abnormalities in Pqbp1-cKO mice, opening a new strategy for treating this intractable developmental disorder.
Collapse
Affiliation(s)
- H Ito
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Shiwaku
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - C Yoshida
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Homma
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Luo
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - X Chen
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Fujita
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
| | - L Musante
- Department of Human Molecular Genetics, Max-Planck Institute for Molecular Genetics, Berlin-Dahlem, Germany
| | - U Fischer
- Department of Human Molecular Genetics, Max-Planck Institute for Molecular Genetics, Berlin-Dahlem, Germany
| | - S G M Frints
- Department of Clinical Genetics, University Hospital azM Maastricht, Maastricht, The Netherlands,School for Oncology and Developmental Biology, GROW, Maastricht University, Maastricht, The Netherlands
| | - C Romano
- Unità Operativa Complessa di Pediatria e Genetica Medica, IRCCS Associazione Oasi Maria Santissima, Troina (Enna), Italy
| | - Y Ikeuchi
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, MO, USA,Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - T Shimamura
- Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Imoto
- Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Miyano
- Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S-i Muramatsu
- Department of Neurology, Jichi Medical University, Tochigi, Japan
| | - T Kawauchi
- Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
| | - M Hoshino
- Department of Biochemistry and Cellular Biology, National Center for Neurology and Psychiatry, Tokyo, Japan
| | - M Sudol
- Laboratory of Signal Transduction and Proteomic Profiling, Weis Center for Research, Geisinger Clinic, Danville, PA, USA
| | - A Arumughan
- Department of Neurogenetics, Max-Delbrück Center for Molecular Medicine, Berlin-Buch, Germany
| | - E E Wanker
- Department of Neurogenetics, Max-Delbrück Center for Molecular Medicine, Berlin-Buch, Germany
| | - T Rich
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - C Schwartz
- JC Self Research Institute of Human Genetics, Greenwood Genetic Center, Greenwood, SC, USA
| | - F Matsuzaki
- Laboratory for Cell Asymmetry, Center for Developmental Biology, RIKEN, Chuo-ku, Kobe, Japan
| | - A Bonni
- Department of Anatomy and Neurobiology, Washington University School of Medicine, St Louis, MO, USA,Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - V M Kalscheuer
- Department of Human Molecular Genetics, Max-Planck Institute for Molecular Genetics, Berlin-Dahlem, Germany
| | - H Okazawa
- Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan,Department of Neuropathology, Medical Research Institute and Center for Brain Integration Research, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan. E-mail:
| |
Collapse
|
34
|
Iriyama N, Fujisawa S, Yoshida C, Wakita H, Chiba S, Okamoto S, Kawakami K, Takezako N, Kumagai T, Inokuchi K, Ohyashiki K, Taguchi J, Yano S, Igarashi T, Kouzai Y, Morita S, Sakamoto J, Sakamaki H. Shorter halving time of BCR-ABL1 transcripts is a novel predictor for achievement of molecular responses in newly diagnosed chronic-phase chronic myeloid leukemia treated with dasatinib: Results of the D-first study of Kanto CML study group. Am J Hematol 2015; 90:282-7. [PMID: 25530131 DOI: 10.1002/ajh.23923] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 01/28/2023]
Abstract
To investigate the factors that affect molecular responses on dasatinib treatment in patients with chronic-phase chronic myeloid leukemia (CML-CP), we performed a clinical trial named the "D-First study." Fifty-two patients with newly diagnosed CML-CP were enrolled in this study and received 100 mg dasatinib once daily. A deep molecular response (DMR) was defined as <50 copies/μg RNA of BCR-ABL1 transcript value corrected by GAPDH, which ensures <0.01% of BCR-ABL1 transcript value according to International Scale (BCR-ABL1(IS)). The halving time for BCR-ABL1 transcripts was calculated using transcript levels before dasatinib treatment, transcript levels after 3 months of treatment, and the treatment time between these two points. In terms of molecular response, 38 of 51 (75%) patients reached major molecular response (MMR) by 12 months, and the rate of DMR by 18 months was 59% (30/51). While both BCR-ABL1 transcript levels before treatment and a shorter halving time of BCR-ABL1 transcripts (≤14 days) were significant factors affecting achievement of MMR by 12 months, the Sokal score at diagnosis was not associated with MMR. Importantly, the halving time was the only factor that predicted achievement of DMR by 18 months. We showed that patients with CML-CP treated with dasatinib can be stratified according to the early treatment response as determined by the halving time of BCR-ABL1 transcripts. These data emphasize the significance of the early response from dasatinib treatment in achieving a DMR. (ClinicalTrials.gov; NCT01464411).
Collapse
Affiliation(s)
- Noriyoshi Iriyama
- Division of Hematology and Rheumatology; Department of Medicine; Nihon University School of Medicine; Tokyo Japan
| | - Shin Fujisawa
- Department of Hematology; Yokohama City University Medical Center; Kanagawa Japan
| | - Chikashi Yoshida
- Department of Hematology; National Hospital Organization Mito Medical Center; Ibaraki Japan
| | - Hisashi Wakita
- Division of Hematology and Oncology; Japanese Red Cross Society, Narita Red Cross Hospital; Narita Japan
| | - Shigeru Chiba
- Department of Hematology; Faculty of Medicine; University of Tsukuba; Ibaraki Japan
| | - Shinichiro Okamoto
- Division of Hematology; Department of Internal Medicine; Keio University School of Medicine; Tokyo Japan
| | - Kimihiro Kawakami
- Department of Hematology and Clinical Oncology; Kagawa Prefectural Central Hospital; Kagawa Japan
| | - Naoki Takezako
- Department of Hematology; National Hospital Organization Disaster Medical Center; Tokyo Japan
| | - Takashi Kumagai
- Department of Hematology; Ohme Municipal General Hospital; Tokyo Japan
| | - Koiti Inokuchi
- Division of Hematology; Department of Internal Medicine; Nippon Medical School; Tokyo Japan
| | | | - Jun Taguchi
- Department of Hematology; Japanese Red Cross Shizuoka Hospital; Shizuoka Japan
| | - Shingo Yano
- Division of Clinical Oncology and Hematology; Department of Internal Medicine; Jikei University School of Medicine; Tokyo Japan
| | - Tadahiko Igarashi
- Division of Hematology and Oncology; Gunma Prefectural Cancer Center; Gunma Japan
| | - Yasuji Kouzai
- Department of Hematology; Tokyo Metropolitan Tama Synthesis Medical Center; Tokyo Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics; Kyoto University Graduate School of Medicine; Kyoto Japan
| | | | - Hisashi Sakamaki
- Hematology Division; Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital; Tokyo Japan
| |
Collapse
|
35
|
Tamura T, Miyazaki K, Yoshida C, Kagohashi K, Satoh H. Acute leukemia secondary to lung cancer in an elderly. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
36
|
Takahashi N, Miura M, Kuroki J, Mitani K, Kitabayashi A, Sasaki O, Kimura H, Imai K, Tsukamoto N, Noji H, Kondo T, Motegi M, Kato Y, Mita M, Saito H, Yoshida C, Torimoto Y, Kimura T, Wano Y, Nomura J, Yamamoto S, Mayama K, Honma R, Sugawara T, Sato S, Shinagawa A, Abumiya M, Niioka T, Harigae H, Sawada K. Multicenter phase II clinical trial of nilotinib for patients with imatinib-resistant or -intolerant chronic myeloid leukemia from the East Japan CML study group evaluation of molecular response and the efficacy and safety of nilotinib. Biomark Res 2014; 2:6. [PMID: 24650752 PMCID: PMC3994575 DOI: 10.1186/2050-7771-2-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/27/2014] [Indexed: 12/31/2022] Open
Abstract
Background Nilotinib is a second-generation tyrosine kinase inhibitor that exhibits significant efficacy as first- or second-line treatment in patients with chronic myeloid leukemia (CML). We conducted a multicenter Phase II Clinical Trial to evaluate the safety and efficacy of nilotinib among Japanese patients with imatinib-resistant or -intolerant CML-chronic phase (CP) or accelerated phase (AP). Results We analyzed 49 patients (33 imatinib-resistant and 16 imatinib-intolerant) treated with nilotinib 400 mg twice daily. The major molecular response (MMR) rate was 47.8% at 12 months among 35 patients who did not demonstrate an MMR at study entry. Somatic BCR-ABL1 mutations (Y253H, I418V, and exon 8/9 35-bp insertion [35INS]) were detected in 3 patients at 12 months or upon discontinuation of nilotinib. Although 75.5% of patients were still being treated at 12 months, nilotinib treatment was discontinued because of progressing disease in 1 patient, insufficient effect in 2, and adverse events in 9. There was no statistically significant correlation between MMR and trough concentrations of nilotinib. Similarly, no correlation was observed between trough concentrations and adverse events, except for pruritus and hypokalemia. Hyperbilirubinemia was frequently observed (all grades, 51.0%; grades 2–4, 29%; grades 3–4, 4.1%). Hyperbilirubinemia higher than grade 2 was significantly associated with the uridine diphosphate glucuronosyltransferase (UGT)1A9 I399C/C genotype (P = 0.0086; Odds Ratio, 21.2; 95% Confidence Interval 2.2–208.0). Conclusions Nilotinib was efficacious and well tolerated by patients with imatinib-resistant or -intolerant CML-CP/AP. Hyperbilirubinemia may be predicted before nilotinib treatment, and may be controlled by reducing the daily dose of nilotinib in patients with UGT1A9 polymorphisms. Trial registration clinicaltrials.gov: UMIN000002201
Collapse
Affiliation(s)
- Naoto Takahashi
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, 010-8543 Akita, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Katsura Y, Ota I, Yoshida C, Ohtani H, Komeno T. HIV-associated peripheral T-cell lymphoma with a cytotoxic phenotype. Intern Med 2014; 53:2127-31. [PMID: 25224201 DOI: 10.2169/internalmedicine.53.1990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Most human immunodeficiency virus (HIV)-related lymphomas are of B-cell origin, and the T-cell type is very rare. We experienced a Japanese case of HIV-associated peripheral T-cell lymphoma (HIV-PTCL). Sudden intestinal hemorrhage necessitated emergent surgical resection of the small intestine, in which an ulcerative lesion was detected. A histopathological examination revealed large tumor cells in the base of the ulcer, which were immunohistochemically CD30(+), CD56(+), granzyme B(+), CD3(+) (focally), CD4(-), CD8(-) and EBER(+). A diagnosis of PTCL, not otherwise specified, was therefore made. The differential diagnosis and significance of Epstein-Barr virus infection are also herein discussed.
Collapse
Affiliation(s)
- Yukitaka Katsura
- Department of Hematology, Mito Medical Center, National Hospital Organization, Japan
| | | | | | | | | |
Collapse
|
38
|
Yoshida C. [Chronic myelogenous leukemia]. Rinsho Ketsueki 2013; 54:61-70. [PMID: 23391648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
MESH Headings
- Antineoplastic Agents/therapeutic use
- Drug Resistance, Neoplasm/drug effects
- Early Detection of Cancer
- Humans
- Immunotherapy/methods
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/physiopathology
- Treatment Outcome
Collapse
|
39
|
Casolari DA, Makri M, Yoshida C, Muto A, Igarashi K, Melo JV. Transcriptional suppression of BACH2 by the Bcr-Abl oncoprotein is mediated by PAX5. Leukemia 2012; 27:409-15. [DOI: 10.1038/leu.2012.220] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
40
|
Cho Y, Hori M, Okoshi Y, Komeno T, Yoshida C, Katsura Y, Ota I, Shinagawa A, Kudo D, Shimizu S, Sasaki K, Tanaka K, Mukai H, Kojima H. Predicting bortezomib-related severe neurologic adverse events by measuring proteasome activity in PBMCs. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8094 Background: Although a proteasome inhibitor bortezomib (BOR) is one of the backbone drugs for the treatment of multiple myeloma, severe neurologic adverse event (sNE) is a major obstacle for continuing the treatment. As there is no clinically available biomarker for predicting the occurrence of sNAE, we measured the proteasome activity (PrsAtv) in peripheral blood mononuclear cells (PBMCs). Methods: Patients (Pts) were treated by either standard Q3wks or weekly (BOR 1.3mg/m2: day 1, 8, 15, 22; Q5wks) schedule depending on physician’s decision. PBMCs were collected from 21 Pts and 99 healthy volunteers. Pts’ samples were collected before treatment, 1 hour after the 1st injection of BOR, and at the end of the 1st course. PrsAtv in PBMCs was measured by using a specific substrate SUC-LLVY-AMC, which becomes fluorescent upon cleavage by proteasome. Results: Levels of PrsAtv among volunteers were highly variable with no certain correlation with age and sex. Pretreatment levels of PrsAtv among Pts were also variable, and didn't correlate with the occurrence of sNAE. After 1 hour of BOR injection, PrsAtv decreased to 33.2±20.5% (mean ± SD) of the pretreatment level, and it generally recovered (112.5±77.6%) at the end of the 1st course. However, in 12 out of 21 Pts, it didn’t recover to ≥ 100%. Among these Pts, 5 manifested with sNAE (≥G3) during the 2nd or 3rd course of the chemotherapy. In a sharp contrast, no patients whose PrsAtv recovered to ≥100% manifested with sNAE. Pts who manifested with sNAE (5 Pts) showed the lower levels of PrsAtv at the end of the 1st course than those without sNAE (16 Pts) (67.4±11.8 vs 126.6±83.8%, p=0.075). It should be also strengthened that all the Pts who manifested with sNAE were treated by the standard Q3wks schedule, although levels of PrsAtv at the end of the 1st course were not significantly different between Q3 and Q5wks groups (109.0±68.3 vs 121.1±96.4 %, p=0.38). Contrary, there was no significant difference of the bortezomib response between these two treatment groups. Conclusions: Pts whose PrsAtv does not recover to ≥100% at the end of the 1st course are at high risk of manifesting with sNAE, and these Pts should not be treated by the standard Q3wks schedule in the subsequent courses.
Collapse
Affiliation(s)
- Yukiko Cho
- Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Mitsuo Hori
- Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | | | | | | | | | | | | | | | | | | | - Keiji Tanaka
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | | | | | | |
Collapse
|
41
|
Yoshida C, Fletcher L, Ohashi K, Wakita H, Kumagai T, Shiseki M, Matsuei K, Inokuchi K, Hatta Y, Shirasugi Y, Yamaguchi T, Sakamoto J, Branford S, Sakamaki H. Harmonization of molecular monitoring of chronic myeloid leukemia therapy in Japan. Int J Clin Oncol 2011; 17:584-9. [PMID: 21986632 DOI: 10.1007/s10147-011-0328-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 09/15/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Real-time quantitative polymerase chain reaction (RQ-PCR) has been widely used for molecular monitoring for patients with chronic myeloid leukemia (CML). Currently, RQ-PCR is not based on the concept of international scale (IS) in Japan; mainly because none of the domestic laboratories have obtained their own conversion factor (CF) which makes it possible to convert locally scaled BCR-ABL (BCR-ABL (L)) value to the IS (BCR-ABL (IS)). To join the global trend of molecular assessment of BCR-ABL in CML patients, we have tried to obtain a CF in Japan. METHODS Samples from 55 patients were exchanged between the Japanese laboratory and the reference laboratory in Adelaide, and BCR-ABL and internal control gene transcripts of the samples were measured using RQ-PCR. The patient bias conversion method was used to determine the CF for the IS using the Bland and Altman method. RESULTS The local CF in the Japanese laboratory was determined to be 0.87. Based on this CF, 0.1% BCR-ABL (IS), defined as major molecular response, becomes equivalent to 731 copy/μg RNA BCR-ABL (L). CONCLUSION This study is the first to introduce a laboratory-specific CF for harmonizing RQ-PCR methodology for detecting BCR-ABL transcripts to Japan, which may open new windows for molecular assessment of CML patients in Japan.
Collapse
Affiliation(s)
- Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Yoshida C, Komeno T, Hori M, Kimura T, Fujii M, Okoshi Y, Suzukawa K, Chiba S, Hasegawa Y, Mukai HY, Ito T, Shimizu S, Kamoshita M, Kudo D, Shinagawa A, Chikatsu N, Monma Y, Watanabe N, Kojima H. Adherence to the standard dose of imatinib, rather than dose adjustment based on its plasma concentration, is critical to achieve a deep molecular response in patients with chronic myeloid leukemia. Int J Hematol 2011; 93:618-623. [DOI: 10.1007/s12185-011-0838-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 03/23/2011] [Accepted: 03/29/2011] [Indexed: 10/18/2022]
|
43
|
Thinh NC, Yoshida C, Long ST, Yusuf M, Nakao T. Adrenocortical Response in Cows after Intramuscular Injection of Long-Acting Adrenocorticotropic Hormone (Tetracosactide Acetate Zinc Suspension). Reprod Domest Anim 2011; 46:296-300. [DOI: 10.1111/j.1439-0531.2010.01666.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
44
|
Abstract
We report a 60-year-old man with diffuse large B-cell lymphoma harboring both t(3 ; 7)(q27 ; p12) and t(8 ; 14)(q24 ; q32). Although he received six courses of conventional combination chemotherapy plus rituximab, early relapse occurred. Four courses of an intensive salvage regimen and high-dose chemotherapy with autologous peripheral blood stem cell transplantation were performed. The patient has remained in complete remission for over 24 months. This case is noteworthy because both genetic abnormalities are implicated in lymphomagenesis.
Collapse
MESH Headings
- Antibodies, Monoclonal, Murine-Derived/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 7/genetics
- Chromosomes, Human, Pair 8/genetics
- DNA-Binding Proteins/genetics
- Genes, myc
- Humans
- Ikaros Transcription Factor/genetics
- Karyotyping
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Oncogene Fusion
- Peripheral Blood Stem Cell Transplantation
- Proto-Oncogene Proteins c-bcl-6
- Remission Induction
- Rituximab
- Salvage Therapy
- Translocation, Genetic
- Transplantation, Autologous
Collapse
Affiliation(s)
- Yukitaka Katsura
- Department of Hematology, Mito Medical Center, National Hospital Organization, Japan
| | | | | | | | | |
Collapse
|
45
|
Ota I, Katsura Y, Yoshida C, Yoshizawa K, Ohtani H, Sata T, Komeno T. [Progressive multifocal leukoencephalopathy after rituximab therapy in a patient with mantle cell lymphoma]. Rinsho Ketsueki 2010; 51:1786-1788. [PMID: 21258190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 74-year-old man, who had mantle cell lymphoma treated with several anticancer drugs including rituximab, was admitted to our hospital because of gait disturbance and progressive paralysis of the right lower limb. T2-weighted MR image showed multiple high intensity lesions in the left parietal lobe. Suspected of being cerebral invasion of lymphoma, high-dose methotrexate was begun, but the patient died of sepsis without neurological improvement. At autopsy, it was proven that neurological symptoms had been caused by progressive multifocal leukoencephalopathy (PML). PML should be considered as a possible complication of heavily treated lymphoma.
Collapse
Affiliation(s)
- Ikuyo Ota
- Department of Hematology, National Hospital Organization Mito Medical Center, Japan
| | | | | | | | | | | | | |
Collapse
|
46
|
Momma Y, Shinagawa A, Katsura T, Yoshida C, Chikatsu N, Kudo D, Komeno T. [Prediction of treatment efficacy by the M-protein reduction rate after the first cycle of VAD therapy for multiple myeloma]. Rinsho Ketsueki 2010; 51:685-689. [PMID: 20805676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In recent years, novel drugs for multiple myeloma such as bortezomib and thalidomide have been shown to be effective. However, in Japan, these drugs are indicated only for patients with relapsed or refractory multiple myeloma. There are no established criteria for the definition of refractory cases, and it is often difficult to determine when treatment methods should be changed for those cases. Therefore, we performed a retrospective study to investigate whether treatment responses can be predicted in the early stage of VAD therapy. After the first and third cycles of VAD, the M-protein reduction rate was evaluated. As a result, it was estimated with a 50% probability that an M-protein reduction rate of 87.6% (lower limit of the 95% CI, 73.9%) after the first cycle of VAD can predict a reduction of 90% after the third cycle. The progression-free survival period was slightly longer in the group achieving 90% M-protein reduction after the third cycle than in the group who did not achieve this rate (3.3 vs 2.2 years, p=0.09). These findings suggest that a change from conventional to novel therapeutic drugs in refractory cases identified by the responses to the first cycle of VAD can be a beneficial treatment strategy.
Collapse
Affiliation(s)
- Yuriko Momma
- Department of Hematology, Hitachi General Hospital
| | | | | | | | | | | | | |
Collapse
|
47
|
Thinh NC, Yoshida C, Long ST, Yusuf M, Nakao T. Adrenocortical response in cows after intramuscular injection of long-acting adrenocorticotropic hormone (tetracosactide acetate zinc suspension). Reprod Domest Anim 2010. [PMID: 20626680 DOI: 10.1111/j.1439–0531.2010.01666.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objectives of this study were first to show adrenocortical response to a long-acting adrenocorticotropic hormone preparation (tetracosactide acetate zinc suspension) (ACTH-Z) and its effect on adrenocortical function in beef cows (Experiment 1) and second to apply the ACTH-Z challenge in dairy cows based on cortisol concentrations in milk collected at routine milking (Experiment 2). In Experiment 1, four beef cows in luteal phase were challenged with ACTH-Z, and plasma cortisol concentrations were determined for 48 h after the injection at 30-min to 2-h intervals. A rapid ACTH test was conducted 3 days before and 2 h after the completion of ACTH-Z injection for 48 h to investigate the effect on adrenocortical function. Plasma cortisol concentrations increased significantly 30 min after ACTH-Z injection (p < 0.001), and the high cortisol levels were maintained for approximately 10 h after the injection. In Experiment 2, eight dairy cows were subjected to ACTH-Z challenge 1-2 weeks and 4-5 weeks post-partum. Blood and milk samples were taken at morning and afternoon milking. All the cows showed a significant increase in cortisol concentrations in plasma as well as in skim milk 8 h after ACTH-Z injection 1-2 weeks and 4-5 weeks post-partum (p < 0.001). There was a significant correlation between plasma and skim milk cortisol concentrations 8 h after ACTH-Z challenge (r = 0.74, p < 0.001). The results obtained in this study suggest that elevated levels of plasma cortisol are maintained for approximately 10 h after ACTH-Z treatment without adverse effect on adrenocortical function and a long-acting ACTH-Z challenge based on cortisol concentrations in milk, which were collected at the morning and the afternoon milking, can be a useful tool to monitor adrenocortical function in cows.
Collapse
Affiliation(s)
- N C Thinh
- Laboratory of Theriogenology, Department of Veterinary Medicine, Faculty of Agriculture, Yamaguchi University, Yoshida, Yamaguchi, Japan.
| | | | | | | | | |
Collapse
|
48
|
Shiotani M, Higuchi T, Takahashi N, Sato S, Makino H, Kuninaka K, Yoshida C, Shibuya H, Hashidate H. 605 Thin slice multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70626-1] [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
|
49
|
Makino H, Kuninaka K, Yoshida C, Hashidate H, Siotani M. 198 Evaluation of serum HER2 extracellular domain levels in patients with metastatic breast cancer and those who underwent preoperative systemic treatment. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70228-7] [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: 11/28/2022] Open
|
50
|
Hashidate H, Shibuya H, Makino H, Kuninaka K, Yoshida C, Shiotani M. 390 Turnaround-time reduction of pathological examination. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70416-x] [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: 10/19/2022] Open
|