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Chiwata M, Itonaga H, Sato S, Hashimoto M, Fujioka M, Kasai S, Sakamoto H, Toriyama E, Nakashima J, Kamijo R, Kitanosono H, Kobayashi Y, Horai M, Taguchi M, Matsuo M, Makiyama J, Takasaki Y, Matsuo E, Horio K, Ando K, Sawayama Y, Taguchi J, Kawaguchi Y, Tsushima H, Imanishi D, Imaizumi Y, Yoshida S, Jo T, Nonaka H, Moriuchi Y, Nagai K, Yokota KI, Hata T, Miyazaki Y. Efficacy and Cardiovascular Adverse Events of Long-term Treatment with Tyrosine Kinase Inhibitors for Chronic Myeloid Leukemia: A Report from the Nagasaki CML Study Group. Intern Med 2021; 60:2207-2216. [PMID: 33612681 PMCID: PMC8355380 DOI: 10.2169/internalmedicine.6620-20] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective The standard treatment for chronic myeloid leukemia (CML) is the continuous use of tyrosine kinase inhibitors (TKIs), which results in a favorable prognosis for the majority of patients. Recent studies have identified cardiovascular diseases (CVDs) as late adverse events (AEs) related to TKIs. In this study, we evaluated the long-term efficacy and AEs of TKIs, focusing on CVDs. Methods We performed a retrospective survey of CML patients (diagnosed from 2001 to 2016) treated with TKIs in Nagasaki Prefecture. Clinical data were obtained from their medical records. We analyzed the survival, estimated cumulative incidence of CVDs, and risk factors for CVD among CML patients treated with TKIs. Results The overall survival rate of 264 CML patients treated with TKIs (median age 58 years old) was 89.6% [95% confidence interval (CI), 84.9-92.9%], and 80.5% (95% CI, 73.4-85.9%) at 5 and 10 years after the CML diagnosis, respectively. CVD events occurred in 26 patients (9.8%, median age 67.5 years old) with a median 65.5 months of TKI treatment. The cumulative incidences at 2 and 5 years was 2.4% (95% CI, 1.0-4.8%) and 5.2% (95% CI, 2.8-8.6%), respectively. Hypertension and a high SCORE chart risk at the diagnosis of CML were associated with CVD events during TKI treatment. Conclusion TKI treatment contributed to the long-term survival of CML patients in Nagasaki Prefecture in a "real-world" setting, but the incidence of CVDs seemed to be increased in these patients. A proper approach to managing risk factors for CVD is warranted to reduce CVD events during TKI treatment.
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Affiliation(s)
- Masahiko Chiwata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital, Japan
| | - Miki Hashimoto
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Nagasaki University Hospital, Japan
| | - Sachie Kasai
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hikaru Sakamoto
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Nagasaki University Hospital, Japan
| | - Eo Toriyama
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Nagasaki University Hospital, Japan
| | - Jun Nakashima
- Department of Hematology, Nagasaki University Hospital, Japan
- Department of Hematology, Japan Community Health care Organization Isahaya General Hospital, Japan
| | - Rena Kamijo
- Department of Hematology, Nagasaki University Hospital, Japan
- Department of Hematology, Sasebo City General Hospital, Japan
| | - Hideaki Kitanosono
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yuji Kobayashi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Japan
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital, Japan
| | | | - Masatoshi Matsuo
- Department of Hematology, Nagasaki University Hospital, Japan
- Department of Hematology, Nagasaki Harbor Medical Center, Japan
| | - Junya Makiyama
- Department of Hematology, Sasebo City General Hospital, Japan
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Japan
| | - Yumi Takasaki
- Department of Hematology, Saint Francis Hospital, Japan
| | - Emi Matsuo
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Japan
- Department of Hematology, Saint Francis Hospital, Japan
| | - Kensuke Horio
- Department of Hematology, Nagasaki Prefecture Shimabara Hospital, Japan
| | - Koji Ando
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | | | - Jun Taguchi
- Department of Hematology, Nagasaki University Hospital, Japan
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Japan
| | - Yasuhisa Kawaguchi
- Department of Internal Medicine, National Hospital Organization Nagasaki Hospital, Japan
| | - Hideki Tsushima
- Department of Hematology, Nagasaki Harbor Medical Center, Japan
| | - Daisuke Imanishi
- Department of Internal Medicine, Nagasaki Prefecture Gotochuoh Hospital, Japan
| | - Yoshitaka Imaizumi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Nagasaki University Hospital, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Japan
| | - Tatsuro Jo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Japan
| | - Hiroaki Nonaka
- Department of Laboratory Medicine, Nagasaki Rosai Hospital, Japan
| | | | - Kazuhiro Nagai
- Transfusion and Cell Therapy Unit, Nagasaki University Hospital, Japan
| | - Ken-Ichi Yokota
- Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Japan
- Department of Hematology, Nagasaki University Hospital, Japan
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Japan
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2
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Fujioka M, Itonaga H, Furumoto T, Kasai S, Sakamoto H, Kitanosono H, Kato T, Horai M, Sato S, Sawayama Y, Taguchi J, Imaizumi Y, Hata T, Yoshida S, Moriuchi Y, Miyazaki Y. The response-guided ATG treatment provides a survival benefit and KPS recovery for patients with steroid refractory acute GVHD: The Nagasaki Transplant Group Experience. Transpl Immunol 2021; 67:101417. [PMID: 34058354 DOI: 10.1016/j.trim.2021.101417] [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: 03/13/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Abstract
Steroid-refractory acute graft-versus-host disease (SR-aGVHD) is a serious complication that negatively affects the prognosis and quality of life of patients who receive allogeneic hematopoietic stem cell transplantation (allo-HSCT). Antithymocyte globulin (ATG) is one of the second-line treatments for SR-aGVHD. We retrospectively evaluated Karnofsky Performance Status (KPS) recovery and clinical response in 11 patients who received the response-guided low-dose ATG treatment for SR-aGVHD after allo-HSCT using alternative donors. The median dose of ATG per cycle was 1.0 mg/kg (range, 1.0-1.25 mg/kg) and the median number of cycles of ATG was 2 (range, 1-4). The overall response rate was 63.6%, and the estimated overall survival rate at 1 year was 63.6%. Two out of seven patients who survived 1 year after the response-guided ATG treatment had KPS of 80 or higher. The remaining 5 patients had KPS of lower than 80 due to moderate chronic GVHD (cGVHD) and/or ≥grade 3 infectious complications. Based on the poor prognosis of patients with SR-aGVHD, the response-guided ATG treatment represents one therapeutic option. The present results also suggest that chronic GVHD and infectious complications after the response-guided ATG treatment were associated with decreased KPS recovery and impaired social function.
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Affiliation(s)
- Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
| | - Takafumi Furumoto
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Sachie Kasai
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hikaru Sakamoto
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hideaki Kitanosono
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | | | - Tomoko Hata
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | | | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan; Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan; Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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3
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Sakamoto H, Itonaga H, Sawayama Y, Kojima A, Chiwata M, Fujioka M, Kitanosono H, Horai M, Miyazaki T, Shiraishi H, Imaizumi Y, Yoshida S, Hata T, Yamano Y, Miyazaki Y. Allogeneic hematopoietic stem cell transplantation for adult T-cell leukemia/lymphoma with HTLV-1-associated myelopathy. Int J Hematol 2021; 113:765-769. [PMID: 33423163 DOI: 10.1007/s12185-020-03075-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 01/10/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be curative for adult T-cell leukemia/lymphoma (ATL), but comorbidities increase transplant-related mortality. Here we report the outcome of allo-HSCT in a patient with ATL with human T-cell leukemia virus type I (HTLV-1)-associated myelopathy-tropical spastic paraparesis (HAM/TSP). A 48-year-old man was diagnosed with HAM/TSP and started prednisolone therapy. Ten years later, he developed lymphoma-type ATL. At the diagnosis of ATL, Osame's Motor Disability Score (OMDS) was 4. When prednisolone was gradually tapered and stopped following chemotherapy for ATL, HAM/TSP symptoms recurred (OMDS 7). Bone marrow transplantation from a human leukocyte antigen allele 8/8 matched unrelated donor was performed while ATL was in partial remission. Neutrophil engraftment with complete donor chimerism was achieved on day 19 after allo-HSCT. Mild gait improvement (OMDS 5) was observed on day 30. Although ATL relapsed on day 275, progression of HAM/TSP symptoms was not observed. Furthermore, there was no clear progression of HAM/TSP symptoms after donor lymphocyte infusions. The outcome of this case suggests that ATL patients with HAM/TSP tolerate allo-HSCT and donor lymphocyte infusions.
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Affiliation(s)
- Hikaru Sakamoto
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Azusa Kojima
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Masahiko Chiwata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroko Kitanosono
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Teiichiro Miyazaki
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hirokazu Shiraishi
- Department of Neurology and Strokology, Nagasaki University Hospital, Nagasaki, Japan
| | | | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
| | - Yoshihisa Yamano
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.,Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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4
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Toriyama E, Hata T, Yokota K, Chiwata M, Kamijo R, Hashimoto M, Taguchi M, Horai M, Matsuo M, Matsuo E, Takasaki Y, Kawaguchi Y, Itonaga H, Sato S, Ando K, Sawayama Y, Taguchi J, Imaizumi Y, Tsushima H, Jo T, Yoshida S, Moriuchi Y, Miyazaki Y. No clear survival benefit of azacitidine for lower-risk myelodysplastic syndromes: A retrospective study of Nagasaki. Cancer Sci 2020; 111:4490-4499. [PMID: 32939867 PMCID: PMC7734160 DOI: 10.1111/cas.14653] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/13/2020] [Accepted: 09/05/2020] [Indexed: 12/11/2022] Open
Abstract
The efficacy of azacitidine (AZA) on survival of lower risk (LR) - myelodysplastic syndromes (MDS) is controversial. To address this issue, we retrospectively evaluated the long-term survival benefit of AZA for patients with LR-MDS defined by International Prognostic Scoring System (IPSS). Using data from 489 patients with LR-MDS in Nagasaki, hematologic responses according to International Working Group 2006 and overall survival (OS) were compared among patients that received best supportive care (BSC), immunosuppressive therapy (IST), erythropoiesis-stimulating agents (ESA), and AZA. Patients treated with AZA showed complete remission (CR) rate at 11.3%, marrow CR at 1.9%, and any hematologic improvement at 34.0%, with transfusion independence (TI) of red blood cells in 27.3% of patients. and platelet in 20% of patients, respectively. Median OS for patients received IST, ESA, BSC, and AZA (not reached, 91 months, 58 months, and 29 months, respectively) differed significantly (P < .001). Infection-related severe adverse events were observed in more than 20% of patients treated with AZA. Multivariate analysis showed age, sex, IPSS score at diagnosis, and transfusion dependence were significant for OS, but AZA treatment was not, which maintained even response to AZA, and IPSS risk status at AZA administration was added as factors. We could not find significant survival benefit of AZA treatment for LR-MDS patients.
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Affiliation(s)
- Eo Toriyama
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Tomoko Hata
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
| | - Ken‐ichi Yokota
- Biostatistics SectionDivision of Scientific Data RegistryAtomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
| | - Masahiko Chiwata
- Department of HematologyNational Hospital Organization Nagasaki Medical CenterOhmuraJapan
| | - Rena Kamijo
- Department of HematologySasebo City General Medical CenterSaseboJapan
| | - Miki Hashimoto
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Masataka Taguchi
- Department of HematologyNagasaki University HospitalNagasakiJapan
| | - Makiko Horai
- Department of HematologyNagasaki University HospitalNagasakiJapan
| | - Masatoshi Matsuo
- Department of HematologyNagasaki Harbor Medical CenterNagasakiJapan
| | - Emi Matsuo
- Department of HematologyJapan Community Health Care Organization Isahaya General HospitalIsahayaJapan
| | - Yumi Takasaki
- Department of Internal MedicineSaint Francis HospitalNagasakiJapan
| | - Yasuhisa Kawaguchi
- Department of Internal MedicineNational Hospital Organization Nagasaki HospitalNagasakiJapan
| | - Hidehiro Itonaga
- Department of HematologyNagasaki University HospitalNagasakiJapan
| | - Shinya Sato
- Department of HematologyNagasaki University HospitalNagasakiJapan
| | - Koji Ando
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
| | - Yasushi Sawayama
- Department of HematologyNagasaki University HospitalNagasakiJapan
| | - Jun Taguchi
- Department of HematologyJapanese Red Cross Nagasaki Genbaku HospitalNagasakiJapan
| | | | - Hideki Tsushima
- Department of HematologyNagasaki Harbor Medical CenterNagasakiJapan
| | - Tatsuro Jo
- Department of HematologyJapanese Red Cross Nagasaki Genbaku HospitalNagasakiJapan
| | - Shinichiro Yoshida
- Department of HematologyNational Hospital Organization Nagasaki Medical CenterOhmuraJapan
| | | | - Yasushi Miyazaki
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
- Department of HematologyAtomic Bomb Disease and Hibakusha Medicine UnitAtomic Bomb Disease InstituteNagasaki UniversityNagasakiJapan
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5
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Sakamoto H, Imaizumi Y, Niino D, Takeuchi M, Matsui K, Horai M, Sato S, Akazawa Y, Ando K, Sawayama Y, Hata T, Ohshima K, Miyazaki Y. [Composite adult T-cell leukemia/lymphoma and Epstein-Barr virus-positive diffuse large B-cell lymphoma]. Rinsho Ketsueki 2020; 61:305-311. [PMID: 32378571 DOI: 10.11406/rinketsu.61.305] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Human T-cell leukemia virus type I (HTLV-1) infection and adult T-cell leukemia-lymphoma (ATL) have been shown to cause immunodeficiency. However, only a few cases have been reported on the development of Epstein-Barr virus positive-diffuse large B-cell lymphoma (EBV-DLBCL) in HTLV-1 carriers or in patients with ATL. Here we report a case of a female HTLV-1 carrier who developed cytomegalovirus (CMV) retinitis. During the CMV retinitis treatment, she developed a liver tumor. The diagnosis of composite ATL and EBV-DLBCL was made by tumor biopsy. The patient also suffered from pulmonary cryptococcosis and invasive pulmonary aspergillosis at the time of chemotherapy initiation. She had repeated CMV antigenemia and bacterial sepsis during the course of chemotherapy, and she died of bacterial sepsis. HTLV-1 carriers who are complicated with opportunistic infections should be carefully observed not only for ATL development but also for the development of EBV-DLBCL and associated infectious complications.
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Affiliation(s)
| | | | - Daisuke Niino
- Department of Pathology, Sasebo City General Hospital
| | - Mai Takeuchi
- Department of Pathology, Kurume University School of Medicine
| | - Kosuke Matsui
- Department of Infectious Diseases, Nagasaki University Hospital
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital
| | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital
| | - Yuko Akazawa
- Tissue and Histopathology Section, Atomic Bomb Disease Institute, Nagasaki University
| | - Koji Ando
- Department of Hematology, Nagasaki University Hospital
| | | | - Tomoko Hata
- Department of Hematology, Nagasaki University Hospital
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine
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6
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Taguchi M, Mishima H, Shiozawa Y, Hayashida C, Kinoshita A, Nannya Y, Makishima H, Horai M, Matsuo M, Sato S, Itonaga H, Kato T, Taniguchi H, Imanishi D, Imaizumi Y, Hata T, Takenaka M, Moriuchi Y, Shiraishi Y, Miyano S, Ogawa S, Yoshiura KI, Miyazaki Y. Genome analysis of myelodysplastic syndromes among atomic bomb survivors in Nagasaki. Haematologica 2020; 105:358-365. [PMID: 31101757 PMCID: PMC7012461 DOI: 10.3324/haematol.2019.219386] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/16/2019] [Indexed: 12/20/2022] Open
Abstract
Ionizing radiation is a risk factor for myeloid neoplasms including myelodysplastic syndromes (MDS), and atomic bomb survivors have been shown to have a significantly higher risk of MDS. Our previous analyses demonstrated that MDS among these survivors had a significantly higher frequency of complex karyotypes and structural alterations of chromosomes 3, 8, and 11. However, there was no difference in the median survival time between MDS among survivors compared with those of de novo origin. This suggested that a different pathophysiology may underlie the causative genetic aberrations for those among survivors. In this study, we performed genome analyses of MDS among survivors and found that proximally exposed patients had significantly fewer mutations in genes such as TET2 along the DNA methylation pathways, and they had a significantly higher rate of 11q deletions. Among the genes located in the deleted portion of chromosome 11, alterations of ATM were significantly more frequent in proximally exposed group with mutations identified on the remaining allele in 2 out of 5 cases. TP53, which is frequently mutated in therapy-related myeloid neoplasms, was equally affected between proximally and distally exposed patients. These results suggested that the genetic aberration profiles in MDS among atomic bomb survivors differed from those in therapy-related and de novo origin. Considering the role of ATM in DNA damage response after radiation exposure, further studies are warranted to elucidate how 11q deletion and aberrations of ATM contribute to the pathogenesis of MDS after radiation exposure.
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Affiliation(s)
- Masataka Taguchi
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Hiroyuki Mishima
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yusuke Shiozawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Chisa Hayashida
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Akira Kinoshita
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Hideki Makishima
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Makiko Horai
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Masatoshi Matsuo
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Shinya Sato
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Takeharu Kato
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | | | - Daisuke Imanishi
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yoshitaka Imaizumi
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Motoi Takenaka
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | | | - Yuichi Shiraishi
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo
| | - Satoru Miyano
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo.,Laboratory of Sequence Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
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7
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Sakamoto H, Itonaga H, Sawayama Y, Furumoto T, Fujioka M, Chiwata M, Toriyama E, Kasai S, Nakashima J, Horai M, Kato T, Sato S, Ando K, Taguchi J, Imaizumi Y, Yoshida S, Hata T, Moriuchi Y, Miyazaki Y. Treatment with mogamulizumab or lenalidomide for relapsed adult T-cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation: The Nagasaki transplant group experience. Hematol Oncol 2020; 38:162-170. [PMID: 31922287 DOI: 10.1002/hon.2712] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/25/2019] [Accepted: 01/04/2020] [Indexed: 12/24/2022]
Abstract
Mogamulizumab (Mog) and lenalidomide (Len) are new therapeutic candidates for relapsed adult T-cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In the present study, we retrospectively analyzed 12 patients who received Mog or Len monotherapy for relapsed ATL after allo-HSCT. Eight and three patients received Mog and Len, respectively. The remaining patient received Mog for the first relapse and Len for the third relapse. A complete response was achieved by three and two patients who received Mog and Len, respectively, two and one of whom remained alive with a complete response for more than 20 months. In terms of adverse events, the emergence or progression of graft-versus-host disease was observed in three out of four patients treated with Len and in none of the patients treated with Mog. The development or progression of cytomegalovirus reactivation was detected in four out of eight patients treated with Mog and in none of those treated with Len. The present results suggest that Mog and Len would be promising treatment options for relapsed ATL after allo-HSCT and need to be selected based on adverse event profiles.
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Affiliation(s)
- Hikaru Sakamoto
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Takafumi Furumoto
- Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Machiko Fujioka
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Masahiko Chiwata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Eo Toriyama
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Sasebo City General Hospital, Sasebo, Japan
| | - Sachie Kasai
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Jun Nakashima
- Department of Hematology, Japan Community Health care Organization Isahaya General Hospital, Isahaya, Japan
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Shinya Sato
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Koji Ando
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | | | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | | | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
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8
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Kato T, Itonaga H, Taguchi J, Makiyama J, Fujioka M, Taguchi M, Horai M, Sawayama Y, Niino D, Imaizumi Y, Hata T, Yoshida S, Sakamoto K, Takeuchi K, Ohshima K, Miyazaki Y. Successful outcome of second allogeneic bone marrow transplantation for blastic plasmacytoid dendritic cell neoplasm with MYC locus rearrangement. Leuk Res Rep 2019; 11:31-33. [PMID: 31061790 PMCID: PMC6487276 DOI: 10.1016/j.lrr.2019.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/09/2019] [Accepted: 04/21/2019] [Indexed: 11/20/2022] Open
Abstract
A 62-year-old male was diagnosed with blastic plasmacytoid dendritic cell neoplasm (BPDCN) with a MYC rearrangement. Four months after the first unrelated bone marrow transplantation (BMT), he developed the relapsed BPDCN. After the achievement of partial remission following re-induction therapy, he underwent a second BMT from another unrelated donor, and experienced complete remission with grade II acute graft-versus-host disease and moderate chronic graft-versus-host disease. He remains alive in complete remission more than 71 months after the second BMT. These results suggested that donor change at the second transplantation may represent a considerable therapeutic option for patients with relapsed BPDCN.
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Affiliation(s)
- Takeharu Kato
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
- Corresponding author.
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Junya Makiyama
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
- Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Machiko Fujioka
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Masataka Taguchi
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Makiko Horai
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Daisuke Niino
- Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yoshitaka Imaizumi
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Kana Sakamoto
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Koichi Ohshima
- Department of Pathology, School of Medicine, Kurume University, Fukuoka, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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9
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Horai M, Satoh S, Matsuo M, Iwanaga M, Horio K, Jo T, Takasaki Y, Kawaguchi Y, Tsushima H, Yoshida S, Taguchi M, Itonaga H, Sawayama Y, Taguchi J, Imaizumi Y, Hata T, Moriuchi Y, Haase D, Yoshiura KI, Miyazaki Y. Chromosomal analysis of myelodysplastic syndromes among atomic bomb survivors in Nagasaki. Br J Haematol 2017; 180:381-390. [DOI: 10.1111/bjh.15050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/09/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Makiko Horai
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Shinya Satoh
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Masatoshi Matsuo
- Department of Internal Medicine; Nagasaki Harbour Medical Centre City Hospital; Nagasaki Japan
| | - Masako Iwanaga
- Department of Frontier Life Science; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Kensuke Horio
- Department of Haematology; Japanese Red Cross Nagasaki Genbaku Hospital; Nagasaki Japan
| | - Tatsuro Jo
- Department of Haematology; Japanese Red Cross Nagasaki Genbaku Hospital; Nagasaki Japan
| | - Yumi Takasaki
- Department of Internal Medicine; St. Francis Hospital; Nagasaki Japan
| | - Yasuhisa Kawaguchi
- Department of Internal Medicine; Nagasaki Harbour Medical Centre City Hospital; Nagasaki Japan
| | - Hideki Tsushima
- Department of Internal Medicine; Nagasaki Harbour Medical Centre City Hospital; Nagasaki Japan
| | - Shinichiro Yoshida
- Department of Internal Medicine; National Hospital Organization Nagasaki Medical Centre; Ohmura Japan
| | - Masataka Taguchi
- Department of Haematology; Sasebo City General Hospital; Sasebo Japan
| | - Hidehiro Itonaga
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Yasushi Sawayama
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Jun Taguchi
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Yoshitaka Imaizumi
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Tomoko Hata
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | | | - Detlef Haase
- Clinic of Haematology and Medical Oncology; University Medical Centre Goettingen; Goettingen Germany
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
| | - Yasushi Miyazaki
- Department of Haematology; Atomic Bomb Disease and Hibakusha Medicine Unit; Atomic Bomb Disease Institute; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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