8 results on '"Nakamura, Ryotaro"'
Search Results
2. Feasibility of implementing a supervised telehealth exercise intervention in frail survivors of hematopoietic cell transplantation: a pilot randomized trial
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Lee, Kyuwan, Shamunee, Justin, Lindenfeld, Lanie, Ross, Elizabeth, Hageman, Lindsey, Sedrak, Mina S., Wong, F. Lennie, Nakamura, Ryotaro, Forman, Stephen J., Bhatia, Smita, and Armenian, Saro H.
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- 2023
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3. Coronary artery calcium and cardiovascular outcomes in patients with lymphoma undergoing autologous hematopoietic cell transplantation.
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Wu, Stephanie, Rhee, June‐Wha, Iukuridze, Aleksi, Bosworth, Alysia, Chen, Sitong, Atencio, Liezl, Manubolu, Venkat, Bhandari, Rusha, Jamal, Faizi, Mei, Matthew, Herrera, Alex, Rodriguez, Fatima, Forman, Stephen, Nakamura, Ryotaro, Wong, F. Lennie, Budoff, Matthew, and Armenian, Saro H.
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CORONARY artery calcification ,HEMATOPOIETIC stem cell transplantation ,STEM cell transplantation ,CARDIOVASCULAR diseases risk factors ,LYMPHOMAS ,CARDIOVASCULAR diseases - Abstract
Background: Patients undergoing autologous hematopoietic cell transplantation (HCT) have a >2‐fold risk of developing cardiovascular disease (CVD; heart failure, myocardial infarction, and stroke), compared to the general population. Coronary artery calcium (CAC) is predictive of CVD in nononcology patients but is not as well studied in patients who underwent HCT and survivors of HCT.The objective of this study was to examine the association between CAC and CVD risk and outcomes after HCT in patients with lymphoma. Methods: This was a retrospective cohort study of 243 consecutive patients who underwent a first autologous HCT for lymphoma between 2009 and 2014. CAC (Agatston score) was determined from chest computed tomography obtained <60 days from HCT. Multivariable Cox regression analysis was used to calculate hazard ratio (HR) estimates and 95% confidence intervals (CIs), adjusted for covariates (age, conventional risk factors [e.g., hypertension and dyslipidemia], and cancer treatment). Results: The median age at HCT was 55.7 years (range, 18.5–75.1 years), 59% were male, and 60% were non‐Hispanic White. The prevalence of CAC was 37%. The 5‐year CVD incidence for the cohort was 12%, and there was an incremental increase in the incidence according to CAC score: 0 (6%), 1–100 (20%), and >100 (32%) (p =.001). CAC was significantly associated with CVD risk (HR, 3.0; 95% CI, 1.2–7.5) and worse 5‐year survival (77% vs. 50%; p <.001; HR, 2.0; 95% CI, 1.1–3.4), compared to those without CAC. Conclusions: CAC is independently associated with CVD and survival after HCT. This highlights the importance of integrating readily available imaging information in risk stratification and decision‐making in patients undergoing HCT, which sets the stage for strategies to optimize outcomes after HCT. Hematopoietic cell transplantation (HCT) survivors have an increased risk of cardiovascular disease (CVD) compared to the general population, and therefore thorough assessment of cardiovascular risk before HCT is essential. This study showed that the coronary artery calcium (CAC) score, obtained from routine pretransplant imaging, is significantly associated with CVD posttransplant and is a useful addition to traditional cardiovascular risk factors. Further prospective studies are needed to understand how CAC screening should be formally incorporated into pretransplant workup, cardiovascular risk assessment, and clinical decision‐making and its effect on posttransplant outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Technology-enabled activation of skin cancer screening for hematopoietic cell transplantation survivors and their primary care providers (TEACH)
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Armenian, Saro H., Lindenfeld, Lanie, Iukuridze, Aleksi, Echevarria, Meagan, Bebel, Samantha, Coleman, Catherine, Nakamura, Ryotaro, Abdullah, Farah, Modi, Badri, Oeffinger, Kevin C., Emmons, Karen M., Marghoob, Ashfaq A., and Geller, Alan C.
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- 2020
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5. Late‐occurring infections in a contemporary cohort of hematopoietic cell transplantation survivors.
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Sy, Andrew, Chanson, Dayana, Berano Teh, Jennifer, Wong, Florence L., Nakamura, Ryotaro, Dadwal, Sanjeet, and Armenian, Saro H.
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HEMATOPOIETIC stem cell transplantation ,GRAFT versus host disease - Abstract
Background: There is a paucity of studies describing the incidence and risk factors for late‐occurring (≥1 year) infectious complications in contemporary survivors of hematopoietic cell transplantation (HCT). Methods: This was a retrospective cohort study of 641 1‐year survivors of HCT, transplanted between 2010 and 2013 as adults, and in remission from their primary disease. Standardized definitions were used to characterize viral, fungal, and bacterial infections. Cumulative incidence of infections was calculated, with relapse/progression considered as a competing risk event. Fine‐Gray subdistribution hazard ratio estimates and 95% confidence intervals (CI) were obtained, adjusted for relevant covariates. Results: Median age at HCT was 55.2 years (range 18.1–78.1 years); 54.0% were survivors of allogeneic HCT. The 5‐year cumulative incidence of a late‐occurring infection for the entire cohort was 31.6%; the incidence of polymicrobial (≥2) infections was 10.1%. In survivors who developed at least one infection, the 5‐year incidence of a subsequent infection was 45.3%. Among allogeneic HCT survivors, patients with acute lymphoblastic (HR = 1.82 95% CI [1.12–2.96]) or myeloid (HR = 1.50 95% CI [1.02–2.20]) leukemia, and those with an elevated HCT‐Comorbidity index score (HR = 1.09 95% CI [1.01–1.17]) were more likely to develop late‐occurring infections; there was an incremental risk associated with severity of graft versus host disease (GVHD) at 1‐year post‐HCT (mild: HR = 2.17, 95% CI [1.09–4.33]; moderate/severe: HR = 3.78, 95% CI [1.90–7.53]; reference: no GVHD). Conclusions: The burden of late‐occurring infections in HCT survivors is substantial, and there are important patient‐ and HCT‐related modifiers of risk over time. These findings may help guide personalized screening and prevention strategies to improve outcomes after HCT. [ABSTRACT FROM AUTHOR]
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- 2021
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6. Iron Overload Is Associated with Delayed Engraftment and Increased Nonrelapse Mortality in Recipients of Umbilical Cord Blood Hematopoietic Cell Transplantation.
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Malki, Monzr M. Al, Song, Joo Y., Yang, Dongyun, Cao, Thai, Aldoss, Ibrahim, Mokhtari, Sally, Dadwal, Sanjeet, Marcucci, Guido, Karanes, Chatchada, Snyder, David, Nademanee, Auayporn, Forman, Stephen J., Nakamura, Ryotaro, and Pullarkat, Vinod
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CORD blood , *CELL transplantation , *BLOOD cells , *IRON , *MORTALITY - Abstract
• Impact of iron overload (serum ferritin [SF] >2000 ng/mL) on umbilical cord blood hematopoietic cell transplantation (HCT) outcomes was examined. • Overall survival rate at 2 years was significantly lower in patients with higher pre-HCT SF levels (P =.005). • Nonrelapse mortality was significantly higher in patients with higher SF (P =.02). • Significantly faster engraftment was seen in patients with lower SF levels. • Iron overload is a strong adverse prognostic factor for cord blood transplant. The negative impact of iron overload (IO) on outcomes of allogeneic hematopoietic cell transplantation (HCT) is well recognized, but its impact on umbilical cord blood (UCB) transplant outcome is unknown. We retrospectively analyzed outcomes of 150 patients who received UCB-HCT at our institution, stratified by pre-HCT serum ferritin (SF) level of 2000 ng/mL. Two-year overall survival rate among patients with SF >2000 and ≤2000 ng/mL was 26.1% (95% CI, 10.6% to 44.7%) and 52.1% (95% CI, 40.1% to 62.8%), respectively; hazard ratio (HR) = 2.26 (95% CI, 1.28 to 4.00, P =.005). Two-year nonrelapse mortality rate was higher among patients with SF >2000 ng/mL (56.5%; 95% CI, 33.3% to 74.4%) compared to SF ≤2000 ng/mL (30.1%; 95% CI, 20.0% to 40.9%); HR = 2.18 (95% CI, 1.10 to 4.31, P =.025). Neutrophil engraftment at 42 days was 78.3% (95% CI, 53.5% to 90.8%) in patients with SF >2000 ng/mL versus 91.8% (95% CI, 82.1% to 96.4%) in patients with SF ≤2000 ng/mL; HR = 0.58 (95% CI, 0.35 to 0.96, P =.034). A significant difference in platelet engraftment at 3 months was also observed: 52.2% (95% CI, 29.4% to 70.8%) for SF >2000 ng/mL versus 80.8% (95% CI, 69.5% to 88.3%) for SF ≤2000 ng/mL; HR = 0.48 (95% CI, 0.23 to 0.98, P =.044). In conclusion, IO defined by SF of 2000 ng/mL is a strong adverse prognostic factor for UCB-HCT and should be considered when UCB is chosen as the graft source for patients without a fully matched donor. [ABSTRACT FROM AUTHOR]
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- 2020
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7. Feasibility and Acceptability of Using a Telehealth Platform to Monitor Cardiovascular Risk Factors in Hematopoietic Cell Transplantation Survivors at Risk for Cardiovascular Disease.
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Chang, Ellen, Iukuridze, Aleksi, Echevarria, Meagan, Teh, Jennifer Berano, Chanson, Dayana, Ky, Bonnie, Chow, Eric J., Nakamura, Ryotaro, Lindenfeld, Lanie, and Armenian, Saro H.
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CARDIOVASCULAR diseases risk factors , *CELL transplantation , *CARDIOVASCULAR diseases , *HYPERTENSION risk factors , *TELEMEDICINE , *BODY mass index - Abstract
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in hematopoietic cell transplantation (HCT) survivors. In these patients, such risk factors as hypertension, diabetes, obesity, and physical inactivity are important modifiers of CVD risk. However, the period when HCT survivors are at greatest risk of developing these risk factors, and in turn CVD, coincides with a drop in engagement in survivorship care. We examined the feasibility and acceptability of a 4-week remote risk-based monitoring (blood pressure monitor, weight scale, pulse oximeter, glucometer) and management program in 18 (11 allogeneic and 7 autologous) HCT survivors at intermediate-high risk of CVD. The median patient age was 66 years (range, 53 to 74 years), 67% had hypertension, 22% had diabetes, 11% were obese (body mass index ≥30 kg/m2), 56% were at intermediate risk of CVD, and 44% were at high risk of CVD. Weekly compliance with the remote monitoring schedule (≥3 readings/week using all devices) ranged from 72% in week 1 to 83% in weeks 2 to 4. Fifteen participants (83%) generated 86 alerts that were outside the predetermined range of normal; 63 of these readings (73%) normalized without intervention, and 23 (27%) necessitated triage by the study research nurse. Nearly all participants reported that the study kept them motivated and involved in their healthcare, and >85% agreed that the study supported their healthcare goals, helped them learn and manage their health conditions, and increased their access to healthcare. These findings may set the foundation for innovative risk-based and remote interventions to reduce the burden of CVD in this growing population of patients. [ABSTRACT FROM AUTHOR]
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- 2020
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8. Dasatinib-Induced Colitis after Allogeneic Stem Cell Transplantation for Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia.
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Aldoss, Ibrahim, Gaal, Karl, Al Malki, Monzr M., Ali, Haris, Nakamura, Ryotaro, Forman, Stephen J., and Pullarkat, Vinod
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DASATINIB , *PROTEIN-tyrosine kinase inhibitors , *HEMATOPOIETIC stem cell transplantation , *LYMPHOBLASTIC leukemia treatment , *CYTOMEGALOVIRUSES , *IMMUNOSUPPRESSION , *THERAPEUTICS - Abstract
The tyrosine kinase inhibitor dasatinib is often used after allogeneic hematopoietic cell transplantation to treat minimal residual disease in Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL). Colitis, sometimes hemorrhagic, has occasionally been described with the use of dasatinib for both chronic myeloid leukemia and Ph+ ALL. The pathogenesis of dasatinib-induced colitis is unclear but may be related to effects of dasatinib on immune function. We describe a series of 5 patients who had 7 episodes of colitis during dasatinib use. No patient had obvious large granular lymphocytosis in peripheral blood. The histopathologic and immunohistochemical features of these cases were indistinguishable from control cases of gut graft-versus-host disease (GVHD). In all patients symptoms resolved upon discontinuation of dasatinib in addition to therapy with local or low-dose systemic steroids. An additional 3 patients who developed cytomegalovirus (CMV) colitis while on dasatinib therapy were identified and studied. Dasatinib colitis may have an immune-mediated mechanism similar to GVHD, and dasatinib use may be associated with CMV colitis. Awareness of this association is important for avoiding unnecessary intensification of immunosuppression for suspected gut GVHD. [ABSTRACT FROM AUTHOR]
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- 2016
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