1
|
Takahashi H, Sakai R, Sakuma T, Matsumura A, Miyashita K, Ishii Y, Nakajima Y, Numata A, Hattori Y, Miyazaki T, Hashimoto C, Koharazawa H, Takemura S, Taguchi J, Fujimaki K, Fujita H, Nakajima H. Comparison of Clinical Features Between Primary and Secondary Breast Diffuse Large B Cell Lymphoma: A Yokohama Cooperative Study Group for Hematology Multicenter Retrospective Study. Indian J Hematol Blood Transfus 2021; 37:60-66. [PMID: 33707836 DOI: 10.1007/s12288-020-01307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022] Open
Abstract
We performed a retrospective analysis of DLBCL with breast involvement to compare the prognosis of primary breast lymphoma (PBL) to secondary breast lymphoma (SBL; especially in limited stage cases). We retrospectively reviewed records of 25 diffuse large B-cell lymphoma (DLBCL) patients with breast involvement who received chemotherapy between January 2000 and August 2012. We compared clinical features and prognosis among patients with PBL (n = 11), limited stage SBL (LSBL; n = 6), and advanced stage SBL (ASBL, n = 8). The PBL group had significantly lesser patients with breast tumours (BTs) > 5 cm than the SBL group (P = 0.02). After a median follow-up of 71.3 months, we observed significantly better 5-year overall survival (OS) in the PBL group (90.0%) than in the LSBL (33.3%, P = 0.01) group, but not for progression-free survival (PFS). Patients with BT > 5 cm had worse OS (P = 0.01) and PFS (P = 0.04) than those with BT ≤ 5 cm. PBL had a better prognosis than SBL among limited stage DLBCL.
Collapse
Affiliation(s)
- Hiroyuki Takahashi
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ward, Yokohama, 241-8515 Kanagawa Japan
| | - Rika Sakai
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ward, Yokohama, 241-8515 Kanagawa Japan
| | - Takayuki Sakuma
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ward, Yokohama, 241-8515 Kanagawa Japan
| | - Ayako Matsumura
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, 2-3-2, Nakao, Asahi-ward, Yokohama, 241-8515 Kanagawa Japan
| | - Kazuho Miyashita
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Kanagawa Japan
| | - Yoshimi Ishii
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Kanagawa Japan
| | - Yuki Nakajima
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Kanagawa Japan
| | - Ayumi Numata
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Kanagawa Japan
| | - Yukako Hattori
- Department of Hematology/Oncology, Yamato Municipal Hospital, Yamato, Kanagawa Japan
| | - Takuya Miyazaki
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Kanagawa Japan
| | - Chizuko Hashimoto
- Department of Hematology/Oncology, Yamato Municipal Hospital, Yamato, Kanagawa Japan
| | | | - Sachiya Takemura
- Department of Internal Medicine, Yokohama Ekisakai Hospital, Yokohama, Kanagawa Japan
| | - Jun Taguchi
- Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan
| | | | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Kanagawa Japan
| | - Hideaki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Kanagawa Japan
| |
Collapse
|
2
|
Ando T, Fujisawa S, Teshigawara H, Ogusa E, Ishii Y, Miyashita K, Motohashi K, Miyazaki T, Tachibana T, Hagihara M, Matsumoto K, Tanaka M, Hashimoto C, Koharazawa H, Fujimaki K, Taguchi J, Fujita H, Kanamori H, Yamazaki E, Nakajima H. Impact of treatment-related weight changes from diagnosis to hematopoietic stem-cell transplantation on clinical outcome of acute myeloid leukemia. Int J Hematol 2019; 109:673-683. [PMID: 30963469 DOI: 10.1007/s12185-019-02647-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 03/31/2019] [Accepted: 04/02/2019] [Indexed: 01/22/2023]
Abstract
We hypothesized that treatment-related weight loss is associated with worse outcomes following HSCT. Overall, 184 patients with AML who underwent induction therapy were classified according to d-BMI (BMI at transplant minus BMI at diagnosis) (kg/m2) as < -2, - 2 to + 2, and > + 2. At 1 year, OS was 67.9% (95% CI, 60.7-74.2), DFS was 64.1% (95% CI, 56.7-70.6), and GRFS was 40.2% (95% CI, 33.1-47.2). For d-BMI groups < - 2, - 2 to + 2, and > + 2, GRFS at 1 year was 16.1% (95% CI, 5.1-31.4), 45.4% (95% CI, 36.4-53.7), and 41.7% (95% CI, 22.2-60.1), respectively (P = 0.0067). Multivariate analysis showed that both worse OS (HR, 1.78; 95% CI, 1.02-3.14; P = 0.007) and GRFS (HR, 2.34; 95% CI, 1.26-4.35; P = 0.007) were associated with reduced BMI (d-BMI < - 2). Treatment-related weight reduction in AML was associated with poor outcome after HSCT.
Collapse
Affiliation(s)
- Taiki Ando
- Department of Stem Cell and Immune Regulation, Graduate School of Medicine, Yokohama City University, Yokohama, Japan. .,Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan.
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan
| | - Haruka Teshigawara
- Department of Stem Cell and Immune Regulation, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Eriko Ogusa
- Department of Stem Cell and Immune Regulation, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan
| | - Yoshimi Ishii
- Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan
| | - Kazuho Miyashita
- Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan
| | - Kenji Motohashi
- Department of Hematology, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa, Japan
| | - Takuya Miyazaki
- Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan
| | | | - Maki Hagihara
- Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kenji Matsumoto
- Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Chizuko Hashimoto
- Department of Hematology/Oncology, Yamato Municipal Hospital, Yamato, Japan
| | | | | | - Jun Taguchi
- Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Etsuko Yamazaki
- Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan.,Clinical Laboratory Department, Yokohama City University Hospital, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Stem Cell and Immune Regulation, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.,Department of Hematology and Clinical Immunology, School of Medicine, Yokohama City University, Yokohama, Japan
| | | |
Collapse
|
3
|
Ishii Y, Fujisawa S, Ando T, Suzuki T, Ishiyama Y, Kishimoto K, Hattori Y, Nakajima Y, Miyazaki T, Takasaki H, Matsumoto K, Koharazawa H, Taguchi J, Fujimaki K, Sakai R, Nakajima H. Primary uterine lymphoma: The Yokohama Cooperative Study Group for Hematology (YACHT) study. Asia Pac J Clin Oncol 2018; 14:e455-e459. [PMID: 29984481 DOI: 10.1111/ajco.13049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
AIM Primary malignant lymphomas arising from the female genital tract are very rare, with an incidence rate of 0.5%. Because of its rarity, its clinical characteristics, prognosis and optimal treatment are still unclear. Here, we retrospectively evaluated female patients with uterine lymphoma. METHODS Between January 2000 and October 2016, 4362 patients were newly diagnosed with malignant lymphoma by the participating institutions of YACHT. Among these 4362 patients, we retrospectively evaluated 14 adult patients with primary uterine lymphoma. RESULTS The median follow up time was 41 months. The median age at diagnosis was 68 years. Of 14 patients, 10 (72%) were diagnosed with diffuse large B-cell lymphoma. Seven patients presented with vaginal bleeding and three with abdominal pain. Eleven patients (79%) had advanced stages at diagnosis. Three patients (21%) had ovarian involvement and 2 (14%) had vaginal involvement. Induction chemotherapy regimens were R-CHOP in seven patients (50%), CHOP in three (21%) and other regimens in four (29%). Among 14 patients, 12 patients (86%) achieved a complete response and 2 (14%) experienced disease progression. Three patients (21%) showed relapse. Five patients (36%) died because of malignant lymphoma. The 3-year overall survival rate was 57.9%. Soluble interleukin-2 receptor levels > 5000 U/mL, anemia, a bulky mass and the presence of > 1 extranodal sites, B symptom at diagnosis were associated with a poor prognosis. CONCLUSION Female genital lymphoma is very rare, and further study of more cases is warranted.
Collapse
Affiliation(s)
- Yoshimi Ishii
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Taiki Ando
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Taisei Suzuki
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | | | - Kumiko Kishimoto
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Yukako Hattori
- Department of Hematology, Fujisawa City Hospital, Fujisawa, Japan
| | - Yuki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Takuya Miyazaki
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | | | - Kenji Matsumoto
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | | | - Jun Taguchi
- Department of Hematology, Shizuoka Red Cross Hospital, Otemachi, Japan
| | | | - Rika Sakai
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hideaki Nakajima
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| |
Collapse
|
4
|
Ando T, Yamazaki E, Ogusa E, Ishii Y, Yamamoto W, Motohashi K, Tachibana T, Hagihara M, Matsumoto K, Tanaka M, Hashimoto C, Koharazawa H, Fujimaki K, Taguchi J, Fujita H, Kanamori H, Fujisawa S, Nakajima H. Body mass index is a prognostic factor in adult patients with acute myeloid leukemia. Int J Hematol 2017; 105:623-630. [DOI: 10.1007/s12185-017-2183-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 11/29/2022]
|
5
|
Koyama S, Fujisawa S, Watanabe R, Itabashi M, Ishibashi D, Ishii Y, Hattori Y, Nakajima Y, Motohashi K, Takasaki H, Kawasaki R, Hashimoto C, Yamazaki E, Koharazawa H, Takemura S, Tomita N, Sakai R, Motomura S, Nakajima H. Serum ferritin level is a prognostic marker in patients with peripheral T-cell lymphoma. Int J Lab Hematol 2016; 39:112-117. [PMID: 27885817 DOI: 10.1111/ijlh.12592] [Citation(s) in RCA: 20] [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: 06/17/2016] [Accepted: 09/10/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The prognostic value of serum ferritin level in patients with peripheral T-cell lymphoma (PTCL) remains unknown. METHODS We retrospectively analyzed clinical data from 78 consecutive patients with newly diagnosed PTCL that were treated with anthracycline-containing regimens between 1998 and 2011. RESULTS The patients consisted of 50 males and 28 females with a median age of 64 years (range, 16-83 years). The subtypes of PTCL were 39 PTCL, not otherwise specified and 39 angioimmunoblastic T-cell lymphoma (AITL). The median observation period for the surviving patients was 50 months. The overall survival (OS) was poorer in patients with serum ferritin level above the upper normal limit (n = 28), compared with patients with serum ferritin level within normal range (n = 50; 4-year OS: 23% vs. 72%; P < 0.001). In the multivariate analysis, poor performance status (P = 0.006) and elevated serum ferritin level (P = 0.018) were independent risk factors for poor OS. CONCLUSION Serum ferritin level is a useful prognostic marker for PTCL.
Collapse
Affiliation(s)
- S Koyama
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - S Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - R Watanabe
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - M Itabashi
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - D Ishibashi
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Y Ishii
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Y Hattori
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Y Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - K Motohashi
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - H Takasaki
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - R Kawasaki
- Department of Hematology/Immunology, Fujisawa City Hospital, Fujisawa, Japan
| | - C Hashimoto
- Department of Hematology, Yamato Municipal Hospital, Yamato, Japan
| | - E Yamazaki
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - H Koharazawa
- Department of Hematology, Yamato Municipal Hospital, Yamato, Japan
| | - S Takemura
- Department of Internal Medicine, Yokohama Ekisaikai Hospital, Yokohama, Japan
| | - N Tomita
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - R Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - S Motomura
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - H Nakajima
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| |
Collapse
|
6
|
Tomita N, Suzuki T, Miyashita K, Yamamoto W, Motohashi K, Tachibana T, Takasaki H, Kawasaki R, Hagihara M, Hashimoto C, Takemura S, Koharazawa H, Yamazaki E, Taguchi J, Fujimaki K, Fujita H, Sakai R, Fujisawa S, Motomura S, Kawamoto K, Sone H, Takizawa J. The SIL index is a simple and objective prognostic indicator in diffuse large B-cell lymphoma. Leuk Lymphoma 2016; 57:2763-2770. [DOI: 10.1080/10428194.2016.1195498] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
7
|
Yamazaki E, Kanamori H, Itabashi M, Ogusa E, Numata A, Yamamoto W, Ito S, Tachibana T, Hagihara M, Matsumoto K, Koharazawa H, Taguchi J, Tomita N, Fujimaki K, Fujita H, Fujisawa S, Ogawa K, Ishigatsubo Y. Hyper-recovery of platelets after induction therapy is a predictor of relapse-free survival in acute myeloid leukemia. Leuk Lymphoma 2016; 58:104-109. [PMID: 27267543 DOI: 10.1080/10428194.2016.1190969] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We verified the association between standard clinical and laboratory variables and the risk of relapse in acute myeloid leukemia (AML), which led us to retrospectively examine the effect of regeneration of hematopoiesis in patients with newly diagnosed AML. We used data from 230 patients who obtained remission after cytarabine-based induction chemotherapy. Platelet counts ≥500 × 109/L and hemoglobin levels ≥9 g/dL on day 28 after treatment initiation were significantly associated with relapse-free survival (RFS) rate, conferring respective multivariate risk ratios of 0.38 (95% CI: 0.18-0.79) and 0.60 (95% CI: 0.40-0.89) for the occurrence of relapse or death. No disease relapse occurred in core binding factor leukemia patients whose platelet counts recovered ≥500 × 109/L at 28 days after therapy initiation. We conclude that regeneration of hematopoiesis, especially platelet hyper-recovery, after induction chemotherapy is a significant predictor of RFS in patients with AML.
Collapse
Affiliation(s)
- Etsuko Yamazaki
- a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan
| | - Heiwa Kanamori
- b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan
| | - Megumi Itabashi
- c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan
| | - Eriko Ogusa
- b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan
| | - Ayumi Numata
- c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan
| | - Wataru Yamamoto
- b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan
| | - Satomi Ito
- d Department of Hematology , Shizuoka Red Cross Hospital , Shizuoka , Japan
| | - Takayoshi Tachibana
- a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan
| | - Maki Hagihara
- c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan
| | - Kenji Matsumoto
- b Department of Hematology , Kanagawa Cancer Center , Yokohama , Japan
| | - Hideyuki Koharazawa
- e Department of Hematology/Oncology , Yamato Municipal Hospital , Yamato , Japan
| | - Jun Taguchi
- d Department of Hematology , Shizuoka Red Cross Hospital , Shizuoka , Japan
| | - Naoto Tomita
- a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan
| | - Katsumichi Fujimaki
- f Department of Hematology/Immunology , Fujisawa City Hospital , Fujisawa , Japan
| | - Hiroyuki Fujita
- g Department of Hematology , Saiseikai Yokohama Nanbu Hospital , Yokohama , Japan
| | - Shin Fujisawa
- c Department of Hematology , Yokohama City University Medical Center , Yokohama , Japan
| | - Koji Ogawa
- h Department of Hematology , Yokosuka City Hospital , Yokosuka , Japan
| | - Yoshiaki Ishigatsubo
- a Department of Internal Medicine and Clinical Immunology , Yokohama City University Graduate School of Medicine , Yokohama, Japan
| |
Collapse
|
8
|
Tomita N, Taguri M, Hashimoto C, Takasaki H, Fujimaki K, Motomura S, Koharazawa H, Takemura S, Fujita H, Yamazaki E, Kawasaki R, Taguchi J, Sakai R, Fujisawa S, Hattori Y, Kanamori H, Yamamoto W, Harano H, Ogawa K, Ishigatsubo Y. Evaluation of soluble interleukin-2 receptor and serum lactate dehydrogenase in malignant lymphoma. Ann Hematol 2015. [PMID: 26208667 DOI: 10.1007/s00277-015-2448-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Naoto Tomita
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Masataka Taguri
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Chizuko Hashimoto
- Department of Hematology/Oncology, Yamato Municipal Hospital, Yamato, Japan
| | - Hirotaka Takasaki
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Katsumichi Fujimaki
- Department of Hematology/Immunology, Fujisawa City Hospital, Fujisawa, Japan
| | - Shigeki Motomura
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Sachiya Takemura
- Department of Internal Medicine, Yokohama Ekisaikai Hospital, Yokohama, Japan
| | - Hiroyuki Fujita
- Department of Hematology, Saiseikai Yokohama Nanbu Hospital, Yokohama, Japan
| | - Etsuko Yamazaki
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Rika Kawasaki
- Department of Hematology/Immunology, Fujisawa City Hospital, Fujisawa, Japan
| | - Jun Taguchi
- Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan
| | - Rika Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yukako Hattori
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Wataru Yamamoto
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroshi Harano
- Department of Hematology, Yokosuka City Hospital, Yokosuka, Japan
| | - Koji Ogawa
- Department of Hematology, Yokosuka City Hospital, Yokosuka, Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| |
Collapse
|
9
|
Tachibana T, Tanaka M, Hagihara M, Kawasaki R, Yamazaki E, Koharazawa H, Taguchi J, Tomita N, Fujimaki K, Sakai R, Fujita H, Fujisawa S, Maruta A, Ishigatsubo Y, Kanamori H. Clinical significance of the administration of cytarabine or thiotepa in addition to total body irradiation and cyclophosphamide for allogeneic hematopoietic cell transplantation in patients with acute leukemia. Int J Hematol 2015; 102:451-9. [PMID: 26173594 DOI: 10.1007/s12185-015-1836-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/30/2015] [Accepted: 07/07/2015] [Indexed: 11/26/2022]
Abstract
A multicenter retrospective study was performed to determine the significance of adding cytarabine (CA) or thiotepa (TT) in the context of total body irradiation (TBI) and cyclophosphamide (CY). A total of 322 patients who underwent allogeneic hematopoietic cell transplantation (HCT) were distributed to the following three groups: TBI/CY (n = 75), TBI/CY/CA (n = 77), and TBI/CY/TT (n = 170). In the TBI/CY/TT group, 164 of patients (96 %) received HCT during the previous year (2000-2005). Multivariate analysis revealed that the TBI/CY/TT group demonstrated a trend of poorer survival rate than the TBI/CY group, [hazard ratio (HR) = 1.49, 95 % confidence interval (CI) 0.99-2.24, P = 0.055] with a higher non-relapse mortality (NRM) (HR = 2.34, 95 % CI 1.35-4.06, P = 0.002) rates, while TBI/CY/CA group demonstrated similar outcomes. Even in the subgroup analyses of disease type or disease risk, the outcomes with intensified conditioning regimens were not superior to those with TBI/CY. In conclusion, although the significant bias has to be carefully considered, the clinical benefit of adding CA or TT to the TBI/CY regimen was not demonstrated.
Collapse
Affiliation(s)
- Takayoshi Tachibana
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
| | - Masatsugu Tanaka
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Maki Hagihara
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Rika Kawasaki
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Etsuko Yamazaki
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | | | - Jun Taguchi
- Department of Hematology, Shizuoka Red Cross Hospital, Shizuoka, Japan
| | - Naoto Tomita
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | | | - Rika Sakai
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroyuki Fujita
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Shin Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Atsuo Maruta
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Heiwa Kanamori
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| |
Collapse
|
10
|
Koharazawa H, Watanabe R, Hattori Y, Numata A, Kawasaki R, Kuwabara H, Hagihara M, Matsumoto K, Tanaka M, Hashimoto C, Takemura S, Yamazaki E, Fujimaki K, Taguchi J, Tomita N, Fujita H, Sakai R, Harano H, Ishigatsubo Y, Fujisawa S. [Analysis of prognostic factors in transplant-eligeble newly diagnosed myeloma patients treated with bortezomib plus dexamethasone as induction therapy]. Rinsho Ketsueki 2015; 56:392-9. [PMID: 25971269 DOI: 10.11406/rinketsu.56.392] [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
We retrospectively analyzed, and herein discuss, the outcomes of and prognostic factors for 35 untreated multiple myeloma patients less than 65 years of age who received induction therapies with bortezomib (Bor) and dexamethasone (BD) for the purpose of up-front autologous peripheral blood stem cell transplantation (SCT). The overall response rate was 77% (27 cases, including 4 [11%] complete response and 13 [37%] very good partial response cases). The rate of SCT accomplishment was 51% (18 cases). The 3 year-progression free survival (PFS) rate for the SCT group was significantly higher than that of the non-SCT group (41% vs 0%, P=0.0037). This result reflects the significantly more severe adverse effects of induction therapy for the non-SCT than the SCT group. Among reasons for SCT drop-out, 29% of cases suffered severe peripheral neuropathy with features such as irreversible numbness and pain. The analysis of PFS revealed a cytogenetic factor, favorable chromosomal type at diagnosis, to predict a better outcome (P values on univariate and multivariate analyses were 0.0004 and 0.0405, respectively). Our observations suggest establishment of induction therapy, aimed at reducing adverse effects and overcoming unfavorable cytogenetic abnormalities, to be necessary for improving the outcomes of patients with multiple myeloma.
Collapse
|
11
|
Tachibana T, Yamamoto E, Kawasaki R, Koharazawa H, Ishibashi D, Nakajima Y, Tanaka M, Matsumoto K, Ishigatsubo Y, Fujisawa S. Successful Engraftment and Durable Graft-versus-host Disease Control with Haploidentical Peripheral Blood and a Short-term Conditioning Regimen for Primary Graft Failure. Intern Med 2015; 54:2749-52. [PMID: 26521905 DOI: 10.2169/internalmedicine.54.4809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary graft failure occurred after cord blood transplantation for a patient with acute lymphoblastic leukemia. The second transplantation was performed using haploidentical peripheral blood. The conditioning regimen consisted of fludarabine (day -1; 30 mg/m(2)), cyclophosphamide (day -1; 2,000 mg/m(2)), and total body irradiation (day -1; 2 Gy). The immunosuppressants contained tacrolimus, prednisolone, and rabbit anti-thymocyte globulin (day -3 to -2; total dose: 3.75 mg/kg). The engraftment was confirmed on day 9. Both acute and chronic graft-versus-host disease were controllable. The present regimen appears to be suitable for immediate management, fast engraftment, and the durable control of complications.
Collapse
|
12
|
Tomita N, Kodama F, Tsuyama N, Sakata S, Takeuchi K, Ishibashi D, Koyama S, Ishii Y, Yamamoto W, Takasaki H, Hagihara M, Kuwabara H, Tanaka M, Hashimoto C, Yamazaki E, Koharazawa H, Fujimaki K, Sakai R, Fujisawa S, Ishigatsubo Y. Biweekly THP-COP therapy for newly diagnosed peripheral T-cell lymphoma patients. Hematol Oncol 2014; 33:9-14. [DOI: 10.1002/hon.2136] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 01/04/2014] [Accepted: 01/07/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Naoto Tomita
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Fumio Kodama
- Department of Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Naoko Tsuyama
- Division of Pathology, The Cancer Institute; Japanese Foundation for Cancer Research; Tokyo Japan
| | - Seiji Sakata
- Pathology Project for Molecular Targets, The Cancer Institute; Japanese Foundation for Cancer Research; Tokyo Japan
| | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute; Japanese Foundation for Cancer Research; Tokyo Japan
- Pathology Project for Molecular Targets, The Cancer Institute; Japanese Foundation for Cancer Research; Tokyo Japan
| | | | - Satoshi Koyama
- Department of Hematology; Shizuoka Red Cross Hospital; Shizuoka Japan
| | - Yoshimi Ishii
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Wataru Yamamoto
- Department of Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Hirotaka Takasaki
- Department of Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Maki Hagihara
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Hideyuki Kuwabara
- Department of Hematology; Yokohama City University Medical Center; Yokohama Japan
| | - Masatsugu Tanaka
- Department of Hematology; Yokohama City University Medical Center; Yokohama Japan
| | - Chizuko Hashimoto
- Department of Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Etsuko Yamazaki
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | | | | | - Rika Sakai
- Department of Medical Oncology; Kanagawa Cancer Center; Yokohama Japan
| | - Shin Fujisawa
- Department of Hematology; Yokohama City University Medical Center; Yokohama Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| |
Collapse
|
13
|
Yamamoto E, Fujisawa S, Hagihara M, Tanaka M, Fujimaki K, Kishimoto K, Hashimoto C, Itabashi M, Ishibashi D, Nakajima Y, Tachibana T, Kawasaki R, Kuwabara H, Koharazawa H, Yamazaki E, Tomita N, Sakai R, Fujita H, Kanamori H, Ishigatsubo Y. European Treatment and Outcome Study score does not predict imatinib treatment response and outcome in chronic myeloid leukemia patients. Cancer Sci 2014; 105:105-9. [PMID: 24450386 PMCID: PMC4317875 DOI: 10.1111/cas.12321] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 10/25/2013] [Accepted: 11/05/2013] [Indexed: 01/28/2023] Open
Abstract
The Sokal and Hasford scores were developed in the chemotherapy and interferon era and are widely used as prognostic indicators in patients with chronic myeloid leukemia (CML). Recently, a new European Treatment and Outcome Study (EUTOS) scoring system was developed. We performed a multicenter retrospective study to validate the effectiveness of each of the three scoring systems. The study cohort included 145 patients diagnosed with CML in chronic phase who were treated with imatinib. In the EUTOS low- and high-risk groups, the cumulative incidence of complete cytogenetic response (CCyR) at 18 months was 86.9% and 87.5% (P = 0.797) and the 5-year overall survival rate was 92.6% and 93.3% (P = 0.871), respectively. The cumulative incidence of CCyR at 12 months, 5-year event-free survival and 5-year progression-free survival were not predicted using the EUTOS scoring system. However, there were significant differences in both the Sokal score and Hasford score risk groups. In our retrospective validation study, the EUTOS score did not predict the prognosis of patients with CML in chronic phase treated with imatinib.
Collapse
Affiliation(s)
- Eri Yamamoto
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Yamamoto E, Tomita N, Sakata S, Tsuyama N, Takeuchi K, Nakajima Y, Miyashita K, Tachibana T, Takasaki H, Tanaka M, Hashimoto C, Koharazawa H, Fujimaki K, Taguchi J, Harano H, Motomura S, Ishigatsubo Y. MIB-1 labeling index as a prognostic factor for patients with follicular lymphoma treated with rituximab plus CHOP therapy. Cancer Sci 2013; 104:1670-4. [PMID: 24112697 DOI: 10.1111/cas.12288] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/28/2013] [Accepted: 09/06/2013] [Indexed: 11/29/2022] Open
Abstract
The MIB-1 labeling index, which is based on Ki67 immunostaining, is widely used to evaluate the proliferation of tumor cells in lymphoma. However, its clinical significance has not been fully assessed. We retrospectively evaluated the prognostic impact of the MIB-1 labeling index at the time of diagnosis, in 98 patients with follicular lymphoma (FL) grade 1-3b who were treated uniformly with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy. The 5-year progression-free survival (PFS) for an MIB-1 labeling index of ≥10% (n = 60) and <10% (n = 38) was 35% and 61%, respectively (P = 0.015). The 5-year overall survival (OS) for an MIB-1 labeling index of ≥10% and <10% was 77% and 92%, respectively (P = 0.025). Pathological grading was not correlated with PFS or OS. In multivariate analysis, an MIB-1 labeling index of ≥10% was independently associated with poor PFS and OS. In conclusion, an MIB-1 labeling index of 10% is a useful cut-off level for predicting the prognosis of patients with FL.
Collapse
Affiliation(s)
- Eri Yamamoto
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Tachibana T, Nozaki A, Enaka M, Yamamoto E, Kawasaki R, Koharazawa H, Hagihara M, Ishibashi D, Nakajima Y, Kuwabara H, Tomita N, Ishigatsubo Y, Fujisawa S. Drug-induced liver injury after allogeneic bone marrow transplantation. Int J Hematol 2013; 98:499-503. [PMID: 24037455 DOI: 10.1007/s12185-013-1434-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 09/05/2013] [Accepted: 09/05/2013] [Indexed: 11/29/2022]
Abstract
A 23-year-old woman developed acute severe hepatitis and jaundice on day 183 after bone marrow transplantation from HLA-B antigen mismatched-related donor. The administration of prednisolone and cessation of the prescribed drugs resolved the liver injury. Drug lymphocyte stimulation test was positive for acyclovir, and liver biopsy indicated the characteristics of drug-induced liver injury (DILI) rather than graft-versus-host disease. Physicians should keep DILI in mind when considering differential diagnosis for liver complications after allogeneic cell transplantation.
Collapse
Affiliation(s)
- Takayoshi Tachibana
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan,
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Tomita N, Takasaki H, Miyashita K, Fujisawa S, Ogusa E, Matsuura S, Kishimoto K, Numata A, Fujita A, Ohshima R, Kuwabara H, Hagihara M, Hashimoto C, Takemura S, Koharazawa H, Yamazaki E, Fujimaki K, Taguchi J, Sakai R, Ishigatsubo Y. R-CHOP therapy alone in limited stage diffuse large B-cell lymphoma. Br J Haematol 2013; 161:383-8. [DOI: 10.1111/bjh.12281] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 11/19/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Naoto Tomita
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Hirotaka Takasaki
- Department of Medical Oncology; Kanagawa Cancer Centre; Yokohama; Japan
| | - Kazuho Miyashita
- Department of Haematology/Immunology; Fujisawa City Hospital; Fujisawa; Japan
| | - Shin Fujisawa
- Department of Haematology; Yokohama City University Medical Centre; Yokohama; Japan
| | - Eriko Ogusa
- Department of Haematology; Shizuoka Red Cross Hospital; Shizuoka; Japan
| | - Shiro Matsuura
- Department of Haematology; Yamato City Hospital; Yamato; Japan
| | - Kumiko Kishimoto
- Department of Haematology; Yokosuka City Hospital; Yokosuka; Japan
| | - Ayumi Numata
- Department of Haematology/Immunology; Fujisawa City Hospital; Fujisawa; Japan
| | - Atsuko Fujita
- Department of Haematology; Yokohama City University Medical Centre; Yokohama; Japan
| | - Rika Ohshima
- Department of Medical Oncology; Kanagawa Cancer Centre; Yokohama; Japan
| | - Hideyuki Kuwabara
- Department of Haematology; Yokohama City University Medical Centre; Yokohama; Japan
| | - Maki Hagihara
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | | | - Sachiya Takemura
- Department of Medical Oncology; Kanagawa Cancer Centre; Yokohama; Japan
| | - Hideyuki Koharazawa
- Department of Haematology/Immunology; Fujisawa City Hospital; Fujisawa; Japan
| | - Etsuko Yamazaki
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| | - Katsumichi Fujimaki
- Department of Haematology/Immunology; Fujisawa City Hospital; Fujisawa; Japan
| | - Jun Taguchi
- Department of Haematology; Shizuoka Red Cross Hospital; Shizuoka; Japan
| | - Rika Sakai
- Department of Medical Oncology; Kanagawa Cancer Centre; Yokohama; Japan
| | - Yoshiaki Ishigatsubo
- Department of Internal Medicine and Clinical Immunology; Yokohama City University Graduate School of Medicine; Yokohama; Japan
| |
Collapse
|
17
|
Tomita N, Takasaki H, Fujisawa S, Miyashita K, Ogusa E, Kishimoto K, Matsuura S, Sakai R, Koharazawa H, Yamamoto W, Fujimaki K, Fujita H, Ishii Y, Taguchi J, Kuwabara H, Motomura S, Ishigatsubo Y. Standard R-CHOP Therapy in Follicular Lymphoma and Diffuse Large B-Cell Lymphoma. J Clin Exp Hematop 2013; 53:121-5. [DOI: 10.3960/jslrt.53.121] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
18
|
Miyazaki T, Fujita H, Fujimaki K, Hosoyama T, Watanabe R, Tachibana T, Fujita A, Matsumoto K, Tanaka M, Koharazawa H, Taguchi J, Tomita N, Sakai R, Fujisawa S, Kanamori H, Ishigatsubo Y. Clinical significance of minimal residual disease detected by multidimensional flow cytometry: serial monitoring after allogeneic stem cell transplantation for acute leukemia. Leuk Res 2012; 36:998-1003. [PMID: 22551655 DOI: 10.1016/j.leukres.2012.04.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 03/28/2012] [Accepted: 04/09/2012] [Indexed: 11/16/2022]
Abstract
We analyzed minimal residual disease (MRD) by multidimensional flow cytometry (MFC) after allogeneic stem cell transplantation in 41 patients with acute myeloid leukemia (AML) (n=31) or acute lymphoblastic leukemia (ALL) (n=10). Aberrant antigen expression was compared with the results of quantitative PCR for WT1 mRNA (n=41) and leukemia-specific fusion transcripts (n=12; AML in seven, ALL in five). There was a significant correlation between detection of MRD by MFC and WT1 mRNA, as well as between MFC and fusion transcripts. Serial monitoring of MRD by the three techniques correlated in parallel to the clinical course in most of the patients, but three patients were only positive for WT1 during hematological remission. The overall survival time of patients with complete remission was significantly associated with the appearance of aberrant expression after transplantation. In conclusion, MFC is valuable for clinical management decisions after transplantation.
Collapse
Affiliation(s)
- Takuya Miyazaki
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hattori Y, Taguchi J, Imai N, Wasano K, Matsuura S, Koharazawa H, Ishigatsubo Y, Fujisawa S. [POEMS syndrome diagnosed by detection of M-protein on immunofixation and increased level of vascular endothelial growth factor]. Rinsho Ketsueki 2011; 52:219-222. [PMID: 21566409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 48-year-old male with Castleman disease developed symptoms typical of POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal-protein and skin changes) but M-protein was not detected by immunoelec-trophoresis. He was diagnosed as having POEMS syndrome based on IgA-λ detected by immunofixation electrophoresis and an increased level (3,170 pg/ml) of vascular endothelial growth factor (VEGF). After diagnosis, the patient underwent autologous peripheral blood stem cell transplantation safely and remained relapse-free and in good condition for 15 months. This case suggests that immunofixation electrophoresis and detection of elevated serum VEGF level are useful methods for earlier diagnosis of POEMS syndrome.
Collapse
Affiliation(s)
- Yukako Hattori
- Department of Hematology, Japan Red Cross Shizuoka Hospital
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Ohshima R, Motomura S, Hashimoto C, Miyazaki T, Ito S, Takasaki H, Hyo R, Koharazawa H, Takemura S, Yamazaki E, Fujimaki K, Tomita N, Fujita H, Fujisawa S, Harano H, Kanamori H, Ishigatsubo Y. [ABVD chemotherapy for Hodgkin lymphoma at a single institute]. Rinsho Ketsueki 2010; 51:1756-1761. [PMID: 21258185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Fifty-eight newly diagnosed patients with Hodgkin lymphoma were treated with ABVD chemotherapy at Yokohama City University Hematology group from October 1996 to June 2005. The median age of patients age was 41 years old and ranged from 15 to 75. Thirty-eight patients were in the early stage and 20 patients were in the advanced stage. Patients in the early stage received 3 cycles of ABVD chemotherapy and involved-field radiation therapy, while those in the advanced stage received 6 cycles of ABVD chemotherapy. The overall response rate in patients was 100% (CR 87%, PR 13%) in the early stage and 95% in the advanced stage. With a median follow-up of 44 months, the 3-year progression-free survival and overall survival were 89% and 95% in the early stage, and 70% and 81% in the advanced stage, respectively. The results of this study were similar to those previously reported in Western countries.
Collapse
Affiliation(s)
- Rika Ohshima
- Department of Hematology, Yokohama City University Medial Center, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Fujimaki K, Takasaki H, Koharazawa H, Takabayashi M, Yamaji S, Baba Y, Kanamori H, Ishigatsubo Y. Idiopathic thrombocytopenic purpura and myasthenia gravis after fludarabine treatment for chronic lymphocytic leukemia. Leuk Lymphoma 2009; 46:1101-2. [PMID: 16019566 DOI: 10.1080/10428190500063054] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report a patient with chronic lymphocytic leukemia (CLL) who developed idiopathic thrombocytopenic purpura (ITP) and myasthenia gravis (MG) after fludarabine therapy. ITP developed after 6 cycles of fludarabine treatment, and MG occurred 2 months after the onset of ITP. MG was successfully treated with immunosuppressive therapy and plasma exchange, while rituximab was effective for CLL and ITP. Fludarabine seemed to have an important role in the onset of ITP and MG in this case.
Collapse
MESH Headings
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/therapeutic use
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Male
- Middle Aged
- Myasthenia Gravis/chemically induced
- Myasthenia Gravis/drug therapy
- Myasthenia Gravis/immunology
- Purpura, Thrombocytopenic, Idiopathic/chemically induced
- Purpura, Thrombocytopenic, Idiopathic/drug therapy
- Purpura, Thrombocytopenic, Idiopathic/immunology
- Rituximab
- Salvage Therapy
- Treatment Outcome
- Vidarabine/adverse effects
- Vidarabine/analogs & derivatives
Collapse
Affiliation(s)
- Katsumichi Fujimaki
- First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Koharazawa H, Kanamori H, Sakai R, Hashimoto C, Takemura S, Hattori M, Taguchi J, Fujimaki K, Tomita N, Fujita H, Fujisawa S, Harano H, Ogawa K, Motomura S, Maruta A, Ishigatsubo Y. Long-term outcome of L86 and L97 protocols for adult acute lymphoblastic leukemia. Leuk Lymphoma 2009; 49:2133-40. [DOI: 10.1080/10428190802464711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
23
|
Tomita N, Kodama F, Oshima R, Hashimoto C, Koharazawa H, Takemura S, Yamazaki E, Fujimaki K, Sakai R, Fujita H, Fujisawa S, Kanamori H, Motomura S, Ishigatsubo Y. Phase II study of CHOP-GR therapy for advanced-stage follicular lymphoma. Leuk Lymphoma 2009; 47:1041-7. [PMID: 16840195 DOI: 10.1080/10428190500472784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recently, the cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen plus rituximab (R-CHOP) have been used widely to treat patients with follicular lymphoma. We investigated a fixed scheme of combination chemotherapy protocol including CHOP, granulocyte colony stimulating factor (G-CSF) and rituximab (CHOP-GR) for patients with advanced-stage grade 1 or grade 2 follicular lymphoma in a phase II clinical trial, assessing enhancement of antibody-dependent cellular cytotoxicity of rituximab by G-CSF. Twenty-one untreated patients received two courses of CHOP chemotherapy followed by four courses of CHOP-GR, including G-CSF (s.c.) on days 11 - 14 and rituximab on day 15. Overall response rate was 76% (16 of 21 patients). Two patients, one with no response and subsequent allogeneic hematopoietic stem cell transplantation and one with progressive disease, died of lymphoma. One patient refused to continue therapy, whereas two were rediagnosed and no longer met histologic criteria; these three patients were classified as nonresponders. After a median observation time of 23 months, the 19 histologically assessable patients showed a 2-year progression-free survival rate of 82%, whereas 2-year overall survival was 95%. Fifteen patients (79%) continued in remission during this median follow-up period. Of seven patients with initial bulky mass, five responded to therapy. The most frequent adverse events were leukocytopenia (100%) and neutropenia (100%), followed in turn by alopetia (94%) and nausea/vomiting (79%). Of 11 patients examined for bcl-2 translocation in peripheral blood or marrow by polymerase chain reaction (PCR), four were positive, whereas three of the four had complete remissions and converted to PCR negativity after therapy. According to short-term observation, CHOP-GR is a safe and effective therapy for patients with advanced-stage follicular lymphoma.
Collapse
Affiliation(s)
- Naoto Tomita
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Fujimaki K, Sakai R, Fujisawa S, Fujita H, Tanaka M, Hagihara M, Koharazawa H, Miyazaki T, Tomita N, Kanamori H, Maruta A, Ishigatsubo Y. [Usefulness of hematopoietic cell transplantation-specific comorbidity index after allogeneic hematopoietic stem cell transplantation]. Gan To Kagaku Ryoho 2008; 35:87-91. [PMID: 18195534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We retrospectively investigated the hematopoietic cell transplantation-specific comorbidity index(HCT-CI)to predict non relapse mortality. Of 127 patients who underwent transplantation between January 2000 and December 2003 with conditioning consisting of total body irradiation, cyclophosphamide and thiotepa, HCT-CI scores were obtained for 83 patients. Median age was 42 years. The sources of stem cells included HLA-identical bone marrow or peripheral blood from sibling(30), HLA-matched bone marrow from unrelated donors(45), and HLA-mismatched bone marrow or peripheral blood from family donors(8). Hematological disease was divided into two groups, standard risk(47)and high risk(36). Standard risk indicates acute leukemia in first or second remission and chronic myelocytic leukemia in first chronic phase, while high risk indicates all other diagnoses. There were 45 patients with moderate or severe pulmonary comorbidities. 55 patients with HCT-CI scores of 2 or less had higher 2-year overall survival than 28 patients with HCT-CI scores of 3 or more(65% vs. 36%, p=0.0009). Although the non relapse mortality rate was not different, HCT-CI scores were a more useful indicator to predict survival in high risk patients than in standard risk patients. Prospective evaluation is warranted to clarify the usefulness of HCT-CI.
Collapse
Affiliation(s)
- Katsumichi Fujimaki
- Dept. of Internal Medicine and Clinical Immunology, Yokohama City University, Graduate School of Medicine
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Miyazaki T, Taguchi J, Obana T, Yamaji S, Koharazawa H, Fujimaki K, Kanamori H, Ishigatsubo Y. [Multiple myeloma presenting as cavernous sinus syndrome]. Rinsho Ketsueki 2006; 47:1393-5. [PMID: 17094580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We report on a 70-year-old male who developed cavernous sinus syndrome as the initial symptom of multiple myeloma. He was admitted with diplopia and ptosis in October 2004. The diagnosis of multiple myeloma and cavernous sinus syndrome due to a gross mass at the sinus base were made. Cerebral computed tomography revealed that the lesion occupied the sphenoid sinus and involved the oculomoter nerve. He underwent local irradiation of the mass followed by systemic chemotherapy. The symptoms caused by the mass disappeared after the treatment. Clinicians need to be aware of the rare manifestation of multiple myeloma.
Collapse
Affiliation(s)
- Takuya Miyazaki
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Takasaki H, Kanamori H, Takabayashi M, Yamaji S, Koharazawa H, Taguchi J, Fujimaki K, Ishigatsubo Y. Non-Hodgkin's lymphoma presenting as multiple bone lesions and hypercalcemia. Am J Hematol 2006; 81:439-42. [PMID: 16680736 DOI: 10.1002/ajh.20559] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We report a rare case of a patient with non-Hodgkin's lymphoma who developed multiple bone lesions and hypercalcemia. A 50-year-old woman complained of drowsiness and multiple bone pain on admission. Radiographic examination revealed multiple bone fractures and osteolytic lesions. She was diagnosed with diffuse large B cell lymphoma by biopsy of an inguinal lymph node. Elevation of parathyroid hormone-related protein (PTHrP) and hypercalcemia were confirmed pretreatment, and those serum levels decreased during chemotherapy for lymphoma. However, the disease was resistant to chemotherapy combined with rituximab. These findings suggest that hypercalcemia is associated with PTHrP and the prognosis of patients with bone lymphoma in advanced stage is poor, although it is thought to be a relatively favorable prognosis in localized primary lymphoma of bone.
Collapse
MESH Headings
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Bone Neoplasms/blood
- Bone Neoplasms/complications
- Bone Neoplasms/drug therapy
- Bone Neoplasms/pathology
- Drug Resistance, Neoplasm
- Female
- Fractures, Bone/blood
- Fractures, Bone/drug therapy
- Fractures, Bone/etiology
- Fractures, Bone/pathology
- Humans
- Hypercalcemia/blood
- Hypercalcemia/drug therapy
- Hypercalcemia/etiology
- Hypercalcemia/pathology
- Lymph Nodes/pathology
- Lymphoma, B-Cell/blood
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, Non-Hodgkin/blood
- Lymphoma, Non-Hodgkin/complications
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Middle Aged
- Osteolysis/blood
- Osteolysis/etiology
- Osteolysis/pathology
- Parathyroid Hormone-Related Protein/blood
- Prognosis
- Rituximab
- Sentinel Lymph Node Biopsy
Collapse
Affiliation(s)
- Hirotaka Takasaki
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Tomita N, Kodama F, Motomura S, Koharazawa H, Fujita H, Harano H, Kanamori H, Ishigatsubo Y. Prognostic factors in diffuse large B-cell lymphoma treated by risk-adopted therapy. Intern Med 2006; 45:247-52. [PMID: 16595988 DOI: 10.2169/internalmedicine.45.1549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The International Prognostic Index (IPI) was reported in 1993 and it is now widely used for predicting the outcome in patients with aggressive non-Hodgkin's lymphoma. It defines 5 risk factors and 4 distinct risk groups from retrospective data. In this study, we evaluated the outcome of risk-adopted therapy for diffuse large B-cell lymphoma (DLBCL), the most common aggressive lymphoma, and assessed the possible prognostic factors. METHODS AND PATIENTS We treated 177 consecutive patients newly diagnosed with DLBCL using therapies determined by putative risk factors. Therapies included CHOP followed by involved field irradiation; ACOMPB with the consolidation regimen MLY9; high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation; or performance status (PS) oriented CHOP. Statistical analysis was performed to determine the comprehensive risk factors in DLBCL. RESULTS Overall, the complete response (CR), 3-year overall survival (OS), and 3-year relapse-free survival (RFS) rates for CR patients were 71%, 69%, and 75%, respectively. Male gender, high LDH, poor PS (> or = 2), more than one extranodal involvement site, and B symptoms were independent adverse prognostic factors for OS. High LDH and poor PS were independent, adverse prognostic factors for RFS. CONCLUSION In the 5 risk factors indicated by IPI, high LDH and poor PS remained for OS and RFS even after risk-adopted therapy.
Collapse
MESH Headings
- Aged
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Clinical Protocols
- Cyclophosphamide/therapeutic use
- Doxorubicin/therapeutic use
- Female
- Humans
- L-Lactate Dehydrogenase/blood
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/radiotherapy
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/radiotherapy
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Peripheral Blood Stem Cell Transplantation
- Prednisone/therapeutic use
- Prognosis
- Risk Assessment
- Survival Analysis
- Vincristine/therapeutic use
Collapse
Affiliation(s)
- Naoto Tomita
- Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Koharazawa H, Yamaji S, Takasaki H, Takabayashi M, Fujimaki K, Taguchi J, Kanamori H, Ishigatsubo Y. [Triple secondary malignancy of gingiva, palate and esophagus after an allogeneic bone marrow transplantation for cutaneous T-cell lymphoma]. Rinsho Ketsueki 2005; 46:496-500. [PMID: 16440741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A 31-year-old man was diagnosed as having cutaneous T-cell lymphoma in January 1994. He received an allogeneic bone marrow transplantation (BMT) from an HLA-matched sibling donor in May 1995, because of refractoriness to chemotherapy. The patient had been treated with immunosuppressants including prednisolone and cyclosporin A for chronic graft-versus-host disease (GVHD) of the extensive type following acute GVHD. Five years after the BMT, he developed moderately differentiated squamous cell carcinoma (SCC) on the mandibular gingival mucosa and underwent surgical resection. Furthermore, 6 years after the BMT well differentiated SCC developed on his palate and was resected. Concurrently, he was diagnosed as having esophageal cancer (poorly differentiated SCC) and underwent a subtotal esophagotomy. One year later he had a recurrence of the esophageal cancer with dysphagia and was treated with radiation and chemotherapy. He remains free of triple cancer and lymphoma. It is suggested that total body irradiation, immunosuppressants, and chronic GVHD are associated with a risk of secondary malignancies following allogeneic BMT. These factors might have contributed to the onset of triple cancer in our patient.
Collapse
Affiliation(s)
- Hideyuki Koharazawa
- Department Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Ohshima R, Tomita N, Motohashi K, Ieda A, Hyou R, Fujisawa S, Fujita H, Sakai R, Koharazawa H, Kuwabara H, Kanamori H, Ishigatsubo Y. [Clinical course of 8 patients with intravascular large B-cell lymphoma diagnosed while alive]. Rinsho Ketsueki 2005; 46:453-7. [PMID: 16447727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
We retrospectively evaluated the diagnosis and clinical courses of 8 patients with intravascular large B-cell lymphoma (IVL) diagnosed while they were alive. The median age was 67 years old (range 54 to 82). Most complaints at diagnosis were fever or dyspnea. All patients were in clinical stage IV with B symptoms and 4 patients showed performance status 4. The diagnosis of IVL was confirmed by biopsy specimens from the bone marrow in 4, lung in 2, muscle, adrenal gland, and lymph node in 1 case, respectively. Initial bone marrow involvement was found in 6 patients. Chemotherapy was performed in 7 patients. Rituximab was added to chemotherapy in 5 patients. Though 5 patients are alive at the median follow up of 12.3 months, only 1 patient is in remission. Four of 5 patients treated with Rituximab relapsed. In suspicious cases, it is important to bear IVL in mind and examine bone marrow biopsies for an early diagnosis. In addition, it is suggested that Rituximab may play only a temporary role in the treatment of IVL.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Early Diagnosis
- Female
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Rituximab
- Vascular Neoplasms/diagnosis
- Vascular Neoplasms/pathology
- Vascular Neoplasms/therapy
Collapse
Affiliation(s)
- Rika Ohshima
- Department of Hematology, Yokohama City University Medical Center
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Koharazawa H, Kanamori H, Takabayashi M, Yamaji S, Taguchi J, Fujimaki K, Ishigatsubo Y. Resolution of atopic dermatitis following allogeneic bone marrow transplantation for chronic myelogenous leukemia. Bone Marrow Transplant 2005; 35:1223-4. [PMID: 15880131 DOI: 10.1038/sj.bmt.1704990] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
31
|
Motomura S, Hashimoto C, Kodama F, Maruta A, Sakai R, Fujita H, Tomita N, Fujisawa S, Harano H, Koharazawa H, Fujimaki K, Kanamori H, Ishigatsubo Y. [Trial of front-line intensive chemotherapy followed by peripheral blood stem cell transplantation in high-intermediate and high risk non-Hodgkin's lymphoma patients]. Rinsho Ketsueki 2005; 46:350-7. [PMID: 16444968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
High-intermediate (HI)- and high (H)-risk non-Hodgkin lymphoma was treated with front-line intensive chemotherapy followed by autologous peripheral blood stem cell transplantation (auto-PBSCT). Twenty-eight cases were enrolled after obtaining informed consent, from November, 1998 to October, 2003. Initial treatment was 2 or 3 cycles of CHOP-V regimen, followed by three high-dose therapy, one each of cyclophosphamide, methotrexate and etoposide. The final high-dose therapy was a combination of ranimustine, ifosphamide and etoposide, which was followed by auto-PBSCT. Patients with a bulky mass received involved-field radiation therapy (IF-RT) after auto-PBSCT. Complete remission (CR) was achieved in 16 cases (57%) and partial remission (PR) in 9 cases (32%), after auto-PBSCT The final responses after IF-RT were CR in 20 cases (71%) and PR in 5 cases (18%). Overall survival of cases with 2 cycles of CHOP-V regimen was 56% after a median observation time of 30 months, compared with 82% in cases with 3 cycles (p = 0.0732). The results suggested that the reduction of tumor size with the initial CHOP-V treatment was most important. In all cases, progression-free survival was 64% and the overall survival was 74% after a median observation time of 30 months, which showed a good outcome compared with that of HI- and H-risk group defined by the age-adjusted international prognostic index reported by Shipp et al.
Collapse
|
32
|
Takabayashi M, Kanamori H, Takasaki H, Yamaji S, Koharazawa H, Taguchi J, Tomita N, Fujimaki K, Fujisawa S, Maruta A, Ishigatsubo Y. A possible association between the presence of interleukin-4–secreting cells and a reduction in the risk of acute graft-versus-host disease. Exp Hematol 2005; 33:251-7. [PMID: 15676220 DOI: 10.1016/j.exphem.2004.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Revised: 10/07/2004] [Accepted: 10/11/2004] [Indexed: 10/25/2022]
Abstract
OBJECTIVE We monitored cytokine-secreting cells using an enzyme-linked immunospot (ELISPOT) assay in a prospective study to assess the cytokine network after transplantation. PATIENTS AND METHODS Peripheral blood mononuclear cells were collected from 23 patients who received allogeneic stem cell transplantation, from before the preconditioning regimen to 56 days after transplantation. The number of interleukin-4 (IL-4), interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha)-secreting cells were measured by ELISPOT assay. For IL-4 and IFN-gamma, in vitro stimulation with phorbol 12-myristate 13-acetate and phytohemagglutinin was performed. RESULTS The frequency of IL-4-secreting cells was significantly higher in five patients receiving peripheral blood stem cell transplantation (PBSCT) than that in 18 patients who received bone marrow transplantation (BMT). Based on IFN-gamma and TNF-alpha release, there was a trend toward a decrease in the number of cytokine-secreting cells in PBSCT compared with BMT. Furthermore, patients who did not develop acute graft-vs-host disease (GVHD, n=5) showed a significantly higher number of IL-4-secreting cells compared with those who developed acute GVHD (n=18). Both IFN-gamma-secreting cells and TNF-alpha-secreting cells showed a trend to increase in number in patients with acute GVHD. In patients who received reduced-intensity stem cell transplantation (n=7) compared with conventional stem cell transplantation (n=16), there was a large number of cytokine-secreting cells detected by IL-4 and IFN-gamma release. CONCLUSIONS These results are consistent with the hypothesis that IL-4-producing cells inhibit the development of acute GVHD. In addition, the increased percentage of IL-4-secreting cells may be responsible for the unexpected low incidence of acute GVHD in PBSCT, despite the presence of large numbers of mature T cells in the donor infusion.
Collapse
Affiliation(s)
- Maki Takabayashi
- Department of Internal Medicine and Clinical Immunology, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Takasaki H, Takabayashi M, Yamaji S, Koharazawa H, Fujimaki K, Kanamori H, Ishigatsubo Y. [Pulmonary MALT lymphoma with macroglobulinemia]. Rinsho Ketsueki 2005; 46:144-6. [PMID: 16447709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
An 84-year-old man was diagnosed as having pulmonary MALT lymphoma in January 1997. Six years later, he was admitted to our hospital with coughing and dyspnea in November 2003. Dissemination of MALT lymphoma was confirmed by findings of pleural effusion and bone marrow aspiration. A FISH analysis of cells from the pleural effusion revealed t(11;18)(q21;q21) and the serum level of IgM was 8,600 mg/dl (M-protein). The diagnosis of secondary macroglobulinemia was made. The patient received rituximab monotherapy because he was very elderly. Pleural effusion has not been seen after the administration of rituximab, although there have been no changes in the lung mass and serum values of M-protein.
Collapse
MESH Headings
- Aged, 80 and over
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents/therapeutic use
- Biomarkers/blood
- Humans
- Immunoglobulin M/blood
- Lung Neoplasms/complications
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Male
- Rituximab
- Waldenstrom Macroglobulinemia/diagnosis
- Waldenstrom Macroglobulinemia/drug therapy
- Waldenstrom Macroglobulinemia/etiology
Collapse
Affiliation(s)
- Hirotaka Takasaki
- Department Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | |
Collapse
|
34
|
Fujimaki K, Takasaki H, Takabayashi M, Yamaji S, Koharazawa H, Kanamori H, Ishigatsubo Y. [Outcome of allogeneic stem cell transplantation for hematological disorders in patients older than 50]. Gan To Kagaku Ryoho 2005; 32:47-51. [PMID: 15675581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We retrospectively evaluated the outcomes in patients older than 50 years of age who underwent allogeneic hematopoietic transplantation. Twenty-three patients received conventional stem cell transplantation (CST) and 9 patients received reduced intensity stem cell transplantation (RIST). Regimen-related toxicity was observed in 21 (91%) patients with CST and 4 (44%) patients with RIST. Early death occurred within 100 days after transplantation in 6 patients with CST and 2 patients with RIST. Among the patients with complete remission, the two-year probability rate of survival was 44% in patients with CST and 100% in patients with RIST (p=0.08). Among the patients without complete remission, the two-year probability rate of survival was 30% in patients with CST and 0% in those with RIST (p=0.08). For patients receiving RIST without complete remission, relapse and infection were the main causes of death. Our data suggest that patients without complete remission should receive CST to the degree possible.
Collapse
|
35
|
Kanamori H, Takasaki H, Takabayashi M, Yamaji S, Koharazawa H, Fujimaki K, Taguchi J, Ishigatsubo Y. Long-term cytogenetic remission with ubenimex monotherapy in a case of chronic myeloid leukemia. Anticancer Drugs 2004; 15:729-31. [PMID: 15269606 DOI: 10.1097/01.cad.0000136880.34799.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 65-year-old man was diagnosed with chronic myeloid leukemia (CML) in February 1990, and was treated with busulfan and ubenimex. Cytogenetic analysis of the bone marrow revealed the Philadelphia (Ph) chromosome in 100% of cells of analyzed at diagnosis. Treatment with busulfan was stopped in March 1993 due to bone marrow suppression. The Ph chromosome was seen in 80% of cells in June 1993. He received ubenimex monotherapy after cessation of busulfan. Complete disappearance of the Ph chromosome was confirmed in May 1995 and has continued to date. This suggests that ubenimex might specifically affect the Ph chromosome and be useful as maintenance therapy for CML.
Collapse
Affiliation(s)
- Heiwa Kanamori
- First Department of Internal Medicine, Yokohama City University School of Medicine, Kanazawa-ku, Yokohama, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Fujita H, Takemura S, Hyo R, Tanaka M, Koharazawa H, Fujisawa S, Kanamori H, Ishigatsubo Y. Pulmonary Embolism and Thrombotic Thrombocytopenic Purpura in Acute Promyelocytic Leukemia Treated with All- trans Retinoic Acid. Leuk Lymphoma 2003. [DOI: 10.1080/1042819031000097401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
37
|
Fujita H, Takemura S, Hyo R, Tanaka M, Koharazawa H, Fujisawa S, Kanamori H, Ishigatsubo Y. Pulmonary Embolism and Thrombotic Thrombocytopenic Purpura in Acute Promyelocytic Leukemia Treated with All- transRetinoic Acid. Leuk Lymphoma 2003; 44:1627-9. [PMID: 14565670 DOI: 10.3109/10428190309178790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We describe a patient with acute promyelocytic leukemia (APL) who developed pulmonary embolism (PE) and thrombotic thrombocytopenic purpura (TTP) during remission induction all-trans retinoic acid (ATRA) therapy. A 44-year-old man was diagnosed with APL and was treated with ATRA. On day 14, he developed PE, and on day 24, he developed TTP. Both PE and TTP occurred in association with leukocytosis due to ATRA administration. The PE responded to dexamethasone and TTP responded to plasma infusion. The PE and TTP remitted, and he achieved complete remission of APL. To our knowledge, there have been no reports of TTP occurring as a complication of ATRA therapy.
Collapse
Affiliation(s)
- Hiroyuki Fujita
- First department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Kanamori H, Mishima A, Tanaka H, Yamaji S, Fujisawa S, Koharazawa H, Nishikawa M, Mohri H, Ishigatsubo Y, Matsuzaki M. Bronchiolitis obliterans organizing pneumonia (BOOP) with suspected liver graft-versus-host disease after allogeneic bone marrow transplantation. Transpl Int 2001. [DOI: 10.1111/j.1432-2277.2001.tb00056.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
39
|
Kanamori H, Mishima A, Tanaka M, Yamaji S, Fujisawa S, Koharazawa H, Nishikawa M, Matsuzaki M, Mohri H, Ishigatsubo Y. Bronchiolitis obliterans organizing pneumonia (BOOP) with suspected liver graft-versus-host disease after allogeneic bone marrow transplantation. Transpl Int 2001; 14:266-9. [PMID: 11512061 DOI: 10.1007/s001470100330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on a patient with chronic myelogenous leukemia who developed bronchiolitis obliterans organizing pneumonia (BOOP) after allogeneic bone marrow transplantation (BMT). A 19-year-old Japanese male complained of dry cough and dyspnea 7 months after BMT. The chest X-ray and computed tomography revealed patchy infiltrates bilaterally. Lung function test, lung biopsy and bronchoalveolar lavage were consistent with the diagnosis of BOOP. The patient also suffered from suspected graft-versus-host disease (GVHD) of the liver, after discontinuation of cyclosporine. Furthermore, prednisolone proved effective against the BOOP and the liver dysfunction. These findings indicate that BOOP is a possible pulmonary manifestation of chronic GVHD, and that immunological mechanisms may have effected the onset of BOOP after BMT in this case.
Collapse
Affiliation(s)
- H Kanamori
- First Department of Internal Medicine, Yokohama City, University School of Medicine, 3-9 Fukuura Kanazawa-ku, Yokohama 236-0004, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Fujita H, Koharazawa H, Nishida H, Terada S, Morishita T, Kuroyama Y, Ohata M, Ishigatsubo Y. [Successful treatment of hairy cell leukemia with pentostatin]. Rinsho Ketsueki 2001; 42:537-42. [PMID: 11524843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
A 45-year-old woman was admitted to our hospital in August, 1999. Laboratory data showed a white blood cell count of 5,050/microliter with 78% abnormal lymphocytes, hemoglobin 6.8 g/dl, platelets 4.8 x 10(4)/microliter, and soluble IL-2 receptor 97,600/ml. The abnormal cells were characterized by a hairy appearance under phase contrast microscopy, and showed strong tartrate-resistant acid phosphatase activity. Immunophenotype analysis revealed that these cells were positive for CD11c, CD19 and CD25, and negative for CD5. Bone marrow biopsy showed diffuse proliferation of hairy cells with moderate myelofibrosis. We diagnosed the patient as having European-American-type hairy cell leukemia. Pentostatin was administered at a dose of 5 mg/m2 weekly. After twelve doses, the peripheral blood data returned to the normal range with no hairy cells in the blood or bone marrow, although slight splenomegaly remained. The patient underwent splenectomy in December of the same year, and we were unable to find any hairy cells by histological and immunohistochemical examination. Although most patients with hairy cell leukemia in Japan have the Japanese variant, and the European-American type is rare, pentostatin is as effective as it is for European and American patients.
Collapse
Affiliation(s)
- H Fujita
- Department of Hematology/Rheumatology, Shizuoka Red Cross Hospital
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Fujimaki K, Maruta A, Yoshida M, Sakai R, Tanabe J, Koharazawa H, Kodama F, Asahina S, Minamizawa M, Matsuzaki M, Fujisawa S, Kanamori H, Ishigatsubo Y. Severe cardiac toxicity in hematological stem cell transplantation: predictive value of reduced left ventricular ejection fraction. Bone Marrow Transplant 2001; 27:307-10. [PMID: 11277179 DOI: 10.1038/sj.bmt.1702783] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Eighty patients receiving hematological stem cell transplantation (HCT) with a preparative regimen consisting of total body irradiation (12.5 Gy), cyclophosphamide (4000 or 4500 mg/m2), and thiotepa (400 mg/m2) were evaluated for the development of cardiac toxicity. Patients in whom the pretransplant cumulative dose of anthracycline was more than or equal to 300 mg/m2 showed a lower left ventricular ejection fraction (EF) before HCT compared to patients with less than 300 mg/m2 (0.61 +/- 0.09 vs 0.67 +/- 0.06, P = 0.0010). Patients who had undergone more than or equal to six courses of chemotherapy showed a decreased EF before HCT compared to those after less than six courses (0.67 +/- 0.05 vs 0.63 +/- 0.09, P = 0.03). Three of seven patients (43%) whose pretransplant EF had been less than or equal to 0.55 developed severe cardiac toxicity, characterized by congestive heart failure (CHF) compared with none of 83 patients (0%) whose pretransplant EF had been more than 0.55 (P = 0.00026). Of the three patients who developed severe cardiac toxicity, two were given more than 300 mg/m2 of cumulative anthracycline and underwent 23 courses and six courses of chemotherapy, while the other patient received only two courses of chemotherapy with a total dose of 139 mg/m2 of anthracycline. These results indicate that an increased cumulative dose of anthracycline and number of chemotherapy treatments are correlated with a decrease of the EF and that the EF before HCT is useful for predicting the risk of cardiac complications for recipients who have received chemotherapy.
Collapse
Affiliation(s)
- K Fujimaki
- Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Kobayashi S, Maruta A, Yamamoto T, Katayama N, Higuchi R, Sakano Y, Fujita H, Koharazawa H, Tomita N, Taguchi J, Kodama F, Nakamura Y, Shimizu A. Human parvovirus B19 capsid antigen in granulocytes in parvovirus-B19-induced pancytopenia after bone marrow transplantation. Acta Haematol 2000; 100:195-9. [PMID: 9973642 DOI: 10.1159/000040903] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A patient with refractory anemia with an excess of blasts in transformation developed pancytopenia and a concurrent interstitial pneumonia 110 days after allogeneic bone marrow transplantation. Bone marrow examination showed 0.4% giant proerythroblasts and 86.2% granulocytes, some of them large with a bizarre configuration and the others of normal size. Serum folate level was found low, 0.6 ng/ml. Immunocytochemistry with a B19-specific monoclonal antibody MAB8292 revealed B19 capsid antigen only in erythroblasts and large, bizarre granulocytes, but not in granulocytes of normal size. In situ hybridization of bone marrow cells using digoxigenin-labeled DNA probes detecting parvovirus B19 also demonstrated positive signals in 8.5% of marrow cells. Parvovirus B19 DNA was isolated from the serum and the bronchoalveolar lavage fluid of this patient by the polymerase chain reaction. These findings suggest that neutropenia may be caused by an involvement with parvovirus B19 though a deficiency of folic acid may have in part contributed to the genesis of neutropenia in the patient. The relevance of parvovirus B19 to the interstitial pneumonia remains unclear.
Collapse
Affiliation(s)
- S Kobayashi
- Division of Clinical Laboratory, Kanagawa Cancer Center, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Yamaji S, Kanamori H, Tanaka M, Mishima A, Koharazawa H, Fujita H, Fujisawa S, Murata T, Matsuzaki M, Mohri H, Ishigatsubo Y. [Successful emergency operation for subdural hematoma and acute epidural hematoma in a patient with acute promyelocytic leukemia]. Rinsho Ketsueki 1999; 40:606-9. [PMID: 10483146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
A 22-year-old woman was admitted with purpura. Acute promyelocytic leukemia (APL) with disseminated intravascular coagulation (DIC) was diagnosed. On the 17th day after treatment with all-trans retinoic acid (ATRA), left subdural hematoma developed. Although coagulation abnormalities were still observed, emergency surgery was performed. Acute epidural hematoma was confirmed by computed tomographic scan after the operation. A second operation for drainage was successful. Post-operative intracranial hematoma may be caused by rapid decompression induced by surgery, but DIC could also be involved. This case underscored the need for careful consideration of the indications for surgical treatment of such DIC patients, with close follow-up monitoring for the postoperative development of neurological symptoms.
Collapse
Affiliation(s)
- S Yamaji
- First Department of Internal Medicine, Yokohama City University of Medicine
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Fujisawa S, Togawa J, Tanaka M, Koharazawa H, Aoba M, Fujita H, Murata T, Kanamori H, Matsuzaki M, Mohri H, Ishigatsubo Y. De novo acute myelogenous leukemia with trilineage myelodysplasia associated with t(8;21)(q22;q22). Intern Med 1999; 38:607-11. [PMID: 10435370 DOI: 10.2169/internalmedicine.38.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We describe a rare case of de novo acute myelogenous leukemia with trilineage myelodysplasia (AML/TMDS) associated with t(8;21)(q22;q22). The patient was admitted to our hospital with leukocytopenia. AML/TMDS was diagnosed by excess myeloblasts and morphological findings of bone marrow. The karyotype revealed 45, X, -Y, t(8;21)(q22;q22) in 17 of 20 analyzed mitoses, and also AML1/MTG8 transcripts were detected by the reverse transcription polymerase chain reaction (RT-PCR) method. The patient achieved a complete remission with a combination chemotherapy of daunorubicin, cytarabine, and prednisolone. This case suggests that t(8;21)(q22;q22) may participate in the pathogenesis of AML/TMDS, although this type is usually found as one of the chromosomal abnormalities in de novo acute myelogenous leukemia (AML) with maturation.
Collapse
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Cytarabine/administration & dosage
- Daunorubicin/administration & dosage
- Humans
- Karyotyping
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Myelodysplastic Syndromes/complications
- Myelodysplastic Syndromes/drug therapy
- Myelodysplastic Syndromes/genetics
- Prednisolone/administration & dosage
- Translocation, Genetic
Collapse
Affiliation(s)
- S Fujisawa
- First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Tanaka M, Kanamori H, Yamaji S, Mishima A, Fujita H, Fujisawa S, Murata T, Koharazawa H, Matsuzaki M, Mohri H. Low-dose cytarabine-induced hepatic and renal dysfunction in a patient with myelodysplastic syndrome. Anticancer Drugs 1999; 10:289-91. [PMID: 10327034 DOI: 10.1097/00001813-199903000-00006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report a 49-year-old female patient with secondary myelodysplastic syndrome who developed liver dysfunction and acute renal failure caused by low-dose cytosine arabinoside (Ara-C) therapy. Treatment of low-dose Ara-C has widely been used for acute myelogeous leukemia and myelodysplastic syndrome, and it is thought to be a low toxicity except for myelosuppression. The patient complained of a transient adverse reaction in the second and third course of therapy. This rare case indicates that careful observation should be carried out during low-dose Ara-C therapy in view of allergic reactions.
Collapse
Affiliation(s)
- M Tanaka
- The First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Tanabe J, Maruta A, Koharazawa H, Hattori M, Kodama F, Okubo T. Allogeneic peripheral blood progenitor cell transplantation conditioned with anti-thymocyte globulin for treatment of graft failure after allogeneic bone marrow transplantation. Int J Hematol 1998; 67:423-7. [PMID: 9695417 DOI: 10.1016/s0925-5710(98)00027-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 43-year-old female with AML-M1 developed late graft failure 4 months after her first allogeneic bone marrow transplant. The patient then underwent a second transplant with peripheral blood progenitor cells obtained from the same HLA-identical brother. The donor peripheral blood progenitor cells were mobilized with granulocyte colony-stimulating factor (10 micrograms/kg daily s.c. for 6 days). The patient received horse anti-thymocyte globulin alone (15 mg/kg per day for 5 days) as the conditioning regimen. Rapid hematopoietic recovery followed a sustained engraftment. The time to reach 0.5 x 10(9)/l neutrophils and 25 x 10(9)/l platelets was 10 and 12 days, respectively. Cytogenetic analysis of bone marrow performed on day +20 demonstrated a 46XY karyotype of donor origin. There was no acute graft-versus-host disease. The patient remains in complete remission with a karnofsky score of 90% 5 months after peripheral blood progenitor cell transplantation. To treat graft failure after allogeneic bone marrow transplantation, allogeneic peripheral blood progenitor cell transplantation conditioned with anti-thymocyte globulin alone should be considered as a feasible alternative to marrow transplant.
Collapse
Affiliation(s)
- J Tanabe
- Department of Hematology and Chemotherapy, Kanagawa Cancer Center, Japan
| | | | | | | | | | | |
Collapse
|
47
|
Kanamori H, Maruta A, Sasaki S, Yamazaki E, Ueda S, Katoh K, Tamura T, Otsuka-Aoba M, Taguchi J, Harano H, Ogawa K, Mohri H, Okubo T, Matsuzaki M, Watanabe S, Koharazawa H, Fujita H, Kodama F. Diagnostic value of hemostatic parameters in bone marrow transplant-associated thrombotic microangiopathy. Bone Marrow Transplant 1998; 21:705-9. [PMID: 9578311 DOI: 10.1038/sj.bmt.1701151] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We investigated hemostatic parameters in a prospective study of 16 patients who received bone marrow transplants (BMT). We found a significant rise in the levels of fibrinogen, plasmin-alpha2 antiplasmin inhibitor complex, tissue-plasminogen activator.plasminogen activator inhibitor complex (t-PA.PAI), von Willebrand factor antigen, and thrombomodulin on day 14 after transplant compared with values before transplant. Protein C and thrombin-antithrombin III levels did not change significantly. No significant changes in prothrombin time ratio, activated partial thromboplastin time, or protein S were detected. Patients who had grades II-IV graft-versus-host disease (GVHD) (n = 6) showed a significantly higher level of t-PA.PAI on day 14 compared with those with grades 0-I GVHD (n = 10) (P = 0.0062). Three patients with grades II-IV GVHD developed thrombotic microangiopathy (TMA) on days 19, 19 and 62. In these patients, we noted significantly lower levels of fibrinogen (P = 0.0383), and significantly higher levels of t-PA.PAI (P = 0.0008) and thrombomodulin (P = 0.0001) on day 14 compared with those patients who did not develop TMA. These results suggest that prothrombotic states and endothelial damage may be caused by the conditioning regimen and/or acute GVHD during BMT; thrombomodulin values on day 14 post BMT may be useful in surveillance for TMA because of endothelial cell injury.
Collapse
Affiliation(s)
- H Kanamori
- First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Fujita H, Maruta A, Koharazawa H, Hattori M, Tomit N, Kodama F, Mohri H, Okubo T. Successful treatment of a Jehovah's Witness with acute promyelocytic leukemia. Int J Hematol 1997; 65:415-6. [PMID: 9195782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
49
|
Tomita N, Fujita H, Koharazawa H, Maruta A, Kodama F, Yamamoto T, Kobayashi S, Okubo T. [Complete remission achieved by L-asparaginase, vincristine and prednisolone (LVP) therapy in secondary leukemia (M5a type) with an MLL gene rearrangement]. Rinsho Ketsueki 1997; 38:135-41. [PMID: 9059068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 16-year-old boy was operated upon for synovial sarcoma of the right thigh and underwent chemotherapy consisted of adriamycin (320 mg), cisplatin (780 mg), etoposide (4,200 mg) and ifosfamide (30,000 mg). He developed secondary leukemia 18 months after the chemotherapy. Acute lymphoblastic leukemia (L3) was initially diagnosed because of poor staining of alpha-naphtyl butylate esterase and induction chemotherapy with the LVP regimen (L-asparaginase 5,000 U/m2 day 8-21, vincristine 1.5 mg/ m2 day 1, 6, 11, 16, 21, 26, prednisolone 40 mg/m2 day 1-28) was performed. After the therapy was initiated, the leukemia was finally diagnosed as acute momocytic leukemia (M5a) because of the following data; blasts were positive for CD33 and HLA-DR and negative for CD10, CD19 and CD20; serum lysozyme was 104.0 micrograms/ml; re-evaluation revealed that blasts were strongly positive for alpha naphtyl butyrate esterase in a small part of the slides; 95% of the bone marrow cells showed t (9; 11) chromosomal aberration; gene rearrangement was positive for MLL and negative for JH, JK and TCR C beta 1. Nevertheless, complete remission was obtained after 1 course of LVP therapy. He received bone marrow transplantation from an unrelated volunteer donor after 3 courses of consolidation therapy. He has remained in complete remission for 16 months.
Collapse
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Asparaginase/administration & dosage
- Bone Marrow Transplantation
- Combined Modality Therapy
- Gene Rearrangement
- Humans
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Monocytic, Acute/etiology
- Leukemia, Monocytic, Acute/therapy
- Male
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Prednisolone/administration & dosage
- Remission Induction
- Sarcoma, Synovial/drug therapy
- Sarcoma, Synovial/surgery
- Soft Tissue Neoplasms/drug therapy
- Soft Tissue Neoplasms/surgery
- Vincristine/administration & dosage
Collapse
Affiliation(s)
- N Tomita
- Department of Hematology/Chemotherapy, Kanagawa Cancer Center
| | | | | | | | | | | | | | | |
Collapse
|