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Morita K, Karashima S, Terao T, Yoshida K, Yamashita T, Yoroidaka T, Tanabe M, Imi T, Zaimoku Y, Yoshida A, Maruyama H, Iwaki N, Aoki G, Kotani T, Murata R, Miyamoto T, Machida Y, Matsue K, Nambo H, Takamatsu H. 3D CNN-based Deep Learning Model-based Explanatory Prognostication in Patients with Multiple Myeloma using Whole-body MRI. J Med Syst 2024; 48:30. [PMID: 38456950 DOI: 10.1007/s10916-024-02040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024]
Abstract
Although magnetic resonance imaging (MRI) data of patients with multiple myeloma (MM) are used to predict prognosis, few reports have applied artificial intelligence (AI) techniques for this purpose. We aimed to analyze whole-body diffusion-weighted MRI data using three-dimensional (3D) convolutional neural networks (CNNs) and Gradient-weighted Class Activation Mapping (Grad-CAM), an explainable AI, to predict prognosis and explore the factors involved in prediction. We retrospectively analyzed the MRI data of a total of 142 patients with MM obtained from two medical centers. We defined the occurrence of progressive disease after MRI evaluation within 12 months as a poor prognosis and constructed a 3D CNN-based deep learning model to predict prognosis. Images from 111 cases were used as the training and internal validation data; images from 31 cases were used as the external validation data. Internal validation of the AI model with stratified 5-fold cross-validation resulted in a significant difference in progression-free survival (PFS) between good and poor prognostic cases (2-year PFS, 91.2% versus [vs.] 61.1%, P = 0.0002). The AI model clearly stratified good and poor prognostic cases in the external validation cohort (2-year PFS, 92.9% vs. 55.6%, P = 0.004), with an area under the receiver operating characteristic curve of 0.804. According to Grad-CAM, the MRI signals of the spleen and bones of the vertebrae and pelvis contributed to prognosis prediction. This study is the first to show that image analysis of whole-body MRI using a 3D CNN without any other clinical data is effective in predicting the prognosis of patients with MM.
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Affiliation(s)
- Kento Morita
- School of Electrical, Information and Communication Engineering, Kanazawa University, Kakumamachi, Kanazawa, Ishikawa, 920-1192, Japan
| | | | - Toshiki Terao
- Department of Hematology/Oncology, Kameda Medical Center, Kamogawa, Japan
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Kotaro Yoshida
- Department of Radiology, Kanazawa University, Kanazawa, Japan
| | - Takeshi Yamashita
- Division of Internal Medicine, Keiju Kanazawa Hospital, Kanazawa, Japan
| | - Takeshi Yoroidaka
- Department of Hematology, Ishikawa Central Prefectural Hospital, Kanazawa, Japan
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Mikoto Tanabe
- Department of Hematology, Ishikawa Central Prefectural Hospital, Kanazawa, Japan
| | - Tatsuya Imi
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yoshitaka Zaimoku
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Akiyo Yoshida
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Maruyama
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Noriko Iwaki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Go Aoki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Takeharu Kotani
- Department of Hematology, Ishikawa Central Prefectural Hospital, Kanazawa, Japan
| | - Ryoichi Murata
- Division of Internal Medicine, Keiju Kanazawa Hospital, Kanazawa, Japan
| | - Toshihiro Miyamoto
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Youichi Machida
- Department of Radiology, Kameda Medical Center, Kamogawa, Japan
| | - Kosei Matsue
- Department of Hematology/Oncology, Kameda Medical Center, Kamogawa, Japan
| | - Hidetaka Nambo
- Faculty of Transdisciplinary Sciences for Innovation, Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Kakumamachi, Kanazawa, Ishikawa, 920-1192, Japan.
| | - Hiroyuki Takamatsu
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University, Kanazawa, Japan.
- Faculty of Transdisciplinary Sciences for Innovation, Institute of Transdisciplinary Sciences for Innovation, Kanazawa University, Kakumamachi, Kanazawa, Ishikawa, 920-1192, Japan.
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2
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Kaimi Y, Takahashi Y, Taniguchi H, Ochi T, Makino H, Makita S, Iwaki N, Fukuhara S, Munakata W, Ogawa C, Izutsu K, Maeshima AM. Loss of or decrease in CD30 expression in four patients with anaplastic large cell lymphoma after brentuximab vedotin-containing therapy. Virchows Arch 2024; 484:465-473. [PMID: 38349387 DOI: 10.1007/s00428-024-03764-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 04/17/2024]
Abstract
Brentuximab vedotin (BV), CD30 specific antibody drug conjugate, has been used to treat anaplastic large cell lymphoma (ALCL) and classic Hodgkin lymphoma (CHL); it is also used in the treatment of other CD30-positive peripheral T-cell lymphomas. We aimed to investigate the incidence and clinicopathological characteristics of patients with ALCL or CHL with loss of or decrease in CD30 expression after BV-containing therapy. Twelve and nine patients with refractory/relapsed CHL and ALCL, respectively, were analyzed after receiving BV-containing therapy. In four ALCL patients (44%), CD30 expression was lost/decreased in re-biopsy materials, including one with complete loss and three with a reduction of less than 20%. All 12 CHL patients showed consistent CD30 expression levels after BV treatment. Compared with five ALCL patients with consistent CD30 expression, four ALCL patients with a loss of/decrease in CD30 expression received a higher cumulative dose of BV (P = 0.014) and revealed a lower intensity of CD30 expression in initial biopsy materials (P = 0.017). The subtypes of ALCL (ALK positive, ALK negative, and primary cutaneous) were not related to the loss of/decrease in CD30 expression. In conclusion, 44% of ALCL patients, regardless of histological subtypes, showed a loss of/decrease in CD30 expression after receiving BV-containing therapy, but this phenomenon was not observed in CHL patients. A higher cumulative dose of BV and a lower amount of CD30 antigen in tumor cells in the initial biopsy materials might be predictors of a loss of/decrease in CD30 expression in ALCL patients.
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Affiliation(s)
- Yuto Kaimi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Yuka Takahashi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Hirokazu Taniguchi
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
- Department of Pathology and Clinical Laboratory, JR Tokyo General Hospital, 2-1-3 Yoyogi, Shibuya-Ku, Tokyo, 151-8528, Japan
| | - Tetsuro Ochi
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Haruhi Makino
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Shinichi Makita
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Noriko Iwaki
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Akiko Miyagi Maeshima
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
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Takahashi Y, Taniguchi H, Haruhi F, Hattori D, Sasaki H, Makita S, Iwaki N, Fukuhara S, Munakata W, Saito Y, Izutsu K, Maeshima AM. Pathogenesis of Gastrointestinal Follicular Lymphomas: Consideration Based on Histopathology and Endoscopic Findings. Am J Surg Pathol 2023; 47:1134-1143. [PMID: 37493666 DOI: 10.1097/pas.0000000000002095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Gastrointestinal (GI) follicular lymphoma (FL) is the most frequently diagnosed extranodal FL; however, its pathogenesis is debatable. We investigated the distribution, endoscopic, and histopathologic findings of 366 GI FL samples obtained from 298 patients. FLs were most frequently observed in the small intestine (71%), including the duodenum (52%), but were also commonly found in the stomach (15%) and colon (12%). The proportion of granular lesions in the duodenum, terminal ileum, colon, and stomach was 74%, 39%, 24%, and 0%, respectively. Submucosal or ulcerated tumors were frequently observed in the stomach (48%) and colon (52%). Most GI FL showed grade 1 to 2 histology (89%) as well as CD10 + (93%) and BCL2 + (98%) positivity. There were no significant differences in the endoscopic or histologic findings between primary and secondary GI FLs. As known, the mucosa of the small intestine is thin and villous, while the mucosa of the stomach and colon is thicker and has a smooth surface. Granular lesions corresponding to very small FL were detected in the former but rarely in the latter. Nine (7%) patients with primary GI FL developed histologic transformation to diffuse large B-cell lymphoma (n=8) or high-grade B-cell lymphoma (n=1) 10 months to 14 years after the diagnosis of FL. Two patients died of lymphoma. In conclusion, the incidence and endoscopic findings differed, but the histopathology was similar in FLs in each site. These differences might be attributed to variations in each GI site's mucosal structure and the neoplastic follicles' size. Due to its characteristic structure, very small classic FLs might be detectable mainly in the small intestine.
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Affiliation(s)
| | - Hirokazu Taniguchi
- Departments of Diagnostic Pathology
- Pathology and Clinical Laboratory, JR Tokyo General Hospital
| | | | | | | | | | | | | | | | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
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Miyazaki K, Sakai R, Iwaki N, Yamamoto G, Murayama K, Nishikori M, Sunami K, Yoshida I, Yano H, Takahashi N, Okamoto A, Munemoto S, Sawazaki A, Suehiro Y, Fukuhara N, Wake A, Arai A, Masaki Y, Toyama K, Yokoyama A, Tsunemine H, Hasegawa Y, Matsumoto K, Yamada T, Nishimura Y, Tamaru S, Asano N, Miyawaki K, Izutsu K, Kinoshita T, Suzuki R, Ohshima K, Kato K, Katayama N, Yamaguchi M. Five-year follow-up of a phase II study of DA-EPOCH-R with high-dose MTX in CD5-positive DLBCL. Cancer Sci 2023. [PMID: 36929591 DOI: 10.1111/cas.15784] [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: 12/14/2022] [Revised: 02/16/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Ayako Arai
- St. Marianna University, Kawasaki, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
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5
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Maeshima AM, Taniguchi H, Furukawa H, Hattori D, Sasaki H, Makita S, Iwaki N, Fukuhara S, Munakata W, Izutsu K. Diagnostic clues of BCL2-negative, faint, or controversial follicular lymphomas: a study of 103 cases. Hum Pathol 2023; 135:84-92. [PMID: 36702355 DOI: 10.1016/j.humpath.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/10/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023]
Abstract
BCL2 positivity by immunohistochemistry is helpful for the diagnosis of follicular lymphoma (FL); however, a minority of FL cases are BCL2-negative, and the diagnosis is thus challenging. We retrospectively analyzed the incidence, morphology, immunophenotype, and genetic status of BCL21+ (weakly/focally positive by clone 124), BCL20 (negative), and BCL2controversial FLs compared with BCL22+ (strongly positive) FLs to clarify diagnostic clues. In 1068 FL cases, 103 (10%) with BCL21+ (37 cases, 4%), BCL20 (61 cases, 6%), or BCL2controversial (5 cases, 0.5%) were included in the final analysis. BCL21+ and BCL20 FLs tended to have limited stage disease, nodal disease, and grades 3A/3B histology and showed a higher complete response rate than BCL22+ FLs. Among 103 BCL20, BCL21+, or BCL2controversial FL cases, 34 (33%) had a diffuse area composed of CD20-positive small-to medium-sized lymphoid cells, a feature of low-grade B-cell lymphoma. Interfollicular dense CD20-positive cells and interfollicular clusters of CD10-positive cells were observed in 59% and 37% of cases, respectively. In remaining 13/40 cases (33%), BCL2 was converted to BCL22+ by other clones E17/SP66. CD23 and MUM1 were positive in 10/40 (25%) and 1/40 (3%) cases, respectively. IGH/BCL2 fusion and clonality were detected in 6/37 (16%) and 31/34 (91%) cases, respectively. In conclusion, morphological examination of the distribution of CD20-and/or CD10-positive cells and the presence of diffuse area could be used to diagnose FL in most cases. The majority of the remaining FL cases could be diagnosed using other BCL2 clones and clonality analyses.
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Affiliation(s)
| | - Hirokazu Taniguchi
- Department of Diagnostic Pathology, Tokyo 104-0045, Japan; Department of Pathology and Clinical Laboratory, JR Tokyo General Hospital, Tokyo 151-8528, Japan
| | - Haruhi Furukawa
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Daiki Hattori
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Hirokazu Sasaki
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Shinichi Makita
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Noriko Iwaki
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Suguru Fukuhara
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Tokyo 104-0045, Japan
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6
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Liu W, Cai Q, Yu T, Strati P, Hagemeister FB, Zhai Q, Zhang M, Li L, Fang X, Li J, Sun R, Zhang S, Yang H, Wang Z, Qian W, Iwaki N, Sato Y, Oksenhendler E, Xu-Monette ZY, Young KH, Yu L. Clinical characteristics and outcomes of Castleman disease: a multicenter Consortium study of 428 patients with 15-year follow-up. Am J Cancer Res 2022; 12:4227-4240. [PMID: 36225639 PMCID: PMC9548017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/30/2022] [Indexed: 06/16/2023] Open
Abstract
Castleman disease (CD) has been reported as a group of poorly understood lymphoproliferative disorders, including unicentric CD (UCD) and idiopathic multicentric CD (iMCD) which are human immunodeficiency virus (HIV) negative and human herpes virus 8 (HHV-8) negative. The clinical and independent prognostic factors of CD remain poorly elucidated. We retrospectively collected the clinical information of 428 patients with HIV and HHV-8 negative CD from 12 large medical centers with 15-year follow-up. We analyzed the clinicopathologic features of 428 patients (248 with UCD and 180 with iMCD) with a median age of 41 years. The histology subtypes were hyaline-vascular (HV) histopathology for 215 patients (56.58%) and plasmacytic (PC) histopathology for 165 patients (43.42%). Most patients with UCD underwent surgical excision, whereas the treatment strategies of patients with iMCD were heterogeneous. The outcome for patients with UCD was better than that for patients with iMCD, 5-year overall survival (OS) rates were 95% and 74%, respectively. In further analysis, a multivariate analysis using a Cox regression model revealed that PC subtype, hepatomegaly and/or splenomegaly, hemoglobin ≤ 80 g/L, and albumin ≤ 30 g/L were independent prognostic factors of CD for OS. The model of iMCD revealed that age > 60 years, hepatomegaly and/or splenomegaly, and hemoglobin ≤ 80 g/L were independent risk factors. In UCD, single-factor analysis identified two significant risk factors: hemoglobin ≤ 100 g/L and albumin ≤ 30 g/L. Our study emphasizes the distinction of clinical characteristics between UCD and iMCD. The importance of poor risk factors of different clinical classifications may direct more precise and appropriate treatment strategies.
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Affiliation(s)
- Wanying Liu
- Department of Hematology and Oncology, The Second Affiliated Hospital of NanChang UniversityNanChang, China
| | - Qingqing Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer CenterGuangzhou, China
| | - Tiantian Yu
- Department of Hematology and Oncology, The Second Affiliated Hospital of NanChang UniversityNanChang, China
| | - Paolo Strati
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
| | - Frederick B Hagemeister
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
| | - Qiongli Zhai
- Department of Pathology, Tianjin Medical University Cancer Institute and HospitalTianjin, China
| | - Mingzhi Zhang
- Department of Medical Oncology, Zhengzhou University Cancer CenterZhengzhou, China
| | - Ling Li
- Department of Medical Oncology, Zhengzhou University Cancer CenterZhengzhou, China
| | - Xiaosheng Fang
- Department of Hematology and Oncology, Shandong Cancer HospitalShandong, China
| | - Jianyong Li
- Department of Hematology and Oncology, Jiangsu Province Hospital, Nanjing UniversityNanjing, China
| | - Ruifang Sun
- Department of Pathology, Shanxi Cancer HospitalShanxi, China
| | - Shanxiang Zhang
- Department of Pathology, Indiana University School of MedicineIndianapolis, IN, USA
| | - Hanjin Yang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
| | - Zhaoming Wang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
| | - Wenbian Qian
- Department of Hematology and Oncology, The Second Affiliated Hospital, Zhejiang University School of MedicineHangzhou, China
| | - Noriko Iwaki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa UniversityKanazawa, Japan
| | - Yasuharu Sato
- Division of Pathophysiology, Okayama University Graduate School of Health SciencesOkayama, Japan
| | - Eric Oksenhendler
- Département d’Immunologie Clinique, Hôpital Saint-LouisParis, France
| | - Zijun Y Xu-Monette
- Division of Hematopathology and Department of Pathology, Duke University Medical CenterDurham, NC, USA
| | - Ken H Young
- Division of Hematopathology and Department of Pathology, Duke University Medical CenterDurham, NC, USA
- Duke University Cancer CenterDurham, NC, USA
| | - Li Yu
- Department of Hematology and Oncology, The Second Affiliated Hospital of NanChang UniversityNanChang, China
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Arita K, Murakami J, Iwaki N, Hosono N, Tasaki T, Tsujikawa T, Okazawa H, Imi T, Nannya Y, Ogawa S, Nakao S. An eltrombopag-induced remission of bone-marrow aplasia accompanied by marked leukoerythroblastosis and splenomegaly. Br J Haematol 2022; 198:e75-e77. [PMID: 35765195 DOI: 10.1111/bjh.18342] [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: 04/11/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kotaro Arita
- Department of Gastroenterology and Hematology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Kotaro Arita, Department of Hematology and Immunology, School of Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Jun Murakami
- Department of Gastroenterology and Hematology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.,Division of Transfusion Medicine and Cell Therapy, Toyama University Hospital, Toyama, Japan
| | - Noriko Iwaki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.,Noriko Iwaki, Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Hosono
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Toshiki Tasaki
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Tatsuya Imi
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shinji Nakao
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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Sekiguchi N, Rai S, Munakata W, Suzuki K, Handa H, Shibayama H, Endo T, Terui Y, Iwaki N, Fukuhara N, Tatetsu H, Iida S, Ishikawa T, Iguchi D, Izutsu K. Two-year outcomes of tirabrutinib monotherapy in Waldenström's macroglobulinemia. Cancer Sci 2022; 113:2085-2096. [PMID: 35332633 PMCID: PMC9207369 DOI: 10.1111/cas.15344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/03/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022] Open
Abstract
The phase II study of tirabrutinib monotherapy at a daily dose of 480 mg under fasted conditions for treatment-naïve and relapsed/refractory Waldenström's macroglobulinemia (ONO-4059-05 study) demonstrated a promising efficacy and tolerable safety profile. We conducted an unplanned analysis with a median follow-up of 24.8 months to update the efficacy and safety results and to report patient-reported quality of life. Of 27 enrolled patients, 22 patients continued receiving the study drug. The major response assessed by an independent review committee was observed in 25 patients (93%), including 1 and 5 patients who newly achieved complete response and very good partial response, respectively, after the primary analysis. The progression-free and overall survival rates at 24 months were 92.6% and 100%, respectively. Serum IgM levels in all patients except one declined and were maintained at low levels although transient increases occurred after temporal interruption of the study drug. The disease-related symptoms including recurrent fever and hyperviscosity mostly disappeared. Health-related quality of life, assessed by cancer-specific questionnaires, was mostly maintained. Grade 3-4 neutropenia, lymphopenia, and leukopenia were newly recognized in three, two, and one patient, respectively. Grade 3 treatment-related hypertriglyceridemia was also recognized. Nine patients experienced grade 1-2 bleeding events (33%), one patient experienced grade 2 treatment-related atrial fibrillation, and one patient experienced grade 1 treatment-related hypertension. Treatment-related skin adverse events were observed in 14 patients (52%). Taken together, tirabrutinib has durable efficacy with an acceptable safety profile for treatment-naïve and refractory/relapsed Waldenström's macroglobulinemia.
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Affiliation(s)
- Naohiro Sekiguchi
- Department of Hematology, National Hospital Organization Disaster Medical Center, Tachikawa, Japan
| | - Shinya Rai
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Wataru Munakata
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomoyuki Endo
- Department of Hematology, Hokkaido University Hospital, Sapporo, Japan
| | - Yasuhito Terui
- Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.,Department of Hematology, Saitama Medical University Hospital, Saitama, Japan
| | - Noriko Iwaki
- Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiro Tatetsu
- Department of Hematology, Rheumatology and Infectious disease, Kumamoto University Hospital, Kumamoto, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Daisuke Iguchi
- Department of Clinical Development, Ono Pharma USA, Inc., MA, USA
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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Maeshima AM, Taniguchi H, Hattori D, Sasaki H, Hori Y, Makita S, Iwaki N, Fukuhara S, Munakata W, Suzuki T, Izutsu K. CD3-and CD20-negative extramedullary non-Hodgkin leukemia/lymphoma: A histopathological study of 118 cases. Hum Pathol 2022; 124:14-23. [DOI: 10.1016/j.humpath.2022.03.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/27/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
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10
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Gion Y, Doi M, Nishimura Y, Ikeda T, Filiz Nishimura M, Sakamoto M, Egusa Y, Nishikori A, Fujita A, Iwaki N, Nakamura N, Yoshino T, Sato Y. PD-L1 expression is associated with the spontaneous regression of patients with methotrexate-associated lymphoproliferative disorders. Cancer Med 2021; 11:417-432. [PMID: 34842351 PMCID: PMC8729050 DOI: 10.1002/cam4.4462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/31/2021] [Accepted: 11/10/2021] [Indexed: 11/09/2022] Open
Abstract
Background Most patients with methotrexate‐associated lymphoproliferative disorder (MTX‐LPD) show diffuse large B‐cell lymphoma (DLBCL) or classic Hodgkin lymphoma (CHL) types. Patients with MTX‐LPD often have spontaneous remission after MTX discontinuation, but chemotherapeutic intervention is frequently required in patients with CHL‐type MTX‐LPD. In this study, we examined whether programmed cell death‐ligand 1 (PD‐L1) expression levels were associated with the prognosis of MTX‐LPD after MTX discontinuation. Methods A total of 72 Japanese patients diagnosed with MTX‐LPD were clinicopathologically analyzed, and immunohistochemical staining of PD‐L1 was performed in 20 DLBCL‐type and 24 CHL‐type MTX‐LPD cases to compare with the clinical course. Results PD‐L1 was expressed in 5.0% (1/20) of patients with DLBCL‐type MTX‐LPD, whereas it was expressed in 66.7% (16/24) of the patients with CHL‐type MTX‐LPD in more than 51% of tumor cells. Most CHL‐type MTX‐LPD patients with high PD‐L1 expression required chemotherapy owing to exacerbations or relapses after MTX discontinuation. However, no significant differences in clinicopathologic findings at diagnosis were observed between PD‐L1 high‐ and low‐expression CHL‐type MTX‐LPD. Conclusion PD‐L1 expression was significantly higher in patients with CHL‐type than DLBCL‐type MTX‐LPD, suggesting the need for chemotherapy in addition to MTX discontinuation in CHL‐type MTX‐LPD patients to achieve complete remission. No association was observed between PD‐L1 expression levels and clinical findings at diagnosis, suggesting that PD‐L1 expression in tumor cells influences the pathogenesis of CHL‐type MTX‐LPD after MTX discontinuation.
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Affiliation(s)
- Yuka Gion
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Misato Doi
- Division of Clinical Laboratory, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Yoshito Nishimura
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA
| | - Tomoka Ikeda
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Midori Filiz Nishimura
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Misa Sakamoto
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Yuria Egusa
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Asami Nishikori
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Azusa Fujita
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Noriko Iwaki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Sato
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan.,Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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11
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Nishimura Y, Fajgenbaum DC, Pierson SK, Iwaki N, Nishikori A, Kawano M, Nakamura N, Izutsu K, Takeuchi K, Nishimura MF, Maeda Y, Otsuka F, Yoshizaki K, Oksenhendler E, Rhee F, Sato Y. Validated international definition of the thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly clinical subtype (TAFRO) of idiopathic multicentric Castleman disease. Am J Hematol 2021; 96:1241-1252. [PMID: 34265103 DOI: 10.1002/ajh.26292] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/03/2021] [Accepted: 07/10/2021] [Indexed: 12/11/2022]
Abstract
Thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly (TAFRO) syndrome is a heterogeneous entity manifesting with a constellation of symptoms described above that can occur in the context of idiopathic multicentric Castleman disease (iMCD) as well as infectious diseases, malignancies, and rheumatologic disorders. So, iMCD-TAFRO is an aggressive subtype of iMCD with TAFRO syndrome and often hyper-vascularized lymph nodes. Since we proposed diagnostic criteria of iMCD-TAFRO in 2016, we have accumulated new insights on the disorder and additional cases have been reported worldwide. In this systematic review and cohort analysis, we established and validated a definition for iMCD-TAFRO. First, we searched PubMed and Japan Medical Abstracts Society databases using the keyword "TAFRO" to extract cases. Patients with possible systemic autoimmune diseases and hematologic malignancies were excluded. Our search identified 54 cases from 50 articles. We classified cases into three categories: (1) iMCD-TAFRO (TAFRO syndrome with lymph node histopathology consistent with iMCD), (2) possible iMCD-TAFRO (TAFRO syndrome with no lymph node biopsy performed and no other co-morbidities), and (3) TAFRO without iMCD or other co-morbidities (TAFRO syndrome with lymph node histopathology not consistent with iMCD or other comorbidities). Based on the findings, we propose an international definition requiring four clinical criteria (thrombocytopenia, anasarca, fever/hyperinflammatory status, organomegaly), renal dysfunction or characteristic bone marrow findings, and lymph node features consistent with iMCD. The definition was validated with an external cohort (the ACCELERATE Natural History Registry). The present international definition will facilitate a more precise and comprehensive approach to the diagnosis of iMCD-TAFRO.
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Affiliation(s)
- Yoshito Nishimura
- Department of General Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
- Department of Medicine John A. Burns School of Medicine, University of Hawai'i Honolulu Hawaii USA
| | - David C. Fajgenbaum
- Center for Cytokine Storm Treatment & Laboratory, Division of Translational Medicine and Human Genetics Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Sheila K. Pierson
- Center for Cytokine Storm Treatment & Laboratory, Division of Translational Medicine and Human Genetics Perelman School of Medicine, University of Pennsylvania Philadelphia Pennsylvania USA
| | - Noriko Iwaki
- Hematology/Respiratory Medicine Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | - Asami Nishikori
- Division of Pathophysiology Okayama University Graduate School of Health Sciences Okayama Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | - Naoya Nakamura
- Department of Pathology Tokai University School of Medicine Isehara Japan
| | - Koji Izutsu
- Department of Hematology National Cancer Center Hospital Tokyo Japan
| | - Kengo Takeuchi
- Department of Pathology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan
- Division of Pathology Cancer Institute, Japanese Foundation for Cancer Research Tokyo Japan
- Pathology Project for Molecular Targets Cancer Institute, Japanese Foundation for Cancer Research Tokyo Japan
| | - Midori Filiz Nishimura
- Department of Pathology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Yoshinobu Maeda
- Department of Hematology Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Fumio Otsuka
- Department of General Medicine Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama Japan
| | - Kazuyuki Yoshizaki
- Department of Organic Fine Chemicals Institute of Scientific and Industrial Research, Osaka University Osaka Japan
| | - Eric Oksenhendler
- Department of Clinical Immunology Hôpital Saint‐Louis Paris France
- Université de Paris Paris France
| | - Frits Rhee
- Myeloma Center University of Arkansas for Medical Sciences Little Rock Arkansas USA
| | - Yasuharu Sato
- Division of Pathophysiology Okayama University Graduate School of Health Sciences Okayama Japan
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12
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Miyazaki K, Sakai R, Iwaki N, Yamamoto G, Yamada T, Nishimura Y, Tamaru S, Asano N, Miyawaki K, Izutsu K, Kinoshita T, Suzuki R, Ohshima K, Kato K, Katayama N, Yamaguchi M. Long-term follow-up results of a phase II study of dose-adjusted (DA)-EPOCH-R with high-dose methotrexate (HD-MTX) for newly diagnosed stage II-IV CD5-positive diffuse large B-cell lymphoma (CD5+ DLBCL). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7551 Background: CD5+ DLBCL is characterized by a poor prognosis and frequent central nervous system (CNS) relapse after standard immunochemotherapy. In the primary analysis of our multicenter phase II study of DA-EPOCH-R/HD-MTX for newly diagnosed stage II-IV CD5+ DLBCL, the 2-year (yr) progression-free survival (PFS) was 79% and the 2-yr CNS relapse rate was 9% at a median follow-up of 3.1 yrs (Miyazaki, et al. 2020). The aim of this preplanned 5-yr follow-up was to assess PFS, overall survival (OS), the CNS relapse rate, and late toxicity. Methods: A total of 47 patients (pts) with newly diagnosed stage II-IV CD5+ DLBCL between 20-75 yrs old and ECOG PS of 0-3 were enrolled. The treatment included 4 cycles of DA-EPOCH-R followed by 2 cycles of HD-MTX (3.5 g/m2) and 4 additional cycles of DA-EPOCH-R. Intrathecal administration of MTX and/or cytarabine was not allowed. 45 (96%) pts completed the protocol treatment. The data were updated as of December 1, 2020. Results: The median follow-up of alive pts was 6.0 yrs (range, 5.0-7.7). The pts’ characteristics were as follows: age, 37-74 yrs (median, 62); male, 38%; ECOG PS > 1, 4%; stage III/IV, 57%; IPI HI/H, 47%; CNS-IPI high, 21%; and ABC/GCB/unclassified (n = 46), 85%/9%/7%. The 5-yr PFS and OS were 72% (95% CI, 57-83%) and 79% (95% CI, 64-88%), respectively. The 5-yr PFS and OS of pts with CD5+ ABC DLBCL (n = 39) were 72% and 74%, respectively. The 5-yr CNS relapse rate in all 47 pts was 9% (95% CI, 3-22%). There were no CNS relapse events after the primary analysis. Neither grade 3/4 late adverse events nor cardiac events of any grade were observed. Possible second malignancies were recorded in 6 (13%) pts. Among them, one pt who received R-ICE as salvage therapy experienced acute myeloid leukemia. The other 2 pts had colon cancers treated with endoscopic polypectomy/mucosal resection. Conclusions: Both the survival benefit and safety of DA-EPOCH-R/HD-MTX were maintained during a 5-yr follow-up, indicating the excellent efficacy, and safety of this approach as a first-line therapy for CD5+ DLBCL. Clinical trial information: UMIN000008507.
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Affiliation(s)
- Kana Miyazaki
- Mie University Graduate School of Medicine, Tsu, Japan
| | | | | | | | | | | | | | - Naoko Asano
- Nagano Prefectural Sinshu Medical Center, Suzaka, Japan
| | - Kohta Miyawaki
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koji Izutsu
- National Cancer Center Hospital, Tokyo, Japan
| | | | | | | | - Koji Kato
- Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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13
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Ohtsubo K, Yamashita K, Yanagimura N, Suzuki C, Tanimoto A, Nishiyama A, Takeuchi S, Iwaki N, Kawano M, Izumozaki A, Inoue D, Gabata T, Ikeda H, Watanabe M, Yano S. Multiple Malignant Lymphomas of the Bile Duct Developing after Spontaneous Regression of an Autoimmune Pancreatitis-like Mass. Intern Med 2021; 60:409-415. [PMID: 32863365 PMCID: PMC7925286 DOI: 10.2169/internalmedicine.5429-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We herein report a 67-year-old woman with malignant lymphomas of the bile duct that developed after regression of a pancreatic head mass. Computed tomography suggested the mass was pancreatic head cancer. Endoscopic ultrasonography showed a low-echoic mass with hyperechoic strands resembling autoimmune pancreatitis. Her serum IgG4 concentration was elevated to 674 mg/dL. After the pancreatic head mass spontaneously diminished, three masses were detected in the common bile duct. A biopsy of the major papilla revealed high-grade B-cell lymphoma with MYC, BCL2 and/or BCL6 rearrangement. Systemic chemotherapy with rituximab plus etoposide, prednisolone, vincristine, cyclophosphamide and doxorubicin resulted in complete remission.
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Affiliation(s)
- Koushiro Ohtsubo
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Kaname Yamashita
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Naohiro Yanagimura
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Chiaki Suzuki
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Azusa Tanimoto
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Akihiro Nishiyama
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Shinji Takeuchi
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
| | - Noriko Iwaki
- Department of Hematology, Kanazawa University, Japan
| | | | | | - Dai Inoue
- Department of Radiology, Kanazawa University, Japan
| | | | - Hiroko Ikeda
- Division of Human Pathology, Kanazawa University, Japan
| | | | - Seiji Yano
- Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Japan
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14
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Yu L, Shi M, Cai Q, Strati P, Hagemeister F, Zhai Q, Li L, Fang X, Li J, Sun R, Zhang S, Yang H, Wang Z, Qian W, Iwaki N, Sato Y, Zhang L, Li J, Oksenhendler E, Xu-Monette ZY, Young KH. A Novel Predictive Model for Idiopathic Multicentric Castleman Disease: The International Castleman Disease Consortium Study. Oncologist 2020; 25:963-973. [PMID: 32852137 DOI: 10.1634/theoncologist.2019-0986] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/21/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients with multicentric Castleman disease (MCD) who are negative for human immunodeficiency virus and human herpesvirus 8 are considered to have idiopathic MCD (iMCD). The clinical presentation of iMCD varies from mild constitutional symptoms to life-threatening symptoms or death. The treatment strategy varies from "watchful waiting" to high-dose chemotherapy. This diverse clinical presentation calls for a classification stratification system that takes into account the severity of the disease. SUBJECTS, MATERIALS, AND METHODS We analyzed the clinical, laboratory, and pathologic abnormalities and treatment outcomes of 176 patients with iMCD (median follow-up duration 12 years) from the U.S. and China to better understand the characteristics and prognostic factors of this disease. This discovery set of iMCD results was confirmed from the validation set composed of additional 197 patients with iMCD organized from The International Castleman Disease Consortium. RESULTS Using these data, we proposed and validated the iMCD international prognostic index (iMCD-IPI), which includes parameters related to patient characteristics (age > 40 years), histopathologic features (plasma cell variant), and inflammatory consequences of iMCD (hepatomegaly and/or splenomegaly, hemoglobin <80 g/L, and pleural effusion). These five factors stratified patients according to their performance status and extent of organ dysfunction into three broad categories: low risk, intermediate risk, and high risk. The iMCD-IPI score accurately predicted outcomes in the discovery study cohort, and the results were confirmed on the validation study cohort. CONCLUSION This study represents the largest series of studies on patients with iMCD in the field and proposed a novel risk-stratification model for iMCD-IPI that could be used to guide risk-stratified treatment strategies in patients with iMCD. IMPLICATIONS FOR PRACTICE Patients with idiopathic multicentric Castleman disease (iMCD) can benefit from care based on clinical symptoms and disease severity. This study in 176 patients with iMCD constructed an iMCD-IPI score based on five clinical factors, including age >40 years, plasmacytic variant subtype, hepatomegaly and/or splenomegaly, hemoglobin <80 g/L, and pleural effusion, and stratified patients into three risk categories: low risk, intermediate risk, and high risk. The predictive value was validated in an independent set of 197 patients with iMCD from The International Castleman Disease Consortium. The proposed novel model is valuable for predicting clinical outcome and selecting optimal therapies using clinical parameters.
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Affiliation(s)
- Li Yu
- Department of Hematology and Oncology, The Second Affiliated Hospital of NanChang University, NanChang, People's Republic of China
- Division of Hematopathology and Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Menghan Shi
- Department of Hematology and Oncology, The Second Affiliated Hospital of NanChang University, NanChang, People's Republic of China
| | - Qingqing Cai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Paolo Strati
- Departments of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Fredrick Hagemeister
- Departments of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qiongli Zhai
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China
| | - Ling Li
- Department of Medical Oncology, Zhengzhou University Cancer Center, Zhengzhou, People's Republic of China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ji'nan, Shandong, People's Republic of China
| | - Jianyong Li
- Department of Hematology and Oncology, Jiangsu Province Hospital, Nanjing University, Nanjing, People's Republic of China
| | - Ruifang Sun
- Department of Pathology, Shanxi Cancer Hospital, Taiyuan, Shanxi, People's Republic of China
| | - Shanxiang Zhang
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Hanjin Yang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Zhaoming Wang
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Wenbin Qian
- Department of Hematology and Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Noriko Iwaki
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Yasuharu Sato
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Lu Zhang
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Eric Oksenhendler
- Département d'Immunologie Clinique, Hôpital Saint-Louis, Paris, France
| | - Zijun Y Xu-Monette
- Division of Hematopathology and Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
| | - Ken H Young
- Division of Hematopathology and Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Durham, North Carolina, USA
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15
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Sekiguchi N, Rai S, Munakata W, Suzuki K, Handa H, Shibayama H, Endo T, Terui Y, Iwaki N, Fukuhara N, Tatetsu H, Iida S, Ishikawa T, Shiibashi R, Izutsu K. A multicenter, open-label, phase II study of tirabrutinib (ONO/GS-4059) in patients with Waldenström's macroglobulinemia. Cancer Sci 2020; 111:3327-3337. [PMID: 32639651 PMCID: PMC7469793 DOI: 10.1111/cas.14561] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 12/17/2022] Open
Abstract
Tirabrutinib is a second-generation Bruton's tyrosine kinase inhibitor with greater selectivity than ibrutinib. Here, we conducted a multicenter, phase II study of tirabrutinib in patients with treatment-naïve (Cohort A) or with relapsed/refractory (Cohort B) Waldenström's macroglobulinemia (WM). Patients were treated with tirabrutinib 480 mg once daily. The primary endpoint was major response rate (MRR; ≥ partial response). Secondary endpoints included overall response rate (ORR; ≥ minor response), time to major response (TTMR), progression-free survival (PFS), overall survival (OS), and safety. In total, 27 patients (18 in Cohort A; 9 in Cohort B) were enrolled. The median age was 71 y, and the median serum immunoglobulin M level was 3600 mg/dL. Among the patients, 96.2% had the MYD88L265P mutation. MRR and ORR were 88.9% and 96.3%, respectively (Cohort A: MRR, 88.9%; ORR, 94.4%; Cohort B: MRR, 88.9%; ORR, 100%). Median TTMR was 1.87 mo. PFS and OS were not reached with a median follow-up of 6.5 and 8.3 mo for Cohorts A and B, respectively. The most common adverse events (AEs) were rash (44.4%), neutropenia (25.9%), and leukopenia (22.2%), with most AEs classified as grade 1 or 2. Grade ≥ 3 AEs included neutropenia (11.1%), lymphopenia (11.1%), and leukopenia (7.4%). No grade 5 AEs were noted. All bleeding events were grade 1; none were associated with drug-related atrial fibrillation or hypertension. Although the follow-up duration was relatively short, the study met the primary endpoint. Therefore, tirabrutinib monotherapy is considered to be highly effective for both untreated and relapsed/refractory WM with a manageable safety profile. (JapicCTI-173646).
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Affiliation(s)
- Naohiro Sekiguchi
- Department of HematologyNational Hospital Organization Disaster Medical CenterTachikawaJapan
| | - Shinya Rai
- Department of Hematology and RheumatologyFaculty of MedicineKindai UniversityOsakasayamaJapan
| | - Wataru Munakata
- Department of HematologyNational Cancer Center HospitalTokyoJapan
| | - Kenshi Suzuki
- Department of HematologyJapanese Red Cross Medical CenterTokyoJapan
| | - Hiroshi Handa
- Department of HematologyGunma University Graduate School of MedicineMaebashiJapan
| | - Hirohiko Shibayama
- Department of Hematology and OncologyOsaka University Graduate School of MedicineSuitaJapan
| | - Tomoyuki Endo
- Department of HematologyHokkaido University HospitalSapporoJapan
| | - Yasuhito Terui
- Department of Hematology OncologyThe Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan
| | - Noriko Iwaki
- Department of HematologyKanazawa University HospitalKanazawaJapan
| | - Noriko Fukuhara
- Department of Hematology and RheumatologyTohoku University Graduate School of MedicineSendaiJapan
| | - Hiro Tatetsu
- Department of HematologyKumamoto University HospitalKumamotoJapan
| | - Shinsuke Iida
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Takayuki Ishikawa
- Department of HematologyKobe City Medical Center General HospitalKobeJapan
| | - Ryota Shiibashi
- Department of Clinical DevelopmentOno Pharmaceutical Co., LTD.OsakaJapan
| | - Koji Izutsu
- Department of HematologyNational Cancer Center HospitalTokyoJapan
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16
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Iwaki N, Mochizuki K, Ozaki J, Maeda Y, Kurokawa T. A case of hepatosplenic T-cell lymphoma successfully treated by HLA haploidentical stem cell transplantation. J Clin Exp Hematop 2020; 60:55-59. [PMID: 32404572 PMCID: PMC7337272 DOI: 10.3960/jslrt.20003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report a case of hepatosplenic T-cell lymphoma (HSTL) transplanted from an
HLA-haploidentical daughter. A 51-year-old man was referred due to liver function test
abnormalities and fever. He was confirmed to have γδ-type HSTL by bone marrow and liver
biopsies. He was treated with five cycles of a CHOP regimen. Although metabolic complete
response (CR), as defined by positron emission tomography, was achieved, his bone marrow
still contained tumor cells on polymerase chain reaction (PCR). He underwent
transplantation using unmanipulated peripheral blood stem cells from his
HLA-haploidentical daughter. The preconditioning regimen consisted of fludarabine,
melphalan, busulfan and antithymocyte globulin. Graft-versus-host disease (GVHD)
prophylaxis consisted of tacrolimus and short-term methotrexate. Neutrophil engraftment
was achieved on day 14. His bone marrow exhibited a completely female phenotype by
fluorescence in situ hybridization, and no lymphoma cells were detected by
PCR on day 30. Although he developed grade II acute GVHD on day 47, it was successfully
treated by prednisolone. He has a limited type of skin chronic GVHD and still receives
oral immunosuppressive therapy. He remains in CR four years after transplantation.
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Affiliation(s)
- Noriko Iwaki
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
| | - Kanako Mochizuki
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
| | - Jun Ozaki
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
| | - Yoshinobu Maeda
- Division of Diagnostic Pathology, Toyama Red Cross Hospital, Toyama, Japan
| | - Toshiro Kurokawa
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
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17
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Masaki Y, Kawabata H, Fujimoto S, Kawano M, Iwaki N, Kotani T, Nakashima A, Kurose N, Takai K, Suzuki R, Aoki S. Epidemiological analysis of multicentric and unicentric Castleman disease and TAFRO syndrome in Japan. J Clin Exp Hematop 2019; 59:175-178. [PMID: 31708515 PMCID: PMC6954167 DOI: 10.3960/jslrt.19021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Castleman disease is a polyclonal lymphoproliferative disease which is clinically classified into unicentric (UCD) and multicentric (MCD). TAFRO syndrome is a relatively new concept that partly overlaps with MCD. Due to their rarity, their incidence remains unknown. This study investigated the incidence and prevalence of UCD, MCD, and TAFRO syndrome in Japan using a fixed-point observation method based on their incidence in Ishikawa prefecture. The annual incidences of MCD, UCD, and TAFRO syndrome in Japan were 309-731, 71-542, and 110-502, respectively, yielding annual incidence rates per million individuals of 2.4-5.8, 0.6-4.3, and 0.9-4.9, respectively, and nationwide prevalence of 4,180-14,900, 1,350-10,300, and 860-7,240, respectively. In conclusion, MCD, UCD and TAFRO syndrome may not be as rare as previously estimated in Japan.
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18
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Kageyama C, Igawa T, Gion Y, Iwaki N, Tabata T, Tanaka T, Kondo E, Sakai H, Tsuneyama K, Nomoto K, Noguchi H, Yoshino T, Yokota K, Sato Y. Hepatic Campylobacter jejuni infection in patients with Castleman-Kojima disease (idiopathic multicentric Castleman disease with thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome). Pathol Int 2019; 69:572-579. [PMID: 31631463 DOI: 10.1111/pin.12856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/19/2019] [Indexed: 12/28/2022]
Abstract
Castleman-Kojima disease, also known as idiopathic multicentric Castleman disease with TAFRO syndrome (iMCD-TAFRO), is a recently recognized systemic inflammatory disorder with a characteristic series of clinical symptoms, including thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Patients with iMCD-TAFRO often develop severe abdominal pain, elevated alkaline phosphatase levels, and systemic inflammation, but the etiological factors are unknown. To investigate the potential role of bacterial infection in the pathogenesis of iMCD-TAFRO, we performed polymerase chain reaction (PCR) for the bacterial 16S rRNA gene with DNA extracted from liver specimens of three patients with iMCD-TAFRO, four patients with amyotrophic lateral sclerosis, and seven patients with inflammatory conditions. Sequencing of the PCR product showed 99% DNA sequence identity with Campylobacter jejuni in all three patients with iMCD-TAFRO and in two patients with inflammatory conditions. Immunohistochemical and electron microscopy analyses could not identify C. jejuni in patients with iMCD-TAFRO. The findings indicated that C. jejuni infection is not the pathological cause of iMCD-TAFRO; however, this ubiquitous bacterium may play a role in uncontrolled systemic hypercytokinemia, possibly through the development of cross-reactive autoantibodies.
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Affiliation(s)
- Chihiro Kageyama
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Takuro Igawa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yuka Gion
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan.,Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Iwaki
- Department of Hematology, Toyama Red Cross Hospital, Toyama, Japan
| | - Tetsuya Tabata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Eisei Kondo
- Division of Hematology, Kawasaki Medical School, Okayama, Japan
| | - Hajime Sakai
- Department of Hematology, Teine Keijinkai Hospital, Hokkaido, Japan
| | - Koichi Tsuneyama
- Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kazuhiro Nomoto
- Laboratory of Pathology, Kouseiren Takaoka Hospital, Toyama, Japan
| | - Hiroko Noguchi
- Division of Pathology, Hokkaido Cancer Center, Hokkaido, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Kenji Yokota
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Yasuharu Sato
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan.,Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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19
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Fujimoto S, Koga T, Kawakami A, Kawabata H, Okamoto S, Mizuki M, Yano S, Ide M, Uno K, Yagi K, Kojima T, Mizutani M, Tokumine Y, Nishimoto N, Fujiwara H, Nakatsuka SI, Shiozawa K, Iwaki N, Masaki Y, Yoshizaki K. Tentative diagnostic criteria and disease severity classification for Castleman disease: A report of the research group on Castleman disease in Japan. Mod Rheumatol 2017; 28:161-167. [PMID: 28880697 DOI: 10.1080/14397595.2017.1366093] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To determine the tentative diagnostic criteria and disease severity classification for Castleman disease (CD) and describe the clinical and pathologic features among human herpesvirus 8 (HHV-8) negative idiopathic multicentric CD (iMCD) in the Japanese population. METHODS We established the working groups for the research of CD in Japan and had meetings to discuss and define the tentative diagnostic criteria and disease severity classification for CD. We subsequently analyzed 142 patients classified into iMCD by using the nationwide Japanese patient registry. RESULTS We proposed the preliminary diagnostic criteria and disease severity classification for CD based on our discussion. In addition, we made a proposal for the disease activity score. We identified clinical and pathological features of patients with iMCD diagnosed by these diagnostic criteria. In the disease severity classification, 37, 33 and 30% patients were categorized into mild, moderate and severe diseases, respectively. CONCLUSION This is the first proposal for diagnosis and classification of CD by the Japanese group. Further studies are required to validate whether they can distinguish CD from other inflammatory diseases and to determine their sensitivity and specificity.
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Affiliation(s)
- Shino Fujimoto
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Tomohiro Koga
- b Unit of Advanced Preventive Medical Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,c Center for Bioinformatics and Molecular Medicine , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Atsushi Kawakami
- b Unit of Advanced Preventive Medical Sciences , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Hiroshi Kawabata
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Shinichiro Okamoto
- d Division of Hematology, Department of Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Masao Mizuki
- e Chemotherapy and Oncology Center , Osaka University Hospital , Osaka , Japan
| | - Shingo Yano
- f Division of Clinical Oncology and Hematology, Department of Internal Medicine , Jikei University School of Medicine , Tokyo , Japan
| | - Makoto Ide
- g Department of Hematology , Takamatsu Red Cross Hospital , Japan
| | - Kazuko Uno
- h Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Katsumi Yagi
- h Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Toshiyuki Kojima
- i Department of Emergency , Japanese Red Cross Nagoya Daiichi Hospital , Nagoya , Japan
| | - Minoru Mizutani
- j Department of Hematology , JA Mie Kouseiren Matsusaka Central General Hospital , Matsusaka , Japan
| | | | | | - Hiroshi Fujiwara
- m Department of Respiratory Medicine , Yodogawa Christian Hospital , Osaka , Japan
| | - Shin-Ichi Nakatsuka
- n Department of Pathology , Kansai Rosai Hospital , Hyogo , Japan.,o Department of Diagnostic Pathology , Cytology Osaka International Cancer Institute Hospital , Osaka , Japan
| | - Kazuko Shiozawa
- p Rheumatic Diseases Center , Hohnan Kakogawa Hospital , Kakogawa , Japan
| | - Noriko Iwaki
- q Hematology/Respiratory Medicine Kanazawa University Faculty of Medicine , Institute of Medical Pharmaceutical and Health Sciences , Kanazawa , Japan
| | - Yasufumi Masaki
- a Division of Hematology and Immunology, Medicine , Kanazawa Medical University , Ishikawa , Japan
| | - Kazuyuki Yoshizaki
- r Department of Organic Fine Chemicals , The Institute of Scientific and Industrial Research, Osaka University , Osaka , Japan
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20
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Gion Y, Iwaki N, Takata K, Takeuchi M, Nishida K, Orita Y, Tachibana T, Yoshino T, Sato Y. Clinicopathological analysis of methotrexate-associated lymphoproliferative disorders: Comparison of diffuse large B-cell lymphoma and classical Hodgkin lymphoma types. Cancer Sci 2017; 108:1271-1280. [PMID: 28380678 PMCID: PMC5480080 DOI: 10.1111/cas.13249] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 03/10/2017] [Accepted: 03/29/2017] [Indexed: 12/03/2022] Open
Abstract
Patients with rheumatoid arthritis often develop methotrexate‐associated lymphoproliferative disorders (MTX‐LPD) during MTX treatment. MTX‐LPD occasionally regresses spontaneously after simply discontinuing MTX treatment. In patients without spontaneous regression, additional chemotherapy is required to avoid disease progression. However, the differences between spontaneous and non‐spontaneous regression have yet to be elucidated. To clarify the factors important for spontaneous regression, we analyzed the clinicopathological features of 51 patients with rheumatoid arthritis who developed MTX‐LPD (diffuse large B‐cell lymphoma [DLBCL]‐type [n = 34] and classical Hodgkin lymphoma [CHL]‐type [n = 17]). We examined the interval from MTX discontinuation to the administration of additional chemotherapy. The majority of DLBCL‐type MTX‐LPD patients (81%) exhibited remission with MTX discontinuation alone. In contrast, the majority of CHL‐type MTX‐LPD patients (76%) required additional chemotherapy. This difference was statistically significant (P = 0.001). However, overall survival was not significantly different between DLBCL‐type and CHL‐type (91% vs 94%, respectively; P > 0.05). Thus, the morphological differences in the pathological findings of MTX‐LPD may be a factor for spontaneous or non‐spontaneous regression after discontinuation of MTX.
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Affiliation(s)
- Yuka Gion
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Noriko Iwaki
- Department of Cellular Transplantation Biology (Hematology/Oncology and Respiratory Medicine), Division of Cancer Medicine, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mai Takeuchi
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Keiichiro Nishida
- Department of Human Morphology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yorihisa Orita
- Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | | | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.,Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
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21
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Iwaki N, Gion Y, Kondo E, Kawano M, Masunari T, Moro H, Nikkuni K, Takai K, Hagihara M, Hashimoto Y, Yokota K, Okamoto M, Nakao S, Yoshino T, Sato Y. Elevated serum interferon γ-induced protein 10 kDa is associated with TAFRO syndrome. Sci Rep 2017; 7:42316. [PMID: 28205564 PMCID: PMC5304226 DOI: 10.1038/srep42316] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/05/2017] [Indexed: 01/09/2023] Open
Abstract
Multicentric Castleman disease (MCD) is a heterogeneous lymphoproliferative disorder. It is characterized by inflammatory symptoms, and interleukin (IL)-6 contributes to the disease pathogenesis. Human herpesvirus 8 (HHV-8) often drives hypercytokinemia in MCD, although the etiology of HHV-8-negative MCD is idiopathic (iMCD). A distinct subtype of iMCD that shares a constellation of clinical features including thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O) has been reported as TAFRO-iMCD, however the differences in cytokine profiles between TAFRO-iMCD and iMCD have not been established. We retrospectively compared levels of serum interferon γ-induced protein 10 kDa (IP-10), platelet-derived growth factor (PDGF)-AA, interleukin (IL)-10, and other cytokines between 11 cases of TAFRO-iMCD, 6 cases of plasma cell type iMCD, and 21 healthy controls. During flare-ups, patients with TAFRO-iMCD had significantly higher serum IP-10 and tended to have lower PDGF-AA levels than the other 2 groups. In addition, serum IL-10, IL-23, and vascular endothelial growth factor-A were elevated in both TAFRO-iMCD and iMCD. Elevated serum IP-10 is associated with inflammatory diseases including infectious diseases. There was a strong correlation between high serum IP-10 and the presence of TAFRO-iMCD, suggesting that IP-10 might be involved in the pathogenesis of TAFRO-iMCD.
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Affiliation(s)
- Noriko Iwaki
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.,Hematology/Respiratory Medicine Kanazawa University Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Yuka Gion
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Eisei Kondo
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Mitsuhiro Kawano
- Division of Rheumatology, Kanazawa University Hospital, Kanazawa, Japan
| | - Taro Masunari
- Department of Hematology, Chugoku Central Hospital, Fukuyama, Japan
| | - Hiroshi Moro
- Division of Clinical Infection Control and Prevention, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koji Nikkuni
- Division of Hematology, Niigata City General Hospital, Niigata, Japan
| | - Kazue Takai
- Division of Hematology, Niigata City General Hospital, Niigata, Japan
| | - Masao Hagihara
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenji Yokota
- Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
| | - Masataka Okamoto
- Department of Hematology and Medical Oncology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shinji Nakao
- Hematology/Respiratory Medicine Kanazawa University Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.,Division of Pathophysiology, Okayama University Graduate School of Health Sciences, Okayama, Japan
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22
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Iwaki N, Fajgenbaum DC, Nabel CS, Gion Y, Kondo E, Kawano M, Masunari T, Yoshida I, Moro H, Nikkuni K, Takai K, Matsue K, Kurosawa M, Hagihara M, Saito A, Okamoto M, Yokota K, Hiraiwa S, Nakamura N, Nakao S, Yoshino T, Sato Y. Clinicopathologic analysis of TAFRO syndrome demonstrates a distinct subtype of HHV-8-negative multicentric Castleman disease. Am J Hematol 2016; 91:220-6. [PMID: 26805758 DOI: 10.1002/ajh.24242] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/05/2015] [Accepted: 11/10/2015] [Indexed: 12/22/2022]
Abstract
Multicentric Castleman disease (MCD) describes a heterogeneous group of disorders involving systemic inflammation, characteristic lymph node histopathology, and multi-organ dysfunction because of pathologic hypercytokinemia. Whereas Human Herpes Virus-8 (HHV-8) drives the hypercytokinemia in a cohort of immunocompromised patients, the etiology of HHV-8-negative MCD is idiopathic (iMCD). Recently, a limited series of iMCD cases in Japan sharing a constellation of clinical features, including thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O) has been described as TAFRO syndrome. Herein, we report clinicopathological findings on 25 patients (14 males and 11 females; 23 Japanese-born and two US-born), the largest TAFRO syndrome case series, including the first report of cases from the USA. The median age of onset was 50 years old (range: 23-72). The frequency of each feature was as follows: thrombocytopenia (21/25), anasarca (24/25), fever (21/25), organomegaly (25/25), and reticulin fibrosis (13/16). These patients frequently demonstrated abdominal pain, elevated serum alkaline phosphatase levels, and acute kidney failure. Surprisingly, none of the cases demonstrated marked hypergammoglobulinemia, which is frequently reported in iMCD. Lymph node biopsies revealed atrophic germinal centers with enlarged nuclei of endothelial cells and proliferation of endothelial venules in interfollicular zone. 23 of 25 cases were treated initially with corticosteroids; 12 patients responded poorly and required further therapy. Three patients died during the observation period (median: 9 months) because of disease progression or infections. TAFRO syndrome is a unique subtype of iMCD that demonstrates characteristic clinicopathological findings. Further study to clarify prognosis, pathophysiology, and appropriate treatment is needed.
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Affiliation(s)
- Noriko Iwaki
- Department of Pathology; Okayama University Graduate School of Medicine, Dentistry and, Pharmaceutical Sciences; Okayama Japan
- Department of Cellular Transplantation Biology (Hematology/Oncology and Respiratory Medicine), Division of Cancer Medicine; Graduate School of Medical Sciences Kanazawa University; Kanazawa Japan
| | - David C. Fajgenbaum
- Department of Medicine, Division of Hematology & Oncology, Raymond & Ruth Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania
| | - Christopher S. Nabel
- Department of Medicine, Division of Hematology & Oncology, Raymond & Ruth Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania
| | - Yuka Gion
- Department of Pathology; Okayama University Graduate School of Medicine, Dentistry and, Pharmaceutical Sciences; Okayama Japan
| | - Eisei Kondo
- Department of General Medicine; Okayama University Graduate School of Medicine, Dentistry and, Pharmaceutical Sciences; Okayama Japan
| | - Mitsuhiro Kawano
- Division of Rheumatology; Kanazawa University Hospital; Kanazawa Japan
| | - Taro Masunari
- Department of Hematology; Chugoku Central Hospital; Fukuyama Japan
| | - Isao Yoshida
- Department of Hematologic Oncology; National Hospital Organization Shikoku Cancer Center; Matsuyama Japan
| | - Hiroshi Moro
- Division of Clinical Infection Control and Prevention; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Koji Nikkuni
- Division of Hematology; Niigata City General Hospital; Niigata Japan
| | - Kazue Takai
- Division of Hematology; Niigata City General Hospital; Niigata Japan
| | - Kosei Matsue
- Division of Hematology and Oncology, Department of Medicine; Kameda Medical Center; Kamogawa Japan
| | - Mitsutoshi Kurosawa
- Department of Hematology; National Hospital Organization Hokkaido Cancer Center; Sapporo Japan
| | - Masao Hagihara
- Department of Hematology; Eiju General Hospital; Tokyo Japan
| | - Akio Saito
- Department of Hematology; National Hospital Organization Nishigunma National Hospital; Shibukawa Japan
| | - Masataka Okamoto
- Department of Hematology and Medical Oncology; Fujita Health University School of Medicine; Toyoake Japan
| | - Kenji Yokota
- Division of Pathophysiology; Okayama University Graduate School of Health Sciences; Okayama Japan
| | - Shinichiro Hiraiwa
- Department of Pathology; Tokai University School of Medicine; Kanagawa Japan
| | - Naoya Nakamura
- Department of Pathology; Tokai University School of Medicine; Kanagawa Japan
| | - Shinji Nakao
- Cellular Transplantation Biology; Division of Medicine, Kanazawa University Institutes of Medical, Pharmaceutical, and Health Sciences; Kanazawa Japan
| | - Tadashi Yoshino
- Department of Pathology; Okayama University Graduate School of Medicine, Dentistry and, Pharmaceutical Sciences; Okayama Japan
| | - Yasuharu Sato
- Department of Pathology; Okayama University Graduate School of Medicine, Dentistry and, Pharmaceutical Sciences; Okayama Japan
- Division of Pathophysiology; Okayama University Graduate School of Health Sciences; Okayama Japan
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23
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Zaimoku Y, Takahashi W, Iwaki N, Saito C, Yoshida A, Aoki G, Yamaguchi M, Nakao S. Human herpesvirus-8-unrelated primary effusion lymphoma of the elderly not associated with an increased serum lactate dehydrogenase level: A benign sub-group of effusion lymphoma without chemotherapy. Leuk Lymphoma 2016; 57:1625-32. [PMID: 26727336 DOI: 10.3109/10428194.2015.1088649] [Citation(s) in RCA: 6] [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] [Indexed: 01/13/2023]
Abstract
Human herpesvirus-8-unrelated primary effusion lymphoma characterized by lymphomatous effusion without nodal lesions occasionally exhibits spontaneous remission. To elucidate the factors associated with a good prognosis, this study analyzed the clinical parameters of four patients treated in the department and 109 patients reported in case reports. The median age was 71 years and the median overall survival was 20 months. Patients possessing two independent favorable factors, an elderly status (≥ 70 years) and low serum lactate dehydrogenase (< 500 IU/L) showed a markedly higher 1-year survival than patients lacking either of the two factors in the absence of chemotherapy (94% vs 20%, p = 3 × 10(-5)), which was similarly observed in the chemotherapy group (94% vs 51%, p = 0.002). The use of rituximab was also a strong predictor of survival (89% vs 49%, p = 7 × 10(-6)). Elderly patients not exhibiting an increased lactate dehydrogenase may represent a benign sub-group of effusion lymphoma, which do not require chemotherapy to achieve remission.
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Affiliation(s)
- Yoshitaka Zaimoku
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan
| | - Wakana Takahashi
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan ;,b Department of Hematology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - Noriko Iwaki
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan
| | - Chizuru Saito
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan ;,b Department of Hematology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - Akiyo Yoshida
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan
| | - Go Aoki
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan
| | - Masaki Yamaguchi
- b Department of Hematology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan
| | - Shinji Nakao
- a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan
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24
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Iwaki N, Sato Y, Takata K, Kondo E, Ohno K, Takeuchi M, Orita Y, Nakao S, Yoshino T. Atypical hyaline vascular-type castleman's disease with thrombocytopenia, anasarca, fever, and systemic lymphadenopathy. J Clin Exp Hematop 2014; 53:87-93. [PMID: 23801139 DOI: 10.3960/jslrt.53.87] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Recently, atypical Castleman's disease (CD) was reported in Japan. This disease is considered as TAFRO syndrome or non-idiopathic plasmacytic lymphadenopathy (IPL), a constellation of clinical symptoms, namely, thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly without hyper-γ-globulinemia. Histopathologically, this disease is similar to hyaline vascular (HV)-type CD. Here, we present a 43-year-old Japanese woman meeting the clinical criteria of TAFRO syndrome who was successfully treated with combined corticosteroid therapy. She showed a rapidly progressive course of thrombocytopenia, systemic lymphadenopathy, fever, anasarca, and increase in acute inflammatory proteins without hyper-γ-globulinemia. Lymph node biopsy was performed and revealed HV-type CD without human herpes virus 8 infection, which was clinicopathologically compatible with non-IPL. The association of these atypical features with well-known multicentric Castleman's disease (MCD), namely, HV-type histology with systemic lymphadenopathy, marked thrombocytopenia even with a high level of interleukin-6, and increased acute inflammatory proteins without hyper-γ-globulinemia, suggests that TAFRO syndrome as presented in our case is a novel entity, which may have been diagnosed as MCD in the past. To define this novel entity more clearly and to demonstrate its etiology, further nationwide surveys of this syndrome and MCD are needed.
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Affiliation(s)
- Noriko Iwaki
- Departments of Pathology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho, Okayama, Japan
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25
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Morichika D, Sato-Hisamoto A, Hotta K, Takata K, Iwaki N, Uchida K, Minami D, Kubo T, Tanimoto M, Kiura K. Fatal Candida septic shock during systemic chemotherapy in lung cancer patient receiving corticosteroid replacement therapy for hypopituitarism: a case report. Jpn J Clin Oncol 2014; 44:501-5. [PMID: 24646812 DOI: 10.1093/jjco/hyu019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Invasive candidiasis has increased as nosocomial infection recently in cancer patients who receive systemic chemotherapy, and the timely risk assessment for developing such specific infection is crucial. Especially in those concomitantly with hypopituitarism, febrile neutropenia with candidiasis can cause severe stress and lead potentially to sudden fatal outcome when the temporal steroid coverage for the adrenal insufficiency is not fully administered. We report a 72-year-old male case diagnosed as non-small-cell lung cancer, Stage IIIA. He had received a steroid replacement therapy for the prior history of hypophysectomy due to pituitary adenoma with hydrocortisone of 3.3 mg/day, equivalent to prednisolone of 0.8 mg/day. This very small dosage of steroid was hardly supposed to weaken his immune system, but rather potentially led to an inappropriate supplementation of his adrenal function, assuming that the serum sodium and chlorine levels decreased. On Day 6 of second cycle of chemotherapy with carboplatin and paclitaxel, he developed sudden febrile neutropenia, septic shock and ileus, leading to death. After his death, the venous blood culture on Day 7 detected Candida albicans. Autopsy findings showed a massive necrotizing enterocolitis with extensive Candida invasion into submucous tissue. In conclusion, this case may suggest that (i) immediate initiation of antifungal therapy soon after the careful risk assessment of Candida infection and (ii) adequate administration of both basal steroid replacement therapy and temporal steroid coverage for febrile neutropenia might have improved his fatal outcome.
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Affiliation(s)
- Daisuke Morichika
- *Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
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Hanakawa H, Orita Y, Sato Y, Takeuchi M, Ohno K, Iwaki N, Ito T, Nishizaki K, Yoshino T. Cutting needle biopsy combined with immunohistochemical study of myeloperoxidase for the diagnosis of histiocytic necrotizing lymphadenitis. Acta Otolaryngol 2013; 133:1328-32. [PMID: 24245703 DOI: 10.3109/00016489.2013.824112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Cutting needle biopsy (CNB) combined with immunohistochemical study of myeloperoxidase (MPO) is a useful minimally invasive diagnostic procedure for histiocytic necrotizing lymphadenitis (HNL). OBJECTIVES HNL is mainly diagnosed by pathological findings of open surgical biopsy (OSB) specimens. Recently the appearance of anti-MPO positive histiocytes has been reported as a highly specific pathological diagnosis for HNL. Considering the cosmetic impact and burden on the patients, we performed CNB combined with immunohistochemical study of MPO for the diagnosis of HNL. Few studies have reported the utility of this method in the diagnosis of HNL. METHODS A retrospective study was conducted using clinical data from 20 HNL patients. RESULTS CNB was performed in 8 patients and OSB in 13 (OSB after CNB in 1). MPO-positive histiocytes were observed in all of the 20 cases. The accuracy of the diagnoses was finally confirmed by the clinical courses in all cases.
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Ohno K, Sato Y, Ohshima KI, Takata K, Ando M, Abd Al-Kader L, Iwaki N, Takeuchi M, Orita Y, Yoshino T. IgG4-related disease involving the sclera. Mod Rheumatol 2013; 24:195-8. [DOI: 10.3109/14397595.2013.852842] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Kyotaro Ohno
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Koh-ichi Ohshima
- Department of Ophthalmology, National Hospital Organization Okayama Medical Center,
Okayama, Japan
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Midori Ando
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Lamia Abd Al-Kader
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
- Department of Pathology, Faculty of Medicine, Mansoura University,
Mansoura, Egypt
| | - Noriko Iwaki
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Mai Takeuchi
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Yorihisa Orita
- Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science,
2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan
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Hanakawa H, Orita Y, Sato Y, Takao S, Marunaka H, Morishita T, Yamashita Y, Hori Y, Domae S, Inokuchi I, Akagi S, Kondo E, Iwaki N, Motomiya K, Okumura H, Yoshino T, Nishizaki K. Novel and simple prognostic index for nasal natural killer/T-cell lymphoma. Head Neck 2013; 36:551-6. [PMID: 23780926 DOI: 10.1002/hed.23322] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Few studies have investigated the prognostic factors for nasal natural killer (NK)/T-cell lymphoma. METHODS This was a retrospective multicenter clinical study. The clinical records of 36 patients with nasal NK/T-cell lymphoma who had been first treated between 1996 and 2011 were collected from 12 hospitals. RESULTS High serum levels of C-reactive protein (≥1.0 mg/dL), lactate dehydrogenase (≥350 IU/L), and soluble interleukin-2 receptor (sIL-2R; ≥600 U/mL) were associated with worse prognosis. A prognostic score was devised by totaling the number of these 3 predictors: 0 or 1 = score 0; and 2 or 3 = score 1. As for tumor invasion, local invasion beyond the nasal cavity was associated with poor prognosis, and a prognostic score was devised as: tumor restricted to nasal cavity, yes = score 0; no = score 1. A novel prognostic index (NPI) was established based on these scores from 0 to 2. Disease-specific survival rates at 5 years were: 90.0% for NPI = 0; 29.3% for NPI = 1; and 0.0% for NPI = 2. CONCLUSION Our NPI is valid for anticipating prognosis of nasal NK/T-cell lymphoma.
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Affiliation(s)
- Hiroyuki Hanakawa
- Department of Otolaryngology Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Igawa T, Sato Y, Takata K, Iwaki N, Tanaka T, Asano N, Maeda Y, Orita Y, Nakamura N, Nakamura S, Yoshino T. De novo CD5-positive diffuse large B-cell lymphomas show high specificity for cyclin D2 expression. Diagn Pathol 2013; 8:81. [PMID: 23675804 PMCID: PMC3658991 DOI: 10.1186/1746-1596-8-81] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 04/30/2013] [Indexed: 12/20/2022] Open
Abstract
D cyclins positively regulate the cell cycle and mediate the pathogenesis of some lymphomas. Cyclin D1 overexpression is the hallmark of mantle cell lymphoma, whereas cyclins D2 and D3 are reportedly not as specific to certain lymphomas as cyclin D1. In this study, cyclin D2 was found to be overexpressed in 98% of de novo CD5-positive diffuse large B-cell lymphomas (DLBCLs) (50/51) and in 28% of CD5-negative DLBCLs (14/51). A statistically significant difference was observed between these two groups (p<0.0001). In contrast, no statistical difference was found in the cyclin D3 expression between CD5-positive (18/51) and CD5-negative (24/51) DLBCLs (p=0.23). Based on these findings, cyclin D2 is therefore considered to be closely associated with de novo CD5-positive DLBCLs. This insight may be useful for overcoming the inferior survival of this aggressive lymphoma.
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Affiliation(s)
- Takuro Igawa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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Habara T, Sato Y, Takata K, Iwaki N, Okumura H, Sonobe H, Tanaka T, Orita Y, Abd Al-Kader L, Asano N, Ennishi D, Yoshino T. Germinal center B-cell-like versus non-germinal center B-cell-like as important prognostic factor for localized nodal DLBCL. J Clin Exp Hematop 2013; 52:91-9. [PMID: 23037624 DOI: 10.3960/jslrt.52.91] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common form of non-Hodgkin's lymphoma. Although many investigations have been performed on the prognostic factors of DLBCL, no reports have focused on localized nodal DLBCL. We examined the prognostic significance of 39 Japanese patients with localized nodal DLBCL with special reference to the germinal center B-cell-like (GCB) versus non-germinal center B-cell-like (NGCB) types. The median age was 65 years with 23 males and 16 females. Using Hans algorithm of immunohistochemistry, 18 patients (46%) exhibited GCB type and 21 (54%) exhibited NGCB type. Twenty-nine patients (74%) presented with disease in the neck (neck group) and 10 (26%) had disease in non-neck regions (non-neck group). Comparing Hans, Choi, and Muris algorithms, patients with GCB type showed statistically significant progression-free survival (PFS) only with Hans algorithm (P = 0.022, P = 0.100, and P = 0.130, respectively). Patient survival analyses revealed that GCB-type patients by Hans algorithm had a better PFS (P = 0.012), and neck-group patients had better PFS and overall survival (OS) (P = 0.018 and P = 0.012, respectively). Univariate analysis revealed that only neck vs. non-neck exhibited a significant difference in terms of OS (P = 0.026). Multivariate analysis revealed that GCB type by Hans algorithm and neck vs. non-neck were significantly different in terms of PFS (P = 0.025 and P = 0.033, respectively). Therefore, the subclassifications of GCB type vs. NGCB type and neck vs. non-neck are important predictive prognostic factors in localized nodal DLBCL.
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Affiliation(s)
- Toshiyuki Habara
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikaata-cho, Okayama, Japan
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Sato Y, Takeuchi M, Takata K, Ohno K, Iwaki N, Orita Y, Goto N, Hida AI, Iwamoto T, Asano N, Ito T, Hanakawa H, Yanai H, Yoshino T. Clinicopathologic analysis of IgG4-related skin disease. Mod Pathol 2013; 26:523-32. [PMID: 23174935 DOI: 10.1038/modpathol.2012.196] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IgG4-related disease is a recently recognized systemic syndrome characterized by mass-forming lesions with lymphoplasmacytic infiltration, increase in the number of IgG4(+) cells in affected tissues and elevation of serum IgG4 levels. In 2009, we were the first to report skin lesions in patients with IgG4-related disease, but no large case series has been reported and clinicopathological findings remain unclear. To clarify these features, we herein report 10 patients (9 men and 1 woman; median age, 64 years; age range, 46-81 years) with IgG4-related skin disease. All patients had erythematous and itchy plaques or subcutaneous nodules on the skin of the head and neck, particularly in the periauricular, cheek, and mandible regions, except for one patient, whose forearm and waist skin were affected. In addition, eight patients had extracutaneous lesions: these were found on the lymph nodes in six patients, the lacrimal glands in three patients, the parotid glands in three patients, and the kidney in one patient. Histologically examined extracutaneous lesions were consistent with IgG4-related disease; five of six lymph node lesions showed progressively transformed germinal centers-type IgG4-related lymphadenopathy. Cases of IgG4-related skin disease were classified into two histological patterns: those exhibiting a nodular dermatitis pattern and those with a subcutaneous nodule pattern. The infiltrate was rich in plasma cells, small lymphocytes, and eosinophils; the majority of the plasma cells were IgG4(+). The IgG4(+) cell count was 49-396 per high-power field (mean±s.d., 172±129), with an IgG4(+)/IgG(+) cell ratio ranging from 62 to 92%. Serum IgG4 levels were elevated in all examined patients. In conclusion, patients with IgG4-related skin disease had uniform clinicopathology. Lesions were frequently present on the skin of the periauricular, cheek, and mandible regions, and were frequently accompanied by IgG4-related lymphadenopathy.
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Affiliation(s)
- Yasuharu Sato
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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Iwaki N, Sato Y, Kurokawa T, Maeda Y, Ohno K, Takeuchi M, Takata K, Orita Y, Nakao S, Yoshino T. B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma without mediastinal disease: mimicking nodular sclerosis classical Hodgkin lymphoma. Med Mol Morphol 2013; 46:172-6. [DOI: 10.1007/s00795-013-0038-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 02/06/2013] [Indexed: 02/06/2023]
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33
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Al-Kader LA, Sato Y, Takata K, Ohshima KI, Sogabe Y, Fujii K, Iwaki N, Yoshino T. A Case of Conjunctival Follicular Lymphoma Mimicking Mucosa-Associated Lymphoid Tissue Lymphoma. J Clin Exp Hematop 2013; 53:49-52. [DOI: 10.3960/jslrt.53.49] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Takeuchi M, Sato Y, Takata K, Kobayashi K, Ohno K, Iwaki N, Orita Y, Yoshino T. Cutaneous multicentric Castleman's disease mimicking IgG4-related disease. Pathol Res Pract 2012; 208:746-9. [PMID: 23102767 DOI: 10.1016/j.prp.2012.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 09/12/2012] [Accepted: 09/22/2012] [Indexed: 12/20/2022]
Abstract
Castleman's disease, an uncommon lymphoproliferative disorder, can be difficult to differentiate from immunoglobulin (Ig) G4-related disease. The latter is typically characterized by elevated serum IgG4 levels and abundant IgG4-positive cells. However, multicentric Castleman's disease can also have elevated serum IgG4 levels and even fulfill the histological diagnostic criteria for IgG4-related disease. We present a case of cutaneous multicentric Castleman's disease mimicking IgG4-related disease. A 55-year-old Japanese woman developed erythematous and brown plaques on her back. Skin biopsy revealed regressive follicles with interfollicular plasmacytosis, and many plasma cells were positive for IgG4 (mean 263.67±79.19, range 214-355 per high power field). The IgG4-/IgG-positive cell ratios were 35.6%, 36.2%, and 48.4%, respectively, with an average of 40.6%, thus fulfilling the histological diagnostic criteria for IgG4-related disease. Furthermore, serum IgG4 level was significantly elevated (1490 mg/dl; normal range: 4.8-105 mg/dl). However, laboratory findings of anemia, hypoalbuminemia, polyclonal gammaglobulinemia, high C-reactive protein level, and elevated serum interleukin-6 level were consistent with hyper-IL-6 syndrome. Hence, the diagnosis of cutaneous multicentric Castleman's disease was made. In conclusion, IgG4-related disease cannot be differentiated from hyper-IL-6 syndromes on histology alone. Instead, laboratory analyses are necessary to distinguish between the two diseases.
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Affiliation(s)
- Mai Takeuchi
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Kita-ku, Okayama, Japan
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35
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Ohno K, Sato Y, Ohshima KI, Takata K, Ando M, Abd Al-Kader L, Iwaki N, Takeuchi M, Orita Y, Yoshino T. IgG4-related disease involving the sclera. Mod Rheumatol 2012. [DOI: 10.1007/s10165-012-0758-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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36
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Kashiwagi S, Iwaki N, Yoshida S, Yamaguchi H, Shiozawa T, Yamaguchi F. Clinical efficacy of long-acting neuraminidase inhibitor, laninamivir octanoate hydrate, in postmarketing surveillance. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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37
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Ohata K, Iwaki N, Kotani T, Kondo Y, Yamazaki H, Nakao S. An Epstein-Barr virus-associated leukemic lymphoma in a patient treated with rabbit antithymocyte globulin and cyclosporine for hepatitis-associated aplastic anemia. Acta Haematol 2012; 127:96-9. [PMID: 22178718 DOI: 10.1159/000333609] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Accepted: 09/25/2011] [Indexed: 11/19/2022]
Abstract
Lymphoproliferative disorders (LPDs) are generally caused by uncontrolled B-cell proliferation induced by the Epstein-Barr virus (EBV) in the setting of impaired EBV-specific T-cell immunity, particularly when there is pharmacological immunosuppression including antithymocyte globulin. We herein present an unusual case of EBV associated with LPD (EBV-LPD) in which LPD occurred 3 weeks after the use of rabbit antithymocyte globulin administered for severe hepatitis-associated aplastic anemia; the patient died of fulminant leukemic lymphoma 5 days after the onset. We also review the pertinent literature on EBV-LPD after immunosuppressive therapy and document the efficacy of EBV viral load monitoring and the need for preemptive therapy.
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Affiliation(s)
- Kinya Ohata
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Japan
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Abstract
Thyroid MALT lymphoma is an extremely rare malignancy believed to arise against a background of Hashimoto's thyroiditis. Rituximab is a monoclonal antibody directed against B cell specific antigen CD20. Recently, there have been reports that rituximab is effective for autoimmune thyroid diseases such as Graves' disease as well as for treatment of B cell malignant lymphoma. We present the changes in thyroid autoantibodies in Hashimoto's thyroiditis after rituximab administration for 3 cases of thyroid MALT lymphoma. Case 1 had been taking levothyroxine and was diagnosed with thyroid MALT lymphoma. She was treated with rituximab monotherapy, and her thyroid enlargement improved. Anti-thyroid peroxidase antibody (TPOAb) turned negative after rituximab monotherapy, and TSH levels decreased with the same levothyroxine dosage. Case 2 was diagnosed with recurrent thyroid MALT lymphoma after chemotherapy (CHOP). He suffered from leg sensory disturbance because of vincristine sulfate. The patient was treated with rituximab. TPOAb decreased, but did not turn negative. TSH levels were within normal range during the disease course, but TSH levels were low in comparison with before rituximab therapy. Case 3 was diagnosed with thyroid MALT lymphoma after radiation therapy on the neck for laryngeal cancer. Thyroid enlargement improved after rituximab monotherapy, and thyroid autoantibody levels decreased. TSH increased transiently after radiation therapy, but TSH decreased gradually without levothyroxine after rituximab monotherapy. We report 3 cases in which thyroid autoantibody levels in Hashimoto's thyroiditis decreased after rituximab monotherapy for thyroid MALT lymphoma, but it is controversial whether thyroid dysfunction due to Hashimoto's thyroiditis is restored.
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Affiliation(s)
- Toshio Kahara
- Department of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama, Japan.
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Kurokawa T, Ishiyama K, Ozaki J, Yamashita Y, Iwaki N, Saito C, Arahata M, Kaya H, Yoshida T. Haploidentical hematopoietic stem cell transplantation to adults with hematologic malignancies: analysis of 66 cases at a single Japanese center. Int J Hematol 2010; 91:661-9. [PMID: 20390388 DOI: 10.1007/s12185-010-0561-5] [Citation(s) in RCA: 17] [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] [Received: 01/22/2010] [Revised: 03/12/2010] [Accepted: 03/18/2010] [Indexed: 10/19/2022]
Abstract
Sixty-six adult patients with hematologic malignancies underwent haploidentical hematopoietic stem cell transplantation (haplo-HSCT) without T cell depletion. The patients were preconditioned with a reduced intensity regimen, and tacrolimus was used for graft-versus-host disease (GVHD) prophylaxis. Successful engraftment occurred in 60 patients (90.1%) and graft rejection in only 4 patients (6.1%). Among the 60 engrafted patients, only 5 developed severe (grade III or IV) acute GVHD. Twenty patients, including 19 relapse-free patients were alive at a median follow-up of 48 months (range 6-77 months). The overall survival (OS) at 6 years was 29.3%. The OS of 45 patients < 60 years of age was 43.6%, which was superior to that of 21 patients who were 60 years of age and older (9.5%) (P < 0.01). The OS of 11 patients from human leukocyte antigen (HLA) 1 locus-mismatched donors (63.6%) was higher than that of 28 patients from HLA 3 loci-mismatched donors (12.5%) (P < 0.01). Organ injury and infection were the main causes of mortality. Notably, immunosuppressive therapy could be successfully stopped in 9 patients transplanted from HLA 2 or 3 loci-mismatched donors with a median duration of 45 months (range 5-71 months). These data suggest that haplo-HSCT is a promising treatment for patients who need urgent allogeneic transplantation but lack HLA-identical family donors.
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Affiliation(s)
- Toshiro Kurokawa
- Department of Internal Medicine, Toyama Prefectural Central Hospital, Nishinagae, Toyama, Japan.
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Kahara T, Nakajima KI, Takahashi K, Iwaki N, Michigishi T, Usuda R. Accumulations in the salivary gland due to Tc-99m pertechnetate imaging improved after isotope therapy for Graves' disease. Intern Med 2008; 47:179-80. [PMID: 18239329 DOI: 10.2169/internalmedicine.47.0527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Toshio Kahara
- Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
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Abstract
This study examined the hypothesis (Eriksen & Schultz, 1979) that a subject checks whether a prepared response is correct or not in the Eriksen and Eriksen (1974) cognitive conflict task, using event-related potentials (ERPs). Fourteen right-handed subjects were required to respond selectively to a central target letter flanked with compatible (e.g., HHHHHHH) or incompatible (e.g., SSSHSSS) noise letters, or not to respond to asterisks (*******). The results showed that the lateralized readiness potential indicating an incorrect preparation and the NO-GO potential reflecting a response inhibition emerged for incompatible stimuli. These findings indicate that a prepared response was recognized as erroneous, and was inhibited. Therefore, it is suggested that the check operation functioned in the cognitive conflict task. Furthermore, the result that the NO-GO potential latency for incompatible stimuli was longer than that for NO-GO stimuli suggests that the timing of NO-GO decision and response inhibition by the check operation influenced the NO-GO potential latency.
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Affiliation(s)
- N Iwaki
- Department of Psychology, Faculty of Education, Hiroshima University, Higashi-Hiroshima
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42
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Mineo H, Iwaki N, Kogishi K, Onaga T, Kato S, Zabielski R. Effects of proglumide on cholecystokinin-8-induced exocrine and endocrine pancreatic responses in conscious sheep. Comp Biochem Physiol A Physiol 1997; 118:759-64. [PMID: 9406447 DOI: 10.1016/s0300-9629(97)00057-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The effects of cholecystokinin (CCK)-8, either alone or together with the CCK antagonist, proglumide on both exocrine and endocrine pancreatic responses were examined in conscious sheep. Intravenous infusions of CCK-8 (120 pmol/kg/min for 40 min) with vehicle (0 mumol/kg/min proglumide) significantly increased both amylase output in pancreatic juice and plasma insulin concentrations (P < 0.05). Concomitant infusions of proglumide (5-40 mumol/kg/min for 50 min) inhibited both amylase and insulin secretory responses induced by CCK-8 infusion. The antagonistic effects of proglumide occurred in a dose-dependent manner, and proglumide infusion at dose of 20 mumol/kg/min or above simultaneously inhibited CCK-8-induced amylase and insulin responses. In conclusion, although the type of receptor involved is not characterized at present, exogenously infused CCK-8 acts on B cells via a CCK-receptor-mediated mechanism and induces insulin secretion in sheep.
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Affiliation(s)
- H Mineo
- Faculty of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
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43
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Abstract
This study examined whether cognitive conflict, reported by Eriksen and Eriksen (1974), could be explained by a model of reciprocal inhibition between correct and incorrect response preparation. Subjects responded selectively to a central target letter with flanking compatible (e.g., HHHHH) or incompatible (e.g., SSHSS) noise letters. In the mixed condition all four stimuli were mixed randomly in a block, and in the blocked condition only two stimuli with identical noises were used. The results showed that the reaction times to incompatible stimuli were delayed in the mixed condition compared with that to compatible stimuli, while the delay was significantly reduced in the blocked condition. This blocking effect was also shown on P3 latencies, an event-related potential measure of stimulus evaluation, but not on lateralized readiness potentials (LRPs), a measure of response preparation. Furthermore, irrespective of blocked/mixed conditions, LRPs indicating incorrect preparation were observed. These findings suggest that cognitive conflict could not be explained by the reciprocal inhibition model based on response preparation, but by a model based on stimulus evaluation.
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Affiliation(s)
- N Iwaki
- Department of Psychology, Faculty of Education, Hiroshima University
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44
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Mineo H, Iwaki N, Kogishi K, Zabielski R, Onaga T, Kato S. Effects of intravenous infusions of cholecystokinin (CCK)-8 on exocrine and endocrine pancreatic secretion in conscious sheep. Comp Biochem Physiol A Physiol 1995; 111:133-8. [PMID: 7537612 DOI: 10.1016/0300-9629(95)98529-p] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The effects of cholecystokinin (CCK)-8 on both exocrine and endocrine pancreatic functions were examined simultaneously in five conscious sheep. Intravenous infusions of CCK-8 (0, 5, 10, 20, 30, 60, 120 and 240 pmol/kg/min for 40 min) induced dose-dependent increases in flow rate, and in protein and amylase outputs in pancreatic juice. The same CCK-8 infusions induced dose-dependent increases in plasma insulin, but no change in plasma glucagon concentrations. The threshold dose (10-30 pmol/kg/min) of CCK-8 infusion for stimulating insulin secretion was similar to that for stimulating amylase output. In conclusion, using amylase output as an indicator of physiological action, CCK is one of the potential candidates as a physiological regulator of insulin, but not glucagon secretion in sheep.
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Affiliation(s)
- H Mineo
- Department of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
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Mineo H, Iwaki N, Onaga T, Kato S. Effects of intravenous infusions of cholecystokinin-8 and pentagastrin on plasma concentrations of insulin and glucagon in sheep. Res Vet Sci 1994; 56:298-302. [PMID: 8073180 DOI: 10.1016/0034-5288(94)90145-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The effects of cholecystokinin-8 (CCK-8) and pentagastrin on insulin and glucagon secretion were studied in conscious sheep. Intravenous infusions of CCK-8 (3 to 1000 pmol kg-1 min-1 for 30 minutes) induced a dose-dependent increase in plasma insulin, but did not alter plasma glucagon concentration. The threshold dose of CCK-8 for stimulation of insulin secretion was 10 to 30 pmol kg-1 min-1. Pentagastrin was infused intravenously at doses of 10 to 3000 pmol kg-1 min-1. The maximal dose of pentagastrin slightly stimulated insulin, but not glucagon, secretion. The insulin secretory activity of pentagastrin was only 1/300 that of CCK-8 on a molar basis. The threshold dose of CCK-8 for stimulation of insulin secretion was similar to that for exocrine pancreatic secretion obtained in earlier studies. In conclusion, CCK is a potential candidate as a physiological factor regulating insulin secretion in sheep.
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Affiliation(s)
- H Mineo
- Department of Veterinary Medicine, Rakuno Gakuen University, Hokkaido, Japan
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Ito M, Katsuta Y, Koyama M, Murakami M, Iwaki N, Okano A, Tsukida K. Optical resolution of (+/-)-all-trans-3-hydroxyretinal by use of high-performance liquid chromatography. J Nutr Sci Vitaminol (Tokyo) 1992; 38:111-5. [PMID: 1506917 DOI: 10.3177/jnsv.38.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Racemic all-trans-3-hydroxyretinal (3-OH-RAL) (1) was converted by a reaction with (-)-camphanic acid chloride (CpCl) into a diastereomixture of camphanates (2a) and (2b) which was separated by preparative high-performance liquid chromatography (HPLC) to give two esters (2a) and (2b) in pure state, respectively. Saponification of (2a) and (2b) independently afforded optically active (3S)- and (3R)-3-OH-RALs (3a) and (3b), respectively, whose absolute structures were determined by circular dichroism (CD) spectra. Racemic 3-OH-RAL was separated to two peaks by HPLC using chiral column (ChiraSpher, Merck). Cochromatography with authentic specimens (3a) and (3b) showed that the peak with a short retention time corresponded to (3R)-isomer and the other to (3S).
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Affiliation(s)
- M Ito
- Kobe Women's College of Pharmacy, Japan
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Saito Y, Koga M, Iwaki N, Ishitobi A, Miyamoto Y. [Outbreak of scarlet fever in a kindergarten in Tachikawa city]. Kansenshogaku Zasshi 1974; 48:8-17. [PMID: 4212729 DOI: 10.11150/kansenshogakuzasshi1970.48.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Iwaki N. [Variations in the compositions of lipids and fatty acids in experimental allergic encephalomyelitis]. Nihon Shonika Gakkai Zasshi 1972; 76:95-101. [PMID: 5065623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Murakami M, Sekimoto H, Nakat I, Iwaki N, Nakai T. [Comparative test of antihypertensive effects of N-diethylaminoethyl reserpine (bietaserpine) and other similar drugs]. Saishin Igaku 1971; 26:145-53. [PMID: 5539259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Iwaki N. [Studies on the role of vascular permeability factors of the polymorphonuclear leukocyte]. Jpn Circ J 1970; 34:1125-37. [PMID: 4998981 DOI: 10.1253/jcj.34.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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