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Matsumoto K, Takagi S, Asano-Mori Y, Yamaguchi K, Yuasa M, Kageyama K, Kaji D, Nishida A, Ishiwata K, Yamamoto H, Araoka H, Miyazaki Y, Uchida N, Taniguchi S, Morita K. Evaluation of the pharmacokinetics of liposomal amphotericin B and analysis of the relationship between pharmacokinetics, efficacy and safety in patients with hematological diseases. J Infect Chemother 2024; 30:504-510. [PMID: 38097040 DOI: 10.1016/j.jiac.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024]
Abstract
INTRODUCTION This study aimed to identify factors responsible for changes in blood concentrations of a liposomal formulation of amphotericin B (AMPH-B, L-AMB) and analyze the relationships between blood concentrations and efficacy or toxicity. METHODS L-AMB was administered to 30 patients being treated for hematological diseases. AMPH-B plasma concentrations were determined right before the initiation (Cmin) and at the end (Cmax) of infusion on at least 1 day, beginning on Day 3 of L-AMB treatment. The relationships of Cmin divided by dose (C/D ratio) to body weight, age, hepatic function, renal function, serum albumin, C-reactive protein (CRP), response, hypokalemia, and renal impairment were evaluated. RESULTS C/D ratio was not correlated with age, hepatic function, renal function, or serum albumin. Body weight adjusted C/D ratio was negatively correlated with CRP. Cmax and Cmin were compared between responders and non-responders, those with or without hypokalemia, and those with or without renal impairment. A higher Cmax in patients with hypokalemia was the only significant difference seen. CONCLUSIONS The negative correlation between CRP and plasma concentrations was likely caused by higher distribution of L-AMB from the blood to infected tissue in patients with a greater degree of infection, with a resulting decrease in plasma concentrations. AMPH-B plasma concentrations were not related to response. Higher Cmax of AMPH-B were observed in patients with hypokalemia, but no relationship between plasma concentration and renal toxicity was observed, suggesting that AMPH-B plasma concentrations appear to be minimally related to PD when used as L-AMB.
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Affiliation(s)
- Kana Matsumoto
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Japan.
| | | | | | | | | | | | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Japan
| | | | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Diseases, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Japan; Okinaka Memorial Institute for Medical Research, Japan
| | | | - Kunihiko Morita
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Japan
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2
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Tsumita K, Takagi S, Asano-Mori Y, Watanabe O, Shindo M, Yamaguchi K, Yuasa M, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Yamamoto H, Araoka H, Yamamoto G, Makino S, Wake A, Uchida N, Taniguchi S, Koike Y. Long-term lymphocyte subset number reconstitution is unique but comparable between umbilical cord blood and unrelated bone marrow transplantation. Int J Hematol 2024; 119:573-582. [PMID: 38407785 DOI: 10.1007/s12185-024-03727-x] [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: 06/20/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/27/2024]
Abstract
The number of umbilical cord blood transplantation (U-CBT) procedures has been growing annually, but little research has been done on long-term immune recovery after U-CBT. Infection risk is high in U-CBT recipients, and this can be partially attributed to immature immunocompetent cells in umbilical cord blood. In this study, we analyzed lymphocyte subset (LST) number to determine the long-term recovery timeline. We included 36 U-CBT and 10 unrelated bone marrow transplantation (U-BMT) recipients who survived more than 2 years after transplantation, and followed them for up to 10 years post-transplant. Recovery kinetics in the early phase post-transplant was different for each LST. Recovery of CD19+ B cells was faster after U-CBT than after U-BMT in the first 5 years after transplantation. Although CD4+ T cells increased in the first several months after U-CBT, long-term cell count recovery was impaired in approximately 20% of patients. Thus, although the LST recovery pattern after U-CBT was unique, LST number recovery was statistically comparable between U-CBT and U-BMT past 5 years post-transplantation.
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Affiliation(s)
- Keiko Tsumita
- Department of Clinical Laboratory, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1050001, Japan
| | - Shinsuke Takagi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Yuki Asano-Mori
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Otoya Watanabe
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Michiho Shindo
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kyosuke Yamaguchi
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Hisashi Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
| | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | | | - Yukako Koike
- Department of Clinical Laboratory, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 1050001, Japan.
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3
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Osada M, Yamamoto H, Watanabe O, Yamaguchi K, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Takagi S, Makino S, Asano-Mori Y, Yamamoto G, Taniguchi S, Wake A, Uchida N. Lymphocyte Crossmatch Testing or Donor HLA-DP and -DQ Allele Typing Effectiveness in Single Cord Blood Transplantation for Patients with Anti-HLA antibodies Other Than Against HLA-A, -B, -C, and -DRB1. Transplant Cell Ther 2024:S2666-6367(24)00350-6. [PMID: 38641011 DOI: 10.1016/j.jtct.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Anti-human leukocyte antigen (HLA) antibodies other than those against HLA-A, -B, -C, and DRB1 are a risk factor for engraftment delay and failure, especially in cord blood transplantation (CBT) OBJECTIVES: The primary objective of this study was to assess the impact of the presence of anti-HLA antibodies on CBT and to evaluate the utility of lymphocyte crossmatch testing or additional HLA-DP and HLA-DQ typing of CB units in improving transplant outcomes STUDY DESIGN: We retrospectively assessed the engraftment rates and transplant outcomes of 772 patients who underwent their first CBT at our hospital between 2012 and 2021. Donors were routinely typed for HLA-A, -B, -C, and-DRB1 alleles, and the anti-HLA antibodies of recipients were screened before donor selection in all cases. Among patients who had antibodies against other than HLA-A, -B, -C, and DRB1 (n=58), lymphocyte crossmatch testing (n=32) or additional HLA-DP/-DQ alleles typing of CB (n=15) was performed to avoid the use of units with corresponding alleles RESULTS: The median patient age was 57 years (16-77). Overall, 75.7% had a high-risk disease status at transplantation, 83.5% received myeloablative conditioning regimens, and > 80% were heavily transfused. Two hundred and twenty-nine of the 772 recipients (29.6%) were positive for anti-HLA antibodies. There were no statistical differences in the number of infused CD34-positive cells between the anti-HLA antibody-positive and the anti-HLA antibody-negative patients. Of the 229 patients with anti-HLA antibodies, 168 (73.3%) had antibodies against HLA-A, -B, -C, and-DRB1 (group A), whereas 58 (25.3%) had antibodies against HLA-DP, HLA-DQ, or -DRB3/4/5 with or without antibodies against HLA-A, -B, C, and-DRB1 (group B). No patients in both group A and B exhibited DSAs against HLA-A, -B, -C, -and DRB1. The neutrophil engraftment rate was lower in patients with anti-HLA antibodies than in those without antibodies (89.9% vs. 94.1%), whereas non-relapse mortality (NRM) before engraftment was higher in antibody-positive patients (9.6% vs. 4.9%). In patients who received two or more HLA allele-mismatched CB in the host-versus-graft (HVG) direction (n = 685), the neutrophil engraftment rate was lower in the anti-HLA antibody-positive recipients than in the antibody-negative recipients with significant differences (88.8% vs. 93.8%) (P = 0.049). Similarly, transplant outcomes were worse in the antibody-positive patients with respect to two-year overall survival (OS) (43.1% vs. 52.3%) and NRM (44.0% vs. 30.7%) than in the antibody-negative patients. In contrast, the results of group B were comparable to those of the antibodies-negative patients, while the results of group A were statistically worse than the antibody-negative patients in terms of all engraftment rate (88.6%), OS (34.2%), and NRM (49.0%) CONCLUSIONS: The presence of anti-HLA antibodies negatively impacts engraftment, NRM, and OS in CBT. However, HLA-DP/-DQ allele typing of CB units or lymphocyte crossmatch testing could be useful strategies to overcome poor engraftment rates and transplant outcomes, especially in patients with anti-HLA antibodies against HLA-DP, HLA-DQ, or -DRB3/4/5.
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Affiliation(s)
- Makoto Osada
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Department of Hematology, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
| | | | - Otoya Watanabe
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | | | - Shigeyoshi Makino
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Yuki Asano-Mori
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
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Sugio T, Uchida N, Miyawaki K, Ohno Y, Eto T, Mori Y, Yoshimoto G, Kikushige Y, Kunisaki Y, Mizuno S, Nagafuji K, Iwasaki H, Kamimura T, Ogawa R, Miyamoto T, Taniguchi S, Akashi K, Kato K. Prognostic impact of HLA supertype mismatch in single-unit cord blood transplantation. Bone Marrow Transplant 2024; 59:466-472. [PMID: 38238452 DOI: 10.1038/s41409-023-02183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 11/26/2023] [Accepted: 12/12/2023] [Indexed: 04/06/2024]
Abstract
The "human leukocyte antigen (HLA) supertype" is a functional classification of HLA alleles, which was defined by structural features and peptide specificities, and has been reportedly associated with the clinical outcomes of viral infections and autoimmune diseases. Although the disparity in each HLA locus was reported to have no clinical significance in single-unit cord blood transplantation (sCBT), the clinical significance of the HLA supertype in sCBT remains unknown. Therefore, we retrospectively analyzed clinical data of 1603 patients who received sCBT in eight institutes in Japan between 2000 and 2017. Each HLA allele was categorized into 19 supertypes, and the prognostic effect of disparities was then assessed. An HLA-B supertype mismatch was identified as a poor prognostic factor (PFS: hazard ratio [HR] = 1.23, p = 0.00044) and was associated with a higher cumulative incidence (CI) of relapse (HR = 1.24, p = 0.013). However, an HLA-B supertype mismatch was not associated with the CI of acute and chronic graft-versus-host-disease. The multivariate analysis for relapse and PFS showed the significance of an HLA-B supertype mismatch independent of allelic mismatches, and other previously reported prognostic factors. HLA-B supertype-matched grafts should be selected in sCBT.
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Affiliation(s)
- Takeshi Sugio
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
- Divisions of Oncology and Hematology, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kohta Miyawaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yuju Ohno
- Department of Hematology, Kitakyushu Municipal Medical Center, Fukuoka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yoshikane Kikushige
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yuya Kunisaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Shinichi Mizuno
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Nagafuji
- Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiromi Iwasaki
- Department of Hematology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | | | - Ryosuke Ogawa
- Department of Hematology, JCHO Kyushu Hospital, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
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5
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Yamaguchi K, Yamamoto H, Izutsu K, Yuasa M, Kaji D, Nishida A, Ishiwata K, Takagi S, Yamamoto G, Asano-Mori Y, Uchida N, Taniguchi S. Fatal outcome of BK virus encephalitis in an allogeneic stem cell transplantation recipient. J Infect Chemother 2024:S1341-321X(24)00096-5. [PMID: 38514025 DOI: 10.1016/j.jiac.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
BK virus (BKV) encephalitis is a rare complication after hematopoietic stem cell transplantation (HSCT). A 43-year-old woman with recurrent follicular lymphoma after autologous HSCT received allogeneic bone marrow transplantation from a human leukocyte antigen-matched related donor. Neutrophil engraftment was achieved on post-transplant day 13. Memory loss and noncooperative attitude toward the medical staff were observed on day 16, and her mental status worsened progressively. Magnetic resonance imaging (MRI) showed nonspecific findings on day 19; however, cerebrospinal fluid (CSF) analysis including real-time polymerase chain reaction on day 20 revealed elevated levels of BKV 4.67 × 104 copy/mL. BKV encephalitis was diagnosed based on CSF findings, intravenous administration of immunoglobulin and cidofovir was started, and the immunosuppressive agent dose was reduced. Diffusion-weighted MRI on day 28 showed signal abnormalities in the bilateral periventricular white matter. Although the follow-up CSF analysis on day 35 was negative for BKV, her mental status and MRI findings did not improve, and she died on day 55 because of respiratory failure. This case emphasizes the importance of considering BKV encephalitis as a differential diagnosis of post-transplant encephalitis, considering the central nervous system-associated immune reconstitution inflammatory syndrome in patients with worsening central nervous system findings after eradication of BKV in the CSF.
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Affiliation(s)
| | | | - Koji Izutsu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
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6
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Sugita J, Kuroha T, Ishikawa J, Eto T, Fukushima K, Yokota I, Akashi K, Taniguchi S, Harada M, Teshima T. Posttransplant cyclophosphamide in unrelated and related peripheral blood stem cell transplantation from HLA-matched and 1 allele mismatched donor. Bone Marrow Transplant 2024; 59:344-349. [PMID: 38114645 DOI: 10.1038/s41409-023-02162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 12/21/2023]
Abstract
Posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis has been increasingly used in HLA-haploidentical transplantation and recent studies also demonstrated the efficacy of PTCy in HLA-matched transplantation. We conducted a prospective multicenter phase II study to evaluate the safety and efficacy of PTCy with tacrolimus and mycophenolate mofetil in 43 patients who underwent HLA-matched (n = 21), 1 allele mismatched (n = 20), or 2 allele mismatched (n = 2) peripheral blood stem cell transplantation (PBSCT) following myeloablative (n = 28) or reduced-intensity (n = 15) conditioning. The incidence of grade III-IV acute GVHD at 100 days was 2.3%. The incidences of grades II-IV acute GVHD, all grade chronic GVHD, and moderate to severe chronic GVHD at 2 years were 16.3%, 14.0%, and 4.7%, respectively. Overall survival, disease-free survival, and non-relapse mortality at 2 years were 75.3%, 74.0%, and 7.0%, respectively. GVHD-free, relapse-free survival at 2 years was 67.0%. The rate of off-immunosuppressants in patients who survived without relapse at 2 years was 85.4%. These results indicate that PTCy is a valid option for GVHD prophylaxis in both HLA-matched and HLA 1-2 allele mismatched PBSCT.
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Affiliation(s)
- Junichi Sugita
- Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Takashi Kuroha
- Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Jun Ishikawa
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Kentaro Fukushima
- Department of Hematology and Oncology, Osaka University Hospital, Suita, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Akashi
- Department of Hematology/Oncology, Kyushu University Hospital, Fukuoka, Japan
| | | | - Mine Harada
- Karatsu Higashimatsuura Medical Center, Karatsu, Japan
| | - Takanori Teshima
- Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan.
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Kato K, Takagi S, Takano H, Tsunoda S, Watanabe O, Yamaguchi K, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Yamamoto H, Yamamoto G, Asano-Mori Y, Koike Y, Makino S, Wake A, Taniguchi S, Uchida N. A case report of a truncated ABL1 mutation in 2 cases with Philadelphia chromosome-positive B cell precursor acute lymphoblastic leukemia. Int J Hematol 2024; 119:205-209. [PMID: 38236369 DOI: 10.1007/s12185-023-03691-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/03/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
Acquired point mutations in the ABL1 gene are widely recognized as a cause of Philadelphia chromosome-positive B cell precursor acute lymphoblastic leukemia (Ph+ B-ALL) that is resistant to tyrosine kinase inhibitors, whereas there are few reports about other types of the ABL1 mutation. Here, we report 2 cases of Ph+ B-ALL gaining a partial deletion type mutation of the ABL1 gene (Δ184-274 mutation), which resulted in truncation of the ABL1 molecule and loss of kinase activity. In both cases, the disease was refractory to multiple agents in the recurrent phase after allogeneic hematopoietic cell transplantation. This is a case report of a truncated ABL1 mutation in 2 patients with Ph+ B-ALL.
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Affiliation(s)
- Kana Kato
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Shinsuke Takagi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan.
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan.
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
| | - Hirofumi Takano
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Shinichi Tsunoda
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Otoya Watanabe
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Kyosuke Yamaguchi
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Hisashi Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
| | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Yuki Asano-Mori
- Center for Long-Term Follow-Up After Hematopoietic Cell Transplantation, Toranomon Hospital, Tokyo, Japan
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Yukako Koike
- Department of Clinical Laboratory, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-0001, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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8
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Yoshino T, Kuriyama T, Utsumi S, Shimakawa T, Minami M, Hayashi M, Matsuo Y, Kokame K, Nakamura E, Matsumoto M, Eto T, Taniguchi S. [Congenital thrombotic thrombocytopenic purpura diagnosed in adulthood after repeated thrombocytopenia since neonatal period]. Rinsho Ketsueki 2024; 65:142-146. [PMID: 38569856 DOI: 10.11406/rinketsu.65.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
A 27-year-old woman was diagnosed with idiopathic thrombocytopenic purpura in the neonatal period, and was admitted to our hospital after presenting with impaired consciousness, purpura, nausea and vomiting, with a platelet count of 10×109/l. Congenital thrombotic thrombocytopenic purpura (cTTP) was suspected on the basis of recurrent thrombocytopenia and impaired consciousness, so tests for ADAMTS13 activity and inhibitor were performed. ADAMTS13 activity was severely decreased, ADAMTS13 inhibitor was negative, and platelet count increased after transfusion of fresh frozen plasma. These findings and the results of genetic testing done on all family members led to a diagnosis of cTTP. cTTP requires differential diagnosis even in adults. If a patient diagnosed with ITP in childhood has a history or findings that suggest cTTP during follow-up observation, it is necessary to actively consider ADAMTS13 testing.
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Affiliation(s)
| | | | - Sae Utsumi
- Department of hematology, Hamanomachi Hospital
| | | | | | | | | | - Koichi Kokame
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center
| | - Eriko Nakamura
- Department of Blood Transfusion Medicine, Nara Medical University
| | | | - Tetsuya Eto
- Department of hematology, Hamanomachi Hospital
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9
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Shimizu Y, Kaji D, Watanabe O, Yamaguchi K, Kageyama K, Taya Y, Nishida A, Ishiwata K, Takagi S, Yamamoto H, Mori YA, Wake A, Uchida N, Taniguchi S, Yamamoto G. Rituximab/bendamustine/cytarabine for transplant-eligible patients with mantle cell lymphoma: A retrospective study. Cancer Med 2023. [PMID: 37199050 DOI: 10.1002/cam4.6114] [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: 03/25/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Mantle cell lymphoma is considered an aggressive B-cell lymphoma. The optimal induction regimen remains controversial as no randomized controlled trial has compared the efficacy of different induction therapies. METHOD Herein, we performed a retrospective analysis of the clinical characteristics of 10 patients who received induction treatment consisting of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and rituximab, bendamustine, and cytarabine (R-BAC) at Toranomon Hospital between November 2016 and February 2022. RESULT Although one patient discontinued R-BAC therapy due to a rash, the other nine completed the scheduled chemotherapy. All patients achieved complete response, underwent high-dose chemotherapy and autologous stem cell transplantation, and maintained complete remission with a median follow-up of 15 months. Hematological adverse events (AEs) occurred in all patients; however, none developed documented infection. There were also no fatal non-hematological AEs specific to R-BAC. CONCLUSION R-CHOP/R-BAC may be a good induction therapy for transplant-eligible patients with mantle cell lymphoma.
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Affiliation(s)
- Yuki Shimizu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Otoya Watanabe
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Kajigaya, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital, Kajigaya, Japan
| | | | | | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Kajigaya, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
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10
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Oliveira VR, Paula CC, Taniguchi S, Ortis F. Pre-treatment with IL-6 potentiates β-cell death induced by pro-inflammatory cytokines. BMC Mol Cell Biol 2023; 24:11. [PMID: 36977992 PMCID: PMC10045109 DOI: 10.1186/s12860-023-00476-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Type I Diabetes mellitus (T1D) is characterized by a specific destruction of β-cells by the immune system. During this process pro-inflammatory cytokines are released in the pancreatic islets and contribute for β-cells demise. Cytokine-induced iNOS activation, via NF-κB, is implicated in induction of β-cells death, which includes ER stress activation. Physical exercise has been used as an adjunct for better glycemic control in patients with T1D, since it is able to increase glucose uptake independent of insulin. Recently, it was observed that the release of IL-6 by skeletal muscle, during physical exercise, could prevent β-cells death induced by pro-inflammatory cytokines. However, the molecular mechanisms involved in this beneficial effect on β-cells are not yet completely elucidated. Our aim was to evaluate the effect of IL-6 on β-cells exposed to pro-inflammatory cytokines. RESULTS Pre-treatment with IL-6 sensitized INS-1E cells to cytokine-induced cell death, increasing cytokine-induced iNOS and Caspase-3 expression. Under these conditions, however, there was a decrease in cytokines-induced p-eIF2-α but not p-IRE1expression, proteins related to ER stress. To address if this prevention of adequate UPR response is involved in the increase in β-cells death markers induced by IL-6 pre-treatment, we used a chemical chaperone (TUDCA), which improves ER folding capacity. Use of TUDCA increased cytokines-induced Caspase-3 expression and Bax/Bcl-2 ratio in the presence of IL-6 pre-treatment. However, there is no modulation of p-eIF2-α expression by TUDCA in this condition, with increase of CHOP expression. CONCLUSION Treatment with IL-6 alone is not beneficial for β-cells, leading to increased cell death markers and impaired UPR activation. In addition, TUDCA has not been able to restore ER homeostasis or improve β-cells viability under this condition, suggesting that other mechanisms may be involved.
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Affiliation(s)
- V R Oliveira
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - C C Paula
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - S Taniguchi
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - F Ortis
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
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11
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Sakoh T, Kimura M, Takagi S, Ogura S, Morishima M, Yamamuro R, Yamaguchi K, Yuasa M, Kaji D, Kageyama K, Taya Y, Nishida A, Ishiwata K, Yamamoto H, Yamamoto G, Asano-Mori Y, Wake A, Uchida N, Taniguchi S, Araoka H. Predictive scoring system for distinguishing Stenotrophomonas maltophilia bacteremia from Pseudomonas aeruginosa bacteremia in patients with hematological malignancies. Ann Hematol 2023; 102:1239-1246. [PMID: 36971808 DOI: 10.1007/s00277-023-05185-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
Difficulties in immediately distinguishing Stenotrophomonas maltophilia (SM) bacteremia from Pseudomonas aeruginosa (PA) bacteremia in the clinical setting can lead to treatment delay. We aimed to develop a scoring system to immediately distinguish SM bacteremia from PA bacteremia using clinical indicators. We enrolled cases of SM and PA bacteremia in adult patients with hematological malignancies between January 2011 and June 2018. The patients were randomized into derivation and validation cohorts (2:1), and a clinical prediction tool for SM bacteremia was developed and verified. In total, 88 SM and 85 PA bacteremia cases were identified. In the derivation cohort, the following independent predictors of SM bacteremia were identified: no evidence of PA colonization, antipseudomonal β-lactam breakthrough bacteremia, and central venous catheter insertion. We scored each of the three predictors according to their regression coefficient (2, 2, and 1, respectively). Receiver operating characteristic curve analysis confirmed the score's predictive performance, with an area under the curve of 0.805. The combined sensitivity and specificity (0.655 and 0.821) was highest with a cut-off value of 4 points. Positive and negative predictive values were 79.2% (19/24) and 69.7% (23/33), respectively. This novel predictive scoring system is potentially useful for distinguishing SM bacteremia from PA bacteremia, which would facilitate immediate administration of appropriate antimicrobial therapy.
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12
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Taniguchi S, Utsumi S, Kochi Y, Taya Y, Mori Y, Semba YI, Sugio T, Miyawaki K, Kikushige Y, Kunisaki Y, Yoshimoto G, Numata A, Kato K, Uchida N, Maeda T, Miyamoto T, Taniguchi S, Akashi K. Successful pseudo-autologous stem cell transplantation for donor-derived Burkitt lymphoma occurring 9 years after allogeneic transplantation. Int J Hematol 2023; 117:287-292. [PMID: 36136227 DOI: 10.1007/s12185-022-03458-x] [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: 06/28/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 02/03/2023]
Abstract
Donor-derived hematological malignancies have been recognized as rare but serious late complications in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Most cases in the literature were diagnosed as myelodysplastic syndrome or acute leukemia, with very few malignant lymphoma reported. We herein present another case of donor-derived Burkitt lymphoma that occurred 9 years after allo-HSCT under continued administration of immunosuppressants for chronic graft-versus-host disease (GVHD). The patient achieved a partial response after rituximab-combined intensive chemotherapy. To reduce the risk of relapse and to avoid organ toxicities due to repeated chemotherapies, we performed upfront high-dose chemotherapy followed by stem cell rescue using donor-derived CD34+ cells, called pseudo-autologous HSCT (pASCT), and adjusted immunosuppressants appropriately. The patient remained disease-free for 23 months after pASCT without exacerbation of cGVHD. Although the observation period has been relatively short and longer follow-up is needed, pASCT may be a feasible option for donor-derived lymphoma even in patients with active cGVHD.
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Affiliation(s)
- Shiho Taniguchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Sae Utsumi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yu Kochi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yu-Ichiro Semba
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takeshi Sugio
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kohta Miyawaki
- Division of Precision Medicine, Kyushu University School of Medicine, Fukuoka, Japan
| | - Yoshikane Kikushige
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yuya Kunisaki
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Goichi Yoshimoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Akihiko Numata
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Takahiro Maeda
- Division of Precision Medicine, Kyushu University School of Medicine, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | | | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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13
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Kohno S, Izumikawa K, Takazono T, Miyazaki T, Yoshida M, Kamei K, Ogawa K, Taniguchi S, Akashi K, Tateda K, Mukae H, Miyazaki Y, Okada F, Kanda Y, Kakeya H, Suzuki J, Kimura SI, Kishida M, Matsuda M, Niki Y. Efficacy and safety of isavuconazole against deep-seated mycoses: A phase 3, randomized, open-label study in Japan. J Infect Chemother 2023; 29:163-170. [PMID: 36307059 DOI: 10.1016/j.jiac.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/08/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Isavuconazole is a convenient triazole antifungal agent with a broad antifungal spectrum. A randomized, open-label study (ClinicalTrials.gov, NCT03471988) was conducted to evaluate the efficacy and safety of isavuconazole in Japanese patients with deep-seated mycoses. PATIENTS AND METHODS In Cohort A, patients with aspergillosis (chronic pulmonary aspergillosis and invasive aspergillosis) were randomized in a 2:1 ratio to isavuconazole or voriconazole, and in Cohort B, patients with cryptococcosis and mucormycosis were assigned to isavuconazole for up to 84 days of treatment. The overall outcome was evaluated according to the clinical, radiological, and mycological responses at Days 42 and 84 and at the end of treatment (EOT). RESULTS A total of 103 participants were enrolled and received the study drug. The overall response rate of patients with chronic pulmonary aspergillosis in the isavuconazole (52 patients) and voriconazole (27 patients) groups was 82.7% and 77.8% at EOT, respectively. The response rate in patients with cryptococcosis (10 patients, isavuconazole group only) was 90.0%. One of three participants with invasive aspergillosis and one of three participants with mucormycosis responded in the isavuconazole group. In the safety evaluation, the incidence of adverse events in participants with chronic pulmonary aspergillosis was similar in both groups. Adverse drug reactions were reported in 32 (61.5%) patients receiving isavuconazole and 23 (85.2%) patients receiving voriconazole. CONCLUSIONS Isavuconazole showed efficacy and safety in Japanese patients with chronic pulmonary aspergillosis and cryptococcosis, for which the drug is not currently indicated.
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Affiliation(s)
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan.
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
| | - Taiga Miyazaki
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Minoru Yoshida
- Fourth Department of Internal Medicine, Teikyo University Hospital Mizonokuchi, Kawasaki, 213-8507, Japan
| | - Katsuhiko Kamei
- Department of Clinical Research, Medical Mycology Research Center, Chiba University, Chiba, 260-8673, Japan
| | - Kenji Ogawa
- Department of Respiratory Medicine, National Hospital Organization Higashinagoya National Hospital, Nagoya, 465-8620, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, 105-8470, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Tokyo, 143-8540, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
| | - Fumito Okada
- Department of Radiology, Oita Prefectural Hospital, Oita, 870-8511, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, 330-8503, Japan; Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, 329-0498, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine, Osaka, 545-8585, Japan
| | - Junko Suzuki
- Center for Pulmonary Diseases, Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, Tokyo, 204-8585, Japan
| | - Shun-Ichi Kimura
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, 330-8503, Japan
| | | | | | - Yoshihito Niki
- Division of Clinical Infectious Diseases, Department of Medicine, School of Medicine, Showa University, Tokyo, 142-8555, Japan
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14
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Utsumi S, Shima T, Kubara C, Semba Y, Hayashi M, Takigawa K, Yoshino T, Minami M, Matsuo Y, Kuriyama T, Akashi K, Maeda T, Taniguchi S, Eto T. [Acute myeloid leukemia with type I CBFB::MYH11 fusion gene not detected by screening test for leukemia-related chimeric genes]. Rinsho Ketsueki 2023; 64:1503-1507. [PMID: 38220149 DOI: 10.11406/rinketsu.64.1503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
A 27-year-old woman with pancytopenia was admitted to our hospital. Bone marrow aspiration revealed 52.2% myeloperoxidase-positive myeloblasts, leading to a diagnosis of acute myeloid leukemia. While a screening test for chimeric genes related to leukemia initially yielded negative results, including for the CBFB::MYH11 fusion gene, G-banded karyotyping uncovered the presence of inv (16)(p13.1q22). Further investigation by fluorescence in situ hybridization (FISH) confirmed the split signals for CBFB. A second screening test for leukemia-related chimeric genes with different PCR primers revealed the elusive CBFB::MYH11 fusion gene. Subsequently, the type I CBFB::MYH11 fusion gene was identified through exhaustive exploration using RNA sequencing for fusion gene discovery. This exceptional case highlights the existence of a distinctive subtype of CBFB::MYH11 that may yield false-negative results in conventional chimeric fusion screening, thus emphasizing the indispensable utility of PCR primer modification, FISH, and RNA sequencing in the investigative process.
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Affiliation(s)
- Sae Utsumi
- Department of Hematology, Hamanomachi Hospital
| | - Takahiro Shima
- Department of Hematology, Hamanomachi Hospital
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Chiaki Kubara
- Department of Hematology, Hamanomachi Hospital
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Yuichiro Semba
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences
| | | | | | | | | | | | | | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Takahiro Maeda
- Division of Precision Medicine, Kyushu University Graduate School of Medical Sciences
| | | | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital
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15
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Shimano R, Yamamoto H, Nasu I, Kashiwamura Y, Yamamoto G, Uchida N, Taniguchi S, Hayashi M, Ito T. Comparison between filgrastim biosimilar and filgrastim original for the management of neutropenia after salvage chemotherapy for malignant lymphoma. Int J Hematol 2022; 116:856-862. [PMID: 35976562 DOI: 10.1007/s12185-022-03438-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 11/27/2022]
Abstract
In this study, the efficacy and safety of filgrastim biosimilar (F-BS) were retrospectively compared to those of filgrastim original in the treatment of malignant lymphoma with CHASE (± R) or DeVIC(± R) in 78 patients. The median number of filgrastim doses was 11 in the F-BS group and 8 in the filgrastim group after CHASE (± R) (p = 0.8), and 10 in the F-BS group and 10 in the filgrastim group after DeVIC (± R) (p = 0.45). The median days until neutrophil recovery to ≥ 1000/μL was 10 days with F-BS versus 10 days with filgrastim after CHASE ± R (p = 0.59), and 9 days with F-BS versus 10 days with filgrastim after DeVIC ± R (p = 0.828). Febrile neutropenia (FN) was observed in 5 patients (41.7%) in the F-BS group and 9 (52.9%) in the filgrastim group after CHASE ± R therapy (p = 0.616), and in 11 patients (36.7%) in the F-BS group and 9 (47.4%) in the filgrastim group after DeVIC ± R (p = 0.462). The present results suggest that the efficacy and safety of F-BS are comparable to those of filgrastim original, with no significant differences in clinical factors. Use of F-BS also reduced medical costs per course of CHASE ± R therapy by 170.22 US dollars.
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Affiliation(s)
- Rena Shimano
- Department of Pharmacology, Toranomon Hospital, Tokyo, Japan
| | - Hisashi Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. .,Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
| | - Izumi Nasu
- Department of Pharmacology, Toranomon Hospital, Tokyo, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | | | - Tadaaki Ito
- Department of Pharmacology, Toranomon Hospital, Tokyo, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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16
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Murakami M, Taniguchi S, Murakami T, Imamura H, Marutsuka K, Shimamoto T. Postpartum regression of human papillomavirus-related vulvar cancer: A case report. J Obstet Gynaecol Res 2022; 48:2982-2987. [PMID: 35975323 DOI: 10.1111/jog.15389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/30/2022] [Accepted: 07/23/2022] [Indexed: 11/28/2022]
Abstract
We report a case of a 23-year-old pregnant woman (gravida 2 para 0, pregnancy 33 weeks and 3 days) with a history of laser ablation for cervical intraepithelial neoplasia-3 at 22 years. At initial visit, a 2 × 2 × 1-cm elevated mass was found on right labia majora. Biopsy results revealed squamous cell carcinoma of right labia; immunostaining revealed p16 positivity. Patient was diagnosed with human papillomavirus-related vulvar cancer. Selective cesarean section was performed at 36 weeks and 4 days of gestation. Postoperative histopathological diagnosis of squamous cell carcinoma, and 1.7-mm deep infiltrations led to vulvar cancer stage IB diagnosis. Reduction operation was performed, and postoperative follow-up of 1 year and 8 months revealed no recurrence. These results emphasize that small vulvar tumors during pregnancy should not be underestimated and histological examinations should be performed without hesitation. Careful observation and evaluation of tumors is necessary during pregnancy and after delivery because they may shrink postdelivery.
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Affiliation(s)
- Mayu Murakami
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Shuichi Taniguchi
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Takeshi Murakami
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Hiroko Imamura
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Kousuke Marutsuka
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Tomihiro Shimamoto
- Obstetrics and Gynecology, Anatomic pathology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
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17
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Oyama T, Kageyama K, Araoka H, Mitsuki T, Yamaguchi K, Kaji D, Taya Y, Nishida A, Ishiwata K, Takagi S, Yamamoto H, Yamamoto G, Asano-Mori Y, Uchida N, Wake A, Makino S, Taniguchi S. Clinical and microbiological characteristics of bacterial meningitis in umbilical cord blood transplantation recipients. Int J Hematol 2022; 116:966-972. [PMID: 35932398 DOI: 10.1007/s12185-022-03425-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/24/2022]
Abstract
Bacterial meningitis is a rare but severe infectious complication after hematopoietic stem cell transplantation. However, its clinical features were previously not clear. We reviewed the cases of 7 patients diagnosed with bacterial meningitis with a positive cerebrospinal fluid culture among 1147 patients who underwent cord blood transplantation (CBT) at our institution between September 2007 and September 2020. The diagnosis was made on day + 5- + 45, and 5 patients developed bacterial meningitis before neutrophil engraftment. The causative organisms were all Gram-positive cocci: Enterococcus faecium and Enterococcus gallinarum (2 patients each), and Staphylococcus haemolyticus, Streptococcus mitis/oralis, and Rothia mucilaginosa (1 patient each). Six patients developed bacterial meningitis secondary to prior or concomitant bacteremia caused by the same bacterium. Five patients had received anti-MRSA agents at onset: vancomycin in 3, teicoplanin in 1, and daptomycin in 1. After diagnosis of bacterial meningitis, linezolid was eventually used for 6 patients. Two patients with E. gallinarum were alive at day + 1380 and + 157 after CBT, respectively, whereas 5 patients died 17-53 (median 43) days after the onset of bacterial meningitis. Breakthrough meningitis in CBT can occur even during the use of anti-MRSA drugs, and intensive antibiotic treatment is necessary.
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Affiliation(s)
- Takashi Oyama
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan.
| | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Takashi Mitsuki
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kyosuke Yamaguchi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Shinsuke Takagi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Hisashi Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Yuki Asano-Mori
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Shigeyoshi Makino
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, 2-2-2 Toranomon, Minato-Ku, Tokyo, 105-8470, Japan
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18
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Kanda J, Hirabayashi S, Yokoyama H, Kawase T, Tanaka H, Uchida N, Taniguchi S, Takahashi S, Onizuka M, Tanaka M, Sugio Y, Eto T, Kanda Y, Kimura T, Ichinohe T, Atsuta Y, Morishima S. Effect of multiple HLA-locus mismatches on outcomes after single cord blood transplantation. Transplant Cell Ther 2022; 28:398.e1-398.e9. [PMID: 35577322 DOI: 10.1016/j.jtct.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/16/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Effect of single or multiple mismatches at each HLA locus on outcomes after cord blood transplantation (CBT) is controversial. OBJECTIVE We analyzed the effects of single or multiple HLA-locus mismatches on the outcomes after single CBT using a Japanese registry data from the Japan Society for Hematopoietic Cell Transplantation (JSHCT). STUDY DESIGN Patients with acute leukemia and myelodysplastic syndromes, aged 16 years or older, who underwent their first CBT between 2003 and 2017 (n = 4,074) were included. The effect of the number of HLA-locus mismatches (0, 1, and 2, for the HLA-A, -B, -C, and -DRB1 loci) on outcomes was analyzed after adjusting for other significant variables. RESULTS The median age of the patients was 54 years. Median total nucleated and CD34 cell doses were 2.6 × 107/kg and 0.8 × 105/kg, respectively. The number of CBTs with single or double mismatches were 2,099 and 292 for HLA-A locus, 2,699 and 341 for HLA-B locus, 2,555 and 609 for HLA-C locus, and 2,593 and 571 for HLA-DRB1 locus, respectively. Single and double HLA-DRB1 mismatches were associated with a higher risk of grade II-IV acute graft-versus-host disease (GVHD, single: HR 1.29, P<0.001, double: HR 1.49, P<0.001, trend-P: P<0.001). Single and double mismatches at HLA-DRB1 as well as single mismatches at HLA-A and HLA-B were also associated with grade III-IV acute GVHD. Single and double HLA-B mismatches and double HLA-DRB1 mismatches were associated with a high risk of non-relapse mortality. On the other hand, double mismatches at HLA-A or HLA-DRB1 and single mismatches at HLA-B were associated with a lower risk of relapse. CONCLUSION HLA-DRB1 double mismatch was associated with high risks of grade II-IV and III-IV acute GVHD and non-relapse mortality but lower risk of relapse. Not only the locus mismatch but also the number of mismatches may be considered in cord blood unit selection.
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Affiliation(s)
- Junya Kanda
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Shigeki Hirabayashi
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisayuki Yokoyama
- Department of Hematology and Rheumatology, Tohoku University School of Medicine, Sendai, Japan
| | - Takakazu Kawase
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | | | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo, Japan
| | - Satoshi Takahashi
- Division of Clinical Precision Research Platform, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Yasuhiro Sugio
- Department of Internal Medicine, Kitakyushu City Hospital Organization, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Tetsuya Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Takafumi Kimura
- Preparation Department, Japanese Red Cross Kinki Block Blood Center, Tokyo, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Satoko Morishima
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Second Department of Internal Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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19
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Himeji D, Tanaka GI, Shiiba R, Matsumoto R, Takamura K, Morishita H, Taniguchi S, Moriguchi S, Marutsuka K. Pneumocystis Pneumonia in a Patient with Ovarian Cancer Receiving Olaparib Therapy. Intern Med 2022; 61:217-221. [PMID: 34248119 PMCID: PMC8851181 DOI: 10.2169/internalmedicine.7485-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a case of pneumocystis pneumonia (PCP) in a 77-year-old woman with ovarian cancer who was receiving olaparib therapy. After the patient's second relapse of ovarian cancer, she was administered olaparib as maintenance therapy following successful completion of docetaxel and carboplatin therapy. On receiving olaparib, she showed symptoms of a fever and malaise. Based on laboratory and imaging findings, she was diagnosed with PCP. After treatment with corticosteroids and trimethoprim/sulfamethoxazole followed by atovaquone, the patient's general condition improved. The lymphocytopenia observed after olaparib administration may have been associated with the development of PCP.
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Affiliation(s)
- Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Gen-Ichi Tanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Ritsuya Shiiba
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Ryoichi Matsumoto
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Kazuhiro Takamura
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Hirotaka Morishita
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Shuichi Taniguchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Sayaka Moriguchi
- Department of Anatomic Pathology, Miyazaki Prefectural Miyazaki Hospital, Japan
| | - Kousuke Marutsuka
- Department of Anatomic Pathology, Miyazaki Prefectural Miyazaki Hospital, Japan
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20
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Kaji D, Kusakabe M, Sakata-Yanagimoto M, Makishima K, Suehara Y, Hattori K, Ota Y, Mitsuki T, Yuasa M, Kageyama K, Taya Y, Nishida A, Ishiwata K, Takagi S, Yamamoto H, Asano-Mori Y, Ubara Y, Izutsu K, Uchida N, Wake A, Taniguchi S, Yamamoto G, Chiba S. Retrospective analyses of other iatrogenic immunodeficiency-associated lymphoproliferative disorders in patients with rheumatic diseases. Br J Haematol 2021; 195:585-594. [PMID: 34558064 PMCID: PMC9290981 DOI: 10.1111/bjh.17824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 01/24/2023]
Abstract
Other iatrogenic immunodeficiency‐associated lymphoproliferative disorders (OIIA‐LPDs) occur in patients receiving immunosuppressive drugs for autoimmune diseases; however, their clinicopathological and genetic features remain unknown. In the present study, we analysed 67 patients with OIIA‐LPDs, including 36 with diffuse large B‐cell lymphoma (DLBCL)‐type and 19 with Hodgkin lymphoma (HL)‐type. After discontinuation of immunosuppressive drugs, regression without relapse was achieved in 22 of 58 patients. Spontaneous regression was associated with Epstein–Barr virus positivity in DLBCL‐type (P = 0·013). The 2‐year overall survival and progression‐free survival (PFS) at a median follow‐up of 32·4 months were 92·7% and 72·1% respectively. Furthermore, a significant difference in the 2‐year PFS was seen between patients with DLBCL‐type and HL‐type OIIA‐LPDs (81·0% vs. 40·9% respectively, P = 0·021). In targeted sequencing of 47 genes in tumour‐derived DNA from 20 DLBCL‐type OIIA‐LPD samples, histone‐lysine N‐methyltransferase 2D (KMT2D; eight, 40%) and tumour necrosis factor receptor superfamily member 14 (TNFRSF14; six, 30%) were the most frequently mutated genes. TNF alpha‐induced protein 3 (TNFAIP3) mutations were present in four patients (20%) with DLBCL‐type OIIA‐LPD. Cases with DLBCL‐type OIIA‐LPD harbouring TNFAIP3 mutations had shorter PFS and required early initiation of first chemotherapy. There were no significant factors for spontaneous regression or response rates according to the presence of mutations. Overall, OIIA‐LPDs, especially DLBCL‐types, showed favourable prognoses.
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Affiliation(s)
- Daisuke Kaji
- Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Manabu Kusakabe
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Hematology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Mamiko Sakata-Yanagimoto
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Hematology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Kenichi Makishima
- Department of Hematology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yasuhito Suehara
- Department of Hematology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Keiichiro Hattori
- Department of Hematology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Yasunori Ota
- Department of Pathology, Research Hospital, The Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Takashi Mitsuki
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Pathology, Research Hospital, The Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | | | | | - Yoshifumi Ubara
- Nephrology Center, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Koji Izutsu
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Shigeru Chiba
- Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Hematology, University of Tsukuba Hospital, Ibaraki, Japan
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21
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Taniguchi S, Yamauchi T, Choi I, Fukuhara N, Potluri J, Salem AH, Hong WJ, Honda H, Nishimura Y, Okubo S, Usuki K. Venetoclax in combination with azacitidine in Japanese patients with acute myeloid leukaemia: phase 1 trial findings. Jpn J Clin Oncol 2021; 51:857-864. [PMID: 33712849 DOI: 10.1093/jjco/hyab018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Venetoclax plus azacitidine is indicated in the USA for the treatment of newly diagnosed acute myeloid leukaemia in older patients (≥75 years) or those ineligible for induction chemotherapy due to co-morbidities. METHODS In this phase 1/2 study (NCT02265731), Japanese patients (≥60 years) with untreated (ineligible for induction chemotherapy) or relapsed/refractory acute myeloid leukaemia received oral venetoclax 400 mg/day (3-day ramp up in cycle 1) plus subcutaneous or intravenous azacitidine 75 mg/m2 on days 1-7 per 28-day cycle until disease progression or unacceptable toxicity. RESULTS As of 10 December 2019, six patients were enrolled (median age: 75 years; untreated: n = 5; relapsed/refractory: n = 1); median treatment duration: 10.3 months (range, 0.7-29.4). Most common grade ≥ 3 adverse events were lymphopaenia and febrile neutropaenia (n = 4 each). Four patients reported serious adverse events; only an event of grade 3 fungal pneumonia was considered possibly related to both study drugs, requiring dose interruption of venetoclax and delay of azacitidine. Five (83%) patients had responses (complete remission: n = 3). Median time to first response of complete remission/complete remission with incomplete count recovery was 1.0 month (range, 0.8-5.5); median overall survival: 15.7 months (95% confidence interval: 6.2, not reached). CONCLUSIONS Venetoclax plus azacitidine was well tolerated and showed high response rates in Japanese patients with acute myeloid leukaemia.
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Affiliation(s)
- Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Japan
| | - Ilseung Choi
- Department of Hematology, National Hospital Organization, Kyushu Cancer Centerk, Fukuoka, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | | | - Ahmed Hamed Salem
- AbbVie Inc., North Chicago, IL, USA.,Department of Clinical Pharmacy, Ain Shams University, Cairo, Egypt
| | | | | | | | | | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
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22
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Abe M, Kimura M, Maruyama H, Watari T, Ogura S, Takagi S, Uchida N, Otsuka Y, Taniguchi S, Araoka H. Clinical characteristics and drug susceptibility patterns of Corynebacterium species in bacteremic patients with hematological disorders. Eur J Clin Microbiol Infect Dis 2021; 40:2095-2104. [PMID: 33895886 DOI: 10.1007/s10096-021-04257-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/15/2021] [Indexed: 01/13/2023]
Abstract
The aim of this study was to clarify the clinical and microbiological characteristics of Corynebacterium bacteremia in hematological patients. We retrospectively reviewed the medical records of patients with Corynebacterium bacteremia from April 2013 to June 2018. The causative Corynebacterium species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Drug susceptibility tests were performed using the broth microdilution method recommended by the Clinical and Laboratory Standards Institute. In total, 147 cases of Corynebacterium bacteremia were identified during the study period. Corynebacterium striatum was the most frequent pathogen. Catheter-related bloodstream infection was diagnosed in 19.7% of all patients, and moderate/severe oral or severe gastrointestinal mucosal impairment was detected in 19.7%. Polymicrobial infection was found in about 20% of cases, with Enterococcus faecium being the most frequent isolate. The overall 30-day mortality was 34.7% (51/147). Multivariate analysis showed that E. faecium co-infection (odds ratio (OR) 9.3; 95% confidence interval (CI) 2.1-40), systemic corticosteroids (OR 3.6; 95% CI 1.4-8.9), other immunosuppressive drugs (OR 0.32; 95% CI 0.13-0.76), and a Pitt bacteremia score ≥4 (OR 12; 95% CI 3.9-40) were significant risk factors for overall 30-day mortality. The drug susceptibility rates for beta-lactam antimicrobial agents were quite low. All isolates were susceptible to glycopeptides and linezolid. However, some C. striatum isolates were resistant to daptomycin. Corynebacterium bacteremia can occur in the presence of several types of mucosal impairment. Our drug susceptibility data indicate that Corynebacterium bacteremia in hematological patients could be treated by glycopeptides or linezolid.
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Affiliation(s)
- Masahiro Abe
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Hideyuki Maruyama
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Tomohisa Watari
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Sho Ogura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | | | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yoshihito Otsuka
- Department of Laboratory Medicine, Kameda Medical Center, Kamogawa, Chiba, Japan
| | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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23
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Nitahara K, Fujita Y, Tanaka D, Magarifuchi N, Taniguchi S, Shimamoto T. Laser vaporization of the cervix is associated with an increased risk of preterm birth and rapid labor progression in subsequent pregnancies. Arch Gynecol Obstet 2021; 304:895-902. [PMID: 33740103 DOI: 10.1007/s00404-021-06025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Laser vaporization of the cervix is an established method of treating cervical intra-epithelial neoplasia, but its effect on subsequent pregnancies remains controversial. The aim of this study was to investigate pregnancy outcomes after laser vaporization. METHODS We conducted a retrospective study involving women who delivered live singletons between 2012 and 2019 in a tertiary hospital. The risks of adverse pregnancy outcomes after laser vaporization of the cervix were assessed using a multivariate regression model. The primary outcome was the adjusted odds ratio for preterm births. We also evaluated the course of labor progression, duration of labor, risk of emergency cesarean deliveries, and the risk of cervical laceration as secondary outcomes. RESULTS In total, 3359 women were analyzed in this study. The risk of preterm birth was significantly higher in pregnancies after laser vaporization of the cervix (adjusted odds ratio [AOR] 1.84, 95% confidence interval [95% CI] 1.06-3.20; p = 0.030). The duration of the first stage of labor was significantly shorter in the post-treatment group (median 255 min vs. 355 min; p = 0.0049). We did not observe significant differences in the duration of the second stage of labor (median 21 min vs 20 min; p = 0.507) or the rates of other obstetric events, including emergency cesarean deliveries (AOR 0.736; 95% CI 0.36-1.50; p = 0.400) and cervical laceration (AOR 0.717; 95% CI 0.22-2.35; p = 0.582). CONCLUSION Laser vaporization of the cervix is associated with an increased risk of preterm births and a shorter duration of the first stage of labor in subsequent pregnancies. Careful consideration is necessary when selecting a method of treatment for the uterine cervix of patients wishing future pregnancies.
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Affiliation(s)
- Kenta Nitahara
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan. .,Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa, Japan.
| | - Yasuyuki Fujita
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan.,Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, Japan
| | - Daichi Tanaka
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan
| | - Naomi Magarifuchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan.,Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka, Japan
| | - Shuichi Taniguchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan
| | - Tomihiro Shimamoto
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan
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24
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Hashimoto M, Saito Y, Nakagawa R, Ogahara I, Takagi S, Takata S, Amitani H, Endo M, Yuki H, Ramilowski JA, Severin J, Manabe RI, Watanabe T, Ozaki K, Kaneko A, Kajita H, Fujiki S, Sato K, Honma T, Uchida N, Fukami T, Okazaki Y, Ohara O, Shultz LD, Yamada M, Taniguchi S, Vyas P, de Hoon M, Momozawa Y, Ishikawa F. Combined inhibition of XIAP and BCL2 drives maximal therapeutic efficacy in genetically diverse aggressive acute myeloid leukemia. ACTA ACUST UNITED AC 2021; 2:340-356. [DOI: 10.1038/s43018-021-00177-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 01/22/2021] [Indexed: 01/18/2023]
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25
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Yuasa M, Asano-Mori Y, Mitsuki T, Yamaguchi K, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Takagi S, Yamamoto H, Yamamoto G, Araoka H, Wake A, Makino S, Koike Y, Uchida N, Taniguchi S. Prognostic significance of lymphocyte reconstitution in the early phase after cord blood transplantation. Br J Haematol 2021; 193:423-427. [PMID: 33751547 DOI: 10.1111/bjh.17376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/19/2021] [Accepted: 02/01/2021] [Indexed: 01/02/2023]
Affiliation(s)
| | | | - Takashi Mitsuki
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | | | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Japan
| | - Hideki Araoka
- Department of Infectious Disease, Toranomon Hospital, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | - Yukako Koike
- Department of Clinical Laboratory, Toranomon Hospital, Tokyo, Japan
| | | | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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26
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Sawada A, Taniguchi S, Takahashi S, Inoue M, Onishi Y, Tanaka M, Henzan H, Kubo M, Nishida A, Kawa K. Dynamics of Epstein-Barr virus after cord blood transplantation: A nationwide survey in Japan. Blood Cell Ther 2021; 4:9-14. [PMID: 36712842 PMCID: PMC9847270 DOI: 10.31547/bct-2020-010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/03/2020] [Indexed: 06/18/2023]
Abstract
Epstein-Barr virus (EBV) is a common virus that latently infects most adults and has a tropism to B lymphocytes. In 1988, two cases of EBV infection were reported to be eradicated by hematopoietic stem cell transplantation from an EBV-negative donor. However, the dynamics of EBV after cord blood transplantation (CBT), namely, the kinetics of anti-EBV antibodies, the incidence of negative/adverse seroconversion (from positive to negative), and the clinical course of re-infection (second primary infection) by EBV, have not yet been characterized in detail. Therefore, we performed a nationwide survey that focused on the dynamics of EBV after CBT 1 year or later after CBT. Negative seroconversion occurred in 23% of previously EBV-infected patients. The incidence of late-onset EBV-associated events was 1.9% (13/674): 5 infectious mononucleosis, 2 hemophagocytic lymphohistiocytosis (HLH), and 6 remaining typical lymphoproliferative disease. HLH occurred in newly infected patients (primary or second primary) and also in those with reactivation and was fatal. The annual monitoring of anti-EBV antibody titers may facilitate the early detection of these late-onset EBV-associated events and treatment initiation before disease progression.
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Affiliation(s)
- Akihisa Sawada
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | | | - Satoshi Takahashi
- Division of Molecular Therapy, The Advanced Clinical Research Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hideho Henzan
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Masayuki Kubo
- Department of Respiratory Medicine, Allergology and Hematology, Nara Medical University Hospital, Kashihara, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Keisei Kawa
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Izumi, Japan
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27
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Kimura M, Yamamoto H, Uchida N, Ogura S, Yamamuro R, Mitsuki T, Yuasa M, Kaji D, Kageyama K, Nishida A, Taya Y, Ishiwata K, Takagi S, Yamamoto G, Asano-Mori Y, Wake A, Taniguchi S, Araoka H. Stenotrophomonas maltophilia bloodstream infections in adult recipients of umbilical cord blood transplantation. Transplant Cell Ther 2020; 27:269.e1-269.e7. [PMID: 33781536 DOI: 10.1016/j.jtct.2020.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/20/2020] [Accepted: 11/29/2020] [Indexed: 11/30/2022]
Abstract
Limited data are available on Stenotrophomonas maltophilia bloodstream infections (SM-BSIs) and the therapeutic efficacy of trimethoprim-sulfamethoxazole (SXT) against SM-BSI in umbilical cord blood transplant (uCBT) recipients. Medical and microbiological records of adult patients who received uCBTs between December 2008 and December 2015 at Toranomon Hospital (Tokyo, Japan) were reviewed. The efficacy and safety of SXT were evaluated only for recipients who were treated with ≥7 days of intravenous SXT for SM-BSI (evaluation cohort). Of 561 uCBT recipients, 34 developed SM-BSI. Diabetes mellitus (P = .005) and age ≥ 60 years (P = .013) were significant independent risk factors for SM-BSI. Moreover, SM-BSI was identified as an independent risk factor for all-cause mortality up to 100 days following uCBT (P = .025). Of the 34 recipients with SM-BSI, 24 were treated with an intravenous SXT-containing regimen (iSXT-CR). Septic shock (P = .0021), pneumonia (P = .011), neutropenia (P = .0015), and systemic steroid administration (P = .018) were identified as significant independent risk factors for 7-day crude mortality. The evaluation cohort included nine recipients. Doses of SXT were 2.4 to 6.9 mg/kg/day of the trimethoprim component. Of the nine recipients, five developed SM-BSI during the pre-engraftment phase. The 30-day crude-mortality rate and clinical cure rate of the cohort were 22% and 67%, respectively. Only one of the nine recipients experienced significant neutrophil toxicity. In this study, the epidemiology of SM-BSI in uCBT recipients was determined and its negative impact on survival was demonstrated. A low- to moderate-dose iSXT-CR appeared to be a tolerable and important therapeutic option for SM-BSI in the uCBT setting, including during the pre-engraftment phase.
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Affiliation(s)
- Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan.
| | | | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Sho Ogura
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Ryosuke Yamamuro
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | | | | | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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28
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Ogura S, Kimura M, Takagi S, Mitsuki T, Yuasa M, Kageyama K, Kaji D, Nishida A, Taya Y, Ishiwata K, Yamamoto H, Asano-Mori Y, Yamamoto G, Uchida N, Wake A, Taniguchi S, Araoka H. Characteristics of gram-negative bacteremia during febrile neutropenia among allogeneic hematopoietic stem cell transplant recipients on levofloxacin prophylaxis. Eur J Clin Microbiol Infect Dis 2020; 40:941-948. [PMID: 33185742 DOI: 10.1007/s10096-020-04096-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/30/2020] [Indexed: 11/27/2022]
Abstract
The aim of this study is to clarify the characteristics of gram-negative bacteremia (GNB), including extended-spectrum β-lactamase (ESBL)-producing pathogens, among allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients on levofloxacin (LVFX) prophylaxis. A retrospective analysis on GNB at the first episode of febrile neutropenia (FN) was conducted among allo-HSCT recipients (age ≥ 20 years) on 500 mg/day of oral LVFX prophylaxis. Epidemiological and microbiological features of GNB were investigated and compared between the inappropriate and appropriate empiric therapy groups. In total, FN occurred in 414 allo-HSCT cases, and bacteremia at the first episode of FN occurred in 169 cases. Overall, 29 GNB cases were documented, and the causative organisms identified were Escherichia coli in 21 cases (including 10 ESBLs), Klebsiella pneumoniae in 2, Pseudomonas aeruginosa in 2, and other in 4. The crude 30-day mortality rate was not significantly different among cases of GNB (6.9%), gram-positive bacteremia (GPB) (7.1%), or non-bacteremia (5.4%; P = 0.78). Cefepime (CFPM) was administered in all cases in the inappropriate empiric therapy group, and all causative organisms were ESBL-producing E. coli (ESBL-EC). All patients in the inappropriate empiric therapy group had a low Pitt bacteremia score (≤ 2). Thirty-day mortality did not differ significantly between the inappropriate and appropriate empiric therapy groups (1/10 vs. 1/15, P = 0.61). In conclusion, GNB was not a significant cause of death. In LVFX breakthrough ESBL-EC bacteremia among allo-HSCT recipients, the administration of CFPM as empiric therapy did not lead to significantly poor prognosis. Empiric CFPM administration might be an acceptable strategy.
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Affiliation(s)
- Sho Ogura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
| | | | | | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | | | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
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29
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Uruga H, Sato T, Nishida A, Uchida N, Tsuji M, Moriguchi S, Takahashi Y, Ogawa K, Murase K, Hanada S, Takaya H, Miyamoto A, Morokawa N, Kimura M, Araoka H, Tsuchihashi R, Asano-Mori Y, Wake A, Taniguchi S, Kishi K. Safety of bronchoscopy in patients with malignant hematologic disorders. BMC Pulm Med 2020; 20:243. [PMID: 32917185 PMCID: PMC7488692 DOI: 10.1186/s12890-020-01283-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022] Open
Abstract
Background Factors affecting the safety of bronchoscopy in patients with malignant hematologic disorders have not been well described. We evaluated the safety of bronchoscopy and describe factors affecting its complication rate in such patients. Methods Between January 2009 and December 2018, 316 bronchoscopies in 282 patients with malignant hematologic disorders and pulmonary infiltrates were performed at our institution. The bronchoscopic procedure used and its complications were evaluated. Results The most common underlying disease was acute myeloid leukemia (134/282 patients, 47.5%). Platelet transfusion was performed the day before or the day of bronchoscopy in 42.4%, supplemental oxygen was administered before the procedure in 23.1%, and midazolam was used in 74.4%. Thirty-five bronchoscopies (11.1%) were complicated by hemoptysis and 7 patients developed pneumothorax, 4 of whom required thoracic drainage. Two patients (0.6%) were intubated within 48 h of the procedure and prolonged oxygen desaturation (> 48 h) occurred in 3.8%. Multivariate analysis showed that only use of midazolam significantly reduced the risk of prolonged oxygen desaturation (hazard ratio 0.28, 95% confidence interval 0.09–0.85, p = 0.03). Transbronchial lung biopsy significantly increased the risk of hemoptysis (hazard ratio 10.40, 95% confidence interval 4.18–25.90, p = 0.00), while use of midazolam significantly reduced the risk (hazard ratio 0.31, 95% confidence interval 0.14–0.73, p = 0.01). Conclusions Bronchoscopy is relatively safe in patients with malignant hematologic disorders. Caution and judicious use of sedatives may improve the patient’s procedural tolerance and lower complications.
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Affiliation(s)
- Hironori Uruga
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan. .,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan. .,Okinaka Memorial Institute for Medical Research, Tokyo, Japan.
| | - Toshitaka Sato
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Respiratory Center, KKR Sapporo Medical Center, Sapporo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan.,Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Masanori Tsuji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Shuhei Moriguchi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Yui Takahashi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Kazumasa Ogawa
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Kyoko Murase
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Shigeo Hanada
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Hisashi Takaya
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Atsushi Miyamoto
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Nasa Morokawa
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Hideki Araoka
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan.,Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | | | | | - Atsushi Wake
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan.,Department of Hematology, Toranomon Hospital, Tokyo, Japan.,Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan
| | - Shuichi Taniguchi
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan.,Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Kazuma Kishi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan.,Department of Respiratory Medicine, Toranomon Hospital Kajigaya, Kawasaki, Kanagawa, Japan.,Okinaka Memorial Institute for Medical Research, Tokyo, Japan.,Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
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30
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Yuasa M, Yamamoto H, Mitsuki T, Kageyama K, Kaji D, Taya Y, Nishida A, Ishiwata K, Takagi S, Yamamoto G, Asano-Mori Y, Wake A, Koike Y, Makino S, Uchida N, Taniguchi S. Prognostic Impact of Cytogenetic Evolution on the Outcome of Allogeneic Stem Cell Transplantation in Patients with Acute Myeloid Leukemia in Nonremission: A Single-Institute Analysis of 212 Recipients. Biol Blood Marrow Transplant 2020; 26:2262-2270. [PMID: 32871257 DOI: 10.1016/j.bbmt.2020.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 08/16/2020] [Accepted: 08/22/2020] [Indexed: 12/16/2022]
Abstract
Recent progress in genetic analysis technology has helped researchers understand the pathogenesis of acute myeloid leukemia (AML). Considering this progress, AML karyotype is still one of the most significant prognostic factors that provides risk-adapted treatment approaches. Karyotype changes during treatment have been observed at times, but their prognostic impact is sparse, especially on allogeneic stem cell transplantation (allo-SCT). Here, we retrospectively investigated the effect of chromosomal changes between diagnosis and pretransplantation on the prognosis of allo-SCT by analyzing the outcomes of 212 consecutive patients who underwent allo-SCT for the first time at Toranomon Hospital, Tokyo, Japan, between 2008 and 2018. Cytogenetic abnormalities at diagnosis and pretransplantation were categorized based on the 2017 European Leukemia Net risk stratification. Genetic abnormalities such as FLT3-ITD and NPM1 were not considered in this study due to lack of genetic information in most patients. We defined cytogenetic evolution as chromosomal changes classified from lower category to higher category. Seventeen patients (8%) had cytogenetic evolution between diagnosis and pretransplantation, and they showed a significantly worse relapse rate than those who were categorized in the intermediate group based on the karyotype at diagnosis (3-year confidence interval [CI] of relapse, 57.4% versus 24.9%; P < .01). In multivariate analysis, cytogenetic evolution before allo-SCT had a significant impact on the CI of relapse (hazard ratio [HR], 3.89; CI, 1.75 to 8.67; P < .01), as well as the high score of the hematopoietic cell transplantation-specific comorbidity index (HR, 0.54; CI, 0.31 to 0.94; P = .03), but had no significant impact on overall survival or nonrelapse mortality. These results indicate that cytogenetic evolution has a significant impact after allo-SCT and should be considered during AML treatment.
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Affiliation(s)
| | | | - Takashi Mitsuki
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Aya Nishida
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Kazuya Ishiwata
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital Kajigaya, Kanagawa, Japan
| | - Yukako Koike
- Department of Clinical Laboratory, Toranomon Hospital, Tokyo, Japan
| | - Shigeyoshi Makino
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan.
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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31
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Nitahara K, Fujita Y, Magarifuchi N, Taniguchi S, Shimamoto T. Maternal characteristics and neonatal outcomes of emergency repeat caesarean deliveries due to early-term spontaneous labour onset. Aust N Z J Obstet Gynaecol 2020; 61:48-54. [PMID: 32783334 DOI: 10.1111/ajo.13225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The optimal timing of elective repeat caesarean delivery has yet to be determined. One of the reasons to schedule an elective repeat caesarean delivery before 39 weeks gestation is to avoid emergency caesarean delivery due to spontaneous onset of labour. AIMS By ascertaining maternal characteristics and neonatal outcomes associated with early-term onset of spontaneous labour, we aim to determine the optimal timing for each individual repeat caesarean delivery. MATERIALS AND METHODS We performed a retrospective analysis of women with repeat caesarean deliveries planned at 38 weeks gestation between 2005 and 2019 at a tertiary referral hospital in Japan. A multivariate logistic regression analysis was adopted to identify independent contributing factors for early-term spontaneous labour onset. We also compared the rate of neonatal adverse events between women who underwent emergency repeat caesarean deliveries due to the onset of early-term labour and the ones who underwent elective repeat caesarean deliveries at 38 weeks. RESULTS We included 1152 women. History of vaginal deliveries (adjusted odds ratio (AOR), 2.12; 95% confidence interval (95% CI), 1.21-3.74), history of preterm deliveries (AOR, 2.28; 95% CI, 1.38-3.77), and inadequate maternal weight gain during pregnancy (AOR, 1.78; 95% CI, 1.15-2.75) significantly increased the risk of early-term spontaneous labour onset. In terms of occurrence rate of neonatal complications, we found no significant difference between the groups. CONCLUSION These maternal factors are significant predictors for early-term labour onset of repeat caesarean deliveries. The onset of early-term labour did not increase the likelihood of neonatal complications.
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Affiliation(s)
- Kenta Nitahara
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Yasuyuki Fujita
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Naomi Magarifuchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Shuichi Taniguchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
| | - Tomihiro Shimamoto
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan
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32
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Inamoto T, Komura K, Uehara H, Ibuki N, Ichihashi A, Minami K, Taniguchi S, Hirano H, Nomi H, Azuma H. Bladder preserving tetra-modal therapy for octogenarian with localized muscle invasive bladder cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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33
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Yuasa M, Yamamoto H, Kageyama K, Kaji D, Taya Y, Takagi S, Yamamoto G, Asano-Mori Y, Wake A, Yoneyama A, Makino S, Uchida N, Taniguchi S. Splenomegaly Negatively Impacts Neutrophil Engraftment in Cord Blood Transplantation. Biol Blood Marrow Transplant 2020; 26:1689-1696. [PMID: 32505808 DOI: 10.1016/j.bbmt.2020.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/16/2020] [Accepted: 05/20/2020] [Indexed: 12/24/2022]
Abstract
Delayed neutrophil engraftment (NE) has been reported in cord blood transplantation (CBT) compared with other stem cell transplantation methods. The numbers of total nucleated cells (TNCs), CD34+ cells (generally ≥ 1 × 105/kg), and granulocyte/macrophage colony-forming units (CFU-GM) significantly impact NE. Splenomegaly exerts negative effects on NE, but the appropriate cell dose for the patients with splenomegaly has not yet been determined, especially in CBT. We retrospectively investigated the effect of splenomegaly and number of CD34+ cells infused on NE through the analysis of outcomes of 502 consecutive patients who underwent single CBT for the first time at Toranomon Hospital between 2011 and 2018. Spleen index, Lmax × Hvert (SI Lmax × Hvert), was defined as maximal length at any transverse section, (Lmax) × vertical height (Hvert), and splenomegaly was defined as SI Lmax × Hvert ≥ 115 cm2. Our results show that splenomegaly (hazard ratio [HR], .60; P < .01) and low dose of infused CD34+ cells (HR, .58; P < .01) had significant negative impact on NE, whereas neither CFU-GM dose nor TNC dose had any impact on NE in multivariate analysis. Other factors with a significant negative impact on NE in multivariate analysis were myeloid disease (HR, .62; P < .01), nonremission status at CBT (HR, .71; P < .01), low Eastern Cooperative Oncology Group Performance Status (HR, .68; P < .01), and graft-versus-host disease prophylaxis (other than tacrolimus alone) (HR, .76; P < .01). Without splenomegaly, even patients infused with < .8 × 105/kg CD34+ cells achieved up to 94.3% NE, with the median value observed at 21 days post-CBT. This study shows that splenomegaly has a significant negative impact on NE after CBT. Cord blood units with < .8 × 105/kg CD34+ cells may still be a suitable choice for patients without splenomegaly.
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Affiliation(s)
| | | | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kaji
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Yuki Taya
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Atsushi Wake
- Department of Hematology, Toranomon Hospital, Kanagawa, Japan
| | - Akiko Yoneyama
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - Shigeyoshi Makino
- Department of Transfusion Medicine, Toranomon Hospital, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan.
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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34
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Hendawy AO, Shirai M, Takeya H, Sugimura S, Miyanari S, Taniguchi S, Sato K. Effects of 5-aminolevulinic acid supplementation on milk production, iron status, and immune response of dairy cows. J Dairy Sci 2019; 102:11009-11015. [PMID: 31587902 DOI: 10.3168/jds.2018-15982] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 06/12/2019] [Indexed: 02/02/2023]
Abstract
The objective of this study was to investigate the effect of 5-aminolevulinic acid (5-ALA) as a dietary supplement on milk yield and composition as well as iron status and immune response in lactating dairy cows. In this study 13 lactating Holstein cows were randomly assigned to either a control group or a treatment group supplemented with 10 mg of 5-ALA per kilogram of dry matter. During feeding, 5-ALA was mixed with a small amount of the total mixed ration and top-dressed. The experiments followed a crossover design with 2 periods. Each period consisted of an adaptation period of 12 d and a test period of 2 d. Dairy cows fed the diet supplemented with 5-ALA exhibited increased counts of white blood cells and granulocytes compared with the control group. The rate of phagocytosis and mitogen-induced proliferation of peripheral blood mononuclear cells in cows fed 5-ALA were higher than in cows fed a basal diet. However, 5-ALA did not affect iron status or plasma biochemical composition. Supplementation with 5-ALA improved milk protein and milk casein contents; however, it had no effect on milk production, milk fat, lactose, total solids, or solids-not-fat, compared with the control. We conclude that dietary supplementation of 5-ALA to lactating dairy cows may have a positive effect on milk protein synthesis and the immune response.
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Affiliation(s)
- A O Hendawy
- Department of Biological Production, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - M Shirai
- Department of Biological Production, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - H Takeya
- Department of Biological Production, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - S Sugimura
- Department of Biological Production, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | | | | | - K Sato
- Department of Biological Production, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan.
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35
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Kizawa R, Miura Y, Oda Y, Nagaoka Y, Masuda J, Ozaki Y, Kondoh C, Moriguchi S, Takahashi Y, Ogawa K, Hashimoto YT, Taniguchi S, Okaneya T, Kishi A, Hayashi N, Takaya H, Takano T. Eosinophilia during treatment of immune checkpoint inhibitors (ICIs) predicts succeeding onset of immune-related adverse events (irAEs). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Yuasa M, Shiiba M, Kaji D, Kageyama K, Nishida A, Takagi S, Yamamoto H, Asano-Mori Y, Uchida N, Ishihara M, Izutsu K, Taniguchi S, Yamamoto G. CLINICAL SIGNIFICANCE OF UPTAKE VALUE ON F18-FDG PET/CT AND HISTOLOGICAL GRADE IN 164 PATIENTS WITH FOLLICULAR LYMPHOMA INCLUDING TRANSFORMATION - A SINGLE CENTER RETROSPECTIVE STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.63_2631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Yuasa
- Hematology; Toramono Hospital; Tokyo Japan
| | - M. Shiiba
- Dignostic Imaging Center; Toramono Hospital; Tokyo Japan
| | - D. Kaji
- Hematology; Toramono Hospital; Tokyo Japan
| | | | - A. Nishida
- Hematology; Toramono Hospital; Tokyo Japan
| | - S. Takagi
- Hematology; Toramono Hospital; Tokyo Japan
| | | | | | - N. Uchida
- Hematology; Toramono Hospital; Tokyo Japan
| | - M. Ishihara
- Dignostic Imaging Center; Toramono Hospital; Tokyo Japan
| | - K. Izutsu
- Hematology; National Cancer Center Hospital; Tokyo Japan
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Kurosawa S, Yamaguchi T, Oshima K, Yanagisawa A, Fukuda T, Kanamori H, Mori T, Takahashi S, Kondo T, Kohno A, Miyamura K, Umemoto Y, Teshima T, Taniguchi S, Yamashita T, Inamoto Y, Kanda Y, Okamoto S, Atsuta Y. Resolved versus Active Chronic Graft-versus-Host Disease: Impact on Post-Transplantation Quality of Life. Biol Blood Marrow Transplant 2019; 25:1851-1858. [PMID: 31129353 DOI: 10.1016/j.bbmt.2019.05.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/05/2019] [Accepted: 05/11/2019] [Indexed: 12/16/2022]
Abstract
The aim of this study was to determine whether impaired quality of life (QOL) persisted among patients who experienced resolved chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic cell transplantation (allo-HCT). Eligible participants were patients who were relapse-free for 3 years after allo-HCT who were age ≥16 years at the time of transplantation and age ≥20 years without relapse at the time of the survey. The Medical Outcomes Study's 36-Item Short-Form Survey (SF-36), the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT), and a visual analog scale (VAS) were administered to assess QOL. Physicians evaluated the current status of chronic GVHD at survey using National Institutes of Health (NIH) criteria, and pretransplantation characteristics and history of GVHD were extracted from the national transplant registry database. Patients without currently active GVHD but with a history of chronic GVHD were categorized as having "resolved GVHD." Of 1250 patients informed of the study, 1216 provided consent and 1130 were included in the final analysis. A total of 745 patients (66%) had currently active chronic GVHD, 149 (13%) had resolved chronic GVHD, and 236 (21%) never had chronic GVHD after allo-HCT. Multivariable analyses showed that compared with patients with resolved or no chronic GVHD, those with active chronic GVHD reported significantly poorer QOL. The QOL scores were similar in patients with resolved chronic GVHD and those without chronic GVHD. Greater between-group differences were observed in SF-36 Physical component and VAS scores in patients age ≥50 years, but the differences were not statistically significant. Our data indicate that only currently active chronic GVHD has a significant impact on physical, mental, and social QOL in allo-HCT survivors, whereas previous chronic GVHD does not impair QOL if it has been resolved.
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Affiliation(s)
- Saiko Kurosawa
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kumi Oshima
- Department of Hematology, Jyoban Hospital, Tokiwa Foundation, Fukushima, Japan
| | - Atsumi Yanagisawa
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Takahashi
- Department of Hematology and Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tadakazu Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akio Kohno
- Department of Hematology and Oncology, JA Aichi Konan Kosei Hospital, Konan, Japan
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Yukari Umemoto
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Takanori Teshima
- Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Takuya Yamashita
- Department of Hematology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan; Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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38
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Kizawa R, Miura Y, Oda Y, Nagaoka Y, Ozaki Y, Kondoh C, Moriguchi S, Takahashi Y, Ogawa K, Tanabe-Hashimoto Y, Taniguchi S, Okaneya T, Kishi A, Hayashi N, Kishi K, Takano T, Masuda J. Eosinophilia during treatment of immune checkpoint inhibitors (ICIs) to predict succeeding onset of immune-related adverse events (irAEs). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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
e14110 Background: ICIs such as anti-PD-1/-L1 Inhibitor and anti-CTLA-4 Inhibitor have been used in many types of cancer, and irAEs occur in a considerable proportion of patients. Predictive biomarkers could help us to manage irAEs promptly. Methods: We retrospectively analyzed the consecutive patients treated with nivolumab, pembrolizumab, atezolizumab or ipilimumab, not used as investigational drugs, between March 2015 and December 2018 based on the electric medical records in our institution. We evaluated the relationship between clinical and laboratory factors (gender, age, body mass index, lymphocyte-to-monocyte ratio and eosinophilia) and the occurrence of irAEs using univariate and multivariate analyses. Eosinophilia was defined as absolute eosinophil count over 500/mm3 at least once between initiation of treatment and the occurrence of irAEs. We graded irAEs according to CTCAE v. 5.0. Results: Among 139 patients analyzed in this study, 136, 13 and 6 patients were treated with PD-1, PD-L1 and CTLA-4 inhibitors, respectively (cumulative total of 155 patients). This study included non-small cell lung cancer (n = 78; 56.1%), renal cell carcinoma (n = 17; 12.2%), melanoma (n = 16; 11.5%), gastric cancer (n = 15; 10.8%), Hodgkin lymphoma (n = 7; 5.0%), urothelial carcinoma (n = 3; 2.2%), head and neck carcinoma (n = 3; 2.2%) and mesothelioma (n = 1; 0.7%). Any grade and grade 3-5 irAEs occurred in 60 (38.7%) and 23 (14.8%) cumulative patients, respectively. The most common irAEs in any grade were endocrine disorders including thyroid dysfunction and adrenal insufficiency (n = 21) and skin disorders (n = 20). Eosinophilia occurred in 43 cumulative patients (27.7%). Eighteen patients out of them had eosinophilia from baseline. Among the clinical and laboratory factors, only eosinophilia was significantly associated with the occurrence of any grade of irAEs in both univariate (p = 0.0193) and multivariate (p = 0.0464) analysis. Notably, endocrine irAEs were significantly related to eosinophilia (p = 0.0287). Conclusions: Eosinophilia after the initiation of treatment with ICIs predicts succeeding onset of irAEs.
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Affiliation(s)
- Rika Kizawa
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Yuji Miura
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Yasuhiro Oda
- Department of Pharmacy, Toranomon Hospital, Tokyo, Japan
| | | | - Yukinori Ozaki
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Chihiro Kondoh
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Shuhei Moriguchi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Yui Takahashi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Kazumasa Ogawa
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | | | | | | | - Akiko Kishi
- Department of Dermatology, Toranomon Hospital, Tokyo, Japan
| | | | - Kazuma Kishi
- Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Tokyo, Japan
| | - Toshimi Takano
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Jun Masuda
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
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39
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Makita E, Kuroda S, Itabashi K, Taniguchi S, Maruyama A, Sato H, Ichihashi K. Two Neonatal Cases of Food Protein-Induced Enterocolitis Syndrome With Pale Stool and Transient Biliary Dilatation. J Investig Allergol Clin Immunol 2019; 29:158-159. [PMID: 31017121 DOI: 10.18176/jiaci.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E Makita
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - S Kuroda
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan.,Department of Pediatrics, Saitama Red Cross Hospital, Saitama, Japan
| | - K Itabashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - S Taniguchi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - A Maruyama
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - H Sato
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - K Ichihashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
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40
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Sugita J, Ota S, Kamimura T, Omoto E, Kuroha T, Matsuo K, Akashi K, Taniguchi S, Harada M, Teshima T. The Impact of Reduced Dose of Posttransplant Cyclophosphamide in HLA-Haploidentical Peripheral Blood Stem Cell Transplantation. Biol Blood Marrow Transplant 2019. [DOI: 10.1016/j.bbmt.2018.12.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cipro CVZ, Bustamante P, Taniguchi S, Silva J, Petry MV, Montone RC. Seabird colonies as relevant sources of pollutants in Antarctic ecosystems: Part 2 - Persistent Organic Pollutants. Chemosphere 2019; 214:866-876. [PMID: 30317167 DOI: 10.1016/j.chemosphere.2018.09.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/03/2018] [Accepted: 09/04/2018] [Indexed: 06/08/2023]
Abstract
Despite typically not being taken into account (usually in favour of the 'global distillation' process), the input of persistent organic pollutants (POPs) through biological activities can be indeed relevant at the local scale in terrestrial polar environments when seabird colonies are considered. Seabirds can bioaccumulate and biomagnify POPs, gather in large numbers and excrete on land during their reproductive season, thus making them locally as relevant secondary sources of POPs. The first part of this study indicated that these colonies act as so for several essential and non-essential trace elements, and this second part tests the same hypothesis concerning POPs using the very same samples. Lichens (n = 55), mosses (n = 58) and soil (n = 37) were collected from 13 locations in the South Shetlands Archipelago during the austral summers of 2013-14 and 2014-15. They were divided in colony (within the colony itself for soil and within and surrounding the colony for vegetation) and control (at least 150 m away from any colony interference) and analysed for POPs such as organochlorine pesticides, polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers and stable isotopes (C and N). Results showed that colonies act clearly as a secondary source for PCBs and likely for hexachlorobenzene. As in the first part, probable local sources other than the colonies themselves are hypothesised because of high concentrations found in control sites. Again, soil seemed the most adequate matrix for the intended purposes especially because of some particularities in the absorption of animal-derived organic matter by vegetation, pointed out by stable isotope analyses.
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Affiliation(s)
- C V Z Cipro
- Laboratório de Química Orgânica Marinha, Instituto Oceanográfico (LabQOM), Universidade de São Paulo, Praça do Oceanográfico n° 191, 05508-120, São Paulo, SP, Brazil; Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, 17042 La Rochelle Cedex 01, France.
| | - P Bustamante
- Littoral Environnement et Sociétés (LIENSs), UMR 7266, CNRS-Université de La Rochelle, 2 rue Olympe de Gouges, 17042 La Rochelle Cedex 01, France
| | - S Taniguchi
- Laboratório de Química Orgânica Marinha, Instituto Oceanográfico (LabQOM), Universidade de São Paulo, Praça do Oceanográfico n° 191, 05508-120, São Paulo, SP, Brazil
| | - J Silva
- Laboratório de Química Orgânica Marinha, Instituto Oceanográfico (LabQOM), Universidade de São Paulo, Praça do Oceanográfico n° 191, 05508-120, São Paulo, SP, Brazil
| | - M V Petry
- Laboratório de Ornitologia e Animais Marinhos, Universidade do Vale do Rio dos Sinos, Av. Unisinos n° 950, Cristo Rei, São Leopoldo, Rio Grande do Sul, 93022-750, Brazil
| | - R C Montone
- Laboratório de Química Orgânica Marinha, Instituto Oceanográfico (LabQOM), Universidade de São Paulo, Praça do Oceanográfico n° 191, 05508-120, São Paulo, SP, Brazil
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Hirano H, Matsunaga T, Maenosono R, Taniguchi S, Uehara H, Nomi H, Kano Y, Fujiwara Y, Ichihashi A, Kobayashi D, Tsutsumi T, Komura K, Ibuki N, Inamoto T, Matsumura H, Ashida A, Azuma H. Effect of Systematic Conversion to Generic Mycophenolate Mofetil (MMF) in Kidney Transplantation: A Single-Center Clinical Experience from Japan. Transplant Proc 2018; 50:3255-3257. [PMID: 30577194 DOI: 10.1016/j.transproceed.2018.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 04/09/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Recently, more and more generic drugs have been used for immunosuppressive drugs in the field of organ transplantation. Some reports have indicated that blood concentration of most generic drugs is difficult to maintain stability, and it may cause the difference in graft survival of transplanted organs between original drugs and generic drugs. In this article, we report the cases could not maintain blood concentration of generic drugs of mycophenolate mofetil (MMF). RESULTS In 4 cases out of 5 cases that we had to change original MMF to generic MMF, there were cases that blood concentration level was not stabilized. There were possibility that the lowered blood concentration level of MMF caused a rejection, in two cases. Mean MMF trough level was decreased from 3.6 ± 1.9 μg/mL to 0.6 ± 0.4 μg/mL. Due to the early detection, it did not become severe or failure of graft function, however, we cannot deny the possibilities that side effects were increased and rejection rose. In these cases, we discontinued to use the generic drugs thereafter due to unstable plasma concentration of MMF. DISCUSSION Some reports have indicated that failure to maintain plasma concentration of MMF leads to rejection. Therefore, maintenance of effective plasma concentration and prevention of rejection are essential to long-term graft survival in kidney transplant. CONCLUSION Generic drug formulations may exhibit differences in effects and absorption compared to the brand-name drug. If the generic drug should be used, patients should be closely monitored.
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Affiliation(s)
- H Hirano
- Department of Urology, Osaka Medical College, Takatsuki, Japan.
| | - T Matsunaga
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - R Maenosono
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - S Taniguchi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Uehara
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Nomi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - Y Kano
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - Y Fujiwara
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - A Ichihashi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - D Kobayashi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - T Tsutsumi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - K Komura
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - N Ibuki
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - T Inamoto
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Matsumura
- Department of Pediatric, Osaka Medical College, Takatsuki, Japan
| | - A Ashida
- Department of Pediatric, Osaka Medical College, Takatsuki, Japan
| | - H Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Japan
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Hirano H, Maenosono R, Matsunaga T, Uehara H, Nomi H, Ichihashi A, Kobayashi D, Taniguchi S, Tsutsumi T, Tsujino T, Komura K, Ibuki N, Inamoto T, Azuma H. Safety of Elderly Living Kidney Donors: 2 Cases of Donors Older Than 80 Years: A Case Report. Transplant Proc 2018; 50:2569-2571. [PMID: 30316400 DOI: 10.1016/j.transproceed.2018.03.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/02/2018] [Indexed: 11/26/2022]
Abstract
Much controversy exists over the performance of elderly living donor kidney transplantation. We report the safety of 2 cases of elderly living kidney donations in our hospital. CASE 1: An 82-year-old man was a living kidney donor for his 56-year-old son. The donor suffered from hypertension, but has successfully managed his blood pressure with only one medication. His serum creatinine was 0.7 mg/dL and inulin clearance was 122.5 mL/min, which met the usual criteria for living kidney donors. This was his son's secondary kidney transplantation, and no other donors existed. CASE 2: An 80-year-old woman was a living kidney donor for her 45-year-old son. Her serum creatinine was 0.61 mg/dL and inulin clearance was 71.7 mL/min, which met the marginal kidney donor criteria. In both cases, we determined that the donor kidney function was acceptable. Though we explained the risks of the transplantation thoroughly, the patients' strong will to offer a kidney to their family member did not change. We decided to carry out the transplantation. At the time of publication, nearly 2 years have passed since the transplantation, but both donors and recipients are doing well. In the future, it seems more likely that the number of elderly living donor kidney transplantation will rise. On one hand, there is no absolute contraindication for elderly donors, while on the other hand, the criteria for a living kidney donor must be strictly examined. Furthermore, careful observation of both donors and recipients after transplantation is required.
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Affiliation(s)
- H Hirano
- Department of Urology, Osaka Medical College, Osaka, Japan.
| | - R Maenosono
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Matsunaga
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Uehara
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Nomi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - A Ichihashi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - D Kobayashi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - S Taniguchi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Tsutsumi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Tsujino
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - K Komura
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - N Ibuki
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Inamoto
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Azuma
- Department of Urology, Osaka Medical College, Osaka, Japan
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Mitsuki T, Kimura M, Araoka H, Kageyama K, Takagi S, Yamamoto G, Nakamura S, Miyazaki Y, Uchida N, Yoneyama A, Taniguchi S. Cryptococcal meningitis following umbilical cord blood transplantation, association between the occurrence of cryptococcal infection and tacrolimus discontinuation among allogeneic hematopoietic stem cell recipients. J Infect Chemother 2018; 25:289-292. [PMID: 30316744 DOI: 10.1016/j.jiac.2018.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/18/2018] [Accepted: 09/13/2018] [Indexed: 12/01/2022]
Abstract
Few cases of cryptococcal infection following umbilical cord blood transplantation (UCBT) have been reported. We report a case, where cryptococcal infection occurred soon after rapidly reducing the dose of tacrolimus in a UCBT recipient who received micafungin prophylaxis during the early phase of transplantation. The etiology of cryptococcal infection following allogeneic hematopoietic stem cell transplantation (allo-HSCT), including UCBT, might be associated with rapid dose-reduction of calcineurin inhibitors, such as tacrolimus during early phase of allo-HSCT. To our knowledge, this is the first English-language report to describe in detail a case of cryptococcal meningitis with fungemia during early phase of UCBT.
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Affiliation(s)
| | - Muneyoshi Kimura
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan.
| | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Kosei Kageyama
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | | | - Go Yamamoto
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Akiko Yoneyama
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Shuichi Taniguchi
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Okinaka Memorial Institute for Medical Research, Tokyo, Japan
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Kurosawa S, Yamaguchi T, Oshima K, Yanagisawa A, Fukuda T, Kanamori H, Mori T, Takahashi S, Kondo T, Fujisawa S, Onishi Y, Yano S, Onizuka M, Kanda Y, Mizuno I, Taniguchi S, Yamashita T, Inamoto Y, Okamoto S, Atsuta Y. Employment status was highly associated with quality of life after allogeneic hematopoietic cell transplantation, and the association may differ according to patient age and graft-versus-host disease status: analysis of a nationwide QOL survey. Bone Marrow Transplant 2018; 54:611-615. [PMID: 30287939 DOI: 10.1038/s41409-018-0343-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Saiko Kurosawa
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kumi Oshima
- Department of Hematology, Jyoban Hospital, Tokiwa Foundation, Fukushima, Japan
| | - Atsumi Yanagisawa
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Takahashi
- Department of Hematology and Oncology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tadakazu Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Onishi
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Shingo Yano
- Department of Clinical Oncology and Hematology, The Jikei University School of Medicine, Tokyo, Japan
| | - Makoto Onizuka
- Department of Hematology/Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Ishikazu Mizuno
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | | | - Takuya Yamashita
- Department of Hematology, St. Luke's International Hospital, Tokyo, Japan
| | - Yoshihiro Inamoto
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - Shinichiro Okamoto
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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46
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Nishio S, Aihara S, Shimokawa M, Fujishita A, Taniguchi S, Hachisuga T, Yanazume S, Kobayashi H, Murakami F, Numa F, Kotera K, Okura N, Toki N, Yokoyama M, Ushijima K. Efficacy of palonosetron plus dexamethasone in preventing chemotherapy-induced nausea and emesis in patients receiving carboplatin-based chemotherapy for gynecologic cancers: a phase II study by the West Japan Gynecologic Oncology Group (WJGOG 131). J Gynecol Oncol 2018; 29:e77. [PMID: 30022637 PMCID: PMC6078893 DOI: 10.3802/jgo.2018.29.e77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/23/2018] [Accepted: 05/10/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Palonosetron is effective for the management of acute and delayed chemotherapy-induced nausea and vomiting (CINV). While emetogenic carboplatin-based chemotherapy is widely used to treat gynecologic cancers, few studies have evaluated the antiemetic effectiveness of palonosetron in this setting. METHODS A multicenter, single-arm, open-label phase II trial was conducted to evaluate the safety and effectiveness of palonosetron in controlling CINV in patients with gynecologic cancer. Chemotherapy-naïve patients received intravenous palonosetron (0.75 mg/body) and dexamethasone before the infusion of carboplatin-based chemotherapy on day 1. Dexamethasone was administered (orally or intravenously) on days 2-3. The incidence and severity of CINV were evaluated using the patient-completed Multinational Association of Supportive Care in Cancer Antiemesis Tool and treatment diaries. The primary endpoint was the proportion of patients experiencing complete control (CC) of vomiting, with "no rescue antiemetic medication" and "no clinically significant nausea" or "only mild nausea" in the delayed phase (24-120 hours post-chemotherapy). Secondary endpoints were the proportion of patients with a complete response (CR: "no vomiting" and "no rescue antiemetic medication") in the acute (0-24 hours), delayed (24-120 hours), and overall (0-120 hours) phases, and CC in the acute and overall phases. RESULTS Efficacy was assessable in 77 of 80 patients recruited. In the acute and delayed phases, the CR rates the primary endpoint, were 71.4% and 59.7% and the CC rates, the secondary endpoint, were 97.4% and 96.1%, respectively. CONCLUSION While palonosetron effectively controls acute CINV, additional antiemetic management is warranted in the delayed phase after carboplatin-based chemotherapy in gynecologic cancer patients (Trial registry at UMIN Clinical Trials Registry, UMIN000012806).
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Affiliation(s)
- Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan.
| | - Satomi Aihara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | | | - Akira Fujishita
- Department of Obstetrics and Gynecology, Saiseikai Nagasaki Hospital, Nagasaki, Japan
| | - Shuichi Taniguchi
- Department of Obstetrics and Gynecology, Miyazaki Prefectural Hospital, Miyazaki, Japan
| | - Toru Hachisuga
- Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shintaro Yanazume
- Department of Gynecology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Kagoshima University School of Medicine, Kagoshima, Japan
| | - Fumihiro Murakami
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Kurume, Japan
| | - Fumitaka Numa
- Department of Obstetrics and Gynecology, Tokuyama Central Hospital, Shunan, Japan
| | - Kohei Kotera
- Department of Obstetrics and Gynecology, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | - Naofumi Okura
- Department of Obstetrics and Gynecology, NHO Kokura Medical Center, Kitakyushu, Japan
| | - Naoyuki Toki
- Department of Obstetrics and Gynecology, Kyushu Rosai Hospital, Kitakyushu, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Kimio Ushijima
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Japan
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Kawamura K, Nakasone H, Kurosawa S, Yoshimura K, Misaki Y, Gomyo A, Hayakawa J, Tamaki M, Akahoshi Y, Kusuda M, Kameda K, Wada H, Ishihara Y, Sato M, Terasako-Saito K, Kikuchi M, Kimura SI, Tanihara A, Kako S, Kanamori H, Mori T, Takahashi S, Taniguchi S, Atsuta Y, Kanda Y. Refractory Graft-Versus-Host Disease–Free, Relapse-Free Survival as an Accurate and Easy-to-Calculate Endpoint to Assess the Long-Term Transplant Success. Biol Blood Marrow Transplant 2018; 24:1521-1526. [DOI: 10.1016/j.bbmt.2018.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/07/2018] [Indexed: 12/20/2022]
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48
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Saito Y, Mochizuki Y, Ogahara I, Watanabe T, Hogdal L, Takagi S, Sato K, Kaneko A, Kajita H, Uchida N, Fukami T, Shultz LD, Taniguchi S, Ohara O, Letai AG, Ishikawa F. Overcoming mutational complexity in acute myeloid leukemia by inhibition of critical pathways. Sci Transl Med 2018; 9:9/413/eaao1214. [PMID: 29070697 DOI: 10.1126/scitranslmed.aao1214] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/25/2017] [Indexed: 12/16/2022]
Abstract
Numerous variant alleles are associated with human acute myeloid leukemia (AML). However, the same variants are also found in individuals with no hematological disease, making their functional relevance obscure. Through NOD.Cg-PrkdcscidIl2rgtmlWjl/Sz (NSG) xenotransplantation, we functionally identified preleukemic and leukemic stem cell populations present in FMS-like tyrosine kinase 3 internal tandem duplication-positive (FLT3-ITD)+ AML patient samples. By single-cell DNA sequencing, we identified clonal structures and linked mutations with in vivo fates, distinguishing mutations permissive of nonmalignant multilineage hematopoiesis from leukemogenic mutations. Although multiple somatic mutations coexisted at the single-cell level, inhibition of the mutation strongly associated with preleukemic to leukemic stem cell transition eliminated AML in vivo. Moreover, concurrent inhibition of BCL-2 (B cell lymphoma 2) uncovered a critical dependence of resistant AML cells on antiapoptotic pathways. Co-inhibition of pathways critical for oncogenesis and survival may be an effective strategy that overcomes genetic diversity in human malignancies. This approach incorporating single-cell genomics with the NSG patient-derived xenograft model may serve as a broadly applicable resource for precision target identification and drug discovery.
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Affiliation(s)
- Yoriko Saito
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Yoshiki Mochizuki
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Ikuko Ogahara
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Takashi Watanabe
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Leah Hogdal
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Shinsuke Takagi
- Department of Hematology, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Kaori Sato
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Akiko Kaneko
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Hiroshi Kajita
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Naoyuki Uchida
- Department of Hematology, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Takehiro Fukami
- RIKEN Program for Drug Discovery and Medical Technology Platforms, Yokohama, Kanagawa 230-0045, Japan
| | | | | | - Osamu Ohara
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan.,Kazusa DNA Research Institute, Kisarazu, Chiba 292-0818, Japan
| | - Anthony G Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Fumihiko Ishikawa
- Laboratory for Human Disease Models, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan.
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Moriguchi S, Abe M, Kimura M, Yoshino C, Baba M, Okada C, Izutsu K, Taniguchi S, Araoka H, Yoneyama A. The Diagnosis of Legionella pneumophila Serogroup 5 Bacteremic Pneumonia during Severe Neutropenia Using Loop-mediated Isothermal Amplification. Intern Med 2018; 57:1045-1048. [PMID: 29269681 PMCID: PMC5919869 DOI: 10.2169/internalmedicine.9810-17] [Citation(s) in RCA: 2] [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] [Received: 07/12/2017] [Accepted: 07/31/2017] [Indexed: 11/13/2022] Open
Abstract
A 60-year-old man developed pneumonia after undergoing autologous peripheral blood stem cell transplantation for diffuse large-B cell lymphoma. A urinary antigen test and sputum culture were both negative for Legionella pneumophila; however, a sputum sample that was examined by loop-mediated isothermal amplification (LAMP) was positive for Legionella spp. On admission, the results of blood culturing using a BACTEC system were negative for 7 days. However, L. pneumophila serogroup 5 was detected in a blood subculture using WYOα medium. The patient was successfully treated with a fluoroquinolone-based regimen. LAMP is useful for the diagnosis of Legionella spp.
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Affiliation(s)
| | - Masahiro Abe
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | | | - Chiemi Yoshino
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | - Masaru Baba
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | - Chikako Okada
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | - Koji Izutsu
- Department of Hematology, Toranomon Hospital, Japan
| | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital, Japan
| | - Akiko Yoneyama
- Department of Infectious Diseases, Toranomon Hospital, Japan
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50
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Ueda T, Mizuguchi K, Tsuji T, Tabayashi N, Abe T, Naito H, Takewa Y, Taniguchi S. Regulation of Perfusion Pressure during Cardiopulmonary bypass using Sevoflurane. Int J Artif Organs 2018. [DOI: 10.1177/039139880102400106] [Citation(s) in RCA: 4] [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: 11/15/2022]
Abstract
In hypothermic cardiopulmonary bypass (CPB), various vasodilators are used to control the perfusion pressure. These agents, however, often decrease the pressure excessively, and the low perfusion pressure may persist until the end of CPB. In this study we evaluate the safety and characteristics of the regulation of perfusion pressure during CPB using a volatile anesthetic, sevoflurane which has an extremely low partition coefficient. Twenty adult patients who underwent cardiac surgery were studied. Sevoflurane was applied by a vaporizer inserted into the oxygenator gas supply line. Pump flows were fixed at 2.4 L/min/m2 during the hypothermic period. Sevoflurane concentration was adjusted to keep mean arterial pressure (MAP) between 40 and 70 mmHg during CPB. Hemodynamic and metabolic parameters were measured and compared to the group we previously treated with chlorpromazine. In all cases, MAP could be maintained adequately. In the sevoflurane group, systemic vascular resistance indices (SVRI) during the rewarming period and at the end of CPB were higher, and doses of norepinephrine needed at the end of CPB were significantly lower than in the chlorpromazine group. The regulation of perfusion pressure during CPB using sevoflurane was safe and could easily maintain adequate SVRI.
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Affiliation(s)
- T. Ueda
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - K. Mizuguchi
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - T. Tsuji
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - N. Tabayashi
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - T. Abe
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - H. Naito
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - Y. Takewa
- Department of Surgery III, Nara Medical University, Nara - Japan
| | - S. Taniguchi
- Department of Surgery III, Nara Medical University, Nara - Japan
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