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Sakamoto K, Miyazaki O, Shioda Y. Honeycomb lung appearance accompanied by pediatric Langerhans cell histiocytosis: changes in imaging findings following chemotherapy. Int J Hematol 2024:10.1007/s12185-024-03776-2. [PMID: 38622431 DOI: 10.1007/s12185-024-03776-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/04/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Affiliation(s)
- Kenichi Sakamoto
- Department of Pediatrics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
- Department of Pediatrics, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
| | - Osamu Miyazaki
- Departments of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Department of Pediatrics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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2
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Morimoto A, Sakamoto K, Kudo K, Shioda Y. [Central nervous system disorders secondary to histiocytoses: neurodegeneration with potential for improvement]. Rinsho Shinkeigaku 2024; 64:85-92. [PMID: 38281751 DOI: 10.5692/clinicalneurol.cn-001899] [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] [Indexed: 01/30/2024]
Abstract
Histiocytoses, including Langerhans cell histiocytosis (LCH) and Erdheim-Chester disease (ECD), are inflammatory myeloid tumors in which monocyte lineage cells aggregate in various organs, causing tissue damage. Most of these tumors harbor oncogenic mutations in mitogen-activated protein kinase (MAPK) pathway genes, typified by BRAFV600E. Some patients with LCH develop bilateral symmetrical cerebellar lesions and brain atrophy several years after diagnosis when the initial symptoms disappear, leading to cerebellar ataxia and higher cerebral dysfunction. A similar neurological disorder has also been reported in ECD. This neurological disorder can be improved with MAPK inhibitors. When patients with this neurological disorder are identified among neurodegeneration of unknown etiology or histiocytosis patients and treated early with MAPK inhibitors, the disorder can be reversible.
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Affiliation(s)
| | | | - Ko Kudo
- Department of Pediatrics, Hirosaki University School of Medicine
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development
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Imai T, Sakamoto K, Hasegawa T, Shioda Y, Tsutsumi Y, Sakaue S, Imamura T, Morimoto A, Iehara T. Cerebellar peduncle damage in Langerhans cell histiocytosis-associated neurodegenerative disease revealed by diffusion tensor imaging. Neuroradiology 2024; 66:43-54. [PMID: 37983002 DOI: 10.1007/s00234-023-03249-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/12/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE To confirm the hypothesis that brain white matter damage is involved in the pathogenesis and disease progression of Langerhans cell histiocytosis (LCH)-associated neurodegenerative disease (ND), we aimed to analyze pediatric patients with LCH using diffusion tensor imaging (DTI). METHODS We enrolled 33 patients with LCH and obtained 33 DTI datasets. Using DTI-based tractography, fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD) were measured in the cerebral and cerebellar white matter tracts. The participants were divided into three groups-non-ND, ND without clinical symptoms (r-ND), and ND with clinical symptoms (c-ND)-according to their clinical status during the examination with DTI. We compared the DTI parameters in white matter tracts were compared among the three groups. RESULTS In the order of non-ND, r-ND, and c-ND groups, the FA in superior cerebellar peduncle (SCP) and middle cerebellar peduncle (MCP) significantly decreased, the ADC, AD, and RD of MCP, and the RD of SCP were significantly elevated (FA-SCP; p < 0.001, FA-MCP; p = 0.026, ADC-MCP; p < 0.001, AD-MCP; p = 0.002, RD-MCP; p = 0.003, and RD-SCP; p = 0.018). Furthermore, in the simple linear regression analysis, the FA, ADC, AD, and RD values in the MCP and the FA value in the SCP were significantly influenced by the presence of neurological symptoms and ND findings on MRI (all p < 0.001). CONCLUSION In LCH-ND, we identified microstructural damage in the SCP and MCP. DTI parameters in these tracts may help monitor LCH-ND; therefore, future studies are required to validate these results in a large cohort.
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Affiliation(s)
- Tomohiko Imai
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Kenichi Sakamoto
- Departments of Pediatrics, Shiga University of Medical Science, Shiga, Japan
| | - Tatsuji Hasegawa
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
| | - Yoko Shioda
- Departments of Pediatrics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiyuki Tsutsumi
- Departments of Radiology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Satoshi Sakaue
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Akira Morimoto
- Departments of Pediatrics, Showa Inan General Hospital, Komagane, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
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Ono R, Sakamoto K, Doi T, Yanagisawa R, Morimoto A, Kanegane H, Nakazawa Y, Shioda Y. Dexamethasone palmitate as an etoposide-free treatment for children with hemophagocytic lymphohistiocytosis after hematopoietic cell transplantation. Bone Marrow Transplant 2023; 58:1286-1288. [PMID: 37644136 DOI: 10.1038/s41409-023-02098-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Rintaro Ono
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Kenichi Sakamoto
- Department of Pediatrics, Shiga University of Medical Science, Shiga, Japan.
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Tochigi, Japan
- Department of Pediatrics, Showa Inan Hospital, Komagane, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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5
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Yoshida M, Nakabayashi K, Yang W, Sato-Otsubo A, Tsujimoto SI, Ogata-Kawata H, Kawai T, Ishiwata K, Sakamoto M, Okamura K, Yoshida K, Shirai R, Osumi T, Kiyotani C, Shioda Y, Terashima K, Ishimaru S, Yuza Y, Takagi M, Arakawa Y, Imamura T, Hasegawa D, Inoue A, Yoshioka T, Ito S, Tomizawa D, Koh K, Matsumoto K, Kiyokawa N, Ogawa S, Manabe A, Niwa A, Hata K, Yang JJ, Kato M. Prevalence of pathogenic variants in cancer-predisposing genes in second cancer after childhood solid cancers. Cancer Med 2023. [PMID: 37021926 DOI: 10.1002/cam4.5835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 02/17/2023] [Accepted: 03/11/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Second malignant neoplasms (SMNs) are one of the most severe late complications after pediatric cancer treatment. However, the effect of genetic variation on SMNs remains unclear. In this study, we revealed germline genetic factors that contribute to the development of SMNs after treatment of pediatric solid tumors. METHODS We performed whole-exome sequencing in 14 pediatric patients with SMNs, including three brain tumors. RESULTS Our analysis revealed that five of 14 (35.7%) patients had pathogenic germline variants in cancer-predisposing genes (CPGs), which was significantly higher than in the control cohort (p < 0.01). The identified genes with variants were TP53 (n = 2), DICER1 (n = 1), PMS2 (n = 1), and PTCH1 (n = 1). In terms of the type of subsequent cancer, leukemia and multiple episodes of SMN had an exceptionally high rate of CPG pathogenic variants. None of the patients with germline variants had a family history of SMN development. Mutational signature analysis showed that platinum drugs contributed to the development of SMN in three cases, which suggests the role of platinum agents in SMN development. CONCLUSIONS We highlight that overlapping effects of genetic background and primary cancer treatment contribute to the development of second cancers after treatment of pediatric solid tumors. A comprehensive analysis of germline and tumor samples may be useful to predict the risk of secondary cancers.
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Affiliation(s)
- Masanori Yoshida
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Wentao Yang
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Tennessee, Memphis, USA
| | - Aiko Sato-Otsubo
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shin-Ichi Tsujimoto
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hiroko Ogata-Kawata
- Department of Maternal-Fetal Biology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoko Kawai
- Department of Maternal-Fetal Biology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Keisuke Ishiwata
- Department of Maternal-Fetal Biology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Mika Sakamoto
- Medical Genome Center, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Kohji Okamura
- Department of Systems BioMedicine, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Kaoru Yoshida
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Ryota Shirai
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tomoo Osumi
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Sae Ishimaru
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
- Trial and Data Center, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Yuki Yuza
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuki Arakawa
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Daisuke Hasegawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Akiko Inoue
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Akira Niwa
- Department of Clinical Application, Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Department of Human Molecular Genetics, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Jun J Yang
- Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Tennessee, Memphis, USA
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, USA
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, Research Institute, National Center for Child Health and Development, Tokyo, Japan
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, The University of Tokyo, Tokyo, Japan
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Shimizu S, Sakamoto K, Kudo K, Morimoto A, Shioda Y. Detection of BRAF V600E mutation in radiological Langerhans cell histiocytosis-associated neurodegenerative disease using droplet digital PCR analysis. Int J Hematol 2023:10.1007/s12185-023-03588-w. [PMID: 37010809 DOI: 10.1007/s12185-023-03588-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/19/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023]
Abstract
Langerhans cell histiocytosis-associated neurodegenerative disease (LCH-ND) is the most serious late complication secondary to LCH and is gradually progressive, destructive, and irreversible. Detection of the BRAF V600E mutation in peripheral blood mononuclear cells (PBMCs), even in the absence of active LCH lesions, is considered a sign of clinical LCH-ND, presenting with both abnormal imaging findings and neurological symptoms. However, the detection of the BRAF V600E mutation in PBMCs of patients with asymptomatic radiological LCH-ND (rLCH-ND) without active LCH lesions who present only with abnormal imaging findings is unknown. In this study, we analyzed the BRAF V600E mutations in PBMCs and cell-free DNA (cfDNA) of patients with rLCH-ND without active LCH lesions (n = 5) using a droplet digital polymerase chain reaction (ddPCR) assay. The BRAF V600E mutation in PBMCs was detected in three out of five (60%) cases. The mutant allele frequencies in the three positive cases were 0.049%, 0.027%, and 0.015%, respectively. However, the cfDNA BRAF V600E mutation remained undetected in all patients. Detection of the BRAF V600E mutant allele in PBMCs may be helpful in identifying asymptomatic rLCH-ND in patients at high risk for developing LCH-ND, including those with relapses at CNS risk sites or central diabetes insipidus.
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Affiliation(s)
- Soichiro Shimizu
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
- Department of Pediatrics, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
| | - Ko Kudo
- Department of Pediatrics, Hirosaki University School of Medicine, Hirosaki, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Morimoto A, Shioda Y, Kudo K, Kanegane H, Imamura T, Koh K, Kosaka Y, Yuza Y, Nakazawa A, Saito AM, Watanabe T, Nakazawa Y. Intensification of treatment with vinca alkaloid does not improve outcomes in pediatric patients with Langerhans cell histiocytosis: results from the JPLSG LCH-12 study. Int J Hematol 2023:10.1007/s12185-023-03568-0. [PMID: 36871086 DOI: 10.1007/s12185-023-03568-0] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/06/2023]
Abstract
Chemotherapy with cytarabine, vincristine (VCR), and prednisolone has achieved low mortality rates in pediatric patients with Langerhans cell histiocytosis (LCH). However, relapse rates remain high, making event-free survival (EFS) rates unsatisfactory. A nationwide clinical trial, LCH-12, tested a modified protocol in which the early maintenance phase was intensified with increasing dosages of VCR. Patients newly diagnosed with multifocal bone (MFB) or multisystem (MS) LCH and aged < 20 years at diagnosis were enrolled between June 2012 and November 2017. Of the 150 eligible patients, 43 with MFB were treated for 30 weeks and 107 with MS LCH were treated for 54 weeks. One patient with MS LCH died of sepsis during the induction phase. The 3-year EFS rates among patients with MFB LCH, risk organ (RO)-negative MS LCH, and RO-positive MS LCH were 66.7% (95% confidential interval [CI], 56.5-77.0%), 66.1% (95% CI 52.9-76.4%), and 51.1% (95% CI 35.8-64.5%), respectively, similar to previously observed rates. EFS rates were significantly lower in patients with disease activity scores > 6 than in those with scores ≤ 6. The strategy that included more intense treatment with VCR was not effective. Other strategies are required to improve outcomes in patients with pediatric LCH.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan. .,Department of Pediatrics, Showa Inan General Hospital, 3230, Akaho, Komagane, Nagano, 399-4117, Japan.
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology/Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuki Yuza
- Departments of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Tomoyuki Watanabe
- Department of Health and Nutrition, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Sakamoto K, Morimoto A, Shioda Y, Imamura T, Imashuku S. Relapses of multisystem/multifocal bone Langerhans cell histiocytosis in paediatric patients: Data analysis from the JLSG-96/02 study. Br J Haematol 2023; 200:769-775. [PMID: 36511451 DOI: 10.1111/bjh.18583] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
We assessed relapse patterns in paediatric patients with relapsed Langerhans cell histiocytosis (LCH) who were initially treated with the JLSG-96/02 protocol. We analysed 187 relapse events in 101 relapsed LCH patients [31 with multifocal bone (MFB) and 70 with multisystem (MS) at LCH diagnosis] among a total 317 patients enrolled in JLSG-96/-02 studies. Relapse of LCH was defined as an exacerbation of the non-active disease (NAD) condition. Of the 317 patients, 101 (31.9%) had the first relapse at 1.5 years after initiation of therapy. The first relapse and subsequent relapses did not differ between patients with MFB and MS disease. Of the 187 relapse events, relapse occurred as a single-system disease (n = 159; 85%), in which isolated bone relapse (n = 104; 55%) was the most common. Relapse at MS disease with the risk of organ involvement is extremely rare. After relapse(s), most patients underwent chemotherapy (122/187; 65%) and 87% of them achieved NAD status again. The incidence of permanent consequences was significantly higher in patients with relapses than in those without relapses. In the JLSG cohort, bone relapse most occurred in both MFB and MS patients. Most relapses could be effectively controlled by repeated administration of the initial chemotherapy.
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Affiliation(s)
- Kenichi Sakamoto
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Imashuku
- Division of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
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Sakamoto K, Kikuchi K, Sako M, Kato M, Takimoto T, Shioda Y. Pilot study to estimate the safety and effectiveness of hydroxyurea and methotrexate recurrent langerhans cell histiocytosis (LCH-HU-pilot). Medicine (Baltimore) 2022; 101:e31475. [PMID: 36550910 PMCID: PMC9771280 DOI: 10.1097/md.0000000000031475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study was a non-blinded, multicenter, single-arm study. Recurrent (relapsed) LCH is defined as the appearance of new lesions or the enlargement of preexisting lesions due to LCH. In this study, all patients received hydroxyurea, and if the treatment response was unsatisfactory, methotrexate was added. The duration of treatment was 48 weeks. The primary endpoint was the rate of non-active disease achievement, which was 24 weeks after initiating hydroxyurea administration. No active disease is defined as the resolution of all the signs and symptoms related to LCH.
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Affiliation(s)
- Kenichi Sakamoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
| | - Kayoko Kikuchi
- Department of Clinical Research Promotion, Clinical Research Center, National Center for Child Health and Development, Setagaya, Tokyo, Japan
| | - Mayumi Sako
- Department of Clinical Research Promotion, Clinical Research Center, National Center for Child Health and Development, Setagaya, Tokyo, Japan
| | - Miho Kato
- Department of Cancer Data Management, National Center for Child Health and Development, Tokyo, Japan
| | - Tetsuya Takimoto
- Department of Cancer Data Management, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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10
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Sakamoto K, Shioda Y. Radiologic zebra line sign in a patient with Langerhans cell histiocytosis on bisphosphonate therapy. eJHaem 2022; 3:1046-1047. [PMID: 36051035 PMCID: PMC9421972 DOI: 10.1002/jha2.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Kenichi Sakamoto
- Department of Pediatrics Shiga University of Medical Science Otsu Japan
- Children's Cancer Center National Center for Child Health and Development Tokyo Japan
| | - Yoko Shioda
- Children's Cancer Center National Center for Child Health and Development Tokyo Japan
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11
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Shioda Y, Sakamoto K, Morimoto A. New biomarker paves the way for a clinical trial for neurodegeneration in Langerhans cell histiocytosis. Br J Haematol 2022; 198:623-624. [PMID: 35727899 DOI: 10.1111/bjh.18308] [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: 05/13/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/27/2022]
Abstract
Neurodegeneration in Langerhans cell histiocytosis (ND-LCH) is a major clinical issue requiring urgent resolution. Sveijer et al. showed that plasma neurofilament light protein is a promising biomarker for screening patients with ND-LCH and determining the therapeutic effect of a mitogen-activated protein kinase inhibitor. Therefore, this can be a powerful tool for conducting clinical trials for ND-LCH. Commentary on: Sveijer M, von Bahr Greenwood T, Jädersten M, Kvedaraite E, Zetterberg H, Blennow K, et al. Screening for neurodegeneration in Langerhans cell histiocytosis with neurofilament light in plasma. Br J Haematol. 2022;00:1-8. doi: 10.1111/bjh.18247.
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Affiliation(s)
- Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakamoto
- Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan
| | - Akira Morimoto
- Department of Pediatrics, Showa Inan General Hospital, Komagane, Japan
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12
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Shirai R, Osumi T, Sato-Otsubo A, Nakabayashi K, Ishiwata K, Yamada Y, Yoshida M, Yoshida K, Shioda Y, Kiyotani C, Terashima K, Tomizawa D, Takasugi N, Takita J, Miyazaki O, Kiyokawa N, Yoneda A, Kanamori Y, Hishiki T, Matsumoto K, Hata K, Yoshioka T, Kato M. Quantitative assessment of copy number alterations by liquid biopsy for neuroblastoma. Genes Chromosomes Cancer 2022; 61:662-669. [PMID: 35655408 DOI: 10.1002/gcc.23073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/08/2022] Open
Abstract
Liquid biopsy, a method of detecting genomic alterations using blood specimens, has recently attracted attention as a non-invasive alternative to surgical tissue biopsy. We attempted quantitative analysis to detect amplification of MYCN (MYCNamp) and loss of heterozygosity at 11q (11qLOH), which are clinical requisites as prognostic factors of neuroblastoma. In this study, cell-free DNA (cfDNA) was extracted from plasma samples from 24 neuroblastoma patients at diagnosis. Copy numbers of MYCN and NAGK genes were quantitatively analyzed by droplet digital PCR (ddPCR). 11qLOH was also assessed by detecting allelic imbalances of heterozygous single nucleotide polymorphisms in the 11q region. The results obtained were compared to those of specimens from tumor tissues. The correlation coefficient of MYCN copy number of cfDNA and tumor DNA was 0.88 (P < 0.00001). 11qLOH was also accurately detected from cfDNA, except for one case with localized NB. Given the high accuracy of liquid biopsy, to investigate components of cfDNA, the proportion of tumor-derived DNA was estimated by examining the variant allele frequency of tumor-specific mutations in cfDNA. The proportion of tumor-derived DNA in cfDNA was 42.5% (range, 16.9%-55.9%), suggesting sufficient sensitivity of liquid biopsy for neuroblastoma. In conclusion, MYCN copy number and 11qLOH could be quantitatively analyzed in plasma cfDNA by ddPCR assay. These results suggest that plasma cfDNA can be substituted for tumor DNA and can also be applied for comprehensive genomic profiling analysis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ryota Shirai
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Tomoo Osumi
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Aiko Sato-Otsubo
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Keisuke Ishiwata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yuji Yamada
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Masanori Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kaoru Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Nao Takasugi
- Department of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Graduate School of Medicine Kyoto University, Kyoto City, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Akihiro Yoneda
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, University of Tokyo, Tokyo, Japan
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13
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Takagi M, Ogawa C, Iehara T, Aoki-Nogami Y, Ishibashi E, Imai M, Kimura T, Nagata M, Yasuhara M, Masutani M, Yoshimura K, Tomizawa D, Ogawa A, Yonemori K, Morishita A, Miyamoto S, Takita J, Kihara T, Nobori K, Hasebe K, Miya F, Ikeda S, Shioda Y, Matsumoto K, Fujimura J, Mizutani S, Morio T, Hosoi H, Koike R. First phase 1 clinical study of olaparib in pediatric patients with refractory solid tumors. Cancer 2022; 128:2949-2957. [PMID: 35593736 DOI: 10.1002/cncr.34270] [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: 10/26/2021] [Revised: 04/03/2022] [Accepted: 04/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The survival of patients with high-risk, refractory, relapsed, or metastatic solid tumors remains dismal. A poly(ADP-ribose) polymerase (PARP) inhibitor could be effective for the treatment of pediatric solid tumors with defective homologous recombination. METHODS This open-label, multicenter phase 1 clinical trial evaluated the safety, tolerability, and efficacy of olaparib, a PARP inhibitor, in pediatric patients with refractory solid tumors to recommend a dose for Phase 2 trials. Olaparib (62.5, 125, and 187.5 mg/m2 twice daily) was administered orally every day (1 cycle = 28 days) using a standard 3 + 3 dose-escalation design. Patients aged 3-18 years with recurrent pediatric solid tumors were eligible. Pharmacokinetic and pharmacodynamic analyses were performed. RESULTS Fifteen patients were enrolled and received olaparib monotherapy, which was well tolerated. The recommended phase 2 dose for daily administration was 187.5 mg/m2 twice daily. Pharmacokinetics were dose proportional. The area under the concentration-time curve from 0 to 12 h and the peak plasma concentration for 187.5 mg/m2 twice daily in children were comparable to previous data obtained in a 200-mg, twice-daily cohort and lower than those in the 300-mg twice-daily cohort in adults. Pharmacodynamic studies demonstrated substantial inhibition of PARP activity. Two partial responses were observed in patients with Wilms tumor and neuroblastoma. CONCLUSIONS This report is the first clinical trial to describe the use of a PARP inhibitor as monotherapy in children. Olaparib was well tolerated, with preliminary antitumor responses observed in DNA damage response-defective pediatric tumors. LAY SUMMARY This Phase 1 trial evaluated the efficacy and safety of olaparib in patients with refractory childhood solid tumors. Olaparib was well tolerated, achieving objective response in 2/15 patients. The DNA damage response was attenuated in nearly one-half of advanced neuroblastoma patients, demonstrating the utility of the PARP inhibitor. The results support further investigation of olaparib as a new treatment for DNA damage-response or repair-defective pediatric cancers.
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Affiliation(s)
- Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Tomoko Iehara
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Yuki Aoki-Nogami
- Department of Pediatric Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eri Ishibashi
- University Research Administration Division, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Minoru Imai
- University Research Administration Division, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Toshimi Kimura
- Department of Pharmacy, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Masashi Nagata
- Department of Pharmacokinetics and Pharmacodynamics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
| | - Masato Yasuhara
- Department of Pharmacokinetics and Pharmacodynamics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo
| | - Mitsuko Masutani
- Department of Molecular and Genomic Biomedicine, Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichi Yoshimura
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Ishikawa, Japan.,Future Medical Center, Hiroshima University Hospital, Minami-ku, Hiroshima, Japan
| | - Daisuke Tomizawa
- National Center for Child Health and Development, Children's Cancer Center, Setagaya-ku, Tokyo, Japan
| | - Atsushi Ogawa
- Pediatrics, Niigata Cancer Center Hospital, Chuo-ku, Niigata, Japan
| | - Kan Yonemori
- Medical Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Aoi Morishita
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Miyamoto
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, Kyoto University, Sakyo-ku, Kyoto, Japan
| | - Tetsuro Kihara
- University Research Administration Division, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kiyoshi Nobori
- Medical Innovation Promotion Center, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Kazuhisa Hasebe
- University Research Administration Division, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Fuyuki Miya
- Department of Medical Science Mathematics, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Sadakatsu Ikeda
- Department of Precision Cancer Medicine, Center for Innovative Cancer Treatment, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yoko Shioda
- National Center for Child Health and Development, Children's Cancer Center, Setagaya-ku, Tokyo, Japan
| | - Kimikazu Matsumoto
- National Center for Child Health and Development, Children's Cancer Center, Setagaya-ku, Tokyo, Japan
| | - Junya Fujimura
- Department of Pediatrics and Adolescent Medicine, Juntendo University, School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shuki Mizutani
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Hajime Hosoi
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan
| | - Ryuji Koike
- Medical Innovation Promotion Center, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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14
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Ono R, Sakamoto K, Doi T, Yanagisawa R, Tamura A, Hashimoto H, Kanegane H, Ishii E, Nakazawa Y, Shioda Y. A retrospective survey of patients who discontinued participation in the JPLSG HLH-2004 clinical trial. Int J Hematol 2022; 116:434-441. [PMID: 35524025 DOI: 10.1007/s12185-022-03357-1] [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: 12/08/2021] [Revised: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022]
Abstract
Although clinical trials have reported an improvement in the prognosis of hemophagocytic lymphohistiocytosis (HLH), current treatment outcomes are unsatisfactory, especially in severe cases. Most clinical trial patients with severe disease discontinue participation due to complications associated with HLH or treatment-related toxicity. A retrospective survey of patients who discontinued participation in the JPLSG HLH-2004 clinical trial was conducted to review the detailed course of these cases to optimize HLH treatment and supportive care. Findings in these patients were compared with those of 45 patients who completed the protocol treatment. The 3 year overall survival rate of patients who completed treatment was 86.7%, versus 50.7% for those who did not complete treatment. Incidence of serious adverse events, such as infections, coagulopathy, and posterior reversible encephalopathy syndrome, during the initial 8 weeks of treatment was much higher in patients who did not complete treatment than in patients who completed treatment. To improve overall outcomes of patients with HLH, it is important to not only optimize HLH-directed therapy but also provide appropriate supportive care.
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Affiliation(s)
- Rintaro Ono
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Kenichi Sakamoto
- Department of Pediatrics, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Japan.
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ryu Yanagisawa
- Division of Blood Transfusion, Shinshu University Hospital, Matsumoto, Japan
| | - Akihiro Tamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroya Hashimoto
- Core Laboratory, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Eiichi Ishii
- Department of Pediatrics, Imabari City Hospital, Ehime, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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15
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Yamada Y, Osumi T, Kato M, Shioda Y, Kiyotani C, Terashima K, Hayakawa A, Iijima-Yamashita Y, Horibe K, Matsumoto K, Tomizawa D. Gemtuzumab Ozogamicin Followed by Unrelated Cord Blood Transplantation With Reduced-intensity Conditioning for a Child With Refractory Acute Promyelocytic Leukemia. J Pediatr Hematol Oncol 2022; 44:178-180. [PMID: 35091516 DOI: 10.1097/mph.0000000000002404] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/12/2021] [Indexed: 11/25/2022]
Abstract
There is no established treatment for patients with acute promyelocytic leukemia (APL) refractory to targeted therapies with all-trans retinoic acid (ATRA) and/or arsenic trioxide (ATO). We report here a case of an 8-month-old girl with APL who failed standard ATRA-combined chemotherapy. Although molecular remission was achieved after introducing ATRA/ATO combination therapy, molecular relapse occurred during the ATO consolidation courses. Subsequent molecular remission was rapidly achieved after administering 2 doses of gemtuzumab ozogamicin. She was successfully treated with unrelated cord blood transplantation using reduced-intensity conditioning. Gemtuzumab ozogamicin might be a preferable choice for patients with APL refractory to standard therapy.
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Affiliation(s)
- Yuji Yamada
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Akira Hayakawa
- Department of Pediatrics, Kobe University, Kobe
- Department of Palliative Medicine, Yodogawa Christian Hospital, Osaka
| | - Yuka Iijima-Yamashita
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
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16
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Kudo K, Toki T, Kanezaki R, Tanaka T, Kamio T, Sato T, Sasaki S, Imamura M, Imai C, Ando K, Kakuda H, Doi T, Kawaguchi H, Irie M, Sasahara Y, Tamura A, Hasegawa D, Itakura Y, Watanabe K, Sakamoto K, Shioda Y, Kato M, Kudo K, Fukano R, Sato A, Yagasaki H, Kanegane H, Kato I, Umeda K, Adachi S, Kataoka T, Kurose A, Nakazawa A, Terui K, Ito E. BRAFV600E-positive cells as molecular markers of bone marrow disease in pediatric Langerhans cell histiocytosis. Haematologica 2022; 107:1719-1725. [PMID: 35295077 PMCID: PMC9244822 DOI: 10.3324/haematol.2021.279857] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Indexed: 11/09/2022] Open
Abstract
Not available.
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Affiliation(s)
- Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki.
| | - Tsutomu Toki
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Rika Kanezaki
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Tatsuhiko Tanaka
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Takuya Kamio
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Tomohiko Sato
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Shinya Sasaki
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Masaru Imamura
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Chihaya Imai
- Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata
| | - Kumiko Ando
- Department of Hematology and Oncology, Chiba Children's Hospital, Chiba
| | - Harumi Kakuda
- Department of Hematology and Oncology, Chiba Children's Hospital, Chiba
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Hiroshi Kawaguchi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima
| | - Masahiro Irie
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai
| | - Yoji Sasahara
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai
| | - Akihiro Tamura
- Department of Hematology and Oncology, Children's Cancer Center, Hyogo Prefectural Kobe Children's Hospital, Kobe
| | - Daiichiro Hasegawa
- Department of Hematology and Oncology, Children's Cancer Center, Hyogo Prefectural Kobe Children's Hospital, Kobe
| | - Yosuke Itakura
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka
| | - Kenichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan; Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Aichi
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Yamaguchi
| | - Atsushi Sato
- Department of Hematology and Oncology, Miyagi Children's Hospital, Sendai
| | - Hiroshi Yagasaki
- Department of Pediatrics, Nihon University Graduate School of Medicine, Tokyo
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Itaru Kato
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto
| | - Katsutsugu Umeda
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto
| | - Souichi Adachi
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto
| | - Tatsuki Kataoka
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Pathology, Iwate Medical University, Iwate
| | - Akira Kurose
- Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama
| | - Kiminori Terui
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki
| | - Etsuro Ito
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Community Medicine, Hirosaki University Graduate School of Medicine, Hirosaki.
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17
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Morimoto A, Shioda Y, Sakamoto K, Imamura T, Imashuku S. Bone lesions of Langerhans cell histiocytosis triggered by trauma in children. Pediatr Int 2022; 64:e15199. [PMID: 35770832 DOI: 10.1111/ped.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/09/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bone lesions of Langerhans cell histiocytosis (LCH) may be triggered by trauma. METHODS The characteristics of pediatric patients in the JLSG-02 study cohort who developed a bone lesion at the trauma site at diagnosis of LCH were analyzed retrospectively. RESULTS Of the 261 pediatric patients with LCH, 12 (4.6%), of median age 4.9 years, had trauma-triggered bone LCH lesions at diagnosis, making them significantly older than the remaining patients (P = 0.006). Trauma sites included the craniofacial regions in 10 patients and the lumbar spine and pelvis in one patient each. At the time of trauma, six patients had a bump at the site, whereas none had extradural hematomas or bone fractures. The median time from trauma to onset was 4 weeks. Of these 12 patients, three had isolated bone (IB) disease; four had multifocal bone (MFB) disease, including the bone lesion at the trauma site; and five had multisystem disease, including four with lesions in neighboring tissue and one with polyuria (posterior pituitary lesion) more than 1 year before the trauma-triggered bone lesion. Treatment responses were good in all 12 patients and none died, but relapses were observed in two patients, one each with IB and MFB disease. CONCLUSIONS About 5% of pediatric patients with LCH developed new trauma-triggered bone lesions at a relatively old age. These lesions can manifest as IB, or, in patients with underlying LCH diseases, as MFB or multisystem. Good clinical outcomes were observed in these patients.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Showa Innan General Hospital, Komagane, Japan.,Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | | | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Imashuku
- Department of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
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18
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Morimoto A, Shioda Y, Sakamoto K, Kudo K, Imamura T, Kudo K. [Elucidated pathogenesis and therapeutic prospects in Langerhans cell histiocytosis]. Rinsho Ketsueki 2022; 63:373-382. [PMID: 35662160 DOI: 10.11406/rinketsu.63.373] [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: 06/15/2023]
Abstract
Langerhans cell histiocytosis (LCH) is characterized by immature dendritic cell proliferation, which is currently classified as an inflammatory myeloid neoplasm. Clinical features and outcomes vary from spontaneously regressing isolated bone disease to fatal liver, spleen, or hematopoietic system (risk organ) involvement-positive multisystem disease. LCH cells have the only mutation in the mitogen-activated protein kinase (MAPK) signaling pathway gene, represented by the BRAF V600E mutation, which is the driver mutation. The type of disease depends on the stage of hematopoietic cell differentiation at which the mutation occurs. LCH cells acquire anti-apoptosis and senescence-associated secretory phenotype by oncogene-induced senescence, with migration failure to lymph nodes. These cause LCH cell accumulation and various inflammatory cell recruitment in the lesion, resulting in severe inflammation. Tissue damage in LCH is due to this inflammation, not the LCH cell proliferation. Patients with a risk of organ involvement without the initial treatment response may be rescued by allogeneic hematopoietic stem cell transplantation after reducing the disease activity with MAPK inhibitors. Intravenous zoledronic acid and intrathecal cytarabine injections have been introduced into the ongoing clinical trial in Japan to reduce bone recurrence and prevent neurodegeneration as sequelae.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development
| | | | - Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University
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19
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Irie R, Shioda Y, Osumi T, Sakamoto KI, Kasahara M, Matsumoto K, Nakazawa A. Pediatric liver failure with massive sinusoidal infiltration of histiocytes. J Clin Exp Hematop 2021; 62:25-34. [PMID: 34840207 PMCID: PMC9010498 DOI: 10.3960/jslrt.21022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Histiocytic neoplasms, such as Langerhans cell histiocytosis (LCH) and disseminated juvenile xanthogranuloma (JXG), can involve the liver and sometimes cause liver failure. We aimed to classify non-LCH histiocytic proliferating disorders that do not exhibit typical disseminated JXG histology. We examined four pediatric patients who presented with liver failure and splenomegaly. Two patients with liver cirrhosis without cholestasis underwent liver transplantation (LT). The other two patients presented with giant cell hepatitis causing neonatal/infantile acute liver failure (ALF). The infantile ALF patient also underwent LT. Liver dysfunction developed after LT in all three transplant cases and the grafts exhibited massive sinusoidal infiltration of histiocytes with hemophagocytosis, similar to the native liver. The neonatal ALF patient was treated with an LCH-type chemotherapy regimen, and is alive and well at 18 months. Infiltrating histiocytes were positive for CD68 and CD163, and negative for CD1a, CD207, and S-100 protein. The BRAF V600E mutation was not present. Liver histological findings were not consistent with conventional disseminated JXG or LCH, although the histological findings in other organs overlapped those of well-known histiocytic neoplasms. The histological and immunohistochemical findings of infiltrating histiocytes suggest that these four cases constituted a disseminated JXG-like systemic disease.
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Affiliation(s)
- Rie Irie
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan.,Department of Pathology, Nippon Koukan Hospital, Kanagawa, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ken-Ichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mureo Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan.,Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
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20
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Nishi K, Kamei K, Ogura M, Sato M, Ishiwa S, Shioda Y, Kiyotani C, Matsumoto K, Nozu K, Ishikura K, Ito S. Risk factors for post-nephrectomy hypotension in pediatric patients. Pediatr Nephrol 2021; 36:3699-3709. [PMID: 33988732 DOI: 10.1007/s00467-021-05115-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/12/2021] [Accepted: 04/30/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although hypotension is a life-threatening complication of nephrectomy in children, risk factors for its development remain unknown. We evaluated the incidence, clinical course, and associated risk factors of pediatric post-nephrectomy hypotension in an observational study. METHODS This retrospective observational study included the clinical data of children who underwent nephrectomy in our center between 2002 and 2020. Patients undergoing nephrectomy at kidney transplantation and those who developed hypotension before nephrectomy were excluded. RESULTS The study included 55 nephrectomies in 51 patients, including 42 unilateral, 4 two-stage bilateral, and 5 simultaneous bilateral nephrectomies. The diagnoses were isolated Wilms tumor, neuroblastoma, congenital nephrotic syndrome, Denys-Drash syndrome, WAGR (Wilms tumor, aniridia, genitourinary malformations, and mental retardation) syndrome, and autosomal recessive polycystic kidney disease in 24, 10, 9, 6, 1, and 1 patient, respectively. Post-nephrectomy hypotension developed in 11 (20%) patients. Two patients (3.6%) had persistent hypotension; both had their kidneys resected, and one patient (1.8%) died. Male sex, kidney disease, resection of both kidneys, low estimated glomerular filtration rate, increased left ventricular posterior wall thickness in diastole, hypertension before nephrectomy, antihypertensive use, hyperreninemia, and hyperaldosteronism were significantly associated with post-nephrectomy hypotension. Multivariate logistic regression analysis revealed that hypertension before nephrectomy was the only significant risk factor for post-nephrectomy hypotension (P = 0.04). CONCLUSIONS Hypertension before nephrectomy is a significant risk factor for pediatric post-nephrectomy hypotension. Life-threatening hypotension, which might occur after bilateral nephrectomy in infants, should be considered, especially in children with higher risks.
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Affiliation(s)
- Kentaro Nishi
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Masao Ogura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mai Sato
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Sho Ishiwa
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kenji Ishikura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Shuichi Ito
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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21
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Nishi K, Kamei K, Ogura M, Sato M, Ishiwa S, Shioda Y, Kiyotani C, Matsumoto K, Nozu K, Ishikura K, Ito S. Correction to: Risk factors for post-nephrectomy hypotension in pediatric patients. Pediatr Nephrol 2021; 36:3805-3806. [PMID: 34251496 DOI: 10.1007/s00467-021-05198-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kentaro Nishi
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Masao Ogura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mai Sato
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Sho Ishiwa
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Kenji Ishikura
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Department of Pediatrics, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Shuichi Ito
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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22
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Yamazaki F, Yamasaki K, Kiyotani C, Hashii Y, Shioda Y, Hara J, Matsumoto K. Thiotepa-melphalan myeloablative therapy for high-risk neuroblastoma. Pediatr Blood Cancer 2021; 68:e28896. [PMID: 33788375 DOI: 10.1002/pbc.28896] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 12/02/2020] [Accepted: 12/26/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Appropriate high-dose chemotherapy (HDC) for high-risk neuroblastoma has not yet been established. In Japan, a unique HDC regimen that comprises two cycles of a total of 800 mg/m2 of thiotepa and a total of 280 mg/m2 of melphalan is widely utilized. METHODS To evaluate the safety and efficacy of this thiotepa-melphalan high-dose therapy for high-risk neuroblastoma, we reviewed the medical records of 41 patients with high-risk neuroblastoma who underwent this regimen followed by autologous peripheral blood stem cell rescue between 2002 and 2012. MYCN-amplified high-risk neuroblastomas were observed in 23 patients. All patients underwent intensive multidrug induction chemotherapy, but none underwent anti-GD2 antibody immunotherapy. The primary tumor was resected at the adequate time point. RESULTS The median follow-up duration for living patients was 9.2 years (range 5.5-14.0 years). The 5-year event-free survival (EFS) and overall survival from treatment initiation were 41.5 ± 7.7% and 56.1 ± 7.8%, respectively. The 5-year EFS of MYCN-amplified high-risk neuroblastoma patients was 60.9 ± 10.2%, which was significantly superior compared with those with MYCN-nonamplified high-risk neuroblastoma (16.7 ± 8.8%; p < .001). MYCN amplification was the most favorable prognostic factor for EFS (hazard ratio = 0.29; 95% confidence interval = 0.12-0.66). Of the 41 patients, three died because of regimen-related toxicity (infection, n = 2; microangiopathy, n = 1). CONCLUSION The thiotepa-melphalan high-dose therapy with thiotepa and melphalan may be effective for high-risk neuroblastoma. However, this regimen is toxic and warrants special attention in clinical practice.
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Affiliation(s)
- Fumito Yamazaki
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan.,Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kai Yamasaki
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Chikako Kiyotani
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan
| | - Yoshiko Hashii
- Department of Pediatrics, Osaka University Hospital, Osaka, Japan
| | - Yoko Shioda
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan
| | - Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Kimikazu Matsumoto
- National Center for Child Health and Development, Children's Cancer Center, Tokyo, Japan
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23
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Uehara Y, Wada YS, Iwasaki Y, Yoneda K, Ikuta Y, Amari S, Maruyama H, Tsukamoto K, Isayama T, Sakamoto K, Shioda Y, Miyazaki O, Irie R, Yoshioka T, Mochimaru N, Yoshida K, Ito Y. Neonatal systemic juvenile Xanthogranuloma with Hydrops diagnosed by Purpura skin biopsy: a case report and literature review. BMC Pediatr 2021; 21:161. [PMID: 33823829 PMCID: PMC8022363 DOI: 10.1186/s12887-021-02632-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic juvenile xanthogranuloma is a very rare disease typically presents as skin lesions with yellow papules or nodules and is sometimes fatal. We report a case of congenital neonatal systemic juvenile xanthogranuloma with atypical skin appearance that made the diagnosis difficult. CASE PRESENTATION A preterm Japanese female neonate with prenatally diagnosed fetal hydrops in-utero was born with purpuric lesions involving the trunk and face. Since birth, she had hypoxemic respiratory failure, splenomegaly, anemia, thrombocytopenia, coagulopathy, and was transfusion dependent for red blood cells, fresh frozen plasma, and platelets. Multiple cystic lesions in her liver, part of them with vascular, were detected by ultrasound. A liver biopsy was inconclusive. A skin lesion on her face similar to purpura gradually changed to a firm and solid enlarged non-yellow nodule. Technically, the typical finding on skin biopsy would have been histiocytic infiltration (without Touton Giant cells) and immunohistochemistry results which then would be consistent with a diagnosis of systemic juvenile xanthogranuloma, and chemotherapy improved her general condition. CONCLUSIONS This case report shows that skin biopsies are necessary to detect neonatal systemic juvenile xanthogranuloma when there are organ symptoms and skin eruption, even if the skin lesion does not have a typical appearance of yellow papules or nodules.
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Affiliation(s)
- Yohji Uehara
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yuka Sano Wada
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Yuka Iwasaki
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kota Yoneda
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yasuhisa Ikuta
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Shoichiro Amari
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Hidehiko Maruyama
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Keiko Tsukamoto
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Tetsuya Isayama
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kenichi Sakamoto
- Chilldren's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yoko Shioda
- Chilldren's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Rie Irie
- Department of Clinical Pathology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.,Department of Pathology, Nippon Koukan Hospital, 1-2-1 Koukandouri, Kawasaki-ku, Kawasaki City, Kanagawa, 210-0852, Japan
| | - Takako Yoshioka
- Department of Clinical Pathology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Naoko Mochimaru
- Department of Dermatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kazue Yoshida
- Department of Dermatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yushi Ito
- Department of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
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24
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Taniguchi M, Sakamoto K, Shioda Y, Doi T, Kudo K, Fujino H, Kudo K, Morimoto A. Salvage therapy with 2-chlorodeoxyadenosine for refractory and relapsed pediatric Langerhans cell histiocytosis: an updated nationwide survey in Japan. Int J Hematol 2021; 113:461-463. [PMID: 33564966 DOI: 10.1007/s12185-020-03073-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Maki Taniguchi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kenichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Takehiko Doi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ko Kudo
- Department of Pediatrics, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hisanori Fujino
- Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University, Toyoake, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
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25
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Shirai R, Osumi T, Terashima K, Kiyotani C, Uchiyama M, Tsujimoto S, Yoshida M, Yoshida K, Uchiyama T, Tomizawa D, Shioda Y, Sekiguchi M, Watanabe K, Keino D, Ueno-Yokohata H, Ohki K, Takita J, Ito S, Deguchi T, Kiyokawa N, Ogiwara H, Hishiki T, Ogawa S, Okita H, Matsumoto K, Yoshioka T, Kato M. ATRT-11. PREVALENCE OF GERMLINE VARIANTS IN SMARCB1 INCLUDING SOMATIC MOSAICISM IN AT/RT AND OTHER RHABDOID TUMORS. Neuro Oncol 2020. [PMCID: PMC7715345 DOI: 10.1093/neuonc/noaa222.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Genetic hallmark of atypical teratoid/rhabdoid tumor (AT/RT) is loss-of-function variants or deletions in SMARCB1 gene on 22q11.2 chromosome, which is common to extracranial malignant rhabdoid tumors (MRT). Previous studies demonstrated that approximately one-thirds of AT/RT and extracranial MRT patients harbored germline SMARCB1 variants as the rhabdoid tumor predisposing syndrome. We studied herein intensive analysis of the SMARCB1 gene in AT/RT and extracranial MRT patients focusing on prevalence of germline genetic variants. PROCEDURE: In total, 16 patients were included. Both tumor-derived DNA and germline DNA were obtained from all patients. First, screening for SMARCB1 alterations in the tumor specimens was done by direct sequencing, ddPCR and SNP array analysis. Then, analysis of germline DNA samples focusing on the genomic abnormalities detected in the paired tumors in each case was performed.
RESULTS
In eight of 16 cases (50%), genomic alterations observed in the tumor-derived DNA were also detected in the germline DNA. It is worth noting that three patients had germline mosaicism. Two of three patients had mosaic deletion, including SMARCB1 region, and the average copy number of the deleted region in the SMARCB1 gene in the germline was 1.60 and 1.76. For another patient, the fraction of SMARCB1 variants in normal cells was as low as 1.7%.
CONCLUSIONS
Approximately half the MRT cases in this study had SMARCB1 germline alterations. Considering the presence of low-frequency mosaicisms which conventional methods might overlook, inherited germline variants in predisposition genes are more important than previously assumed for the pathogenesis of pediatric cancers.
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Affiliation(s)
- Ryota Shirai
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Yokohama City University, Yokohama, Japan
| | - Tomoo Osumi
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Meri Uchiyama
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shinichi Tsujimoto
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masanori Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Pediatrics, Yokohama City University, Yokohama, Japan
| | - Kaoru Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Toru Uchiyama
- Department of Human Genetics, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | | | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children’s Hospital, Shizuoka, Japan
| | - Dai Keino
- Department of Pediatrics, St. Marianna University School of Medicine Hospital, Kawasaki, Japan
| | - Hitomi Ueno-Yokohata
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Shuichi Ito
- Department of Pediatrics, Yokohama City University, Yokohama, Japan
| | - Takao Deguchi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hideki Ogiwara
- Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgery Oncology, Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Okita
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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26
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Sugawa M, Terashima K, Matsukawa Y, Mizuno T, Isshiki K, Tsujimoto S, Uchiyama M, Sakamoto K, Gocho Y, Osumi T, Shioda Y, Kiyotani C, Kato M, Tomizawa D, Usami K, Ogiwara H, Tsutsumi Y, Nakano M, Yoshioka T, Matsumoto K. ETMR-11. A CASE OF PRIMARY DIFFUSE LEPTOMENINGEAL PRIMITIVE NEUROECTODERMAL TUMOR. Neuro Oncol 2020. [PMCID: PMC7715369 DOI: 10.1093/neuonc/noaa222.215] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Primary diffuse leptomeningeal primitive neuroectodermal tumor (PDL PNET) is a rare embryonal brain tumor which arises primarily in the meninges without an intraparenchymal mass. Few previous reports of this condition exist, and the clinical outcomes are poor. We herein report a case of a child with PDL PNET and present a cursory review of the literature. CASE: A 3-year-old female patient was seen at a local clinic due to vomiting, headaches, and seizures. As a head MRI revealed hydrocephalus but no mass, acute encephalopathy was initially diagnosed. She received steroid pulse therapy, but the symptoms progressed to hallucination and lethargy. Another MRI at the 1-month follow-up revealed diffuse leptomeningeal enhancement. Thereafter she was transferred to our hospital. A spine MRI revealed spinal dissemination. She underwent a dura mater biopsy, and the pathological analysis led to the diagnosis of PDL PNET. She received chemotherapy consisting of vincristine, cyclophosphamide, etoposide, cisplatin, and intrathecal methotrexate injections two months after the initial presentation. The progressive hydrocephalus was managed with external ventricular drainage. Two weeks after the first cycle of chemotherapy the hydrocephalus resolved, and the external ventricular drainage was removed. A follow-up MRI showed that the leptomeningeal enhancement decreased during the four cycles of chemotherapy without radiotherapy. The patient is scheduled to receive high-dose chemotherapy as consolidation therapy. CONCLUSION PDL PNET is extremely rare, and its diagnosis is often delayed. Treatment of PDL PNET is very difficult due to its aggressive course, and surgical resection is impossible. Early diagnosis may help improve outcomes.
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Affiliation(s)
- Masahiro Sugawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Matsukawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takanori Mizuno
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kyohei Isshiki
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Shinichi Tsujimoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Meri Uchiyama
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakamoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshihiro Gocho
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Usami
- Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hideki Ogiwara
- Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiaki Tsutsumi
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Masayuki Nakano
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Terashima K, Sugawa M, Sakamoto K, Kiyotani C, Osumi T, Shioda Y, Deguchi T, Kato M, Tomizawa D, Usami K, Ogiwara H, Tsutsumi Y, Fuji H, Nakano N, Yoshioka T, Nakano Y, Ichimura K, Matsumoto K. HGG-49. A PEDIATRIC THALAMIC HIGH-GRADE GLIOMA WITH H3F3A K27M AND BRAF V600E DOUBLE MUTATIONS. Neuro Oncol 2020. [PMCID: PMC7715763 DOI: 10.1093/neuonc/noaa222.329] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
CASE
A 18-month-old boy presented with approximately 2 months history of progressive left hemiparesis and left exotropia. MRI study showed a 3–4 cm T1-iso, T2-high tumor at right thalamus to midbrain with little contrast enhancement. The patient underwent endoscopic biopsy of the tumor, which showed relatively dense proliferation of small cells with round nuclei, mitosis of the tumor cell, but no necrosis. Immunohistochemical showed positive stain of GFAP and Olig2. Ki-67 was 34%. The histopathological diagnosis was compatible with high grade glioma. Chemotherapy with vincristine, cyclophosphamide, cisplatin and etoposide was initiated. Molecular testing of the tumor revealed H3F3A K27M and BRAF V600E double mutations in DNA from frozen tumor tissue.
DISCUSSION
The concurrent mutation of H3F3A K27M and BRAF V600E in pediatric glioma is very rare, but there are several cases previously reported in literature. Interestingly those cases are heterogenous in age, location, histopathological subtypes and clinical outcome.
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Affiliation(s)
- Keita Terashima
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masahiro Sugawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Sakamoto
- Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takao Deguchi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Usami
- Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hideki Ogiwara
- Department of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiyuki Tsutsumi
- Department of Diagnostic Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroshi Fuji
- Department of Radiation Oncology, National Center for Child Health and Development, Tokyo, Japan
| | - Noriyuki Nakano
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiko Nakano
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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28
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Sakamoto K, Morimoto A, Shioda Y, Imamura T, Imashuku S. Long-term complications in uniformly treated paediatric Langerhans histiocytosis patients disclosed by 12 years of follow-up of the JLSG-96/02 studies. Br J Haematol 2020; 192:615-620. [PMID: 33236384 DOI: 10.1111/bjh.17243] [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: 09/02/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasia derived from immature myeloid dendritic cells with the mitogen-activated protein kinase (MAPK) pathway gene mutation. LCH is rarely fatal, but patients develop various permanent consequences (PCs). We report the frequencies of LCH-related PCs in paediatric patients (n = 317) treated by the JLSG-96/02 AraC-containing regimens. One-third of LCH patients had at least one PC at a median follow-up of 12 years. Central nervous system (CNS)-related PCs (neurological and endocrinological) accounted for 21·5%, non-CNS-related 16·7%. We require novel therapeutic measures to further reduce the frequency of LCH-related PCs.
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Affiliation(s)
- Kenichi Sakamoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Imashuku
- Division of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
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29
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Hishiki T, Fujino A, Watanabe T, Tahara K, Ohno M, Yamada Y, Tomonaga K, Kutsukake M, Fujita T, Kawakubo N, Matsumoto K, Kiyotani C, Shioda Y, Miyazaki O, Fuji H, Yoshioka T, Kanamori Y. Definitive Tumor Resection after Myeloablative High Dose Chemotherapy Is a Feasible and Effective Option in the Multimodal Treatment of High-Risk Neuroblastoma: A Single Institution Experience. J Pediatr Surg 2020; 55:1655-1659. [PMID: 31575417 DOI: 10.1016/j.jpedsurg.2019.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND/PURPOSE The delayed local treatment approach (DL) in high-risk neuroblastoma (HR-NB) refers to the process in which tumor resection is performed after the completion of all the courses of chemotherapy, including myeloablative high-dose chemotherapy (HDC). Alternatively, in the conventional local treatment approach (CL), tumor resection is performed during induction chemotherapy. In this study, we compared the surgical outcomes in HR-NB patients treated by CL and DL. METHOD Forty-seven patients with abdominal HR-NB underwent primary tumor resection from 2002 to 2018. The timing of surgery was generally determined by following the trials and guidelines available at the time. The outcomes and surgical complications between the two strategies were compared. RESULT Operation time, blood loss, and postoperative WBC counts were lower in the DL group (n = 25) when compared to the CL group (n = 22), statistical significance notwithstanding. Major vascular structures were less frequently encased in the DL group tumors, while immediate surgical complications were significantly more frequent in the CL group (P < 0.05). Furthermore, the 3-year EFSs were 50.0% and 53.9% in the DL and CL groups, respectively. CONCLUSION DL appears to be a feasible and effective treatment option for HR-NB. Nonetheless, further verifications using larger cohorts are warranted. LEVEL OF EVIDENCE Treatment study, Level III.
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Affiliation(s)
- Tomoro Hishiki
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development; Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development; Department of Pediatric Surgical Oncology, National Cancer Center Hospital.
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Kazunori Tahara
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Yohei Yamada
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Kotaro Tomonaga
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Mai Kutsukake
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Takuro Fujita
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Naonori Kawakubo
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development; Department of Pediatric Surgical Oncology, National Cancer Center Hospital
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development
| | - Hiroshi Fuji
- Department of Radiology, National Center for Child Health and Development
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
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30
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Hayase T, Saito S, Shioda Y, Imamura T, Watanabe K, Ohki K, Yoshioka T, Oh Y, Kawahara Y, Niijima H, Imashuku S, Morimoto A. Analysis of the BRAF and MAP2K1 mutations in patients with Langerhans cell histiocytosis in Japan. Int J Hematol 2020; 112:560-567. [PMID: 32654047 DOI: 10.1007/s12185-020-02940-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 02/13/2020] [Revised: 06/11/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
In Langerhans cell histiocytosis (LCH), somatic gene mutations in the mitogen-activated protein kinase pathway have been identified in more than 80% of cases in Western countries, in which mutually exclusive BRAF and MAP2K1 mutations are involved. Among them, BRAF V600E mutation is the major contributor (50-60%). In 59 patients (50 children and nine adults) with LCH (not including pulmonary LCH) in Japan, we first screened for BRAF V600E in all patients followed by target sequencing for other gene mutations in 17 of BRAF V600E-negative patients. As a result, BRAF V600E mutation was detected in 27/59 (46%) patients. We also identified BRAF mutations other than V600E in five and MAP2K1 mutations in nine patients. Thus, gene mutations in BRAF or MAP2K1 were identified in 41/44 (93%) of the fully tested patients. Regarding the correlation of clinical features and genotype in pediatric patients, we found that BRAF V600E mutation status was not correlated with sex, age at diagnosis, disease extent, response to first-line therapy, relapse, or CNS-related sequelae. Interestingly, MAP2K1 exon 2 in-frame deletion was related to the risk organ involvement; however, further studies are required to clarify the impact of these gene mutations on the clinical features of patients with LCH.
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Affiliation(s)
- Tomomi Hayase
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shiori Saito
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yoko Shioda
- Department of Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenichiro Watanabe
- Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Kentaro Ohki
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Yukiko Oh
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yuta Kawahara
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hitomi Niijima
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shinsaku Imashuku
- Division of Laboratory Medicine, Uji Tokushukai Medical Center, Uji, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
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31
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Maeda M, Morimoto A, Shioda Y, Asano T, Koga Y, Nakazawa Y, Kanegane H, Kudo K, Ohga S, Ishii E. Long-term outcomes of children with extracutaneous juvenile xanthogranulomas in Japan. Pediatr Blood Cancer 2020; 67:e28381. [PMID: 32383820 DOI: 10.1002/pbc.28381] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 03/27/2020] [Accepted: 04/16/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Juvenile xanthogranuloma (JXG) is the most common non-Langerhans cell histiocytosis in children. The mortality and morbidity of JXG with extracutaneous lesions remain unclear. METHODS Data of patients aged < 18 years who were diagnosed with JXG between 2001 and 2010 were retrospectively collected through a nationwide survey. RESULTS Twenty patients (11 male and nine female) had extracutaneous lesions. The median observation time was 10 years (range, 0-17). Six patients presented with symptoms at birth. The median age at diagnosis was 8.5 months (range, 0 month-13 years). Fifteen patients underwent treatment for JXG, including chemotherapy (n = 11), and five did not receive treatment. All patients except one survived; 17 were disease-free and two survived with disease. One newborn-onset patient with liver, spleen, and bone marrow involvement died of the disease. Permanent sequelae included central diabetes insipidus, growth hormone deficiency, and panhypopituitarism detected at diagnosis in three, one, and two patients, respectively. Four patients had visual impairment (optic nerve compression and intraocular invasion in two each), three had epilepsy, one had mental retardation, and one had a skin scar. Eight patients who had intracranial lesions were older at diagnosis, and had a higher frequency of disease-related comorbidities and permanent sequelae than those without intracranial involvement. CONCLUSIONS Patients with extracutaneous JXG had good outcomes, although those with intracranial lesions had serious permanent sequelae. Effective and safe treatment regimens for patients with intracranial JXG need to be developed.
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Affiliation(s)
- Miho Maeda
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takeshi Asano
- Department of Pediatrics, Nippon Medical School Chiba Hokuso Hospital, Chiba, Japan
| | - Yuhki Koga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University, Matsumoto, Japan
| | - Hirokazu Kanegane
- Department of Child Health and Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiichi Ishii
- Department of Pediatrics, Ehime University Graduate School of Medicine, Toon, Japan
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32
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Utano T, Kato M, Osumi T, Shioda Y, Kiyotani C, Terashima K, Tomizawa D, Matsumoto K, Yamatani A. Tacrolimus blood concentration increase depends on administration route when combined with voriconazole in pediatric stem cell transplant recipients. Pediatr Transplant 2020; 24:e13619. [PMID: 31820535 DOI: 10.1111/petr.13619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Understanding of TAC pharmacokinetics is required to avoid both overdosing and underdosing. VRCZ is known to increase the TAC blood concentration by inhibiting CYP3A4; however, detailed, practical information on pediatric cases is still scarce. Herein, we investigated the association between the TAC blood concentration and dosage focusing on the administration route and concomitant use of VRCZ in children. METHODS In total, 38 children who received TAC during stem cell transplantation at our hospital between January 2013 and April 2018 were included. The ratio of the TAC blood concentration (ng/mL) to dosage (mg/kg/day) (C/D) was calculated at the last continuous intravenous infusion (C/Div) and after switching to oral administration (C/Dpo). RESULTS Patients with VRCZ (n = 14) showed a higher C/D regardless of administration route (median C/Div: with VRCZ/without VRCZ = 832/643, median C/Dpo: with VRCZ/without VRCZ = 339/45). Additionally, the (C/Div)/(C/Dpo) was about one-fourth in cases with VRCZ; the median (C/Div)/(C/Dpo) was 3.3 for cases with VRCZ and 13.5 for cases without VRCZ. Interestingly, the increase in the TAC blood concentration due to VRCZ was higher when TAC was administered orally, especially in adolescent patients. CONCLUSIONS To obtain an optimal TAC blood concentration, dose adjustment based on multiple factors, such as administration route, concomitant use of VRCZ, and age, is required.
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Affiliation(s)
- Tomoyuki Utano
- Department of Pharmaceuticals, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akimasa Yamatani
- Department of Pharmaceuticals, National Center for Child Health and Development, Tokyo, Japan
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33
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Akazawa Y, Hosono A, Yoshikawa T, Kaneda H, Hara J, Kinoshita Y, Kohashi K, Manabe A, Shioda Y, Shoda K, Shimomura M, Mizuno S, Nakamoto Y, Nakatsura T. Abstract A001: Phase I study of vaccine therapy with a cocktail of peptides for pediatric patients with refractory solid tumors. Cancer Immunol Res 2019. [DOI: 10.1158/2326-6074.cricimteatiaacr18-a001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Recently, the aggressive intervention of multidisciplinary therapy has resulted in improving the life prognosis of pediatric solid tumors. However, in the pediatric patients with metastatic or refractory solid tumors, the prognosis remains poor. Additionally, various critical, late complications could continue to occur. Therefore, the development of novel, effective therapy is urgently required. Immunotherapy could be the one of effective therapeutic strategy for pediatric solid tumors. Actually, the KOC1, FOXM1, and KIF20A might be capable of being an ideal target of anticancer immunotherapy against pediatric solid tumors that highly had expression of these cancer antigens. In this nonrandomized, open-label, phase I clinical trial, we analyzed the safety and efficacy of NCCV cocktail 1 vaccine, a cocktail of cancer peptides derived from KOC1, FOXM1, and KIF20A, in patients with pediatric solid tumors. Experimental Design: Twelve patients with refractory pediatric solid tumors, including 3 patients with neuroblastoma, 2 patients with Ewing’s sarcoma, 5 patients with rhabdomyosarcoma, and 2 patients with osteosarcoma, underwent NCCV cocktail 1 vaccination (intradermal injections every a week). In 9 enrolled patients, the histologic expression of KOC1, FOXM1, and KIF20A before vaccination were evaluated using tissue specimen obtained from biopsy or surgery. The primary endpoint was the safety of NCCV cocktail 1 vaccination. The secondary endpoints were immune response, as measured by in vivo and in vitro interferon (IFN)-r enzyme-linked immunospot (ELISPOT) assay and Dextramer assay, and the clinical outcomes of tumor response and progression free survival (PFS).Results:No dose-limiting toxicity (DLT) was observed in this trial, and we suggested that NCCV cocktail 1 vaccination was well-tolerated. Of nine patients, 6 patients (66.7%), 6 patients (66.7%), and 7 patients (77.8%), exhibited positive expression of KOC1, FOXM1, and KIF20A before vaccination, respectively. Of eleven patients, 4 patients (36.4%), 8 patients (72.7%), and 5 patients (45.5%) were induced peptide-specific CTL response of KOC, FOXM1, and KIF20A by NCCV cocktail 1 vaccine, respectively. Also, 4 patients showed stable disease after 8 weeks, and 2 patients showed during of remission for more than 11 months after second complete remission. Additionally, patients with high peptide-specific CTL frequencies of all KOC, FOXM1, and KIF20A (n=4) had better PFS than those with low frequencies (n=7) by Kaplan-Meier analysis (log-rank test, P =0.019). By Cox proportional hazard models, univariate and multivariate analysis indicated that only induction of peptide specific CTL in all of these three antigens was independent factor related to PFS (P = 0.039; HR = 5.60; 95% CI 1.09-28.91, P = 0.050; HR = 6.00; 95% CI 1.00-36.32, respectively). Conclusions:The results of this trial demonstrated that the NCCV cocktail 1 vaccine was safe and had ability to induce some degree of immune response, which could result in the benefit for preventing the recurrence of pediatric solid tumors, especially after a second complete remission.
Citation Format: Yu Akazawa, Ako Hosono, Toshiaki Yoshikawa, Hide Kaneda, Junichi Hara, Yoshiaki Kinoshita, Kenichi Kohashi, Atsushi Manabe, Yoko Shioda, Kayoko Shoda, Manami Shimomura, Shoichi Mizuno, Yasunari Nakamoto, Tetsuya Nakatsura. Phase I study of vaccine therapy with a cocktail of peptides for pediatric patients with refractory solid tumors [abstract]. In: Proceedings of the Fourth CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; Sept 30-Oct 3, 2018; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2019;7(2 Suppl):Abstract nr A001.
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Affiliation(s)
- Yu Akazawa
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Ako Hosono
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Toshiaki Yoshikawa
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Hide Kaneda
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Junichi Hara
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Yoshiaki Kinoshita
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Kenichi Kohashi
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Atsushi Manabe
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Yoko Shioda
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Kayoko Shoda
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Manami Shimomura
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Shoichi Mizuno
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Yasunari Nakamoto
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
| | - Tetsuya Nakatsura
- National Cancer Center, Kashiwa, Japan; National Cancer Center Hospital, Tokyo, Japan; Osaka City General Hospital, Osaka, Japan; Kyushu University Hospital, Fukuoka, Japan; St Luke's International Hospital, Tokyo, Japan; National Center for Child Health and Development, Tokyo, Japan; Fukui University, Fukui, Japan
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Sakamoto K, Morimoto A, Shioda Y, Imamura T, Imashuku S. Central diabetes insipidus in pediatric patients with Langerhans cell histiocytosis: Results from the JLSG-96/02 studies. Pediatr Blood Cancer 2019; 66:e27454. [PMID: 30207064 DOI: 10.1002/pbc.27454] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 08/16/2018] [Accepted: 08/16/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE We analyzed central diabetes insipidus (CDI) development in pediatric patients with Langerhans cell histiocytosis (LCH) treated according to the Japan LCH Study Group (JLSG) regimen, which is the combination chemotherapy including cytarabine (Ara-C). METHODS Retrospective data from 317 patients (multisystem disease (MS), n = 206; multiple focal bone (MFB), n = 111) treated according to the JLSG-96/02 regimens were analyzed. RESULTS The median follow-up duration was 10.6 years (range, 0.1-21.1). A total of 50/317 (15.8%) patients developed CDI (MFB, n = 4; MS, n = 46). Of the 50 cases, CDI was already present at the time of LCH diagnosis (pre-CDI) in 25, and it newly developed after the diagnosis and initiation of treatment (post-CDI) in the other 25 cases. The cumulative incidence of post-CDI at 10-year calculated by Kaplan-Meier analysis was 9.0% for total and 12.0% for MS patients. A positive correlation with LCH lesions at the CNS risk sites at diagnosis was found in pre-CDI cases (17/164 vs 8/171; P = 0.0359), but not in post-CDI cases (14/129 vs 11/163; P = 0.254). Multivariate analysis showed that relapse at the CNS risk sites was significantly associated with post-CDI development (hazard ratio: 4.70; 95% CI, 1.29-17.1, P < 0.05). CONCLUSIONS In the JLSG-96/02 studies, CDI developed in 15.8% of the cohort in which half as pre- and the other half as post-CDI. Relapse, particularly at the CNS risk sites, was linked with the development of post-CDI.
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Affiliation(s)
- Kenichi Sakamoto
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinsaku Imashuku
- Division of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
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- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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35
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Ueno-Yokohata H, Okita H, Nakasato K, Hishiki T, Shirai R, Tsujimoto S, Osumi T, Yoshimura S, Yamada Y, Shioda Y, Kiyotani C, Terashima K, Miyazaki O, Matsumoto K, Kiyokawa N, Yoshioka T, Kato M. Preoperative diagnosis of clear cell sarcoma of the kidney by detection of BCOR internal tandem duplication in circulating tumor DNA. Genes Chromosomes Cancer 2018; 57:525-529. [PMID: 30126017 DOI: 10.1002/gcc.22648] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 05/01/2018] [Revised: 06/06/2018] [Accepted: 06/06/2018] [Indexed: 01/06/2023] Open
Abstract
Clear cell sarcoma of the kidney (CCSK) is the second most common renal malignancy in children. The prognosis is poorer in CCSK than in Wilms' tumor, and multimodal treatment including surgery, intensive chemotherapy, and radiation is required to improve the outcome for children with CCSK. Histological evaluation is required for the diagnosis. However, biopsies of tumors to obtain diagnostic specimens are not routinely performed because of the risk of spreading tumor cells during the procedure. Recently, internal tandem duplication (ITD) of BCOR has been recognized as a genetic hallmark of CCSK. We herein established a novel BCOR-ITD-specific polymerase chain reaction method with well-designed primers, and then performed a liquid biopsy for cell-free DNA (cfDNA) obtained from plasma of three children with nonmetastatic renal tumors (stage II) and from one control. BCOR-ITD was positively detected in the cfDNA of two cases, both of which were later diagnosed as CCSK based on histological feature of the resected tumor specimen, while it was not detected for a normal control and a patient diagnosed with Wilms' tumor. Our study is the first one of preoperative circulating tumor DNA assay in pediatric renal tumors. The liquid biopsy method enables less invasive, preoperative diagnosis of CCSK with no risk of tumor spillage, which can avoid iatrogenic upstaging.
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Affiliation(s)
- Hitomi Ueno-Yokohata
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hajime Okita
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pathology, Keio University School of Medicine, Tokyo, Japan.,Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Keiko Nakasato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ryota Shirai
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Shinichi Tsujimoto
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Satoshi Yoshimura
- Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yuji Yamada
- Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Division of Leukemia and Lymphoma/Solid Tumor, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.,Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.,Division of Stem Cell Transplantation and Cellular Therapy, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Division of Stem Cell Transplantation and Cellular Therapy, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Osumi T, Tomizawa D, Kawai T, Sako M, Inoue E, Takimoto T, Tamura E, Uchiyama T, Imadome KI, Taniguchi M, Shirai R, Yoshida M, Ando R, Tsumura Y, Fuji H, Matsumoto K, Shioda Y, Kiyotani C, Terashima K, Onodera M, Matsumoto K, Kato M. A prospective study of allogeneic transplantation from unrelated donors for chronic granulomatous disease with target busulfan-based reduced-intensity conditioning. Bone Marrow Transplant 2018; 54:168-172. [DOI: 10.1038/s41409-018-0271-9] [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: 03/27/2018] [Revised: 06/09/2018] [Accepted: 06/11/2018] [Indexed: 12/26/2022]
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37
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Terashima K, Kiyotani C, Kimura Y, Osumi T, Shioda Y, Kato M, Tomizawa D, Usami K, Ogiwara H, Aoki H, Tsutsumi Y, Irie R, Yoshioka T, Matsumoto K. LGG-41. BEVACIZUMAB FOR PEDIATRIC LOW GRADE GLIOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.382] [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: 11/13/2022] Open
Affiliation(s)
- Keita Terashima
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yui Kimura
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Usami
- Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hideki Ogiwara
- Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hidekazu Aoki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiyuki Tsutsumi
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Rie Irie
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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38
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Kimura Y, Terashima K, Kiyotani C, Osumi T, Shioda Y, Kato M, Tomizawa D, Fuji H, Usami K, Aoki H, Irie R, Ogiwara H, Tsutsumi Y, Yoshioka T, Matsumoto K. DIPG-47. RE-IRRADIATION FOR RECURRENT DIFFUSE INTRINSIC PONTINE GLIOMA. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy059.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yui Kimura
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoo Osumi
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroshi Fuji
- Division of Radiation Oncology, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Usami
- Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hidekazu Aoki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Rie Irie
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Hideki Ogiwara
- Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiyuki Tsutsumi
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children’s Cancer Center, National Center for Child Health and Development, Tokyo, Japan
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Iinuma T, Fukui Y, Shioda Y, Lee J, Fukumoto M, Gionhaku N, Arai Y, Takayama M. SATISFACTION WITH DIETARY LIFE AFFECTS SUBJECTIVE WELL-BEING IN VERY ELDERLY PEOPLE. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T. Iinuma
- Nihon University School of Dentistry, Tokyo, Japan,
| | - Y. Fukui
- Nihon University School of Dentistry, Tokyo, Japan,
| | - Y. Shioda
- Nihon University School of Dentistry, Tokyo, Japan,
| | - J. Lee
- Nihon University School of Dentistry, Tokyo, Japan,
| | - M. Fukumoto
- Nihon University School of Dentistry, Tokyo, Japan,
| | - N. Gionhaku
- Nihon University School of Dentistry, Tokyo, Japan,
| | - Y. Arai
- Keio University School of Medicine, Tokyo, Japan
| | - M. Takayama
- Keio University School of Medicine, Tokyo, Japan
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40
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Morimoto A, Oh Y, Nakamura S, Shioda Y, Hayase T, Imamura T, Kudo K, Imashuku S. Inflammatory serum cytokines and chemokines increase associated with the disease extent in pediatric Langerhans cell histiocytosis. Cytokine 2017; 97:73-79. [PMID: 28582647 DOI: 10.1016/j.cyto.2017.05.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 05/23/2017] [Accepted: 05/27/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Langerhans cell histiocytosis (LCH) is characterized by immature dendritic cell proliferation, infiltration of LCH lesions by various inflammatory cells, and a lesional cytokine storm. It is classified into three groups on the basis of disease extent, namely, multisystem with risk-organ involvement (MS+), multisystem without risk-organ involvement (MS-), and single-system (SS) disease. We comprehensively analyzed whether serum levels of cytokines/chemokines reflect the disease extent. METHODS Serum samples from 52 children with LCH (eight, 25, and 19 with MS+, MS-, and SS, respectively) and 34 control children were analyzed quantitatively for 48 humoral factors. DNA samples extracted from biopsied LCH lesions from 12 patients were tested for BRAF V600E status. RESULTS The LCH patients had significantly higher serum levels of IL-1Ra, IL-3, IL-6, IL-8, IL-9, IL-10, IL12, IL-13, IL-15, IL-17, IL-18, TNF-α, G-CSF, M-CSF, MIF, HGF, VEGF, CCL2, CCL3, CCL7, CXCL1, and CXCL9 than the controls by univariate analysis. Of these IL-9, IL-15 and MIF were significant by multivariate analysis; but not differed between MS and SS diseases. MS disease associated with significantly higher IL-2R, IL-3, IL-8, IL-18, M-CSF, HGF, CCL2, CXCL1, and CXCL9 levels than SS disease by univariate analysis. Of these, CCL2 and M-CSF were significant by multivariate analysis. IL-18 levels were significantly higher in MS+ disease than MS- disease. The LCH patients with BRAF V600E mutation had higher serum levels of CCL7. CONCLUSION Numerous inflammatory cytokines and chemokines play a role in LCH. Of those, more specific ones reflect the disease extent (MS vs. SS and MS+ vs. MS-) or the BRAF V600E mutation status. It is thought that the most responsible cytokines and chemokines involved in the poor outcome may become future candidate therapeutic targets in LCH.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Jichi Medical University, School of Medicine, Shimotsuke, Japan.
| | - Yukiko Oh
- Department of Pediatrics, Jichi Medical University, School of Medicine, Shimotsuke, Japan
| | - Sachie Nakamura
- Department of Pediatrics, Jichi Medical University, School of Medicine, Shimotsuke, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tomomi Hayase
- Department of Pediatrics, Jichi Medical University, School of Medicine, Shimotsuke, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuko Kudo
- Department of Pediatrics, Fujita Health University, Toyoake, Japan
| | - Shinsaku Imashuku
- Division of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Japan
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41
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Terashima K, Yoshida K, Kiyotani C, Shioda Y, Osumi T, Kato M, Tomizawa D, Usami K, Ogiwara H, Tsutsumi Y, Fuji H, Yoshioka T, Iwafuchi H, Nakano Y, Ichimura K, Matsumoto K. DIPG-31. CLINICO-PATHOLOGICAL REVIEW OF 26 CHILDREN WITH DIFFUSE INTRINSIC PONTINE GLIOMA. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox083.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Ohno M, Takezoe T, Watanabe T, Tahara K, Hishiki T, Fujino A, Matsuo M, Higuchi M, Kawasaki K, Shioda Y, Kato M, Kiyotani C, Matsumoto K, Takakuwa E, Irie R, Yoshioka T, Kimura S, Seki M, Takita J, Kanamori Y. A female case of pleuropulmonary blastoma type 1 whose pulmonary cystic lesion was followed since neonate. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.02.009] [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: 10/20/2022] Open
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43
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Tatsuno M, Shioda Y, Iwafuchi H, Yamazaki S, Iijima K, Takahashi C, Ono H, Uchida K, Okamura O, Matubayashi M, Okuyama T, Matsumoto K, Yoshioka T, Nakazawa A. BRAF V600 mutations in Langerhans cell histiocytosis with a simple and unique assay. Diagn Pathol 2016; 11:39. [PMID: 27094161 PMCID: PMC4837618 DOI: 10.1186/s13000-016-0489-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/10/2016] [Indexed: 12/12/2022] Open
Abstract
Background BRAF (V-raf murine sarcoma viral oncogene homolog B1) is a serine-threonine protein kinase involved in cell survival, proliferation, and differentiation. The most common missense mutation of BRAF (mainly V600E) contributes to the incidence of various cancers, including Langerhans cell histiocytosis (LCH). BRAF inhibitors molecularly targeting the V600E mutation have been developed to counteract the effect of the mutation. To ensure the administration of effective pharmacotherapy, it is therefore imperative to develop an effective assay to screen LCH patients for the V600E mutation. However, tumor tissues of LCH typically contain many inflammatory cells which make a correct judgement of the mutation status difficult in the DNA sequence analysis. Results In this study, we present a new, highly sensitive analyzing method combining PCR, restriction enzyme digestion, and a sequencing assay using DNA extracted from formalin-fixed paraffin-embedded (FFPE) tissue specimens. TspRI is a restriction enzyme that cleaves the sequence encompassing the wild-type BRAF codon 600 into two fragments, which cannot be used as a template for subsequent BRAF PCR amplification. We therefore evaluated the sensitivity of BRAF V600 mutation detection by amplifying the primary PCR product digested with TspRI and sequencing the secondary PCR products. The V600E mutation was detected in FFPE tissue samples from 32 LCH patients; our assay was able to identify mutations in four samples that gave inconclusive results, and ten that were negative, according to standard PCR and sequencing. Conclusions We presented a new and highly sensitive method to detect BRAF V600 mutations. This screening method is expected to play an important role to select the most effective therapies.
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Affiliation(s)
- Michiko Tatsuno
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.
| | - Yoko Shioda
- Department of Children's Cancer Center, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Hideto Iwafuchi
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Shigeki Yamazaki
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.,Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Kenta Iijima
- Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Chiaki Takahashi
- Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Hiromi Ono
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.,Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Kiyono Uchida
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.,Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Osamu Okamura
- Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Mamoru Matubayashi
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.,Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Torayuki Okuyama
- Department of Clinical Laboratory Medicine, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Kimikazu Matsumoto
- Department of Children's Cancer Center, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Pathology, National Center for Child Health and Development, PO Box 157-8535, 2-10-1 Okura, Setagaya-ku, Tokyo, Japan.,Department of Pathology, Tokai University School of Medicine, PO Box 259-1193, 143 Shimokasuya, Isehara-shi, Kanagawa, Japan
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Osumi T, Mori T, Shioda Y, Kiyotani C, Terashima K, Kato M, Tomizawa D, Ohki K, Kiyokawa N, Iwafuchi H, Yoshioka T, Nakazawa A, Matsumoto K. [LMB chemotherapy for mature B-cell neoplasms in children: a single-center experience]. Rinsho Ketsueki 2016; 57:346-52. [PMID: 27076248 DOI: 10.11406/rinketsu.57.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND LMB chemotherapy based on the FAB LMB96 study is internationally accepted as one of the standard treatments for pediatric B-cell non-Hodgkin lymphoma (B-NHL), though experience with this regimen in Japan is very limited. Since 2009, we have administered LMB chemotherapy to children with B-NHL at the National Center for Child Health and Development. Thus, we herein report the clinical characteristics and outcomes of 13 children with B-NHL given LMB chemotherapy. RESULTS Median age was 7.5 years. Five patients were girls and 8 were boys. Nine were subclassified as having Burkitt lymphoma and 4 as having diffuse large B-cell lymphoma. According to the St. Jude staging system, 3, 4, 2, 1, and 3 patients had stages 1, 2, 3, 4, and B-ALL disease, respectively. According to the LMB group classification system, nine patients were classified into Group B and four into Group C. At a median follow-up of 2.3 years, all patients are alive without lymphoma relapse. In Group C, myelosuppression and severe mucositis were the main adverse events especially during induction therapy. High-dose methotrexate at a dose of 8 g/m2 was manageable using standard supportive therapy even with 24-hour infusion. CONCLUSION Our experience indicates the feasibility of LMB chemotherapy for Japanese children with B-NHL.
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Affiliation(s)
- Tomoo Osumi
- Children's Cancer Center, National Center for Child Health and Development
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Morimoto A, Shioda Y, Imamura T, Kudo K, Kawaguchi H, Sakashita K, Yasui M, Koga Y, Kobayashi R, Ishii E, Fujimoto J, Horibe K, Bessho F, Tsunematsu Y, Imashuku S. Intensified and prolonged therapy comprising cytarabine, vincristine and prednisolone improves outcome in patients with multisystem Langerhans cell histiocytosis: results of the Japan Langerhans Cell Histiocytosis Study Group-02 Protocol Study. Int J Hematol 2016; 104:99-109. [DOI: 10.1007/s12185-016-1993-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 12/01/2022]
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Goto H, Kaneko T, Shioda Y, Kajiwara M, Sakashita K, Kitoh T, Hayakawa A, Miki M, Kato K, Ogawa A, Hashii Y, Inukai T, Kato C, Sakamaki H, Yabe H, Suzuki R, Kato K. Hematopoietic stem cell transplantation for patients with acute lymphoblastic leukemia and Down syndrome. Pediatr Blood Cancer 2015; 62:148-52. [PMID: 25262825 DOI: 10.1002/pbc.25245] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/11/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HSCT) is one curable option for high-risk acute lymphoblastic leukemia (ALL); however, transplant-related toxicities might be severe in patients with Down syndrome and ALL (DS-ALL). PROCEDURE HSCTs performed in patients with DS-ALL were identified in the Japan Society for Hematopoietic Cell Transplantation registry. RESULTS In the registry data, 11 patients with DS-ALL were identified. The median age at HSCT was 9 years (range: 6-22 years). Six patients underwent HSCT at non-remission status. Allogeneic grafts were utilized in all patients, including eight patients who received HSCT from unrelated donors. Reduced intensity conditioning regimens were used in three patients. All patients achieved neutrophil engraftment by a median of day 18 (range: day 11-61). Ten patients experienced grade 3 or more infectious episodes. Six patients experienced complications of the respiratory system. The incidences of II-IV or III-IV acute GVHD were nine (81.8%) or seven patients (63.6%), respectively. Chronic GVHD was observed in five (55.6%) out of nine evaluable patients. Seven patients died at a median of 6 months (range: 0-24 months) after HSCT. Two-year relapse-free and overall survival were 33.3% (95% CI: 2.5-64.1%) or 37.5% (95% CI: 5.9-69.1%), respectively. The causes of death were relapse (n = 2), infection (n = 2), bleeding (n = 1), thrombotic microangiopathy (n = 1), and chronic GVHD (n = 1). CONCLUSIONS Therapy-related mortality accounted for five out of seven deceased patients in this case series. Attempts to reduce toxicities should be considered in HSCT for patients with DS-ALL.
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Affiliation(s)
- Hiroaki Goto
- Division of Hemato-Oncology and Regenerative Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
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Imashuku S, Fujita N, Shioda Y, Noma H, Seto S, Minato T, Sakashita K, Ito N, Kobayashi R, Morimoto A. Follow-up of pediatric patients treated by IVIG for Langerhans cell histiocytosis (LCH)-related neurodegenerative CNS disease. Int J Hematol 2014; 101:191-7. [DOI: 10.1007/s12185-014-1717-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 11/20/2014] [Accepted: 11/27/2014] [Indexed: 02/02/2023]
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Morimoto A, Oh Y, Shioda Y, Kudo K, Imamura T. Recent advances in Langerhans cell histiocytosis. Pediatr Int 2014; 56:451-61. [PMID: 24840547 DOI: 10.1111/ped.12380] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 03/27/2014] [Accepted: 05/01/2014] [Indexed: 12/12/2022]
Abstract
The purpose of this review is to provide an updated overview of the pathogenesis and treatment of Langerhans cell histiocytosis (LCH). The pathogenesis of LCH remains obscure and the optimal treatment for LCH has not been established, although incremental progress has been made. Proinflammatory cytokines and chemokines are known to play a role in LCH, which suggests that LCH is an immune disorder. However, the oncogenic BRAF mutation is also detected in more than half of LCH patients, which suggests that LCH is a neoplastic disorder. Remaining major issues in the treatment of LCH are how to rescue patients who have risk-organ involvement but do not respond to first-line therapy, the optimal treatment for the orphan disease of multifocal adult LCH, and how to reduce and treat central nervous system-related consequences, such as central diabetes insipidus and neurodegeneration. More research is needed to better understand the pathogenesis of this disease and to resolve the treatment issues.
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Affiliation(s)
- Akira Morimoto
- Department of Pediatrics, Jichi Medical University of Medicine, Shimotsuke, Japan
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Oh Y, Morimoto A, Shioda Y, Imamura T, Kudo K, Imashuku S. High serum osteopontin levels in pediatric patients with high risk Langerhans cell histiocytosis. Cytokine 2014; 70:194-7. [PMID: 25086462 DOI: 10.1016/j.cyto.2014.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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: 01/18/2014] [Revised: 06/18/2014] [Accepted: 07/07/2014] [Indexed: 11/17/2022]
Abstract
Osteopontin (OPN) acts as an osteoclast activator, a proinflammatory cytokine, and a chemokine attracting histiocytes/monocytes and is abundantly expressed in Langerhans cell histiocytosis (LCH). We investigated whether serum OPN levels are related to disease types in LCH. Fifty-eight newly diagnosed LCH patients were studied; eight with risk organ (liver, spleen and/or hematopoietic) involvements positive multisystem (MS+) disease, 27 with risk organ involvement negative multisystem (MS-) disease and 23 with single system (SS) disease. Pediatric patients with non-inflammatory disease (n=27) were used as controls. All of patients with MS+ disease were younger than 3 years. Serum OPN levels and 44 kinds of humoral factors were measured by ELISA and Bio-Plex suspension array system, respectively. In the patients younger than 3 years, the median serum OPN level (interquartile range) was 240.3 ng/ml (137.6-456.0) in MS+ (n=8); 92.7 ng/ml (62.0-213.8) in MS- (n=14) and 72.5 ng/ml (55.6-94.0) in SS (n=9) and 74.4 ng/ml (42.2-100.0) in control (n=12). The OPN values were significantly higher in the MS+ group than the MS-, SS and control groups (p=0.044, p=0.001 and p=0.002, respectively), but not different between the MS-, SS and control groups. In the patients older than 3 years, the median level of serum OPN (IQR) was 56.2 ng/ml (22.9-77.5) in MS- (n=13), 58.9 ng/ml (31.0-78.7) in SS (n=14) and 41.9 (28.9-54.1) in control (n=15). These values did not differ significantly between each group. The serum OPN levels were positively correlated with the serum IL-6, CCL2, IL-18, IL-8 and IL-2 receptor concentration. OPN may be involved in risk organ dissemination and poor prognosis of LCH through the function as inflammatory cytokine/chemokine.
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Affiliation(s)
- Yukiko Oh
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Akira Morimoto
- Department of Pediatrics, Jichi Medical University School of Medicine, Shimotsuke, Japan.
| | - Yoko Shioda
- Division of Pediatric Oncology, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Imamura
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kazuko Kudo
- Division of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
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Vaidyanathan G, Gururangan S, Bigner D, Zalutsky M, Morfouace M, Shelat A, Megan J, Freeman BB, Robinson S, Throm S, Olson JM, Li XN, Guy KR, Robinson G, Stewart C, Gajjar A, Roussel M, Sirachainan N, Pakakasama S, Anurathapan U, Hansasuta A, Dhanachai M, Khongkhatithum C, Hongeng S, Feroze A, Lee KS, Gholamin S, Wu Z, Lu B, Mitra S, Cheshier S, Northcott P, Lee C, Zichner T, Lichter P, Korbel J, Wechsler-Reya R, Pfister S, Project IPT, Li KKW, Xia T, Ma FMT, Zhang R, Zhou L, Lau KM, Ng HK, Lafay-Cousin L, Chi S, Madden J, Smith A, Wells E, Owens E, Strother D, Foreman N, Packer R, Bouffet E, Wataya T, Peacock J, Taylor MD, Ivanov D, Garnett M, Parker T, Alexander C, Meijer L, Grundy R, Gellert P, Ashford M, Walker D, Brent J, Cader FZ, Ford D, Kay A, Walsh R, Solanki G, Peet A, English M, Shalaby T, Fiaschetti G, Baulande S, Gerber N, Baumgartner M, Grotzer M, Hayase T, Kawahara Y, Yagi M, Minami T, Kanai N, Yamaguchi T, Gomi A, Morimoto A, Hill R, Kuijper S, Lindsey J, Schwalbe E, Barker K, Boult J, Williamson D, Ahmad Z, Hallsworth A, Ryan S, Poon E, Robinson S, Ruddle R, Raynaud F, Howell L, Kwok C, Joshi A, Nicholson SL, Crosier S, Wharton S, Robson K, Michalski A, Hargrave D, Jacques T, Pizer B, Bailey S, Swartling F, Petrie K, Weiss W, Chesler L, Clifford S, Kitanovski L, Prelog T, Kotnik BF, Debeljak M, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer MA, Gevorgian A, Morozova E, Kazantsev I, Iukhta T, Safonova S, Kumirova E, Punanov Y, Afanasyev B, Zheludkova O, Grajkowska W, Pronicki M, Cukrowska B, Dembowska-Baginska B, Lastowska M, Murase A, Nobusawa S, Gemma Y, Yamazaki F, Masuzawa A, Uno T, Osumi T, Shioda Y, Kiyotani C, Mori T, Matsumoto K, Ogiwara H, Morota N, Hirato J, Nakazawa A, Terashima K, Fay-McClymont T, Walsh K, Mabbott D, Smith A, Wells E, Madden J, Chi S, Owens E, Strother D, Packer R, Foreman N, Bouffet E, Lafay-Cousin L, Sturm D, Northcott PA, Jones DTW, Korshunov A, Lichter P, Pfister SM, Kool M, Hooper C, Hawes S, Kees U, Gottardo N, Dallas P, Siegfried A, Bertozzi AI, Sevely A, Loukh N, Munzer C, Miquel C, Bourdeaut F, Pietsch T, Dufour C, Delisle MB, Kawauchi D, Rehg J, Finkelstein D, Zindy F, Phoenix T, Gilbertson R, Pfister S, Roussel M, Trubicka J, Borucka-Mankiewicz M, Ciara E, Chrzanowska K, Perek-Polnik M, Abramczuk-Piekutowska D, Grajkowska W, Jurkiewicz D, Luczak S, Kowalski P, Krajewska-Walasek M, Lastowska M, Sheila C, Lee S, Foster C, Manoranjan B, Pambit M, Berns R, Fotovati A, Venugopal C, O'Halloran K, Narendran A, Hawkins C, Ramaswamy V, Bouffet E, Taylor M, Singhal A, Hukin J, Rassekh R, Yip S, Northcott P, Singh S, Duhman C, Dunn S, Chen T, Rush S, Fuji H, Ishida Y, Onoe T, Kanda T, Kase Y, Yamashita H, Murayama S, Nakasu Y, Kurimoto T, Kondo A, Sakaguchi S, Fujimura J, Saito M, Arakawa T, Arai H, Shimizu T, Lastowska M, Jurkiewicz E, Daszkiewicz P, Drogosiewicz M, Trubicka J, Grajkowska W, Pronicki M, Kool M, Sturm D, Jones DTW, Hovestadt V, Buchhalter I, Jager NN, Stuetz A, Johann P, Schmidt C, Ryzhova M, Landgraf P, Hasselblatt M, Schuller U, Yaspo ML, von Deimling A, Korbel J, Eils R, Lichter P, Korshunov A, Pfister S, Modi A, Patel M, Berk M, Wang LX, Plautz G, Camara-Costa H, Resch A, Lalande C, Kieffer V, Poggi G, Kennedy C, Bull K, Calaminus G, Grill J, Doz F, Rutkowski S, Massimino M, Kortmann RD, Lannering B, Dellatolas G, Chevignard M, Lindsey J, Kawauchi D, Schwalbe E, Solecki D, McKinnon P, Olson J, Hayden J, Grundy R, Ellison D, Williamson D, Bailey S, Roussel M, Clifford S, Buss M, Remke M, Lee J, Caspary T, Taylor M, Castellino R, Lannering B, Sabel M, Gustafsson G, Fleischhack G, Benesch M, Doz F, Kortmann RD, Massimino M, Navajas A, Reddingius R, Rutkowski S, Miquel C, Delisle MB, Dufour C, Lafon D, Sevenet N, Pierron G, Delattre O, Bourdeaut F, Ecker J, Oehme I, Mazitschek R, Korshunov A, Kool M, Lodrini M, Deubzer HE, von Deimling A, Kulozik AE, Pfister SM, Witt O, Milde T, Phoenix T, Patmore D, Boulos N, Wright K, Boop S, Gilbertson R, Janicki T, Burzynski S, Burzynski G, Marszalek A, Triscott J, Green M, Foster C, Fotovati A, Berns R, O'Halloran K, Singhal A, Hukin J, Rassekh SR, Yip S, Toyota B, Dunham C, Dunn SE, Liu KW, Pei Y, Wechsler-Reya R, Genovesi L, Ji P, Davis M, Ng CG, Remke M, Taylor M, Cho YJ, Jenkins N, Copeland N, Wainwright B, Tang Y, Schubert S, Nguyen B, Masoud S, Gholamin S, Lee A, Willardson M, Bandopadhayay P, Bergthold G, Atwood S, Whitson R, Cheshier S, Qi J, Beroukhim R, Tang J, Wechsler-Reya R, Oro A, Link B, Bradner J, Cho YJ, Vallero SG, Bertin D, Basso ME, Milanaccio C, Peretta P, Cama A, Mussano A, Barra S, Morana G, Morra I, Nozza P, Fagioli F, Garre ML, Darabi A, Sanden E, Visse E, Stahl N, Siesjo P, Cho YJ, Vaka D, Schubert S, Vasquez F, Weir B, Cowley G, Keller C, Hahn W, Gibbs IC, Partap S, Yeom K, Martinez M, Vogel H, Donaldson SS, Fisher P, Perreault S, Cho YJ, Guerrini-Rousseau L, Dufour C, Pujet S, Kieffer-Renaux V, Raquin MA, Varlet P, Longaud A, Sainte-Rose C, Valteau-Couanet D, Grill J, Staal J, Lau LS, Zhang H, Ingram WJ, Cho YJ, Hathout Y, Brown K, Rood BR, Sanden E, Visse E, Stahl N, Siesjo P, Darabi A, Handler M, Hankinson T, Madden J, Kleinschmidt-Demasters BK, Foreman N, Hutter S, Northcott PA, Kool M, Pfister S, Kawauchi D, Jones DT, Kagawa N, Hirayama R, Kijima N, Chiba Y, Kinoshita M, Takano K, Eino D, Fukuya S, Yamamoto F, Nakanishi K, Hashimoto N, Hashii Y, Hara J, Taylor MD, Yoshimine T, Wang J, Guo C, Yang Q, Chen Z, Perek-Polnik M, Lastowska M, Drogosiewicz M, Dembowska-Baginska B, Grajkowska W, Filipek I, Swieszkowska E, Tarasinska M, Perek D, Kebudi R, Koc B, Gorgun O, Agaoglu FY, Wolff J, Darendeliler E, Schmidt C, Kerl K, Gronych J, Kawauchi D, Lichter P, Schuller U, Pfister S, Kool M, McGlade J, Endersby R, Hii H, Johns T, Gottardo N, Sastry J, Murphy D, Ronghe M, Cunningham C, Cowie F, Jones R, Sastry J, Calisto A, Sangra M, Mathieson C, Brown J, Phuakpet K, Larouche V, Hawkins C, Bartels U, Bouffet E, Ishida T, Hasegawa D, Miyata K, Ochi S, Saito A, Kozaki A, Yanai T, Kawasaki K, Yamamoto K, Kawamura A, Nagashima T, Akasaka Y, Soejima T, Yoshida M, Kosaka Y, Rutkowski S, von Bueren A, Goschzik T, Kortmann R, von Hoff K, Friedrich C, Muehlen AZ, Gerber N, Warmuth-Metz M, Soerensen N, Deinlein F, Benesch M, Zwiener I, Faldum A, Kuehl J, Pietsch T, KRAMER K, -Taskar NP, Zanzonico P, Humm JL, Wolden SL, Cheung NKV, Venkataraman S, Alimova I, Harris P, Birks D, Balakrishnan I, Griesinger A, Remke M, Taylor MD, Handler M, Foreman NK, Vibhakar R, Margol A, Robison N, Gnanachandran J, Hung L, Kennedy R, Vali M, Dhall G, Finlay J, Erdrich-Epstein A, Krieger M, Drissi R, Fouladi M, Gilles F, Judkins A, Sposto R, Asgharzadeh S, Peyrl A, Chocholous M, Holm S, Grillner P, Blomgren K, Azizi A, Czech T, Gustafsson B, Dieckmann K, Leiss U, Slavc I, Babelyan S, Dolgopolov I, Pimenov R, Mentkevich G, Gorelishev S, Laskov M, Friedrich C, Warmuth-Metz M, von Bueren AO, Nowak J, von Hoff K, Pietsch T, Kortmann RD, Rutkowski S, Mynarek M, von Hoff K, Muller K, Friedrich C, von Bueren AO, Gerber NU, Benesch M, Pietsch T, Warmuth-Metz M, Ottensmeier H, Kwiecien R, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Mynarek M, von Hoff K, Muller K, Friedrich C, von Bueren AO, Gerber NU, Benesch M, Pietsch T, Warmuth-Metz M, Ottensmeier H, Kwiecien R, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Yankelevich M, Laskov M, Boyarshinov V, Glekov I, Pimenov R, Ozerov S, Gorelyshev S, Popa A, Dolgopolov I, Subbotina N, Mentkevich G, Martin AM, Nirschl C, Polanczyk M, Bell R, Martinez D, Sullivan LM, Santi M, Burger PC, Taube JM, Drake CG, Pardoll DM, Lim M, Li L, Wang WG, Pu JX, Sun HD, Remke M, Taylor MD, Ruggieri R, Symons MH, Vanan MI, Bandopadhayay P, Bergthold G, Nguyen B, Schubert S, Gholamin S, Tang Y, Bolin S, Schumacher S, Zeid R, Masoud S, Yu F, Vue N, Gibson W, Paolella B, Mitra S, Cheshier S, Qi J, Liu KW, Wechsler-Reya R, Weiss W, Swartling FJ, Kieran MW, Bradner JE, Beroukhim R, Cho YJ, Maher O, Khatua S, Tarek N, Zaky W, Gupta T, Mohanty S, Kannan S, Jalali R, Kapitza E, Denkhaus D, Muhlen AZ, Rutkowski S, Pietsch T, von Hoff K, Pizer B, Dufour C, van Vuurden DG, Garami M, Massimino M, Fangusaro J, Davidson TB, da Costa MJG, Sterba J, Benesch M, Gerber NU, Mynarek M, Kwiecien R, Clifford SC, Kool M, Pietsch T, Finlay JL, Rutkowski S, Pietsch T, Schmidt R, Remke M, Korshunov A, Hovestadt V, Jones DT, Felsberg J, Goschzik T, Kool M, Northcott PA, von Hoff K, von Bueren A, Skladny H, Taylor M, Cremer F, Lichter P, Faldum A, Reifenberger G, Rutkowski S, Pfister S, Kunder R, Jalali R, Sridhar E, Moiyadi AA, Goel A, Goel N, Shirsat N, Othman R, Storer L, Korshunov A, Pfister SM, Kerr I, Coyle B, Law N, Smith ML, Greenberg M, Bouffet E, Taylor MD, Laughlin S, Malkin D, Liu F, Moxon-Emre I, Scantlebury N, Mabbott D, Nasir A, Othman R, Storer L, Onion D, Lourdusamy A, Grabowska A, Coyle B, Cai Y, Othman R, Bradshaw T, Coyle B, de Medeiros RSS, Beaugrand A, Soares S, Epelman S, Jones DTW, Hovestadt V, Wang W, Northcott PA, Kool M, Sultan M, Landgraf P, Reifenberger G, Eils R, Yaspo ML, Wechsler-Reya RJ, Korshunov A, Zapatka M, Radlwimmer B, Pfister SM, Lichter P, Alderete D, Baroni L, Lubinieki F, Auad F, Gonzalez ML, Puya W, Pacheco P, Aurtenetxe O, Gaffar A, Gros L, Cruz O, Calvo C, Navajas A, Shinojima N, Nakamura H, Kuratsu JI, Hanaford A, Eberhart C, Archer T, Tamayo P, Pomeroy S, Raabe E, De Braganca K, Gilheeney S, Khakoo Y, Kramer K, Wolden S, Dunkel I, Lulla RR, Laskowski J, Fangusaro J, Goldman S, Gopalakrishnan V, Ramaswamy V, Remke M, Shih D, Wang X, Northcott P, Faria C, Raybaud C, Tabori U, Hawkins C, Rutka J, Taylor M, Bouffet E, Jacobs S, De Vathaire F, Diallo I, Llanas D, Verez C, Diop F, Kahlouche A, Grill J, Puget S, Valteau-Couanet D, Dufour C, Ramaswamy V, Thompson E, Taylor M, Pomeroy S, Archer T, Northcott P, Tamayo P, Prince E, Amani V, Griesinger A, Foreman N, Vibhakar R, Sin-Chan P, Lu M, Kleinman C, Spence T, Picard D, Ho KC, Chan J, Hawkins C, Majewski J, Jabado N, Dirks P, Huang A, Madden JR, Foreman NK, Donson AM, Mirsky DM, Wang X, Dubuc A, Korshunov A, Ramaswamy V, Remke M, Mack S, Gendoo D, Peacock J, Luu B, Cho YJ, Eberhart C, MacDonald T, Li XN, Van Meter T, Northcott P, Croul S, Bouffet E, Pfister S, Taylor M, Laureano A, Brugmann W, Denman C, Singh H, Huls H, Moyes J, Khatua S, Sandberg D, Silla L, Cooper L, Lee D, Gopalakrishnan V. MEDULLOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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