1
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Fujikawa T, Uemura S, Hasegawa D, Morisada N, Nakamura S, Kozaki A, Saito A, Kishimoto K, Ishida T, Mori T, Yakushijin K, Katayama Y, Yamashita D, Wakamatsu M, Hamada M, Muramatsu H, Takahashi Y, Kosaka Y. Novel mutation in KIF23 causing congenital dyserythropoietic anemia type III in patients who underwent allogeneic hematopoietic stem cell transplantation. Pediatr Blood Cancer 2024; 71:e30736. [PMID: 38523246 DOI: 10.1002/pbc.30736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 03/26/2024]
Affiliation(s)
- Tomoko Fujikawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Suguru Uemura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Naoya Morisada
- Department of Clinical Genetics, Kobe Children's Hospital, Kobe, Japan
| | - Sayaka Nakamura
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Aiko Kozaki
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Atsuro Saito
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kenji Kishimoto
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Toshiaki Ishida
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Takeshi Mori
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | | | - Daiki Yamashita
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Manabu Wakamatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Motoharu Hamada
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideki Muramatsu
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Takahashi
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan
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2
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Ichikawa H, Yakushijin K, Kurata K, Tsuji T, Takemoto N, Joyce M, Okazoe Y, Takahashi R, Matsumoto S, Sakai R, Kitao A, Miyata Y, Saito Y, Kawamoto S, Yamamoto K, Ito M, Murayama T, Matsuoka H, Minami H. Utility of the refined EBMT diagnostic and severity criteria 2023 for sinusoidal obstruction syndrome/veno-occlusive disease. Bone Marrow Transplant 2024; 59:518-525. [PMID: 38287083 PMCID: PMC10994840 DOI: 10.1038/s41409-024-02215-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
Sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a life-threatening complication of hematopoietic stem cell transplantation (HSCT). Early diagnosis of SOS/VOD is associated with improved clinical outcomes. In 2023, the refined European Society for Blood and Marrow Transplantation diagnostic and severity criteria (refined EBMT criteria 2023) have been advocated. The revision has introduced new diagnostic categories, namely; probable, clinical, and proven SOS/VOD. In addition, the Sequential Organ Failure Assessment (SOFA) score has been newly incorporated into the SOS/VOD severity grading. We performed a retrospective analysis to evaluate the utility of these criteria. We analyzed 161 cases who underwent allogeneic HSCT. We identified 53 probable, 23 clinical, and 4 proven SOS/VOD cases. Probable SOS/VOD was diagnosed a median of 5.0 days earlier (interquartile range: 2-13 days, P < 0.001) than that of clinical SOS/VOD. The development of probable SOS/VOD alone was associated with a significantly inferior survival proportion compared to non-SOS/VOD (100-day survival, 86.2% vs. 94.3%, P = 0.012). The SOFA score contributed to the prediction of prognosis. Consequently, the refined EBMT criteria 2023 demonstrated the utility of SOS/VOD diagnosis and severity grading. Further investigations and improvements in these criteria are warranted.
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Affiliation(s)
- Hiroya Ichikawa
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.
| | - Keiji Kurata
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Takahiro Tsuji
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Naoko Takemoto
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Miki Joyce
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yuri Okazoe
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Ruri Takahashi
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Rina Sakai
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Department of Oncology and Hematology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Department of Artificial Intelligence and Digital Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Saito
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Division of Molecular and Cellular Signaling, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Kawamoto
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Transfusion Medicine and Cell Therapy, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Katsuya Yamamoto
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Mitsuhiro Ito
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Tohru Murayama
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Department of Integrated Analyses of Bioresource and Health Care, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
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3
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Okada Y, Usui Y, Hayashi H, Nishikubo M, Toubai T, Uchida N, Tanaka M, Onizuka M, Takahashi S, Doki N, Uehara Y, Maruyama Y, Ishiwata K, Kawakita T, Sawa M, Eto T, Ishimaru F, Kato K, Fukuda T, Atsuta Y, Kanda J, Yakushijin K, Nakasone H. Development of an umbilical cord blood transplantation-specific nonrelapse mortality risk assessment score. Blood Adv 2024; 8:1359-1368. [PMID: 38163321 PMCID: PMC10945135 DOI: 10.1182/bloodadvances.2023011837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
ABSTRACT Higher rate of nonrelapse mortality (NRM) remains yet to be resolved in umbilical cord blood transplantation (UCBT). Considering that UCBT has some unique features compared with allogeneic hematopoietic cell transplantation from other graft sources, a UCBT-specific NRM risk assessment system is required. Thus, in this study, we sought to develop a UCBT-specific NRM Risk Assessment (CoBRA) score. Using a nationwide registry database, we retrospectively analyzed 4437 recipients who had received their first single-unit UCBT. Using the backward elimination method, we constructed the CoBRA score in a training cohort (n = 2687), which consisted of recipients age ≥55 years (score 2), hematopoietic cell transplantation-specific comorbidity index ≥3 (score 2), male recipient, graft-versus-host disease prophylaxis other than tacrolimus in combination with methotrexate, performance status (PS) 2 to 4, HLA allele mismatch ≥ 2, refined Disease Risk Index high risk, myeloablative conditioning, and CD34+ cell doses < 0.82 × 105/kg (score 1 in each). The recipients were categorized into 3 groups: low (0-4 points), intermediate (5-7 points), and high (8-11 points) groups according to the CoBRA score. In the validation cohort (n = 1750), the cumulative incidence of NRM at 2 years was 14.9%, 25.5%, and 47.1% (P < .001), and 2-year overall survival (OS) was 74.2%, 52.7%, and 26.3% (P < .001) in the low, intermediate, and high groups, respectively. In summary, the CoBRA score could predict the NRM risk as well as OS after UCBT. Further external validation will be needed to confirm the significance of the CoBRA score.
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Affiliation(s)
- Yosuke Okada
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Yoshiaki Usui
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Hiromi Hayashi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomomi Toubai
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Satoshi Takahashi
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yasufumi Uehara
- Department of Hematology, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations, Toranomon Hospital, Kajigaya, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Fumihiko Ishimaru
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Koji Kato
- Central Japan Cord Blood Bank, Aichi, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Division of Emerging Medicine for Integrated Therapeutics (EMIT), Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan
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4
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Inoue J, Saito T, Makiura D, Ono R, Doi H, Yakushijin K, Sakai Y. Factors Influencing Life Space Mobility in Cancer Survivors Following Hematopoietic Stem Cell Transplantation - Physical Function, Depression, Fatigue, Neighborhood Walkability, and Employment Status. Hematol Oncol Stem Cell Ther 2024; 17:146-153. [PMID: 38560975 DOI: 10.56875/2589-0646.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/27/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND/OBJECTIVE The level of physical activity in the daily lives of cancer survivors following hematopoietic stem cell transplantation (HSCT) is crucial for maintaining their physical and mental health. Considering that life space mobility (LSM) may limit physical activity, maintaining and expanding LSM is particularly essential for post-HSCT survivors. This study aimed to identify factors influencing LSM in post-HSCT survivors. METHODS Thirty cancer survivors after HSCT (14 women, mean age 52.0 ± 12.3 years, 196-3017 days post-HSCT) were included in this cross-sectional study. The assessment encompassed patient characteristics, employment status, life space (Life Space Assessment; LSA), physical function (handgrip strength, isometric knee extension strength, 5 chair standing test, walking speed), depression (Self-rating Depression Scale; SDS), fatigue (Cancer Fatigue Scale), and neighborhood walkability (Walk Score®). The association between LSA and each factor was compared by correlation analysis. Subsequently, multiple regression analysis was conducted, with LSA as the dependent variable and independent variables being outcome measures exhibiting a significant correlation with LSA. RESULTS Variables significantly correlated with LSA included SDS (r =-0.65, p < .01), employment status (r=-0.60, p < .01), handgrip strength (r = 0.43, p = .02), and isometric knee extension strength (r = 0.40, p = .03). Results of multiple regression analysis show that SDS (β = -0.53, p < .01), employment status (β = 0.48, p < .01), and isometric knee extension strength (β = 0.27, p = .02) were significantly associated with LSA (R2 = 0.74). CONCLUSION Depression, employment status, and isometric knee extension strength were identified as factors related to LSM in post-HSCT survivors.
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Affiliation(s)
- Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 651-0017, Japan
| | - Takashi Saito
- Division of Rehabilitation Medicine, Tokushima University Hospital, 2-50-1 Kuramoto-cho, Tokushima, 770-8503, Japan
| | - Daisuke Makiura
- Division of Rehabilitation Medicine, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 651-0017, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Hisayo Doi
- Division of Nursing, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 651-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 651-0017, Japan
| | - Yoshitada Sakai
- Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 651-0017, Japan
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5
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Onozawa M, Kusumoto S, Najima Y, Hashimoto H, Okada K, Tamaki M, Tanaka M, Sato T, Takahashi T, Hatano K, Onodera K, Moriuchi Y, Yakushijin K, Kanda J, Nagafuji K, Ogata M, Nakano N, Tamori A, Mizokami M. Outcomes of Cessation of Nucleos(t)ide Analog Administration on Hepatitis B Virus Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation: A Nationwide Retrospective Study. Transplant Cell Ther 2024; 30:330.e1-330.e8. [PMID: 38242442 DOI: 10.1016/j.jtct.2024.01.059] [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: 11/13/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
Monitoring of hepatitis B virus (HBV)-DNA and HBV-DNA-guided preemptive therapy using nucleos(t)ide analogs (NAs) are recommended to prevent the development of hepatitis due to HBV reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in recipients with resolved HBV infection. However, little is known about the appropriate duration of NA treatment and the effect of NA cessation on the recurrence of HBV reactivation. This study aimed to clarify the consequences of NA cessation in allo-HSCT recipients with resolved HBV infection who experienced HBV reactivation following transplantation. We retrospectively reviewed the clinical records of recipients with resolved HBV infection (hepatitis B surface antigen [HBsAg]-negative, anti-HBc-positive) before allo-HSCT who had been diagnosed with HBV reactivation (HBsAg-positive and/or HBV-DNA detectable) after allo-HSCT between January 2010 and December 2020. A total of 72 patients from 16 institutions were registered (median age, 60 years; age range, 27 to 73 years; 42 males and 30 females). The day of initial HBV reactivation ranged from day 10 to day 3034 after allo-HSCT (median, 513 days). Anti-HBs were lost in >80% of the patients at the time of HBV reactivation. All 72 patients received preemptive NAs, and no fatal HBV reactivation-related hepatitis was observed. HBV-DNA without hepatitis was continuously detected in 5 patients during the follow-up period. Administration of NAs was discontinued in 24 of 72 patients (33%) by physician decision. Second HBV reactivation occurred in 11 of the 24 patients (46%) in whom administration of NAs was discontinued. The duration of NA treatment did not differ significantly between patients with or without second HBV reactivation. The frequency of further HBV reactivation tended to be lower in patients with an anti-HBs titer of >10 mIU/mL at the time of NA cessation. Multiple reactivations of HBV after NA cessation was common in patients with HBV reactivation who underwent allo-HSCT despite the long duration of NAs. Careful monitoring of HBV-DNA is important even after the discontinuation of NAs in the case with HBV reactivation after allo-HSCT, because multiple reactivations could occur. Active immunization by HB vaccine might be effective for suppressing further HBV reactivation after cessation of NAs.
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Affiliation(s)
- Masahiro Onozawa
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Hiroya Hashimoto
- Clinical Research Management Center, Nagoya City University Hospital, Nagoya, Japan
| | - Kohei Okada
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Masaharu Tamaki
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masatsugu Tanaka
- Department of Hematology and Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takayuki Sato
- Department of Haematology Oncology, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Kaoru Hatano
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Koichi Onodera
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | | | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Junya Kanda
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Koji Nagafuji
- Department of Hematology and Oncology, Kurume University Hospital, Kurume, Japan
| | - Masao Ogata
- Department of Hematology, Oita University Hospital, Yufu, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Akihiro Tamori
- Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Masashi Mizokami
- Genome Medical Sciences Project, National Center for Global Health and Medicine, Ichikawa, Japan
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6
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Yanagisawa R, Koyama H, Yakushijin K, Uchida N, Jinguji A, Takeda W, Nishida T, Tanaka M, Eto T, Ohigashi H, Ikegame K, Matsuoka KI, Katayama Y, Kanda Y, Sawa M, Kawakita T, Onizuka M, Fukuda T, Atsuta Y, Shinohara A, Nakasone H. Analysis of risk factors for fatal renal complications after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2024; 59:325-333. [PMID: 38104219 DOI: 10.1038/s41409-023-02172-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/25/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
Various complications can influence hematopoietic cell transplantation (HCT) outcomes. Renal complications can occur during the early to late phases of HCT along with various factors. However, studies focusing on fatal renal complications (FRCs) are scarce. Herein, we analyzed 36,596 first allogeneic HCT recipients retrospectively. Overall, 782 patients died of FRCs at a median of 108 (range, 0-3,440) days after HCT. The cumulative incidence of FRCs was 1.7% and 2.2% at one and five years, respectively. FRCs were associated with older age, male sex, non-complete remission (non-CR), lower performance status (PS), and HCT comorbidity index (HCT-CI) associated with renal comorbidity in multivariate analysis. The risk factors within 100 days included older age, multiple myeloma, PS, and HCT-CI comorbidities (psychiatric disturbance, hepatic disease, obesity, and renal disease). Older age and male sex were risk factors between 100 days and one year. After one year, HCT-CI was associated with the presence of diabetes and prior solid tumor; total body irradiation was identified as a risk factor. Non-CR was a common risk factor in all three phases. Furthermore, acute and chronic graft-versus-host disease, reactivation of cytomegalovirus, and relapse of underlying disease also affected FRCs. Systematic follow-up may be necessary based on the patients' risk factors and post-HCT events.
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Affiliation(s)
- Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan.
| | - Hiroaki Koyama
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo, Japan
| | - Atsushi Jinguji
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Wataru Takeda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Nishida
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hiroyuki Ohigashi
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Kazuhiro Ikegame
- Department of Hematology, Hyogo Medical University Hospital, Nishinomiya, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihito Shinohara
- Department of Hematology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
- Division of Emerging Medicine for Integrated Therapeutics, Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Japan
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7
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Fuji S, Sugita J, Najima Y, Konishi T, Tanaka T, Ohigashi H, Eto T, Nagafuji K, Hiramoto N, Matsuoka KI, Maruyama Y, Ota S, Ishikawa J, Kawakita T, Akasaka T, Kamimura T, Hino M, Fukuda T, Atsuta Y, Yakushijin K. Low- versus standard-dose post-transplant cyclophosphamide as GVHD prophylaxis for haploidentical transplantation. Br J Haematol 2024; 204:959-966. [PMID: 38037468 DOI: 10.1111/bjh.19228] [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: 10/25/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023]
Abstract
Haploidentical haematopoietic cell transplantation (haplo-HCT) using post-transplant cyclophosphamide (PTCY) as graft-versus-host disease (GVHD) prophylaxis is the standard of care for various haematological malignancies. The original PTCY dose after haplo-HCT was 100 mg/kg, but no dose-finding studies have been performed to identify the optimal dose. We performed a retrospective analysis to compare standard-dose PTCY (100 mg/kg) with reduced-dose PTCY (80 mg/kg): 969 in the standard-dose group and 538 in the reduced-dose group. As there was a significant difference between the two groups regarding patient and transplant characteristics, we performed propensity score (PS) matching. After PS matching, 425 patients in each group were included. The probabilities of 2-year OS were 55.9% in the standard-dose group and 47.0% in the reduced-dose group (p = 0.36). The cumulative incidences of 2-year non-relapse mortality were 21.3% in the standard-dose group and 20.5% in the reduced-dose group (p = 0.55). There was no significant difference in the incidence of acute (grade II-IV 29.2% [95% CI, 24.9-33.6] vs. 25.3% [95% CI, 21.3-29.6]; grade III-IV 7.3% [95% CI, 5.1-10.0] vs. 6.6% [95% CI, 4.5-9.3]) or chronic GVHD. In conclusion, reduced- and standard-dose PTCY were comparable in terms of major clinical outcomes.
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Affiliation(s)
- Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Junichi Sugita
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tatsuya Konishi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Tōon-shi, Ehime, Japan
| | - Takashi Tanaka
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Chuo City, Tokyo, Japan
| | - Hiroyuki Ohigashi
- Department of Hematology, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Fukuoka, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | | | | | - Masayuki Hino
- Department of Hematology, Osaka Metropolitan University, Osaka City, Osaka, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Chuo City, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Seto, Aichi, Japan
- Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute-shi, Aichi, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
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8
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Kitahiro Y, Yamamoto K, Yakushijin K, Ioroi T, Tanda M, Itohara K, Omura T, Minami H, Yano I. The Efficacy of Bepotastine Besilate Compared With Hydroxyzine Pamoate for Preventing Infusion Reactions to the First Dose of Rituximab in Patients With Non-Hodgkin Lymphoma: Protocol for a Phase II, Double-Blind, Multicenter Randomized Trial. JMIR Res Protoc 2024; 13:e54882. [PMID: 38386393 PMCID: PMC10921330 DOI: 10.2196/54882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Rituximab, an anti-CD20 monoclonal antibody, can cause infusion reactions (IRs), especially during the initial rituximab infusion therapy. Generally, patients are administered a histamine H1-receptor antagonist before the rituximab infusion, along with an antipyretic analgesic, to prevent or reduce IRs. Multiple retrospective case-control studies indicate that the second generation of histamine H1-receptor antagonists might be more effective than the first generation in suppressing IRs caused by the rituximab infusion. OBJECTIVE This study aimed to assess the efficacy of first- and second-generation histamine H1-receptor antagonists for preventing IRs resulting from the initial infusion of rituximab in patients diagnosed with non-Hodgkin lymphoma. METHODS This is a phase II, double-blind, active-controlled randomized trial. It will be a multicenter study conducted across 3 facilities that aims to enroll a total of 40 patients diagnosed with non-Hodgkin lymphoma who will receive their initial rituximab infusion. Participating patients will be administered hydroxyzine pamoate or bepotastine besilate, representing first- or second-generation histamine H1-receptor antagonists, respectively. This will be combined with 400-mg acetaminophen tablets taken approximately 30 minutes before the first infusion of rituximab. The primary end point of this trial is to assess severe IRs, equivalent to grade 2 or higher as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events, version 5.0, that occur within a 4-hour period after the initiation of rituximab infusion. The secondary end points include assessing the severity of the initial IR, the maximum severity of the IR, and the duration between rituximab infusion initiation and the onset of the first IR within a 4-hour period. Additionally, the trial will evaluate histamine H1-receptor antagonist-induced drowsiness using the visual analogue scale, with each patient providing their individual response. RESULTS This study began with patient recruitment in April 2023, with 17 participants enrolled as of November 12, 2023. The anticipated study completion is set for February 2026. CONCLUSIONS This study is the first randomized controlled trial comparing the effects of oral first- and second-generation histamine H1-receptor antagonists in preventing IRs induced by the initial administration of rituximab. The findings from this study hold the potential to establish the rationale for a phase III study aimed at determining the standard premedication protocol for rituximab infusion. TRIAL REGISTRATION Japan Registry of Clinical Trials jRCTs051220169; https://jrct.niph.go.jp/latest-detail/jRCTs051220169. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54882.
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Affiliation(s)
- Yumi Kitahiro
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | | | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Takeshi Ioroi
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Masaaki Tanda
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Kotaro Itohara
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Tomohiro Omura
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, Kobe, Japan
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9
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Hirakawa Y, Kitao A, Watanabe M, Matsumoto S, Komaki R, Sakai R, Morimoto K, Yakushijin K, Minami H. Irreversible Intrathecal Chemotherapy-induced Myelopathy in a Patient with Diffuse Large B-cell Lymphoma. Intern Med 2024; 63:547-551. [PMID: 37380452 PMCID: PMC10937126 DOI: 10.2169/internalmedicine.2031-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/17/2023] [Indexed: 06/30/2023] Open
Abstract
Intrathecal chemotherapy is often administered for prophylaxis and treatment of central nervous system involvement in hematological malignancies. However, it may rarely cause neurotoxicity as a side effect. We herein report a 74-year-old woman with diffuse large B-cell lymphoma including a spinal lesion. She received systemic and intrathecal chemotherapy. After five doses of intrathecal chemotherapy, she developed intrathecal chemotherapy-induced myelopathy. Intrathecal treatment was discontinued, and she was administered vitamin B12 and folic acid, along with steroid pulses. However, her symptoms did not improve. Intrathecal chemotherapy-induced myelopathy is rare, but may be irreversible; therefore, clinicians should be aware of this potential complication.
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Affiliation(s)
- Yuri Hirakawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Ryohei Komaki
- Division of Neurology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Kohei Morimoto
- Division of Neurology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine School of Medicine, Japan
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10
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Yanagita M, Muto S, Nishiyama H, Ando Y, Hirata S, Doi K, Fujiwara Y, Hanafusa N, Hatta T, Hoshino J, Ichioka S, Inoue T, Ishikura K, Kato T, Kitamura H, Kobayashi Y, Koizumi Y, Kondoh C, Matsubara T, Matsubara K, Matsumoto K, Okuda Y, Okumura Y, Sakaida E, Shibagaki Y, Shimodaira H, Takano N, Uchida A, Yakushijin K, Yamamoto T, Yamamoto K, Yasuda Y, Oya M, Okada H, Nangaku M, Kashihara N. Correction to: Clinical questions and good practice statements of clinical practice guidelines for management of kidney injury during anticancer drug therapy 2022. Clin Exp Nephrol 2024; 28:123-124. [PMID: 38070021 PMCID: PMC10808267 DOI: 10.1007/s10157-023-02436-9] [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: 01/26/2024]
Affiliation(s)
- Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
| | - Satoru Muto
- Department of Urology, Graduate School of Medicine, Juntendo University, Bunkyo City, Tokyo, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Sumio Hirata
- Department of Academic Education, I and H Co., Ltd, Ashiya, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo City, Tokyo, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan
| | - Takahiro Hatta
- Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan
| | - Satoko Ichioka
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takamitsu Inoue
- Department of Renal and Urologic Surgery, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Kenji Ishikura
- Department of Pediatrics, Kitasato University School of Medicine, Minato, Kanagawa, Japan
| | - Taigo Kato
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Minato, Tokyo, Japan
| | - Yuichi Koizumi
- Department of Pharmacy, Seichokai Fuchu Hospital, Izumi, Japan
| | - Chihiro Kondoh
- Departments of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Matsubara
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Matsubara
- Department of Pharmacy, Wakayama Medical University Hospital, Wakayama, Japan
| | | | - Yusuke Okuda
- Department of Pediatrics, Kitasato University School of Medicine, Minato, Kanagawa, Japan
| | - Yuta Okumura
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, Saint Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hideki Shimodaira
- Division of Medical Oncology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nao Takano
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Uchida
- Department of Nursing, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Takehito Yamamoto
- Department of Pharmacy, The University of Tokyo Hospital, Bunkyo City, Tokyo, Japan
| | | | - Yoshinari Yasuda
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Minato, Tokyo, Japan
| | - Hirokazu Okada
- Department of Nephrology, Saitama Medical University, Saitama, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Naoki Kashihara
- Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan
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11
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Yanagita M, Muto S, Nishiyama H, Ando Y, Hirata S, Doi K, Fujiwara Y, Hanafusa N, Hatta T, Hoshino J, Ichioka S, Inoue T, Ishikura K, Kato T, Kitamura H, Kobayashi Y, Koizumi Y, Kondoh C, Matsubara T, Matsubara K, Matsumoto K, Okuda Y, Okumura Y, Sakaida E, Shibagaki Y, Shimodaira H, Takano N, Uchida A, Yakushijin K, Yamamoto T, Yamamoto K, Yasuda Y, Oya M, Okada H, Nangaku M, Kashihara N. Clinical questions and good practice statements of clinical practice guidelines for management of kidney injury during anticancer drug therapy 2022. Clin Exp Nephrol 2024; 28:85-122. [PMID: 37878114 PMCID: PMC10808569 DOI: 10.1007/s10157-023-02415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan.
| | - Satoru Muto
- Department of Urology, Graduate School of Medicine, Juntendo University, Bunkyo City, Tokyo, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Sumio Hirata
- Department of Academic Education, I and H Co., Ltd, Ashiya, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Bunkyo City, Tokyo, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Norio Hanafusa
- Department of Blood Purification, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan
| | - Takahiro Hatta
- Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, Shinjuku City, Tokyo, Japan
| | - Satoko Ichioka
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Takamitsu Inoue
- Department of Renal and Urologic Surgery, International University of Health and Welfare Narita Hospital, Chiba, Japan
| | - Kenji Ishikura
- Department of Pediatrics, Kitasato University School of Medicine, Minato, Kanagawa, Japan
| | - Taigo Kato
- Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Minato, Tokyo, Japan
| | - Yuichi Koizumi
- Department of Pharmacy, Seichokai Fuchu Hospital, Izumi, Japan
| | - Chihiro Kondoh
- Departments of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Matsubara
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuo Matsubara
- Department of Pharmacy, Wakayama Medical University Hospital, Wakayama, Japan
| | | | - Yusuke Okuda
- Department of Pediatrics, Kitasato University School of Medicine, Minato, Kanagawa, Japan
| | - Yuta Okumura
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, Saint Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hideki Shimodaira
- Division of Medical Oncology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nao Takano
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akiko Uchida
- Department of Nursing, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Takehito Yamamoto
- Department of Pharmacy, The University of Tokyo Hospital, Bunkyo City, Tokyo, Japan
| | | | - Yoshinari Yasuda
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Minato, Tokyo, Japan
| | - Hirokazu Okada
- Department of Nephrology, Saitama Medical University, Saitama, Japan
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Naoki Kashihara
- Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan
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12
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Nishikage S, Fujisawa A, Endoh H, Sakamoto H, Suzuki T, Kanzawa M, Ishii S, Okano M, Nitta E, Yakushijin K, Asakura H, Nozu K, Nitta R, Katayama Y, Sakaguchi K. Amyloid deposition through endocytosis in vascular endothelial cells. Exp Hematol 2024; 129:104129. [PMID: 37952890 DOI: 10.1016/j.exphem.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/02/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
No mechanistic lead is known for establishing AL amyloid deposits in organs. We here report an electron microscopic (EM) analysis in a case of intestinal AL amyloidosis before initiating treatment for amyloidosis. The dense deposits of amyloid fibrils are concentrated around the small blood vessels in the submucosal area of intestinal tissue. Surprisingly, we observed endothelial cells (ECs) of blood vessels containing plenty of endocytotic (pinocytotic) and transcytotic vesicles at the luminal side and above the basement membrane, indicating the one-way active trafficking of either the immunoglobulin (Ig) light chain or preassembled amyloid fibrils from the luminal side of ECs to the extraluminal area of ECs. Immunoelectron microscopy displayed that the immuno-gold signals were observed in the vascular cavity and the subendothelial area of amyloid deposits. However, there is no sign of an Ig light chain in pinocytotic vesicles. Therefore, the intestinal ECs may actively pump out mainly the preassembled amyloid fibrils (not light chains) from the blood stream into the subendothelial area as a physiologic function.
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Affiliation(s)
- Seiji Nishikage
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Akira Fujisawa
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Hiromi Endoh
- Division of Structural Medicine and Anatomy, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Hirotaka Sakamoto
- Department of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama University, Kita-ku, Okayama, Japan
| | - Tomohide Suzuki
- Division of Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Maki Kanzawa
- Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Shinichi Ishii
- Division of Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Mitsumasa Okano
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Eriko Nitta
- Division of Structural Medicine and Anatomy, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Oncology/Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Hidesaku Asakura
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Ryo Nitta
- Division of Structural Medicine and Anatomy, Department of Physiology and Cell Biology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan
| | - Yoshio Katayama
- Division of Hematology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
| | - Kazuhiko Sakaguchi
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
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13
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Yamamoto K, Kitao A, Watanabe M, Kanehira H, Joyce M, Hirakawa Y, Matsumoto S, Yakushijin K, Minami H. RUNX1 rearrangement in mature B-cell acute lymphoblastic leukemia with non-L3 morphology. J Clin Exp Hematop 2023; 63:240-245. [PMID: 37899239 PMCID: PMC10861373 DOI: 10.3960/jslrt.23028] [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: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 10/31/2023] Open
Abstract
Mature B-cell acute lymphoblastic leukemia (ALL) is defined by the expression of light chain-restricted surface immunoglobulin (sIg) and usually has features of the leukemic phase of Burkitt lymphoma including FAB-L3 morphology and MYC rearrangement. Recently, another distinct entity in childhood mature B-cell ALL has been characterized as non-L3 morphology and KMT2A rearrangement. Here we report an unusual case of mature B-cell ALL that presented with RUNX1 rearrangement. A 65-year-old male was admitted to our department for thorough examination of leukocytosis and thrombocytopenia. The patient's bone marrow was hypercellular and infiltrated with 97.8% myeloperoxidase-negative, medium-to-large-sized blasts without cytoplasmic vacuoles. Immunophenotypes were characterized by the presence of light chain-restricted sIg and the lack of immature markers, indicating a diagnosis of mature B-cell ALL with L2 morphology: sIg-κ+, CD19+, CD20+, CD22+, CD79a+, TdT-, and CD34-. G-banding combined with spectral karyotyping showed the following complex karyotype: 45,X,der(Y;10)(p10;q10),del(13)(q?),inv(21)(p13q22.1). Fluorescence in situ hybridization revealed separated signals of RUNX1 at 21q22.1, whereas rearrangements of MYC and KMT2A were not found. To our knowledge, inv(21)(p13q22.1) involving RUNX1 is a novel cytogenetic aberration and this is the first case of mature B-cell ALL that presented with RUNX1 rearrangement. Thus, RUNX1 may be implicated in the pathogenesis of mature B-cell ALL showing non-L3 morphology without MYC rearrangement.
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Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Kanehira
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Miki Joyce
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuri Hirakawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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14
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Saito Y, Iida-Norita R, Afroj T, Refaat A, Hazama D, Komori S, Ohata S, Takai T, Oduori OS, Kotani T, Funakoshi Y, Koma YI, Murata Y, Yakushijin K, Matsuoka H, Minami H, Yokozaki H, Manz MG, Matozaki T. Preclinical evaluation of the efficacy of an antibody to human SIRPα for cancer immunotherapy in humanized mouse models. Front Immunol 2023; 14:1294814. [PMID: 38162643 PMCID: PMC10757636 DOI: 10.3389/fimmu.2023.1294814] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Tumor-associated macrophages (TAMs) are abundant in the tumor microenvironment and are considered potential targets for cancer immunotherapy. To examine the antitumor effects of agents targeting human TAMs in vivo, we here established preclinical tumor xenograft models based on immunodeficient mice that express multiple human cytokines and have been reconstituted with a human immune system by transplantation of human CD34+ hematopoietic stem and progenitor cells (HIS-MITRG mice). HIS-MITRG mice supported the growth of both human cell line (Raji)- and patient-derived B cell lymphoma as well as the infiltration of human macrophages into their tumors. We examined the potential antitumor action of an antibody to human SIRPα (SE12C3) that inhibits the interaction of CD47 on tumor cells with SIRPα on human macrophages and thereby promotes Fcγ receptor-mediated phagocytosis of the former cells by the latter. Treatment with the combination of rituximab (antibody to human CD20) and SE12C3 inhibited Raji tumor growth in HIS-MITRG mice to a markedly greater extent than did rituximab monotherapy. This enhanced antitumor effect was dependent on human macrophages and attributable to enhanced rituximab-dependent phagocytosis of lymphoma cells by human macrophages. Treatment with rituximab and SE12C3 also induced reprogramming of human TAMs toward a proinflammatory phenotype. Furthermore, the combination treatment essentially prevented the growth of patient-derived diffuse large B cell lymphoma in HIS-MITRG mice. Our findings thus support the study of HIS-MITRG mice as a model for the preclinical evaluation in vivo of potential therapeutics, such as antibodies to human SIRPα, that target human TAMs.
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Affiliation(s)
- Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rie Iida-Norita
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tania Afroj
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Alaa Refaat
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Hazama
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Satomi Komori
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Ohata
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoko Takai
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Okechi S. Oduori
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takenori Kotani
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yu-Ichiro Koma
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoji Murata
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Bioresource Research and Development, Department of Social/Community Medicine and Health Science, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Yokozaki
- Division of Pathology, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Markus G. Manz
- Department of Medical Oncology and Hematology, University and University Hospital Zurich, Zurich, Switzerland
- Comprehensive Cancer Center Zurich at the University of Zurich, Zurich, Switzerland
| | - Takashi Matozaki
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
- Division of Biosignal Regulation, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
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15
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Tamaki M, Akahoshi Y, Okada Y, Uchida N, Tanaka M, Doki N, Sawa M, Maruyama Y, Ueda Y, Miyakoshi S, Katayama Y, Kawakita T, Kimura T, Onizuka M, Fukuda T, Atsuta Y, Yanagisawa R, Yakushijin K, Kanda J, Nakasone H. Unrelated female-to-male bone marrow transplantation would be preferred over cord blood transplantation in male patients. Cytotherapy 2023; 25:1220-1228. [PMID: 37341665 DOI: 10.1016/j.jcyt.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND AIMS Allogeneic hematopoietic stem cell transplantation from female donors to male recipients (female-to-male allo-HCT) is a well-established risk factor for a greater incidence of non-relapse mortality (NRM) and chronic graft-versus-host disease (GVHD). In contrast, unrelated cord blood transplantation (UCBT) is associated with a lower incidence of chronic GVHD. In this study, survival outcomes were compared between the UCBT and unrelated female-to-male bone marrow transplantation (UFMBMT) groups. METHODS We evaluated male allo-HCT recipients who underwent UCBT or UFMBMT between 2012 and 2020 in Japan. There were 2517 cases in the UCBT group, 456 cases in the HLA-matched UFMBMT group and 457 cases in the HLA-mismatched UFMBMT group. RESULTS HLA-mismatched UFMBMT was significantly associated with a decreased risk of relapse (hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.57-0.98], P = 0.033) and HLA-matched UFMBMT had the tendency of a decreased risk of relapse (HR 0.78; 95% CI 0.61-1.01, P = 0.059). HLA-matched UFMBMT was also associated with favorable OS (HR 0.82; 95% CI 0.69-0.97, P = 0.021). The relationship between the donor sources and relapse was similarly observed in the lymphoid malignancy cohort. CONCLUSIONS The difference of graft-versus leukemia effect by H-Y immunity according to donor sources might contribute to the difference in clinical impact. It might be desirable for patients who could sufficiently wait for donor coordination to select BMT rather than UCBT, even if only unrelated female donors are available for male recipients.
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Affiliation(s)
- Masaharu Tamaki
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
| | - Yu Akahoshi
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Tisch Cancer Institute, Ichan School of Medicine at Mount Sinai, New York, New York, USA
| | - Yosuke Okada
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Association Toranomon Hospital, Tokyo, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology and Transfusion and Hemapheresis Center, Kurashiki Central Hospital, Kurashiki, Japan
| | | | - Yuta Katayama
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Toshiro Kawakita
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Takafumi Kimura
- Preparation Department, Japanese Red Cross Kinki Block Blood Center, Osaka, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
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16
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Mizutani Y, Kawamoto S, Takahashi M, Doi H, Wakida K, Tabuchi S, Tanda M, Soga A, Chijiki R, Takakura H, Kawaguchi K, Higashime A, Watanabe M, Ichikawa H, Matsumoto S, Sakai R, Goto H, Kurata K, Kakiuchi S, Miyata Y, Uryu K, Inui Y, Kitao A, Yakushijin K, Matsuoka H, Minami H. Efficacy and Safety of Synbiotics in Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation: A Randomized, Double-blinded, Placebo-controlled Pilot Study. Intern Med 2023; 62:2949-2958. [PMID: 36792187 PMCID: PMC10641206 DOI: 10.2169/internalmedicine.1314-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/26/2022] [Indexed: 02/16/2023] Open
Abstract
Objective High-dose chemotherapy with autologous hematopoietic stem cell transplantation (auto-HSCT) is an effective treatment option for relapsed and refractory aggressive malignant lymphoma. However, patients frequently experience treatment-induced gastrointestinal symptoms. Synbiotics, including live microorganisms and nondigestible food ingredients, reportedly ameliorate chemotherapy-induced mucosal damage. In this study, we assessed the efficacy and safety of synbiotics in patients undergoing auto-HSCT. Methods This randomized, double-blinded study included patients with malignant lymphoma eligible for auto-HSCT. The patients were randomly assigned to either a synbiotic group receiving Bifidobacterium longum (BB536) and guar gum or a placebo group receiving a placebo containing dextrin. The supplements were administered twice daily from the start of conditioning chemotherapy up to 28 days after auto-HSCT. The primary endpoint was the duration of total parenteral nutrition (TPN). Results In total, 12 patients were included and randomized. The median duration of TPN was 15 (range, 12-33) days in the synbiotic group and 17.5 (range, 0-32) days in the placebo group. The median duration of grade ≥3 diarrhea was shorter in the synbiotic group than in then placebo group (2.5 vs. 6.5 days), as was the duration of hospital stay (31.5 vs. 43 days). The oral intake and quality of life regarding diarrhea and anorexia improved in the synbiotic group after engraftment. Synbiotic infections, including bacteremia, were not observed. Conclusion Synbiotics may reduce gastrointestinal toxicity, thereby reducing nutritional problems and improving the quality of life of patients undergoing auto-HSCT, without severe adverse events.
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Affiliation(s)
- Yu Mizutani
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Japan
| | | | - Hisayo Doi
- Division of Nursing, Kobe University Hospital, Japan
| | - Kumiko Wakida
- Division of Nutrition, Kobe University Hospital, Japan
| | | | - Masaaki Tanda
- Department of Pharmacy, Kobe University Hospital, Japan
| | - Akihiro Soga
- Department of Pharmacy, Kobe University Hospital, Japan
| | - Ruri Chijiki
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Hidetomo Takakura
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Koji Kawaguchi
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Ako Higashime
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Marika Watanabe
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Hiroya Ichikawa
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Rina Sakai
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Keiji Kurata
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Seiji Kakiuchi
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Kiyoaki Uryu
- Department of Medical Oncology/Hematology, Kobe University Hospital, Japan
| | - Yumiko Inui
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Kobe University Graduate School of Medicine and Hospital, Japan
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17
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Kuroda R, Niikura T, Matsumoto T, Fukui T, Oe K, Mifune Y, Minami H, Matsuoka H, Yakushijin K, Miyata Y, Kawamoto S, Kagimura T, Fujita Y, Kawamoto A. Phase III clinical trial of autologous CD34 + cell transplantation to accelerate fracture nonunion repair. BMC Med 2023; 21:386. [PMID: 37798633 PMCID: PMC10557317 DOI: 10.1186/s12916-023-03088-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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND We previously demonstrated that CD34 + cell transplantation in animals healed intractable fractures via osteogenesis and vasculogenesis; we also demonstrated the safety and efficacy of this cell therapy in an earlier phase I/II clinical trial conducted on seven patients with fracture nonunion. Herein, we present the results of a phase III clinical trial conducted to confirm the results of the previous phase studies using a larger cohort of patients. METHODS CD34 + cells were mobilized via administration of granulocyte colony-stimulating factor, harvested using leukapheresis, and isolated using magnetic cell sorting. Autologous CD34 + cells were transplanted in 15 patients with tibia nonunion and 10 patients with femur nonunion, who were followed up for 52 weeks post transplantation. The main outcome was a reduction in time to heal the tibia in nonunion patients compared with that in historical control patients. We calculated the required number of patients as 15 based on the results of the phase I/II study. An independent data monitoring committee performed the radiographic assessments. Adverse events and medical device failures were recorded. RESULTS All fractures healed during the study period. The time to radiological fracture healing was 2.8 times shorter in patients with CD34 + cell transplantation than in the historical control group (hazard ratio: 2.81 and 95% confidence interval 1.16-6.85); moreover, no safety concerns were observed. CONCLUSIONS Our findings strongly suggest that autologous CD34 + cell transplantation is a novel treatment option for fracture nonunion. TRIAL REGISTRATION UMIN-CTR, UMIN000022814. Registered on 22 June 2016.
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Affiliation(s)
- Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Takahiro Niikura
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Tomoaki Fukui
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Keisuke Oe
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Yutaka Mifune
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Chuo-Ku, Kobe, 650-0017, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Chuo-Ku, Kobe, 650-0017, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
| | - Yasuyuki Fujita
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
| | - Atsuhiko Kawamoto
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Chuo-Ku, Kobe, 650-0047, Japan
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18
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Ando Y, Nishiyama H, Shimodaira H, Takano N, Sakaida E, Matsumoto K, Nakanishi K, Sakai H, Tsukamoto S, Komine K, Yasuda Y, Kato T, Fujiwara Y, Koyama T, Kitamura H, Kuwabara T, Yonezawa A, Okumura Y, Yakushijin K, Nozawa K, Goto H, Matsubara T, Hoshino J, Yanagita M. Chapter 3: Management of kidney injury caused by cancer drug therapy, from clinical practice guidelines for the management of kidney injury during anticancer drug therapy 2022. Int J Clin Oncol 2023; 28:1315-1332. [PMID: 37453935 DOI: 10.1007/s10147-023-02382-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Cisplatin should be administered with diuretics and Magnesium supplementation under adequate hydration to avoid renal impairment. Patients should be evaluated for eGFR (estimated glomerular filtration rate) during the treatment with pemetrexed, as kidney injury has been reported. Pemetrexed should be administered with caution in patients with a CCr (creatinine clearance) < 45 mL/min. Mesna is used to prevent hemorrhagic cystitis in patients receiving ifosfamide. Febuxostat is effective in avoiding hyperuricemia induced by TLS (tumor lysis syndrome). Preventative rasburicase is recommended in high-risk cases of TLS. Thrombotic microangiopathy could be triggered by anticancer drugs and there is no evidence of efficacy of plasma exchange therapy. When proteinuria occurs during treatment with anti-angiogenic agents or multi-kinase inhibitors, dose reductions or interruptions based on grading should be considered. Grade 3 proteinuria and renal dysfunction require urgent intervention, including drug interruption or withdrawal, and referral to a nephrologist should be considered. The first-line drugs used for blood pressure elevation due to anti-angiogenic agents are ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers). The protein binding of drugs and their pharmacokinetics are considerably altered in patients with hypoalbuminemia. The clearance of rituximab is increased in patients with proteinuria, and the correlation with urinary IgG suggests similar pharmacokinetic changes when using other antibody drugs. AIN (acute interstitial nephritis) is the most common cause of ICI (immune checkpoint inhibitor)-related kidney injury that is often treated with steroids. The need for renal biopsy in patients with kidney injury that occurs during treatment with ICI remains controversial.
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Affiliation(s)
- Yuichi Ando
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hideki Shimodaira
- Division of Medical Oncology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Nao Takano
- Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | | | - Koki Nakanishi
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | | | - Keigo Komine
- Department of Medical Oncology, Tohoku University Hospital, Sendai, Japan
| | - Yoshinari Yasuda
- Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Taigo Kato
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Takafumi Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Takashige Kuwabara
- Department of Nephrology, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Atsushi Yonezawa
- Department of Clinical Pharmacology and Therapeutics, Kyoto University Hospital, Kyoto, Japan
| | - Yuta Okumura
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Kazuki Nozawa
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Center for Cancer Genomics and Advanced Therapeutics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hideaki Goto
- Department of Oncology and Hematology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Hyogo, Japan
| | - Takeshi Matsubara
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Motoko Yanagita
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan
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19
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Nishikubo M, Tanaka Y, Mitsui S, Doi T, Hokka D, Hojo W, Sakai H, Funakoshi Y, Yakushijin K, Ohji G, Minami H, Maniwa Y. Comparable efficacy and safety of COVID-19 vaccines for patients receiving tegafur-uracil as postoperative adjuvant chemotherapy. Surg Today 2023; 53:1057-1063. [PMID: 36752867 PMCID: PMC9907870 DOI: 10.1007/s00595-023-02649-1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE Many effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed, but a weaker response in individuals undergoing anticancer treatment has been reported. This study evaluates the immunogenic status and safety of SARS-CoV-2 vaccines for patients with non-small-cell lung cancer (NSCLC), receiving tegafur-uracil (UFT) as postoperative adjuvant chemotherapy. METHODS The subjects of this prospective study were 40 patients who underwent surgery for NSCLC and received SARS-CoV-2 vaccines postoperatively. We compared the antibody titers of SARS-CoV-2 vaccines and the adverse events between patients who received adjuvant UFT and patients who did not. RESULTS The mean anti-S1 IgG titers were not significantly different between the UFT and without-UFT groups (mean optimal density, 0.194 vs. 0.205; P = 0.76). Multivariate analysis identified the period after the second vaccination as an independent predictor of anti-S1 IgG titer (P = 0.049), but not the UFT status (with or without-UFT treatment; P = 0.47). The prevalence of adverse events did not differ significantly between the groups, and no severe adverse events occurred. CONCLUSIONS The efficacy and safety of the SARS-CoV-2 vaccines for NSCLC patients who received postoperative adjuvant UFT chemotherapy were comparable to those for NSCLC patients who did not receive postoperative adjuvant UFT chemotherapy. CLINICAL TRIAL REGISTRATION This study was registered with the University Hospital Medical Information Network (UMIN) in Japan (UMIN000047380).
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Affiliation(s)
- Megumi Nishikubo
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Suguru Mitsui
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Wataru Hojo
- R&D, Cellspect Co., Ltd., 2-4-23 Kitaiioka, Morioka, Iwate, 020-0857, Japan
| | - Hironori Sakai
- R&D, Cellspect Co., Ltd., 2-4-23 Kitaiioka, Morioka, Iwate, 020-0857, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Goh Ohji
- Division of Infection Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
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20
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Ichikawa H, Yakushijin K, Miyata Y, Kanehira H, Joyce M, Hirakawa Y, Matsumoto S, Nagao S, Sakai R, Kurata K, Kitao A, Saito Y, Kawamoto S, Yamamoto K, Ito M, Murayama T, Matsuoka H, Minami H. Early diagnosis of sinusoidal obstruction syndrome after hematopoietic stem cell transplantation, with modified diagnostic criteria including refractory thrombocytopenia. EJHaem 2023; 4:695-704. [PMID: 37601886 PMCID: PMC10435725 DOI: 10.1002/jha2.728] [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] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 08/22/2023]
Abstract
Sinusoidal obstruction syndrome (SOS) is a fatal complication of hematopoietic stem cell transplantation (HSCT). Early diagnosis for SOS can improve clinical outcomes significantly. Here, we performed a retrospective study to investigate the Cairo diagnostic criteria, in which SOS was defined as the development of two or more in seven events, including transfusion-refractory thrombocytopenia. Among 154 cases of allogeneic HSCT, 10 cases of SOS using the European Society for Blood and Marrow Transplantation criteria (EBMT16) as the reference standard were identified. The original Cairo criteria could diagnose SOS 5 days earlier than any other established criteria, with some false-positive results (sensitivity = 100.0%; specificity = 72.2%). When the cutoff was set to three events for the Cairo criteria, the diagnosis of SOS could be made 3 days earlier than that using the EBMT16 criteria, with comparable precision (specificity = 86.1%). The accuracy of the Cairo criteria improved further when the cutoff point was set to four (specificity = 93.8%). The fulfillment of the Cairo criteria was associated with high mortality. Based on our results, the Cairo criteria were also considered clinically useful, especially at three or four cutoff points. Further studies are required to validate and refine the criteria.
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Affiliation(s)
- Hiroya Ichikawa
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | | | - Hirofumi Kanehira
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Miki Joyce
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Yuri Hirakawa
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Sakuya Matsumoto
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Shigeki Nagao
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Rina Sakai
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Keiji Kurata
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
- Jerome Lipper Multiple Myeloma CenterDepartment of Medical OncologyDana‐Farber Cancer InstituteHarvard Medical SchoolBostonMassachusettsUSA
| | - Akihito Kitao
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Yasuyuki Saito
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
- Division of Molecular and Cellular SignalingKobe University Graduate School of MedicineKobeJapan
| | - Shinichiro Kawamoto
- Transfusion Medicine and Cell TherapyKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Katsuya Yamamoto
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
| | - Mitsuhiro Ito
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
- Laboratory of HematologyDivision of Medical BiophysicsKobe University Graduate School of Health SciencesKobeJapan
| | - Tohru Murayama
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
- Department of HematologyHyogo Cancer CenterAkashiJapan
| | | | - Hironobu Minami
- Division of Medical Oncology/HematologyDepartment of MedicineKobe University Hospital and Graduate School of MedicineKobeJapan
- Cancer CenterKobe University HospitalKobeJapan
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21
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Funakoshi Y, Yakushijin K, Ohji G, Matsutani T, Hojo W, Sakai H, Matsumoto S, Watanabe M, Kitao A, Saito Y, Kawamoto S, Yamamoto K, Koyama T, Nagatani Y, Kimbara S, Imamura Y, Kiyota N, Ito M, Minami H. Response to mRNA SARS-CoV-2 vaccination evaluated by B-cell receptor repertoire after tixagevimab/cilgavimab administration. Br J Haematol 2023; 202:504-516. [PMID: 37349876 DOI: 10.1111/bjh.18932] [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: 03/22/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023]
Abstract
The use of anti-SARS-CoV-2 antibody products like tixagevimab/cilgavimab represents an important strategy to protect immunocompromised patients with haematological malignancies from COVID-19. Although patients who receive these agents should still be vaccinated, the use of tixagevimab/cilgavimab can mask the production of anti-spike antibody after vaccination, making it hard to assess vaccine response. We have newly established a quantification method to assess the response to SARS-CoV-2 vaccination at the mRNA level using B-cell receptor (BCR) repertoire assay and the Coronavirus Antibody Database (CoV-AbDab). Repeated blood samples before and after vaccination were analysed for the BCR repertoire, and BCR sequences were searched in the database. We analysed the number and percentage frequency of matched sequences. We found that the number of matched sequences increased 2 weeks after the first vaccination and quickly decreased. Meanwhile, the number of matched sequences more rapidly increased after the second vaccination. These results show that the postvaccine immune response can be assessed at the mRNA level by analysing the fluctuation in matching sequences. Finally, BCR repertoire analysis with CoV-AbDab clearly demonstrated the response to mRNA SARS-CoV-2 vaccination even after tixagevimab/cilgavimab administration in haematological malignancy patients who underwent allogeneic haematopoietic stem cell transplantation.
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Affiliation(s)
- Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Goh Ohji
- Division of Infection Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Takaji Matsutani
- Research & Development Department, Repertoire Genesis Inc., Ibaraki, Japan
| | | | | | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Japan
| | - Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Taiji Koyama
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshiaki Nagatani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Shiro Kimbara
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshinori Imamura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Mitsuhiro Ito
- Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Cancer Center, Kobe University Hospital, Kobe, Japan
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22
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Nagao S, Yakushijin K, Higashime A, Kawaguchi K, Watanabe M, Sakai R, Ichikawa H, Mizutani Y, Goto H, Kakiuchi S, Kurata K, Kitao A, Miyata Y, Imamura Y, Hirota Y, Takahashi M, Kawamoto S, Yamamoto K, Matsuoka H, Minami H. Safety and Accuracy of Professional Continuous Glucose Monitoring in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Blood Cell Ther 2023; 6:54-60. [PMID: 37342353 PMCID: PMC10279490 DOI: 10.31547/bct-2022-024] [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] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/18/2023] [Indexed: 06/22/2023]
Abstract
Hyperglycemia in the early days following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a well-known risk factor for acute graft-versus-host disease (GVHD) and non-relapse mortality. The FreeStyle Libre Pro, a factory calibrated continuous glucose monitoring (CGM) device, has been used for the retrospective analysis of glucose testing in patients with diabetes. We assessed the safety and accuracy of the device in patients undergoing allo-HSCT. We recruited eight patients who underwent allo-HSCT between August 2017 and March 2020. They wore the FreeStyle Libre Pro on the day before or on the day of transplantation until 28 days after transplantation. Adverse events, especially bleeding and infection, were monitored to assess safety, and blood glucose levels were measured and compared with the device values. None of the eight participants experienced bleeding that was difficult to stop from the sensor site or local infection that required antimicrobial administration. The device value was well correlated with blood glucose (correlation coefficient r=0.795, P<0.01); however, the overall mean absolute relative difference was 32.1%±16.0%. Our study demonstrated the safety of FreeStyle Libre Pro in allo-HSCT patients. However, the sensor results tended to be lower than the blood glucose levels.
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Affiliation(s)
- Shigeki Nagao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Ako Higashime
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Koji Kawaguchi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Hiroya Ichikawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yu Mizutani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Seiji Kakiuchi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Keiji Kurata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- BioResource Center, Kobe University Hospital, Kobe, Japan
| | - Yoshinori Imamura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yushi Hirota
- Diabetes and Endocrinology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Michiko Takahashi
- Department of Nutrition, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Kawamoto
- Transfusion Medicine and Cell Therapy, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
- BioResource Center, Kobe University Hospital, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
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23
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Tamaki M, Akahoshi Y, Ashizawa M, Misaki Y, Koi S, Kim SW, Ozawa Y, Fujiwara SI, Kako S, Matsuoka KI, Sawa M, Katayama Y, Onizuka M, Kanda Y, Fukuda T, Atsuta Y, Yakushijin K, Nakasone H. Impact of anti-thymocyte globulin on survival outcomes in female-to-male allogeneic hematopoietic stem cell transplantation. Sci Rep 2023; 13:7166. [PMID: 37138004 PMCID: PMC10156723 DOI: 10.1038/s41598-023-34442-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/30/2023] [Indexed: 05/05/2023] Open
Abstract
Allogeneic hematopoietic cell transplantation between female donors and male recipients (female-to-male allo-HCT) is a well-established risk factor for inferior survival outcomes due to a higher incidence of graft-versus-host disease (GVHD). However, a clinical significance of anti-thymocyte globulin (ATG) in the female-to-male allo-HCT has not been elucidated. In this study, we retrospectively evaluated male patients who underwent allo-HCT between 2012 and 2019 in Japan. In the female-to-male allo-HCT cohort (n = 828), the use of ATG was not associated with a decreased risk of GVHD (HR of acute GVHD 0.691 [95% CI: 0.461-1.04], P = 0.074; HR of chronic GVHD 1.06 [95% CI: 0.738-1.52], P = 0.76), but was associated with favorable overall survival (OS) and a decreased risk of non-relapse mortality (NRM) (HR of OS 0.603 [95% CI: 0.400-0.909], P = 0.016; HR of NRM 0.506 [95% CI: 0.300-0.856], P = 0.011). The use of ATG in female-to-male allo-HCT resulted in survival outcomes that were almost equivalent to those in the male-to-male allo-HCT group. Therefore, GVHD prophylaxis with ATG might overcome the inferiority of survival outcomes in female-to-male allo-HCT.
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Affiliation(s)
- Masaharu Tamaki
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
| | - Yu Akahoshi
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Yukiko Misaki
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Satoshi Koi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Sung-Won Kim
- Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yukiyasu Ozawa
- Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | | | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
| | - Ken-Ichi Matsuoka
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, 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
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan
- Division of Hematology, Jichi Medical University, Shimotsuke, Japan
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan
- Department of Registry Science for Transplantation and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Hideki Nakasone
- Division of Hematology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.
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24
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Yamamoto K, Matsumoto H, Matsumoto S, Sakai R, Kitao A, Watanabe M, Goto H, Sugimoto T, Yano Y, Yakushijin K, Minami H. Unexpected appearance of KMT2A::MLLT10 fusion transcript in acute myeloid leukemia with t(5;11)(q31;q23.3). Cancer Genet 2023; 272-273:41-46. [PMID: 36774707 DOI: 10.1016/j.cancergen.2023.02.002] [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: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/02/2023] [Indexed: 02/06/2023]
Abstract
As an uncommon but nonrandom translocation in acute myeloid leukemia (AML) t(5;11)(q31;q23) results in fusion between KMT2A at 11q23 and ARHGAP26 at 5q31. The 5q31 region has another KMT2A partner, AFF4, which was identified in acute lymphoblastic leukemia harboring ins(5;11)(q31;q13q23). We report here a 65-year-old woman with AML M5b. G-banding and spectral karyotyping demonstrated 46,XX,t(5;11)(q31;q23.3). Fluorescence in situ hybridization revealed not only separated 5' and 3' KMT2A signals but a faint 5' KMT2A signal. Reverse transcription polymerase chain reaction (RT-PCR), using a KMT2A sense primer and ARHGAP26 antisense primer, detected no band whereas RT-PCR with a AFF4 antisense primer revealed an amplified band. However, sequence analysis unexpectedly disclosed that KMT2A exon 6 was connected with MLLT10 exons 15 to 18. This may be due to cross-hybridization between MLLT10 exon 18 and AFF4 antisense primer derived from AFF4 exon 10 since both exons had eight identical bases (AAGCAGCT). The MLLT10 gene is located at 10p12.31; a faint 5' KMT2A signal was probably present at this locus. These findings indicate that in AML the 5' KMT2A fragment containing exons 1 to 6 may be cryptically inserted into MLLT10 intron 14 when a reciprocal translocation t(5;11)(q31;q23.3) involving KMT2A occurred.
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Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Hisayuki Matsumoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Hematology and Oncology, Kita-Harima Medical Center, Ono, Japan
| | - Takeshi Sugimoto
- Department of Hematology and Oncology, Kita-Harima Medical Center, Ono, Japan
| | - Yoshihiko Yano
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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25
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Yamamoto K, Kawamoto S, Chijiki R, Watanabe M, Matsumoto S, Kitao A, Mizutani Y, Kajimoto K, Hayashi Y, Yakushijin K, Minami H. Biclonal Diffuse Large B-cell Lymphoma Commonly Characterized by Partial Trisomy 18q Involving MALT1 and BCL2. Intern Med 2023; 62:285-292. [PMID: 35705274 PMCID: PMC9908399 DOI: 10.2169/internalmedicine.9711-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
A 68-year-old man was admitted because of a left shoulder mass and swollen right testis. Pathological examinations indicated a diagnosis of diffuse large B-cell lymphoma (DLBCL) with the CD20+BCL6+MUM1+BCL2+CD10-MYC- phenotype in both lesions. G-banding of soft tissue showed 47,XY,+18, whereas testicular cells showed 47,X,+X,-Y,der (4) t (4;18) (p15;?),del (5) (q?),+13. Fluorescence in situ hybridization detected additional MALT1 and BCL2 signals in both lesions. Southern blot demonstrated different IGH rearrangements between the soft tissue and testis. The patient was diagnosed with biclonal DLBCL with different karyotypes but similar immunophenotypes. Partial trisomy 18q involving MALT1 and BCL2 may be commonly involved in the pathogenesis of this biclonal DLBCL.
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Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Japan
| | - Ruri Chijiki
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Yu Mizutani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Kazuyoshi Kajimoto
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Japan
- Department of Pathology, Hyogo Cancer Center, Japan
| | - Yoshitake Hayashi
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Japan
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26
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Okamoto S, Urade T, Yakushijin K, Kido M, Kuramitsu K, Komatsu S, Gon H, Yamashita H, Shirakawa S, Tsugawa D, Terai S, Yanagimoto H, Toyama H, Fukumoto T. Successful Management of Refractory Autoimmune Hemolytic Anemia with Cold Agglutinin Disease with Splenectomy: A Case Report with Review of Literature. Kobe J Med Sci 2023; 68:E30-E34. [PMID: 36647084 PMCID: PMC10117625] [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] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia characterized by agglutination of red blood cells at temperatures below the normal core body temperature. In patients with CAD, splenectomy is not indicated because of its low therapeutic effect on hemolytic anemia induced by extravascular hemolysis. Herein, we report a case of refractory hemolytic anemia with CAD successfully managed with splenectomy. CLINICAL CASE A 60-year-old man visited a municipal hospital with the chief complaint of fatigue. He was found to have hemolytic anemia and icterus with increased cold agglutination and was diagnosed with CAD. Malignant lymphoma was suspected as the underlying disease; however, no clear underlying disease was identified. Hemolytic anemia progressed during the subsequent winter seasons, and he was treated with temperature control, warming, and weekly blood transfusions. However, despite the blood transfusions, his hemoglobin level did not improve during the summer 2 years after diagnosis, and his previously observed splenomegaly had progressed. He was referred to our department, and a splenectomy was performed to diagnose any occult malignant lymphoma and improve the refractory hemolytic anemia. Because histopathological examination revealed no evidence of malignant lymphoma, a diagnosis of primary CAD was made. The hemolytic anemia improved, and no blood transfusion was required after splenectomy. CONCLUSIONS Splenectomy significantly improved the patient's refractory hemolytic anemia due to primary CAD. Thus, it may be an effective treatment option in such cases, although further cases and studies are required to evaluate the effects of splenectomy.
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Affiliation(s)
- Shuji Okamoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Urade
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masahiro Kido
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kaori Kuramitsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shohei Komatsu
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidetoshi Gon
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironori Yamashita
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sachiyo Shirakawa
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Daisuke Tsugawa
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sachio Terai
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Yanagimoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirochika Toyama
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Fukumoto
- Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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27
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Inase A, Maimaitili Y, Kimbara S, Mizutani Y, Miyata Y, Ohata S, Matsumoto H, Kitao A, Sakai R, Kawaguchi K, Higashime A, Nagao S, Kurata K, Goto H, Kawamoto S, Yakushijin K, Minami H, Matsuoka H. GSK3 inhibitor enhances gemtuzumab ozogamicin-induced apoptosis in primary human leukemia cells by overcoming multiple mechanisms of resistance. EJHaem 2022; 4:153-164. [PMID: 36819180 PMCID: PMC9928658 DOI: 10.1002/jha2.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 12/15/2022]
Abstract
In acute myeloid leukemia (AML), the heterogeneity of genetic and epigenetic characteristics makes treatment difficult. The prognosis for AML is therefore poor, and there is an urgent need for new treatments for this condition. Gemtuzumab ozogamicin (GO), the first antibody-drug conjugate (ADC), targets the CD33 antigen expressed in over 90% of AML cases. GO therefore has the potential to counter the heterogeneity of AML patients. However, a major clinical problem is that drug resistance to GO diminishes its effect over time. Here, we report that the inhibition of glycogen synthase kinase 3 (GSK3) alone overcomes several forms of GO resistance at concentrations without antileukemic effects. The GSK3 inhibitors tested significantly enhanced the cytotoxic effect of GO in AML cell lines. We elucidated four mechanisms of enhancement: (1) increased expression of CD33, the target antigen of GO; (2) activation of a lysosomal function essential for hydrolysis of the GO linker; (3) reduced expression of MDR1 that eliminates calicheamicin, the payload of GO; and (4) reduced expression of the anti-apoptotic factor Bcl-2. A similar combination effect was observed against patient-derived primary AML cells. Combining GO with GSK3 inhibitors may be efficacious in treating heterogeneous AML.
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Affiliation(s)
- Aki Inase
- Division of Bioresource Research and DevelopmentDepartment of Social/Community Medicine and Health ScienceKobe University Graduate School of MedicineKobeJapan,Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yimamu Maimaitili
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Shiro Kimbara
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yu Mizutani
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Yoshiharu Miyata
- Division of Bioresource Research and DevelopmentDepartment of Social/Community Medicine and Health ScienceKobe University Graduate School of MedicineKobeJapan,Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Shinya Ohata
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | | | - Akihito Kitao
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Rina Sakai
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Koji Kawaguchi
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan,Department of Medical Oncology/HematologyKonan Medical CenterKobeJapan
| | - Ako Higashime
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Shigeki Nagao
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Keiji Kurata
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Hideaki Goto
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan,Department of Hematology and OncologyKita‐harima Medical CenterOnoJapan
| | | | - Kimikazu Yakushijin
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
| | - Hironobu Minami
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan,Cancer Center, Kobe University HospitalKobeJapan
| | - Hiroshi Matsuoka
- Division of Bioresource Research and DevelopmentDepartment of Social/Community Medicine and Health ScienceKobe University Graduate School of MedicineKobeJapan,Division of Medical Oncology and HematologyDepartment of MedicineKobe University Graduate School of MedicineKobeJapan
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28
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Okumura S, Ishihara M, Kiyota N, Yakushijin K, Takada K, Kobayashi S, Ikeda H, Endo M, Kato K, Kitano S, Matsumine A, Nagata Y, Kageyama S, Shiraishi T, Yamada T, Horibe K, Takesako K, Miwa H, Watanabe T, Miyahara Y, Shiku H. Chimeric antigen receptor T-cell therapy targeting a MAGE A4 peptide and HLA-A*02:01 complex for unresectable advanced or recurrent solid cancer: protocol for a multi-institutional phase 1 clinical trial. BMJ Open 2022; 12:e065109. [PMID: 36375974 PMCID: PMC9664294 DOI: 10.1136/bmjopen-2022-065109] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Adoptive cell transfer of genetically engineered T cells is a promising treatment for malignancies; however, there are few ideal cancer antigens expressed on the cell surface, and the development of chimeric antigen receptor T cells (CAR-T cells) for solid tumour treatment has been slow. CAR-T cells, which recognise major histocompatibility complex and peptide complexes presented on the cell surface, can be used to target not only cell surface antigens but also intracellular antigens. We have developed a CAR-T-cell product that recognises the complex of HLA-A*02:01 and an epitope of the MAGE-A4 antigen equipped with a novel signalling domain of human GITR (investigational product code: MU-MA402C) based on preclinical studies. METHODS AND ANALYSIS This is a dose-escalation, multi-institutional, phase 1 study to evaluate the tolerability and safety of MU-MA402C for patients with MAGE A4-positive and HLA-A*02:01-positive unresectable advanced or recurrent solid cancer. Two dose cohorts are planned: cohort 1, MU-MA402C 2×108/person; cohort 2, MU-MA402C 2×109/person. Prior to CAR-T-cell infusion, cyclophosphamide (CPA) and fludarabine (FLU) will be administered as preconditioning chemotherapy. Three evaluable subjects per cohort, for a total of 6 subjects (maximum of 12 subjects), will be recruited for this clinical trial. The primary endpoints are safety and tolerability. The severity of each adverse event will be evaluated in accordance with Common Terminology Criteria for Adverse Events V.5.0. The secondary endpoint is efficacy. Antitumour response will be evaluated according to Response Evaluation Criteria in Solid Tumours V.1.1. ETHICS AND DISSEMINATION This clinical trial will be conducted in accordance with the current version of Good Clinical Practice. The protocol was approved by the Clinical Research Ethics Review Committee of Mie University Hospital (approval number F-2021-017). The trial results will be published in peer-reviewed journals and/or disseminated through international conferences. TRIAL REGISTRATION NUMBER jRCT2043210077.
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Affiliation(s)
- Satoshi Okumura
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | | | - Naomi Kiyota
- Cancer Center, Kobe University Hospital, Kobe, Hyogo, Japan
- Department of Medical Oncology and Haematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Haematology, Kobe University Hospital, Kobe, Hyogo, Japan
| | - Kohichi Takada
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | | | - Hiroaki Ikeda
- Department of Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Makoto Endo
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shigehisa Kitano
- Department of Advanced Medical Development, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akihiko Matsumine
- Department of Orthopaedics and Rehabilitation Medicine, Unit of Surgery, Division of Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Yasuhiro Nagata
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shinichi Kageyama
- Department of Medical Oncology/Chemotherapy Center, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | - Taizo Shiraishi
- Department of Pathology, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Tomomi Yamada
- Department of Medical Innovation, Osaka University Hospital, Osaka, Japan
| | - Keizo Horibe
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Kazuto Takesako
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hiroshi Miwa
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Takashi Watanabe
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yoshihiro Miyahara
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hiroshi Shiku
- Department of Personalized Cancer Immunotherapy, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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29
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Watanabe M, Yakushijin K, Tanaka H, Chijiki R, Saeki M, Hirakawa Y, Takakura H, Usui Y, Ichikawa H, Sakai R, Matsumoto S, Nagao S, Mizutani Y, Kurata K, Kitao A, Miyata Y, Saito Y, Kawamoto S, Yamamoto K, Ito M, Matsuoka H, Minami H. Global longitudinal strain is superior to ejection fraction for long-term follow-up after allogeneic hematopoietic stem cell transplantation. EJHaem 2022; 4:192-198. [PMID: 36819160 PMCID: PMC9928647 DOI: 10.1002/jha2.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
Global longitudinal strain (GLS), a new cardiac parameter measured by the speckle-tracking method, is reportedly more sensitive than ejection fraction (EF) in detecting slight cardiac dysfunction in heart failure patients. We validated the utility of GLS in allogeneic hematopoietic stem cell transplantation (HSCT) patients during a long-term follow-up. Medical records of patients who underwent allogeneic HSCT between 2013 and 2020 were reviewed retrospectively. We evaluated the last echocardiography performed before transplantation and those performed annually during the 5 years after transplantation. We also investigated newly diagnosed cardiac events, which developed after HSCT. Among 85 patients, 22 used cardioprotective drugs. The median follow-up duration in surviving patients was 54.1 months (range, 2.9-92.6 months). GLS significantly decreased year by year, and patients taking cardioprotective agents tended to have a better GLS at 5 years than at 3 years, while EF did not change. Fifteen patients developed newly diagnosed cardiac events. Multivariate analysis revealed that low GLS and high serum ferritin levels at baseline were independently associated with the development of cardiac events. Therefore, we need a continuous follow-up of cardiac function by GLS and prescription of cardioprotective drugs might be considered for HSCT patients with low GLS. Further research is warranted.
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Affiliation(s)
- Marika Watanabe
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Hidekazu Tanaka
- Division of Cardiovascular MedicineDepartment of Internal MedicineKobe University Graduate School of MedicineKobeJapan
| | - Ruri Chijiki
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Miki Saeki
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Yuri Hirakawa
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Hidetomo Takakura
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Yutaro Usui
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Hiroya Ichikawa
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Rina Sakai
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Sakuya Matsumoto
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Shigeki Nagao
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Yu Mizutani
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Keiji Kurata
- Jerome Lipper Multiple Myeloma CenterDepartment of Medical OncologyDana‐Farber Cancer InstituteHarvard Medical SchoolBostonMassachusettsUSA
| | - Akihito Kitao
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Yoshiharu Miyata
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan,BioResource CenterKobe University HospitalKobeJapan
| | - Yasuyuki Saito
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Shinichiro Kawamoto
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Katsuya Yamamoto
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
| | - Mitsuhiro Ito
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan,Laboratory of HematologyDivision of Medical BiophysicsKobe University Graduate School of Health SciencesKobeJapan
| | - Hiroshi Matsuoka
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan,BioResource CenterKobe University HospitalKobeJapan
| | - Hironobu Minami
- Division of Medical Oncology and HematologyDepartment of MedicineKobe University HospitalKobeJapan
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30
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Watanabe M, Yakushijin K, Funakoshi Y, Ohji G, Ichikawa H, Sakai H, Hojo W, Saeki M, Hirakawa Y, Matsumoto S, Sakai R, Nagao S, Kitao A, Miyata Y, Koyama T, Saito Y, Kawamoto S, Yamamoto K, Ito M, Murayama T, Matsuoka H, Minami H. A Third Dose COVID-19 Vaccination in Allogeneic Hematopoietic Stem Cell Transplantation Patients. Vaccines (Basel) 2022; 10:1830. [PMID: 36366338 PMCID: PMC9695068 DOI: 10.3390/vaccines10111830] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 10/06/2023] Open
Abstract
We previously reported that a second dose of BNT162b2 was safe and effective for allogeneic hematopoietic stem cell transplantation (HSCT) patients. Here, we investigated the safety and efficacy of a third dose of COVID-19 mRNA vaccine in allogeneic HSCT patients. Antibody titers against the S1 spike protein were measured using the QuaResearch COVID-19 Human IgM IgG ELISA kit. The previous study included 25 allogeneic HSCT patients who received two doses of BNT162b2. Following the exclusion of three patients because of the development of COVID-19 (n = 2) and loss to follow-up (n = 1), the study evaluated 22 allogeneic HSCT patients who received a third dose of COVID-19 mRNA vaccine (BNT162b2 [n = 15] and mRNA-1273 [n = 7]). Median age at the time of the first vaccination was 56 (range, 23-71) years. Five patients were receiving immunosuppressants at the third vaccination, namely calcineurin inhibitors (CI) alone (n = 1), steroids alone (n = 2), or CI combined with steroids (n = 2). Twenty-one patients (95%) seroconverted after the third dose. None of our patients had serious adverse events, new-onset graft-versus-host disease (GVHD), or GVHD exacerbation after vaccination. A third dose of the BNT162b2 and mRNA-1273 COVID-19 vaccines was safe and effective for allogeneic HSCT patients.
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Affiliation(s)
- Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Goh Ohji
- Division of Infectious Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Hiroya Ichikawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | | | - Wataru Hojo
- R&D, Cellspect Co., Ltd., Morioka 020-0857, Japan
| | - Miki Saeki
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yuri Hirakawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Shigeki Nagao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshiharu Miyata
- BioResource Center, Kobe University Hospital, Kobe 650-0047, Japan
| | - Taiji Koyama
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Shinichiro Kawamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
| | - Mitsuhiro Ito
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
- Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe 654-0142, Japan
| | - Tohru Murayama
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
- Department of Hematology, Hyogo Cancer Center, Akashi 673-0021, Japan
| | - Hiroshi Matsuoka
- BioResource Center, Kobe University Hospital, Kobe 650-0047, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital Graduate School of Medicine, Kobe 650-0017, Japan
- Cancer Center, Kobe University Hospital, Kobe 650-0017, Japan
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31
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Goto H, Yakushijin K, Adachi Y, Matsumoto H, Yamamoto K, Matsumoto S, Yamashita T, Higashime A, Kawaguchi K, Kurata K, Matsuoka H, Minami H. A Pathogenic NRAS c.38 G>A (p.G13D) Mutation in RARA Translocation-negative Acute Promyelocytic-like Leukemia with Concomitant Myelodysplastic Syndrome. Intern Med 2022; 62:1329-1334. [PMID: 36130886 DOI: 10.2169/internalmedicine.0174-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
An acute promyelocytic leukemia (APL) patient not demonstrating the retinoic acid receptor α (RARA) translocation is rare. A 76-year-old man was diagnosed with myelodysplastic syndrome (MDS). After a year, abnormal promyelocytes were detected with pancytopenia and disseminated intravascular coagulopathy. Morphologically, the patient was diagnosed with APL; however, a genetic examination failed to detect RARA translocation. Thereafter, whole-genome sequencing revealed an NRAS missense mutation [c.38 G>A (p.G13D)]. This mutation was not detected in posttreatment bone marrow aspirate, despite residual MDS. Few reports are available on similar cases. Furthermore, the NRAS c.38 G>A mutation may be a novel pathogenic variant exacerbating RARA translocation-negative acute promyelocytic-like leukemia.
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Affiliation(s)
- Hideaki Goto
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
- Department of Oncology and Hematology, Hyogo Prefectural HarimaHimeji General Medical Center, Japan
- Department of Internal Medicine, JCHO Kobe Central Hospital, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Yoko Adachi
- Department of Internal Medicine, JCHO Kobe Central Hospital, Japan
| | | | - Katsuya Yamamoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Sakuya Matsumoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Tomoe Yamashita
- Department of Clinical Laboratory, Kobe University Hospital, Japan
| | - Ako Higashime
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Koji Kawaguchi
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Keiji Kurata
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
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32
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Nakajima T, Nagano T, Miyata Y, Murakami S, Mitsuyuki S, Funakoshi Y, Yakushijin K, Horimoto H, Nishimura Y, Kobayashi K. Inhaled corticosteroids do not affect the antibody titer against the SARS-CoV-2 spike protein in BNT162b2 mRNA vaccinated patients. Allergy Asthma Clin Immunol 2022; 18:78. [PMID: 36008820 PMCID: PMC9403962 DOI: 10.1186/s13223-022-00719-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022]
Abstract
Objectives Oral corticosteroids reduce the antibody titer of the BNT162b2 mRNA vaccine against SARS-CoV-2. To date, the effect of inhaled corticosteroids on antibody titers is unknown. Study design The design of this study is retrospective study. Methods We analyzed the relationship between the clinical features and total antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein in 320 subjects who had never been infected with Coronavirus disease 2019 (COVID-19) and were vaccinated the second time with the BNT162b2 mRNA vaccine between October 1 to December 28, 2021. Results Of the 320 subjects, 205 were treated with inhaled corticosteroids. The median antibody titer of patients treated with inhaled corticosteroids was 572 U/mL, which was significantly higher than that of patients treated without inhaled corticosteroids (454U/mL, P = 0.00258). The median antibody titers of smokers, men, and patients aged 65 years and over, were 315.5 U/mL, 385 U/mL, and 425.5 U/mL, respectively. These results are significantly lower than those of patients who never smoked, women, and patients aged less than 64 years (582 U/mL [P < 0.0001], 682.5 U/mL [P < 0.0001], and 717 U/mL [P < 0.0001], respectively). The multivariate analysis revealed that females and age were independent antibody titer-reducing factors (P = 0.0001 and P < 0.0001, respectively). Conclusions The use of inhaled corticosteroids did not reduce the antibody titer against SARS-CoV-2 spike protein. Clinicians should continue treatment with inhaled corticosteroids if indicated.
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Affiliation(s)
- Takeo Nakajima
- Nakajima Medical Clinic, 1-8-3 Mikagenakamachi, Higashinada-ku, Kobe, 658-0054, Japan
| | - Tatsuya Nagano
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yoshiharu Miyata
- Division of Bioresource Research and Development, Department of Social/Community Medicine and Health Science, Kobe University Graduate School of Medicine, 1-5-1 Minatojimanakamachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Shoko Murakami
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Satoshi Mitsuyuki
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hitoshi Horimoto
- Horimoto Clinic, 4-4-23, Okamoto, Higashinada-ku, Kobe, 658-0072, Japan
| | - Yoshihiro Nishimura
- Department of Respiratory Medicine, Kitaharima Medical Center, 926-250 Ichiba-cho, Ono, Hyogo, 675-1392, Japan
| | - Kazuyuki Kobayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Ainai S, Komaki R, Muramae N, Uno R, Mori K, Otsui K, Yakushijin K, Sakaguchi K. Biclonal Gammopathy as a Misleading Indicator to Diagnose POEMS Syndrome: An Autopsy Case Report and a Review of the Literature. Cureus 2022; 14:e25153. [PMID: 35747029 PMCID: PMC9206714 DOI: 10.7759/cureus.25153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 12/03/2022] Open
Abstract
A 76-year-old man presented with a four-month history of progressive bilateral lower limb muscle weakness and dysesthesia. The patient had extravascular volume overload, and laboratory findings confirmed hypothyroidism, renal dysfunction, and chronic inflammation. Serum protein and immunofixation electrophoresis revealed biclonality of immunoglobulin A (IgA)-kappa and IgA-lambda, which was attributed to chronic inflammation. Subsequently, we detected the proliferation of monoclonal plasma cells in the bone marrow, which led to a diagnosis of POEMS syndrome. Despite the initiation of chemotherapy, the patient died of aspiration pneumonia. In this case, biclonal gammopathy in peripheral blood delayed a diagnosis of POEMS syndrome.
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Fuji S, Cheng J, Yakushijin K, Wanitpongpun C. Nutritional support in allogeneic hematopoietic stem cell transplantation Asian perspective. Blood Cell Ther 2022; 5:54-60. [PMID: 36710949 PMCID: PMC9870687 DOI: 10.31547/bct-2021-024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/01/2022] [Indexed: 02/01/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an integral part of the treatment strategy for patients with malignant or non-malignant hematological diseases. Clinical outcomes of patients undergoing allo-HSCT have significantly improved in recent decades. However, transplant-related morbidity and mortality remain major issues for allo-HSCT recipients. With regard to nutrition, patients undergoing allo-HSCT are at high risk for malnutrition. It is expected that clinical practice concerning nutritional support in allo-HSCT has been improving in recent decades; however, no data directly support this expectation. One major issue in managing nutritional support during allo-HSCT is the lack of large-scale randomized prospective studies, which leads to a lack of well-established strategies. Accordingly, we need to gather data from studies in non-HSCT and allo-HSCT settings. In some Asia-Pacific countries, a physician's lack of knowledge of nutritional support may impede the application of nutritional support practices recommended by existing guidelines. Another barrier may be the lack of access to an adequately qualified or trained registered dietitian (RD) at allo-HSCT units. Adequate training in the nutritional management of allo-HSCT patients should be provided to all RDs working with HSCT. Herein, we summarize the information on nutritional support in allo-HSCT, focusing on an Asian perspective.
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Affiliation(s)
- Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan,Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group
| | - Jessica Cheng
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Bone Marrow Transplant & Haematology, St Vincent's Public Hospital Sydney, Sydney, Australia
| | - Kimikazu Yakushijin
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Chinadol Wanitpongpun
- Nutrition Support WG, Asia-Pacific Blood and Marrow Transplantation group,Hematology Unit, Department of Internal Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand
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35
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Funakoshi Y, Yakushijin K, Ohji G, Hojo W, Sakai H, Watanabe M, Saeki M, Hirakawa Y, Sakai R, Matsumoto S, Mizutani Y, Kitao A, Miyata Y, Saito Y, Kawamoto S, Yamamoto K, Ito M, Nishimura M, Imamura Y, Kiyota N, Matsuoka H, Mori Y, Minami H. Limited increase in antibody titers following mRNA SARS-CoV-2 vaccination for more than 3 years after final dose of anti-CD20 antibody. Int J Hematol 2022; 115:7-10. [PMID: 34981433 PMCID: PMC8723797 DOI: 10.1007/s12185-021-03247-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 02/04/2023]
Abstract
We investigated the efficacy of BNT162b2 mRNA COVID-19 vaccine in patients with B-cell malignancies treated with anti-CD20 antibody. Although T-cell-mediated immune responses were detected even in patients receiving R-CHOP treatment, the S1 antibody titer following BNT162b2 vaccination remained only marginally increased for more than 3 years after the final dose of anti-CD20 antibody. We found no relationship between the percent of B-cells and S1 antibody titer. The duration of this suppression was much longer than we anticipated. Further protection and treatment strategies against COVID-19 for these patients are warranted.
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Affiliation(s)
- Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Goh Ohji
- Division of Infection Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Wataru Hojo
- R&D, Cellspect Co., Ltd, Morioka, Iwate, Japan
| | | | - Marika Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Miki Saeki
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yuri Hirakawa
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yu Mizutani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | | | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinichiro Kawamoto
- Department of Transfusion Medicine and Cell Therapy, Kobe University Hospital, Kobe, Japan
| | - Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Mitsuhiro Ito
- Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Meiko Nishimura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshinori Imamura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
| | | | - Yasuko Mori
- Division of Clinical Virology, Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
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Funakoshi Y, Yakushijin K, Ohji G, Hojo W, Sakai H, Takai R, Nose T, Ohata S, Nagatani Y, Koyama T, Kitao A, Nishimura M, Imamura Y, Kiyota N, Harada K, Tanaka Y, Mori Y, Minami H. Safety and Immunogenicity of the COVID-19 vaccine BNT162b2 in patients undergoing chemotherapy for solid cancer. J Infect Chemother 2021; 28:516-520. [PMID: 35090826 PMCID: PMC8716153 DOI: 10.1016/j.jiac.2021.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/06/2021] [Accepted: 12/19/2021] [Indexed: 12/15/2022]
Abstract
Background Although COVID-19 severity in cancer patients is high, the safety and immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in patients undergoing chemotherapy for solid cancers in Japan have not been reported. Methods We investigated the safety and immunogenicity of BNT162b2 in 41 patients undergoing chemotherapy for solid cancers and in healthy volunteers who received 2 doses of BNT162b2. We evaluated serum IgG antibody titers for S1 protein by ELISA at pre-vaccination, prior to the second dose and 14 days after the second vaccination in 24 cancer patients undergoing cytotoxic chemotherapy (CC group), 17 cancer patients undergoing immune checkpoint inhibitor therapy (ICI group) and 12 age-matched healthy volunteers (HV group). Additionally, inflammatory cytokine levels were compared between the HV and ICI groups at pre and the next day of each vaccination. Results Anti-S1 antibody levels were significantly lower in the ICI and CC groups than in the HV group after the second dose (median optimal density: 0.241 [0.063–1.205] and 0.161 [0.07–0.857] vs 0.644 [0.259–1.498], p = 0.0024 and p < 0.0001, respectively). Adverse effect profile did not differ among the three groups, and no serious adverse event occurred. There were no differences in vaccine-induced inflammatory cytokines between the HV and ICI groups. Conclusion Although there were no significant differences in adverse events in three groups, antibody titers were significantly lower in the ICI and CC groups than in the HV group. Further protection strategies should be considered in cancer patients undergoing CC or ICI.
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37
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Yamamoto K, Kurata K, Kitao A, Sakai R, Matsumoto S, Matsumoto H, Saegusa J, Yakushijin K, Minami H. Cryptic insertion of CBFB into MYH11 leading to a type D fusion in acute myeloid leukemia with normal karyotype. Int J Lab Hematol 2021; 44:e36-e39. [PMID: 34490987 DOI: 10.1111/ijlh.13694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/11/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiji Kurata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rina Sakai
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sakuya Matsumoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisayuki Matsumoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Jun Saegusa
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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38
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Yamamoto K, Yakushijin K, Mizutani Y, Okuni-Watanabe M, Goto H, Higashime A, Miyata Y, Kitao A, Matsumoto H, Saegusa J, Matsuoka H, Minami H. Expression of a novel type of KMT2A/EPS15 fusion transcript in FLT3 mutation-positive B-lymphoblastic leukemia with t(1;11)(p32;q23). Cancer Genet 2021; 254-255:92-97. [PMID: 33647817 DOI: 10.1016/j.cancergen.2021.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 10/07/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
The t(1;11)(p32;q23) translocation is a rare but recurrent cytogenetic aberration in acute myeloid leukemia (AML) and B-cell acute lymphoblastic leukemia (B-ALL). This translocation was initially shown to form a fusion gene between KMT2A exon 8 at 11q23 and EPS15 exon 2 at 1p32 in AML. Activating mutations of FLT3 are frequently found in AML but are very rare in ALL. Here, we describe a 75-year-old woman who was diagnosed with B-ALL since her bone marrow was made up of 98.2% lymphoblasts. These blasts were positive for CD19, CD22, CD79a, CD13, and CD33 but negative for CD10 and myeloperoxidase. The karyotype by G-banding and spectral karyotyping was 46,XX,t(1;11)(p32;q23). Expression of KMT2A/EPS15 and reciprocal EPS15/KMT2A fusion transcripts were shown: KMT2A exon 8 was in-frame fused to EPS15 exon 12, indicating that this fusion transcript was a novel type. Considering three reported B-ALL cases, EPS15 breakpoints were markedly different between AML (exon 2) and B-ALL (exons 10-12). Furthermore, an uncommon type of FLT3 mutation in the juxtamembrane domain was detected: in-frame 4-bp deletion and 10-bp insertion. Accordingly, our results indicate that the novel type of KMT2A/EPS15 fusion transcript and FLT3 mutation may cooperate in the pathogenesis of adult B-ALL as class II and class I mutations, respectively.
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Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yu Mizutani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Marika Okuni-Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Ako Higashime
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hisayuki Matsumoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Jun Saegusa
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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Takai R, Funakoshi Y, Suto H, Nagatani Y, Imamura Y, Toyoda M, Yakushijin K, Kiyota N, Harada KI, Yamashita K, Kakeji Y, Minami H. Serum Soluble Interleukin-2 Receptor as a Potential Biomarker for Immune-related Adverse Events. Anticancer Res 2021; 41:1021-1026. [PMID: 33517310 DOI: 10.21873/anticanres.14857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Biomarkers for immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICIs) are required. We encountered a patient whose skin irAE fluctuated in parallel with serum soluble interleukin-2 receptor (sIL-2R). PATIENTS AND METHODS We examined 15 patients with cancer who received ICIs. Serum sIL-2R levels before and during ICI treatment were measured. The sIL-2R levels of preserved serum samples from another five patients who developed grade 3 irAEs were measured. RESULTS Twelve patients showed no significant changes in sIL-2R levels during ICI treatment. Baseline serum sIL-2R levels in three patients increased beyond the normal range before the second cycle. These three patients had grade ≥2 irAEs at the second cycle treatment visit, supporting our hypothesis. Furthermore, at diagnosis of irAEs, the sIL-2R levels of all preserved samples from patients with grade 3 irAEs were significantly elevated. CONCLUSION Serum sIL-2R is a promising biomarker for the diagnosis of irAEs.
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Affiliation(s)
- Ryo Takai
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yohei Funakoshi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan;
| | - Hirotaka Suto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshiaki Nagatani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshinori Imamura
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Masanori Toyoda
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Naomi Kiyota
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Ken-Ichi Harada
- Division of Urology, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Kimihiro Yamashita
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan.,Cancer Center, Kobe University Hospital, Kobe, Japan
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Saito T, Makiura D, Inoue J, Doi H, Yakushijin K, Okamura A, Matsuoka H, Mukohara T, Saura R, Sakai Y, Ono R. Comparison between quantitative and subjective assessments of chemotherapy-induced peripheral neuropathy in cancer patients: A prospective cohort study. Phys Ther Res 2021; 23:166-171. [PMID: 33489655 DOI: 10.1298/ptr.e10027] [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: 01/23/2020] [Accepted: 04/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event experienced by cancer patients. In general, CIPN is evaluated subjectively based on patient self-assessment or clinician-reported scales; evidence supporting the utility and validity of quantitative sensory tests (QST) is lacking in this patient population. The aim of this study was to objectively assess CIPN of lower extremities by QSTs, and to evaluate the concordance between QSTs and subjective assessments. METHODS In this prospective cohort study, outpatients with cancer receiving chemotherapy were recruited at a single university hospital. We assessed CIPN at the lower extremities at baseline and three months after baseline. The QSTs were performed by applying a monofilament and a tuning fork to determine touch and vibration thresholds, respectively, at the affected site. Subjective assessments were performed based on the visual analog scale (VAS) and the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) toxicity grade. Kappa coefficients were calculated to evaluate the concordance between QSTs and subjective assessments. RESULTS After exclusion and drop-outs during follow-up, nineteen patients were included in the analysis. The prevalence of patients with abnormal sensation was 37% based on QSTs, 32% based on the VAS, and 14% based on CTCAE grading, respectively. Kappa coefficients were 0.32 between QSTs and VAS, and 0.28 between QSTs and CTCAE. CONCLUSIONS The concordance rates between quantitative and subjective assessments were low. CIPN should be assessed using both quantitative and subjective assessments.
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Affiliation(s)
- Takashi Saito
- Department of Public Health Sciences, Kobe University Graduate School of Health Sciences
| | | | | | - Hisayo Doi
- Division of Nursing, Kobe University Hospital
| | | | - Atsuo Okamura
- Department of Medical Oncology and Hematology, Kakogawa Central City Hospital
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital
| | - Toru Mukohara
- Department of Breast and Medical Oncology, National Cancer Center Hospital East
| | - Ryuichi Saura
- Department of Physical and Rehabilitation Medicine, Osaka Medical College
| | - Yoshitada Sakai
- Department of Rehabilitation Medicine, Kobe University Graduate School of Medicine
| | - Rei Ono
- Department of Public Health Sciences, Kobe University Graduate School of Health Sciences
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Kimbara S, Imamura Y, Yakushijin K, Higashime A, Koyama T, Fujishima Y, Funakoshi Y, Toyoda M, Kiyota N, Matsuoka H, Minami H. Regorafenib-induced exacerbation of chronic immune thrombocytopenic purpura in remission: A case report. Mol Clin Oncol 2021; 14:30. [PMID: 33414911 PMCID: PMC7783712 DOI: 10.3892/mco.2020.2192] [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: 12/27/2019] [Accepted: 11/12/2020] [Indexed: 12/03/2022] Open
Abstract
Regorafenib is an oral multi-kinase inhibitor which targets tumor angiogenesis, the tumor microenvironment and oncogenesis. Based on this mode of action, regorafenib has a broad spectrum of toxicities. However, at present, few reports have focused on autoimmune adverse events. We report a first case of regorafenib-induced exacerbation of chronic immune thrombocytopenic purpura in remission during treatment for the patients with heavily treated advanced colorectal cancer. This case report highlights the need for caution with regard to regorafenib treatment in patients with cancer with concomitant immune thrombocytopenic purpura.
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Affiliation(s)
- Shiro Kimbara
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Yoshinori Imamura
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Ako Higashime
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Taiji Koyama
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Yoshimi Fujishima
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Yohei Funakoshi
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Masanori Toyoda
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Naomi Kiyota
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan.,Cancer Center, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Hironobu Minami
- Department of Medical Oncology/Hematology, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan.,Cancer Center, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
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42
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Kakiuchi S, Yakushijin K, Takagi I, Rikitake J, Akiyama H, Matsuba H, Hayashi Y, Kajimoto K, Iwata N. Case Report: Composite Angioimmunoblastic T-Cell Lymphoma and Epstein-Barr Virus-Positive B-Cell Lymphoproliferative Disorder as Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Disorders. Front Med (Lausanne) 2020; 7:625442. [PMID: 33425968 PMCID: PMC7785868 DOI: 10.3389/fmed.2020.625442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/07/2020] [Indexed: 12/02/2022] Open
Abstract
Immunosuppressants are widely used to treat patients with rheumatoid arthritis (RA), and their adverse effects have been known to cause other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs). We report a patient with RA who had been treated with methotrexate (MTX) and tacrolimus (TAC) and who developed whole body lymphadenopathy. We simultaneously confirmed angioimmunoblastic T-cell lymphoma (AITL) through a right cervical lymph node biopsy and Epstein-Barr virus-positive B-cell lymphoproliferative disorder (EBV-positive B-LPD) through a bone marrow examination. After cessation of immunosuppressant therapy, both LPDs completely disappeared. Patients with AITL are occasionally reported to develop B-cell lymphoma through reactivation of the EBV, which leads to clonal expansion in the microenvironment. Immunohistochemistry results revealed that both LPD components were positive for EBV-encoded RNA. Moreover, in this patient, the plasma EBV DNA level was found to be high; therefore, EBV infection was a probable etiology. Synchronous coexistence of AITL and B-LPD as an OIIA-LPD has rarely been reported. This case report is the first to discuss the disappearance of both LPDs on withdrawal of immunosuppressants only. AITL occasionally accompany B-LPD; however, this composite lymphoma comprised AITL and B-LPD, and OIIA-LPDs should not be overlooked.
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Affiliation(s)
- Seiji Kakiuchi
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan.,Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikumi Takagi
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Junpei Rikitake
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan.,Division of Medical Oncology and Hematology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Akiyama
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Hiroyuki Matsuba
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
| | - Yoshitake Hayashi
- Division of Molecular Medicine & Medical Genetics, Department of Pathology, Kobe Graduate School of Medicine, Kobe, Japan
| | | | - Nobuko Iwata
- Department of Hematology, Yodogawa Christian Hospital, Osaka, Japan
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43
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Kurata K, Nishimura S, Higashime A, Kawaguchi K, Nagao S, Kozuki Y, Sai S, Yakushijin K, Yamamoto K, Ito M, Matsuoka H, Minami H. Disseminated cryptococcosis resembling miliary tuberculosis in a patient with acute myeloid leukemia. J Infect Chemother 2020; 26:1216-1219. [PMID: 32747210 DOI: 10.1016/j.jiac.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
Disseminated cryptococcosis, usually involving the lungs and central nervous system, carries a high risk of morbidity and mortality in immunocompromised hosts. In this report, we describe a case of miliary pulmonary cryptococcosis in a patient with acute myeloid leukemia, initially resembling miliary tuberculosis. The diagnosis of disseminated cryptococcosis was made based on transbronchial lung biopsy with subsequent detection of Cryptococcus neoformans in blood and cerebrospinal fluid. The patient was treated with liposomal amphotericin B as induction therapy, followed by fluconazole as consolidation and maintenance therapies thereafter. The infection was improved immediately, and he successfully underwent hematopoietic stem cell transplantation. The present case serves as a timely reminder that a radiological miliary pattern necessitates a thorough search for a definitive microbiological and histopathological diagnosis.
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Affiliation(s)
- Keiji Kurata
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan.
| | - Sho Nishimura
- Division of Infectious Diseases, Kobe University Hospital, Japan
| | - Ako Higashime
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Koji Kawaguchi
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Shigeki Nagao
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Yoko Kozuki
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Satoshi Sai
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Katsuya Yamamoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Mitsuhiro Ito
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, Japan
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44
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Yamamoto K, Yakushijin K, Ito M, Goto H, Higashime A, Kajimoto K, Hayashi Y, Matsuoka H, Minami H. MYC amplification on double minute chromosomes in plasma cell leukemia with double IGH/CCND1 fusion genes. Cancer Genet 2020; 242:35-40. [PMID: 32035866 DOI: 10.1016/j.cancergen.2020.01.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/08/2020] [Accepted: 01/20/2020] [Indexed: 01/18/2023]
Abstract
In multiple myeloma (MM), MYC rearrangements that result in increased MYC expression are associated with an aggressive form of MM and adverse outcome. However, the consequences of MYC amplification in MM remain unclear. Here, we describe an unusual case of plasma cell leukemia (PCL) harboring MYC amplification on double minute chromosomes (dmin). A 79-year-old woman was initially diagnosed as having BJP-κ type MM with bone lesions. After seven months, the disease progressed to secondary PCL: leukocytes 49.1 × 109/L with 77% plasma cells showing lymphoplasmacytic appearance. The bone marrow was infiltrated with 76% plasma cells immunophenotypically positive for CD38 and negative for CD45, CD19, CD20, and CD56. The karyotype by G-banding and spectral karyotyping was 48,XX,der(14)t(11;14)(q13;q32),+der(14)t(14;19)(q32;q13.1),+18,6~95dmin[15]/46,XX[5]. Fluorescence in situ hybridization detected multiple MYC signals on dmin and double IGH/CCND1 fusion signals on der(14)t(11;14) and der(14)t(14;19). Most plasma cells were diffusely and strongly positive for MYC and CCND1 by immunohistochemistry. The patient died of progressive disease after one week. MYC amplification led to high expression of MYC and rapid disease progression, indicating its clinical significance in the pathogenesis of MM/PCL. MYC amplification on dmin may be a very rare genetic event closely associated with the progression to PCL and coexistence of IGH/CCND1 fusions.
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Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mitsuhiro Ito
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ako Higashime
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuyoshi Kajimoto
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Pathology, Hyogo Cancer Center, Akashi, Japan
| | - Yoshitake Hayashi
- Division of Molecular Medicine and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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45
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Uho S, Goto H, Higashime A, Kawaguchi K, Ishikawa Y, Koyama T, Kurata K, Miyata Y, Yakushijin K, Matsuoka H, Minami H. Relative adrenal insufficiency post-discontinuation of topical steroids in a patient with acute lymphoblastic leukemia. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Kurata K, Yamamoto K, Okazaki Y, Noguchi Y, Matsui K, Matsumoto H, Inui Y, Yakushijin K, Ito M, Nakamachi Y, Matsuoka H, Saegusa J, Minami H. Detection of a novel CBFB-MYH11 fusion transcript in acute myeloid leukemia M1 with inv(16)(p13q22). Cancer Genet 2019; 241:72-76. [PMID: 31353165 DOI: 10.1016/j.cancergen.2019.07.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/13/2019] [Accepted: 07/12/2019] [Indexed: 01/12/2023]
Abstract
Acute myeloid leukemia (AML) with an inv(16)(p13q22) or t(16;16)(p13;q22) chromosomal abnormality represents one of the most common subtypes of de novo cases. These chromosomal rearrangements result in multiple CBFB-MYH11 fusion transcripts, with type-A being the most frequent. We here describe a unique case of de novo AML-M1, with inv(16)(p13q22), leading to an unusual CBFB-MYH11 fusion transcript, and der(7)t(7;11)(q31;q21). The fusion transcript involves a CBFB exon 5 with a breakpoint at nucleotide 754, an insertion of a 13-bp sequence of CBFB intron 5 at the fusion point, and the MYH11 exon 27 with a breakpoint at nucleotide 3464. To our knowledge, this CBFB-MYH11 fusion transcript has never been reported previously. The clinical characteristics of the present case are in line with previous reports suggesting that rare CBFB-MYH11 fusion transcripts lead to aberrant characteristics such as an atypical cytomorphology and additional cytogenetic abnormalities.
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Affiliation(s)
- Keiji Kurata
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan.
| | - Katsuya Yamamoto
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
| | - Yoko Okazaki
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Yoriko Noguchi
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Keiji Matsui
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hisayuki Matsumoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Yumiko Inui
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
| | - Kimikazu Yakushijin
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
| | - Mitsuhiro Ito
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
| | - Yuji Nakamachi
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hiroshi Matsuoka
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
| | - Jun Saegusa
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hironobu Minami
- Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City 650-0017, Japan
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47
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Yamamoto K, Yakushijin K, Okuni-Watanabe M, Hashimoto A, Matsuoka H, Minami H. Tetrasomy 8 and isochromosome 7q in CD5-positive hepatosplenic T-cell lymphoma with leukemic presentation. Int J Hematol 2019; 110:521-523. [PMID: 31342408 DOI: 10.1007/s12185-019-02708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/14/2019] [Accepted: 07/17/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Katsuya Yamamoto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Marika Okuni-Watanabe
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akiko Hashimoto
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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48
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Mizutani Y, Inase A, Maimaitili Y, Miyata Y, Kitao A, Matsumoto H, Kawaguchi K, Higashime A, Goto H, Kurata K, Yakushijin K, Minami H, Matsuoka H. An mTORC1/2 dual inhibitor, AZD2014, acts as a lysosomal function activator and enhances gemtuzumab ozogamicin-induced apoptosis in primary human leukemia cells. Int J Hematol 2019; 110:490-499. [PMID: 31286402 DOI: 10.1007/s12185-019-02701-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 01/20/2023]
Abstract
Gemtuzumab ozogamicin (GO), an anti-CD33 antibody linked to calicheamicin via an acid-labile linker, is the first antibody-drug conjugate (ADC). The acidic environment inside lysosomes of target cells is an important intracellular determinant of the cytocidal action of GO, as the linker is hydrolyzed under acidic conditions. However, lysosomal activity in acute myeloid leukemia (AML) blasts in GO therapy has been insufficiently evaluated. It has been suggested that lysosome activity is suppressed in AML due to hyperactivation of the phosphoinositide 3-kinase/Akt pathway. We therefore hypothesized that agents which activate lysosomal function would potentiate the cytotoxicity of GO. Here, we found that a clinically useful mTORC1/2 dual inhibitor, AZD2014, reduced pH in the acidic organelles, including lysosomes, as shown by increased LysoTracker fluorescent intensity, and synergistically enhanced the cytotoxic effect of GO in primary leukemia cells. GO-induced cytotoxicity appeared to be enhanced with the increase in lysosomal activity by AZD2014. These results indicate that AZD2014 activated lysosomal function in primary leukemia cells, which in turn enhanced the cytotoxicity of GO. Enhancement of lysosomal activity may represent a new therapeutic strategy in the treatment of GO and other ADCs, particularly in cases with low lysosomal activity.
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Affiliation(s)
- Yu Mizutani
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Aki Inase
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yimamu Maimaitili
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yoshiharu Miyata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akihito Kitao
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hisayuki Matsumoto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Koji Kawaguchi
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ako Higashime
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hideaki Goto
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Keiji Kurata
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kimikazu Yakushijin
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hironobu Minami
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
- Cancer Center, Kobe University Hospital, Kobe, Japan
| | - Hiroshi Matsuoka
- Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
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49
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Yamamoto K, Yakushijin K, Ichikawa H, Okamura A, Nagao S, Kakiuchi S, Kurata K, Kawamoto S, Matsui K, Nakamachi Y, Saegusa J, Matsuoka H, Minami H. Coexpression of ETV6/MDS1/EVI1 and ETV6/EVI1 fusion transcripts in acute myeloid leukemia with t(3;12)(q26.2;p13) and thrombocytosis. Leuk Lymphoma 2019; 60:1294-1298. [PMID: 30526151 DOI: 10.1080/10428194.2018.1529311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/13/2018] [Accepted: 09/22/2018] [Indexed: 10/27/2022]
MESH Headings
- Bone Marrow/pathology
- Cell Line, Tumor
- Chromosomes, Human, Pair 12
- Chromosomes, Human, Pair 3
- DNA Mutational Analysis
- Gene Expression Regulation, Leukemic
- Humans
- Karyotype
- Leukemia, Myeloid, Acute/genetics
- MDS1 and EVI1 Complex Locus Protein/genetics
- Male
- Oncogene Proteins, Fusion/genetics
- Proto-Oncogene Proteins c-ets/genetics
- Repressor Proteins/genetics
- Thrombocytosis/genetics
- Translocation, Genetic
- Young Adult
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Katsuya Yamamoto
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Kimikazu Yakushijin
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Hiroya Ichikawa
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Atsuo Okamura
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Shigeki Nagao
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Seiji Kakiuchi
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Keiji Kurata
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Shinichiro Kawamoto
- a Division of Medical Oncology/Hematology, Department of Medicine , Kobe University Graduate School of Medicine , Kobe , Japan
| | - Keiji Matsui
- b Department of Clinical Laboratory , Kobe University Hospital , Kobe , Japan
| | - Yuji Nakamachi
- b Department of Clinical Laboratory , Kobe University Hospital , Kobe , Japan
| | - Jun Saegusa
- b Department of Clinical Laboratory , Kobe University Hospital , Kobe , Japan
| | - Hiroshi Matsuoka
- b Department of Clinical Laboratory , Kobe University Hospital , Kobe , Japan
| | - Hironobu Minami
- b Department of Clinical Laboratory , Kobe University Hospital , Kobe , Japan
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50
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Okuni M, Yakushijin K, Uehara K, Ichikawa H, Suto H, Hashimoto A, Tanaka Y, Shinzato I, Sakai R, Mizutani Y, Nagao S, Kurata K, Kakiuchi S, Miyata Y, Inui Y, Saito Y, Kawamoto S, Yamamoto K, Ito M, Matsuoka H, Minami H. Successful Bridging Chemotherapy with Gemcitabine, Carboplatin, and Dexamethasone before Unrelated Stem Cell Transplantation for Hepatosplenic T-cell Lymphoma. Intern Med 2019; 58:707-712. [PMID: 30449784 PMCID: PMC6443557 DOI: 10.2169/internalmedicine.1266-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A 45-year-old woman was diagnosed with hepatosplenic T-cell lymphoma (HSTCL), a rare subtype of peripheral T-cell lymphoma. She received different types of chemotherapy, but disease progression was observed. To reduce the tumor burden before an unrelated bone marrow transplantation, combination chemotherapy consisting of the gemcitabine, carboplatin, and dexamethasone (GCD) was administered as bridging therapy, resulting in a reduction in the number of lymphoma cells. We were then able to perform bone marrow transplantation. Although she experienced some adverse events, she successfully achieved long-term remission. We herein report a successful case of HSTCL treated with unrelated stem cell transplantation following the GCD regimen as bridging chemotherapy.
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Affiliation(s)
- Marika Okuni
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Kimikazu Yakushijin
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Keiichiro Uehara
- Department of Diagnostic Pathology, Kobe University Hospital, Japan
| | - Hiroya Ichikawa
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Hirotaka Suto
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Akiko Hashimoto
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Yasuhiro Tanaka
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Isaku Shinzato
- Department of Hematology and Clinical Immunology, Kobe City Nishi-Kobe Medical Center, Japan
| | - Rina Sakai
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Yu Mizutani
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Shigeki Nagao
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Keiji Kurata
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Seiji Kakiuchi
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Yoshiharu Miyata
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Yumiko Inui
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Yasuyuki Saito
- Division of Molecular and Cellular Signaling, Department of Biochemistry and Molecular Biology, Kobe University Graduate School of Medicine, Japan
| | - Shinichiro Kawamoto
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Katsuya Yamamoto
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Mitsuhiro Ito
- Laboratory of Hematology, Division of Medical Biophysics, Kobe University Graduate School of Health Sciences, Japan
| | - Hiroshi Matsuoka
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
| | - Hironobu Minami
- The Division of Medical Oncology and Hematology, Department of Medicine, Kobe University Hospital, Japan
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