10 results on '"Shotaro Shimada"'
Search Results
2. Comparative Study of Tacrolimus and Short-Term Methotrexate: 2-Day versus 3-Day Methotrexate as Graft-versus-Host-Disease Prophylaxis after Umbilical Cord Blood Transplantation in Adults
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Maasa Abe, Bungo Saito, Kouji Yanagisawa, Ayaka Nakata, Shun Fujiwara, Yuta Baba, Tsuyoshi Nakamaki, Norimichi Hattori, Yui Uto, Nana Arai, Yukiko Kawaguchi, Tomoharu Matsui, Shotaro Shimada, Nobuyuki Kabasawa, Yohei Sasaki, Megumi Watanuki, So Murai, Hiroyuki Tsukamoto, and Hiroshi Harada
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Adult ,medicine.medical_specialty ,Graft vs Host Disease ,chemical and pharmacologic phenomena ,Lower risk ,Gastroenterology ,Tacrolimus ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Humans ,Retrospective Studies ,Transplantation ,Univariate analysis ,Neutrophil Engraftment ,business.industry ,Umbilical Cord Blood Transplantation ,Hematology ,medicine.disease ,Calcineurin ,Methotrexate ,Graft-versus-host disease ,030220 oncology & carcinogenesis ,Cord Blood Stem Cell Transplantation ,business ,030215 immunology ,medicine.drug - Abstract
Methotrexate (MTX) in combination with a calcineurin inhibitor has been commonly used for prophylaxis of graft-versus-host disease (GVHD) following umbilical cord blood transplantation (UCBT) in Japan. However, the appropriate prophylactic MTX dosage in UCBT has not been established to date. To determine the preferential GVHD prophylaxis in UCBT, this study retrospectively investigated the administration of short-term MTX for 2 days versus 3 days. Of 103 adult patients submitted to UCBT enrolled in the study, 73 received tacrolimus (TAC) with 2 days of MTX given at 10 mg/m2 on day 1 and 7 mg/m2 on day 3 (very short-term [vs] MTX), whereas 30 patients received TAC with 3 days of MTX given at 10 mg/m2 on day 1, 7 mg/m2 on day 3, and 7 mg/m2 on day 6 (short-term [s] MTX). In univariate analysis, neutrophil engraftment was shown to be significantly better (P = .039) in the vsMTX/TAC group. Among high-risk patients, the vsMTX/TAC group also exhibited earlier neutrophil engraftment (P = .042); however, the incidence of acute GVHD was higher in the vsMTX/TAC group (P = .035) on univariate analysis. In multivariate analysis, compared with sMTX/TAC, vsMTX/TAC was associated with lower risk of relapse (hazard ratio, .27; 95% confidence interval, .11 to .64; P = .003) . These results suggest that vsMTX/TAC can be appropriate GVHD prophylaxis after UCBT, especially in higher-risk patients.
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- 2020
3. A Cluster of Respiratory Syncytial Virus Infections in a Hospital Ward for Adult Immunocompromised Patients
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Yoshihiko Niki, Shun Fujiwara, Maasa Abe, Megumi Watanuki, Takahiro Takuma, Nobuyuki Kabasawa, Kouji Yanagisawa, Bungo Saito, Issei Tokimatsu, Norimichi Hattori, Yasuhiro Nagatomo, Tsuyoshi Nakamaki, Tomoharu Matsui, Nana Arai, Shotaro Shimada, Youhei Sasaki, Yukiko Kawaguchi, Ayaka Nakata, Yui Uto, Yuta Baba, So Murai, and Hiroyuki Tsukamoto
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Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,Outbreak ,Respiratory system ,Hospital ward ,Disease cluster ,business ,Virus - Published
- 2020
4. Corrigendum to ‘Comparative Study of Tacrolimus and Short-Term Methotrexate: 2-Day versus 3-Day Methotrexate as Graft-versus-Host-Disease Prophylaxis after Umbilical Cord Blood Transplantation in Adults’ [Biology of Blood and Marrow Transplantation 26/2 (2020) 367-372]
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Megumi Watanuki, Maasa Abe, Norimichi Hattori, Shun Fujiwara, Bungo Saito, Kouji Yanagisawa, Nana Arai, Hiroshi Harada, Tsuyoshi Nakamaki, Yui Uto, Nobuyuki Kabasawa, Yohei Sasaki, Yukiko Kawaguchi, Ayaka Nakata, Yuta Baba, Tomoharu Matsui, Shotaro Shimada, So Murai, and Hiroyuki Tsukamoto
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Transplantation ,medicine.medical_specialty ,Umbilical Cord Blood Transplantation ,Marrow transplantation ,business.industry ,Cell Biology ,Hematology ,medicine.disease ,Gastroenterology ,Tacrolimus ,Graft-versus-host disease ,Internal medicine ,medicine ,Molecular Medicine ,Immunology and Allergy ,Methotrexate ,business ,medicine.drug - Published
- 2022
5. Increased MYC expression without MYC gene translocation in patients with the diffuse large B-cell-lymphoma subtype of iatrogenic immunodeficiency-associated lymphoproliferative disorders
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Mayumi Homma, Shun Fujiwara, Nobuyuki Kabasawa, Norimichi Hattori, Masafumi Takimoto, Tsuyoshi Nakamaki, Nana Arai, Hirotaka Sakai, Yukiko Kawaguchi, Toshiko Yamochi-Onizuka, Ayaka Nakata, Hiroshi Harada, Yohei Sasaki, Kouji Yanagisawa, Megumi Watanuki, Yui Uto, Yuta Baba, Tomoharu Matsui, Shotaro Shimada, So Murai, Hiroyuki Tsukamoto, Eisuke Shiozawa, and Yuka Uesugi
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Pathology ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,CD30 ,Iatrogenic Disease ,Genes, myc ,Lymphoproliferative disorders ,medicine.disease_cause ,Lymphoid hyperplasia ,Epstein–Barr virus ,Immunocompromised Host ,Mixed connective tissue disease ,hemic and lymphatic diseases ,Autoimmune disease ,medicine ,Humans ,Immunocompromised ,Immunodeficiency ,Aged ,Aged, 80 and over ,business.industry ,Organ transplantation ,Germinal center ,General Medicine ,Middle Aged ,medicine.disease ,Lymphoproliferative Disorders ,Lymphoma ,surgical procedures, operative ,Gene Expression Regulation ,Original Article ,Disease Susceptibility ,Lymphoma, Large B-Cell, Diffuse ,medicine.symptom ,business ,Diffuse large B-cell lymphoma ,Immunosuppressive Agents - Abstract
Post-transplant lymphoproliferative disorder (PTLD) and other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPD) are iatrogenic lymphoproliferative disorders (LPD) that develop in association with immunosuppressive treatment in the setting of organ transplantation and autoimmune disease, respectively. Each has a spectrum of pathologies ranging from lymphoid hyperplasia to lymphoma. To clarify the characteristics of the diffuse large B-cell lymphoma (DLBCL) subtype in a cohort of 25 patients with PTLD or OIIA-LPD from our institute, we selected 13 with a histological subtype of DLBCL, including 2 cases of PTLD and 11 of OIIA-LPD. The median patient age at diagnosis was 70 years, with a female predominance. Both PTLD cases developed after kidney transplant. Of the patients with OIIA-LPD, 10 had rheumatoid arthritis, 1 had mixed connective tissue disease, and 8 were treated using methotrexate. Both of the PTLD patients and 6 of the OIIA-LPD patients had extranodal manifestations. All patients except for one were classified as having the non-germinal center B-cell (non-GCB) subtype according to the Hans algorithm. Tissue samples from 8 patients were positive for CD30 and 8 were positive for Epstein-Barr virus (EBV)-encoded small RNA. Seven patients had MYC-positive tissue samples, but none had MYC translocation. Our study suggests that extranodal manifestations and the non-GCB subtype are common, that EBV is associated with the DLBCL subtype of PTLD and OIIA-LPD, and that anti-CD30 therapy is applicable. In addition, our patients with the DLBCL subtype of PTLD and OIIA-LPD exhibited MYC overexpression without MYC translocation, suggesting an alternative mechanism of MYC upregulation.
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- 2021
6. Status of Natural Killer Cell Recovery in Day 21 Bone Marrow after Allogeneic Hematopoietic Stem Cell Transplantation Predicts Clinical Outcome
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Shun Fujiwara, Norimichi Hattori, Nana Arai, Yui Uto, Megumi Watanuki, Yuta Baba, Maasa Abe, Bungo Saito, Yukiko Kawaguchi, Nobuyuki Kabasawa, Hirotsugu Ariizumi, Tsuyoshi Nakamaki, So Murai, Hiroyuki Tsukamoto, Kouji Yanagisawa, Yohei Sasaki, Hiroshi Harada, and Shotaro Shimada
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Transplantation Conditioning ,Multivariate analysis ,Adolescent ,medicine.medical_treatment ,Cell ,Hematopoietic stem cell transplantation ,Natural killer cell ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Bone Marrow ,Internal medicine ,Humans ,Transplantation, Homologous ,Medicine ,Aged ,Transplantation ,business.industry ,Hazard ratio ,Hematopoietic Stem Cell Transplantation ,Hematology ,Middle Aged ,Confidence interval ,Killer Cells, Natural ,Treatment Outcome ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Bone marrow ,business ,Early phase ,030215 immunology - Abstract
Rapid immune recovery following allogeneic hematopoietic stem cell transplantation (allo-HSCT) is important for clinical outcome prediction. In most studies, immune recovery after allo-HSCT is monitored via peripheral blood. However, few reports regarding the status of absolute lymphocyte subsets in the bone marrow (BM) microenvironment have been undertaken. Therefore, we evaluated the clinical impact of immune recovery in the early period following allo-HSCT using BM samples. We showed that delayed natural killer cell recovery was independently associated with a poor prognosis for overall survival (hazard ratio [HR], 3.07; 95% confidence interval [CI], 1.37- 6.89; P = .007), progression-free survival (HR, 3.42; 95% CI, 1.47-7.94; P = .004), and nonrelapse mortality (HR, 6.68; 95% CI, 1.82-25.0; P = .004) by multivariate analysis. In addition, low NK cell counts were associated with the presence of 1 or more bacterial, viral, or fungal infections. Our results indicate that investigating absolute lymphocyte subsets in BM in the early phase following allo-HSCT can be useful for predicting and improving survival outcomes.
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- 2018
7. Increased MYC expression without MYC gene translocation in patients with the diffuse large B-cell-lymphoma subtype of iatrogenic immunodeficiency-associated lymphoproliferative disorders.
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Nobuyuki Kabasawa, Eisuke Shiozawa, So Murai, Mayumi Homma, Yuka Uesugi, Tomoharu Matsui, Ayaka Nakata, Shotaro Shimada, Yohei Sasaki, Yuta Baba, Megumi Watanuki, Nana Arai, Shun Fujiwara, Yukiko Kawaguchi, Hiroyuki Tsukamoto, Yui Uto, Kouji Yanagisawa, Norimichi Hattori, Hirotaka Sakai, and Hiroshi Harada
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- 2021
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8. Monitoring TIGIT/DNAM-1 and PVR/PVRL2 Immune Checkpoint Expression Levels in Allogeneic Stem Cell Transplantation for Acute Myeloid Leukemia
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Yohei Sasaki, So Murai, Yukiko Kawaguchi, Kouji Yanagisawa, Hiroyuki Tsukamoto, Yuta Baba, Norimichi Hattori, Hiroshi Harada, Nobuyuki Kabasawa, Nana Arai, Shun Fujiwara, Tsuyoshi Nakamaki, Bungo Saito, Yui Uto, Maasa Abe, Megumi Watanuki, and Shotaro Shimada
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Antigens, Differentiation, T-Lymphocyte ,Survival ,T cell ,Graft vs Host Disease ,Immune system ,TIGIT ,Bone Marrow ,Monitoring, Immunologic ,medicine ,Humans ,Transplantation, Homologous ,Receptors, Immunologic ,Transplantation ,business.industry ,Hematopoietic Stem Cell Transplantation ,Immunity ,Myeloid leukemia ,Hematology ,Immune checkpoint ,Killer Cells, Natural ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,Cancer research ,Receptors, Virus ,Bone marrow ,Stem cell ,business - Abstract
After allogeneic stem cell transplantation (alloSCT), several immune checkpoints play an important role in the antileukemic immune response in the bone marrow (BM) microenvironment. However, immune checkpoint expression levels in the BM have not been reported after alloSCT in patients with acute myeloid leukemia (AML). We investigated the clinical impact of immune checkpoint expression in BM samples after alloSCT for AML. Higher expression of T cell immunoreceptor with Ig and ITIM domains (TIGIT) was associated with a decreased incidence of acute graft-versus-host disease (P = .048) and poor overall (P = .046) and progression-free survival (P = 0.024). In addition, higher expression of TIGIT at engraftment after alloSCT was correlated with a decreased number of natural killer cells in BM (P = .019). Monitoring TIGIT expression in the BM could be useful for predicting outcome after alloSCT for AML. Our findings raise the possibility that blockade of TIGIT would improve survival.
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- 2018
9. Association of red cell distribution width with clinical outcomes in myelodysplastic syndrome
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So Murai, Yukiko Kawaguchi, Hiroyuki Tsukamoto, Shotaro Shimada, Kouji Yanagisawa, Yuta Baba, Norimichi Hattori, Shun Fujiwara, Nana Arai, Yui Uto, Nobuyuki Kabasawa, Yohei Sasaki, Tsuyoshi Nakamaki, Hirotsugu Ariizumi, Bungo Saito, Hiroshi Harada, and Maasa Abe
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Adult ,Erythrocyte Indices ,Male ,Cancer Research ,medicine.medical_specialty ,Erythroblasts ,Refractory anemia ,Gastroenterology ,03 medical and health sciences ,Hemoglobins ,Young Adult ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,In patient ,Erythropoiesis ,Inverse correlation ,Erythropoietin ,Lenalidomide ,Aged ,Retrospective Studies ,Aged, 80 and over ,Mean corpuscular hemoglobin concentration ,medicine.diagnostic_test ,business.industry ,Hemoglobin synthesis ,Hematopoietic Stem Cell Transplantation ,Red blood cell distribution width ,Hematology ,Middle Aged ,Prognosis ,Survival Analysis ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Myelodysplastic Syndromes ,Azacitidine ,Female ,Bone marrow ,Hemoglobin ,business ,Immunosuppressive Agents ,030215 immunology - Abstract
Studies showed red cell distribution width (RDW) can improve the detection of morphological changes in red blood cells and the understanding of their contribution to dyserythropoiesis in myelodysplastic syndrome (MDS). The purpose of the study was to evaluate dyserythropoiesis in MDS by RDW analysis and to explore the utility of RDW in clinical practice. We retrospectively analyzed laboratory and clinical data of 101 patients (59 patients was refractory anemia (RA) according to the French-American-British (FAB) classification). In patients with RA, RDW was showed weak inverse correlation with both hemoglobin concentration (Hb) (rs = −0.37, P = 0.0035) and mean corpuscular hemoglobin concentration (MCHC) (rs = −0.36, P = 0.0047). On the other hand, RDW was showed weak correlation with the number of ringed sideroblasts in bone marrow (rs = 0.31, P = 0.023). The increased RDW (≥15.0%) was associated with shorter overall survival (OS) (P = 0.0086). In patients with refractory anemia with excess blasts (RAEB) and RAEB in transformation (RAEB-t), effect of RDW on OS was less evident. These results suggested that increased RDW might reflect dyserythropoiesis, associated with deregulated hemoglobin synthesis and iron metabolism in MDS. Furthermore, increased RDW may have potential to be a prognostic significance in RA.
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- 2017
10. Impact of Red Cell Distribution Width on Dysplasia and Clinical Outcome in 66 Patients with Myelodysplastic Syndrome without Increased Blasts
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Norimichi Hattori, Bungo Saito, Nana Arai, Tsuyoshi Nakamaki, Nobuyuki Kabasawa, Yuta Baba, Shun Fujiwara, Yukiko Kawaguchi, Kouji Yanagisawa, Yui Uto, Shotaro Shimada, Hiroshi Harada, Maasa Abe, So Murai, Hiroyuki Tsukamoto, and Yohei Sasaki
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Pathology ,medicine.medical_specialty ,business.industry ,Anemia ,Immunology ,Red blood cell distribution width ,Cell Biology ,Hematology ,medicine.disease ,Biochemistry ,Cell nucleus ,medicine.anatomical_structure ,Dysplasia ,hemic and lymphatic diseases ,Precursor cell ,Medicine ,Anisocytosis ,Hemoglobin ,Bone marrow ,business - Abstract
Both clonal hematopoiesis as defined by genomic alteration and morphological cell dysplasia is a hallmark of pathology of myelodysplastic syndrome (MDS). Studies showed that, red cell distribution width (RDW), a quantitative non-subjective index of red cell anisocytosis, has diagnostic significance in anemia associated with MDS. Our recent study showed that increase of RDW has close association with dyserythropoiesis and also shorter overall survival (OS) in refractory anemia (Leuk Res 2018;67:56-59). To explore the clinical significance of RDW in MDS without increased blasts, we examined the details of correlation between RDW and morphological dysplasia which characterize MDS. We retrospectively analyzed 101 MDS patients, including 66 patients without increased blasts (blasts in the bone marrow of less than 5% and the peripheral blood of 1% or less). RDW was calculated using automated blood cell analyzer. Dysplasia was assessed according to the WHO 2008 classification by different two investigators. 100 cells (at least 25 cells) of myeloid and erythroid series were counted. At least 25 cells of megakaryocyte were also counted. Karyotype of bone marrow cells was analyzed by using routine G-band technique and categorized according to MDS cytogenetic scoring system. Correlations of RDW and clinical variables were analyzed. Based on previous study, MDS patients was divided into two groups, RDW-H (RDW was 15% or more, 48 cases) and RDW-L (RDW was lower than 15%, 18 cases). Comparisons of dysplasia or OS between these two groups were analyzed. In MDS without increase of blasts, weak inverse correlation was found between RDW and hemoglobin (rs = −0.31, P = 0.01). RDW was correlated with the presence of ring sideroblasts (RS) in the bone marrow (rs = 0.40, P = 0.001), and also weakly correlated with budding of nucleus of erythroblasts (rs = 0.33, P = 0.007). Dysgranulopoiesis was less observed than either dyserythropoiesis or dysmegakaryopoiesis (P Table showed the subtype of MDS, details of morphological dysplasia. Between two groups, RDW-H showed significantly higher percentages of dyserythropoiesis, dysgranulopoiesis, and dysmegakaryopoiesis. The increased RDW (≥15.0%) was associated with shorter OS (P = 0.02) (hazard ratio, 1.15e + 9 (95% confidence interval = 2.49-2.49)) (Figure). In contrast, there was no association between RDW and OS in MDS patients with increased blasts. Earlier studies showed increase of RDW was evident in refractory anemia with ring sideroblasts (RARS) which showed erythrocyte anisocytosis called dimorphism. Revised WHO classification (2017) defined MDS-RS with single lineage dysplasia (MDS-RS-SLD) which is characterized with specific mutation of splicing factors, such as SF3B1 and with favorable prognosis. This classification also defined MDS-RS with multi lineage dysplasia (MDS-RS-MLD) which has additional dysplasia in myeloid and/or megakaryocyte lineage in addition to RS. Pathology of MDS-RS-MLD is still to be remained. Our findings partly agree the earlier observations, showing close association between red cell anisocytosis evaluated with increase of RDW and the presence of RS. Furthermore, RDW-H group contained MDS with dysplasia of myeloid and/or megakaryocyte lineage not limited to the erythroid dysplasia(s) with RS. RDW could discriminate MDS-MLD with poor prognosis from MDS-SLD with favorable prognosis. To explore the significance of RDW in MDS, it is necessary to study large number of patient combined with genetic analysis. Nevertheless, RDW is potentially simple and useful laboratory parameters in clinical practice in MDS, representing hematopoietic defect (ineffective hematopoiesis), associated with iron metabolism and hemoglobin synthesis in MDS. Disclosures No relevant conflicts of interest to declare.
- Published
- 2018
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