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Kogure Y, Handa H, Ito Y, Ri M, Horigome Y, Iino M, Harazaki Y, Kobayashi T, Abe M, Ishida T, Ito S, Iwasaki H, Kuroda J, Shibayama H, Sunami K, Takamatsu H, Tamura H, Hayashi T, Akagi K, Shinozaki T, Yoshida T, Mori I, Iida S, Maeda T, Kataoka K. ctDNA improves prognostic prediction in relapsed/refractory MM receiving ixazomib, lenalidomide, and dexamethasone. Blood 2024:blood.2023022540. [PMID: 38427753 DOI: 10.1182/blood.2023022540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
It remains elusive how driver mutations, including those detected in circulating tumor DNA (ctDNA), affect prognosis in relapsed/refractory multiple myeloma (RRMM). Here we performed targeted-capture sequencing using bone marrow plasma cells (BMPC) and ctDNA of 261 RRMM cases uniformly treated with ixazomib, lenalidomide, and dexamethasone in a multicenter, prospective, observational study. We detected 24 and 47 recurrently mutated genes in BMPC and ctDNA, respectively. In addition to clonal hematopoiesis-associated mutations, varying proportion of driver mutations, particularly TP53 mutations (59.2% of mutated cases), were present in only ctDNA, suggesting their subclonal origin. In univariable analyses, ctDNA mutations of KRAS, TP53, DIS3, BRAF, NRAS, and ATM were associated with worse progression-free survival (PFS). BMPC mutations of TP53 and KRAS were associated with inferior PFS, while KRAS mutations were prognostically relevant only when detected in both BMPC and ctDNA. A total number of ctDNA mutations in the six relevant genes was a strong prognostic predictor (2-year PFS rates: 57.3%, 22.7%, and 0% for 0, 1, and ≥ 2 mutations, respectively) and independent of clinical factors and plasma DNA concentration. Using the number of ctDNA mutations, plasma DNA concentration, and clinical factors, we developed a prognostic index (ctRRMM-PI), classifying patients into three categories with 2-year PFS rates of 57.9%, 28.6%, and 0%. Serial analysis of ctDNA mutations in 94 cases revealed that TP53 and KRAS mutations frequently emerge after therapy. Thus, we clarify the genetic characteristics and clonal architecture of ctDNA mutations and demonstrate their superiority over BMPC mutations for prognostic prediction in RRMM.
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Affiliation(s)
| | - Hiroshi Handa
- Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yuta Ito
- The Jikei University School of Medicine, Japan
| | - Masaki Ri
- Nagoya City University Graduate School of Medical Sciences, Ngoya, Japan
| | | | - Masaki Iino
- Yamanashi Prefectural Central Hospital, Kofu, Japan
| | | | | | | | | | | | | | - Junya Kuroda
- Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Kazutaka Sunami
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | | | | | - Kiwamu Akagi
- Saitama Cancer Center, Ina, kitaadachigun, Saitama, Japan
| | | | | | - Ikuo Mori
- Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Shinsuke Iida
- Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takahiro Maeda
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Abe Y, Kubonishi S, Ri M, Iino M, Sunami K, Ito T, Fukaya M, Kitano T, Ikeda S, Ota S, Kuroi T, Iriyama N, Jo T, Adachi M, Akahane D, Kai T, Kohara Y, Kadowaki N, Katayama T. An observational study of once-weekly carfilzomib in patients with multiple myeloma in Japan (Weekly-CAR study). Future Oncol 2024. [PMID: 38420911 DOI: 10.2217/fon-2023-0834] [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] [Indexed: 03/02/2024] Open
Abstract
Background: The ARROW study demonstrated that once-weekly carfilzomib and dexamethasone (wKd) therapy significantly prolonged progression-free survival compared with twice-weekly carfilzomib and dexamethasone therapy in relapsed or refractory multiple myeloma patients. Aim: To describe the treatment patterns, effectiveness and safety of wKd therapy in real-world settings in Japan. Methods: We investigated data from the medical records of 126 Japanese patients with relapsed or refractory multiple myeloma. Results: The overall response rate was 66.3%. The median progression-free survival was 9.5 months. The incidence of treatment-emergent adverse events of any grade and grade ≥3 were 45.8 and 20.8%, respectively. Conclusion: There were no new or unexpected safety signals in this study. This study demonstrated the effectiveness and safety profiles of wKd therapy in Japan.
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Affiliation(s)
- Yu Abe
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, 1508935, Japan
| | - Shiro Kubonishi
- Department of Hematology and Oncology, Japanese Red Cross Society Himeji Hospital, Himeji, Hyogo, 6708540, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, Nagoya, Aichi, 4678602, Japan
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, 4008506, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, 7011192, Japan
| | - Tomoki Ito
- Division of Hematology, First Department of Internal Medicine, Kansai Medical University Medical Center, Moriguchi, Osaka, 5708507, Japan
| | - Masafumi Fukaya
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, 4118777, Japan
| | - Toshiyuki Kitano
- Department of Hematology, Medical Research Institute Kitano Hospital, Osaka, 5308480, Japan
| | - Sho Ikeda
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, 0108543, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Hokkaido, 0030006, Japan
| | - Taiga Kuroi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Hiroshima, 7200001, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, 1738610, Japan
| | - Tatsuro Jo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, 8528511, Japan
| | - Masaaki Adachi
- Department of Hematology, JCHO Sapporo Hokushin Hospital, Sapporo, Hokkaido, 0048618, Japan
| | - Daigo Akahane
- Department of Hematology, Tokyo Medical University Hospital, Tokyo, 1600023, Japan
| | - Tatsuyuki Kai
- Division of Hematology, Kita-Fukushima Medical Center, Fukushima, 9600502, Japan
| | - Yoichi Kohara
- Department of Hematology, Showa Inan General Hospital, Nagano, 3994117, Japan
| | - Norimitsu Kadowaki
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, 7610793, Japan
| | - Teruaki Katayama
- Oncology Medical Affairs, Ono Pharmaceutical Co., Ltd, Osaka, 5418564, Japan
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Horigome Y, Iino M, Harazaki Y, Kobayashi T, Handa H, Hiramatsu Y, Kuroi T, Tanimoto K, Matsue K, Abe M, Ishida T, Ito S, Iwasaki H, Kuroda J, Shibayama H, Sunami K, Takamatsu H, Tamura H, Hayashi T, Akagi K, Maeda T, Yoshida T, Mori I, Shinozaki T, Iida S. A prospective, multicenter, observational study of ixazomib plus lenalidomide-dexamethasone in patients with relapsed/refractory multiple myeloma in Japan. Ann Hematol 2024; 103:475-488. [PMID: 37695378 PMCID: PMC10798923 DOI: 10.1007/s00277-023-05428-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023]
Abstract
Real-world studies permit inclusion of a more diverse patient population and provide more information on the effectiveness of treatments used in routine clinical practice. This prospective, multicenter, observational study investigated the effectiveness and safety of ixazomib plus lenalidomide and dexamethasone (IRd) in 295 patients with relapsed/refractory multiple myeloma (RRMM) in routine clinical practice in Japan. Patients had a median age of 74 years, 80.0% were aged ≥ 65 years, 42.0% had received ≥ 3 lines of prior treatment, and 28.5% were "frail" according to the International Myeloma Working Group frailty score. After a median follow-up of 25.0 months, median progression-free survival (PFS) was 15.3 (95% CI 12.4-19.5) months, while median overall survival was not reached. The overall response rate was 53.9%, and 31.5% of patients had a very good partial response or better. In the subgroup analysis, median PFS was better in patients with 1 versus 2 or ≥ 3 lines of prior treatment (29.0 vs 19.2 or 6.9 months) and paraprotein versus clinical relapse (16.0 vs 7.9 months), but median PFS was not notably affected by frailty score or age group. Dose adjustment was more frequent among patients aged > 75 years, especially early after IRd treatment initiation. Treatment-emergent adverse events (TEAEs) of any grade occurred in 84.4% of patients and 24.7% of patients discontinued treatment due to TEAEs; no new safety concerns were found. These findings suggest that oral IRd triplet regimen is an effective and tolerable treatment option for RRMM patients in real-world settings outside of clinical trials.ClinicalTrials.gov identifier: NCT03433001; Date of registration: 14 February 2018.
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Affiliation(s)
- Yuichi Horigome
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yoriko Harazaki
- Department of Hematology, Miyagi Cancer Center, Natori, Japan
| | - Takahiro Kobayashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasushi Hiramatsu
- Department of Hematology and Oncology, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Taiga Kuroi
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - Kazuki Tanimoto
- Department of Hematology and Oncology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Kosei Matsue
- Division of Hematology/Oncology, Department of Internal Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School, Tokushima, Japan
| | - Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shigeki Ito
- Department of Hematology and Oncology, Iwate Medical University Hospital, Iwate, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hirohiko Shibayama
- Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | - Hideto Tamura
- Department of Hematology, Nippon Medical School, Tokyo, Japan
| | - Toshiaki Hayashi
- Department of Hematology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kiwamu Akagi
- Division of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Ina, Japan
| | - Takahiro Maeda
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Yoshida
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Ikuo Mori
- Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Co. Ltd, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, 1, Kawasumi, Mizuho-Cho, Mizuho-Ku, Nagoya, Aichi, 467-8601, Japan.
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Yoshida C, Yamaguchi H, Doki N, Murai K, Iino M, Hatta Y, Onizuka M, Yokose N, Fujimaki K, Hagihara M, Oshikawa G, Murayama K, Kumagai T, Kimura S, Najima Y, Iriyama N, Tsutsumi I, Oba K, Kojima H, Sakamaki H, Inokuchi K. Importance of TKI treatment duration in treatment-free remission of chronic myeloid leukemia: results of the D-FREE study. Int J Hematol 2023; 117:694-705. [PMID: 36739328 PMCID: PMC10121524 DOI: 10.1007/s12185-023-03549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023]
Abstract
Treatment-free remission (TFR) is a new goal for patients with chronic myeloid leukemia in chronic phase (CML-CP) with a sustained deep molecular response (DMR) to treatment with tyrosine kinase inhibitors (TKIs). However, optimal conditions for successful TFR in patients treated with second-generation (2G)-TKIs are not fully defined. In this D-FREE study, treatment discontinuation was attempted in newly diagnosed CML-CP patients treated with the 2G-TKI dasatinib who achieved BCR-ABL1 levels of ≤ 0.0032% (MR4.5) on the international scale (BCR-ABL1IS) and maintained these levels for exactly 1 year. Of the 173 patients who received dasatinib induction therapy for up to 2 years, 123 completed and 60 (48.8%) reached MR 4.5. Among the first 21 patients who maintained MR4.5 for 1 year and discontinued dasatinib, 17 experienced molecular relapse defined as loss of major molecular response (BCR-ABL1IS > 0.1%) confirmed once, or loss of MR4 (BCR-ABL1IS > 0.01%) confirmed on 2 consecutive assessments. The estimated molecular relapse-free survival rate was 16.7% at 12 months. This study was prematurely terminated according to the protocol's safety monitoring criteria. The conclusion was that sustained DMR for just 1 year is insufficient for TFR in CML-CP patients receiving dasatinib for less than a total of 3 years of treatment.
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Affiliation(s)
- Chikashi Yoshida
- Department of Hematology, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193, Japan.
| | | | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kazunori Murai
- Department of Hematology, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Norio Yokose
- Department of Hematology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | | | - Masao Hagihara
- Department of Hematology, EIJU General Hospital, Taito-Ku, Japan
| | - Gaku Oshikawa
- Japanese Red Cross Musashino Hospital, Musashino, Japan
| | - Kayoko Murayama
- Division of Hematology, Gunma Prefectural Cancer Center, Ohta, Japan
| | - Takashi Kumagai
- Department of Hematology, Ome Municipal General Hospital, Ome-Shi, Tokyo, Japan
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuho Najima
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Noriyoshi Iriyama
- Division of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Ikuyo Tsutsumi
- Department of Hematology, National Hospital Organization Mito Medical Center, 280 Sakuranosato, Ibarakimachi, Higashiibarakigun, Ibaraki, 311-3193, Japan
| | - Koji Oba
- Department of Biostatistics, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Kojima
- Ibaraki Clinical Education and Training Center, University of Tsukuba Hospital, Kasama, Japan
| | - Hisashi Sakamaki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Koiti Inokuchi
- Department of Hematology, Nippon Medical School, Tokyo, Japan
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Iino M, Sato T, Nakadate A, Onuki T, Takayama N. Forodesine maintenance therapy for newly diagnosed peripheral T-cell lymphoma: a single-institutional, observational, retrospective analysis. Ann Hematol 2022; 101:2351-2352. [PMID: 35751680 DOI: 10.1007/s00277-022-04898-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Masaki Iino
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan.
| | - Tomoya Sato
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Ayato Nakadate
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan
| | - Tomoya Onuki
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu, Yamanashi, 400-8506, Japan.,Department of Hematology, Kyorin University School of Medicine, Tokyo, Japan
| | - Nobuyuki Takayama
- Department of Hematology, Kyorin University School of Medicine, Tokyo, Japan
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Iino M, Jinguji A, Sato T, Nakadate A. Real-world experience of treatment with thrombopoietin receptor agonists in anti-thymocyte globulin-naïve patients with aplastic anemia: an observational retrospective analysis in a single institution. Hematology 2022; 27:360-366. [DOI: 10.1080/16078454.2022.2045725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Masaki Iino
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Atsushi Jinguji
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Tomoya Sato
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Ayato Nakadate
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Japan
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Miyamoto T, Iino M, Komorizono Y, Kiguchi T, Furukawa N, Otsuka M, Sawada S, Okamoto Y, Yamauchi K, Muto T, Fujisaki T, Tsurumi H, Nakamura K. Screening for Gaucher Disease Using Dried Blood Spot Tests: A Japanese Multicenter, Cross-sectional Survey. Intern Med 2021; 60:699-707. [PMID: 33642560 PMCID: PMC7990619 DOI: 10.2169/internalmedicine.5064-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Received: 06/02/2020] [Accepted: 08/25/2020] [Indexed: 01/10/2023] Open
Abstract
Objective For patients with Gaucher disease (GD), a rare, inherited lysosomal storage disease, obtaining a definitive diagnosis is currently time-consuming and costly. A simplified screening method to measure the glucocerebrosidase (GBA) activity using dried blood spots (DBS) on filter paper has recently been developed. Using this newly developed screening method, we evaluated real-world GD screening in patients suspected of having GD. Methods This multicenter, cross-sectional, observational study with a diagnostic intervention component evaluated real-world screening in patients suspected of having GD based on their clinical symptoms and a platelet count <120,000/μL. The endpoint was the number of patients with low GBA activity determined using DBS. Results In 994 patients who underwent initial DBS screening, 77 had low GBA activity. The assay was not repeated in 1 patient who was diagnosed as having a high possibility of GD due to clinical symptoms, and a further 21 patients completed the study without undergoing the second assay. Of the remaining 55 patients who had 2 DBS assays performed, 11 had a low GBA activity in both assays. Overall, DBS screening identified 12 (1.2%) patients with a low GBA activity, a proportion consistent with prior screening studies. Conclusion These results suggest that the simplified DBS method was less burdensome to patients, was easily utilized by many physicians, and could be a useful first-tier screening assay for GD prior to initiating burdensome genetic testing.
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Affiliation(s)
- Toshihiro Miyamoto
- Department of Medicine and Bioregulatory Science, Kyushu University, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Japan
| | | | - Toru Kiguchi
- Department of Hematology, Chugoku Central Hospital, Japan
| | | | - Maki Otsuka
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Japan
| | - Shohei Sawada
- Department of Dialysis and Neurology, Ijinkai Takeda General Hospital, Japan
| | | | | | - Toshitaka Muto
- Department of Hematology, National Hospital Organization Kokura Medical Center, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Japan
| | - Hisashi Tsurumi
- Department of Hematology, Matsunami General Hospital and Gifu University Hospital, Japan
| | - Kimitoshi Nakamura
- Division of Pediatrics, Graduate School of Medical Science, Kumamoto University, Japan
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Miyamoto T, Iino M, Komorizono Y, Kiguchi T, Furukawa N, Otsuka M, Sawada S, Okamoto Y, Yamauchi K, Muto T, Fujisaki T, Tsurumi H, Nakamura K. Erratum for Screening for Gaucher Disease Using Dried Blood Spot Tests: A Japanese Multicenter, Cross-sectional Survey. Intern Med 2021; 60:2347. [PMID: 34261827 PMCID: PMC8355399 DOI: 10.2169/internalmedicine.e005-21] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Toshihiro Miyamoto
- Department of Medicine and Bioregulatory Science, Kyushu University, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Japan
| | | | - Toru Kiguchi
- Department of Hematology, Chugoku Central Hospital, Japan
| | | | - Maki Otsuka
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Japan
| | - Shohei Sawada
- Department of Dialysis and Neurology, Ijinkai Takeda General Hospital, Japan
| | | | | | - Toshitaka Muto
- Department of Hematology, National Hospital Organization Kokura Medical Center, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Japan
| | - Hisashi Tsurumi
- Department of Hematology, Matsunami General Hospital and Gifu University Hospital, Japan
| | - Kimitoshi Nakamura
- Division of Pediatrics, Graduate School of Medical Science, Kumamoto University, Japan
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Iino M, Sato T, Sakamoto Y. Minimum-Dose, Short-Term Methotrexate With Tacrolimus for Graft-vs-Host Disease Prophylaxis Following Unrelated Cord Blood Transplantation in Adults: A Retrospective Analysis at a Single Institution. Transplant Proc 2020; 53:396-404. [PMID: 33308840 DOI: 10.1016/j.transproceed.2020.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/29/2020] [Accepted: 10/01/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Methotrexate (MTX) or mycophenolate mofetil with tacrolimus (TAC) is used for graft-vs-host disease (GVHD) prophylaxis in unrelated cord blood transplantation (CBT). However, there is no consensus regimen for GVHD prophylaxis in CBT. We aimed to assess the efficacy and feasibility of minimum-dose, short-term MTX (MS-MTX) for GVHD prophylaxis in CBT. METHODS We retrospectively evaluated 35 consecutive adult patients who underwent CBT and received MS-MTX (6 mg/m2 day 1; 3 mg/m2 days 3 and 6, intravenously) with TAC for GVHD prophylaxis in our hospital between 2015 and 2019. Transplantation outcomes with respect to time to hematopoietic recovery, engraftment, incidence and severity of GVHD, adverse events, relapse, nonrelapse mortality (NRM), and overall survival were evaluated. RESULTS The median time to neutrophil, platelet, and reticulocyte recovery was 22, 38, and 32 days, respectively. Cumulative neutrophil engraftment was 91.4%. After a median 3.2-year follow-up, the 2-year overall survival was 64.3%. The 2-year cumulative incidence of relapse and NRM was 20.4% and 14.9%, respectively. The 100-day cumulative incidence of grade II-IV acute GVHD and 2-year cumulative incidence of chronic GVHD were 28.6% and 36.6%, respectively. No grade IV acute GVHD was observed. Sixteen patients experienced oral mucositis and/or pharyngeal pain (46%; grades 1-2, n = 15; grade 3 pharyngeal pain, n = 1). No patients suffered from human herpesvirus 6 encephalitis/myelitis. CONCLUSIONS MS-MTX with TAC is feasible and safe and yields lower rates of severe oropharyngeal mucositis and human herpesvirus 6 encephalitis/myelitis without increasing GVHD, graft failure, relapse, or NRM.
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Affiliation(s)
- Masaki Iino
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan.
| | - Tomoya Sato
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
| | - Yuma Sakamoto
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan
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10
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Miura K, Tsujimura H, Masaki Y, Iino M, Takizawa J, Maeda Y, Yamamoto K, Tamura S, Yoshida A, Yagi H, Yoshida I, Kitazume K, Masunari T, Choi I, Kakinoki Y, Suzuki R, Yoshino T, Nakamura S, Hatta Y, Yoshida T, Kanno M. Consolidation with 90 Yttrium-ibritumomab tiuxetan after bendamustine and rituximab for relapsed follicular lymphoma. Hematol Oncol 2020; 39:51-59. [PMID: 32978820 DOI: 10.1002/hon.2809] [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: 05/31/2020] [Revised: 09/19/2020] [Accepted: 09/19/2020] [Indexed: 11/07/2022]
Abstract
Bendamustine and rituximab (BR) are widely used in patients with follicular lymphoma (FL) previously treated with conventional immunochemotherapy, but the role of consolidation radioimmunotherapy in these patients is unknown. This study evaluated the efficacy and safety of consolidation with 90 Yttrium-ibritumomab tiuxetan (90 Y-IT) after re-induction therapy with BR in patients with previously treated FL. This study included adult patients with relapsed FL who had undergone one or two prior therapies. Re-induction therapy with BR was administered every 4 weeks up to 4-6 cycles. If patients achieved at least partial response, 90 Y-IT was administered as consolidation therapy. The primary endpoint was 2-year progression-free survival (PFS) after consolidation. A total of 24 FL patients (median age 60 years) who had undergone one (n = 17) or two (n = 7) prior treatments received BR. After BR therapy, 22 patients proceeded to consolidation with 90 Y-IT, resulting in an overall 88% response rate to the protocol treatment. Within a median observation period of 46.8 months, the estimated 2-year PFS rate after the consolidation among the 22 patients receiving 90 Y-IT was 59% (95% confidence interval [CI], 38%-77%). Patients whose remission after previous treatment had lasted ≥2 years had a significantly higher 2-year PFS rate than patients whose remission after previous treatment had been <2 years (68% vs. 33%, Wilcoxon p = 0.0211). Major adverse events during the protocol treatment and within 2 years after the consolidation were hematological toxicities, but they were generally acceptable. Consequently, the estimated 2-year overall survival after the consolidation was 95% (95% CI, 74%-99%). In conclusion, in a subset of patients with previously treated FL, 90 Y-IT consolidation after BR re-induction conferred a durable remission, indicating that consolidation therapy using 90 Y-IT may be a novel therapeutic option for patients with relapsed FL (UMIN000008793).
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Affiliation(s)
- Katsuhiro Miura
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | | | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Ishikawa, Japan
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Shinobu Tamura
- Department of Hematology/Oncology, Kinan Hospital, Tanabe, Japan
| | - Akiyo Yoshida
- Department of Hematology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Hideo Yagi
- Department of Hematology and Oncology, Nara Prefecture General Medical Center, Nara, Japan
| | - Isao Yoshida
- Department of Hematologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Koichi Kitazume
- Department of Hematology, Showa General Hospital, Tokyo, Japan
| | - Taro Masunari
- Department of Infectious Diseases, Chugoku Central Hospital, Fukuyama, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | | | - Ritsuro Suzuki
- Department of Oncology/Hematology, Innovative Cancer Center, Shimane University Hospital, Izumo, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shigeo Nakamura
- Department of Pathology and Biological Response, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Hatta
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Yoshida
- Member, Society of Lymphoma Treatment in Japan, Kashihara, Japan
| | - Masatoshi Kanno
- Oncology Center, Nara Medical University Hospital, Kashihara, Japan
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11
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Kimura SI, Kanda Y, Iino M, Fukuda T, Sakaida E, Oyake T, Yamaguchi H, Fujiwara SI, Jo Y, Okamoto A, Fujita H, Takamatsu Y, Saburi Y, Matsumura I, Yamanouchi J, Shiratori S, Gotoh M, Nakamura S, Tamura K. Efficacy and safety of micafungin in empiric and D-index-guided early antifungal therapy for febrile neutropenia; A subgroup analysis of the CEDMIC trial. Int J Infect Dis 2020; 100:292-297. [PMID: 32891738 DOI: 10.1016/j.ijid.2020.08.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES The D-index is defined as the area over the neutrophil curve during neutropenia. The CEDMIC trial confirmed the noninferiority of D-index-guided early antifungal therapy (DET) using micafungin to empirical antifungal therapy (EAT). In this study, we evaluated the efficacy and safety of micafungin in these settings. METHODS From the CEDMIC trial, we extracted 67 and 113 patients who received micafungin in the DET and EAT groups, respectively. Treatment success was defined as the fulfilment of all components of a five-part composite end point. Fever resolution was evaluated at seven days after the completion of therapy. RESULTS The proportion of high-risk treatments including induction chemotherapy for acute leukemia and allogeneic hematopoietic stem cell transplantation was significantly higher in the DET group than in the EAT group (82.1% vs. 52.2%). The efficacy of micafungin was 68.7% (95%CI: 56.2-79.4) and 79.6% (71.0-86.6) in the DET and EAT groups, respectively. When we focused on high-risk treatments, the efficacy was 69.1% (55.2-80.9%) and 78.0% (65.3-87.7%), respectively (P = 0.30). There was no significant difference in any of the 5 components between the two groups. CONCLUSIONS The efficacy of micafungin in patients undergoing high-risk treatment was not strongly impaired in DET compared to that in EAT.
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Affiliation(s)
- Shun-Ichi Kimura
- Division of Hematology, Jichi Medical University Saitama Medical Center, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Japan; Division of Hematology, Department of Medicine, Jichi Medical University, Japan.
| | - Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Japan
| | - Tatsuo Oyake
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
| | | | | | - Yumi Jo
- Department of Oncology and Hematology / Infection Control Division, Shimane University Hospital, Japan
| | - Akinao Okamoto
- Department of Hematology, Fujita Health University School of Medicine, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Japan
| | - Yoshio Saburi
- Department of Hematology, Oita Prefectural Hospital, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Japan
| | - Jun Yamanouchi
- Departments of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan
| | - Souichi Shiratori
- Department of Hematology, Hokkaido University, Faculty of Medicine, Japan
| | - Moritaka Gotoh
- Department of Hematology, Tokyo Medical University, Japan
| | - Shingen Nakamura
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Kazuo Tamura
- General Medical Research Center, Fukuoka University, Japan
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12
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Sakurai M, Okamoto S, Matsumura I, Murakami S, Takizawa M, Waki M, Hirano D, Watanabe-Nakaseko R, Kobayashi N, Iino M, Mitsui H, Ishikawa Y, Takahashi N, Kawaguchi T, Suzuki R, Yamamoto K, Kizaki M, Ohnishi K, Naoe T, Akashi K. Treatment outcomes of chronic-phase chronic myeloid leukemia with resistance and/or intolerance to a 1st-line tyrosine kinase inhibitor in Japan: the results of the New TARGET study 2nd-line. Int J Hematol 2020; 111:812-825. [DOI: 10.1007/s12185-020-02843-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/27/2022]
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13
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Kanda Y, Kimura SI, Iino M, Fukuda T, Sakaida E, Oyake T, Yamaguchi H, Fujiwara SI, Jo Y, Okamoto A, Fujita H, Takamatsu Y, Saburi Y, Matsumura I, Yamanouchi J, Shiratori S, Gotoh M, Nakamura S, Tamura K. D-Index-Guided Early Antifungal Therapy Versus Empiric Antifungal Therapy for Persistent Febrile Neutropenia: A Randomized Controlled Noninferiority Trial. J Clin Oncol 2020; 38:815-822. [PMID: 31977270 DOI: 10.1200/jco.19.01916] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Empiric antifungal therapy (EAT) is recommended for persistent febrile neutropenia (FN), but in most patients, it is associated with overtreatment. The D-index, calculated as the area surrounded by the neutrophil curve and the horizontal line at a neutrophil count of 500/μL, reflects both the duration and depth of neutropenia and enables real-time monitoring of the risk of invasive fungal infection in individual patients at no cost. We investigated a novel approach for patients with persistent FN called D-index-guided early antifungal therapy (DET), in which antifungal treatment is postponed until a D-index reaches 5,500 or the detection of positive serum or imaging tests, and compared it with EAT in this multicenter open-label noninferiority randomized controlled trial. PATIENTS AND METHODS We randomly assigned 423 patients who underwent chemotherapy or hematopoietic stem-cell transplantation for hematologic malignancies to the EAT or DET group. The prophylactic use of antifungal agents other than polyenes, echinocandins, or voriconazole was allowed. Micafungin at 150 mg per day was administered as EAT or DET. RESULTS In an intent-to-treat analysis of 413 patients, the incidence of probable/proven invasive fungal infection was 2.5% in the EAT group and 0.5% in the DET group, which fulfilled the predetermined criterion of noninferiority of the DET group (-2.0%; 90% CI, -4.0% to 0.1%). The survival rate was 98.0% versus 98.6% at day 42 and 96.4% versus 96.2% at day 84. The use of micafungin was significantly reduced in the DET group (60.2% v 32.5%; P < .001). CONCLUSION A novel strategy, DET, decreased the use and cost of antifungal agents without increasing invasive fungal infections and can be a reasonable alternative to empiric or preemptive antifungal therapy.
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Affiliation(s)
- Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.,Division of Hematology, Department of Medicine, Jichi Medical University, Saitama, Japan
| | - Shun-Ichi Kimura
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Emiko Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - Tatsuo Oyake
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan
| | | | - Shin-Ichiro Fujiwara
- Division of Hematology, Department of Medicine, Jichi Medical University, Saitama, Japan
| | - Yumi Jo
- Infection Control Division, Department of Oncology and Hematology, Shimane University Hospital, Izumo, Japan
| | - Akinao Okamoto
- Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Yoshio Saburi
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Jun Yamanouchi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Souichi Shiratori
- Department of Hematology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Moritaka Gotoh
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Shingen Nakamura
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kazuo Tamura
- General Medical Research Center, Fukuoka University, Fukuoka, Japan
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14
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Iino M, Yamamoto T, Sato T, Sakamoto Y. Yttrium-90 ibritumomab tiuxetan consolidation versus rituximab maintenance therapy for indolent non-Hodgkin lymphoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Sakaida E, Kanda Y, Kimura SI, Iino M, Fukuda T, Oyake T, Yamaguchi H, Fujiwara SI, Suzumiya J, Okamoto A, Fujita H, Takamatsu Y, Saburi Y, Matsumura I, Yamanouchi J, Shiratori S, Gotoh M, Nakamura S, Tamura K. D-index-guided early antifungal therapy for persistent FN in patients with hematological malignancies (CEDMIC trial). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz339.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Iino M, Sakamoto Y, Sato T. Yttrium-90 ibritumomab tiuxetan consolidation versus rituximab maintenance therapy after induction chemotherapy in patients with indolent non-Hodgkin lymphoma: a single-institution experience. ACTA ACUST UNITED AC 2019; 24:623-630. [PMID: 31496425 DOI: 10.1080/16078454.2019.1664094] [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] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Indolent B-cell non-Hodgkin lymphomas (iNHLs) are considered incurable. Rituximab maintenance and yttrium-90 ibritumomab tiuxetan (90Y-IT) consolidation are promising post-remission therapies. However, only one randomized phase II trial has compared their efficacies and adverse effects. Here, we compared the efficacy and safety of 90Y-IT consolidation and rituximab maintenance in iNHL patients. METHODS We retrospectively examined 75 iNHL patients with complete or partial response after initial chemotherapy between January 2008 and December 2018. Twenty-seven patients received 90Y-IT consolidation and 48 received rituximab maintenance (every 2 months for 2 years). Progression-free survival (PFS), overall survival (OS), and time to next treatment (TTNT) were estimated from the start of the treatment, and adverse effects were evaluated. RESULTS After a median 3.6-year follow-up, the 5-year PFSs of the 90Y-IT consolidation and rituximab maintenance groups were 75.5% and 82.4%, respectively (log-rank test, p = 0.839), and the 5-year OSs were 100% and 97.8%, respectively (log-rank test, p = 0.465). The corresponding median TTNTs were not reached (log-rank test, p = 0.804). The commonest adverse effect with 90Y-IT consolidation was hematotoxicity; lower rates and grades of cytopenia were observed in patients who received rituximab maintenance. Secondary malignancies were observed in 1 patient (4%) who received 90Y-IT consolidation and 2 patients (4.2%) who received rituximab maintenance (Fisher's exact test, p > 0.99). CONCLUSION 90Y-IT consolidation and rituximab maintenance were similar with respect to PFS, OS, and TTNT. However, the features and grades of adverse effects significantly differed. Patient-specific characteristics should be considered when deciding post-remission treatments.
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Affiliation(s)
- Masaki Iino
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital , Kofu, Yamanashi , Japan
| | - Yuma Sakamoto
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital , Kofu, Yamanashi , Japan
| | - Tomoya Sato
- Department of Hematology and Hematopoietic Stem Cell Transplantation, Yamanashi Prefectural Central Hospital , Kofu, Yamanashi , Japan
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17
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Kanno M, Miura K, Masaki Y, Tsujimura H, Iino M, Takizawa J, Maeda Y, Yamamoto K, Tamura S, Yoshida A, Yagi H, Yoshida I, Kitazume K, Masunari T, Choi I, Kakinoki Y, Suzuki R, Yoshino T, Nakamura S, Yoshida T. CONSOLIDATION THERAPY USING 90
Y-IBRITUMOMAB TIUXETAN AFTER BENDAMUSTINE AND RITUXIMAB FOR RELAPSED FOLLICULAR LYMPHOMA; A MULTICENTER, PHASE II STUDY (BRiZ2012). Hematol Oncol 2019. [DOI: 10.1002/hon.61_2631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. Kanno
- Oncology Center; Nara Medical University Hospital; Kashihara Japan
| | - K. Miura
- Division of Hematology and Rheumatology; Nihon University School of Medicine; Tokyo Japan
| | - Y. Masaki
- Department of Hematology and Immunology; Kanazawa Medical University; Ishikawa Japan
| | - H. Tsujimura
- Division of Medical Oncology; Chiba Cancer Center; Chiba Japan
| | - M. Iino
- Department of Medical Oncology; Yamanashi Prefectural Central Hospital; Kofu Japan
| | - J. Takizawa
- Department of Hematology; Endocrinology and Metabolism, Niigata University Faculty of Medicine; Niigata Japan
| | - Y. Maeda
- Department of Hematology and Oncology; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - K. Yamamoto
- Department of Hematology; Okayama City Hospital; Okayama Japan
| | - S. Tamura
- Department of Hematology/Oncology; Kinan Hospital; Tanabe Japan
| | - A. Yoshida
- Department of Hematology; Toyama Prefectural Central Hospital; Toyama Japan
| | - H. Yagi
- Department of Hematology and Oncology; Nara Prefecture General Medical Center; Nara Japan
| | - I. Yoshida
- Department of Hematologic Oncology; National Hospital Organization, Shikoku Cancer Center; Matsuyama Japan
| | - K. Kitazume
- Department of Hematology; Showa General Hospital; Kodaira Japan
| | - T. Masunari
- Department of Infectious Diseases; Chugoku Central Hospital; Fukuyama Japan
| | - I. Choi
- Department of Hematology; National Hospital Organization, Kyushu Cancer Center; Fukuoka Japan
| | - Y. Kakinoki
- Department of Hematology; Asahikawa City Hospital; Ashikawa Japan
| | - R. Suzuki
- Department of Oncology/Hematology, Innovative Cancer Center; Shimane University Hospital; Izumo Japan
| | - T. Yoshino
- Department of Pathology; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - S. Nakamura
- Department of Pathology and Biological Response; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - T. Yoshida
- Member; Society of Lymphoma Treatment in Japan (SoLT-J); Kanazawa Japan
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18
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Iino M, Yamamoto T, Sakamoto Y. Outcomes of unplanned tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia: retrospective analysis of real-world experience in a single institution. ACTA ACUST UNITED AC 2019; 24:355-361. [PMID: 30880635 DOI: 10.1080/16078454.2019.1590964] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To explore real-world prognoses for tyrosine kinase inhibitor (TKI) discontinuation in chronic myeloid leukemia (CML) patients and the associated reasons for TKI discontinuation. METHODS We investigated, using the medical records of 85 consecutive CML patients who received TKIs between December 2001 and August 2016 at our hospital, reasons for discontinuation, duration of TKI treatment before discontinuation, molecular response (MR) status at TKI discontinuation, treatment-free remission (TFR) duration, and overall survival after TKI discontinuation. RESULTS TKI therapy was discontinued in 21 patients. The median treatment duration before discontinuation was 68.3 months. The response statuses at discontinuation were MR4 (n = 2), MR4.5 (n = 4), and ≥MR5 (n = 15). The reasons were pleural effusion (n = 5); requests for prolonged deep molecular response (DMR) (n = 4); ischemic heart disease, anemia, and economic problems (each, n = 3); renal dysfunction (n = 2); and hyperkalemia, diarrhea, dementia, asthma, and desire to get pregnant, (each, n = 1). All patients were alive with median follow-up period of 32.1 months. TFR was maintained in 14 patients, and the 2-year TFR proportion was 66.7%. Seven patients restarted TKI therapy and achieved MR4 within median of 3 months. The duration of TKI administration before discontinuation (≥ 70 months) was favored longer TFR durations. CONCLUSION TKI was safely discontinued in clinical practice and yielded TFR rates similar to those observed in previous clinical trials, regardless of reason. Achievement of TFR significantly impacts patients' quality of life and should be considered in clinical practice.
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Affiliation(s)
- Masaki Iino
- a Department of Hematology and Hematopoietic Stem Cell Transplantation , Yamanashi Prefectural Central Hospital , Kofu , Japan
| | - Takeo Yamamoto
- a Department of Hematology and Hematopoietic Stem Cell Transplantation , Yamanashi Prefectural Central Hospital , Kofu , Japan
| | - Yuma Sakamoto
- a Department of Hematology and Hematopoietic Stem Cell Transplantation , Yamanashi Prefectural Central Hospital , Kofu , Japan
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19
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Iino M, Yamamoto T. Efficacy and Safety of Biosimilar Filgrastim for Cord Blood Transplantation: A Single-Institution Retrospective Analysis. Transplant Proc 2018; 50:3804-3810. [DOI: 10.1016/j.transproceed.2018.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/07/2018] [Accepted: 06/27/2018] [Indexed: 01/20/2023]
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20
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Kanno M, Miura K, Masaki Y, Tsujimura H, Iino M, Takizawa J, Maeda Y, Yamamoto K, Tamura S, Yoshida A, Yagi H, Yoshida I, Kitazume K, Masunari T, Choi I, Kakinoki Y, Yoshino T, Nakamura S, Yoshida T. Bendamustine and rituximab followed by 90Y-ibritumomab tiuxetan for relapsed follicular lymphoma: A preliminary analysis of a multicenter, prospective phase II study (BRiZ2012). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy286.012] [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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21
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Iino M, Yamamoto T. Gemcitabine, carboplatin, and dexamethasone as salvage chemotherapy for outpatients with relapsed or refractory lymphoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy375.049] [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: 11/13/2022] Open
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22
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Iino M, Yamamoto T. [Efficacy and safety of biosimilar filgrastim for autologous peripheral blood stem cell harvest and transplantation: a single-institutional retrospective analysis]. Rinsho Ketsueki 2018. [PMID: 29515065 DOI: 10.11406/rinketsu.59.145] [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: 11/09/2022]
Abstract
Three biosimilar filgrastim products are currently available in Japan. Among these, the safety and efficacy of two imported drugs for autologous peripheral blood stem cell harvest (autoPBSCH) and autologous peripheral blood stem cell transplantation (autoPBSCT) have been studied widely; however, evidence of the safety and efficacy of domestically manufactured filgrastim is limited. Therefore, we compared the efficacy and safety of domestic biosimilar filgrastim (BF1, n=23) with those of originator filgrastim (OF, n=21) for autoPBSCH and autoPBSCT. Before autoPBSCH, the same median total dose of 3.3 mg filgrastim was administered to patients in the BF1 and OF groups. Median numbers of CD34-positive cells harvested did not significantly differ between BF1 (4.32×106/kg) and OF (4.75×106/kg) groups. After autoPBSCT, the median total doses of BF1 and OF used for neutrophil recovery were 2.7 and 3.3 mg, respectively. There were no significant inter-group differences in the time to bone marrow recovery, total transfusion units, hospitalization duration, overall survival at 1 year, or adverse events. Compared with OF, the cost of BF1 was considerably lower by 229,529 yen per transplantation case. Thus, the efficacy and safety of BF1 were comparable to those of OF, making BF1 an effective and economical alternative to OF.
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Affiliation(s)
- Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital.,Department of Medical Oncology, Yamanashi Prefectural Central Hospital
| | - Takeo Yamamoto
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital
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23
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Tsukune Y, Sasaki M, Odajima T, Sunami K, Takei T, Moriuchi Y, Iino M, Isoda A, Nakaya A, Muta T, Miyake T, Miyazaki K, Shimizu T, Nakajima K, Igarashi A, Nagafuji K, Kurihara T, Aoyama T, Sugimori H, Komatsu N. Incidence and risk factors of hepatitis B virus reactivation in patients with multiple myeloma in an era with novel agents: a nationwide retrospective study in Japan. Blood Cancer J 2017; 7:631. [PMID: 29167420 PMCID: PMC5802507 DOI: 10.1038/s41408-017-0002-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/03/2017] [Accepted: 08/23/2017] [Indexed: 12/18/2022] Open
Affiliation(s)
- Yutaka Tsukune
- Department of Hematology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Makoto Sasaki
- Department of Hematology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Takeshi Odajima
- Faculty of Health Science, Daito Bunka University, School of Sports and Health Science, Higashi-Matsuyama, Saitama, 355-8501, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Okayama, 701-1192, Japan
| | - Tomomi Takei
- Department of Hematology, Japanese Red Cross Medical Center, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Yukiyoshi Moriuchi
- Department of Hematology, Sasebo City General Hospital, Sasebo, 857-0056, Nagasaki, Japan
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, 400-8506, Japan
| | - Atsushi Isoda
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, 377-0280, Japan
| | - Aya Nakaya
- First Department of Internal Medicine, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Tsuyoshi Muta
- Department of Hematology/Oncology, Japan Community Health Care Organization Kyushu Hospital, Kita-Kyusyu, Fukuoka, 806-8501, Japan
| | - Takaaki Miyake
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Shimane, 693-8501, Japan
| | - Koji Miyazaki
- Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Kanagawa, 252-0374, Japan
| | - Takayuki Shimizu
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kei Nakajima
- Department of Hematology/Oncology, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Aiko Igarashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Bukyo-ku, Tokyo, 113-8677, Japan
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Taro Kurihara
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Niigata, 951-8566, Japan
| | - Tomonori Aoyama
- Department of Gastroenterology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroki Sugimori
- Department of Preventive Medicine, Daito Bunka University, Graduate School of Sports and Health Science, Higashi-Matsuyama, Saitama, 355-8501, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan
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Iino M. Discontinuation of BCR-ABL tyrosine kinase inhibitors in patients with chronic myeloid leukemia: a retrospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx621.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Iino M, Yamamoto T. Recombinant soluble thrombomodulin for disseminated intravascular coagulation patients with hematological malignancy. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv472.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Iino M, Nakagomi H, Teramoto K. Clinical Outcomes and Prognostic Factors for Survival of Cancer of Unknown Primary Site at Our Hospital. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu436.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Iino M. Functional and esthetic rehabilitation with maxillary prosthesis supported by zygomatic implants for a patient with maxillary defect resulting from cancer ablative surgery. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Asano K, Kawamoto R, Iino M, Fruichi T, Nojiri K, Takamizawa T, Miyazaki M. Effect of Pre-reacted Glass-ionomer Filler Extraction Solution on Demineralization of Bovine Enamel. Oper Dent 2014; 39:159-65. [DOI: 10.2341/13-034-l] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective
To determine the effect of pre-reacted glass-ionomer (PRG) filler extraction solution on the demineralization of bovine enamel by measuring changes in the ultrasound transmission velocity.
Methods
The specimens were prepared by cutting bovine teeth into enamel blocks. The specimens were immersed in buffered lactic acid solution for 10 minutes twice a day, and then stored in artificial saliva. Other specimens were stored in PRG filler extraction solution for 10 minutes, followed by 10-minute immersion in the buffered lactic acid solution twice a day. The propagation time of longitudinal ultrasonic waves was measured by a pulser receiver. Six specimens were used for each condition, and analyses of variance followed by Tukey tests (α=0.05) were done.
Results
No changes in sonic velocity were found for specimens stored in the PRG filler extraction solution, indicating that the PRG extraction solution had an effect on inhibiting the demineralization of bovine enamel.
Conclusions
The results obtained with the use of an ultrasound measurement technique suggested that PRG filler extraction solution has the ability to prevent demineralization of enamel.
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Affiliation(s)
- K Asano
- Kazumasa Asano, DDS, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - R Kawamoto
- Ryo Kawamoto, DDS, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - M Iino
- Masayoshi Iino, DDS, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - T Fruichi
- Tetsuya Fruichi, DDS, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - K Nojiri
- Kie Nojiri, DDS, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - T Takamizawa
- Toshiki Takamizawa, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
| | - M Miyazaki
- Masashi Miyazaki, DDS, PhD, Operative Dentistry, Nihon University School of Dentistry, Chiyoda-Ku, Tokyo, Japan
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29
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Iino M, Nakagomi H, Teramoto K. Characteristics of Malignant Lymphoma and the Treatment Outcomes in Patients Aged 80 Years or Over at Our Institution. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Koh H, Hino M, Ohta K, Iino M, Urase F, Yamaguchi M, Yamanouchi J, Usui N, Yoshida M, Tanimoto M, Ohyashiki K, Urabe A, Tamura K, Kanamaru A, Masaoka T. Empirical voriconazole therapy for febrile neutropenic patients with hematological disorders: a prospective multicenter trial in Japan. J Infect Chemother 2013; 19:1126-34. [PMID: 23813092 PMCID: PMC3857881 DOI: 10.1007/s10156-013-0634-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/10/2013] [Indexed: 11/28/2022]
Abstract
An open-label, prospective, multicenter study was conducted between October 2006 and March 2010 to assess the efficacy and safety of intravenous voriconazole (VRCZ) as empirical therapy for antibiotic-refractory febrile neutropenia in Japanese patients with hematological disorders. In addition, to find the patient groups that may benefit from antifungal therapy, the definition of invasive fungal infection proposed by EORTC/MSG (2002) was assessed in this study. Plasma (1-3)-β-d-glucan and Aspergillus PCR in blood were also measured to improve the diagnostic accuracy. A total of 103 patients (median age, 59 years), including 25 undergoing induction chemotherapies and 19 allogeneic hematopoietic cell transplants, were evaluable. Sixty-nine percent of the patients achieved resolution of clinical symptoms and 31 % achieved treatment success, defined as fulfilling the previously described five-part composite endpoint. Although VRCZ was discontinued in 9.7 % of the patients because of adverse effects, all the patients recovered soon after discontinuation of VRCZ. The treatment success rate of VRCZ appeared to be higher in patients categorized as “not classified” compared with “possible invasive fungal disease” according to the EORTC/MSG criteria. Moreover, six “not classified” patients were positive for either plasma (1-3)-β-d-glucan (n = 5) or Aspergillus PCR in blood (n = 2). The present study demonstrates that empirical VRCZ therapy is safe and effective in Japanese patients. Additionally, (1-3)-β-d-glucan and Aspergillus PCR tests were expected to provide additional information on the diagnosis of invasive fungal infections.
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Affiliation(s)
- Hideo Koh
- Hematology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan,
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31
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Iino M, Nakagomi H, Teramoto K. Screening for Hepatitis B Virus Carriers and the Incidence of Hepatitis B Reactivation in Patients with Malignant Lymphoma at Our Institution. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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32
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Iino M, Iizuka C. [Contingent diagnosis of sarcoidosis by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) after completion of chemotherapy for malignant lymphoma]. Rinsho Ketsueki 2012; 53:540-542. [PMID: 22728558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 55-year-old man with bilateral cervical lymphadenopathy was diagnosed with diffuse large B-cell lymphoma, stage IIA, and underwent sequential chemoradiotherapy (R-CHOP, 3 courses followed by 30 Gy cervical irradiation). Chemotherapy response was evaluated by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). 18F-FDG uptake of the primary lesion was completely diminished; however, a new paratracheal uptake was observed. FDG-PET-guided biopsy revealed sarcoidosis. Sarcoidosis with lymphoma is a rare condition, and it is difficult to distinguish early-stage sarcoidosis from lymphoma without biopsy. Routine FDG-PET significantly increases the detection of unexpected diseases. Physicians should perform biopsies of lesions or follow them carefully in lymphoma patients with unexpected 18F-FDG uptake.
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Affiliation(s)
- Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital, Japan
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33
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Iino M. Interstitial pneumonitis associated with the immunomodulatory drugs thalidomide and lenalidomide. Int J Hematol 2011; 95:223-4. [PMID: 22198829 DOI: 10.1007/s12185-011-0997-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 12/12/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
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34
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O'Donnell C, Iino M, Mansharan K, Leditscke J, Woodford N. Contribution of postmortem multidetector CT scanning to identification of the deceased in a mass disaster: Experience gained from the 2009 Victorian bushfires. Forensic Sci Int 2010; 205:15-28. [PMID: 20691550 DOI: 10.1016/j.forsciint.2010.05.026] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 05/26/2010] [Indexed: 11/26/2022]
Abstract
CT scanning of the deceased is an established technique performed on all individuals admitted to VIFM over the last 5 years. It is used primarily to assist pathologists in determining cause and manner of death but is also invaluable for identification of unknown deceased individuals where traditional methods are not possible. Based on this experience, CT scanning was incorporated into phase 2 of the Institute's DVI process for the 2009 Victorian bushfires. All deceased individuals and fragmented remains admitted to the mortuary were CT scanned in their body bags using established protocols. Images were reviewed by 2 teams of 2 radiologists experienced in forensic imaging and the findings transcribed onto a data sheet constructed specifically for the DVI exercise. The contents of 255 body bags were examined in the 28 days following the fires. 164 missing persons were included in the DVI process with 163 deceased individuals eventually identified. CT contributed to this identification in 161 persons. In 2 cases, radiologists were unable to recognize commingled remains. CT was utilized in the initial triage of each bag's contents. If radiological evaluation determined that bodies were incomplete then this information was provided to search teams who revisited the scenes of death. CT was helpful in differentiation of human from non-human remains in 8 bags, recognition of human/animal commingling in 10 bags and human commingling in 6 bags. In 61% of cases gender was able to be determined on CT using a novel technique of genitalia detection and in all but 2 cases this was correct. Age range was able to be determined on CT in 94% with an accuracy of 76%. Specific identification features detected on CT included the presence of disease (14 disease entities in 13 cases), medical devices (26 devices in 19 cases) and 274 everyday metallic items associated with the remains of 135 individuals. CT scanning provided useful information prior to autopsy by flagging likely findings including the presence of non-human remains, at the time of autopsy by assisting in the localization of identifying features in heavily disfigured bodies, and after autopsy by retrospective review of images for clarification of issues that arose at the time of pathologist case review. In view of the success of CT scanning in this mass disaster, DVI administrators should explore the incorporation of CT services into their disaster plans.
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Affiliation(s)
- C O'Donnell
- Victorian Institute of Forensic Medicine, Australia; Department of Forensic Medicine, Monash University, Australia
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Abstract
Positive phototropic curvature of Phycomyces sporangiophores (stage I) induced by a short pulse (10 sec) of blue light has been characterized. The curvature response, measured 40 min after irradiation, increases with increasing fluences up to approximately 10(-4) J.m(-2); it then decreases and becomes nearly 0 at a fluence of approximately 10(-1) J.m(-2). The threshold fluence is found near 10(-7) J.m(-2), indicating over 1000-fold higher sensitivity than the first positive phototropism of grass coleoptiles. Positive curvature of the sporangiophore becomes detectable 5 min after irradiation and increases with time up to approximately 40 min. During the course of this curvature development, overall elongation growth of the sporangiophore is first stimulated and then inhibited. The relationship between the phototropic response and the response in overall elongation growth is discussed, and it is suggested that the primary mechanisms of these responses are distinct.
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Affiliation(s)
- M Iino
- Carnegie Institution of Washington, Department of Plant Biology, 290 Panama Street, Stanford, CA 94305
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Abstract
The stomatal response to blue light was analyzed with gas-exchange techniques in Commelina communis L. leaves by using high-fluence-rate short pulses. Pulses of blue light were given under a background of high-fluence-rate red light, which maintained photosynthesis at near saturation and stomatal conductance at a steady state. A single blue light pulse of 1-100 sec induced an increase in stomatal conductance, which peaked after 15 min and then returned to the initial steady-state level within 50-60 min after the pulse. The response could be repeatedly induced in the same leaf. Red light pulses on a red background did not induce any comparable response. The stomatal response quantified by integrating the conductance increases after pulse application approached saturation with increasing pulse duration (t((1/2)) approximately 9 sec with 250 mumol.m(-2).sec(-1) of blue light). After a saturating pulse, sensitivity to a second pulse was restored slowly. This recovery response, quantified from the conductance increases caused by the two pulses, approached saturation with a t((1/2)) of approximately 9 min. These results were used to test a model in which a molecular component in the sensory transduction process is considered to exist in two interconvertible forms, A and B. If B is the physiologically active form inducing stomatal opening, then A is the inactive form. The A to B conversion is a light-induced reaction and the B to A conversion is a thermal reaction. Rate constants for these reactions were estimated from single- and double-pulse experiments (at a fluence rate of 250 mumol.m(-2).sec(-1), k(1) = 0.075 sec(-1); thermal rate constant k(d) = 0.0014 sec(-1)), allowing the calculation of steady-state concentration of B under continuous irradiation. The calculated values accurately predicted the steady-state stomatal conductances under continuous blue light.
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Affiliation(s)
- M Iino
- Carnegie Institute of Washington, Department of Plant Biology, 290 Panama Street, Stanford, CA 94305
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Abstract
Glutamate transporters play a critical role in the maintenance of low extracellular concentrations of glutamate, which prevents the overactivation of post-synaptic glutamate receptors. Four distinct glutamate transporters, GLAST/EAAT1, GLT-1/EAAT2, EAAC1/EAAT3 and EAAT4, are distributed in the molecular layer of the cerebellum, especially near glutamatergic synapses in Purkinje cells (PCs). This review summarizes the current knowledge about the differential roles of these transporters at excitatory synapses of PCs. Data come predominantly from electrophysiological experiments in mutant mice that are deficient in each of these transporter genes. GLAST expressed in Bergmann glia contributes to the clearing of the majority of glutamate that floods out of the synaptic cleft immediately after transmitter release from the climbing fibre (CF) and parallel fibre (PF) terminals. It is indispensable to maintain a one-to-one relationship in synaptic transmission at the CF synapses by preventing transcellular glutamate spillover. GLT-1 plays a similar but minor role in the uptake of glutamate as GLAST. Although the loss of neither GLAST nor GLT-1 affects cerebellar morphology, the deletion of both GLAST and GLT-1 genes causes the death of the mutant animal and hinders the folium formation of the cerebellum. EAAT4 removes the low concentrations of glutamate that escape from uptake by glial transporters, preventing the transmitter from spilling over into neighbouring synapses. It also regulates the activation of metabotropic glutamate receptor 1 (mGluR1) in perisynaptic regions at PF synapses, which in turn affects mGluR1-mediated events including slow EPSCs and long-term depression. No change in synaptic function is detected in mice that are deficient in EAAC1.
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Affiliation(s)
- Y Takayasu
- Department of Otolaryngology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
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38
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Mori Y, Susami T, Chikazu D, Saijo H, Sakiyama M, Matsuzaki M, Abe M, Wada M, Iino M, Takato T. Unilateral expansion of a narrow mandibular dental arch combined with bimaxillary osteotomies in a patient with hypoglossia. Int J Oral Maxillofac Surg 2009; 38:689-93. [PMID: 19406615 DOI: 10.1016/j.ijom.2009.03.719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 12/12/2008] [Accepted: 03/30/2009] [Indexed: 11/26/2022]
Abstract
A 23-year-old female with hypoglossia, who had a narrow mandibular dental arch, was treated using the gradual expansion technique. Three lower incisors were missing and the right molar occlusion showed a scissor bite. Her speech was acceptable. Gradual unilateral expansion of the mandibular alveolar bone was performed. Orthodontic tooth alignment was performed prior to surgical treatment. A tooth-borne expander was devised using a hyrax-type screw to move the inclined right alveolar bone into an upright position. Alveolar bone osteotomies were performed under general anesthesia and the expander was placed in the mandibular dental arch. After a 5-day latency period, the screw was activated for 21 days. After expansion, the width of the mandibular dental arch increased by 10mm at the first molar region and the right molars were moved to an upright position. After a consolidation period of 7 days, simultaneous two-jaw surgery that combined Le Fort I osteotomy and intraoral vertical ramus osteotomies was performed to obtain a stable occlusion. After post-surgical orthodontic and prosthodontic treatment, her occlusion improved without deterioration of her speech. The results indicate that this technique is useful for unilateral expansion of distorted mandibular alveolar process.
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Affiliation(s)
- Y Mori
- Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan.
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Iino M. [Severe liver injury following nelarabine chemotherapy for T-cell lymphoblastic lymphoma]. Rinsho Ketsueki 2009; 50:49-51. [PMID: 19225230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 41-year-old man received allogeneic hematopoietic stem cell transplantation for T-cell lymphoblastic lymphoma. Recurrence occurred 20 months post-transplantation. Combination chemotherapy (etoposide, prednisolone, daunorubicin, vincristine) was performed, but the effect was limited, necessitating nelarabine administration. After 2 courses (1.5 g/m2/day, days 1, 3, 5), blood chemistry indicated severe liver injury. DDW-J 2004 guidelines on drug-induced liver injury indicated nelarabine as the most plausible etiologic agent. After administering ursodeoxycholic acid, phenobarbital and prednisolone, liver function improved. Although previous studies reported neurotoxicity as the most frequent and severe toxicity, we also need to consider that severe liver injury might be induced by nelarabine.
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Affiliation(s)
- Masaki Iino
- Department of Medical Oncology, Yamanashi Prefectural Central Hospital
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Iino M, Nakajima A, Shindo H. [Long-term complete remission in primary plasma cell leukemia after treatment with VAD chemotherapy and tandem autologous peripheral blood stem cell transplantation]. Gan To Kagaku Ryoho 2008; 35:2441-2443. [PMID: 19098420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 54-year-old woman visited our hospital with the chief complaints of generalized pain and thirst. Through hematologic and bone marrow examination, we diagnosed her illness as primary plasma cell leukemia. Three courses of VAD (vincristine, adriamycin and dexamethasone)therapy induced complete remission. Afterward, the patient received high-dose cyclophosphamide (4 g/m(2))for hematopoietic stem cell mobilization, and peripheral blood hematopoietic stem cells were collected 14 days later from the start of chemotherapy. Thereafter, the patient received 2 courses of high-dose melphalan (200 mg/m(2)), followed by tandem autologous peripheral blood stem cell transplantation. The patient developed no adverse events other than fever and stomatitis during the 2 transplantation courses. Fifty-six months after the transplantations, she remains in complete remission with continuous oral administration of bisphosphonate alone. Taken together, although primary plasma cell leukemia is a rare hematologic malignancy with poor prognosis, the intensive chemotherapy followed by tandem autologous peripheral blood stem cell transplantation may well improve the clinical outcome.
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Affiliation(s)
- Masaki Iino
- Dept. of Medical Oncology, Yamanashi Prefectural Central Hospital, Japan
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Yata H, Sato J, Kawaguchi K, Kawaguchi K, Suzuki M, Matoba Y, Iino M, Imamura E, Seto K. P.369 A new osteotome technique for sinus floor augmentation. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)72157-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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43
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Narimatsu H, Iino M, Ichihashi T, Yokozawa T, Hayakawa M, Kiyoi H, Takeo T, Sawamoto A, Iida H, Tsuzuki M, Yanada M, Naoe T, Suzuki R, Sugiura I. Clinical significance of minimal residual disease in patients with t(8;21) acute myeloid leukemia in Japan. Int J Hematol 2008; 88:154-158. [PMID: 18553224 DOI: 10.1007/s12185-008-0108-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2008] [Revised: 05/11/2008] [Accepted: 05/15/2008] [Indexed: 11/30/2022]
Abstract
To examine the prognostic significance of minimal residual disease (MRD) in t(8;21) acute myeloid leukemia (AML), 96 bone marrow samples from 26 Japanese patients in complete remission (CR) were analyzed regarding the RUNX1/MTG8 transcript using real-time reverse transcriptase polymerase chain reaction assay. All patients were treated with intensive chemotherapy. The median copy number of the RUNX1/MTG8 transcript, measured after each treatment course decreased over time. However, an increase in the MRD level was documented in three patients after the second consolidation, and all of them subsequently relapsed. The relapse-free survival (RFS) did not differ between the patients whose MRD levels were below or above 1,000 copies/microg after the first consolidation, with respective 2-year rates of 62 and 86% (P = 0.21). With respect to the MRD level after induction therapy, our data also failed to show any favorable effect of a lower MRD on RFS. Although these findings need to be confirmed with a larger number of patients, our data indicate that the MRD level at a given time during the early course in CR does not predict the outcome in Japanese patients.
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Affiliation(s)
- Hiroto Narimatsu
- Department of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan. .,Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Masaki Iino
- Department of Hematology, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | | | - Toshiya Yokozawa
- Department of Hematology/Oncology, Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Masaya Hayakawa
- Department of Hematology, Komaki City Hospital, Komaki, Japan
| | - Hitoshi Kiyoi
- Department of Infectious Diseases, Nagoya University School of Medicine, Nagoya, Japan
| | - Takaaki Takeo
- Department of Hematology, Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Akiyo Sawamoto
- Department of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Hiroatsu Iida
- Department of Hematology, Meitetsu Hospital, Nagoya, Japan
| | - Motohiro Tsuzuki
- Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - Masamitsu Yanada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Tomoki Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Ritsuro Suzuki
- Department of HSCT Data Management, Nagoya University School of Medicine, Nagoya, Japan
| | - Isamu Sugiura
- Department of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
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Narimatsu H, Yokozawa T, Iida H, Tsuzuki M, Hayakawa M, Takeo T, Iino M, Ichihashi T, Kato C, Sawamoto A, Sao H, Yanada M, Emi N, Kiyoi H, Yamaguchi T, Naoe T, Suzuki R, Sugiura I. Clinical characteristics and outcomes in patients with t(8;21) acute myeloid leukemia in Japan. Leukemia 2007; 22:428-32. [PMID: 17713551 DOI: 10.1038/sj.leu.2404905] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Female
- Humans
- Japan
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Male
- Middle Aged
- Retrospective Studies
- Translocation, Genetic
- Treatment Outcome
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Abstract
The self-assembly of ethanethiol (C(2)) and 1-octanethiol (C(8)) on Ag-Au(111) alloy films was studied by X-ray photoelectron spectroscopy (XPS), cyclic voltammetry (CV), and scanning tunneling microscopy (STM), to illuminate how the monolayer structures and chemisorption-induced substrate defect structures depend on the alloy composition. The thiolate packing density at saturation increased approximately linearly with increasing Ag ratio. The CV data for reductive desorption of thiolates evidenced predominant or major contributions of Ag atoms to the substrate-sulfur interactions for the alloy surfaces. The STM study supported the lack of elemental periodicity on Ag-Au(111) and the consequent absence of periodicity in substrate-sulfur bonding. For C(8)-covered films, we observed systematic changes of substrate defect structures from elevated monatomic islands on Ag(111) to vacancy island structure on Au(111), in good correlation with the reductive desorption characteristics. The former type of defects can be explained best in terms of breakup of atomic terraces under excess thiolate packing density for Ag(111) and Ag-rich Ag-Au(111). As for the vacancy island formation, the present results are not agreeable with the chemical etching model but compatible with the lattice relaxation model.
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Affiliation(s)
- Mitsuo Kawasaki
- Department of Molecular Engineering, Graduate School of Engineering, Kyoto University, Katsura, Kyoto 615-8510, Japan.
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Hamada Y, Kondoh T, Holmlund AB, Iino M, Kobayashi K, Seto K. Influence of arthroscopically observed fibrous adhesions before and after joint irrigation on clinical outcome in patients with chronic closed lock of the temporomandibular joint. Int J Oral Maxillofac Surg 2005; 34:727-32. [PMID: 15982854 DOI: 10.1016/j.ijom.2005.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 01/06/2004] [Revised: 11/01/2004] [Accepted: 02/07/2005] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the changes in the state of arthroscopically observed fibrous adhesions (FA) after visually guided irrigation (VGIR) and the influence of FA on clinical outcome in patients with chronic closed lock of the temporomandibular joint (TMJ). Forty-eight TMJs of 48 patients with unilateral chronic closed lock were enrolled in this study. All 48 joints underwent VGIR twice. After the first VGIR (immediately before the second VGIR), clinical outcome was assessed as regards maximal interincisal opening (MIO) and self-evaluated TMJ pain (VAS). Thirty patients were symptom-free (good outcome group) and the remaining 18 patients had symptoms (poor outcome group). In each group, the changes of the MIO, VAS and severity of FA (FA score) after the first VGIR were studied. The influence of FA score in the first and second VGIR on clinical outcome was analyzed by logistic regression analysis. There was no joint with disappearance or reduction of FA after the first VGIR. In both groups, MIO and VAS were significantly improved after the first VGIR even though the state of FA became significantly worse. The multivariate logistic regression analysis showed that the risk of poor outcome for FA scores in the first and second VGIR were 0.89-times (95% CI: 0.33-2.40, P=0.82) and 1.76-times (95% CI: 0.54-5.73, P=0.35), respectively. The dose-response relationships between FA scores in the first or second VGIR were not significant. In conclusion, our results indicate that the presence of FA or a postoperative worsening of FA (including postoperative new FA formation) seems not to affect the clinical outcome as regards MIO and VAS in patients with chronic closed lock of the TMJ.
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Affiliation(s)
- Y Hamada
- First Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama 230-8501, Japan.
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Seki H, Fukuda M, Iino M, Takahashi T, Yoshioka N. Immunohistochemical localization of cyclooxygenase-1 and -2 in synovial tissues from patients with internal derangement or osteoarthritis of the temporomandibular joint. Int J Oral Maxillofac Surg 2004; 33:687-92. [PMID: 15337183 DOI: 10.1016/j.ijom.2004.01.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2004] [Indexed: 10/26/2022]
Abstract
This study examined the immunohistochemical expression and localization of cyclooxygenase-1 and -2 (COX-1 and COX-2) in synovial tissues from patients with internal derangement (ID) or osteoarthritis (OA) of the temporomandibular joint (TMJ). Synovial tissues from patients with condylar fractures of the mandible were studied as control. Synovial tissues from 13 TMJs of 10 patients with ID or OA and from 5 TMJs of 4 patients with fractures were examined for COX-1 and COX-2 expression by immunohistochemical staining using two monoclonal antibodies. In addition, whether the COX-2 expression grade correlated with the synovitis score and clinical findings was assessed. COX-2 was expressed in the synovial lining, infiltrating mononuclear cells, fibroblast-like cells, and blood vessels, including CD31-positive endothelial cells, in the synovium of patients with ID or OA. Expression levels of COX-1 in synovial lining cells and endothelial cells were similar in the specimens obtained from the patients with ID or OA and those obtained from the controls. The expression of COX-2 positively correlated with arthroscopic findings of synovitis (p = 0.55, P = 0.023) and with joint pain (p = 0.56, P = 0.021). These results suggest that up-regulation of COX-2 in synovium may play a part in the pathogenesis of synovitis in patients with ID or OA of the TMJ.
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Affiliation(s)
- H Seki
- Division of Dentistry and Oral Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita City, Akita 010-8543, Japan.
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Sivaniah E, Hayashi Y, Iino M, Hashimoto T, Fukunaga K. Observation of Perpendicular Orientation in Symmetric Diblock Copolymer Thin Films on Rough Substrates. Macromolecules 2003. [DOI: 10.1021/ma021625f] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. Sivaniah
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto 606-8501, Japan
| | - Y. Hayashi
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto 606-8501, Japan
| | - M. Iino
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto 606-8501, Japan
| | - T. Hashimoto
- Department of Polymer Chemistry, Graduate School of Engineering, Kyoto University, Kyoto 606-8501, Japan
| | - K. Fukunaga
- UBE Industries, Ltd., 8-1 Goi-minamikaigan, Ichihara, Chiba 290-0045, Japan
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Ozaki S, Narita M, Narita M, Iino M, Miyoshi K, Suzuki T. Suppression of the morphine-induced rewarding effect and G-protein activation in the lower midbrain following nerve injury in the mouse: involvement of G-protein-coupled receptor kinase 2. Neuroscience 2003; 116:89-97. [PMID: 12535942 DOI: 10.1016/s0306-4522(02)00699-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The present study was designed to investigate whether a state of neuropathic pain induced by sciatic nerve ligation could alter the rewarding effect, antinociception, and G-protein activation induced by a prototype of mu-opioid receptor agonist morphine in the mouse. The sciatic nerve ligation caused a long-lasting and profound thermal hyperalgesia. Under this neuropathic pain-like state, an i.c.v. morphine-induced place preference was observed in sham-operated mice but not in sciatic nerve-ligated mice. However, no differences in the antinociceptive effect of i.c.v.-administered morphine were noted between the groups. The increases in the binding of guanosine-5'-o-(3-[(35)S]thio)triphosphate induced by morphine in lower midbrain membranes including the ventral tegmental area, which contributes to the expression of the rewarding effect of opioid, were significantly attenuated in sciatic nerve-ligated mice. On the other hand, there were no differences in the stimulation of guanosine-5'-o-(3-[(35)S]thio)triphosphate binding to pons/medulla membranes, which plays an important role in the antinociception of mu-opioid receptor agonists, between the groups. In addition, no changes in levels of guanosine-5'-o-(3-[(35)S]thio)triphosphate binding by either the selective delta- or kappa-opioid receptor agonists were noted in membrane of the lower midbrain and limbic forebrain membranes obtained from sciatic nerve-ligated mice. Reverse transcription-polymerase chain reaction analysis showed that sciatic nerve ligation did not alter the mRNA product of mu-opioid receptors in the lower midbrain, indicating that a decrease in some mu-opioid receptor functions may result from the uncoupling of mu-opioid receptors from G-proteins. We found a significant increase in protein levels of G-protein-coupled receptor kinase 2, which causes receptor phosphorylation in membranes of the lower midbrain but not in the pons/medulla, obtained from mice with nerve injury, whereas there were no changes in the protein level of phosphorylated-protein kinase C in the lower midbrain. These results suggest that the uncoupling of mu-opioid receptors from G-proteins by G-protein-coupled receptor kinase 2 in the lower midbrain may, at least in part, contribute to the suppression of the rewarding effect of morphine under neuropathic pain.
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Affiliation(s)
- S Ozaki
- Department of Toxicology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, Tokyo 142-8501, Japan
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Abstract
We report here on a patient with bilateral cleft lip and palate (BCLP) and a missing premaxilla, who underwent dentoalveolar reconstruction of the cleft and premaxillary alveolus using endosteal implants after bone grafting. The patient, whose maxillary incisors and premaxilla were missing, had corticocancellous bone grafting from the iliac crest, followed by excellent bone formation at the anterior alveolus. After the placement of the endosteal implants and the completion of the pre-surgical orthodontic alignment, orthognathic surgery was performed for the restoration of a Class III open bite. After post-operative orthodontic preparation, the final fixed prostheses were completed. This treatment procedure offers an option of dentoalveolar reconstruction for BCLP patients with an excised premaxilla.
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Affiliation(s)
- M Fukuda
- Division of Dentistry and Oral Surgery, Akita University School of Medicine, Akita, Japan.
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