1
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Nakaya Y, Nakamae H, Nishikubo M, Kondo E, Fukuda T, Hiramoto N, Mori Y, Nagafuji K, Eto T, Onishi Y, Uchida N, Ishikawa J, Matsuoka KI, Yui S, Takase K, Kawakita T, Kanda J, Ichinohe T, Atsuta Y, Kako S. Peripheral blood stem cell transplantation using HLA-haploidentical donor with post-transplant cyclophosphamide versus HLA-matched sibling donor for lymphoma. Bone Marrow Transplant 2024:10.1038/s41409-024-02229-y. [PMID: 38355911 DOI: 10.1038/s41409-024-02229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
Data comparing HLA-haploidentical donors and HLA-matched sibling donors (MSDs) in peripheral blood stem cell transplantation (PBSCT) for lymphoma are scarce. We retrospectively analyzed 465 patients with lymphoma aged 16 years or older who underwent PBSCT using haploidentical donors with post-transplant cyclophosphamide (PTCy-haplo) (n = 166) or MSDs with calcineurin inhibitor-based graft-versus-host disease (GVHD) prophylaxis (n = 299). Two-year overall survival (OS), progression-free survival (PFS), and GVHD-free, relapse-free survival (GRFS) in the PTCy-haplo and MSD groups were 49.2% versus 51.9% (P = 0.64), 38.0% versus 39.9% (P = 0.97), and 27.7% versus 18.5% (P = 0.006), respectively. In multivariable analyses, PTCy-haplo recipients had slower neutrophil recovery (hazard ratio [HR], 0.62; P < 0.001) and platelet recovery (HR, 0.54; P < 0.001), lower risk of chronic GVHD (HR, 0.64; P = 0.038) and extensive chronic GVHD (HR, 0.45; P = 0.008), and better GRFS (HR, 0.66; P = 0.003) than MSD transplant recipients. OS, PFS, relapse or progression, and non-relapse mortality were similar between the groups. The difference might be mainly due to PTCy use rather than donor type; however, the results suggested that PTCy-haplo could be a possible option as an alternative to conventional MSD transplantation for lymphoma in PBSCT.
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Affiliation(s)
- Yosuke Nakaya
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
| | - Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Eisei Kondo
- Department of Hematology, Kawasaki Medical School, Kurashiki, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuo Mori
- Hematology, Oncology and Cardiovascular medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Kurume, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yasushi Onishi
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Shunsuke Yui
- Department of Hematology, Nippon Medical School Hospital, Tokyo, Japan
| | - Ken Takase
- Department of Hematology, NHO Kyusyu Medical Center, Fukuoka, Japan
| | - Toshiro Kawakita
- Department of Hematology, NHO Kumamoto Medical Center, Kumamoto, Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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2
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Minakata D, Uchida T, Nakano A, Takase K, Tsukada N, Kosugi H, Kawata E, Nakane T, Takahashi H, Endo T, Nishiwaki S, Fujiwara H, Saito AM, Saito TI, Akashi K, Matsumura I, Mitani K. Characteristics and prognosis of patients with COVID-19 and hematological diseases in Japan: a cross-sectional study. Int J Hematol 2024; 119:183-195. [PMID: 38172385 PMCID: PMC10830869 DOI: 10.1007/s12185-023-03685-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024]
Abstract
The Japanese Society of Hematology performed an observational cross-sectional study to clarify the morbidity, prognosis, and prognostic factors in patients with COVID-19 with hematological diseases (HDs) in Japan. The study included patients with HDs who enrolled in our epidemiological survey and had a COVID-19 diagnosis and a verified outcome of up to 2 months. The primary endpoints were characteristics and short-term prognosis of COVID-19 in patients with HDs. A total of 367 patients from 68 institutes were enrolled over 1 year, and the collected data were analyzed. The median follow-up among survivors was 73 days (range, 1-639 days). The 60-day overall survival (OS) rate was 86.6%. In the multivariate analysis, albumin ≤ 3.3 g/dL and a need for oxygen were independently associated with inferior 60-day OS rates (hazard ratio [HR] 4.026, 95% confidence interval (CI) 1.954-8.294 and HR 14.55, 95% CI 3.378-62.64, respectively), whereas 60-day survival was significantly greater in patients with benign rather than malignant disease (HR 0.095, 95% CI 0.012-0.750). Together, these data suggest that intensive treatment may be necessary for patients with COVID-19 with malignant HDs who have low albumin levels and require oxygen at the time of diagnosis.
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Affiliation(s)
- Daisuke Minakata
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Tomoyuki Uchida
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Aya Nakano
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Ken Takase
- Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - Nodoka Tsukada
- Department of Hematology/Oncology, Asahikawa Kosei General Hospital, Asahikawa, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Eri Kawata
- Department of Hematology, Panasonic Health Insurance Organization Matsushita Memorial Hospital, Moriguchi, Japan
| | - Takahiko Nakane
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Hiroyuki Takahashi
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tomoyuki Endo
- Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Nishiwaki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Toshiki I Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osakasayama, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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3
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Usuki K, Ohtake S, Honda S, Matsuda M, Wakita A, Nawa Y, Takase K, Maeda A, Sezaki N, Yokoyama H, Takada S, Hirano D, Tomikawa T, Sumi M, Yano S, Handa H, Ota S, Fujita H, Fujimaki K, Mugitani A, Kojima K, Kajiguchi T, Fujimoto K, Asou N, Usui N, Ishikawa Y, Katsumi A, Matsumura I, Miyazaki Y, Kiyoi H. Real-world data of MDS and CMML in Japan: results of JALSG clinical observational study-11 (JALSG-CS-11). Int J Hematol 2024; 119:130-145. [PMID: 38091231 DOI: 10.1007/s12185-023-03686-9] [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: 08/26/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 02/01/2024]
Abstract
We conducted a multicenter, prospective observational study of acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and chronic myelomonocytic leukemia (CMML) in Japan. From August 2011 to January 2016, we enrolled 6568 patients. Herein, we report the results for MDS (n = 2747) and CMML (n = 182). The percentage of patients aged 65 years or older was 79.5% for MDS and 79.7% for CMML. The estimated overall survival (OS) rate and cumulative incidence of AML evolution at 5 years were 32.3% (95% confidence interval: 30.2-34.5%) and 25.7% (23.9-27.6%) for MDS, and 15.0% (8.9-22.7%) and 39.4% (31.1-47.6%) for CMML. Both diseases were more common in men. The most common treatment for MDS was azacitidine, which was used in 45.4% of higher-risk and 12.7% of lower-risk MDS patients. The 5-year OS rate after treatment with azacitidine was 12.1% (9.5-15.1%) for of higher-risk MDS patients and 33.9% (25.6-42.4%) for lower-risk patients. The second most common treatment was erythropoiesis-stimulating agents, given to just 20% of lower-risk patients. This is the first paper presenting large-scale, Japanese data on survival and clinical characteristics in patients with MDS and CMML.
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Affiliation(s)
- Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Higashi-Gotanda 5-9-22, Shinagawa-ku, Tokyo, 141-8625, Japan.
| | | | - Sumihisa Honda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Atsushi Wakita
- Nagoya City University East Medical Center, Nagoya, Japan
| | - Yuichiro Nawa
- Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | | | | | | | - Satoru Takada
- Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Daiki Hirano
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Tatsuki Tomikawa
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | | | - Shingo Yano
- Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
| | | | | | - Hiroyuki Fujita
- Department of Hematology, Yokohama Nanbu Hospital, Yokohama, Japan
| | | | | | - Kensuke Kojima
- Department of Hematology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tomohiro Kajiguchi
- Department of Hematology and Oncology, Tosei General Hospital, Seto, Japan
| | - Ko Fujimoto
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Norio Asou
- International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Noriko Usui
- Department of Clinical Oncology and Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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4
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Usuki K, Ohtake S, Honda S, Matsuda M, Wakita A, Nawa Y, Takase K, Maeda A, Sezaki N, Yokoyama H, Takada S, Hirano D, Tomikawa T, Sumi M, Yano S, Handa H, Ota S, Fujita H, Fujimaki K, Mugitani A, Kojima K, Kajiguchi T, Fujimoto K, Asou N, Usui N, Ishikawa Y, Katsumi A, Matsumura I, Kiyoi H, Miyazaki Y. Real-world data of AML in Japan: results of JALSG clinical observational study-11 (JALSG-CS-11). Int J Hematol 2024; 119:24-38. [PMID: 38015362 DOI: 10.1007/s12185-023-03677-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
This report covers acute myeloid leukemia (AML) results from a multicenter, prospective observational study of AML, myelodysplastic syndromes, and chronic myelomonocytic leukemia in Japan. From August 2011 to January 2016, 3728 AML patients were registered. Among them, 42% were younger than 65, and the male-to-female ratio was 1.57:1. With a median follow-up time of 1807 days (95% confidence interval [CI]: 1732-1844 days), the estimated 5-year overall survival (OS) rate in AML patients (n = 3707) was 31.1% (95% CI: 29.5-32.8%). Trial-enrolled patients had a 1.7-fold higher OS rate than non-enrolled patients (5-year OS, 58.9% [95% CI: 54.5-63.1%] vs 35.5% [33.3-37.8%], p < 0.0001). Women had a higher OS rate than men (5-year OS, 34% [95% CI; 31.4-36.7%] vs 27.7% [25.7-29.7%], p < 0.0001). The OS rate was lower in patients aged 40 and older than those under 40, and even lower in those over 65 (5-year OS for ages < 40, 40-64, 65-74, ≥ 75: 74.5% [95% CI; 69.3-79.0%] vs 47.5% [44.4-50.6%] vs 19.3% [16.8-22.0%] vs 7.3% [5.5-9.4%], respectively). This is the first paper to present large-scale data on survival and clinical characteristics in Japanese AML patients.
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Affiliation(s)
- Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Higashi-Gotanda 5-9-22, Shinagawa-Ku, Tokyo, 141-8625, Japan.
| | | | - Sumihisa Honda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Atsushi Wakita
- Nagoya City University East Medical Center, Nagoya, Japan
| | - Yuichiro Nawa
- Division of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | | | | | | | | | - Satoru Takada
- Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Daiki Hirano
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Tatsuki Tomikawa
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | | | - Shingo Yano
- Division of Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
| | | | | | - Hiroyuki Fujita
- Department of Hematology, Yokohama Nanbu Hospital, Yokohama, Japan
| | | | | | - Kensuke Kojima
- Department of Hematology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tomohiro Kajiguchi
- Department of Hematology and Oncology, Tosei General Hospital, Seto, Japan
| | - Ko Fujimoto
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Norio Asou
- International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Noriko Usui
- Department of Clinical Oncology and Hematology, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Yuichi Ishikawa
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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5
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Nakagawa N, Ishiyama K, Usuki K, Takada S, Tomikawa T, Handa H, Katsuoka Y, Hirano D, Sezaki N, Sumi M, Fujisawa S, Taniguchi Y, Mugitani A, Yoshimura T, Ohtsuka E, Takase K, Suehiro Y, Ota S, Kajiguchi T, Maeda T, Yamamoto M, Ohtake S, Katsumi A, Kiyoi H, Matsumura I, Miyazaki Y. Outcomes of transplant-eligible patients with myelodysplastic syndrome with excess blasts registered in an observational study: The JALSG-CS11-MDS-SCT. Ann Hematol 2024; 103:307-320. [PMID: 37940714 DOI: 10.1007/s00277-023-05527-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-SCT) is the sole curative therapy for myelodysplastic syndrome (MDS). However, whether bridging therapy (BRT) including azacitidine (AZA) and combination chemotherapy (CCT) prior to allo-SCT should be performed is unclear. We analyzed BRT and the outcomes of patients with myelodysplastic syndrome with excess blasts (MDS-EB) who were ≤ 70 years old at the time of registration for a prospective observational study to clarify the optimal allo-SCT strategy for high-risk MDS. A total of 371 patients were included in this study. Among 188 patients (50.7%) who were considered for allo-SCT, 141 underwent allo-SCT. Among the patients who underwent allo-SCT, 64 received AZA, 29 received CCT, and 26 underwent allo-SCT without BRT as the initial treatment. Multivariate analysis identified BRT as an independent factor influencing overall survival (AZA vs. without BRT, hazard ratio [HR] 3.33, P = 0.005; CCT vs. without BRT, HR 3.82, P = 0.003). In multivariate analysis, BRT was independently associated with progression-free survival (AZA vs. without BRT: HR, 2.23; P = 0.041; CCT vs. without BRT: HR, 2.94; P = 0.010). Transplant-eligible patients with MDS-EB should undergo allo-SCT when clinically acceptable, and upfront allo-SCT without BRT may be superior to AZA or CCT.
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Affiliation(s)
- Noriharu Nakagawa
- Department of Internal Medicine, Keiju Medical Center, Nanao, Japan
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
| | - Ken Ishiyama
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan.
- Department of Hematology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, 162-8655, Japan.
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Shinagawa, Japan
| | - Satoru Takada
- Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan
| | - Tatsuki Tomikawa
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Hospital, Maebashi, Japan
| | - Yuna Katsuoka
- Department of Hematology, Sendai Medical Center, National Hospital Organization, Sendai, Japan
| | - Daiki Hirano
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Nobuo Sezaki
- Department of Hematology, Chugoku Central Hospital, Miyukichokamiiwanari, Japan
| | - Masahiko Sumi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasuhiro Taniguchi
- Department of Hematology and Rheumatology, Kindai University Hospital, Osakasayama, Japan
| | | | - Takuro Yoshimura
- Department of Hematology, Osaka City General Hospital, Osaka, Japan
| | - Eiichi Ohtsuka
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Ken Takase
- Department of Hematology, Kyushu Medical Center, Fukuoka, Japan
| | - Youko Suehiro
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Tomohiro Kajiguchi
- Department of Hematology and Oncology, Tosei General Hospital, Seto, Japan
| | - Tomoya Maeda
- Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University, Hidaka, Japan
| | - Masahide Yamamoto
- Department of Hematology, Tokyo Medical and Dental University, Bunkyo, Japan
| | - Shigeki Ohtake
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
| | - Akira Katsumi
- Department of Hematology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hitoshi Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Hospital, Osakasayama, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
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6
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Yamasaki S, Mizuno S, Iwasaki M, Seo S, Uchida N, Shigesaburo M, Nakano N, Ishiwata K, Uehara Y, Eto T, Takase K, Kawakita T, Tanaka M, Sawa M, Katayama Y, Nawa Y, Makoto O, Ichinohe T, Atsuta Y, Kanda J, Yanada M. Efficacy and safety of allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients aged > 65 years with unfavorable cytogenetics. Ann Hematol 2023; 102:1549-1559. [PMID: 37126115 DOI: 10.1007/s00277-023-05243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/24/2023] [Indexed: 05/02/2023]
Abstract
Unrelated donor bone marrow transplantation (UR-BMT), unrelated donor cord blood stem cell transplantation (UR-CBT), and haploidentical peripheral blood stem cell transplantation (Haplo-PBSCT) are the main alternative stem cell sources for allogeneic hematopoietic cell transplantation (HCT) in Japan. The present study aimed to identify factors associated with the outcomes of UR-BMT, UR-CBT, and Haplo-PBSCT in older patients with acute myeloid leukemia (AML) and intermediate- or poor-risk cytogenetics to improve the clinical efficacy and safety of allogeneic HCT. We retrospectively analyzed data for 448 AML patients aged > 65 years who received UR-BMT (n = 102), UR-CBT (n = 250), or Haplo-PBSCT (n = 96) between 2014 and 2020. Overall survival (OS) in the UR-BMT group was superior (P = 0.033) to that in the other groups. However, all patients without complete remission (non-CR) who had Karnofsky performance status (KPS) < 80 at HCT and poor-risk cytogenetics died within 1 year after HCT. Multivariate Cox regression analysis identified KPS <80 at HCT and poor-risk cytogenetics as independent predictors of worse OS in non-CR patients. KPS < 80 may be an alternative indicator for non-CR AML patients with poor-risk cytogenetics during the selection of HCT, alternative treatments, or best supportive therapy, and the optimal KPS is important for the success of HCT.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Makoto Iwasaki
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Mibu, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Toranomon Hospital, Tokyo, Japan
| | | | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kawasaki, Japan
| | - Yasufumi Uehara
- Department of Hematology, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yuichiro Nawa
- Department of Hematology, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Onizuka Makoto
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Tatsuo Ichinohe
- Department of Hematology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Masamitsu Yanada
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
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7
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Ito Y, Ozawa H, Eto T, Miyamoto T, Kamimura T, Ogawa R, Uchida N, Wake A, Fujisaki T, Ohno Y, Takase K, Okumura H, Takamatsu Y, Kawano N, Akashi K, Nagafuji K. IKZF1 plus alterations are not associated with outcomes in Philadelphia-positive acute lymphoblastic leukemia patients enrolled in the FBMTG ALL/MRD2008 trial. Eur J Haematol 2023. [PMID: 36991564 DOI: 10.1111/ejh.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE The prognostic significance of IKZF1plus in adult Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL) patients had remained to be clarified. METHODS We conducted a prospective, multicenter study, the ALL/MRD2008 trial, and investigated clinical significance of IKZF1plus . RESULTS From December 2008 to November 2013, 38 untreated Ph+ ALL patients were enrolled. At the end of the induction, 97.4% of patients (37/38) achieved complete hematological remission, with MRD-negativity of 48.6% (18/37). There were 19 patients with IKZF1plus , 13 with IKZF1 deletion alone (ΔIKZF1) and 4 with no IKZF1 deletions (no ΔIKZF1). The probability of 3-year DFS and OS in these Ph+ ALL patients were 50% (95% confidence interval (CI), 33 to 65) and 55% (95% CI, 38 to 69), respectively. There was no significant difference between IKZF1plus , ΔIKZF1, and no ΔIKZF1 in DFS (47%, 54%, 75% [p = 0.63]) or OS (47%, 62%, NA [p = 0.39]). CONCLUSIONS We revealed no relationship between IKZF1plus status and survival outcomes in Ph+ ALL patients treated with imatinib/dasatinib combination chemotherapy. Further investigations are warranted to clarify the prognostic significance of IKZF1plus in adult Ph+ ALL patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yoshikiyo Ito
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Hidetoshi Ozawa
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
- Division of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | | | - Ryosuke Ogawa
- Department of Hematology and Oncology, Japan Community Health Care Organization (JCHO) Kyushu Hospital, Kitakyushu, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Atsusi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Tomoaki Fujisaki
- Department of Hematology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Yuju Ohno
- Department of Hematology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hirokazu Okumura
- Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan
- Department of Hematology, Minamisoma Municipal General Hospital, Minamisoma, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Noriaki Kawano
- Department of Hematology, Miyazaki Prefectural Hospital, Miyazaki, Japan
| | - Koichi Akashi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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8
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Iwasaki H, Yamasaki S, Kadowaki M, Minami M, Nukada T, Takase K. [Safety and feasibility of outpatient management in relapsed/refractory lymphoma treated with pegfilgrastim after multi-agent salvage therapy: a single-center, open-label, non-randomized, prospective interventional study]. Rinsho Ketsueki 2023; 64:596-607. [PMID: 37544718 DOI: 10.11406/rinketsu.64.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
OBJECTIVE We sought to assess the safety and feasibility of outpatient management in Japanese patients with relapsed/refractory lymphoma who had received pegfilgrastim after salvage therapy. METHOD This was a single-center, open-label, non-randomized, prospective interventional analysis. Patients were completely hospitalized for cycle 1 of chemotherapy. Those who met the outpatient management criteria (outpatient group) were subsequently admitted to the hospital for chemotherapy cycles but were discharged after each cycle was completed. The inpatient group was discharged when white blood cell and platelet counts improved. Pegfilgrastim was given as a single 3.6 mg dose by subcutaneous injection 2 days after the completion of each chemotherapy cycle. RESULTS The percentage of outpatient management days (primary endpoint) ranged from 68.2%-75.0% in the outpatient group and 28.6%-50.0% in the inpatient group. According to the secondary endpoints, there were no hospitalizations due to febrile neutropenia during the outpatient period. There were no major safety concerns raised. CONCLUSIONS For patients with relapsed/refractory lymphoma, pegfilgrastim administration after salvage therapy in an outpatient setting was feasible and safe for those who satisfied the outpatient management criteria.
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Affiliation(s)
- Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | - Mariko Minami
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
| | | | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center
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9
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Shoji F, Takase K, Kozuma Y, Yamazaki K, Kawauchi S, Takeo S. Induction immunotherapy followed by surgery for hilar unicentric Castleman disease. Thorac Cancer 2022; 13:1722-1725. [PMID: 35437953 PMCID: PMC9161333 DOI: 10.1111/1759-7714.14424] [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: 03/04/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022] Open
Abstract
Castleman disease is a rare disease borne of a B cell lymphoproliferative disorder of uncertain cause. Standard therapy for the unicentric type of Castleman disease localized as a single mass or single lymph‐node station is surgical extirpation. Nevertheless, in the thoracic cavity, unresectable cases or cases of incomplete extirpation of the tumor without lung scarring owing to tumor size/location have been noted. In such cases, lung resection (e.g., lobectomy, pneumonectomy) or additional therapy (immunotherapy, chemotherapy, radiotherapy) after resection is required. However, few instances of patients receiving induction immunotherapy or chemotherapy followed by surgery have been reported. Here, we describe a 21‐year‐old woman with unicentric Castleman disease originating from the left hilum. The tumor seemed to involve/be in contact with the pulmonary vein and bronchus. Tumor location indicated that initial resection was necessary to sacrifice upper and lower pulmonary lobes. To avoid these pulmonary resections, induction therapy followed by surgery was selected. Induction therapy using rituximab was very efficacious. Resection after induction therapy was completed only by tumor extirpation, and resulted in preservation of pulmonary function. Thoracic surgeons might consider induction therapy followed by resection if the tumor is resectable UCAD, but initial resection is needed and sacrifices a large amount of pulmonary function.
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Affiliation(s)
- Fumihiro Shoji
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yuka Kozuma
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Koji Yamazaki
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Shigeto Kawauchi
- Department of Pathology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Sadanori Takeo
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Tanaka T, Nakamae H, Ito A, Fuji S, Hirose A, Eto T, Henzan H, Takase K, Yamasaki S, Makiyama J, Moriuchi Y, Choi I, Nakano N, Hiramoto N, Kato K, Sato T, Sawayama Y, Kim SW, Inoue Y, Inamoto Y, Fukuda T. A Phase I/II Multicenter Trial of HLA-Haploidentical PBSCT with PTCy for Aggressive Adult T Cell Leukemia/Lymphoma. Transplant Cell Ther 2021; 27:928.e1-928.e7. [PMID: 34274491 DOI: 10.1016/j.jtct.2021.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
Adult T cell leukemia/lymphoma (ATL) is a highly aggressive hematologic malignancy with a very poor prognosis, and most patients with ATL are elderly. Although post-transplantation cyclophosphamide (PTCy) has yielded promising results in various diseases, available data are limited regarding its outcomes in ATL. The aim of this study was to determine the safety and efficacy of reduced-intensity peripheral blood stem cell transplantation (PBSCT) from a human leukocyte antigen (HLA)-haploidentical donor using PTCy as graft-versus-host disease (GVHD) prophylaxis. This was a prospective, multicenter phase I/II study (UMIN000021783) conducted at 16 hospitals in Japan. The primary endpoint was the probability of survival with engraftment and without grade III/IV acute GVHD at day 60 after PBSCT. The expected probability of the primary endpoint was estimated to be 60%, and the threshold probability was set at 30% on the basis of previous studies. The conditioning regimen consisted of fludarabine (30 mg/m2/d from day -7 to -2), melphalan (40 mg/m2/d on days -3 and -2), and total body irradiation (2 Gy on day -1). GVHD prophylaxis consisted of tacrolimus starting at 0.02 mg/kg/d on day -1, PTCy (50 mg/kg/d on days +3 and +5), and mycophenolate mofetil 2000 mg/d starting on day +6. Eighteen ATL patients underwent PBSCT. The probability of patients who met the primary endpoint was 89% (95% confidence interval, 65% to 99%). The cumulative incidences of grade II to IV acute GVHD, III/IV acute GVHD, and moderate-to-severe chronic GVHD were 39%, 11%, and 17%, respectively. The probabilities of overall survival were 83% at 1 year and 73% at 2 years. The cumulative incidences of non-relapse mortality and disease progression at 1 year were 11% and 28%, respectively. HLA-haploidentical PBSCT with PTCy as GVHD prophylaxis is a valid option for patients with aggressive ATL.
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Affiliation(s)
- Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Hirohisa Nakamae
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Ayumu Ito
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Asao Hirose
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Yamasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junya Makiyama
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | | | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Koji Kato
- Department of Hematology, Oncology & Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takahiko Sato
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Yasushi Sawayama
- Department of Hematology, Sasebo University Hospital, Sasebo, Japan
| | - Sung-Won Kim
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Inoue
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
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11
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Yamasaki S, Matsushima T, Minami M, Kadowaki M, Takase K, Iwasaki H. Clinical impact of comprehensive geriatric assessment in patients aged 80 years and older with diffuse large B-cell lymphoma receiving rituximab-mini-CHOP: a single-institute retrospective study. Eur Geriatr Med 2021; 13:195-201. [PMID: 34254266 DOI: 10.1007/s41999-021-00539-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Comprehensive geriatric assessment (CGA) has been used to help identify elderly patients with diffuse large B-cell lymphoma (DLBCL) who were suitable for rituximab combined with CHOP therapy (cyclophosphamide, Adriamycin, vincristine, and prednisolone), but there are few reports of CGA for elderly patients with DLBCL who received R-mini-CHOP. METHODS We retrospectively analyzed the risk factors for outcomes among 142 patients aged 80 years and older (≤ 85 years, n = 102; > 85 years, n = 40) with DLBCL who received R-mini-CHOP at 4-week intervals at our institute between 2008 and 2019. We performed a comparison between CGA and treatment outcomes. RESULTS There were significant differences in progression-free survival between patients with international prognostic index (IPI) scores of > 3 and ≤ 3 at diagnosis and in overall survival between patients with instrumental activities of daily living (IADL) scores of ≥ 5 and IADL < 5 before the initial treatment and patients aged ≤ 85 years and > 85 years. CONCLUSION Strategies that carefully select elderly patients aged 80 years and older with DLBCL using CGA may help to identify individuals suitable for novel therapies.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. .,Department of Internal Medicine, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita, 874-0838, Japan.
| | - Takumi Matsushima
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Mariko Minami
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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12
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Wang Z, Kimura S, Iwasaki H, Takase K, Oshiro Y, Gamachi A, Makihara K, Ogata M, Daa T, Momosaki S, Takamatsu Y, Takeshita M. Clinicopathological findings of systemic Epstein-Barr virus-positive T-lymphoproliferative diseases in younger and older adults. Diagn Pathol 2021; 16:48. [PMID: 34088321 PMCID: PMC8176609 DOI: 10.1186/s13000-021-01107-1] [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: 02/16/2021] [Accepted: 05/04/2021] [Indexed: 02/08/2023] Open
Abstract
Background Systemic Epstein-Barr virus+ T-cell lymphoma (sEBV+ TCL) occurs in childhood and young adults, and is exceptionally rare in older adults. Methods We investigated clinicopathological features in 16 patients of various ages with systemic EBV+ CD8+ T-lymphoproliferative diseases. Results Eight younger patients and four of eight older adults had sEBV+ CD8+ TCL, with invasion by medium-sized to/or large atypical lymphocytes primarily in bone marrow and lymph nodes, hemophagocytic lymphohistiocytosis (HLH), and progressive clinicopathological course. A further two patients demonstrated EBV+ node-based CD8+ large TCL without HLH, while the remaining two had the systemic form of chronic active EBV infection (sCAEBV) with CD8+ small lymphocytes. Past history of sCAEBV-like lesions was observed in one sEBV+ TCL patient (8.3%). Immunohistologically, in 12 sEBV+ TCL patients, atypical lymphocytes were positive for phosphate signal transducer and activator of transcription 3 (66.7%), CMYC (83.3%), and p53 (75%). Strong reactions of programmed cell death-ligand (PD-L)1+ tumor or non-neoplastic cells were detected in nine sEBV+ TCL patients (75%). Clonal peaks of the T-cell receptor (TCR) γ gene were detected in eight sEBV+ TCL patients by polymerase chain reaction. Four younger patients in sEBV+ TCL (33.3%) are in remission with chemotherapies including etoposide, and three of the four underwent allogeneic stem cell transplantation (SCT). Conclusion sEBV+ CD8+ TCL was observed in younger and older adults with less history of sCAEBV. HLH, tumor cell atypia, immunohistological findings, and progressive clinical course were characteristic of sEBV+ CD8+ TCL. Prompt chemotherapy and SCT induced tumor regression in sEBV+ CD8+ TCL patients.
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Affiliation(s)
- Ziyao Wang
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Shoichi Kimura
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Hiromi Iwasaki
- Departments of Hematology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Ken Takase
- Departments of Hematology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Yumi Oshiro
- Department of Pathology, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama, 7910000, Japan
| | - Ayako Gamachi
- Department of Pathology, Almeida Memorial Hospital, 1509-2. Oita, Miyazaki, 8701195, Japan
| | - Kosuke Makihara
- Department of Pathology, Kyushu Rosai Hospital, 1-1, Sonekita, Kokura South Ward, Kitakyushu, 800-0296, Japan
| | - Masao Ogata
- Departments of Hematology, Faculty of Medicine, Oita University, Idaigaoka, Hazama-machi, Yufushi, Oita, 8795593, Japan
| | - Tsutomu Daa
- Departments of Pathology, Faculty of Medicine, Oita University, Idaigaoka, Hazama-machi, Yufushi, Oita, 8795593, Japan
| | - Seiya Momosaki
- Departments of Pathology, Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 8108563, Japan
| | - Yasushi Takamatsu
- Departments of Internal Medicine, Division of Medical Oncology, Hematology and Infectious Disease, Faculty of Medicine, and Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan
| | - Morishige Takeshita
- Graduate School of Medical Sciences, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan. .,Department of Pathology, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 8140180, Japan.
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13
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Harada T, Iwasaki H, Muta T, Urata S, Sakamoto A, Kohno K, Takase K, Miyamura T, Sawabe T, Asaoku H, Oryoji K, Fujisaki T, Mori Y, Yoshimoto G, Ayano M, Mitoma H, Miyamoto T, Niiro H, Yamamoto H, Oshiro Y, Miyoshi H, Ohshima K, Takeshita M, Akashi K, Kato K. Outcomes of methotrexate-associated lymphoproliferative disorders in rheumatoid arthritis patients treated with disease-modifying anti-rheumatic drugs. Br J Haematol 2021; 194:101-110. [PMID: 33822354 DOI: 10.1111/bjh.17456] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/12/2021] [Indexed: 12/20/2022]
Abstract
Recently, the use of targeted synthetic or biological disease-modifying anti-rheumatic drugs (ts/bDMARDs) in addition to conventional synthetic (cs)DMARDs including methotrexate (MTX) for rheumatoid arthritis (RA) has increased. However, whether ts/bDMARDs are associated with the development and clinicopathological features of MTX-associated lymphoproliferative disorder (MTX-LPD) in patients with RA remains unknown. Therefore, we evaluated the clinical outcomes of 121 patients with MTX-LPD. Results showed that prior use of ts/bDMARDs was not associated with the different histopathological subtypes of MTX-LPD. Patients with polymorphic-type LPD had a better event-free survival than those with diffuse large B-cell lymphoma (DLBCL), classical Hodgkin lymphoma and peripheral T-cell lymphoma. The pathological subtype of lymphoma could predict the clinical outcome of MTX-LPD. In patients with DLBCL, the use of tumour necrosis factor-alpha (TNF-α) inhibitors prior to MTX-LPD onset was associated with a higher non-relapse mortality. Further, patients with RA previously treated with Janus kinase (JAK) inhibitors more commonly required chemotherapy than those treated with csDMARDs alone, indicating disease aggressiveness. Hence, special caution should be observed when managing patients with MTX-LPD previously treated with JAK or TNF-α inhibitors for RA.
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Affiliation(s)
- Takuya Harada
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.,Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Tsuyoshi Muta
- Department of Haematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Shingo Urata
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Aiko Sakamoto
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Kentaro Kohno
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Ken Takase
- Department of Haematology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Tomoya Miyamura
- Department of Internal Medicine and Rheumatology, National Hospital Organisation Kyushu Medical Centre, Fukuoka, Japan
| | - Takuya Sawabe
- Department of Rheumatology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Hideki Asaoku
- Department of Haematology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Kensuke Oryoji
- Centre for Rheumatic Diseases, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Masahiro Ayano
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroki Mitoma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroaki Niiro
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Kyushu, Japan
| | - Yumi Oshiro
- Department of Diagnostic Pathology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University Faculty of Medicine, Fukuoka, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University Faculty of Medicine, Fukuoka, Japan
| | - Morishige Takeshita
- Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
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14
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Tomohara S, Harano R, Wada S, Ohashi I, Yoshino F, Mito D, Kadowaki M, Takase K, Kuwashiro T, Takaba H, Yasaka M, Okada Y. Recurrent Guillain-Barré and Fisher Syndromes in Two Patients Who Were Subsequently Diagnosed with Aplastic Anemia. Case Rep Neurol 2020; 12:148-152. [PMID: 32595475 PMCID: PMC7315140 DOI: 10.1159/000507778] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/08/2020] [Indexed: 11/19/2022] Open
Abstract
Guillain-Barré (GBS) and Fisher (FS) syndromes rarely recur and the characteristics of recurrence have not been fully elucidated. We describe the cases of 2 patients with GBS or FS that recurred more than twice and who were subsequently diagnosed with aplastic anemia. Case 1 was a 66-year-old man who was diagnosed with aplastic anemia 10 months before admission with limb ataxia and a sensory disturbance of the distal limbs that developed 3 days after an upper respiratory tract infection. He had a history of double vision with ataxia at the ages of 38 and 56 years. Case 2 was a 66-year-old woman who had been treated for aplastic anemia 1 year previously. She had a history of upper limb weakness after upper respiratory tract infections at the ages of 39 and 60 years. Tendon reflexes were absent in both patients at the time of onset and they were respectively diagnosed with FS and GBS and treated with intravenous immunoglobulin. No neurological deficits persisted. Blood findings showed that both were positive for IgG type ganglioside antibodies and HLA-DR15. The positive HLA-DR15 might have been associated with the recurrent GBS or FS and the development of aplastic anemia.
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Affiliation(s)
- Saori Tomohara
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Risa Harano
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Shinichi Wada
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Ikkei Ohashi
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Fumitaka Yoshino
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Daiki Mito
- Division of Cerebrovascular Medicine, Mutual Aid Association of Public School Teachers, Kyushu Central Hospital, Fukuoka, Japan
| | - Masanori Kadowaki
- Division of Hematology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Division of Hematology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Takahiro Kuwashiro
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Hitonori Takaba
- Division of Cerebrovascular Medicine, Mutual Aid Association of Public School Teachers, Kyushu Central Hospital, Fukuoka, Japan
| | - Masahiro Yasaka
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Yasushi Okada
- Division of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
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Yoshida I, Saito AM, Tanaka S, Choi I, Hidaka M, Miyata Y, Inoue Y, Yamasaki S, Kagoo T, Iida H, Niimi H, Komeno T, Yoshida C, Tajima F, Yamamoto H, Takase K, Ueno H, Shimomura T, Sakai T, Nakashima Y, Yoshida C, Kubonishi S, Sunami K, Yoshida S, Sakurai A, Kaneko Y, Miyazaki Y, Nagai H. Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever. Mycoses 2020; 63:794-801. [PMID: 32391919 PMCID: PMC7497187 DOI: 10.1111/myc.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fungal infections are a major complication of neutropaenia following chemotherapy. Their early diagnosis is difficult, and empirical antifungal treatment is widely used, and uses of less toxic drugs that reduce breakthrough infection are required. OBJECTIVE We conducted a multicentre, open-label, randomised, non-inferiority trial to compare the safety and efficacy of intravenous itraconazole (ivITCZ) and liposomal amphotericin B (LAmB) as empirical antifungal therapy in patients with haematological malignancies with neutropaenia and persistent fever. METHODS Patients with haematological malignancies who developed fever refractory to broad-spectrum antibacterial agents under neutropaenia conditions were enrolled. Patients were randomised for treatment with LAmB (3.0 mg/kg/d) or ivITCZ (induction: 400 mg/d, maintenance: 200 mg/d). RESULTS Observed overall favourable response rates of 17/52 (32.7%) and 18/50 (36.0%) in the LAmB and ivITCZ groups, with a model-based estimate of a 4% difference (90% CI, -12% to 20%), did not fulfil the statistical non-inferiority criterion. In the LAmB group, there were two cases of breakthrough infection and five cases of probable invasive fungal disease, whereas in the itraconazole group, neither breakthrough infection nor probable invasive fungal disease occurred. Patients in the ivITCZ group had significantly fewer grade 3-4 hypokalaemia-related events than LAmB group patients (P < .01). The overall incidence of adverse events tended to be lower in the ivITCZ group (P = .07). CONCLUSION ivITCZ showed similar efficacy and safety as LAmB as empirical antifungal therapy in haematological malignancy patients with febrile neutropaenia, although the small sample size and various limitations prevented demonstration of its non-inferiority.
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Affiliation(s)
- Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Shiro Tanaka
- Department of Clinical Biostatistics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiko Miyata
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Yoshiko Inoue
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Toshiya Kagoo
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroatsu Iida
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Hiromasa Niimi
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Takuya Komeno
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Chikamasa Yoshida
- Department of Hematology, National Hospital Organization Minami-Okayama Medical Center, Okayama, Japan
| | - Fumihito Tajima
- Stem Cell Transplantation Center, National Hospital Organization Yonago Medical Center, Yonago, Japan
| | - Hideyuki Yamamoto
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hironori Ueno
- Department of Hematology and Internal Medicine, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Shimomura
- Department of Internal Medicine, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Tatsunori Sakai
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Yasuhiro Nakashima
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, Higashiibarakigun, Japan
| | - Shiro Kubonishi
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Aki Sakurai
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Yukihiro Kaneko
- Department of Bacteriology, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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16
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Sugisawa J, Matsumoto Y, Suda A, Ota H, Tsuchiya S, Ohyama K, Takeuchi M, Shindo T, Ikeda S, Hao K, Kikuchi Y, Takahashi J, Takase K, Kohzuki M, Shimokawa H. 3332Exercise training ameliorates vasodilator capacity of coronary microvessels in patients with vasospastic angina - A new therapeutic approach for the coronary functional disorder. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
We have recently demonstrated that coronary vasospasm could develop in both epicardial coronary arteries and intramuscular coronary microvessels in patients with vasospastic angina (VSA). However, it remains to be examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients and if so, whether exercise training could ameliorate vasodilator capacity of coronary microvessels on the top of calcium channel blockers. The effectiveness of exercise training is established for organic coronary artery disease but remained to be examined for VSA.
Purpose
We thus examined whether vasodilator capacity of coronary microvessels is impaired in VSA patients without organic coronary stenosis using an adenosine-stress dynamic computed tomography perfusion (CTP) that can measure absolute value of myocardial blood flow (MBF). We also examined whether exercise training ameliorates not only vasodilator capacity of coronary microvessels but also exercise capacity and frequency of angina attack.
Methods
In the first protocol, we measured MBF using CTP in consecutive 32 VSA patients with acetylcholine-induced diffuse coronary spasm in the left anterior descending coronary arteries (LAD) and 12 non-VSA controls. In the second protocol, we conducted a randomized controlled trial (RCT; Exercise VSA trial, UMIN: ehz745.008423996), where 20 VSA patients were randomly assigned to either exercise group (Ex group: supervised exercise training session for 30-min using bicycle ergometer, once/week at the hospital and more than 3 times/week at home) or non-exercise group (Non-Ex group) (n=10 each) (Figure A). Before and 3 months after exercise training, we measured MBF with adenosine-stress dynamic CTP and peak VO2 by cardiopulmonary exercise tests, and also assessed angina attack with Seattle Angina Questionnaire (SAQ).
Results
In the first protocol, CTP showed that adenosine-stress MBF was significantly decreased in the VSA group compared with the non-VSA group (VSA, 137.2±6.6 vs. Non-VSA, 174.4±10.7 ml/100g/min, P<0.01) (Figure B), although patient characteristics were comparable between the 2 groups. In the second protocol, exercise training was performed safely in all patients, and RCT showed that MBF was significantly increased in the Ex group compared with the non-Ex group (Figures C, D), although patient characteristics were also comparable between the 2 groups. Furthermore, peak VO2 was significantly increased in the Ex group compared with the non-Ex group (Figure E), and frequency of angina was significantly decreased in the Ex group compared with the non-Ex group (Figure F). Finally, there was a significant positive correlation between the extents of the changes in peak VO2 and the SAQ score for angina frequency in the Ex group (P<0.01, R=0.67).
Figures
Conclusions
These results provide the first evidence that vasodilator capacity of coronary microvessels is impaired in VSA patients, which can be ameliorated by exercise training.
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Affiliation(s)
- J Sugisawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Matsumoto
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - A Suda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Ota
- Tohoku University Graduate School of Medicine, Department of Radiology, Sendai, Japan
| | - S Tsuchiya
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Ohyama
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - M Takeuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Shindo
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Ikeda
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Hao
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Kikuchi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - J Takahashi
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Takase
- Tohoku University Graduate School of Medicine, Department of Radiology, Sendai, Japan
| | - M Kohzuki
- Tohoku University Graduate School of Medicine, Department of Internal Medicine & Rehabilitation Science, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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17
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Terui Y, Sugimura K, Ota H, Hiroshi T, Sato H, Nochioka K, Tatebe S, Miyata S, Sakata Y, Ishida T, Takase K, Shimokawa H. P3117Usefulness of cardiac magnetic resonance imaging for early detection of subclinical chemotherapy-related cardiac dysfunction in cancer patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Long-term prognosis of cancer patients has been improved along with the progress in chemotherapies. However, chemotherapy-related cardiac dysfunction (CTRCD) is emerging as a serious adverse effect as it worsens patients' outcome and quality of life. Thus, early detection of subclinical CTRCD is an important emerging issue in the management of cancer patients. Cardiac magnetic resonance (CMR) utilizes parametric mapping approach and strain analysis to provide detailed information about cardiac tissue and diastolic cardiac function.
Purpose
We examined whether the novel CMR imaging techniques are useful for early detection of CTRCD.
Methods and results
We performed both retrospective and prospective studies. (1) Retrospective study: We retrospectively enrolled 52 cancer patients (mean age 55.6±13 yrs., M/F=14/38) who had been treated with anthracyclines. We examined the usefulness of CMR for quantitative assessment of myocardial fibrosis caused by chemotherapies. We found that native T1 value was significantly prolonged in cancer patients compared with healthy controls (N=10) (1,279±56 vs. 1,240±34 msec, P=0.036). (2) Prospective study: A total of 99 consecutive female patients with breast cancer treated with chemotherapies were enrolled in this study from August 2017 to January 2019. To evaluate CTRCD in those patients, we performed CMR (at baseline and/or 6 months) and biomarkers analysis for cardiac troponin T (cTnT) and BNP at baseline and every 3 months during chemotherapies. In the 99 patients, 52 (mean age 53.0±12.7 yrs.) completed cardiac assessment at 6 months, and 6 (12%) developed CTRCD defined as a reduction in left ventricular ejection fraction (LVEF) >10% from baseline and below 53% without symptoms. In patients with CTRCD (CTRCD group, N=6), as compared with those without it (non-CTRCD group, N=46), native T1 value was significantly prolonged after chemotherapies (1,303±32 vs. 1,322±22 msec at 6 months, P=0.03). Plasma cTnT levels at 3 months were also significantly higher in the CTRCD group compared with the non-CTRCD group [0.022 (IQR 0.015–0.026) vs. 0.01 (0.006–0.014) ng/mL, P=0.024], whereas there was no difference in BNP values. In the 52 patients, 28 (mean age 56.3±12.3 yrs.) underwent CMR both before and 6 months after chemotherapies. In those patients, LVEF and global radial strain were significantly decreased at 6 months from baseline (LVEF, from 70.5±4.6 to 66.0±7.1%; global radial strain, from 70.0±22.5 to 61.1±22.6%, respectively, both P<0.05). In patients with elevated cTnT levels at 3 months, as compared with those without it, LVEF and extracellular volume fraction (ECV) at 6 months were significantly worse (LVEF, 59.0±6.0 vs. 62.7±2.6%, P=0.042; ECV, 32.3±2.9 vs. 30.2±2.3%, P=0.049, respectively).
Conclusions
These results indicate that novel CMR imaging techniques are useful for early detection of CTRCD among cancer patients treated with chemotherapies.
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Affiliation(s)
- Y Terui
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Sugimura
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - H Ota
- Tohoku University Graduate School of Medicine, Department of Diagnostic Radiology, Sendai, Japan
| | - T Hiroshi
- Tohoku University Graduate School of Medicine, Department of Surgical Oncology, Sendai, Japan
| | - H Sato
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - K Nochioka
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Tatebe
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - S Miyata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - Y Sakata
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
| | - T Ishida
- Tohoku University Graduate School of Medicine, Department of Surgical Oncology, Sendai, Japan
| | - K Takase
- Tohoku University Graduate School of Medicine, Department of Diagnostic Radiology, Sendai, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Department of Cardiovascular Medicine, Sendai, Japan
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18
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Nagafuji K, Miyamoto T, Eto T, Ogawa R, Okumura H, Takase K, Kawano N, Miyazaki Y, Fujisaki T, Wake A, Ohno Y, Kurokawa T, Kamimura T, Takamatsu Y, Yokota S, Akashi K. Prospective evaluation of minimal residual disease monitoring to predict prognosis of adult patients with Ph-negative acute lymphoblastic leukemia. Eur J Haematol 2019; 103:164-171. [PMID: 31132205 DOI: 10.1111/ejh.13268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We investigated whether minimal residual disease (MRD) status in adult patients with Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) is useful for decision on clinical indications for allogeneic hematopoietic stem cell transplantation (HSCT). METHODS We prospectively monitored MRD after induction and consolidation therapy in adult patients with Ph-negative ALL. RESULTS Among 103 adult ALL patients enrolled, 59 were Ph-negative, and MRD status was assessed in 51 patients. The probability of 3-year overall survival (OS) and disease-free survival (DFS) was 69% (95%CI 54-80) and 50% (95%CI 36-63), respectively. Patients who were MRD-negative after induction therapy (n = 15) had a significantly better 3-year DFS compared with those who were MRD-positive (n = 30; 73% vs 41%, P = 0.018). Patients who were MRD-positive after induction but became MRD-negative after consolidation chemotherapy C in the first course (n = 11) showed a significantly worse 3-year DFS compared with patients who were MRD-negative after induction chemotherapy A in the first course (45% vs 73%, P = 0.025). CONCLUSIONS These results indicate that DFS of about 70% can be expected in MRD-negative patients after induction therapy, and the patients did not benefit from HSCT in 1CR. This study was registered with the UMIN Clinical Trials Registry (UMIN-CTR), number UMIN000001519.
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Affiliation(s)
- Koji Nagafuji
- Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Toshihiro Miyamoto
- Department of Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ryosuke Ogawa
- Department of Hematology and Oncology, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
| | - Hirokazu Okumura
- Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Noriaki Kawano
- Department of Hematology, Miyazaki Prefectural Hospital, Miyazaki, Japan
| | | | - Tomoaki Fujisaki
- Department of Hematology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Yuju Ohno
- Department of Hematology, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Toshiro Kurokawa
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
| | - Tomohiko Kamimura
- Department of Hematology, HaraSanshin General Hospital, Fukuoka, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | | | - Koichi Akashi
- Department of Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan
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19
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Yamasaki S, Kadowaki M, Jiromaru T, Takase K, Iwasaki H. Acquired Hemophilia A Associated with Dipeptidyl Peptidase-4 Inhibitors for the Treatment of Type 2 Diabetes Mellitus: A Single-Center Case Series in Japan. Diabetes Ther 2019; 10:1139-1143. [PMID: 30927215 PMCID: PMC6531581 DOI: 10.1007/s13300-019-0609-3] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Indexed: 11/30/2022] Open
Abstract
Herein we describe four patients with acquired hemophilia A (AHA) caused by factor VIII (FVIII) inhibitor and histories of dipeptidyl peptidase-4 inhibitor (DPP4-I) treatment for diabetes mellitus (DM). Drug exposure can cause a breakdown of immune tolerance to FVIII associated with CD4 T cells, resulting in the induction of autoantibodies against FVIII. In patient 1 in the present series, FVIII inhibitor disappeared after DPP4-I treatment. The DPP4-I treatment was stopped faster in patient 1 than it was in patient 2, whose FVIII inhibitor titer was higher than patient 1's. Two patients died: patient 3 due to brain infarction after recurrence associated with the development of sigmoid colon rupture, and patient 4 due to multiple organ failure associated with Clostridium difficile colitis. DPP4-I treatment may create an ideal environment for the induction of new antibodies and AHA onset associated with tumor necrosis factor-α reduction. These are the first reported cases of the potential development and/or prolonging of AHA after DDP4-I treatment for DM, and they suggest possible disease associations.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan.
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Takashi Jiromaru
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
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20
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Takase K, Kada A, Iwasaki H, Yoshida I, Sawamura M, Yoshio N, Yoshida S, Iida H, Otsuka M, Takafuta T, Ogata Y, Suehiro Y, Hirabayashi Y, Hishita T, Yoshida C, Ito T, Hidaka M, Tsutsumi I, Saito AM, Nagai H. High-dose Dexamethasone Therapy as the Initial Treatment for Idiopathic Thrombocytopenic Purpura: Protocol for a Multicenter, Open-label, Single Arm Trial. Acta Med Okayama 2018; 72:197-201. [PMID: 29674771 DOI: 10.18926/amo/55863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Standard therapy for idiopathic thrombocytopenic purpura (ITP) has not been established. We are conducting a multicenter, prospective trial to determine the efficacy and safety of short-term, high-dose dexamethasone therapy in ITP patients aged 18-80 years with platelet counts of <20, 000 /μL, or with <50, 000/ μL and bleeding symptoms. The primary endpoints of this trial are the proportion of responses (complete plus partial response) on day 180 (day 46+180) after the completion of the 46-day high-dose dexamethasone therapy. The results of this investigation of the effectiveness and safety of this regimen will be essential for the establishment of standard therapy for ITP.
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Affiliation(s)
- Ken Takase
- Department of Hematology, Kyushu Medical Center, Fukuoka 810-8563,
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21
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Mugikura S, Takahashi S, Takase K. Relationship between Ischemic Injury and Patient Outcomes after Surgical or Endovascular Treatment of Ruptured Anterior Communicating Artery Aneurysms. AJNR Am J Neuroradiol 2018; 39:E51-E52. [PMID: 29449285 DOI: 10.3174/ajnr.a5564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- S Mugikura
- Department of Diagnostic Radiology Graduate School of Medicine Tohoku University Sendai, Japan
| | - S Takahashi
- Department of Diagnostic Radiology Graduate School of Medicine Tohoku University Sendai, Japan
| | - K Takase
- Department of Diagnostic Radiology Graduate School of Medicine Tohoku University Sendai, Japan
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Yoshida S, Henzan H, Ueno T, Shimakawa T, Matsuo Y, Kuriyama T, Saito N, Kawano I, Numata A, Takase K, Iino T, Eto T. The Confirmation of Safety for the Intensified Conditioning Regimens: A Retrospective Study of Allogeneic Hematopoietic Stem Cell Transplantation for Non-Remission Hematological Malignant Diseases. Int J Hematol Oncol Stem Cell Res 2018; 12:123-131. [PMID: 30233774 PMCID: PMC6141425] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: The prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) for non-remission hematological malignant diseases is usually unfavorable. The most uncontrollable factor is residual disease or relapse. To overcome this problem, intensified conditioning regimens- sequential and/or additional chemotherapy to the standard regimen- could be effective. However, increasing the intensity of conditioning might also lead to more complications. Materials and Methods: We retrospectively analyzed 81 patients with non-remission disease who received allogeneic HSCT in our institution between 2007 and 2011. Results: 55.6% in 36 myeloablative conditioning patients and 46.7% in 45 reduced-intensity conditioning patients received intensified conditioning. The 5-year probability of overall survival was 35.0% and 17.1% in the standard and intensified group, respectively (p=0.027). Relapse mortality was 30% in the standard regimen group and 36.6% in the intensified regimen group (p=0.54). Transplant-related mortality (TRM) at 30 and 100 days was 5%, 17.1% (p=0.086) and 27.5%, 34.2% (p=0.52) in the standard and intensified group, respectively. There was no difference in TRM between the 2 groups at 30 days and 100 days. Conclusion: The results of the study confirm the safety of the intensified conditioning regimen. Meanwhile, it could be considered as one of the few methods available to reduce the tumor burden before HSCT for refractory malignant diseases.
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Affiliation(s)
- Shuro Yoshida
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Toshiyuki Ueno
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | | | - Yayoi Matsuo
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Takuro Kuriyama
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Noriyuki Saito
- Department of Hematology, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Ichiro Kawano
- Hematology and Oncology Division, Japan Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Akihiko Numata
- Department of Medicine and Biosystemic Science, Kyushu University, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyushu Medical Hospital, Fukuoka, Japan
| | - Tadafumi Iino
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
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Yamasaki S, Kohno K, Kadowaki M, Takase K, Iwasaki H. Cytomegalovirus retinitis in relapsed or refractory low-grade B cell lymphoma patients treated with bendamustine. Ann Hematol 2017; 96:1215-1217. [PMID: 28447162 DOI: 10.1007/s00277-017-3005-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan.
| | - Kentaro Kohno
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Masanori Kadowaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Ken Takase
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
| | - Hiromi Iwasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-Ku, Fukuoka, 810-8563, Japan
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24
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Miyamoto T, Takashima S, Kato K, Takase K, Yoshimoto G, Yoshida S, Henzan H, Osaki K, Kamimura T, Iwasaki H, Eto T, Teshima T, Nagafuji K, Akashi K. Comparison of cyclosporine and tacrolimus combined with mycophenolate mofetil in prophylaxis for graft-versus-host disease after reduced-intensity umbilical cord blood transplantation. Int J Hematol 2016; 105:92-99. [PMID: 27686673 DOI: 10.1007/s12185-016-2093-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 11/30/2022]
Abstract
Umbilical cord blood transplantation with a reduced-intensity conditioning regimen (RIC-UCBT) is used increasingly in patients who have comorbid organ functions and lack human leukocyte antigen-identical donors. We compared the outcomes in 35 patients who received mycophenolate mofetil plus cyclosporine (MMF/CSP, n = 17) or MMF plus tacrolimus (MMF/TAC, n = 18) for graft-versus-host disease (GVHD) prophylaxis after RIC-UCBT. Cumulative incidence of neutrophil engraftment was 94 and 89 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.34). The incidence of pre-engraftment immune reaction did not differ between the MMF/CSP (41 %) and MMF/TAC (39 %, p = 1.00) groups; however, patients in the MMF/TAC group tended to have a lower incidence of grade II-IV acute GVHD than those in MMF/CSP group (28 vs 53 %, p = 0.11). Overall survival (OS) at 1 year was 43 and 60 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.39). Progression-free survival, non-relapse mortality, and relapse rate were comparable between the two groups (p = 0.76, 0.59, and 0.88, respectively). In multivariate analyses, MMF/TAC GVHD prophylaxis was closely associated with improved OS, but not with incidence of engraftment and acute GVHD. These results suggest that more intensive GVHD prophylaxis with MMF/TAC decreased acute GVHD without affecting other clinical outcomes, resulting in improved OS after RIC-UCBT.
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Affiliation(s)
- Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Shuichiro Takashima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ken Takase
- Department of Hematology, National Kyushu Medical Center, Fukuoka, Japan.,Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shuro Yoshida
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Koichi Osaki
- Department of Hematology, Kurume University Hospital, Kurume, Japan
| | | | - Hiromi Iwasaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Department of Hematology, National Kyushu Medical Center, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Takanori Teshima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Koji Nagafuji
- Department of Hematology, Kurume University Hospital, Kurume, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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25
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Takase K, Yamamoto K. Arthroscopic procedures and therapeutic results of anatomical reconstruction of the coracoclavicular ligaments for acromioclavicular Joint dislocation. Orthop Traumatol Surg Res 2016; 102:583-7. [PMID: 27317638 DOI: 10.1016/j.otsr.2016.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/30/2016] [Accepted: 04/25/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Surgical treatment is recommended for type 5 acromioclavicular joint dislocation on Rockwood's classification. We believe that anatomic repair of the coracoclavicular ligaments best restores the function of the acromioclavicular joint. We attempted to correctly reconstruct the anatomy of the coracoclavicular ligaments under arthroscopy, and describe the minimally invasive arthroscopic procedure. MATERIALS AND METHODS There were 22 patients; mean age at surgery, 38.1 years. Mean time to surgery was 13.2 days. Mean follow-up was 3 years 2 months. The palmaris longus tendon was excised from the ipsilateral side to replace the conoid ligament, while artificial ligament was used for reconstructing the trapezoid ligament. Both ligament reconstructions were performed arthroscopically. No temporary fixation of the acromioclavicular joint was performed. RESULTS On postoperative radiographic evaluation, 4 patients showed subluxation and 2 showed dislocation of the acromioclavicular joint; the other 16 patients had maintained reduction at the final consultation. MR images 1year after surgery clearly revealed the reconstructed ligaments in 19 patients. Only 1 patient showed osteoarthritis of the acromioclavicular joint. CONCLUSION Although it requires resection of the ipsilateral palmaris longus for grafting, we believe that anatomic reconstruction of both coracoclavicular ligaments best restores the function of the acromioclavicular joint. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- K Takase
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, 160-0023 Tokyo, Japan.
| | - K Yamamoto
- Department of Orthopedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, 160-0023 Tokyo, Japan
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26
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Sugio T, Kato K, Aoki T, Ohta T, Saito N, Yoshida S, Kawano I, Henzan H, Kadowaki M, Takase K, Muta T, Miyawaki K, Yamauchi T, Shima T, Takashima S, Mori Y, Yoshimoto G, Kamezaki K, Takenaka K, Iwasaki H, Ogawa R, Ohno Y, Eto T, Kamimura T, Miyamoto T, Akashi K. Mogamulizumab Treatment Prior to Allogeneic Hematopoietic Stem Cell Transplantation Induces Severe Acute Graft-versus-Host Disease. Biol Blood Marrow Transplant 2016; 22:1608-1614. [PMID: 27220263 DOI: 10.1016/j.bbmt.2016.05.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 05/16/2016] [Indexed: 12/13/2022]
Abstract
Mogamulizumab (MOG), a humanized anti-CC chemokine receptor 4 (CCR4) monoclonal antibody, has recently played an important role in the treatment of adult T cell leukemia/lymphoma (ATLL). Because CCR4 is expressed on normal regulatory T cells as well as on ATLL cells, MOG may accelerate graft-versus-host disease (GVHD) by eradicating regulatory T cells in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, there is limited information about its safety and efficacy in patients treated with MOG before allo-HSCT. In the present study, 25 patients with ATLL were treated with MOG before allo-HSCT, after which 18 patients (72%) achieved remission. The overall survival and progression-free survival at 1 year post-transplantation were 20.2% (95% CI, 6.0% to 40.3%) and 15.0% (95% CI, 4.3% to 32.0%), respectively. The cumulative incidence of acute GVHD was 64.0% (95% CI, 40.7% to 80.1%) for grade II-IV and 34.7% (95% CI, 15.8% to 54.4%) for grade III-IV. The cumulative incidence of transplantation-related mortality (TRM) was 49.0% (95% CI, 27.0% to 67.8%). Six of 7 patients with acute GVHD grade III-IV died from GVHD, which was the leading cause of death. In particular, a shorter interval from the last administration of MOG to allo-HSCT was associated with more severe GVHD. MOG use before allo-HSCT may decrease the ATLL burden; however, it is associated with an increase in TRM due to severe GVHD. Because MOG is a potent anti-ATLL agent, new treatment protocols should be developed to integrate MOG at suitable doses and timing of administration to minimize unwanted GVHD development.
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Affiliation(s)
- Takeshi Sugio
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Takatoshi Aoki
- Department of Hematology, Harasanshin Hospital, Fukuoka, Japan
| | - Takanori Ohta
- Department of Hematology, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Noriyuki Saito
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Shuro Yoshida
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Ichiro Kawano
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Masanori Kadowaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tsuyoshi Muta
- Department of Hematology, JCHO Kyushu Hospital, Fukuoka, Japan
| | - Kohta Miyawaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takuji Yamauchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Shima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shuichiro Takashima
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kenjiro Kamezaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Katsuto Takenaka
- Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiromi Iwasaki
- Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Ryosuke Ogawa
- Department of Hematology, JCHO Kyushu Hospital, Fukuoka, Japan
| | - Yuju Ohno
- Department of Hematology, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | | | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan; Center for Cellular and Molecular Medicine, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
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Rohde M, Peeters JWR, Pucciarelli A, Kiss A, Rao YF, Onder EN, Muehlbauer P, Batta A, Hartig M, Chatoorgoon V, Thiele R, Chang D, Tavoularis S, Novog D, McClure D, Gradecka M, Takase K. A Blind, Numerical Benchmark Study on Supercritical Water Heat Transfer Experiments in a 7-Rod Bundle. Journal of Nuclear Engineering and Radiation Science 2016. [DOI: 10.1115/1.4031949] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Heat transfer in supercritical water reactors (SCWRs) shows a complex behavior, especially when the temperatures of the water are near the pseudocritical value. For example, a significant deterioration of heat transfer may occur, resulting in unacceptably high cladding temperatures. The underlying physics and thermodynamics behind this behavior are not well understood yet. To assist the worldwide development in SCWRs, it is therefore of paramount importance to assess the limits and capabilities of currently available models, despite the fact that most of these models were not meant to describe supercritical heat transfer (SCHT). For this reason, the Gen-IV International Forum initiated the present blind, numerical benchmark, primarily aiming to show the predictive ability of currently available models when applied to a real-life application with flow conditions that resemble those of an SCWR. This paper describes the outcomes of ten independent numerical investigations and their comparison with wall temperatures measured at different positions in a 7-rod bundle with spacer grids in a supercritical water test facility at JAEA. The wall temperatures were not known beforehand to guarantee the blindness of the study. A number of models have been used, ranging from a one-dimensional (1-D) analytical approach with heat transfer correlations to a RANS simulation with the SST turbulence model on a mesh consisting of 62 million cells. None of the numerical simulations accurately predicted the wall temperature for the test case in which deterioration of heat transfer occurred. Furthermore, the predictive capabilities of the subchannel analysis were found to be comparable to those of more laborious approaches. It has been concluded that predictions of SCHT in rod bundles with the help of currently available numerical tools and models should be treated with caution.
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Affiliation(s)
- M. Rohde
- Delft University of Technology, Mekelweg 15, Delft 2629 JB, The Netherlands e-mail:
| | - J. W. R. Peeters
- Delft University of Technology, Mekelweg 15, Delft 2629 JB, The Netherlands
| | - A. Pucciarelli
- University of Pisa, Largo Lucio Lazzarino 2, 56126 Pisa, Italy
| | - A. Kiss
- BME NTI, Muegyetem rkp. 9 R bld. 317/7a, Budapest 1111, Hungary
| | - Y. F. Rao
- CNL, 286 Plant Road, Chalk River, ON K0J 1J0, Canada
| | - E. N. Onder
- CNL, 286 Plant Road, Chalk River, ON K0J 1J0, Canada
| | - P. Muehlbauer
- Research Centre Rez Ltd., Hlavní 130, Rez 250 68, Czech Republic
| | - A. Batta
- KIT-IKET, Hermann-von-Helmholtz-Platz 1, Karlsruhe 76344, Germany
| | - M. Hartig
- KIT-IKET, Hermann-von-Helmholtz-Platz 1, Karlsruhe 76344, Germany
| | - V. Chatoorgoon
- University of Manitoba, 75A Chancellors Circle, Winnipeg, MB R3T 5V6, Canada
| | - R. Thiele
- KTH Royal Institute of Technology, Roslagstullsbacken 21, Stockholm 106 91, Sweden
| | - D. Chang
- University of Ottawa, 161 Louis Pasteur, Ottawa, ON K1N6N5, Canada
| | - S. Tavoularis
- University of Ottawa, 161 Louis Pasteur, Ottawa, ON K1N6N5, Canada
| | - D. Novog
- McMaster University, Somestreet 1, Hamilton, ON 333AS, Canada
| | - D. McClure
- McMaster University, Somestreet 1, Hamilton, ON 333AS, Canada
| | - M. Gradecka
- Warsaw University of Technology, ul. nowowiejska 21/25, Warsaw 00665, Poland
| | - K. Takase
- Japan Atomic Energy Agency, 2-4 Shirakata, Tokai, Naka Ibaraki, Ibaraki-ken 319-1195, Japan
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28
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Kawano I, Matsumoto K, Jiromaru T, Jinnochi F, Semba Y, Sugio T, Sakamoto K, Saito N, Yoshida S, Henzan H, Takase K, Morita K, Eto T. [Significance of monitoring trough plasma concentration levels for invasive fungal infection prophylaxis with itraconazole oral solution in patients with hematological malignancies: a prospective study]. Rinsho Ketsueki 2016; 57:2475-2480. [PMID: 28090013 DOI: 10.11406/rinketsu.57.2475] [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: 06/06/2023]
Abstract
In this prospective study, we examined the prophylactic effect of itraconazole oral solution (ITCZ-OS) against invasive fungal disease in hematologic malignancy patients. The participants were 36 patients, at least 16 years of age, with hematologic malignancies treated at our hospital. ITCZ-OS 200 mg/day was administered orally twice a day with a target trough plasma concentration of 350 ng/ml. If the patient did not achieve the target trough plasma concentration, the dose was increased. The success rate of achieving the target trough plasma concentration of ITCZ with a dose of 200 mg/day was 63.9%. During the observation period, 2 patients (5.6%) were diagnosed with possible invasive fungal disease according to the EORTC/MSG 2008 criteria. Adverse events were observed in 2 patients (5.6%). The results showed administration of ITCZ-OS while monitoring ITCZ trough plasma concentrations to be effective for preventing invasive fungal disease, and no serious adverse events occurred. Since predicting trough levels in response to ITCZ administrations is difficult, its measurement is necessary to maintain the prophylactic effect of ITCZ.
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29
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Shoji F, Yamazaki K, Kouso H, Mori R, Takase K, Okamura S, Takeo S. Clinicopathological Features and Outcome of Lung Cancer Patients with Hematological Malignancy. Ann Surg Oncol 2015; 23:633-7. [PMID: 26442920 DOI: 10.1245/s10434-015-4885-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to report the incidence of lung cancer in patients with hematological malignancy (HM), as well as patient characteristics and outcome. METHODS We investigated 1503 consecutive patients treated for HM and 1208 patients who underwent surgical resection for lung cancer. RESULTS Lung cancer with HM was observed in 12 patients (0.8 % of HM cases and 1.0 % of lung cancer cases), including eight men who were smokers and four women who had never smoked. The average Brinkman index was 1010, which suggested heavy smokers. In synchronous cases, all four patients preceded to HM treatment; however, three patients died from HM. In metachronous cases, during a mean 52.7 months after treatment of lung cancer, three patients had HM. At a mean 41.4 months after HM treatment, five patients had lung cancer and underwent surgery without serious postoperative events. CONCLUSIONS A second cancer tended to be detected within 5 years after treatment of the first cancer. Men with a history of heavy smoking might be at risk for combined lung cancer and HM. Careful follow-up is recommended within 5 years after treatment of the first cancer. Most lung cancer detected synchronously with HM had poor prognosis. In metachronous cases, surgical resection of lung cancer after treatment of HM was feasible and safe.
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Affiliation(s)
- Fumihiro Shoji
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
| | - Koji Yamazaki
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hidenori Kouso
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ryo Mori
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Ken Takase
- Department of Hematology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Seiichi Okamura
- Department of Hematology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Sadanori Takeo
- Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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30
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Sato M, Morimoto R, Seiji K, Iwakura Y, Ono Y, Kudo M, Satoh F, Ito S, Ishibashi T, Takase K. Cost-Effectiveness Analysis of the Diagnosis and Treatment of Primary Aldosteronism in Japan. Horm Metab Res 2015; 47:826-32. [PMID: 26305168 DOI: 10.1055/s-0035-1559645] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 10/23/2022]
Abstract
Approximately 10% of cases of hypertension in Japan are caused by primary aldosteronism (PA), amounting to about 4 million patients in total. Primary aldosteronism due to unilateral aldosterone hypersecretion is potentially curable by adrenalectomy. The clinical benefits of identifying and treating PA have been reported internationally, but its cost-effectiveness is unclear. We examined whether diagnosing and treating hidden PA in hypertensive population was cost-effective compared with suboptimal treatment. Our hypothetical patient was a 50-year-old man diagnosed with stage I-III hypertension. We established a Markov decision model based on plausible clinical pathways and prognoses of PA. We applied cost-effectiveness analysis comparing a comprehensive diagnostic strategy for PA (measurement of plasma aldosterone/renin ratio, 2 loading tests, imaging, and selective adrenal venous sampling) with a suboptimal strategy to manage hypertension by medication unless the typical signs of PA or other complication were manifest. Outcome measures were expected costs, expected effectiveness, and incremental cost-effectiveness ratio. The robustness of the findings was established by one-way and scenario sensitivity analyses. The comprehensive PA diagnostic strategy increased the expected costs by 64 004 JPY and expected life-years by 0.013 compared with standard treatment. The incremental cost-effectiveness ratio for the diagnosis of PA was 4 923 385 JPY per year. Our findings were sensitive to the outcomes of screening and treatment, and the costs of continuous or periodic medication for hypertension and the treatment of stroke and its complications.
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Affiliation(s)
- M Sato
- Division of Clinical Imaging, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - R Morimoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - K Seiji
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Y Iwakura
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Y Ono
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - M Kudo
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - F Satoh
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - S Ito
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - T Ishibashi
- Division of Clinical Imaging, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - K Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Inadomi K, Kumagai H, Takayoshi K, Ariyama H, Kusaba H, Nishie A, Yamamoto H, Takase K, Tanaka M, Sagara K, Okumura Y, Nio K, Nakano M, Arita S, Oda Y, Akashi K, Baba E. Successful combination chemotherapy for metastatic inflammatory myofibroblastic tumor: A case report. Oncol Lett 2015; 10:2981-2985. [PMID: 26722275 DOI: 10.3892/ol.2015.3708] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 05/29/2015] [Indexed: 12/21/2022] Open
Abstract
A 64-year-old male presented with increased abdo-minal fullness and fever. Radiological examination revealed moderate ascites, a tumor with a diameter of 12.5 cm in the mesenteric region, as well as multiple tumors in the thoracic and abdominal para-aortic regions and in the left supraclavicular regions. Pathohistological findings of the biopsy specimen revealed atypical spindle cells accompanied by infiltration of lymphocytes. The plasmacytes were positive for CD68, murine double minute 2 and S-100, while they were negative for α-smooth muscle actin, cyclin-dependent kinase 4 and anaplastic lymphoma kinase. Clinically, the patient presented systemic symptoms and laboratory results indicated an elevation in the inflammatory response, while the CT and MRI findings were consistent with an inflammatory myofibroblastic tumor (IMT). Based on the clinical and histological findings, the patient was diagnosed with IMT. In total, 4 cycles of combination chemotherapy with doxorubicin and ifosfamide were administered. Tumor size reduction by 50% was achieved subsequent to the 4th chemotherapy cycle. In conclusion, successful control of this rare metastatic IMT was achieved by systemic chemotherapy.
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Affiliation(s)
- Kyoko Inadomi
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Hozumi Kumagai
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Kotoe Takayoshi
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Hiroshi Ariyama
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Hitoshi Kusaba
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Akihiro Nishie
- Department of Clinical Radiology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Ken Takase
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka 810-0065, Japan
| | - Mamoru Tanaka
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Kosuke Sagara
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Yuta Okumura
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Kenta Nio
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Michitaka Nakano
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Shuji Arita
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
| | - Koichi Akashi
- Department of Hematology and Oncology, Kyushu University Hospital, Fukuoka 812-8582, Japan
| | - Eishi Baba
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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Takase K, Matsuo Y, Yanagisawa Y, Higashine K, Oda M, Manabe M, Shimada Y, Ogura R, Takahashi T, Hiasa Y. Efficacy of a home-based exercise program for recently hospitalized chronic heart failure patients. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1448] [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: 10/23/2022]
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Yamasaki S, Kohno K, Kadowaki M, Takase K, Okamura S. Dose-adjusted Lenalidomide Combined with Low-dose Dexamethasone Rescues Older Patients with Bortezomib-resistant Multiple Myeloma. Intern Med 2015; 54:1711-5. [PMID: 26179523 DOI: 10.2169/internalmedicine.54.4075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
OBJECTIVE The aim of this study was to assess the safety and efficacy of lenalidomide (Len), with the dose adjusted according to the renal function, plus low-dose dexamethasone (Dex) in older patients with bortezomib (Bor)-resistant multiple myeloma (MM). METHODS The study included 68 consecutive patients 70 years of age or older diagnosed with MM at our institute and ineligible for high-dose melphalan therapy plus autologous stem cell transplantation. Fifteen older patients with relapsed or refractory MM (RRMM) previously treated with Bor-containing regimens were treated with the combination of Len plus low-dose Dex. RESULTS The median treatment duration was 12 months (range, 9 to 43 months), with all patients responding to Len plus low-dose Dex. All patients showed significant renal dysfunction between the beginning and end of treatment; however, the renal function improved in all cases. CONCLUSION Treatment with dose-adjusted Len combined with low-dose Dex is an effective and safe therapy for older RRMM patients exhibiting renal impairment after receiving Bor-based therapies.
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Affiliation(s)
- Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan
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Takase K, Miyamoto T. [Allogeneic hematopoietic stem cell transplantation for multiple myeloma]. Nihon Rinsho 2015; 73:107-113. [PMID: 25626314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In the past two decades, autologous hematopoietic stem cell transplantation (HSCT) in combination with novel agents such as bortezomib, thalidomide, and lenalidomide have dramatically prolonged the survival of patients with multiple myeloma (MM), however, MM still remains incurable. Allogeneic HSCT can be a potentially curative therapy for MM through the graft-versus-myeloma (GVM) effect, but allogeneic HSCT is not regarded as a standard therapy because of high incidence of treatment-related mortality. Several studies have been employed to investigate efficacy of reduced-intensity conditioning regimens, autologous HSCT followed by consecutive allogeneic HSCT, and introduction of novel agents prior to and/or after allogeneic HSCT.
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Watanabe Y, Uenoyama Y, Suzuki J, Takase K, Suetomi Y, Ohkura S, Inoue N, Maeda KI, Tsukamura H. Oestrogen-induced activation of preoptic kisspeptin neurones may be involved in the luteinising hormone surge in male and female Japanese monkeys. J Neuroendocrinol 2014; 26:909-17. [PMID: 25283748 DOI: 10.1111/jne.12227] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 09/24/2014] [Accepted: 09/29/2014] [Indexed: 11/27/2022]
Abstract
The oestrogen-induced luteinising hormone (LH) surge is evident in male primates, including humans, whereas male rodents never show the LH surge, even when treated with a preovulatory level of oestrogen. This suggests that the central mechanism governing reproductive hormones in primates is different from that in rodents. The present study aimed to investigate whether male Japanese monkeys conserve a brain mechanism mediating the oestrogen-induced LH surge via activation of kisspeptin neurones. Adult male and female Japanese monkeys were gonadectomised and then were treated with oestradiol-17β for 2 weeks followed by a bolus injection of oestradiol benzoate. Both male and female monkeys showed an oestrogen-induced LH surge. In gonadectomised monkeys sacrificed just before the anticipated time of the LH surge, oestrogen treatment significantly increased the number of KISS1-expressing cells in the preoptic area (POA) and enhanced the expression of c-fos in POA KISS1-positive cells of males and females. The oestrogen treatment failed to induce c-fos expression in the arcuate nucleus (ARC) kisspeptin neurones in both sexes just prior to LH surge onset. Thus, kisspeptin neurones in the POA but not in the ARC might be involved in the positive-feedback action of oestrogen that induces LH surge in male Japanese monkeys, as well as female monkeys. The present results indicate that oestrogen-induced activation of POA kisspeptin neurones may contribute to the LH surge generation in both sexes. The conservation of the LH surge generating system found in adult male primates, unlike rodents, could be a result of the capability of oestrogen to induce POA kisspeptin expression and activation.
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Affiliation(s)
- Y Watanabe
- Graduate School of Bioagricultural Sciences, Nagoya University, Nagoya, Aichi, Japan
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36
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Takase K, Aikawa M, Okada K, Watanabe Y, Okamoto K, Sato H, Nonaka K, Yamaguchi S, Sakuramoto S, Koyama I, Miyazawa M. Development of novel treatment with a bioabsorbable esophageal patch for benign esophageal stricture. Dis Esophagus 2014; 28:728-34. [PMID: 25286827 DOI: 10.1111/dote.12281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Using a large animal model, we examined whether circumferential stricture after esophageal endoscopic submucosal dissection (ESD) can be treated by grafting a bioabsorbable esophageal patch. Circumferential ESD was performed on the thoracic esophagus in pigs (n = 6) to create a stricture, for which one of the following interventions was performed: (1) the stricture site was longitudinally incised, and an artificial esophageal wall (AEW) was grafted after placing a bioabsorbable stent (AEW patch group, n = 3); (2) endoscopic balloon dilation (EBD) was performed every other week after stricture development (EBD group, n = 3). In both groups, esophageal fluoroscopy was performed 8 weeks after the interventions, and the esophagus was excised for histological examination of the patched site. In the AEW patch group, esophageal fluoroscopy revealed favorable passage through the patched site. Histologically, the mucosal epithelium and lamina propria had regenerated as in the normal area. In the EBD group, the circumferential stricture site showed marked thickening, and there were hypertrophic scars associated with epithelial defects on the luminal surface. Histologically, defects of the mucosal epithelium and full-thickness proliferation of connective tissue were observed. AEW patch grafting was suggested to be a potentially novel treatment strategy for post-ESD esophageal circumferential stricture.
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Affiliation(s)
- K Takase
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - M Aikawa
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - K Okada
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - Y Watanabe
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - K Okamoto
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - H Sato
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - K Nonaka
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - S Yamaguchi
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - S Sakuramoto
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - I Koyama
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
| | - M Miyazawa
- Department of Surgery, Gastrointestinal Center, Saitama Medical University, International Medical Center, Saitama, Japan
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Umezawa R, Ota H, Takanami K, Ichinose A, Matsushita H, Saito H, Takase K, Jingu K. MRI findings of radiation-induced myocardial damage in patients with oesophageal cancer. Clin Radiol 2014; 69:1273-9. [PMID: 25246336 DOI: 10.1016/j.crad.2014.08.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 06/21/2014] [Accepted: 08/12/2014] [Indexed: 01/09/2023]
Abstract
AIM To evaluate radiation-induced myocardial damage after mediastinal radiotherapy using MRI. MATERIALS AND METHODS Between May 2010 and April 2011, delayed contrast-enhanced MRI was performed for patients who had maintained a complete response to curative radiotherapy for oesophageal cancer for more than 6 months. The patients received radiotherapy with a median total dose of 66 Gy (60-70 Gy) for the primary tumour and metastatic lymph nodes. Images of MRI were analysed by a 17-segment method recommended by the American Heart Association. A segment included mainly in the 40 Gy dose line was defined as Segment 40 Gy, a segment included mainly in the 60 Gy dose line as Segment 60 Gy, and a segment out of the radiation fields as Segment OUT. The percentage of late gadolinium enhancement (LGE) was examined in those categories. The layer in which LGE was predominantly distributed was evaluated for each patient. RESULTS Four hundred and eight segments in 24 patients were analysed. The median interval from completion of radiotherapy to MRI was 23.5 months (range 6-88 months). LGE was detected in 12 of the 24 patients. LGE was detected in 15.38% of Segment 40 Gy cases, 21.21% of Segment 60 Gy cases, and 0% of Segment OUT cases. LGE in mid-myocardial and subendocardial layers was detected in 11 patients and one patient, respectively. CONCLUSION LGE suggesting radiation induced myocardial fibrosis was observed by performing delayed contrast-enhanced MRI. Care should be taken when planning radiotherapy to avoid late cardiac damage.
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Affiliation(s)
- R Umezawa
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan.
| | - H Ota
- Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Japan
| | - K Takanami
- Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Japan
| | - A Ichinose
- Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Japan
| | - H Matsushita
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan
| | - H Saito
- Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K Takase
- Department of Diagnostic Radiology, Tohoku University School of Medicine, Sendai, Japan
| | - K Jingu
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan
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Umezawa R, Takanami K, Ota H, Kaneta T, Kadoya N, Fujita Y, Arai A, Arai K, Matsushita H, Takase K, Jingu K. Assessment of Myocardial Metabolic Disorder Associated With Mediastinal Radiation Therapy for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.762] [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]
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Kato K, Ohno Y, Kamimura T, Kusumoto H, Tochigi T, Jinnouchi F, Kohno K, Kuriyama T, Henzan H, Takase K, Kawano I, Kadowaki M, Nawata R, Muta T, Eto T, Iawasaki H, Ohshima K, Miyamoto T, Akashi K. Long-term remission after high-dose chemotherapy followed by auto-SCT as consolidation for intravascular large B-cell lymphoma. Bone Marrow Transplant 2014; 49:1543-4. [DOI: 10.1038/bmt.2014.189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Mugikura S, Kikuchi H, Fujii T, Murata T, Takase K, Mori E, Marinković S, Takahashi S. MR imaging of subcallosal artery infarct causing amnesia after surgery for anterior communicating artery aneurysm. AJNR Am J Neuroradiol 2014; 35:2293-301. [PMID: 25082820 DOI: 10.3174/ajnr.a4057] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE During surgery to treat an aneurysm in the anterior communicating artery, injury to the subcallosal artery, a perforator of the anterior communicating artery, may lead to infarction that produces basal forebrain amnesia after surgery. Our purpose was to examine whether 3D MR imaging can detect subcallosal artery infarction in patients with amnesia after surgery for an anterior communicating artery aneurysm. MATERIALS AND METHODS We evaluated 3D-T2-weighted MR images obtained a median of 4 months after treatment of anterior communicating artery aneurysm for the presence of infarcted foci in 10 consecutive patients with postoperative amnesia. Because the subcallosal artery and its neighboring perforator, the recurrent artery of Heubner, were considered the most easily affected vessels during that surgery, we focused mainly on 8 regions of the subcallosal artery territory per hemisphere and 5 regions of the recurrent artery of Heubner territory per hemisphere. RESULTS All 10 patients had infarcts in the territory of the subcallosal artery (median, 9 regions per patient), and most were bilateral (9 of 10 patients). Five patients had additional infarcted foci in the territory of the recurrent artery of Heubner (median, 1 region per patient), all unilateral. Among the regions perfused by the subcallosal artery, the column of the fornix was involved in all patients; the anterior commissure, in 9; and the paraterminal gyrus, in 8 patients. CONCLUSIONS 3D MR imaging revealed subcallosal artery infarction, the distribution of which was mostly bilateral, presumably owing to the unpairedness of that artery, in patients with postoperative amnesia after anterior communicating artery aneurysm repair.
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Affiliation(s)
- S Mugikura
- From the Departments of Diagnostic Radiology (S. Mugikura, T.M., K.T., S.T.)
| | - H Kikuchi
- Behavioral Neurology and Cognitive Neuroscience (H.K., T.F., E.M.), Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - T Fujii
- Behavioral Neurology and Cognitive Neuroscience (H.K., T.F., E.M.), Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - T Murata
- From the Departments of Diagnostic Radiology (S. Mugikura, T.M., K.T., S.T.)
| | - K Takase
- From the Departments of Diagnostic Radiology (S. Mugikura, T.M., K.T., S.T.)
| | - E Mori
- Behavioral Neurology and Cognitive Neuroscience (H.K., T.F., E.M.), Tohoku University, Graduate School of Medicine, Sendai, Japan
| | - S Marinković
- Institute of Anatomy (S. Marinković), School of Medicine, University of Belgrade, Belgrade, Serbia
| | - S Takahashi
- From the Departments of Diagnostic Radiology (S. Mugikura, T.M., K.T., S.T.)
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Takase K, Horton SC, Ganesha A, Das S, McHugh A, Emery P, Savic S, Buch MH. What is the utility of routine ANA testing in predicting development of biological DMARD-induced lupus and vasculitis in patients with rheumatoid arthritis? Data from a single-centre cohort. Ann Rheum Dis 2014; 73:1695-9. [PMID: 24854356 DOI: 10.1136/annrheumdis-2014-205318] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine whether serial ANA testing predicts biological disease modifying antirheumatic drugs (bDMARD)-associated ANA/dsDNA production in patients with rheumatoid arthritis (RA). METHODS Serial autoantibody profiles, bDMARD treatment sequences and clinical data were collected from patients identified from our database that since 2005 received (i) a first bDMARD (tumour necrosis factor inhibitor (TNFi)) and (ii) tocilizumab and/or abatacept. RESULTS Of over 1000 patients, 454 RA patients received a first TNFi. Infliximab group demonstrated higher ANA seroconversion rates (31.2%) compared with etanercept (11.8%) and adalimumab (16.1%) (p<0.001). Median (range) treatment duration prior to ANA seroconversion was 10.9 (1.3-80.0) months. Positive anti-dsDNA titres of IgG class (median (range) of 77 IU/mL (65-109)) were noted in six (7.2%) patients, within a median (range) of 2.0 (0.8-4.2) years. Three patients developed classifiable lupus. 4 of 74 (5.4%) primary non-responders and 24 of 111 (21.6%) secondary non-responders developed positive ANA antibodies after TNFi initiation (p=0.003). Seven (9.5%) tocilizumab-treated patients changed to positive ANA; five (8.6%) abatacept-treated patients changed to positive ANA status. CONCLUSIONS This study demonstrates no utility of serial ANA/dsDNA testing that could be used to predict onset of seroconversion and therefore the development of lupus/vasculitis. An association however between seroconversion and the development of a secondary non-response to bDMARD therapy is suggested.
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Affiliation(s)
- K Takase
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - S C Horton
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Ganesha
- Department of Clinical Immunology, St. James's University Hospital, Leeds, UK
| | - S Das
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A McHugh
- Department of Clinical Immunology, St. James's University Hospital, Leeds, UK
| | - P Emery
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Savic
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK Department of Clinical Immunology, St. James's University Hospital, Leeds, UK
| | - M H Buch
- Leeds Institute of Rheumatic & Musculoskeletal Medicine, University of Leeds, Leeds, UK NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Morosawa Y, Naito A, Watanabe T, Takano Y, Takase K. Magnetic properties of the layered oxypnictides (LnO)MnAs (Ln = La, Ce, Pr, Nd). EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20147507004] [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: 11/14/2022] Open
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Takashima S, Eto T, Shiratsuchi M, Hidaka M, Mori Y, Kato K, Kamezaki K, Oku S, Henzan H, Takase K, Matsushima T, Takenaka K, Iwasaki H, Miyamoto T, Akashi K, Teshima T. The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease: the experience of the Fukuoka blood and marrow transplantation (BMT) group. Intern Med 2014; 53:1315-20. [PMID: 24930650 DOI: 10.2169/internalmedicine.53.1858] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL). METHODS Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia. RESULTS Treatment success was achieved in seven of the 11 (64%) patients undergoing BMT or PBSCT and in all four patients (100%) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment. CONCLUSION The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.
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Affiliation(s)
- Shuichiro Takashima
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Japan
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Biedermann GW, Takase K, Wu X, Deslauriers L, Roy S, Kasevich MA. Zero-dead-time operation of interleaved atomic clocks. Phys Rev Lett 2013; 111:170802. [PMID: 24206471 DOI: 10.1103/physrevlett.111.170802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Indexed: 06/02/2023]
Abstract
We demonstrate a zero-dead-time operation of atomic clocks. This clock reduces sensitivity to local oscillator noise, integrating as nearly 1/τ whereas a clock with dead time integrates as 1/τ(1/2) under identical conditions. We contend that a similar scheme may be applied to improve the stability of optical clocks.
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Affiliation(s)
- G W Biedermann
- Physics Department, Stanford University, Stanford, California 94305, USA
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Umezawa R, Jingu K, Takase K, Ota H, Takanami K, Kaneta T, Takeda K, Matsushita H, Takahashi S. Magnetic Resonance Imaging Findings of Radiation-Induced Myocardial Damage in Patients With Esophageal Cancer. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Eto T, Takase K, Miyamoto T, Ohno Y, Kamimura T, Nagafuji K, Takamatsu Y, Teshima T, Gondo H, Taniguchi S, Akashi K, Harada M. Autologous peripheral blood stem cell transplantation with granulocyte colony-stimulating factor combined conditioning regimen as a postremission therapy for acute myelogenous leukemia in first complete remission. Int J Hematol 2013; 98:186-96. [PMID: 23754766 DOI: 10.1007/s12185-013-1378-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 02/01/2011] [Revised: 05/23/2013] [Accepted: 05/28/2013] [Indexed: 11/25/2022]
Abstract
We retrospectively analyzed the outcomes of 81 patients with non-M3 acute myelogenous leukemia (AML) in first complete remission (CR1) who were treated with high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplantation (Auto-PBSCT) by the Fukuoka Blood and Marrow Transplantation Group between 1989 and 2005. Cytogenetically, 16 patients were defined as good risk, 56 as intermediate risk, and nine as poor risk, following the Southwest Oncology Group criteria. The pre-transplant conditioning regimen consisted of high-dose busulfan, etoposide, and cytarabine (BEA regimen), combined with priming by granulocyte colony-stimulating factor (G-CSF). Disease-free survival (DFS) and overall survival at 5 years were 64.0 % (95 % CI 52.5-73.4) and 66.4 % (95 % CI 54.9-75.6) after Auto-PBSCT at a median follow-up time of 103 months (range 3-240 months), respectively. Two patients died of transplant-related pulmonary complications 6 months after Auto-PBSCT without relapse. The 5-year DFS rates of patients in the genetically good-, intermediate-, and poor-risk groups were 80.8, 64.3, and 33.3 %, respectively, but there was no significant difference statistically among the risk groups (log-rank p = 0.0579). These observations suggest that HDCT supported by Auto-PBSCT with the BEA regimen combined with G-CSF priming is a therapeutic option for postremission therapy of AML in CR1.
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Affiliation(s)
- Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, 3-5-27 Maizuru, Chuo-ku, Fukuoka 810-8539, Japan.
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Rakieh C, Saleem B, Takase K, Nam JL, Keen H, Wakefield RJ, Emery P. THU0136 Long Term Outcomes of Stopping Tumour Necrosis Factor Inhibitors (TNFI) in Patients with Established Rheumatoid Arthritis (RA) Who are in Sustained Remission: Is it Worth the Risk? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kishimoto D, Ihata A, Watanabe R, Watanabe T, Terauchi K, Kobayashi K, Uehara T, Takase K, Hama M, Yoshimi R, Ueda A, Takeno M, Ishigatsubo Y. THU0171 Therapeutic response of lupus nephritis based on pathological findings in yokohama city university hospital:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2136] [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: 11/03/2022]
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Yoshimi R, Ihata A, Kishimoto D, Watanabe R, Uehara T, Takase K, Hama M, Asami Y, Ueda A, Takeno M, Ishigatsubo Y. SAT0519 Total Power Doppler Score-8 is a Useful Diagnostic Marker of Musculoskeletal Ultrasonography for Screening and Activity Measurement of Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2243] [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: 11/04/2022]
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50
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Yoshimi R, Hama M, Takase K, Sugiyama Y, Kishimoto D, Watanabe R, Uehara T, Asami Y, Ihata A, Ueda A, Takeno M, Ishigatsubo Y. SAT0520 Ultrasonography is Useful for Predicting Boolean Remission after Achieving DAS28-Based Clinical Remission of Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2244] [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: 11/04/2022]
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