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Maeda T, Matsuda A, Kanda J, Kawabata H, Ishikawa T, Tohyama K, Kitanaka A, Araseki K, Shimbo K, Hata T, Suzuki T, Kayano H, Usuki K, Shindo-Ueda M, Arima N, Nohgawa M, Ohta A, Chiba S, Miyazaki Y, Nakao S, Ozawa K, Arai S, Kurokawa M, Takaori-Kondo A, Mitani K. Clinical impact and characteristics of erythroid dysplasia in adult aplastic anaemia: Results from a multicentre registry. Br J Haematol 2024; 204:2086-2096. [PMID: 38296352 DOI: 10.1111/bjh.19323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/09/2024]
Abstract
Morphological dysplasia in haematopoietic cells, defined by a 10% threshold in each lineage, is one of the diagnostic criteria for myelodysplastic neoplasms. Dysplasia limited to the erythroid lineage has also been reported in some cases of aplastic anaemia (AA); however, its significance remains unclear. We herein examined the impact of erythroid dysplasia on immunosuppressive therapy responses and survival in AA patients. The present study included 100 eligible AA patients without ring sideroblasts. Among them, 32 had dysplasia in the erythroid lineage (AA with minimal dysplasia [mini-D]). No significant sex or age differences were observed between AA groups with and without erythroid dysplasia. In severe/very severe AA and non-severe AA patients, a response to anti-thymocyte globulin + ciclosporin within 12 months was observed in 80.0% and 60.0% of AA with mini-D and 42.9% and 90.0% of those without dysplasia, with no significant difference (p = 0.29 and p = 0.24 respectively). Overall survival and leukaemia-free survival did not significantly differ between the groups. Collectively, the present results indicate that the presence of erythroid dysplasia did not significantly affect clinical characteristics or outcomes in AA patients, suggesting that its presence in AA is acceptable. Therefore, erythroid dysplasia should not exclude an AA diagnosis.
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Affiliation(s)
- Tomoya Maeda
- Department of Hemato-oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Akira Matsuda
- Department of Hemato-oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Junya Kanda
- Department Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Kawabata
- Department of Hematology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kaoru Tohyama
- Department of Medical Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Akira Kitanaka
- Department of Laboratory Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kayano Araseki
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Saitama Medical University, Moroyama, Saitama, Japan
| | - Kei Shimbo
- Clinical Laboratory Center, Dokkyo Medical University Hospital, Shimotsuga, Tochigi, Japan
| | - Tomoko Hata
- Department of Clinical Laboratory, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Takahiro Suzuki
- Department of Hematology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hidekazu Kayano
- Faculty of Health and Medical Care, School of Medical Technology, Saitama Medical University, Hidaka, Saitama, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | | | - Nobuyoshi Arima
- Department of Hematology, Shinko Hospital, Kobe, Hyogo, Japan
| | - Masaharu Nohgawa
- Department of Hematology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Akiko Ohta
- Division of Public Health, Department of Social Medicine, Saitama Medical University Faculty of Medicine, Moroyama, Saitama, Japan
| | - Shigeru Chiba
- Department of Hematology, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusha Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Shinji Nakao
- Japanese Red Cross Ishikawa Blood Center, Kanazawa, Ishikawa, Japan
- Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Keiya Ozawa
- Division of Gene and Cell Therapy for Intractable Diseases, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Shunya Arai
- Department of Hematology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akifumi Takaori-Kondo
- Department Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan
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2
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Kaito Y, Sugimoto E, Nakamura F, Tsukune Y, Sasaki M, Yui S, Yamaguchi H, Goyama S, Nannya Y, Mitani K, Tamura H, Imai Y. Immune checkpoint molecule DNAM-1/CD112 axis is a novel target for natural killer-cell therapy in acute myeloid leukemia. Haematologica 2024; 109:1107-1120. [PMID: 37731380 PMCID: PMC10985452 DOI: 10.3324/haematol.2023.282915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023] Open
Abstract
Acute myeloid leukemia (AML) is a hematologic malignancy that frequently relapses, even if remission can be achieved with intensive chemotherapy. One known relapse mechanism is the escape of leukemic cells from immune surveillance. Currently, there is no effective immunotherapy for AML because of the lack of specific antigens. Here, we aimed to elucidate the association between CD155 and CD112 in AML cell lines and primary AML samples and determine the therapeutic response. Briefly, we generated NK-92 cell lines (NK-92) with modified DNAX-associated molecule 1 (DNAM-1) and T-cell immunoglobulin and ITIM domain (TIGIT), which are receptors of CD155 and CD112, respectively. Analysis of 200 cases of AML indicated that the survival of patients with high expression of CD112 was shorter than that of patients with low expression. NK-92 DNAM-1 exhibited enhanced cytotoxic activity against AML cell lines and primary cells derived from patients with AML. DNAM-1 induction in NK-92 cells enhanced the expression of cytotoxicity-related genes, thus overcoming the inhibitory activity of TIGIT. Between CD155 and CD112, CD112 is an especially important target for natural killer (NK)-cell therapy of AML. Using a xenograft model, we confirmed the enhanced antitumor effect of NK-92 DNAM-1 compared with that of NK-92 alone. We also discovered that CD112 (Nectin-2), an immune checkpoint molecule belonging to the Nectin/Nectin-like family, functions as a novel target of immunotherapy. In conclusion, modification of the DNAM-1/CD112 axis in NK cells may be an effective novel immunotherapy for AML. Furthermore, our findings suggest that the levels of expression of these molecules are potential prognostic markers in AML.
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MESH Headings
- Humans
- Nectins
- Immune Checkpoint Proteins/metabolism
- Killer Cells, Natural
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Leukemia, Myeloid, Acute/metabolism
- Receptors, Immunologic
- Cell- and Tissue-Based Therapy
- Antigens, Differentiation, T-Lymphocyte/genetics
- Antigens, Differentiation, T-Lymphocyte/metabolism
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Affiliation(s)
- Yuta Kaito
- Division of Hematopoietic Disease Control, Institute of Medical Science, The University of Tokyo, Tokyo
| | - Emi Sugimoto
- Division of Cellular Therapy, Institute of Medical Science, The University of Tokyo, Tokyo
| | - Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi
| | - Yutaka Tsukune
- Department of Hematology, Juntendo University School of Medicine, Tokyo
| | - Makoto Sasaki
- Department of Hematology, Juntendo University School of Medicine, Tokyo
| | - Shunsuke Yui
- Department of Hematology, Nippon Medical School, Tokyo
| | | | - Susumu Goyama
- Division of Molecular Oncology, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo
| | - Yasuhito Nannya
- Division of Hematopoietic Disease Control, Institute of Medical Science, The University of Tokyo, Tokyo
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi
| | - Hideto Tamura
- Division of Diabetes, Endocrinology and Hematology, Department of Internal Medicine, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yoichi Imai
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi.
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3
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Mitani K, Lee JW, Jang JH, Tomiyama Y, Miyazaki K, Nagafuji K, Usuki K, Uoshima N, Fujisaki T, Kosugi H, Matsumura I, Sasaki K, Kizaki M, Sawa M, Hidaka M, Kobayashi N, Ichikawa S, Yonemura Y, Murotani K, Shimizu M, Matsuda A, Ozawa K, Nakao S. Long-term efficacy and safety of romiplostim in refractory aplastic anemia: follow-up of a phase 2/3 study. Blood Adv 2024; 8:1415-1419. [PMID: 38134300 PMCID: PMC10950812 DOI: 10.1182/bloodadvances.2023010959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/14/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Affiliation(s)
- Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Jong Wook Lee
- Division of Hematology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun Ho Jang
- Department of Hematology, Sungkyunkwan University Samsung Medical Center, Seoul, Republic of Korea
| | - Yoshiaki Tomiyama
- Department of Blood Transfusion, Osaka University Hospital, Osaka, Japan
| | - Koji Miyazaki
- Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koji Nagafuji
- Department of Hematology, Kurume University Hospital, Kurume, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Naoki Kobayashi
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Satoshi Ichikawa
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | - Yuji Yonemura
- Department of Transfusion Medicine and Cell Therapy, Kumamoto University Hospital, Kumamoto, Japan
| | | | - Mami Shimizu
- Department of Medical Affairs, Kyowa Kirin Co, Ltd, Tokyo, Japan
| | - Akira Matsuda
- Department of Hemato-Oncology, Saitama Medical University International Medical Center, Saitama Medical University, Saitama, Japan
| | - Keiya Ozawa
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Shinji Nakao
- Division of Hematology/Respiratory Medicine, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
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4
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Minakata D, Uchida T, Nakano A, Takase K, Tsukada N, Kosugi H, Kawata E, Nakane T, Takahashi H, Endo T, Nishiwaki S, Fujiwara H, Saito AM, Saito TI, Akashi K, Matsumura I, Mitani K. Characteristics and prognosis of patients with COVID-19 and hematological diseases in Japan: a cross-sectional study. Int J Hematol 2024; 119:183-195. [PMID: 38172385 PMCID: PMC10830869 DOI: 10.1007/s12185-023-03685-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024]
Abstract
The Japanese Society of Hematology performed an observational cross-sectional study to clarify the morbidity, prognosis, and prognostic factors in patients with COVID-19 with hematological diseases (HDs) in Japan. The study included patients with HDs who enrolled in our epidemiological survey and had a COVID-19 diagnosis and a verified outcome of up to 2 months. The primary endpoints were characteristics and short-term prognosis of COVID-19 in patients with HDs. A total of 367 patients from 68 institutes were enrolled over 1 year, and the collected data were analyzed. The median follow-up among survivors was 73 days (range, 1-639 days). The 60-day overall survival (OS) rate was 86.6%. In the multivariate analysis, albumin ≤ 3.3 g/dL and a need for oxygen were independently associated with inferior 60-day OS rates (hazard ratio [HR] 4.026, 95% confidence interval (CI) 1.954-8.294 and HR 14.55, 95% CI 3.378-62.64, respectively), whereas 60-day survival was significantly greater in patients with benign rather than malignant disease (HR 0.095, 95% CI 0.012-0.750). Together, these data suggest that intensive treatment may be necessary for patients with COVID-19 with malignant HDs who have low albumin levels and require oxygen at the time of diagnosis.
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Affiliation(s)
- Daisuke Minakata
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Tomoyuki Uchida
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Aya Nakano
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine Tokyo, Tokyo, Japan
| | - Ken Takase
- Department of Haematology, Clinical Research Centre, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan
| | - Nodoka Tsukada
- Department of Hematology/Oncology, Asahikawa Kosei General Hospital, Asahikawa, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Eri Kawata
- Department of Hematology, Panasonic Health Insurance Organization Matsushita Memorial Hospital, Moriguchi, Japan
| | - Takahiko Nakane
- Department of Hematology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Hiroyuki Takahashi
- Department of Hematology and Medical Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tomoyuki Endo
- Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Nishiwaki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hideaki Fujiwara
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Akiko M Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Toshiki I Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osakasayama, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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5
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Shide K, Takenaka K, Kitanaka A, Numata A, Kameda T, Yamauchi T, Inagaki A, Mizuno S, Takami A, Ito S, Hagihara M, Usuki K, Maekawa T, Sunami K, Ueda Y, Tsutsui M, Ando M, Komatsu N, Ozawa K, Kurokawa M, Arai S, Mitani K, Akashi K, Shimoda K. Real-world clinical characteristics of post-essential thrombocythemia and post-polycythemia vera myelofibrosis. Ann Hematol 2024; 103:97-103. [PMID: 37946031 DOI: 10.1007/s00277-023-05528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
There are few prospective studies on patients with post-essential thrombocythemia myelofibrosis (PET-MF) and post-polycythemia vera myelofibrosis (PPV-MF). Therefore, we conducted a nationwide longitudinal prospective survey to clarify the clinical characteristics of these diseases. A total of 197 PET-MF and 117 PPV-MF patients diagnosed between 2012 and 2021 were analyzed. The median age at diagnosis was 70.0 years for both diseases. The time from diagnosis of ET or PV to that of MF was 9.6 and 10.4 years, respectively, with no significant difference. Patients with PPV-MF had higher hemoglobin levels and white blood cell counts than those with PET-MF, whereas those with PET-MF had higher platelet counts than those with PPV-MF. Although splenomegaly was more frequent in patients with PPV-MF at diagnosis, there was no difference in the frequency of constitutional symptoms. Ruxolitinib was the most common treatment administered to 74.6% and 83.8% of patients with PET-MF and PPV-MF, respectively. Patients with PET-MF and PPV-MF had similar prognoses, with 3-year overall survival (OS) of 0.742 in PET-MF and 0.768 in PPV-MF patients. In both diseases, leukemic transformation was the leading cause of death, followed by infection. The 3-year OS for patients with PET/PPV-MF and primary MF diagnosed during the same period was 0.754 and 0.626, respectively, with no significant difference. This survey provides real-world clinical features and prognostic data on secondary myelofibrosis in the ruxolitinib era.
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Affiliation(s)
- Kotaro Shide
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology, and Infectious Diseases, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Akira Kitanaka
- Department of Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Akihiko Numata
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Takuro Kameda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan
| | - Takuji Yamauchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Atsushi Inagaki
- Department of Hematology and Oncology, Nagoya City West Medical Center, Nagoya, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinichi Ito
- Department of Hematology, Hakodate City Hospital, Hakodate, Japan
| | - Masao Hagihara
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takaaki Maekawa
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Miyuki Tsutsui
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiya Ozawa
- Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunya Arai
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Kazuya Shimoda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan.
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6
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Sato A, Kobayashi M, Yusa N, Ogawa M, Shimizu E, Kawamata T, Yokoyama K, Ota Y, Ichinohe T, Ohno H, Mori Y, Sakaida E, Kondo T, Imoto S, Nannya Y, Mitani K, Tojo A. Clinical and prognostic features of Langerhans cell histiocytosis in adults. Cancer Sci 2023; 114:3687-3697. [PMID: 37364599 PMCID: PMC10475785 DOI: 10.1111/cas.15879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 04/18/2023] [Accepted: 05/21/2023] [Indexed: 06/28/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal expansion of CD1a+ CD207+ myeloid dendritic cells. The features of LCH are mainly described in children and remain poorly defined in adults; therefore, we conducted a nationwide survey to collect clinical data from 148 adult patients with LCH. The median age at diagnosis was 46.5 (range: 20-87) years with male predominance (60.8%). Among the 86 patients with detailed treatment information, 40 (46.5%) had single system LCH, whereas 46 (53.5%) had multisystem LCH. Moreover, 19 patients (22.1%) had an additional malignancy. BRAF V600E in plasma cell-free DNA was associated with a low overall survival (OS) rate and the risk of the pituitary gland and central nervous system involvement. At a median follow-up of 55 months from diagnosis, six patients (7.0%) had died, and the four patients with LCH-related death did not respond to initial chemotherapy. The OS probability at 5 years post-diagnosis was 90.6% (95% confidence interval: 79.8-95.8). Multivariate analysis showed that patients aged ≥60 years at diagnosis had a relatively poor prognosis. The probability of event-free survival at 5 years was 52.1% (95% confidence interval: 36.6-65.5), with 57 patients requiring chemotherapy. In this study, we first revealed the high rate of relapse after chemotherapy and mortality of poor responders in adults as well as children. Therefore, prospective therapeutic studies of adults with LCH using targeted therapies are needed to improve outcomes in adults with LCH.
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Affiliation(s)
- Aki Sato
- Department of Hematology and Oncology, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
| | | | - Nozomi Yusa
- Department of Applied Genomics, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
| | - Miho Ogawa
- Division of Hematopoietic Disease Control, Institute of Medical ScienceUniversity of TokyoTokyoJapan
| | - Eigo Shimizu
- Division of Health Medical Intelligence, Human Genome Center, Institute of Medical ScienceUniversity of TokyoTokyoJapan
| | - Toyotaka Kawamata
- Department of Hematology and Oncology, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
| | - Kazuaki Yokoyama
- Department of Hematology and Oncology, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
| | - Yasunori Ota
- Department of Diagnostic Pathology, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and MedicineHiroshima UniversityHiroshimaJapan
| | | | - Yasuo Mori
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical SciencesFukuokaJapan
| | - Emiko Sakaida
- Department of HematologyChiba University HospitalChibaJapan
| | - Tadakazu Kondo
- Department of Hematology and Oncology, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Seiya Imoto
- Division of Health Medical Intelligence, Human Genome Center, Institute of Medical ScienceUniversity of TokyoTokyoJapan
| | - Yasuhito Nannya
- Department of Hematology and Oncology, Institute of Medical Science Research HospitalUniversity of TokyoTokyoJapan
- Division of Hematopoietic Disease Control, Institute of Medical ScienceUniversity of TokyoTokyoJapan
| | - Kinuko Mitani
- Department of Hematology and OncologyDokkyo Medical UniversityTochigiJapan
| | - Arinobu Tojo
- Institute of Innovation AdvancementTokyo Medical and Dental UniversityTokyoJapan
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7
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Nakamura F, Seo S, Nannya Y, Ayabe R, Takahashi W, Handa T, Arai H, Iso H, Nakamura Y, Nakamura Y, Sasaki K, Ichikawa M, Imai Y, Ogawa S, Mitani K. Progression to B acute lymphoblastic leukemia in 8p11 myeloproliferative syndrome with t(6;8)(q27;p12). Int J Hematol 2023; 118:388-393. [PMID: 36930401 PMCID: PMC10415475 DOI: 10.1007/s12185-023-03577-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
8p11 myeloproliferative syndrome is a rare hematological malignancy caused by the translocation of FGFR1. Patients present with a myeloproliferative neoplasm that frequently transforms into acute myeloid leukemia or T-lymphoblastic lymphoma/leukemia. Here, we report a molecular study of a patient with 8p11 myeloproliferative syndrome who developed acute B-lymphoblastic leukemia and then transformed to mixed-phenotype acute leukemia. A 67-year-old woman was diagnosed with a myeloproliferative neoplasm with t(6;8)(q27;p12) and was monitored for polycythemia vera. Four years later, she developed acute B-lymphoblastic leukemia with an additional chromosomal abnormality of - 7. Despite two induction regimens, she failed to achieve complete remission, and leukemia transformed into mixed-phenotype leukemia. Targeted sequencing of serial bone marrow samples identified the RUNX1 L144R mutation upon transformation to B-cell leukemia. After those two induction regimens, some RUNX1 mutation-positive leukemic cells obtained the JAK2 V617F mutation, which was associated with the emergence of myeloid markers, including myeloperoxidase.
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Affiliation(s)
- Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
- Division of Hematopoietic Disease Control, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Rika Ayabe
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Tomoyuki Handa
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Hisako Iso
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yoichi Imai
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan.
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8
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Shide K, Takenaka K, Kitanaka A, Numata A, Kameda T, Yamauchi T, Inagaki A, Mizuno S, Takami A, Ito S, Hagihara M, Usuki K, Maekawa T, Sunami K, Ueda Y, Tsutsui M, Ando M, Komatsu N, Ozawa K, Kurokawa M, Arai S, Mitani K, Akashi K, Shimoda K. Nationwide prospective survey of secondary myelofibrosis in Japan: superiority of DIPSS-plus to MYSEC-PM as a survival risk model. Blood Cancer J 2023; 13:110. [PMID: 37463903 PMCID: PMC10354019 DOI: 10.1038/s41408-023-00869-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/24/2023] [Accepted: 06/12/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Kotaro Shide
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan
| | - Katsuto Takenaka
- Department of Hematology, Clinical Immunology, and Infectious Diseases, Ehime University Graduate School of Medicine, Touon-shi, Ehime, Japan
| | - Akira Kitanaka
- Department of Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Akihiko Numata
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Takuro Kameda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan
| | - Takuji Yamauchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Atsushi Inagaki
- Department of Hematology and Oncology, Nagoya City West Medical Center, Nagoya, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinichi Ito
- Department of Hematology, Hakodate City Hospital, Hakodate, Japan
| | - Masao Hagihara
- Department of Hematology, Eiju General Hospital, Tokyo, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takaaki Maekawa
- Division of Hematology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yasunori Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - Miyuki Tsutsui
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Miki Ando
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Norio Komatsu
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Keiya Ozawa
- Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunya Arai
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Kazuya Shimoda
- Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara Kiyotake, Miyazaki, 889-1692, Japan.
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9
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Harada K, Onizuka M, Mori T, Shimizu H, Seo S, Aotsuka N, Takeda Y, Sekiya N, Kusuda M, Fujihara S, Shiraiwa S, Shono K, Shingai N, Kanamori H, Momoki M, Takada S, Mukae J, Masuda S, Mitani K, Sakaida E, Tomikawa T, Takahashi S, Usuki K, Kanda Y. Prognostic factors for the development of lower respiratory tract infection after influenza virus infection in allogeneic hematopoietic stem cell transplantation recipients: A KSGCT Multicenter Analysis. Int J Infect Dis 2023; 131:79-86. [PMID: 37001798 DOI: 10.1016/j.ijid.2023.03.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES Influenza virus infection (IVI) occasionally causes lower respiratory tract infection (LRTI) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Although the progression to LRTI entails a high mortality, the role of early antiviral therapy for its prevention has not been fully elucidated. METHODS This was a multicenter retrospective study using an additional questionnaire. Allo-HSCT recipients who developed IVI between 2012 and 2020 were included. RESULTS A total of 278 cases of IVI after allo-HSCT were identified from 15 institutions. The median patient age was 49 years, and the median time from allo-HSCT to IVI was 918 days. Neuraminidase inhibitors were administered within 48 hours of symptom onset (early neuraminidase inhibitor [NAI]) in 199 (76.9%) patients. Subsequently, 36 (12.3%) patients developed LRTI. On the multivariate analysis, age ≥50 years (hazard ratio [HR], 2.16; 95% confidence interval [CI], 1.02-4.58) and moderate to severe chronic graft-versus-host disease (HR, 2.28; 95% CI, 1.14-4.58) were significantly associated with progression to LRTI, whereas early NAI suppressed the progression (HR, 0.17; 95% CI, 0.06-0.46). The IVI-related mortality rate was 2.2%. CONCLUSION To reduce the risk of LRTI development after IVI, early NAI therapy should be considered in allo-HSCT recipients, especially with older patients and those with chronic graft-versus-host disease.
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10
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Kage H, Shinozaki-Ushiku A, Ishigaki K, Sato Y, Tanabe M, Tanaka S, Tanikawa M, Watanabe K, Kato S, Akagi K, Uchino K, Mitani K, Takahashi S, Miura Y, Ikeda S, Kojima Y, Watanabe K, Mochizuki H, Yamaguchi H, Kawazoe Y, Kashiwabara K, Kohsaka S, Tatsuno K, Ushiku T, Ohe K, Yatomi Y, Seto Y, Aburatani H, Mano H, Miyagawa K, Oda K. Clinical utility of Todai OncoPanel in the setting of approved comprehensive cancer genomic profiling tests in Japan. Cancer Sci 2023; 114:1710-1717. [PMID: 36601953 PMCID: PMC10067384 DOI: 10.1111/cas.15717] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/22/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
Comprehensive cancer genome profiling (CGP) has been nationally reimbursed in Japan since June 2019. Less than 10% of the patients have been reported to undergo recommended treatment. Todai OncoPanel (TOP) is a dual DNA-RNA panel as well as a paired tumor-normal matched test. Two hundred patients underwent TOP as part of Advanced Medical Care B with approval from the Ministry of Health, Labour and Welfare between September 2018 and December 2019. Tests were carried out in patients with cancers without standard treatment or when patients had already undergone standard treatment. Data from DNA and RNA panels were analyzed in 198 and 191 patients, respectively. The percentage of patients who were given therapeutic or diagnostic recommendations was 61% (120/198). One hundred and four samples (53%) harbored gene alterations that were detected with the DNA panel and had potential treatment implications, and 14 samples (7%) had a high tumor mutational burden. Twenty-two samples (11.1%) harbored 30 fusion transcripts or MET exon 14 skipping that were detected by the RNA panel. Of those 30 transcripts, 6 had treatment implications and 4 had diagnostic implications. Thirteen patients (7%) were found to have pathogenic or likely pathogenic germline variants and genetic counseling was recommended. Overall, 12 patients (6%) received recommended treatment. In summary, patients benefited from both TOP DNA and RNA panels while following the same indication as the approved CGP tests. (UMIN000033647).
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Affiliation(s)
- Hidenori Kage
- Next-Generation Precision Medicine Development Laboratory, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Shinozaki-Ushiku
- Division of Integrative Genomics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunaga Ishigaki
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Chemotherapy, The University of Tokyo Hospital, Tokyo, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiko Tanabe
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shota Tanaka
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Michihiro Tanikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Gynecology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Kousuke Watanabe
- Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Clinical Laboratory, The University Tokyo Hospital, Tokyo, Japan
| | - Shingo Kato
- Department of Clinical Cancer Genomics, Yokohama City University Hospital, Kanagawa, Japan
| | - Kiwamu Akagi
- Department of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, Saitama, Japan
| | - Keita Uchino
- Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuji Miura
- Department of Medical Oncology and Clinical Genetics Center, Toranomon Hospital, Tokyo, Japan.,Clinical Genetics Center, Toranomon Hospital, Tokyo, Japan
| | - Sadakatsu Ikeda
- Department of Precision Cancer Medicine, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Yasushi Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kiyotaka Watanabe
- Department of Medicine, School of Medicine, Teikyo University, Tokyo, Japan
| | - Hitoshi Mochizuki
- Genome Analysis Center, Yamanashi Prefectural Central Hospital, Yamanashi, Japan
| | - Hironori Yamaguchi
- Department of Clinical Oncology, Jichi Medical University Hospital, Tochigi, Japan
| | - Yoshimasa Kawazoe
- Department of Artificial Intelligence in Healthcare, The University of Tokyo, Tokyo, Japan.,Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Kosuke Kashiwabara
- Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Shinji Kohsaka
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Kenji Tatsuno
- Genome Science and Medicine Laboratory, RCAST, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuhiko Ohe
- Department of Healthcare Information Management, The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Yatomi
- Department of Clinical Laboratory, The University Tokyo Hospital, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Aburatani
- Genome Science and Medicine Laboratory, RCAST, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Mano
- Division of Cellular Signaling, National Cancer Center Research Institute, Tokyo, Japan
| | - Kiyoshi Miyagawa
- Laboratory of Molecular Radiology, Center for Disease Biology and Integrative Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsutoshi Oda
- Division of Integrative Genomics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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11
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Morita Y, Nannya Y, Ichikawa M, Hanamoto H, Shibayama H, Maeda Y, Hata T, Miyamoto T, Kawabata H, Takeuchi K, Tanaka H, Kishimoto J, Miyano S, Matsumura I, Ogawa S, Akashi K, Kanakura Y, Mitani K. ASXL1 mutations with serum EPO levels predict poor response to darbepoetin alfa in lower-risk MDS: W-JHS MDS01 trial. Int J Hematol 2022; 116:659-668. [PMID: 35821550 PMCID: PMC9588475 DOI: 10.1007/s12185-022-03414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/25/2022]
Abstract
Darbepoetin alfa (DA) is used to treat anemia in lower-risk (IPSS low or int-1) myelodysplastic syndromes (MDS). However, whether mutations can predict the effectiveness of DA has not been examined. The present study aimed to determine predictive gene mutations. The primary endpoint was a correlation between the presence of highly frequent (≥ 10%) mutations and hematological improvement-erythroid according to IWG criteria 2006 by DA (240 μg/week) until week 16. The study included 79 patients (age 29–90, median 77.0 years; 52 [65.8%] male). Frequently (≥ 10%) mutated genes were SF3B1 (24 cases, 30.4%), TET2 (20, 25.3%), SRSF2 (10, 12.7%), ASXL1 (9, 11.4%), and DNMT3A (8, 10.1%). Overall response rate to DA was 70.9%. Multivariable analysis including baseline erythropoietin levels and red blood cell transfusion volumes as variables revealed that erythropoietin levels and mutations of ASXL1 gene were significantly associated with worse response (odds ratio 0.146, 95% confidence interval 0.042–0.503; p = 0.0023, odds ratio 0.175, 95% confidence interval 0.033–0.928; p = 0.0406, respectively). This study indicated that anemic patients who have higher erythropoietin levels and harbor ASXL1 gene mutations may respond poorly to DA. Alternative strategies are needed for the treatment of anemia in this population. Trial registration number and date of registration: UMIN000022185 and 09/05/2016.
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Affiliation(s)
- Yasuyoshi Morita
- Divison of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Division of Hematopoietic Disease Control, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Hitoshi Hanamoto
- Department of Hematology, Faculty of Medicine, Nara Hospital Kindai University, Nara, Japan
| | - Hirohiko Shibayama
- Department of Hematology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Hiroshi Kawabata
- Department of Hematology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Kazuto Takeuchi
- Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hiroko Tanaka
- Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Satoru Miyano
- M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Itaru Matsumura
- Divison of Hematology and Rheumatology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Department of Medicine, Kyoto University, Kyoto, Japan.,Center for Hematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.,Sumitomo Hospital, Osaka, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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12
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Nakamura F, Nakamura Y, Nannya Y, Arai H, Shimbo K, Nakamura Y, Seo S, Sasaki K, Ichikawa M, Ogawa S, Mitani K. Emergence of t(3;21)(q26.2;q22) during eltrombopag treatment in a patient with relapsed aplastic anemia who received chemotherapy for angioimmunoblastic T-cell lymphoma. Leuk Res Rep 2022; 17:100305. [PMID: 35371915 PMCID: PMC8966168 DOI: 10.1016/j.lrr.2022.100305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
A 65-year-old man with nonsevere aplastic anemia received rabbit anti-thymocyte globulin and cyclosporine and partially responded. Six months after the initiation of treatment, he was diagnosed with stage IV angioimmunoblastic T-cell lymphoma and received chemotherapy. PET/CT scan analysis indicated a complete response. However, he showed sustained myelosuppression and was diagnosed with relapse of aplastic anemia. He did not respond to cyclosporine, eltrombopag or methenolone. Fifteen months after eltrombopag administration, he developed MDS with t(3;21)(q26.2;q22). Patients should be monitored carefully for the emergence of not only -7/del(7q) but also 3q26 abnormalities, including t(3;21)(q26.2;q22), during and after eltrombopag treatment.
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Affiliation(s)
- Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Kei Shimbo
- Clinical Laboratory Center, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, 321-0293, Japan
- Corresponding author.
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13
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Maehara R, Kawamata Y, Ichikawa M, Mitani K, Yasui-Furukori N, Shimoda K. Suicide attempt induced by drug-induced leukoencephalopathy: A case report. Neuropsychopharmacol Rep 2021; 41:551-553. [PMID: 34652886 PMCID: PMC8698666 DOI: 10.1002/npr2.12214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background Leukoencephalopathy is identified during the administration of anticancer drugs. Symptoms vary from neurological symptoms to psychiatric symptoms depending on the site of damage. There have been no previous reports of suicide attempts due to drug‐induced leukoencephalopathy. Case Presentation The patient was diagnosed with diffuse large B‐cell lymphoma (DLBCL) infiltrating the pharyngeal lesion. Rituximab + methotrexate + oncovin + procarbazine (R‐MPV) therapy, a methotrexate‐containing chemotherapy, was initiated. At the end of the fifth course, the patient attempted suicide by hanging with an appliance cord, which was associated with delusion. A head MRI scan showed no evidence of lymphoma recurrence, but white matter lesions around the ventricles showed progression. Conclusion We report the case of a patient in whom drug‐induced leukoencephalopathy related to methotrexate led to a suicide attempt. In addition to monitoring brain tumors, daily monitoring of psychiatric and neurological symptoms is important for patients with methotrexate‐induced encephalopathy. MRI images revealed that the white matter lesions had progressed even after methotrexate administration was completed. The image taken after one dose of methotrexate also shows mild progression of white matter lesions.![]()
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Affiliation(s)
- Ryo Maehara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yasushi Kawamata
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
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14
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Tamai Y, Ohto H, Yasuda H, Takeshita A, Fujii N, Ogo H, Yazawa Y, Hato T, Mitani K, Suzuki K, Yokohama A, Kato Y, Abe M, Kumagawa M, Ueda Y, Nollet KE, Cooling L, Kitazawa J. Allo-anti-M: Detection peaks around 2 years of age, but may be attenuated by red blood cell transfusion. Transfusion 2021; 61:2718-2726. [PMID: 34287925 PMCID: PMC8518975 DOI: 10.1111/trf.16594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/14/2021] [Accepted: 06/25/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Anti-M is frequently observed as a naturally occurring antibody of little clinical significance. Naturally occurring anti-M is often found in children although the specific triggers of production, persistence, and evanescence of anti-M have yet to be elucidated. METHODS In a retrospective, multicenter, nationwide cohort survey conducted from 2001 to 2015, alloantibody screening was performed before and after transfusion in 18,944 recipients younger than 20 years. Recipients were categorized into six cohorts based on their age at transfusion; within and among these cohorts, allo-anti-M was analyzed in regard to its production, persistence, and evanescence. RESULTS In 44 patients, anti-M detected before and/or after transfusion was an age-related phenomenon, with a median age of 2 years and an interquartile range of 1-3 years; anti-M was most frequently detected in a cohort of children 1 to <5 years (0.77%, 31 of 4035). At least five patients were presumed to have concurrent infections. Among 1575 adolescents/young adults (15 to <20 years), no anti-M was detected. Of 29 patients with anti-M prior to transfusion, the antibody fell to undetectable levels in 17 recipients (89.5%, of whom at least 13 received only M-negative red cells) after anywhere from 5 days to 5.8 years; anti-M persisted in 2, and was not tested in 10. Only 15 recipients (0.08%) produced new anti-M after transfusion. CONCLUSION Naturally occurring anti-M is a phenomenon of younger ages, predominantly between 1 and 3 years. After transfusion, it often falls to undetectable levels.
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Affiliation(s)
- Yoshiko Tamai
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Transfusion and Cell Therapy MedicineHirosaki University Post‐Graduate School of MedicineHirosakiJapan
| | - Hitoshi Ohto
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Blood Transfusion and Transplantation ImmunologyFukushima Medical UniversityFukushimaJapan
| | - Hiroyasu Yasuda
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Medical TechnologyFukushima Prefectural Hygiene InstituteFukushimaJapan
| | - Akihiro Takeshita
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Transfusion and Cell TherapyHamamatsu University School of MedicineHamamatsuJapan
| | - Nobuharu Fujii
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Blood TransfusionOkayama University HospitalOkayamaJapan
| | - Hiroaki Ogo
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Blood TransfusionOkayama University HospitalOkayamaJapan
| | - Yurika Yazawa
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Transfusion LaboratoryTokyo Metropolitan Children's Medical CenterTokyoJapan
| | - Takaaki Hato
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Blood Transfusion and Cell TherapyEhime University HospitalToonJapan
| | - Kinuko Mitani
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Blood Transfusion DepartmentDokkyo Medical University HospitalShimotsuga‐gunJapan
| | - Keijiro Suzuki
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Transfusion MedicineIwate Medical University HospitalMoriokaJapan
| | - Akihiko Yokohama
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Blood Transfusion ServiceGunma University HospitalMaebashiJapan
| | - Yoko Kato
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Transfusion Medicine and Cell TherapyThe Jikei University HospitalTokyoJapan
| | - Misao Abe
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Transfusion Medicine and Cell TherapyKansai Medical University HospitalHirakataJapan
| | - Midori Kumagawa
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Transfusion MedicineFukuoka University HospitalFukuokaJapan
| | - Yasunori Ueda
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Transfusion and Hemapheresis CenterKurashiki Central HospitalKurashikiJapan
| | - Kenneth E. Nollet
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Department of Blood Transfusion and Transplantation ImmunologyFukushima Medical UniversityFukushimaJapan
| | - Laura Cooling
- Department of PathologyThe University of MichiganAnn ArborMichiganUSA
| | - Junichi Kitazawa
- Japan Society of Blood Transfusion and Cell TherapyTokyoJapan
- Division of Clinical Laboratory and Department of Clinical GeneticsAomori Prefectural Central HospitalAomoriJapan
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15
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Sasaki K, Nannya Y, Nakamura Y, Ichikawa M, Ogawa S, Mitani K. Essential thrombocythaemia with aggressive megakaryocytosis after myelofibrotic transformation. ACTA ACUST UNITED AC 2021; 26:594-600. [PMID: 34402416 DOI: 10.1080/16078454.2021.1965714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Among myeloproliferative neoplasms, it is often difficult to distinguish essential thrombocythaemia (ET) from prefibrotic-stage primary myelofibrosis (PMF) with thrombocytosis given their overlapping clinicopathological phenotypes. CASE PRESENTATION We encountered a 45-year-old male who was initially diagnosed with ET and eventually became transformed to secondary myelofibrosis 20 years later. Two distinct types of aberrant megakaryocytes were observed at diagnosis: one type characteristic of ET and the other type characteristic of PMF. With a proliferation in the bone marrow, aberrant megakaryocytes were infiltrated into the extramedullary organs and were even present in the thrombus were observed at autopsy. As a result of next-generation sequencing, the significant increase of variant allele frequency (VAF) of JAK2 V617F and U2AF1 S34Y mutations was observed in the bone marrow cells at the final stage. CONCLUSIONS This patient could be recognized as an atypical case of aggressive megakaryocytosis transformed from ET.
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Affiliation(s)
- Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
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16
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Hamaguchi M, Kokubun N, Matsuda H, Onuma H, Aoki R, Takahashi W, Mitani K, Suzuki K. A case report of secondary neurolymphomatosis showing selective nerve infiltration and massive lumbar plexus enlargement. BMC Neurol 2021; 21:296. [PMID: 34311723 PMCID: PMC8314556 DOI: 10.1186/s12883-021-02330-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background Neurolymphomatosis (NL) is a rare manifestation of malignant lymphoma that shows selective infiltration to the peripheral nervous system primarily or secondarily. We report a patient with secondary NL caused by germinal center B-cell (GCB)-type diffuse large B-cell lymphoma (DLBCL) who showed selective infiltration of the lumbar plexus to the spinal cord and massive nerve enlargement resulting in severe pain. Case presentation A 72-year-old female exhibited asymmetric motor and sensory impairments and pain in the lower limbs that progressed for five months. Magnetic resonance imaging (MRI) showed an enlarged lumbar plexus, which continued to the cauda equina via the L3 and L4 spinal nerves. Her symptoms gradually worsened. Ten months after the onset of symptoms, the enlarged cauda equina filled the spinal canal space, and the spinal cord was swollen. A cauda equina biopsy was performed, and she was diagnosed with GCB-type DLBCL with CD10 positivity. The primary tumor was found in a mammary cyst. The autopsy study did not show apparent infiltration, except in the nervous system. Conclusions Although there are many neurologic phenotypes of malignant lymphoma, the association between the cytological characteristics of lymphoma and the neurological phenotypes is still unclear. Several reports of CD10-positive secondary NL are available, whereas peripheral or central nervous tissue origin lymphoma cases are mostly negative for CD10. CD10 staining may be useful for distinguishing primary NL from secondary NL. NL often has a strong organotropism for peripheral nervous tissue, which makes early diagnosis challenging. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02330-5.
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Affiliation(s)
- Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan.
| | - Norito Kokubun
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Hadzki Matsuda
- Department of Neurosurgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Hiroki Onuma
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Reika Aoki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, 321-0293, Japan
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17
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Nakamura F, Arai H, Nannya Y, Ichikawa M, Furuichi S, Nagasawa F, Takahashi W, Handa T, Nakamura Y, Tanaka H, Nakamura Y, Sasaki K, Miyano S, Ogawa S, Mitani K. Development of Philadelphia chromosome-negative acute myeloid leukemia with IDH2 and NPM1 mutations in a patient with chronic myeloid leukemia who showed a major molecular response to tyrosine kinase inhibitor therapy. Int J Hematol 2021; 113:936-940. [PMID: 33400143 DOI: 10.1007/s12185-020-03074-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 11/25/2022]
Abstract
Tyrosine kinase inhibitors (TKIs) are standard therapies for chronic myeloid leukemia (CML) that can eradicate Ph-positive leukemic cells. However, disease control is not achievable in a minority of cases, most commonly due to evolution of TKI-resistant clones. There have also been rare cases of emergence of Ph-negative clones with other cytogenetic abnormalities, and, less commonly, development of Ph-negative acute myeloid leukemia (AML), whose molecular pathogenesis is largely unknown. Here we report molecular features of a patient with Ph + CML who developed Ph-negative AML after showing a major molecular response to dasatinib. A 55-year-old man was diagnosed with CML. He achieved a complete cytogenetic response three months after dasatinib therapy but developed AML with normal karyotype 1 year later. After receiving induction and consolidation chemotherapy for AML, the patient achieved complete remission with no evidence of CML under maintenance with bosutinib. Targeted sequencing of serial bone marrow samples identified mutations in IDH2 and NPM1 in the Ph-negative AML cells, which had not been detected in CML cells. These results suggest that Ph-negative AML in this patient originated from a preleukemic population, which might have expanded during or after the successful elimination of CML clones with TKI therapy.
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MESH Headings
- Aniline Compounds/administration & dosage
- Dasatinib/administration & dosage
- Humans
- Isocitrate Dehydrogenase/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Male
- Middle Aged
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Nitriles/administration & dosage
- Nuclear Proteins/genetics
- Nuclear Proteins/metabolism
- Nucleophosmin
- Philadelphia Chromosome
- Protein Kinase Inhibitors/administration & dosage
- Quinolines/administration & dosage
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Affiliation(s)
- Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Shiho Furuichi
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Fusako Nagasawa
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Tomoyuki Handa
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Hiroko Tanaka
- Laboratory of DNA Information Analysis, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan
| | - Satoru Miyano
- Laboratory of DNA Information Analysis, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, 880 Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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18
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Jang JH, Tomiyama Y, Miyazaki K, Nagafuji K, Usuki K, Uoshima N, Fujisaki T, Kosugi H, Matsumura I, Sasaki K, Kizaki M, Sawa M, Hidaka M, Kobayashi N, Ichikawa S, Yonemura Y, Enokitani K, Matsuda A, Ozawa K, Mitani K, Lee JW, Nakao S. Efficacy and safety of romiplostim in refractory aplastic anaemia: a Phase II/III, multicentre, open-label study. Br J Haematol 2020; 192:190-199. [PMID: 33152120 PMCID: PMC7821109 DOI: 10.1111/bjh.17190] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 06/07/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
A previous dose-finding study has suggested that romiplostim is effective in patients with refractory aplastic anaemia (AA) and 10 µg/kg once weekly was recommended as a starting dose. In this Phase II/III, multicentre, open-label study, romiplostim was administered subcutaneously at a fixed dose of 10 µg/kg once weekly for 4 weeks (weeks 1-4) followed by weekly doses (5, 10, 15 and 20 µg/kg) titrated by platelet response for up to 52 weeks (weeks 5-52). A total of 31 patients with AA who were refractory to immunosuppressive therapy (IST) and thrombocytopenia (platelet count of ≤30 × 109 /l) were enrolled. The primary efficacy endpoint of the proportion of patients achieving any haematological (platelet, neutrophil and erythrocyte) response at week 27 was 84% [95% confidence interval (CI) 66-95%]. Trilineage response was 39% (95% CI 22-58%) at week 53. The most common treatment-related adverse events (AEs) were headache and muscle spasms (each 13%). All AEs were mild or moderate except for three patients with Grade 3 hepatic AEs; no AEs necessitated romiplostim discontinuation. Two patients developed cytogenetic abnormalities, of whom one returned to normal karyotype at last follow-up. High-dose romiplostim is effective and well tolerated in the treatment of patients with AA refractory to IST.
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Affiliation(s)
- Jun Ho Jang
- Department of Hematology, Sungkyunkwan University Samsung Medical Center, Seoul, Republic of Korea
| | - Yoshiaki Tomiyama
- Department of Blood Transfusion, Osaka University Hospital, Osaka, Japan
| | - Koji Miyazaki
- Department of Transfusion and Cell Transplantation, Kitasato University School of Medicine, Sagamihara, Japan
| | - Koji Nagafuji
- Department of Hematology, Kurume University Hospital, Kurume, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Tomoaki Fujisaki
- Department of Internal Medicine, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Itaru Matsumura
- Department of Hematology and Rheumatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Masahiro Kizaki
- Department of Hematology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Michihiro Hidaka
- Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Naoki Kobayashi
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Satoshi Ichikawa
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Yuji Yonemura
- Department of Transfusion Medicine and Cell Therapy, Kumamoto University Hospital, Kumamoto, Japan
| | | | - Akira Matsuda
- Department of Hemato-Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Keiya Ozawa
- Division of Hematology, Jichi Medical University, Tochigi, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Jong Wook Lee
- Division of Hematology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shinji Nakao
- Division of Transfusion Medicine, Kanazawa University Hospital, Kanazawa, Japan
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19
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Mitani K. Development of novel therapies in MDS. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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20
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Nakamura F, Arai H, Tokita K, Furuichi S, Sugita-Nagasawa F, Takahashi W, Handa T, Iso H, Tadokoro J, Tsurumi S, Nakamura Y, Nakamura Y, Sasaki K, Seo S, Ichikawa M, Mitani K. PECAM is an effective and safe anthracycline-containing third-line regimen for patients with relapsed or refractory non-Hodgkin lymphoma. Leuk Lymphoma 2020; 62:239-242. [PMID: 32914680 DOI: 10.1080/10428194.2020.1817442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Katsuya Tokita
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Shiho Furuichi
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | | | - Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Tomoyuki Handa
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Hisako Iso
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Jiro Tadokoro
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Shigeharu Tsurumi
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi, Japan
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21
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Takahashi W, Ichikawa M, Okazaki A, Nakamura F, Arai H, Handa T, Nakamura Y, Nakamura Y, Seo S, Sasaki K, Mitani K. [Effective treatment of POEMS syndrome accompanied by plasmacytoma with lenalidomide, dexamethasone, and local irradiation]. Rinsho Ketsueki 2020; 61:262-267. [PMID: 32224588 DOI: 10.11406/rinketsu.61.262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A 70-year-old woman experienced pain in both gastrocnemius muscles, numbness in the toes, and muscle weakness in both the legs that lasted for two months. After getting admitted to our hospital, the muscle weakness extended to both her arms, and nerve conduction studies revealed decreased nerve conduction velocity, which was more prominent in the elbow and the axilla than in the wrist. A magnetic resonance imaging revealed a tumor in the right femoral neck, which was histologically diagnosed as plasmacytoma. Laboratory findings revealed IgA lambda type M protein and an elevated VEGF level of 2,320 pg/ml; edema was present in both the legs. After a diagnosis of POEMS syndrome, lenalidomide and dexamethasone treatment were initiated simultaneously, along with irradiation. The treatment improved polyneuropathy, along with a decrease in the VEGF level. Increased vascular permeability due to elevated VEGF led to the development of neuropathy of POEMS syndrome, and treatment against proliferating monoclonal plasma cells is effective. In the present case, we believe that a prompt control of the plasmacytoma with novel therapeutic agents for myeloma with irradiation resulted in the improvement of the neurological symptoms.
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Affiliation(s)
- Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Akihito Okazaki
- Clinical Training Center, Dokkyo Medical University Hospital
| | - Fumi Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Tomoyuki Handa
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Sachiko Seo
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University Hospital
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22
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Ishida T, Kimura H, Ozaki S, Kubo K, Sunami K, Takezako N, Fujita H, Hayashi T, Kiguchi T, Ohashi K, Yamamoto S, Takamatsu H, Kosugi H, Ohta K, Sakai R, Handa H, Kondo S, Abe Y, Omoto E, Mitani K, Morita S, Murakami H, Shimizu K. Continuous lenalidomide treatment after bortezomib-melphalan-prednisolone therapy for newly diagnosed multiple myeloma. Ann Hematol 2020; 99:1063-1072. [PMID: 32248251 DOI: 10.1007/s00277-020-03988-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/01/2020] [Indexed: 01/24/2023]
Abstract
These are the results of phase II study of bortezomib-melphalan-prednisolone (VMP) induction therapy followed by lenalidomide-dexamethasone (Rd) consolidation and lenalidomide maintenance in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). The primary end point was progression-free survival (PFS). Secondary end points included overall survival (OS), overall response rates (ORRs), and safety. Eighty-three eligible patients were enrolled between October 2012 and August 2014. The median PFS was 28.0 months (95% CI 19.6-36.7) and the median OS was 55.3 months (95% CI 51.6-NA). Among the patients who received lenalidomide maintenance therapy, median PFS was significantly improved in patients who had achieved a very good partial response (VGPR) or better (41.8 vs 20.7 months, p = 0.0070). As the best response, the rates of partial response or better were 85.5% comprising stringent complete response (sCR, 21.7%), complete response (CR, 10.8%), VGPR (18.1%), and partial response (PR, 34.9%). The most frequently observed grade 3 or higher adverse events during the VMP therapy were anemia (28.9%), neutropenia (15.6%), thrombocytopenia (6.0%), and peripheral neuropathy (2.4%). The most frequently observed grade 3 or higher adverse events during the Rd therapy were anemia (3.5%), neutropenia (1.8%), and skin rush (5.3%). The most frequently observed grade 3 or higher adverse events during lenalidomide maintenance therapy were anemia (7.4%) and neutropenia (24.1%). Thus, VMP induction therapy followed by Rd consolidation and lenalidomide maintenance is considered a well-tolerated and effective regimen in transplant-ineligible NDMM. This trial is registered with UMIN-CTR with the identification number UMIN000009042.
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Affiliation(s)
- Tadao Ishida
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan. .,Sapporo Medical University, Sapporo, Japan.
| | - Hideo Kimura
- Kita-Fukushima Medical Center, Date, Japan, Fukushima, Japan
| | - Shuji Ozaki
- Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Koumei Kubo
- Aomori Prefectural Central Hospital, Aomori, Japan
| | - Kazutaka Sunami
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | | | | | - Toshiaki Hayashi
- Sapporo Medical University, Sapporo, Japan.,Teine Keijinkai Hospital, Sapporo, Japan
| | | | - Kazuteru Ohashi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | | | | | | | | | | | - Hiroshi Handa
- Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Seiji Kondo
- Saga-Ken Medical Center Koseikan, Saga, Japan
| | - Yu Abe
- Department of Hematology, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Eijiro Omoto
- Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Kinuko Mitani
- Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hirokazu Murakami
- Gunma University Graduate School of Health Sciences, Maebashi, Japan
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23
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Takahashi W, Ichikawa M, Furuichi S, Nagasawa F, Iso H, Arai H, Tsurumi S, Handa T, Tadokoro J, Nakamura Y, Nakamura Y, Sasaki K, Mitani K. [Acquired hemophilia A requiring plasma exchange and mechanical ventilation]. Rinsho Ketsueki 2019; 60:191-196. [PMID: 31068514 DOI: 10.11406/rinketsu.60.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 56-year-old man who sustained a right waist injury 1 month ago, reported to our department complaining of pain in the right waist and femur for 1 day. In a computed tomography examination, hematoma of the right iliopsoas muscle was revealed, and arterial embolization was immediately performed but was not effective. Laboratory findings showed hemoglobin levels as 5.4 g/dl, platelet of 20.2×104/µl, prothrombine time of 13.1 s, partial thromboplastin time (APTT) of 81.1 s, and a convex upward curve of the APTT cross-mixing test. The activity of the coagulation factor VIII was <1.0%, but its amount was 120%, and the level of factor VIII inhibitor was 130 Bethesda Unit/ml. Disseminated intravascular coagulation was not noted. Under the diagnosis of acquired hemophilia A, treatment with prednisolone and recombinant activated factor VII was initiated. However, APTT remained prolonged, and intubation and mechanical ventilation were required because of right hemothorax. After steroid pulse therapy and plasma exchange, APTT returned to its normal range, and the inhibitor disappeared. Thus, we finally succeeded in extubation. This case indicated that intensive care may be necessary in the early phase treatment for acquired hemophilia A.
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Affiliation(s)
- Wataru Takahashi
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Shiho Furuichi
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Fusako Nagasawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Hisako Iso
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Shigeharu Tsurumi
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Tomoyuki Handa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Jiro Tadokoro
- Department of Hematology, Shinmatsudo Central General Hospital
| | - Yuko Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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Ichikawa M, Mitani K. [Ⅰ.Myelodysplastic Syndromes]. Gan To Kagaku Ryoho 2019; 46:862-867. [PMID: 31189805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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25
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Matsuda A, Kawabata H, Tohyama K, Maeda T, Araseki K, Hata T, Suzuki T, Kayano H, Shimbo K, Usuki K, Chiba S, Ishikawa T, Arima N, Nohgawa M, Ohta A, Miyazaki Y, Nakao S, Ozawa K, Arai S, Kurokawa M, Mitani K, Takaori-Kondo A. Interobserver concordance of assessments of dysplasia and blast counts for the diagnosis of patients with cytopenia: From the Japanese central review study. Leuk Res 2018; 74:137-143. [DOI: 10.1016/j.leukres.2018.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/29/2018] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
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26
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Nakamura Y, Ichikawa M, Oda H, Yamazaki I, Sasaki K, Mitani K. RUNX1-EVI1 induces dysplastic hematopoiesis and acute leukemia of the megakaryocytic lineage in mice. Leuk Res 2018; 74:14-20. [PMID: 30278283 DOI: 10.1016/j.leukres.2018.09.015] [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: 03/18/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 01/08/2023]
Abstract
The RUNX1-EVI1 gene generated by the t(3;21) translocation encodes a chimeric transcription factor and is a causative gene in the development of de novo acute megakaryoblastic leukemia and leukemic transformation of hematopoietic stem cell tumors. Heterozygous RUNX1-EVI1 knock-in mice die in utero due to hemorrhage in the central nervous system and spinal cord and complete abolishment of definitive hematopoiesis in the fetal liver. On the other hand, the chimeric knock-in mouse develops acute megakaryoblastic leukemia. We created another mouse model of RUNX1-EVI1 using transplantation of retrovirus-infected bone marrow cells. Some mice transplanted with RUNX1-EVI1-expressing bone marrow cells developed acute megakaryoblastic leukemia within eight months, and the other non-leukemic mice showed thrombocytosis at around a year. In the non-leukemic mice, dysplastic megakaryocytes proliferated in the bone marrow and frequently infiltrated into the spleen, which was not associated with marrow fibrosis. In the leukemic mice, their tumor cells were positive for c-kit and CD41, and negative for TER119. Although they were negative for platelet peroxidase in the electron microscopic analysis, they had multiple centrioles in the cytoplasm, which are characteristic of megakaryocytes that undergo endomitosis. The leukemic cells were serially transplantable, and gene-expression analyses using quantitative RT-PCR arrays revealed that they showed significantly elevated expression of stem cell, primitive hematopoietic cell and endothelial cell-related genes compared with normal bone marrow cells. All these data suggested that RUNX1-EVI1 caused dysplastic hematopoiesis or leukemia of the megakaryocytic lineage and endowed gene expression profiles distinctive of immature hematopoietic cells.
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Affiliation(s)
- Yuka Nakamura
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Motoshi Ichikawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Hideaki Oda
- Department of Pathology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Ieharu Yamazaki
- Department of Electron Microscope, BML Research Institute Inc., Saitama, Japan; Department of Molecular Pathology, Tokyo Medical University, School of Medicine, Tokyo, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan.
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27
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Takahashi N, Nishiwaki K, Nakaseko C, Aotsuka N, Sano K, Ohwada C, Kuroki J, Kimura H, Tokuhira M, Mitani K, Fujikawa K, Iwase O, Ohishi K, Kimura F, Fukuda T, Tanosaki S, Takahashi S, Kameoka Y, Nishikawa H, Wakita H. Treatment-free remission after two-year consolidation therapy with nilotinib in patients with chronic myeloid leukemia: STAT2 trial in Japan. Haematologica 2018; 103:1835-1842. [PMID: 29976734 PMCID: PMC6278957 DOI: 10.3324/haematol.2018.194894] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/28/2018] [Indexed: 12/16/2022] Open
Abstract
The purpose of this trial was to evaluate the efficacy of 2-year consolidation therapy with nilotinib, at a dose of 300 mg twice daily, for achieving treatment-free remission in chronic myeloid leukemia patients with a deep molecular response (BCR-ABL1IS ≤0.0032%). Successful treatment-free remission was defined as no confirmed loss of deep molecular response. We recruited 96 Japanese patients, of whom 78 sustained a deep molecular response during the consolidation phase and were therefore eligible to discontinue nilotinib in the treatment-free remission phase; of these, 53 patients (67.9%; 95% confidence interval: 56.4–78.1%) remained free from molecular recurrence in the first 12 months. The estimated 3-year treatment-free survival was 62.8%. Nilotinib was readministered to all patients (n=29) who experienced a molecular recurrence during the treatment-free remission phase. After restarting treatment, rapid deep molecular response returned in 25 patients (86.2%), with 50% of patients achieving a deep molecular response within 3.5 months. Tyrosine kinase inhibitor withdrawal syndrome was reported in 11/78 patients during the early treatment-free remission phase. The treatment-free survival curve was significantly better in patients with undetectable molecular residual disease than in patients without (3-year treatment-free survival, 75.6 versus 48.6%, respectively; P=0.0126 by the log-rank test). There were no significant differences in treatment-free survival between subgroups based on tyrosine kinase inhibitor treatment before the nilotinib consolidation phase, tyrosine kinase inhibitor-withdrawal syndrome, or absolute number of natural killer cells. The results of this study indicate that it is safe and feasible to stop tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia who have achieved a sustained deep molecular response with 2 years of treatment with nilotinib. This study was registered with UMIN-CTR (UMIN000005904).
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Affiliation(s)
- Naoto Takahashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
| | - Kaichi Nishiwaki
- Department of Oncology and Hematology, Jikei University Kashiwa Hospital
| | - Chiaki Nakaseko
- Department of Hematology, International University of Health and Welfare School of Medicine, Narita.,Department of Hematology, Chiba University Hospital
| | - Nobuyuki Aotsuka
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital
| | - Koji Sano
- Department of Oncology and Hematology, Jikei University Kashiwa Hospital
| | | | - Jun Kuroki
- Department of Internal Medicine, Yuri General Hospital, Yurihonjo
| | - Hideo Kimura
- Department of Hematology, Northern Fukushima Medical Center, Date
| | - Michihide Tokuhira
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University, Tochigi
| | | | - Osamu Iwase
- Department of Hematology, Tokyo Medical University Hachioji Medical Center
| | - Kohshi Ohishi
- Transfusion Medicine and Cell Therapy, Mie University Hospital, Tsu
| | - Fumihiko Kimura
- Division of Hematology, National Defense Medical College, Tokorozawa
| | - Tetsuya Fukuda
- Department of Hematology, Tokyo Medical and Dental University Hospital.,Department of Hematology, Tottori University Hospital, Yonago
| | - Sakae Tanosaki
- Department of Hematology, The Fraternity Memorial Hospital, Tokyo
| | - Saori Takahashi
- Clinical Research Promotion and Support Center, Akita University Hospital
| | - Yoshihiro Kameoka
- Clinical Research Promotion and Support Center, Akita University Hospital
| | - Hiroyoshi Nishikawa
- Division of Cancer Immunology, Research Institute / Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Tokyo/Kashiwa
| | - Hisashi Wakita
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital.,Japanese Red Cross Chiba Blood Center, Funabashi, Japan
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28
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Arai H, Ichikawa M, Furuichi S, Nagasawa F, Takahashi W, Handa T, Nakamura Y, Nakamura Y, Sasaki K, Mitani K. Non-Hodgkin's lymphoma of the breast: a review of 6 cases including 3 patients with a history of autoimmune diseases. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx621.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Kawabata H, Tohyama K, Matsuda A, Araseki K, Hata T, Suzuki T, Kayano H, Shimbo K, Zaike Y, Usuki K, Chiba S, Ishikawa T, Arima N, Nogawa M, Ohta A, Miyazaki Y, Mitani K, Ozawa K, Arai S, Kurokawa M, Takaori-Kondo A. Validation of the revised International Prognostic Scoring System in patients with myelodysplastic syndrome in Japan: results from a prospective multicenter registry. Int J Hematol 2017; 106:375-384. [DOI: 10.1007/s12185-017-2250-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 02/08/2023]
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30
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Kobayashi S, Ueda Y, Nannya Y, Shibayama H, Tamura H, Ogata K, Akatsuka Y, Usuki K, Ito Y, Okada M, Suzuki T, Hata T, Matsuda A, Tohyama K, Kakumoto K, Koga D, Mitani K, Naoe T, Sugiyama H, Takaku F. Prognostic significance of Wilms tumor 1 mRNA expression levels in peripheral blood and bone marrow in patients with myelodysplastic syndromes. Cancer Biomark 2017; 17:21-32. [PMID: 27062571 DOI: 10.3233/cbm-160612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND This present study was designed to follow up 82 patients among 115 MDS patients registered in study ODK-0801 for 5 years, to analyze the relationship between the WT1 mRNA expression level and prognosis. OBJECTIVE This study aimed to investigate the clinical utility of WT1 mRNA expression levels. METHODS After study ODK-0801, we investigated the conditions of the same patients once a year, including any clinical and laboratory findings supporting the diagnosis, and treatment among the living patients. RESULTS When we assessed the survival time of 82 MDS patients by WT1 mRNA expression level, there were significant differences between the < 500 and ≥ 104 copies/μ g RNA groups and between the 500-104 and ≥ 104 copies/μ g RNA groups for BM levels (p < 0.01). Examination of the time of freedom from acute myeloid eukemia (AML) transformation indicated that a high WT1 mRNA expression level (> 104 copies/μ g RNA) was a strong prognostic factor for a short time to AML transformation. CONCLUSION The results indicate that the tumorigenesis of MDS is likely to originate at the stem cell level, suggesting that the WT1 mRNA level measurement in the BM is an effective prognostic marker in patients with MDS.
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Affiliation(s)
- Sumiko Kobayashi
- Department of Hematology and Rheumatology, Nihon University School of Medicine, Tokyo, Japan
| | - Yasunori Ueda
- Department of Haematology/Oncology, Transfusion and Haemapheresis Center, Kurashiki Central Hospital, Okayama, Japan
| | - Yasuhito Nannya
- Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideto Tamura
- Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kiyoyuki Ogata
- Division of Hematology, Department of Medicine, Nippon Medical School, Tokyo, Japan.,Department of Hematology, Shin-Yurigaoka General Hospital, Kanagawa, Japan
| | - Yoshiki Akatsuka
- Department of Hematology, Fujita Health University School of Medicine, Aichi, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yoshikazu Ito
- Department of Hematology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Masaya Okada
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Takahiro Suzuki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akira Matsuda
- Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
| | - Kaoru Tohyama
- Department of Laboratory Medicine, Kawasaki Medical School, Okayama, Japan
| | - Keiji Kakumoto
- Information Management Office, Drug Safety Research Center, Tokushima Research Institute, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Daisuke Koga
- Diagnostic Division, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Tomoki Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Haruo Sugiyama
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Osaka, Japan
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31
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Arai H, Furuichi S, Nakamura Y, Nakamura Y, Ichikawa M, Mitani K. ALK-negative anaplastic large cell lymphoma with loss of CD30 expression during treatment with brentuximab vedotin. Rinsho Ketsueki 2016; 57:634-7. [PMID: 27263791 DOI: 10.11406/rinketsu.57.634] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 59-year-old woman with anaplastic large cell lymphoma (ALCL), ALK-negative, was treated with brentuximab vedotin (BV) against relapse after 6 regimens of systemic chemotherapy and radiation. Despite achieving an initial response, skin lesions worsened after 11 courses. A skin biopsy after the development of resistance to BV confirmed loss of CD30 expression by the tumor cells, suggesting a possible cause of resistance. This case shows that down-regulation of CD30 does occur during BV treatment, resulting in resistance to this drug. Because of this possibility, in the future, expression of CD30 should be carefully monitored with extended use of BV against ALCL.
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Affiliation(s)
- Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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32
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Tokita K, Nakamura Y, Iso H, Nakamura Y, Sasaki K, Mitani K. [Systemic organ invasion accompanied by immunophenotypic change observed in extraosseous plasmacytoma]. Rinsho Ketsueki 2016; 57:56-9. [PMID: 26861106 DOI: 10.11406/rinketsu.57.56] [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 report a 57-year-old man who was diagnosed based on morphological findings as having extraosseous plasmacytoma of the left lower eyelid. Tumor cells were positive not only for CD38 and CD138, but also for CD19 and surface immunoglobulin lambda chain. He obtained a complete remission with irradiation and VAD therapy, but the disease relapsed one year later in the testis and popliteal fossa. Because tumor cells appeared to be blastoid, CHOP therapy was administered, and the patient achieved a temporary remission. Cytoplasmic lambda chain-positive and CD19-negative tumors eventually recurred at multiple sites including the central nervous system but not in the bone marrow. Treatment with the BD regimen and lenalidomide failed, and he died four years after the initial diagnosis.
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Affiliation(s)
- Katsuya Tokita
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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33
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Aoki T, Shimada K, Suzuki R, Izutsu K, Tomita A, Maeda Y, Takizawa J, Mitani K, Igarashi T, Sakai K, Miyazaki K, Mihara K, Ohmachi K, Nakamura N, Takasaki H, Kiyoi H, Nakamura S, Kinoshita T, Ogura M. High-dose chemotherapy followed by autologous stem cell transplantation for relapsed/refractory primary mediastinal large B-cell lymphoma. Blood Cancer J 2015; 5:e372. [PMID: 26636287 PMCID: PMC4735068 DOI: 10.1038/bcj.2015.101] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- T Aoki
- Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.,Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - R Suzuki
- Cancer Center, Shimane University Hospital, Izumo, Japan
| | - K Izutsu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - A Tomita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - J Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan
| | - K Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - T Igarashi
- Department of Hematology and Oncology, Gunma Cancer Center, Oota, Japan
| | - K Sakai
- Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, Matsumoto, Japan.,Department of Hematology, Shinshu University School of Medicine, Matsumoto, Japan
| | - K Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - K Mihara
- Department of Hematology, Hiroshima University Hospital, Hiroshima, Japan
| | - K Ohmachi
- Department of Hematology, Tokai University, Isehara, Japan
| | - N Nakamura
- Department of Pathology, Tokai University, Isehara, Japan
| | - H Takasaki
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - H Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Nakamura
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - T Kinoshita
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| | - M Ogura
- Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.,Department of Hematology, Tokai Central Hospital, Kakamigahara, Japan
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Voutsa D, Anthemidis A, Giakisikli G, Mitani K, Besis A, Tsolakidou A, Samara C. Size distribution of total and water-soluble fractions of particle-bound elements-assessment of possible risks via inhalation. Environ Sci Pollut Res Int 2015; 22:13412-13426. [PMID: 25940472 DOI: 10.1007/s11356-015-4559-7] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 04/16/2015] [Indexed: 06/04/2023]
Abstract
The size distribution of total and water-soluble elemental concentrations in six particle sizes <0.49, 0.49-0.97, 0.97-1.5, 1.5-3.0, 3.0-7.2, and 7.2-30 μm was investigated in Thessaloniki area, N. Greece, at two sites representing urban-traffic and urban-background character during the cold and warm period. The elements As, Cd, Cr, Cu, Pb, Ni, Zn, Ru, and Ir exhibited their highest mass portion in the fine particle mode (0.97-1.5 μm), whereas Al, Ba, Ca, Fe, and Mn occurred predominately in the coarse particle mode (3.0-7.2 μm). The water-soluble elemental fractions exhibited significant spatiotemporal variations and particle size dependence. Possible non-carcinogenic and carcinogenic risks associated with inhalation of particle-bound elements based on total and water-soluble concentrations were in acceptable levels. However, the cumulative risk for all potential particle-bound constituents has to be considered.
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Affiliation(s)
- D Voutsa
- Environmental Pollution Control Laboratory, Department of Chemistry, Aristotle University of Thessaloniki, 541 24, Thesaloniki, Greece,
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35
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Jang JH, Harada H, Shibayama H, Shimazaki R, Kim HJ, Sawada K, Mitani K. A randomized controlled trial comparing darbepoetin alfa doses in red blood cell transfusion-dependent patients with low- or intermediate-1 risk myelodysplastic syndromes. Int J Hematol 2015; 102:401-12. [PMID: 26323997 DOI: 10.1007/s12185-015-1862-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 08/16/2015] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
Abstract
Darbepoetin alfa (DA) is a standard treatment for anemia in lower-risk MDS. However, to date there has been no comparative study to investigate the initial dosage. We, thus, conducted a randomized controlled trial to elucidate the optimal initial dosage of DA. International Prognostic Scoring System low or intermediate-1 risk MDS patients with hemoglobin levels ≤9.0 g/dL, serum erythropoietin levels ≤500 mIU/mL, and red blood cell transfusion dependency were enrolled. Patients were randomized to receive DA either at 60, 120, or 240 μg/week for 16 weeks followed by continuous administration with dose adjustment up to 48 weeks. Of 17, 18, and 15 patients in the 60, 120, and 240 μg DA groups included in the efficacy analysis, 64.7, 44.4, and 66.7 %, respectively, achieved the primary endpoint (major or minor erythroid response), while 17.6, 16.7, and 33.3 % achieved major erythroid responses in the initial 16-week period. No clinically significant safety concerns were identified. DA reduced the transfusion requirements effectively and safely in transfusion-dependent, lower-risk MDS patients. Given the highest achievement rate of the major erythroid response in the 240 μg group and the absence of dose-dependent adverse events, 240 μg weekly is the optimal initial dosage.
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Affiliation(s)
- Jun Ho Jang
- Department of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hironori Harada
- Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan.,Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Hyeoung-Joon Kim
- Department of Hematology/Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Korea
| | | | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, 880, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, 321-0293, Japan.
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36
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Sakamoto K, Nakasone H, Tsurumi S, Sasaki K, Mitani K, Kida M, Hangaishi A, Usuki K, Kobayashi A, Sato K, Karasawa-Yamaguchi M, Izutsu K, Okoshi Y, Chiba S, Kanda Y. Prednisone versus high-dose dexamethasone for untreated primary immune thrombocytopenia. A retrospective study of the Japan Hematology & Oncology Clinical Study Group. J Thromb Thrombolysis 2015; 37:279-86. [PMID: 23686644 DOI: 10.1007/s11239-013-0939-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
High-dose dexamethasone (HDD) has been shown to be an effective initial treatment for immune thrombocytopenia (ITP), but it is not clear whether HDD offers any advantages over conventional-dose prednisone (PSL). We retrospectively compared the efficacy and toxicity of HDD and PSL for newly diagnosed ITP. The response was evaluated according to the International Working Group (IWG) criteria. We analyzed data from 31 and 69 patients in the HDD and PSL groups, respectively. There were no significant differences in patient characteristics between the two groups except for the incidence of the eradication of Helicobacter pylori. The response rate was better in the HDD group (42.7 vs. 28.4 %), and this difference was statistically significant when adjusted for other factors including the eradication of H. pylori. In the HDD group, a response was achieved earlier (28 vs. 152 days in median) and steroids were more frequently discontinued at 6 months (64.5 vs. 37.7 %). Among patients who achieved a response, there was no significant difference in the incidence of loss of response. There were no significant differences in the rate of adverse events, transition to chronic ITP, and splenectomy. In conclusion, HDD might enable the early cessation of steroids without a loss of response.
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Affiliation(s)
- Kana Sakamoto
- Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan
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37
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Aoki T, Izutsu K, Suzuki R, Nakaseko C, Arima H, Shimada K, Tomita A, Sasaki M, Takizawa J, Mitani K, Igarashi T, Maeda Y, Fukuhara N, Ishida F, Niitsu N, Ohmachi K, Takasaki H, Nakamura N, Kinoshita T, Nakamura S, Ogura M. Prognostic significance of pleural or pericardial effusion and the implication of optimal treatment in primary mediastinal large B-cell lymphoma: a multicenter retrospective study in Japan. Haematologica 2014; 99:1817-25. [PMID: 25216682 DOI: 10.3324/haematol.2014.111203] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The prognosis of patients with primary mediastinal large B-cell lymphoma has improved over recent years. However, the optimal treatment strategy including the role of radiotherapy remains unknown. We retrospectively analyzed the clinical outcomes of 345 patients with newly diagnosed primary mediastinal large B-cell lymphoma in Japan. With a median follow up of 48 months, the overall survival at four years for patients treated with R-CHOP (n=187), CHOP (n=44), DA-EPOCH-R (n=9), 2(nd)- or 3(rd)-generation regimens, and chemotherapy followed by autologous stem cell transplantation were 90%, 67%, 100%, 91% and 92%, respectively. Focusing on patients treated with R-CHOP, a higher International Prognostic Index score and the presence of pleural or pericardial effusion were identified as adverse prognostic factors for overall survival in patients treated with R-CHOP without consolidative radiotherapy (IPI: hazard ratio 4.23, 95% confidence interval 1.48-12.13, P=0.007; effusion: hazard ratio 4.93, 95% confidence interval 1.37-17.69, P=0.015). Combined with the International Prognostic Index score and the presence of pleural or pericardial effusion for the stratification of patients treated with R-CHOP without radiotherapy, patients with lower International Prognostic Index score and the absence of effusion comprised approximately one-half of these patients and could be identified as curable patients (95% overall survival at 4 years). The DA-EPOCH-R regimen might overcome the effect of these adverse prognostic factors. Our simple indicators of International Prognostic Index score and the presence of pleural or pericardial effusion could stratify patients with primary mediastinal large B-cell lymphoma and help guide selection of treatment.
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Affiliation(s)
- Tomohiro Aoki
- Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital; Department of Hematology and Oncology, Nagoya University Graduate School of Medicine;
| | - Koji Izutsu
- Department of Hematology, Toranomon Hospital, Tokyo, Japan
| | - Ritsuro Suzuki
- Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Kyoto University, Kyoto
| | - Chiaki Nakaseko
- Department of Hematology, Chiba University Hospital, Kyoto University, Kyoto
| | - Hiroshi Arima
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Kazuyuki Shimada
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
| | - Akihiro Tomita
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine
| | - Makoto Sasaki
- Division of Hematology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo
| | - Jun Takizawa
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Tochigi
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University of Medicine, Tochigi
| | | | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Sendai
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai
| | - Fumihiro Ishida
- Department of Biomedical Laboratory Sciences, Department of Hematology, Shinshu University School of Medicine, Matsumoto
| | - Nozomi Niitsu
- Department of Hematology, International Medical Center, Saitama Medical University, Hidaka
| | - Ken Ohmachi
- Department of Hematology, Tokai University, Isehara
| | | | | | | | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital
| | - Michinori Ogura
- Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital; Department of Internal Medicine and Laboratory Medicine, National Hospital Organization Suzuka National Hospital, Japan
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Takahashi N, Miura M, Kuroki J, Mitani K, Kitabayashi A, Sasaki O, Kimura H, Imai K, Tsukamoto N, Noji H, Kondo T, Motegi M, Kato Y, Mita M, Saito H, Yoshida C, Torimoto Y, Kimura T, Wano Y, Nomura J, Yamamoto S, Mayama K, Honma R, Sugawara T, Sato S, Shinagawa A, Abumiya M, Niioka T, Harigae H, Sawada K. Multicenter phase II clinical trial of nilotinib for patients with imatinib-resistant or -intolerant chronic myeloid leukemia from the East Japan CML study group evaluation of molecular response and the efficacy and safety of nilotinib. Biomark Res 2014; 2:6. [PMID: 24650752 PMCID: PMC3994575 DOI: 10.1186/2050-7771-2-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/27/2014] [Indexed: 12/31/2022] Open
Abstract
Background Nilotinib is a second-generation tyrosine kinase inhibitor that exhibits significant efficacy as first- or second-line treatment in patients with chronic myeloid leukemia (CML). We conducted a multicenter Phase II Clinical Trial to evaluate the safety and efficacy of nilotinib among Japanese patients with imatinib-resistant or -intolerant CML-chronic phase (CP) or accelerated phase (AP). Results We analyzed 49 patients (33 imatinib-resistant and 16 imatinib-intolerant) treated with nilotinib 400 mg twice daily. The major molecular response (MMR) rate was 47.8% at 12 months among 35 patients who did not demonstrate an MMR at study entry. Somatic BCR-ABL1 mutations (Y253H, I418V, and exon 8/9 35-bp insertion [35INS]) were detected in 3 patients at 12 months or upon discontinuation of nilotinib. Although 75.5% of patients were still being treated at 12 months, nilotinib treatment was discontinued because of progressing disease in 1 patient, insufficient effect in 2, and adverse events in 9. There was no statistically significant correlation between MMR and trough concentrations of nilotinib. Similarly, no correlation was observed between trough concentrations and adverse events, except for pruritus and hypokalemia. Hyperbilirubinemia was frequently observed (all grades, 51.0%; grades 2–4, 29%; grades 3–4, 4.1%). Hyperbilirubinemia higher than grade 2 was significantly associated with the uridine diphosphate glucuronosyltransferase (UGT)1A9 I399C/C genotype (P = 0.0086; Odds Ratio, 21.2; 95% Confidence Interval 2.2–208.0). Conclusions Nilotinib was efficacious and well tolerated by patients with imatinib-resistant or -intolerant CML-CP/AP. Hyperbilirubinemia may be predicted before nilotinib treatment, and may be controlled by reducing the daily dose of nilotinib in patients with UGT1A9 polymorphisms. Trial registration clinicaltrials.gov: UMIN000002201
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Affiliation(s)
- Naoto Takahashi
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, 1-1-1 Hondo, 010-8543 Akita, Japan.
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39
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Tokita K, Takahashi W, Arai H, Handa T, Nakamura Y, Maki K, Sasaki K, Mitani K. [Inv(16)-type acute myeloid leukemia with repeated skin infiltration without bone marrow relapse before and after allogeneic hematopoietic stem cell transplantation]. Rinsho Ketsueki 2013; 54:2203-2206. [PMID: 24452154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a 40-year-old woman diagnosed as having acute myeloid leukemia with CBFB-MYH11. Before and after stem cell transplantation in the phase of molecular remission of the marrow, CBFB-MYH11-positive cells were detected by RT-PCR analysis in skin lesions. The former was pathologically diagnosed as leukemic infiltration, while the latter was considered to be graft-versus-host disease. We can speculate that a low level of leukemic stem cells not detectable by RT-PCR analysis remained in the bone marrow, at least prior to transplantation. This case may suggest interesting biological features of inv(16)-type acute myeloid leukemia.
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Affiliation(s)
- Katsuya Tokita
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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40
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Nagasawa F, Nakamura Y, Tokita K, Takahashi W, Iso H, Arai H, Tsurumi S, Handa T, Nakamura Y, Nakamura Y, Sasaki K, Mitani K. [Detection of BCR-ABL1 chimeric gene-positive neutrophils in a patient with mixed phenotype acute leukemia]. Rinsho Ketsueki 2013; 54:2074-2078. [PMID: 24305542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We experienced two patients with mixed phenotype acute leukemia with t(9;22)(q34;q11.2); BCR-ABL1 according to the WHO classification 2008. The type of BCR/ABL1 was major in both patients, and the chimeric gene was also detected in neutrophils from peripheral blood by the fluorescence in situ hybridization technique. Patient 1 was a 59-year-old Japanese woman, and patient 2 a 45-year-old Japanese man. They had both developed leukemia suddenly. Their leukemic blasts expressed B cell and myeloid cell antigens, but concomitantly in patient 1 (biphenotypic) and separately in patient 2 (biclonal). Percentages of BCR-ABL1-positive neutrophils were 98% and 89%, respectively. Both patients received an imatinib (600 mg/day)-combined Hyper-CVAD regimen as induction therapy, followed by treatment with dasatinib (140 mg/day). MEC therapy was also applied between these two treatments in patient 2. At present, patient 1 has obtained complete molecular remission quantitatively and qualitatively, and patient 2 only quantitatively. Considering their acute onsets with no prior history of chronic myelocytic leukemia (CML), they were both diagnosed as having acute leukemia with Ph1, but not blastic crisis of CML. In this tyrosine kinase inhibitor era, it has become more difficult to differentiate these two types of Ph1-positive leukemia development.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Benzamides/therapeutic use
- Dasatinib
- Diagnosis, Differential
- Female
- Fusion Proteins, bcr-abl/genetics
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Neutrophils/metabolism
- Phenotype
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- Thiazoles/therapeutic use
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Affiliation(s)
- Fusako Nagasawa
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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41
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Iriyama N, Hatta Y, Takeuchi J, Ogawa Y, Ohtake S, Sakura T, Mitani K, Ishida F, Takahashi M, Maeda T, Izumi T, Sakamaki H, Miyawaki S, Honda S, Miyazaki Y, Taki T, Taniwaki M, Naoe T. CD56 expression is an independent prognostic factor for relapse in acute myeloid leukemia with t(8;21). Leuk Res 2013; 37:1021-6. [PMID: 23810283 DOI: 10.1016/j.leukres.2013.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/24/2013] [Accepted: 05/03/2013] [Indexed: 10/26/2022]
Abstract
We investigated the significance of surface antigen expression for prognosis by focusing on a specific subtype, AML with t(8;21). The investigation included 144 patients with AML with t(8;21) in the JALSG AML97 study. AML with t(8;21) expressed CD19 (36%), CD34 (96%), and CD56 (65%) more frequently than did other subtypes of AML. CD19 expression had a significant favorable effect on CR (95.7% vs. 83.8%; P=0.049). Univariate analysis showed that increased white blood cell (WBC) counts (WBC ≥ 20 × 10(9)/L), CD19 negativity, and CD56 positivity were critical adverse factors for relapse after CR; multivariate analysis revealed that WBC count and CD56 expression were independent adverse risk factors (HR 2.18; P=0.045, HR 2.30; P=0.011, respectively). We concluded that CD56 expression has a possible role in risk stratification for patients with AML with t(8;21).
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Affiliation(s)
- Noriyoshi Iriyama
- Department of Hematology and Rheumatology, Nihon University Itabashi Hospital, Tokyo, Japan.
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42
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Abstract
Aberrant expression of MIR9 predicts a poor prognosis in acute myelogenous leukemia. To evaluate its clinical significance in acute lymphoblastic leukemia, we analyzed expression levels of MIR9 in bone marrow samples from patients with acute lymphoblastic leukemia and compared them to those in normal bone marrow cells. Approximately 20% of them showed higher expression compared with controls. There was a tendency that patients who showed overexpression of MIR9 underwent worse clinical courses, but without statistical significance. However, when the analyses were restricted to patients who did not receive a stem cell transplant, overexpression of MIR9 was significantly associated with worse overall survival. Interestingly, exaggerated MIR9 expression and higher white blood cell count at presentation were independent unfavorable prognostic factors in all patients for overall survival by multivariate analysis. The presence of higher MIR9 expression could be a useful indicator for treatment stratification.
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Affiliation(s)
- Fusako Sugita
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine , Tochigi , Japan
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43
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Kikuchi M, Nakasone H, Mitani K, Gotoh M, Kobayashi A, Kurita N, Saito T, Sato K, Kanda Y. Retrospective assessment of secondary prophylaxis for invasive aspergillosis in neutropenic hematology patients and identification of risk factors for relapse of fungal disease. ACTA ACUST UNITED AC 2013; 45:531-6. [DOI: 10.3109/00365548.2013.776173] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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44
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Kako S, Kanamori H, Kobayashi N, Shigematsu A, Nannya Y, Nakamae M, Shigeno K, Suzukawa K, Takeuchi M, Tsuzuki M, Usuki K, Hatanaka K, Ogawa K, Mitani K, Nawa Y, Hatta Y, Mizuno I, Kanda Y. Outcome after first relapse in adult patients with Philadelphia chromosome-negative acute lymphoblastic leukaemia. Br J Haematol 2013; 161:95-103. [DOI: 10.1111/bjh.12225] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 12/20/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Shinichi Kako
- Division of Haematology; Saitama Medical Centre; Jichi Medical University; Saitama; Japan
| | - Heiwa Kanamori
- Department of Haematology; Kanagawa Cancer Centre; Kanagawa; Japan
| | - Naoki Kobayashi
- Department of Haematology; Sapporo Hokuyu Hospital; Hokkaido; Japan
| | - Akio Shigematsu
- Department of Haematology and Oncology; Hokkaido University Graduate School of Medicine; Hokkaido; Japan
| | - Yasuhito Nannya
- Department of Haematology and Oncology; Graduate School of Medicine; University of Tokyo; Tokyo; Japan
| | - Mika Nakamae
- Haematology; Graduate School of Medicine; Osaka City University; Osaka; Japan
| | - Kazuyuki Shigeno
- Department of Internal Medicine III; Hamamatsu University School of Medicine; Shizuoka; Japan
| | - Kazumi Suzukawa
- Department of Clinical and Experimental Haematology; Institute of Clinical Medicine; University of Tsukuba; Ibaraki; Japan
| | | | - Motohiro Tsuzuki
- Department of Haematology; School of Medicine; Fujita Health University; Aichi; Japan
| | - Kensuke Usuki
- Division of Haematology; NTT Kanto Medical Centre; Tokyo; Japan
| | - Kazuo Hatanaka
- Department of Haematology; Rinku General Medical Centre; Osaka; Japan
| | - Kazuei Ogawa
- Department of Cardiology and Haematology; Fukushima Medical University; Fukushima; Japan
| | - Kinuko Mitani
- Department of Haematology and Oncology; Dokkyo Medical University School of Medicine; Tochigi; Japan
| | - Yuichiro Nawa
- Division of Haematology; Ehime Prefectural Central Hospital; Ehime; Japan
| | - Yoshihiro Hatta
- Department of Haematology and Rheumatology; Nihon University School of Medicine; Tokyo; Japan
| | - Ishikazu Mizuno
- Haematology Division; Department of Medicine; Hyogo Cancer Centre; Hyogo; Japan
| | - Yoshinobu Kanda
- Division of Haematology; Saitama Medical Centre; Jichi Medical University; Saitama; Japan
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45
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Nakamura Y, Mitani K. [Present and future prospects of MDS therapy]. Rinsho Ketsueki 2013; 54:29-36. [PMID: 23391644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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46
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Ueda Y, Mizutani C, Nannya Y, Kurokawa M, Kobayashi S, Takeuchi J, Tamura H, Ogata K, Dan K, Shibayama H, Kanakura Y, Niimi K, Sasaki K, Watanabe M, Emi N, Teramura M, Motoji T, Kida M, Usuki K, Takada S, Sakura T, Ito Y, Ohyashiki K, Ogawa H, Suzuki T, Ozawa K, Imai K, Kasai M, Hata T, Miyazaki Y, Morita Y, Kanamaru A, Matsuda A, Tohyama K, Koga D, Tamaki H, Mitani K, Naoe T, Sugiyama H, Takaku F. Clinical evaluation of WT1 mRNA expression levels in peripheral blood and bone marrow in patients with myelodysplastic syndromes. Leuk Lymphoma 2012; 54:1450-8. [DOI: 10.3109/10428194.2012.745074] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Yasunori Ueda
- Department of Hematology/Oncology, Transfusion and Hemapheresis Center, Kurashiki Central Hospital,
Okayama, Japan
| | - Chisato Mizutani
- Department of Hematology/Oncology, Transfusion and Hemapheresis Center, Kurashiki Central Hospital,
Okayama, Japan
| | - Yasuhito Nannya
- Department of Hematology and Oncology, University of Tokyo Graduate School of Medicine,
Tokyo, Japan
| | - Mineo Kurokawa
- Department of Hematology and Oncology, University of Tokyo Graduate School of Medicine,
Tokyo, Japan
| | - Sumiko Kobayashi
- Department of Hematology and Rheumatology, Nihon University School of Medicine,
Tokyo, Japan
| | - Jin Takeuchi
- Department of Hematology and Rheumatology, Nihon University School of Medicine,
Tokyo, Japan
| | - Hideto Tamura
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Kiyoyuki Ogata
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Kazuo Dan
- Division of Hematology, Department of Medicine, Nippon Medical School,
Tokyo, Japan
| | - Hirohiko Shibayama
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine,
Osaka, Japan
| | - Yuzuru Kanakura
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine,
Osaka, Japan
| | - Keiko Niimi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
| | - Ko Sasaki
- Department of Hematology and Oncology, Dokkyo Medical University Hospital,
Tochigi, Japan
| | - Masato Watanabe
- Department of Hematology, Fujita Health University School of Medicine,
Aichi, Japan
| | - Nobuhiko Emi
- Department of Hematology, Fujita Health University School of Medicine,
Aichi, Japan
| | - Masanao Teramura
- Department of Hematology, Tokyo Women's Medical University,
Tokyo, Japan
| | - Toshiko Motoji
- Department of Hematology, Tokyo Women's Medical University,
Tokyo, Japan
| | - Michiko Kida
- Division of Hematology, NTT Kanto Medical Center,
Tokyo, Japan
| | - Kensuke Usuki
- Division of Hematology, NTT Kanto Medical Center,
Tokyo, Japan
| | - Satoru Takada
- Department of Hematology, Saiseikai Maebashi Hospital,
Gunma, Japan
| | - Toru Sakura
- Department of Hematology, Saiseikai Maebashi Hospital,
Gunma, Japan
| | - Yoshikazu Ito
- Division of Hematology, Tokyo Medical University Hospital,
Tokyo, Japan
| | - Kazuma Ohyashiki
- Division of Hematology, Tokyo Medical University Hospital,
Tokyo, Japan
| | - Hiroyasu Ogawa
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine,
Hyogo, Japan
| | - Takahiro Suzuki
- Division of Hematology, Department of Medicine, Jichi Medical University,
Tochigi, Japan
| | - Keiya Ozawa
- Division of Hematology, Department of Medicine, Jichi Medical University,
Tochigi, Japan
| | - Kiyotoshi Imai
- Department of Hematology, Sapporo Hokuyu Hospital,
Sapporo, Japan
| | - Masaharu Kasai
- Department of Hematology, Sapporo Hokuyu Hospital,
Sapporo, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences,
Nagasaki, Japan
| | - Yasuyoshi Morita
- Division of Hematology, Kinki University School of Medicine,
Osaka, Japan
| | - Akihisa Kanamaru
- Division of Hematology, Kinki University School of Medicine,
Osaka, Japan
| | - Akira Matsuda
- Department of Hemato-Oncology, Saitama International Medical Center, Saitama Medical University,
Saitama, Japan
| | - Kaoru Tohyama
- Department of Laboratory Medicine, Kawasaki Medical School,
Okayama, Japan
| | - Daisuke Koga
- Diagnostic Division, Otsuka Pharmaceutical Co., Ltd.,
Tokushima, Japan
| | - Hiroya Tamaki
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine,
Hyogo, Japan
| | - Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University Hospital,
Tochigi, Japan
| | - Tomoki Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
| | - Haruo Sugiyama
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine,
Osaka, Japan
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47
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Mitani K, Haruyama N, Hatakeyama J, Igarashi K. Amelogenin splice isoforms stimulate chondrogenic differentiation of ATDC5 cells. Oral Dis 2012; 19:169-79. [DOI: 10.1111/j.1601-0825.2012.01967.x] [Citation(s) in RCA: 4] [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] [Received: 11/14/2011] [Revised: 06/03/2012] [Accepted: 06/15/2012] [Indexed: 12/15/2022]
Affiliation(s)
- K Mitani
- Department of Oral Dysfunction Science; Tohoku University Graduate School of Dentistry; Sendai Japan
| | - N Haruyama
- Department of Oral Dysfunction Science; Tohoku University Graduate School of Dentistry; Sendai Japan
- Global Centre of Excellence Program; International Research Centre for Molecular Science in Tooth and Bone Diseases; Tokyo Medical and Dental University; Tokyo Japan
| | - J Hatakeyama
- Functional Structure Section; Fukuoka Dental College; Fukuoka Japan
| | - K Igarashi
- Department of Oral Dysfunction Science; Tohoku University Graduate School of Dentistry; Sendai Japan
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48
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Mitani K. [Bone marrow failure syndrome (idiopathic hematopoietic disorders): progress in diagnosis and treatment. Topics: I. pathogenesis and pathophysiology of bone-marrow failure; 3. Myelodysplastic syndrome]. Nihon Naika Gakkai Zasshi 2012; 101:1898-905. [PMID: 22896992 DOI: 10.2169/naika.101.1898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Kinuko Mitani
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine, Japan
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49
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Arai H, Maki K, Tadokoro J, Handa T, Nakamura Y, Tsurumi S, Sasaki K, Mitani K. [CD20-positive peripheral T-cell lymphoma, not otherwise specified]. Rinsho Ketsueki 2012; 53:705-709. [PMID: 22975773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report a 69-year-old male with CD3-positive peripheral T-cell lymphoma, not otherwise specified (PTCL-nos). Interestingly, tumor cells slightly expressed CD20 as well. Southern analyses of the tumor cells showed rearrangement for only the T cell receptor gene but not the immunoglobulin genes. This patient achieved partial remission with a treatment regimen of THP-COP excluding prednisolone, but died of pneumonia. Although CD20-positive PTCL is rare, a review of the reported cases suggests that CD20-positive PTCL has a poor prognosis and that bone marrow infiltration of tumor cells results in a poorer prognosis in CD20-positive PTCL than in usual PTCL. By accumulating cases of this rare entity of lymphoma, we need to clarify the biological nature of the tumor cells and usefulness of rituximab combined with standard chemotherapy.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antigens, CD20
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/administration & dosage
- Doxorubicin/administration & dosage
- Doxorubicin/analogs & derivatives
- Fatal Outcome
- Flow Cytometry
- Gene Rearrangement
- Genetic Testing
- Humans
- Lymphoma, T-Cell, Peripheral/diagnosis
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/genetics
- Male
- Middle Aged
- Prednisolone/administration & dosage
- Receptors, Antigen, T-Cell/genetics
- Rituximab
- Vincristine/administration & dosage
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Affiliation(s)
- Honoka Arai
- Department of Hematology and Oncology, Dokkyo Medical University School of Medicine
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Oshima K, Takahashi W, Asano-Mori Y, Izutsu K, Takahashi T, Arai Y, Nakagawa Y, Usuki K, Kurokawa M, Suzuki K, Mitani K, Kanda Y. Intensive chemotherapy for elderly patients with acute myelogeneous leukemia: a propensity score analysis by the Japan Hematology and Oncology Clinical Study Group (J-HOCS). Ann Hematol 2012; 91:1533-9. [PMID: 22576311 DOI: 10.1007/s00277-012-1487-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 04/28/2012] [Indexed: 11/30/2022]
Abstract
The prognosis of acute myelogenous leukemia (AML) in the elderly patients is extremely poor. Although several previous studies have suggested that intensive chemotherapy is associated with a better prognosis, there may have been a selection bias. Therefore, we retrospectively evaluated the impact of intensive chemotherapy for AML in the elderly by stratifying patients according to a propensity score. Eighty-one AML patients aged 70 years or more were included in this study. Patients with acute promyelocytic leukemia were not included. A propensity score for the use of intensive chemotherapy was calculated from four factors at diagnosis. Forty-five patients received intensive chemotherapy, whereas 36 received low-dose or no chemotherapy. We stratified the patients into quartiles based on the propensity score. The numbers of patients in the first, second, third, and forth quartiles who received intensive chemotherapy were 5 of 21, 10 of 20, 12 of 20, and 18 of 20, respectively. A stratified log-rank test showed significantly better overall survival in the intensive chemotherapy group (P = 0.0088). Especially, in the combined second and third quartiles, which showed an equal tendency for intensive and non-intensive strategies; overall survival at 3 years was 37.5 % for the intensive chemotherapy group and 13.0 % for the non-intensive chemotherapy group (P = 0.0022). A conventional multivariate analysis confirmed that intensive chemotherapy was beneficial (hazard ratio 0.50, 95 % confidence interval 0.27-0.93, P = 0.028). In conclusion, intensive chemotherapy may prolong overall survival in elderly AML patients who are considered to be able to tolerate such treatment based on factors at diagnosis.
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Affiliation(s)
- Kumi Oshima
- Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
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