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Ueki H, Ogawa C, Goto H, Nishi M, Yamanaka J, Mochizuki S, Nishikawa T, Kumamoto T, Nishiuchi R, Kikuta A, Yamamoto S, Igarashi S, Sato A, Hori T, Saito AM, Watanabe T, Deguchi T, Manabe A, Horibe K, Toyoda H. TBI, etoposide, and cyclophosphamide conditioning for intermediate-risk relapsed childhood acute lymphoblastic leukemia. Int J Hematol 2024; 119:450-458. [PMID: 38267673 DOI: 10.1007/s12185-024-03710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND In children with intermediate-risk relapsed acute lymphoblastic leukemia (ALL), allogeneic hematopoietic stem cell transplantation (allo-HSCT) has markedly improved the outcome of patients with an unsatisfactory minimal residual disease (MRD) response. Total body irradiation (TBI), etoposide (ETP), and cyclophosphamide (CY) have been shown to be equivalent to or better than TBI + ETP for conditioning, so we hypothesized that even greater survival could be achieved due to recent advances in HSCT and supportive care. PROCEDURE We prospectively analyzed the efficacy and safety of allo-HSCT with a unified conditioning regimen of TBI + ETP + CY in children with intermediate-risk relapsed ALL, based on MRD in the bone marrow after induction, from the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) ALL-R08-II nationwide cohort (UMIN000002025). RESULTS Twenty patients with post-induction MRD ≥ 10-3 and two not evaluated for MRD underwent allo-HSCT. Engraftment was confirmed in all patients, and no transplantation-related mortality was observed. The 3-year event-free survival and overall survival rates after transplantation were 86.4% ± 7.3% and 95.5% ± 4.4%, respectively. CONCLUSION Allo-HSCT based on post-induction MRD with TBI + ETP + CY conditioning was feasible in Japanese children with intermediate-risk relapsed ALL.
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Affiliation(s)
- Hideaki Ueki
- Department of Pediatric Hematology/Oncology, Japanese Red Cross Narita Hospital, Narita, Japan
| | - Chitose Ogawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Masanori Nishi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Junko Yamanaka
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinji Mochizuki
- Department of Pediatrics, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takuro Nishikawa
- Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Tadashi Kumamoto
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Atsushi Kikuta
- Department of Pediatric Oncology, Fukushima Medical University Hospital, Fukushima, Japan
| | - Shohei Yamamoto
- Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan
| | - Shunji Igarashi
- Department of Pediatric Hematology/Oncology, Japanese Red Cross Narita Hospital, Narita, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Toshinori Hori
- Department of Pediatrics, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiko M Saito
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Tomoyuki Watanabe
- Department of Nutritional Science, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nisshin, Japan
| | - Takao Deguchi
- Division of Cancer Immunodiagnostics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University, Sapporo, Japan
| | - Keizo Horibe
- Clinical Research Center, NHO Nagoya Medical Center, Nagoya, Japan
| | - Hidemi Toyoda
- Department of Pediatrics, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
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2
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Okamoto K, Nishio H, Motoki T, Jogamoto T, Aibara K, Kondo Y, Kawamura K, Konishi Y, Tokorodani C, Nishiuchi R, Eguchi M. Changes in the Incidence of Infantile Spinal Muscular Atrophy in Shikoku, Japan between 2011 and 2020. Int J Neonatal Screen 2022; 8:ijns8040052. [PMID: 36278622 PMCID: PMC9590054 DOI: 10.3390/ijns8040052] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder. Al-though there was no cure for SMA, newly developed therapeutic drugs (nusinersen, onasemnogene abeparvovec, and risdiplam) have been proven effective for the improvement of motor function and prevention of respiratory insufficiency of infants with SMA. Nusinersen was introduced in Japan in 2017 and onasemnogene abeparvovec in 2020. We hypothesized that the introduction of these drugs might influence the incidence of SMA (more precisely, increase the diagnosis rate of SMA) in Japan. To test this hypothesis, we conducted a second epidemiological study of infantile SMA using questionnaires in Shikoku, Japan between October 2021 and February 2022. The incidence of infantile SMA during the period 2016-2020 was 7.08 (95% confidence interval [CI] 2.45-11.71) per 100,000 live births. According to our previous epidemiological study, the incidence of infantile SMA during 2011-2015 was 2.70 (95% CI 0.05-5.35) per 100,000 live births. The increased incidence of infantile SMA suggests that the widespread news in Japan regarding the introduction of therapeutic agents, nusinersen and onasemnogene abeparvovec, raised clinicians' awareness about SMA, leading to increased and earlier diagnosis of SMA in Shikoku.
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Affiliation(s)
- Kentaro Okamoto
- Department of Pediatrics, Ehime Prefectural Imabari Hospital, 4-5-5 Ishi-cho, Imabari 794-0006, Japan
- Correspondence: ; Tel.: +81-898-32-7111
| | - Hisahide Nishio
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe 651-2180, Japan
- Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Takahiro Motoki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan
| | - Toshihiro Jogamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan
| | - Kaori Aibara
- Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan
- Department of Pediatrics, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama 790-8524, Japan
| | - Yoichi Kondo
- Department of Pediatrics, Matsuyama Red Cross Hospital, 1 Bunkyo-cho, Matsuyama 790-8524, Japan
| | - Kentaro Kawamura
- Toseikai Healthcare Corporation, Life-Long Care Clinic for Disabled People, 14-3-10 Maeda 4 jo, Teine-ku, Sapporo 006-0814, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, 1750-1 Ikedo, Miki-cho, Kita 761-0701, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, 2125-1 Ike, Kochi 781-8555, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, 2125-1 Ike, Kochi 781-8555, Japan
| | - Mariko Eguchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan
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3
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Nakajima K, Kubota H, Kato I, Isobe K, Ueno H, Kozuki K, Tanaka K, Kawabata N, Mikami T, Tamefusa K, Nishiuchi R, Saida S, Umeda K, Hiramatsu H, Adachi S, Takita J. PAX5 alterations in an infant case of KMT2A-rearranged leukemia with lineage switch. Cancer Sci 2022; 113:2472-2476. [PMID: 35467057 PMCID: PMC9277256 DOI: 10.1111/cas.15380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022] Open
Abstract
Lineage switch is a rare event at leukemic relapse. While mostly known to occur in KMT2A-rearranged infant leukemia, the underlying mechanism is yet to be depicted. This case report describes a female infant who achieved remission of KMT2A-MLLT3-rearranged acute monocytic leukemia, but six months thereafter, relapsed as KMT2A-MLLT3-rearranged acute lymphocytic leukemia. Whole exome sequencing of the bone marrow obtained pre-post lineage switch revealed two somatic mutations of PAX5 in the relapse sample. These two PAX5 alterations were suggested to be loss of function, thus to have played the driver role in the lineage switch from AML to ALL.
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Affiliation(s)
- Koji Nakajima
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirohito Kubota
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Itaru Kato
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kiyotaka Isobe
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroo Ueno
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kagehiro Kozuki
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kuniaki Tanaka
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoko Kawabata
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Mikami
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kosuke Tamefusa
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Satoshi Saida
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsutsugu Umeda
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidefumi Hiramatsu
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Souichi Adachi
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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4
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Tamefusa K, Sunada S, Nakata Y, Agawa H, Nishiuchi R. Delayed therapy initiation for a case with congenital leukemia with transient spontaneous regression. Pediatr Hematol Oncol 2022; 39:286-290. [PMID: 34369838 DOI: 10.1080/08880018.2021.1955059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kosuke Tamefusa
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan.,Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Satoshi Sunada
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Yusei Nakata
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Hirokazu Agawa
- Department of Dermatology, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
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Ishida H, Iguchi A, Aoe M, Nishiuchi R, Matsubara T, Keino D, Sanada M, Shimada A. Panel-based next-generation sequencing facilitates the characterization of childhood acute myeloid leukemia in clinical settings. Biomed Rep 2020; 13:46. [PMID: 32934818 PMCID: PMC7469563 DOI: 10.3892/br.2020.1353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022] Open
Abstract
Acute myeloid leukemia (AML) accounts for ~20% of pediatric leukemia cases. The prognosis of pediatric AML has been improved in recent decades, but it trails that of most other types of pediatric cancer, with mortality rates of 30-40%. Consequently, newer more targeted drugs are required for incorporation into treatment plans. These newer drugs selectively target AML cells with specific gene alterations. However, there are significant differences in genetic alterations between adult and pediatric patients with AML. In the present study, inexpensive and rapid next-generation sequencing (NGS) of >150 cancer-related genes was performed for matched diagnostic, remission and relapse (if any) samples from 27 pediatric patients with AML. In this analysis, seven genes were recurrently mutated. KRAS was mutated in seven patients, NRAS was mutated in three patients, and KIT, GATA1, WT1, PTPN11, JAK3 and FLT3 were each mutated in two patients. Among patients with relapsed AML, six harbored KRAS mutations at diagnosis; however, four of these patients lost these mutations at relapse. Additionally, two genetic alterations (FLT3-ITD and TP53 alterations) were detected among patients who eventually relapsed, and these mutations are reported to be adverse prognostic factors for adult patients with AML. This panel-based, targeted sequencing approach may be useful in determining the genetic background of pediatric AML and improving the prediction of treatment response and detection of potentially targetable gene alterations. RAS pathway mutations were highly unstable at relapse; therefore, these mutations should be chosen as a target with caution. Incorporating this panel-based NGS approach into the clinical setting may allow for a patient-oriented strategy of precision treatment for childhood AML.
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Affiliation(s)
- Hisashi Ishida
- Department of Pediatrics/Pediatric Hematology and Oncology, Okayama University Hospital, Okayama 700-8558, Japan
| | - Akihiro Iguchi
- Department of Pediatrics, Hokkaido University Hospital, Sapporo, Hokkaido 060-8648, Japan
| | - Michinori Aoe
- Division of Medical Support, Okayama University Hospital, Okayama 700-8558, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi 781-8555, Japan
| | - Takehiro Matsubara
- Division of Biobank, Center for Comprehensive Genomic Medicine, Okayama University Hospital, Okayama 700-8558, Japan
| | - Dai Keino
- Department of Pediatrics, St. Marianna University School of Medicine Hospital, Kawasaki, Kanagawa 216-8511, Japan
| | - Masashi Sanada
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Aichi 460-0001, Japan
| | - Akira Shimada
- Department of Pediatrics/Pediatric Hematology and Oncology, Okayama University Hospital, Okayama 700-8558, Japan
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6
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Okamoto K, Motoki T, Saito I, Urate R, Aibara K, Jogamoto T, Fukuda M, Wakamoto H, Maniwa S, Kondo Y, Toda Y, Goji A, Mori T, Soga T, Konishi Y, Nagai S, Takami Y, Tokorodani C, Nishiuchi R, Usui D, Ando R, Tada S, Yamanishi Y, Nagai M, Arakawa R, Saito K, Nishio H, Ishii E, Eguchi M. Survey of patients with spinal muscular atrophy on the island of Shikoku, Japan. Brain Dev 2020; 42:594-602. [PMID: 32505480 DOI: 10.1016/j.braindev.2020.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/22/2020] [Accepted: 05/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spinal muscular atrophy (SMA) is an inherited neuromuscular disorder associated with spinal motor neuron loss and characterized by generalized muscle weakness. Only a few reports exist on SMA epidemiology in Japan. Additionally, nusinersen recently became available as a treatment for this condition. We estimated the prevalence of each type of SMA on Shikoku, Japan's fourth-largest major island. METHODS We sent a questionnaire to all 131 hospitals in Shikoku that have pediatrics or neurology departments from March to September 2019, asking whether each hospital had SMA patients at that time. If so, we sent a second questionnaire to obtain more detailed information on the clinical data and treatment of each patient. RESULTS A total of 117 hospitals (89.3%) responded to our first questionnaire, and 21 SMA patients were reported, 16 of whom had homozygous deletion of SMN1. Of the 21, nine had SMA type 1, five were type 2, five were type 3, one was type 4, and one was unidentified. The estimated prevalence for all instances of SMA and 5q-SMA was 0.56 and 0.43 per 100,000 people, respectively. Thirteen patients had received nusinersen therapy. Its outcomes varied from no obvious effects and being unable to sit to being able to sit independently. CONCLUSION Our data showed the prevalence of SMA types 2 and 3 was relatively low on Shikoku compared with previous reports from other countries, suggesting delayed diagnosis may affect the results. Remaining motor function may be one predicting factor. Greater awareness of SMA among clinicians and patients seems necessary for more accurate epidemiological studies.
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Affiliation(s)
- Kentaro Okamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Pediatrics, Ehime Prefectural Imabari Hospital, Ehime, Japan.
| | - Takahiro Motoki
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Risako Urate
- Faculty of Medicine, Ehime University, Ehime, Japan
| | - Kaori Aibara
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Toshihiro Jogamoto
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Mitsumasa Fukuda
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | - Hiroyuki Wakamoto
- Department of Pediatrics, Ehime Rehabilitation Center For Children, Ehime, Japan
| | - Satoshi Maniwa
- Department of Pediatrics, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Yoichi Kondo
- Department of Pediatrics, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Yoshihiro Toda
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Aya Goji
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Tatsuo Mori
- Department of Pediatrics, Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Tomohiro Soga
- Department of Anesthesiology, Tokushima University Hospital, Tokushima, Japan
| | - Yukihiko Konishi
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Shigehiro Nagai
- Department of Child Neurology, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Yoko Takami
- Department of Pediatrics, Takamatsu Red Cross Hospital, Kagawa, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Daisuke Usui
- Department of Pediatrics, Tano Hospital, Kochi, Japan
| | - Rina Ando
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Satoshi Tada
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Yuki Yamanishi
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Masahiro Nagai
- Department of Clinical Pharmacology and Therapeutics, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Reiko Arakawa
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Kayoko Saito
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisahide Nishio
- Department of Occupational Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Hyogo, Japan; Department of Community Medicine and Social Healthcare Science, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Eiichi Ishii
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan; Imabari City Medical Association Hospital, Ehime, Japan
| | - Mariko Eguchi
- Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan
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7
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Tozawa Y, Abdrabou SSMA, Nogawa-Chida N, Nishiuchi R, Ishida T, Suzuki Y, Sano H, Kobayashi R, Kishimoto K, Ohara O, Imai K, Naruto T, Kobayashi K, Ariga T, Yamada M. A deep intronic mutation of c.1166-285 T > G in SLC46A1 is shared by four unrelated Japanese patients with hereditary folate malabsorption (HFM). Clin Immunol 2019; 208:108256. [DOI: 10.1016/j.clim.2019.108256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023]
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8
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Imai-Okazaki A, Kishita Y, Kohda M, Yatsuka Y, Hirata T, Mizuno Y, Harashima H, Hirono K, Ichida F, Noguchi A, Yoshida M, Tokorodani C, Nishiuchi R, Takeda A, Nakaya A, Sakata Y, Murayama K, Ohtake A, Okazaki Y. Barth Syndrome: Different Approaches to Diagnosis. J Pediatr 2018; 193:256-260. [PMID: 29249525 DOI: 10.1016/j.jpeds.2017.09.075] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/18/2017] [Accepted: 09/27/2017] [Indexed: 12/28/2022]
Abstract
The diagnosis of Barth syndrome is challenging owing to the wide phenotypic spectrum with allelic heterogeneity. Here we report 3 cases of Barth syndrome with phenotypic and allelic heterogeneity that were diagnosed by different approaches, including whole exome sequencing and final confirmation by reverse-transcription polymease chain reaction.
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Affiliation(s)
- Atsuko Imai-Okazaki
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan; Division of Genomic Medicine Research, Medical Genomics Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshihito Kishita
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Masakazu Kohda
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yukiko Yatsuka
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoko Hirata
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yosuke Mizuno
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Hiroko Harashima
- Department of Pediatrics, Saitama Medical University, Saitama, Japan
| | - Keiichi Hirono
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Fukiko Ichida
- Department of Pediatrics, Graduate School of Medicine, University of Toyama, Toyama, Japan
| | - Atsuko Noguchi
- Department of Pediatrics, Graduate School of Medicine, Akita University, Akita, Japan
| | - Masayuki Yoshida
- Department of Molecular Pathology and Tumor Pathology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Atsuhito Takeda
- Department of Pediatrics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Akihiro Nakaya
- Department of Genome Informatics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kei Murayama
- Department of Metabolism, Chiba Children's Hospital, Chiba, Japan
| | - Akira Ohtake
- Department of Pediatrics, Saitama Medical University, Saitama, Japan; Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - Yasushi Okazaki
- Division of Functional Genomics and Systems Medicine, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan; Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan.
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9
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Kanamitsu K, Shimada A, Nishiuchi R, Shigemura T, Nakazawa Y, Koike K, Kodama Y, Shinkoda Y, Kawano Y, Yasui K, Sasaki K, Kajiwara R, Tsukahara H, Manabe A. Pediatric intestinal Behçet disease complicated by myeloid malignancies. Int J Hematol 2016; 105:377-382. [DOI: 10.1007/s12185-016-2127-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 11/01/2016] [Accepted: 11/02/2016] [Indexed: 02/04/2023]
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10
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Maruyama H, Nakata Y, Kanazawa A, Watanabe H, Shigemitsu Y, Iwasaki Y, Tokorodani C, Miyazawa M, Nishiuchi R, Kikkawa K. Ventriculoperitoneal shunt outcomes among infants. Acta Med Okayama 2016; 69:87-93. [PMID: 25899630 DOI: 10.18926/amo/53337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Ventriculoperitoneal shunts (VPSs) are used for the treatment of hydrocephalus. Here we analyzed the outcomes of VPS placements in 24 infants to determine the risk factors for shunt failure. The infants had undergone the initial VPS operation in our hospital between March 2005 and December 2013. They were observed until the end of January 2014. We obtained Kaplan-Meier curves and performed a multivariate Cox regression analysis of shunt failure. Of the 24 cases, the median (range) values for gestational age, birth weight, and birth head circumference (HC) were 37 (27-39) wks, 2,736 (686-3,788) g, and 35.3 (23.0-45.3) cm, respectively. The total number of shunt procedures was 45. Shunt failure rates were 0.51/shunt and 0.0053/shunt/year. Shunt infection rates were 0.13/shunt and 0.0014/shunt/year. The Kaplan-Meier analysis revealed an increased risk for shunt failure in infants <1 month old or in the HC >90%tile. The Cox regression analysis yielded hazard ratios (HRs) of 2.93(95% confidence interval (CI), 0.96-10.95, p=0.059) for age <1 month, and 4.46 (95%CI:1.20-28.91, p=0.023) for the HC >90%tile. The multivariate Cox regression analysis showed adjusted HRs of 17.56 (95%CI:2.69-202.8, p=0.001) for age <1 month, and 2.95 (95%CI:0.52-24.84, p=0.228) for the HC >90%tile. Our findings thus revealed that the risk factors for shunt failure in infants include age <1 month at the initial VPS placement.
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Affiliation(s)
- Hidehiko Maruyama
- Department of Pediatrics, Kochi Health Sciences Center, Kochi 781-8555,
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11
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Kanamitsu K, Kakimoto H, Shimada A, Nakata Y, Ochi H, Watanabe H, Iwasaki Y, Tokorodani C, Kanazawa A, Maruyama H, Miyazawa M, Nishiuchi R, Kikkawa K. Verification of risk scores to predict i.v. immunoglobulin resistance in incomplete Kawasaki disease. Pediatr Int 2016; 58:146-51. [PMID: 26190225 DOI: 10.1111/ped.12755] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/29/2015] [Accepted: 07/10/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND A recent study indicated the efficacy of the addition of prednisolone to i.v. immunoglobulin (IVIG) as initial treatment in patients with higher risk of IVIG resistance. Several different risk scores for predicting IVIG resistance have been proposed, mainly based on typical Kawasaki disease (KD) patients. We investigated the utility of the risk scores to predict IVIG resistance in incomplete KD. METHODS Clinical records of incomplete KD patients who received a single dose of IVIG between 2005 and 2012 at Kochi Health Sciences Center were retrospectively reviewed. Patients were classified into an IVIG-responsive group and an IVIG-resistant group. The Kobayashi, Egami, and Sano risk scores were calculated for each patient and the proportion of high-risk patients was compared between the two groups for each risk score. RESULTS For 51 incomplete KD patients, Kobayashi (66.7% vs 47.6%, P = 0.253), Egami (55.6% vs 38.1%, P = 0.274), and Sano (57.1% vs 10.8%, P = 0.068) risk scores identified a higher proportion of high-risk patients in the IVIG-resistant group compared with the IVIG-responsive group, but significant difference was not observed. Sano risk score had the highest OR (6.19; 95%CI: 1.00-38.26). CONCLUSIONS The proportion of patients identified as being at high risk for IVIG resistance using the Kobayashi, Egami, and Sano risk scores, respectively, was not significantly different between the IVIG-responsive group and the IVIG-resistant group for incomplete KD. Among the three risk scores, the Sano risk score has the best ability to predict IVIG resistance in incomplete KD.
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Affiliation(s)
- Kiichiro Kanamitsu
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan.,Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Hisako Kakimoto
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan.,Cardiovascular Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Akira Shimada
- Department of Pediatrics, Okayama University Hospital, Okayama, Japan
| | - Yusei Nakata
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Hiroaki Ochi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan.,Department of Pediatrics, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Hirokazu Watanabe
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Yuka Iwasaki
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Chiho Tokorodani
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Akane Kanazawa
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Hidehiko Maruyama
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Mari Miyazawa
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Kiyoshi Kikkawa
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
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12
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Muraoka M, Washio K, Kanamitu K, Kanazawa Y, Ishida T, Miyamura T, Chayama K, Nishiuchi R, Oda M, Shimada A. Persistent clonal chromosomal abnormalities in a chronic myeloid leukemia patient. Pediatr Int 2016; 58:53-6. [PMID: 26542480 DOI: 10.1111/ped.12739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 05/29/2015] [Accepted: 06/10/2015] [Indexed: 11/30/2022]
Abstract
Clonal cytogenetic abnormalities (CCA) in Philadelphia chromosome (Ph)-negative cells have been reported in a small population of adult chronic myelogenous leukemia (CML) patients during the clinical course, but CCA in pediatric CML patients are rarely reported. We herein report the case of an 8-year-old boy from the onset of CML. Although he had relapse after unrelated bone marrow transplantation when 9 years old, he has since been in complete molecular response on imatinib mesylate treatment. Surprisingly, various CCA have been observed in this patient, including several reciprocal chromosomal translocations in Ph-negative cells for >12 years. Although dysplasia in the bone marrow cells was identified, no overt transformation to myelodysplastic syndrome or acute myeloid leukemia has been observed. The cause of the CCA remains unknown in this patient, and careful observation is required.
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Affiliation(s)
- Michiko Muraoka
- Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kana Washio
- Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Kiichiro Kanamitu
- Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Yui Kanazawa
- Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Toshiaki Ishida
- Department of Hematology/Oncology, Hyogo Children's Hospital, Kobe, Japan
| | - Takako Miyamura
- Department of Pediatrics, Osaka University Hospital, Osaka, Japan
| | - Kosuke Chayama
- Department of Pediatrics, Toyonaka Municipal Hospital, Osaka, Japan
| | - Ritsuo Nishiuchi
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan
| | - Megumi Oda
- Department of Pediatric Hematology and Oncology, Okayama University Hospital, Okayama, Japan
| | - Akira Shimada
- Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan
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13
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Miyahara H, Maruyama H, Kanazawa A, Iwasaki Y, Shigemitsu Y, Watanabe H, Tokorodani C, Miyazawa M, Nakata Y, Nishiuchi R, Kikkawa K. Changes in the features of invasive pneumococcal disease after introduction of the seven-valent pneumococcal conjugate vaccine in a regional core hospital of Kochi, Japan. Acta Med Okayama 2015; 69:255-60. [PMID: 26289917 DOI: 10.18926/amo/53562] [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: 11/03/2022]
Abstract
Since the introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) in 2007, invasive pneumococcal disease has declined, but the incidence of Streptococcus pneumoniae serotype 19A has risen worldwide. The present study examined changes in the features of invasive pneumococcal disease since the introduction of the PCV7 in Kochi, Japan. Pediatric cases of invasive pneumococcal disease were investigated before and after vaccine introduction (January 2008 to December 2013). Cases of invasive pneumococcal disease tended to decrease after PCV7 introduction. In addition, before introduction of the vaccine, most serotypes causing invasive pneumococcal disease were those included in the vaccine. However, after the introduction, we found cases infected by serotypes not covered by vaccine. Penicillin-resistant S. pneumoniae was the predominant serotype causing invasive pneumococcal disease before introduction of the PCV7, and the susceptibility of this serotype to antibiotics improved after vaccine introduction. Serotype isolates identified after vaccine introduction were also relatively susceptible to antibiotic therapy, but decreased susceptibility is expected.
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Affiliation(s)
- Hiroyuki Miyahara
- Department of Pediatrics, Kochi Health Sciences Center, Kochi 781-8555, Japan
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14
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Umeda K, Shibata H, Saida S, Hiramatsu H, Arakawa Y, Mizowaki T, Nishiuchi R, Adachi S, Heike T, Watanabe KI. Long-term efficacy of bevacizumab and irinotecan in recurrent pediatric glioblastoma. Pediatr Int 2015; 57:169-71. [PMID: 25711258 DOI: 10.1111/ped.12414] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 04/15/2014] [Accepted: 05/13/2014] [Indexed: 11/30/2022]
Abstract
A 5-year-old boy with glioblastoma relapsed soon after postoperative irradiation in combination with temozolomide. Second-line chemotherapy was also ineffective; therefore, the bevacizumab and irinotecan were given after a third gross-total resection of the tumor. Treatment was interrupted for 1 month due to development of posterior reversible encephalopathy syndrome, but was re-initiated at a lower dose of bevacizumab with prolonged intervals between treatments. The patient was alive and disease free 2 years after initial diagnosis. Bevacizumab and irinotecan are a promising regimen for pediatric cases of recurrent glioblastoma after gross-total resection, although the optimal treatment schedule must be determined on a patient-by-patient basis.
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Affiliation(s)
- Katsutsugu Umeda
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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15
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Aoe M, Shimada A, Muraoka M, Washio K, Nakamura Y, Takahashi T, Imada M, Watanabe T, Okada K, Nishiuchi R, Miyamura T, Chayama K, Shibakura M, Oda M, Morishima T. ABL kinase mutation and relapse in 4 pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia cases. Int J Hematol 2014; 99:609-15. [PMID: 24652384 DOI: 10.1007/s12185-014-1565-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 03/01/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
The tyrosine kinase inhibitor (TKI) imatinib mesylate (IM) revolutionized the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-ALL), which had showed poor prognosis before the dawn of IM treatment. However, if Ph-ALL patients showed IM resistance due to ABL kinase mutation, second-generation TKI, dasatinib or nilotinib, was recommended. We treated 4 pediatric Ph-ALL patients with both IM and bone marrow transplantation (BMT); however, 3 relapsed. We retrospectively examined the existence of ABL kinase mutation using PCR and direct sequencing methods, but there was no such mutation in all 4 diagnostic samples. Interestingly, two relapsed samples from patients who were not treated with IM before relapse did not show ABL kinase mutation and IM was still effective even after relapse. On the other hand, one patient who showed resistance to 3 TKI acquired dual ABL kinase mutations, F359C at the IM-resistant phase and F317I at the dasatinib-resistant phase, simultaneously. In summary, Ph-ALL patients relapsed with or without ABL kinase mutation. Furthermore, ABL kinase mutation was only found after IM treatment, so an IM-resistant clone might have been selected during the IM treatment and intensive chemotherapy. The appropriate combination of TKI and BMT must be discussed to cure Ph-ALL patients.
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Affiliation(s)
- Michinori Aoe
- Division of Medical Support, Okayama University Hospital, Okayama, Japan
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16
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Harada D, Nishiuchi R, Iwasaki Y, Watanabe H, Tokorodani C, Kanazawa A, Kiguchi H, Gotoh SI, Miyazawa M, Nakata Y, Morishima T, Kikkawa K. Reliability of a rapid test for the clinical diagnosis of influenza A/H1N1 2009. ACTA ACUST UNITED AC 2012; 44:776-81. [PMID: 22803629 DOI: 10.3109/00365548.2012.686670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The rapid diagnosis of a pandemic influenza A/H1N1 2009 (H1N1pdm) virus infection is required in ambulatory care settings, since early identification can prevent further transmission. However, the sensitivity of rapid influenza diagnostic tests (RIDTs) is still questionable, and specific indicators for H1N1pdm and/or false-negative results by RIDTs have not been clearly determined. METHODS From June to December 2009, nasal swabs from 324 patients at Kochi Health Science Center were used for the diagnosis of infection by RIDT and reverse transcription polymerase chain reaction. RESULTS The sensitivity of the RIDT was determined to be 80.0% and the specificity 97.1%. Multivariate analysis revealed that the frequencies of contagiousness and headache were significant in patients with H1N1pdm infection, in addition to common symptoms of respiratory infection. These data indicated that the H1N1pdm virus had high infectivity and was harmful to the endocranial environment. In the false-negative group, the time interval between onset and consultation was 5.5 ± 6.5 h (median ± interquartile range), which was significantly shorter than the 11.5 ± 7.0 h in the true-positive group. The sensitivity of the RIDT was significantly low during the time-period within 3 h from onset (56.0%); however after 4 h the sensitivity was determined to be >80%. These data indicated that the concentration of the virus in nasal swabs was elevated over the course of the disease. CONCLUSIONS We have demonstrated that the RIDT is reliable for the diagnosis of H1N1pdm infection. Taking into consideration the time interval between onset and consultation and other features of H1N1pdm, such as contagiousness and headache, it may be necessary to re-test RIDT-negative cases later.
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Affiliation(s)
- Daisuke Harada
- Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan.
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17
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Yao Q, Nishiuchi R, Kitamura T, Kersey JH. Human leukemias with mutated FLT3 kinase are synergistically sensitive to FLT3 and Hsp90 inhibitors: the key role of the STAT5 signal transduction pathway. Leukemia 2005; 19:1605-12. [PMID: 16034464 DOI: 10.1038/sj.leu.2403881] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
17-allylamino-17-demethoxygeldanamycin (17-AAG), an inhibitor of the molecular chaperone heat shock protein 90, results in cell type-specific inhibition of proliferation of leukemic cells. GTP14564 is a tyrosine kinase inhibitor actively against FLT3. The current study evaluated the single and combined effects of 17-AAG and GTP14564, and the role of FLT3 in their inhibitory effects. The importance of FLT3 mutations was demonstrated using small interfering RNA (siRNA) targeted to FLT3. Similar to FLT3 siRNA, GTP14564 inhibited FLT3 internal tandem duplication (ITD) cells (MV4;11) and FLT3 amplified wild-type cells (SEMK2-M1), but not wild-type FLT3 cells (RS4;11). However, when RS4;11 cells were stimulated with FLT3-ligand, phosphorylation of STAT5 and GTP14564 inhibition were observed. Responses to GTP14564 in all cell types were directly related to the level of STAT5 phosphorylation in the cells. We observed synergistic effects of combined 17-AAG and GTP14564 in cell lines with FLT3-ITD and amplified wild-type FLT3. Combined treatment with 17-AAG and GTP14564 reduced the levels of p-FLT3 and p-STAT5, enhanced G0/G1 arrest and apoptosis in FLT3-ITD and amplified wild-type FLT3. The combination of 17-AAG with FLT3 kinase inhibitors can enhance targeted therapy in leukemias with FLT3 mutations, such as MLL fusion gene leukemias.
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Affiliation(s)
- Q Yao
- The Cancer Center, University of Minnesota, Minneapolis, MN, USA
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18
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Takemoto C, Nishiuchi R, Endo C, Oda M, Seino Y. Comparison of two methods for evaluating bone marrow metastasis of neuroblastoma: Reverse transcription-polymerase chain reaction for tyrosine hydroxylase and magnetic resonance imaging. Pediatr Int 2004; 46:387-93. [PMID: 15310300 DOI: 10.1111/j.1442-200x.2004.01921.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The presence of bone marrow (BM) metastasis and circulating tumor cells in patients with neuroblastoma is a significant prognostic factor at diagnosis and might antedate detection of a relapse by other diagnostic studies. In this study, the clinical value of reverse transcription-polymerase chain reaction (RT-PCR) to amplify mRNA for tyrosine hydroxylase (TH) and magnetic resonance imaging (MRI) during the clinical course of patients with advanced neuroblastoma, was evaluated. METHODS Four patients with Stage 1, 4 or 4S neuroblastoma, were studied. BM and peripheral blood (PB), including peripheral blood stem cell (PBSC), samples were examined for TH mRNA using RT-PCR. Concurrently, MRI detection of BM metastasis was used. RESULTS In all cases, except one that had no evidence of BM invasion, TH mRNA in BM and PB at diagnosis were positive, and TH mRNA at diagnosis disappeared after chemotherapy. In two cases, although involvement in the neurocentrum BM was detected by MRI, TH mRNA in the iliac crest BM was negative. The pathological area still remained on MRI after intensive therapy. CONCLUSION RT-PCR for TH mRNA might be the most sensitive method for the detection of occult neuroblastoma cells in BM and PB. However, because invasion of the BM by neuroblastoma may have a focal distribution, sampling errors can occur. Therefore, not only RT-PCR but also MRI, need to be used to rule out marrow involvement, especially at diagnosis and BM relapse.
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Affiliation(s)
- Chikayo Takemoto
- Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
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19
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Koyama M, Oka T, Ouchida M, Nakatani Y, Nishiuchi R, Yoshino T, Hayashi K, Akagi T, Seino Y. Activated proliferation of B-cell lymphomas/leukemias with the SHP1 gene silencing by aberrant CpG methylation. J Transl Med 2003; 83:1849-58. [PMID: 14691303 DOI: 10.1097/01.lab.0000106503.65258.2b] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Previously we showed reduced protein and mRNA expression of the SHP1 gene in lymphoma/leukemia cell lines and patient specimens by Northern blot, RT-PCR, Western blot, and immunohistochemical analyses. In this study, aberrant methylation in the SHP1 gene promoter was detected in many B-cell leukemia/lymphoma cell lines as well as in patient specimens, including diffuse large B-cell lymphoma (methylation frequency 93%), MALT lymphoma (82%), mantle cell lymphoma (75%), plasmacytoma (100%) and follicular lymphoma (96%) by methylation-specific PCR, bisulfite sequencing, and restriction enzyme-mediated PCR analyses. The methylation frequency was significantly higher in high-grade MALT lymphoma cases (100%) than in low-grade MALT lymphoma cases (70%), which correlated well with the frequency of no expression of SHP1 protein in high-grade (80%) and low-grade MALT lymphoma (54%). It suggests that the SHP1 gene silencing with aberrant CpG methylation relates to the lymphoma progression. SHP1 protein expression was recovered in B-cell lines after the treatment of the demethylating reagent: 5-aza-2'-deoxycytidine. Transfection of the intact SHP1 gene to the hematopoietic cultured cells, which show no expression of the SHP1 gene, induced growth inhibition, indicating that gene silencing of the SHP1 gene by aberrant methylation plays an important role to get the growth advantage of the malignant lymphoma/leukemia cells. The extraordinarily high frequency (75 to 100%) of CpG methylation of the SHP1 gene in B-cell lymphoma/leukemia patient specimens indicates that the SHP1 gene silencing is one of the critical events to the onset of malignant lymphomas/leukemias as well as important implications for the diagnostic or prognostic markers and the target of gene therapy. These data support the possibility that the SHP1 gene is one of the tumor suppressor genes.
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MESH Headings
- Base Sequence
- Blotting, Southern
- Blotting, Western
- Cell Division
- Cell Line, Tumor
- CpG Islands/genetics
- DNA Methylation
- DNA, Neoplasm/analysis
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic
- Gene Silencing
- Humans
- Intracellular Signaling Peptides and Proteins
- Leukemia, B-Cell/enzymology
- Leukemia, B-Cell/genetics
- Lymphoma, B-Cell/enzymology
- Lymphoma, B-Cell/genetics
- Molecular Sequence Data
- Protein Tyrosine Phosphatase, Non-Receptor Type 6
- Protein Tyrosine Phosphatases/genetics
- Protein Tyrosine Phosphatases/metabolism
- RNA, Messenger/metabolism
- RNA, Neoplasm/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Sequence Analysis, DNA
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Affiliation(s)
- Maho Koyama
- Department of Pediatrics, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan
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20
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Abstract
Identification of the targets of mixed lineage leukemia (MLL) fusion genes will assist in understanding the biology of MLL fusion gene leukemias and in development of better therapies. Numerous studies have implicated HOXA9 as one of the possible targets of MLL fusion proteins. To determine if HOXA9 was required for leukemia development by MLL fusion genes, we compared the effects of the Mll-AF9 knock-in mutation in mice in the presence or absence of Hoxa9. Both groups of mice showed myeloid expansion at 8 weeks and then developed myeloid leukemia with a similar incidence and time course. The leukemia in the mice lacking Hoxa9 generally displayed a more immature myeloid phenotype than that in the mice that were wild-type for Hoxa9. Gene expression profiling revealed that expression of Mll-AF9 led to overexpression of Hoxa5, Hoxa6, Hoxa7, Hoxa9, and Hoxa10. Thus, genes of the Hox-a cluster are important in defining the phenotype but not the incidence of Mll-AF9 leukemia. These results demonstrate that the Mll-AF9 fusion gene disrupts the expression of several Hox genes, none of which as a single gene is likely to be necessary for development of leukemia. Instead, we propose that the "Hox code" minimally defined by the Hoxa5-a9 cluster is central to MLL leukemogenesis.
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Affiliation(s)
- Ashish R Kumar
- Department of Pediatrics, University of Minnesota, Minneapolis, USA
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21
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Yao Q, Nishiuchi R, Li Q, Kumar AR, Hudson WA, Kersey JH. FLT3 expressing leukemias are selectively sensitive to inhibitors of the molecular chaperone heat shock protein 90 through destabilization of signal transduction-associated kinases. Clin Cancer Res 2003; 9:4483-93. [PMID: 14555522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
PURPOSE We conducted studies to evaluate the hypothesis that FLT3 is a client of heat shock protein (Hsp) 90 and inhibitors of Hsp90 may be useful for therapy of leukemia. EXPERIMENTAL DESIGN The effects of the Hsp90-inhibitor 17-allylamino-17-demethoxygeldanamycin (17-AAG) on cell growth, expression of signal transduction kinases, apoptosis, FLT3 phosphorylation and interaction with Hsp90 was determined in FLT3(+) human leukemias. RESULTS We found that FLT3 is included in a multiprotein complex that includes Hsp90 and p23. 17-AAG inhibited FLT3 phosphorylation and interaction with Hsp90. FLT3(+) leukemias were significantly more sensitive to the Hsp90 inhibitors 17-AAG and Herbimycin A in cell growth assays than FLT3-negative leukemias. Cells transfected with FLT3 became sensitive to 17-AAG. Cell cycle inhibition and apoptosis were induced by 17-AAG. Cells with constitutive expression of FLT3, as a result of internal tandem duplication, were the most sensitive; cells with wild-type FLT3 were intermediate in sensitivity, and FLT3-negative cells were the least sensitive. 17-AAG resulted in reduced cellular mass of FLT3, RAF, and AKT. The mass of another Hsp, Hsp70, was increased. The expression level of MLL-AF4 fusion protein was not reduced by 17-AAG in human leukemia cells. CONCLUSIONS FLT3(+) leukemias are sensitive to 17-AAG and Herbimycin A. 17-AAG inhibits leukemia cells with either FLT3-internal tandem duplication or wild-type FLT3, in part through destabilization of client kinases including FLT3, RAF, and AKT. 17-AAG is potentially useful for therapy of FLT3-expressing leukemias, including the mixed lineage leukemia fusion gene leukemias.
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Affiliation(s)
- Qing Yao
- University of Minnesota Cancer Center, Minneapolis, Minnesota 55455, USA
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22
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Abstract
BACKGROUND It has recently been shown that t (12;21) (p13;q 22) is the most common molecular genetic abnormality in childhood acute lymphoblastic leukemia (ALL). We have analyzed this translocation in an attempt to evaluate its incidence and to monitor minimal residual disease (MRD) with t (12; 21) rearrangement by detection of TEL-AML1 transcript in patients with childhood ALL. PROCEDURE All cryopreserved bone marrow samples were analyzed using a nested reverse transcription-polymerase chain reaction (RT-PCR) method. TEL-AML1 transcripts were searched for in 34 ALL patients, including six in relapse consecutively diagnosed at our institution between 1991 and 1997. RESULTS TEL-AML1 transcripts were found in five (19%) of 27 patients with B precursor ALL. The patients with BCR-ABL, chromosome 11q23 rearrangement and T-ALL patients did not express TEL-AML1 transcripts. Moreover, MRD in five patients with TEL-AML1 transcripts were analyzed in serial samples. Although TEL-AML1 transcripts disappeared soon after the beginning of chemotherapy in three of the five patients, one patient continued to express them for up to 21 months without recurrence and remained in continuous complete remission for seven years after the cessation of chemotherapy. The remaining patient was admitted to our hospital after the second relapse but died following a failure to induce complete remission. CONCLUSION For most patients, the presence of TEL-AML1 transcripts suggests excellent chemosensitivity and a favorable prognosis, but some patients with these transcripts have a different outcome. The present study suggests the possibility that a persistence of MRD is not necessarily related to a relapse of ALL with TEL-AML1 fusion. The prognostic significance of TEL-AML1 transcript remains controversial. Further studies are needed to evaluate the relation between the TEL-AML1 transcript and prognosis.
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Affiliation(s)
- Chie Endo
- Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
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23
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Abstract
Therapy for childhood acute lymphoblastic leukemia (ALL) is entering a new era in terms of quality-of-life. In the current study, 21 patients with childhood-onset ALL were assessed for linear growth, bone mineral density (BMD), and endocrinological status, focusing especially on longitudinal analysis of the growth of each patient. Linear growth was uniformly attenuated during therapy in all patients. In contrast, after the cessation of therapy, the growth of each patient varied widely from attenuated to dramatic catch-up growth. In pubertal survivors who had received chemotherapy and cranial irradiation during prepuberty, the degree of growth after the cessation of therapy was negatively correlated with changes in height Z scores during therapy ( r = -0.76, P= 0.004). One of the factors involved in catch-up growth, urinary N-telopeptide/creatinine (U-NTx/Cr), was significantly higher in patients whose Z scores decreased after cessation of therapy ( P = 0.01), despite normal pubertal development and normal endocrinological assessments. The present study revealed individual differences in linear growth after the cessation of therapy and suggests the importance of catch-up growth during puberty.
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Affiliation(s)
- Nobuko Yamashita
- Department of Pediatrics, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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24
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Abstract
We have reported that laminin-10/11 strongly promotes migration of A549 human lung carcinoma cells by activating the alpha3beta1 integrin-dependent signaling pathway. To elucidate the mechanism involved, we investigated whether matrix metalloproteinases (MMPs) are involved in cell migration on laminin-10/11. Here, we demonstrate that laminin-10/11, but not fibronectin which does not greatly promote A549 cell movement, stimulated MMP-2 secretion approximately 3-fold. The cell migration-promoting activity of laminin-10/11 was down-regulated by an MMP inhibitor. In addition, cell motility was significantly increased when cells adhered to a mixture of fibronectin and laminin-10/11 with a concomitant decrease of focal contacts, compared with those adhering to fibronectin alone. The enhanced cell migration was partially suppressed by the MMP inhibitor. Furthermore, an anti-alpha3 integrin, but not an anti-alpha5 integrin, antibody induced the activated form of MMP-2. These data suggest that MMP-2 may play an important role in A549 cell migration on laminin-10/11 through an alpha3beta1 integrin-dependent pathway.
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Affiliation(s)
- J Gu
- Division of Protein Chemistry, Institute for Protein Research, Osaka University, 3-2 Yamadaoka, Suita, 565-0871, Osaka, Japan.
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25
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Tsuchiyama J, Yoshino T, Toba K, Harada N, Nishiuchi R, Akagi T, Furukawa T, Takahashi M, Fuse I, Aizawa Y, Harada M. Induction and characterization of cutaneous lymphocyte antigen on natural killer cells. Br J Haematol 2002; 118:654-62. [PMID: 12139761 DOI: 10.1046/j.1365-2141.2002.03608.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cutaneous lymphocyte antigen (CLA) has been reported to be expressed mainly by memory/effector T lymphocytes infiltrating inflammatory skin lesions and cutaneous T-cell lymphoma. It has been suggested that CLA is a specific homing receptor, facilitating the T-cell migration into skin lesions, and also an indicator of the skin-homing T-cell subset. In the present study, we investigated the expression of CLA in natural killer (NK) cells defined phenotypically as surface CD3- and CD56+ cells in peripheral blood. CLA was definitely expressed on CD3-CD56+ cells at a level comparable to CD3+ cells in peripheral blood of normal Japanese volunteers. After in vitro stimulation of peripheral blood mononuclear cells with interleukin 2 (IL-2) and IL-12, there was a significant increase in the number and percentage of CLA+ NK cells but not CLA+ T cells (P < 0.01). To analyse the characteristics of CLA expressed by NK cells, we investigated a CLA+ NK-leukaemia cell line, NK-YS, established from a patient with NK leukaemia/lymphoma with skin infiltration. In the in vitro study, the CLA-expressing NK-leukaemic cell line bound to E-selectin-transfected cells and was inhibited by HECA 452 antibody or neuraminidase treatment of leukaemic cells. These findings suggest that CLA expressed by NK cells is a homing receptor for the E-selectin molecule and may explain skin infiltration by NK cells and NK lymphoma cells analogous to T cells. An NK-cell subset expressing CLA must play an important role in host defence against microorganisms and neoplasms in skin lesions.
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Affiliation(s)
- Junjiro Tsuchiyama
- First Department of Internal Medicine, Niigata University School of Medicine, 1-754 Asahi-machi, Niigata 951, Japan.
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26
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Urushihara N, Ariki N, Oyama T, Chouda Y, Yagi T, Inoue T, Tomiyama Y, Nishiuchi R, Oda M, Tanaka N. Secondary sclerosing cholangitis and portal hypertension after O157 enterocolitis: Extremely rare complications of hemolytic uremic syndrome. J Pediatr Surg 2001; 36:1838-40. [PMID: 11733919 DOI: 10.1053/jpsu.2001.28858] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The authors experienced an extremely rare case of secondary sclerosing cholangitis and portal hypertension developed as late complications of hemolytic uremic syndrome (HUS) owing to Escherichia coli O157:H7 in a 2-year-old boy. HUS after E coli O157 infection is the most frequent cause of acute renal failure in childhood and occasionally is accompanied by extrarenal complications such as encephalopathy, cardiomyopathy, ischemic colitis, and pancreatitis. Rarely, late colonic stenosis may develop secondary to the ischemic damage. Sclerosing cholangitis and subsequent cirrhosis with portal hypertension are very uncommon as late complications of HUS. To our knowledge, such a case has not been previously reported in the literature. J Pediatr Surg 36:1838-1840.
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Affiliation(s)
- N Urushihara
- Department of Surgery, Okayama University Medical School, Okayama, Japan
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27
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Yamashita N, Nishiuchi R, Oda M, Tomiyama Y, Eguchi N, Endo C, Manki A, Seino Y. Molecular detection of metastatic retinoblastoma cells by reverse transcription polymerase reaction for interphotoreceptor retinoid-binding protein mRNA. Cancer 2001; 91:1568-73. [PMID: 11301407 DOI: 10.1002/1097-0142(20010415)91:8<1568::aid-cncr1167>3.0.co;2-v] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND In the current study, the authors report a 4 year old girl with disseminated retinoblastoma. To find sensitive and specific molecular markers for detection of retinoblastoma cells in blood and marrow, the authors evaluated three photoreceptor-associated gene transcripts by using reverse transcription polymerase chain reaction (RT-PCR). METHOD Samples of bone marrow and blood were obtained from healthy donors and the patient. RT-PCR was performed to detect the cone alpha'-subunit of cGMP phosphodiesterase (cone alpha'-PDE), the rod beta-subunit of cGMP (rod beta-PDE), and the interphotoreceptor retinoid-binding protein (IRBP) gene transcript in RNA extracted from the samples. RESULTS While no expression of rod beta-PDE or IRBP was detected in any of the normal samples, expression of cone alpha'-PDE was detected in two out of seven normal marrow samples. Expression of rod beta-PDE was not detected in the patient samples. Expression of IRBP was detected in the patient samples obtained from iliac bone marrow before intensive chemotherapy but not thereafter. CONCLUSION RT-PCR for IRBP was a useful method for detecting metastatic retinoblastoma cells as well as for evaluating the therapeutic effects of treatment in this particular case.
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Affiliation(s)
- N Yamashita
- Department of Pediatrics, Okayama University Medical School, Okayama, Japan
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28
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Yumura-Yagi K, Inoue M, Sakata N, Okamura T, Yasui M, Nakano T, Nomura K, Nakano T, Park DY, Endo C, Nishiuchi R, Sawada A, Matsuda Y, Oota H, Yoshimoto T, Kawa-Ha K. Chronic graft-versus-host disease in children and adolescents after bone marrow transplantation from HLA-matched donors. Int J Hematol 2000; 71:278-82. [PMID: 10846836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We analyzed 98 pediatric patients who underwent bone marrow transplantation (BMT) from serologically HLA-matched related donors (RD) or unrelated donors (UD) at our institute to clarify the actual status of chronic graft-versus-host disease (cGVHD). There were 36 evaluable cases of RD-BMT and 35 of UD-BMT. cGVHD was observed in 8 RD-BMT cases (22.2%) and in 23 UD-BMT cases (65.7%). In the RD-BMT cases, the limited and extensive types of cGVHD were observed in 4 cases each, whereas in the UD-BMT cases, the limited type was seen in 11 cases and the extensive type in 12. Prior acute GVHD was observed in 6 RD-BMT cases and in 18 UD-BMT cases. Two RD-BMT patients with extensive type cGVHD died of relapse and cytomegalovirus infection, and 4 UD-BMT patients died because of bronchiolitis obliterans, fungal infection, liver failure, and multiple organ failure, respectively. The incidence of cGVHD in these pediatric patients was as high as that in adult patients when UD-BMT was performed. Some UD-BMT patients required long-term immunosuppressive therapy after BMT. These findings suggest that cGVHD is a serious problem in pediatric UD-BMT. Therefore, intensive prophylaxis and treatment of GVHD must always be performed after UD-BMT.
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Affiliation(s)
- K Yumura-Yagi
- Department of Pediatrics, Osaka Medical Center, Japan
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29
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Yoshino T, Okano M, Chen HL, Tsuchiyama J, Kondo E, Nishiuchi R, Teramoto N, Nishizaki K, Akagi T. Cutaneous lymphocyte antigen is expressed on memory/effector B cells in the peripheral blood and monocytoid B cells in the lymphoid tissues. Cell Immunol 1999; 197:39-45. [PMID: 10555994 DOI: 10.1006/cimm.1999.1552] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cutaneous lymphocyte antigen (CLA) is expressed on a subpopulation of human memory T cells and is involved in the primary step of their skin homing. T cells and some B cells in the peripheral blood express CLA, but the pathophysiologic roles of CLA(+) B cells have not yet been clarified. We examined the relationships among CLA expression in B cells and immunoglobulin heavy chain subtype, the localization of CLA(+) B cells in the peripheral lymphoid tissues, and their functional binding to E-selectin. CLA was expressed on class-switched, memory B cells in the peripheral blood and tonsils as revealed by flow cytometry. Immunohistochemical staining of the lymph nodes with various types of inflammation or reactive hyperplasia showed CLA on the monocytoid B cells, which correspond to memory cells. The functional study revealed that CLA on B cells bound to E-selectin transfectants. E-selectin was detected on some of the high endothelial venules in the monocytoid B-cell-rich lymph nodes. These findings suggest that CLA is also expressed on a subset of memory/effector B cells, in addition to a subset of memory T cells. Such B cells were located in the lymph nodes or tonsils and rarely in chronic dermatitis. Therefore, CLA seems to be related to memory/effector B-cell trafficking to the lymph nodes or tonsils. According to the multistep theory, mechanisms involved in the second or third step might be different between CLA(+) B and T cells.
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Affiliation(s)
- T Yoshino
- Department of Pathology, Department of Otorhinolaryngology, Department of Internal Medicine, Department of Pediatrics, Okayama University Medical School, Shikata-cho, 2-5-1, Okayama, 700-8558, Japan
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30
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Sakuma I, Yoshino T, Omonishi K, Nishiuchi R, Teramoto N, Yanai H, Kawahara K, Kubonishi I, Matsuo Y, Akagi T. CD95 ligand is expressed in Reed-Sternberg cells of Hodgkin's disease. Pathol Int 1999; 49:103-9. [PMID: 10355962 DOI: 10.1046/j.1440-1827.1999.00830.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Reed-Sternberg (RS) cells and their mononuclear variants, Hodgkin's (H) cells, are considered to be the neoplastic cells of Hodgkin's disease (HD). The cellular origin of H-RS cells remains the subject of considerable controversy, although most recent papers have claimed that H-RS cells are of B cell origin. Recently, however, it has been reported that some H-RS cells express granzyme B, as observed in cytotoxic T cells and/or natural killer cells, which also express CD95 ligand (FasL/APO-1L). In the present study, the expression of CD95L and granzyme B in H-RS cells of HD was investigated. CD95L was detected in H-RS cells in five of nine HD cases (one case of lymphocyte-rich classical HD, two of these cases of nodular sclerosis type, and two of four cases of mixed cellularity type). All three examined HD cell lines expressed CD95L in the cytoplasm, although cell surface expression was seen only in L428 cells. Three HD cases expressed both CD95L and granzyme B. It was concluded that CD95L is frequently expressed in H-RS cells, which is one of their notable characteristics; albeit it seems to be irrespective of cell lineage.
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Affiliation(s)
- I Sakuma
- Department of Pathology, Okayama University Medical School, Japan
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31
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32
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Abstract
Fas ligand (FasL), a cell surface molecule belonging to the tumour necrosis family, induces apoptosis through its receptor, Fas antigen (Fas). Germinal centre B cells strongly express Fas, but the role of the Fas-FasL system in B-cell selection in the germinal centre remains unclear. In the present study, FasL mRNA in the tonsils was examined by RNA in situ hybridization. FasL mRNA was detected in the lymphocytes of both germinal centres and interfollicular areas, but much more intensively in the former. The distribution of cells strongly expressing FasL mRNA in the germinal centres was quite similar to that of CD45RO-positive T cells. Immunohistochemically, however, most of the germinal centre cells were positive for FasL. Flow cytometric analysis demonstrated that FasL-positive cells of the tonsils included not only CD3-positive/CD45RO-positive T cells, but also CD19-positive B cells. This finding therefore suggests either that germinal centre B cells can produce FasL, although the level of mRNA was equivocal, or that the soluble form of FasL may be released from FasL-positive T cells in the germinal centres and then bind to Fas-positive germinal centre B cells. Thus, the Fas-FasL system may participate in the positive selection of B cells.
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Affiliation(s)
- E Kondo
- Department of Pathology, Okayama University, School of Medicine, Japan
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33
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Nishiuchi R, Yoshino T, Teramoto N, Sakuma I, Hayashi K, Nakamura S, Seino Y, Akagi T. Clonal analysis by polymerase chain reaction of B-cell lymphoma with late relapse: a report of five cases. Cancer 1996; 77:757-62. [PMID: 8616769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Little is known about the clonal heterogeneity of non-Hodgkin's lymphoma between presentation and relapse, although several such reports have been published on acute lymphoblastic leukemia. METHODS We examined five patients with B-cell lymphoma who relapsed more than 5 years after initial presentation. Formalin fixed, paraffin embedded tissues were analyzed for clonal immunoglobulin heavy chain gene rearrangement by the polymerase chain reaction (PCR) and sequencing of the PCR products. Four specimens retained the original histologic type, but one showed histologic transformation from diffuse large cell lymphoma to follicular small cleaved cell lymphoma. RESULTS Although the size of the PCR products looked identical on the gel between presentation and relapse in all patients, only three of the four specimens that retained the original type had identical gene rearrangements at both presentation and relapse. One of these four and the fifth specimen showed novel gene rearrangements. CONCLUSIONS This study suggests that late relapse lymphoma may present as a new clone. Sequencing of the PCR products is important in the evaluation of clonal heterogeneity.
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MESH Headings
- Adult
- Aged
- Antigens, CD/analysis
- Base Sequence
- DNA Primers
- Follow-Up Studies
- Gene Rearrangement
- Humans
- Immunohistochemistry
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Molecular Sequence Data
- Polymerase Chain Reaction/methods
- Receptor-CD3 Complex, Antigen, T-Cell/analysis
- Receptor-CD3 Complex, Antigen, T-Cell/genetics
- Recurrence
- Time Factors
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Affiliation(s)
- R Nishiuchi
- Department of Pediatrics, Okayama University Medical School, Japan
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34
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Nishiuchi R, Yoshino T, Teramoto N, Sakuma I, Hayashi K, Nakamura S, Seino Y, Akagi T. Clonal analysis by polymerase chain reaction of B-cell lymphoma with late relapse: A report of five cases. Cancer 1996. [DOI: 10.1002/(sici)1097-0142(19960215)77:4<757::aid-cncr23>3.0.co;2-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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35
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Nishiuchi R, Yoshino T, Matsuo Y, Sakuma I, Cao L, Seino Y, Takahashi K, Akagi T. The Fas antigen is detected on immature B cells and the representative cell lines show Fas-mediated apoptosis. Br J Haematol 1996; 92:302-7. [PMID: 8602989 DOI: 10.1046/j.1365-2141.1996.d01-1463.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The expression and functions of Fas antigen, a major regulator of apoptosis, in T-cell selection have been intensively investigated, but little is known about its expression i immature B cells which are also selected in the bone marrow, and plasma cells which are at the terminal stage of B-cell differentiation and are designed to die. We examined bone marrow cells and found Fas antigen on these cells at low levels. Next we analysed Fas expression and susceptibility to anti-Fas antibody-mediated apoptosis on B-cell lines representing various stages of differentiation. We also examined the expression of Bcl-2 and Bax on these lines, which were intimately related to apoptosis. Fas antigen was almost negative on pre-pre-B cell lines and was detected on pre-B-cell lines at low levels. All plasma cell lines expressed Fas at a low to moderate level. Some cell lines with peripheral B-cell phenotype expressed Fas antigen. Except for the Burkitt cell lines and one plasma cell line, susceptibility to Fas-mediated apoptosis depended on Fas expression. Bcl-protein was detected on all but one cell line and Bax was detected on 15/23 lines, but neither were related to cellular differentiation or Fas expression.
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Affiliation(s)
- R Nishiuchi
- Department of Paediatrics, Okayama University Medical School, Japan
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36
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Akazai A, Oda M, Nishiuchi R, Horiuchi T, Henmi M, Manki A, Seino Y. [The role of anti L-asparaginase antibody in childhood acute lymphoblastic leukemia]. Rinsho Ketsueki 1996; 37:95-100. [PMID: 8852025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The function of IgG antibody with regard to L-asparaginase (L-asp) was investigated in vivo. Blood samples were collected before, during and after IV administration of L-asp (6,000 U/sqm for 10 days) in 18 children with acute lymphoblastic leukemia (ALL) previously treated with L-asp. Using enzyme-linked immunosorbent assay (ELISA), serum levels of L-asp and anti-L-asp IgG antibody were measured simultaneously. In 11 cases, the level of anti-L-asp IgG antibody increased prior to, but decreased to within the normal range after drug administration whereas the level of serum L-asp increased after drug administration. In 5 cases, the level of anti-L-asp IgG antibody increased as the level of serum L-asp decreased after drug administration. In contrast, in the 13 cases with no increase in anti-L-asp IgG antibody during L-asp administration, the serum L-asp level was stable. These data indicate that anti-L-asp IgG antibodies play an important role in the immunoclearance of L-asp. We would like to continue to carefully follow patients showing high titers of anti-L-asp IgG antibody during the administration of L-asp.
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Affiliation(s)
- A Akazai
- Department of Pediatrics, Okayama University School of Medicine
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37
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Yoshino T, Cao L, Nishiuchi R, Matsuo Y, Yamadori I, Kondo E, Teramoto N, Hayashi K, Takahashi K, Kamikawaji N. Ligation of HLA class II molecules promotes sensitivity to CD95 (Fas antigen, APO-1)-mediated apoptosis. Eur J Immunol 1995; 25:2190-4. [PMID: 7545111 DOI: 10.1002/eji.1830250811] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
CD95 (Fas antigen/APO-1) is up-regulated in activated lymphocytes, and monoclonal antibody (mAb) to CD95 induces apoptosis. HLA class II molecules play a key role in antigen presentation, ligation of which induces signal transduction. We examined 18 lymphoid cell lines (15 B cell and 3 T cell lines) to investigate the effects of ligation of HLA class II molecules on CD95-mediated apoptosis. All of the five immature B cell lines were sensitive to anti-CD95 mAb, and ligation of HLA class II molecules promoted CD95-mediated apoptosis. In seven B-blastoid cell lines, two Burkitt lines were resistant to anti-CD95 mAb in spite of high expression of CD95. In three of five non-Burkitt B-blastoid lines, CD95-mediated apoptosis was augmented by treatment with anti-HLA class II mAb, while the other two lines lacking CD95 were resistant to anti-CD95 mAb. Three plasmacytic cell lines showed CD95-mediated apoptosis, but enhancement by anti-HLA class I mAb was slight in one cell line and was not observed in the other two lines. Out of three HLA class II antigen-positive T cell lines, CD95-mediated apoptosis was observed to some degree in one call line but was not promoted by the treatment with anti-HLA class II mAb, and the other two cell lines were resistant to anti-CD95 mAb. Ligation of HLA class II molecules did not alter CD95 expression in the five cell lines examined, except Su-DHL-4 originated from a follicular lymphoma, which showed slight up-regulation. Taken together, ligation of HLA class II molecules apparently promotes CD95-mediated apoptosis in immature B cells and non-Burkitt B blasts. These findings highlight the role of HLA class II molecules in CD95-mediated apoptosis, which may facilitate rapid clearance of functionally useless cells from the immune system and might be involved in negative selection of B cells.
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Affiliation(s)
- T Yoshino
- Department of Pathology, School of Medicine, Okayama University, Japan
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38
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Cao L, Yoshino T, Nishiuchi R, Yamadori I, Akagi T. Homotypic cell aggregation via conformational change of CD44 molecule induced by anti-CD44 monoclonal antibodies. Immunobiology 1995; 193:1-14. [PMID: 7590860 DOI: 10.1016/s0171-2985(11)80152-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The homotypic cell aggregation of leukocytes is an unique adhesive event which is caused by cellular activation. Anti-CD44 monoclonal antibody (mAb) induces homotypic cell aggregation of hematopoietic cell lines expressing CD44, but the mechanism of homotypic cell aggregation is poorly understood. We used four mAbs against CD44: TL-1 which was newly developed and seemed to react with a non-hyaluronate binding site, OS/37 and BU52 which recognized a hyaluronate binding site, and Hermes-3 which recognized a non-hyaluronate binding site. TL-1 treatment induced strong homotypic cell aggregation in several types of cell lines including a B cell line from a patient with leukocyte adhesion deficiency syndromes (LAD) and normal peripheral blood lymphocytes (PBL). OS/37 and BU52 also induced weak homotypic cell aggregation. None of these anti-CD44 mAbs-induced homotypic cell aggregations was blocked by antibodies against LFA-1, ICAM-1, VLA-4, or L-selectin. Interestingly, the TL-1-induced homotypic cell aggregation was blocked by Hermes-3 or OS/37, but not by BU52. BU52-induced homotypic cell aggregation was blocked by Hermes-3 or OS/37, but not by TL-1. OS/37-induced homotypic cell aggregation was blocked by Hermes-3, TL-1 or BU52. The blocking experiments with anti-metabolic agents revealed that the induced homotypic cell aggregation was energy-dependent and associated with intracytoplasmic actin filaments. This homotypic cell aggregation did not require de novo protein synthesis, because it was not affected by pretreatment with either cycloheximide or actinomycin D. FACS analysis revealed that TL-1 binding did not affect the intensity of expression of the CD44 molecule on the cell surface.
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Affiliation(s)
- L Cao
- Department of Pathology, Okayama University Medical School, Japan
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39
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Saito S, Hayashi K, Ohnoshi T, Kawashima K, Matsutomo S, Tagawa S, Yoshino T, Nishiuchi R, Kimura I. [Occurrence of follicular small cleaved cell lymphoma following chemotherapy for diffuse large cell lymphoma]. Rinsho Ketsueki 1994; 35:676-681. [PMID: 8065020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A 59-year-old man was admitted in July, 1985 because of generalized lymphadenopathy and hypercalcemia. The biopsy specimen of the left inguinal lymph node showed diffuse large cell lymphoma. He achieved a complete remission (CR) in July, 1986 by CHOP therapy. In January, 1992, he visited the outpatient clinic with splenomegaly, and swelling of the left axillary and left supraclavicular lymph nodes. The biopsy specimen of the axillary lymph node showed follicular small cleaved cell lymphoma. Because the spleen and the lymph nodes regressed after the biopsy, he has been followed up without any specific treatment for lymphoma. Histologic change from low-grade lymphoma into more aggressive histologic pattern is well documented. However the converse phenomenon, occurrence of low-grade lymphoma after intermediate-, or high-grade lymphoma has rarely been reported. Histological examination is mandatory when a patient with diffuse large cell lymphoma is suspected to have relapsing disease after the long-term CR.
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Affiliation(s)
- S Saito
- Second Department of Medicine, Okayama University Medical School
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