107 results on '"Henzan, H."'
Search Results
2. Long-term remission after high-dose chemotherapy followed by auto-SCT as consolidation for intravascular large B-cell lymphoma
- Author
-
Kato, K, Ohno, Y, Kamimura, T, Kusumoto, H, Tochigi, T, Jinnouchi, F, Kohno, K, Kuriyama, T, Henzan, H, Takase, K, Kawano, I, Kadowaki, M, Nawata, R, Muta, T, Eto, T, Iawasaki, H, Ohshima, K, Miyamoto, T, and Akashi, K
- Published
- 2014
- Full Text
- View/download PDF
3. Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review
- Author
-
Kamimura, T, Miyamoto, T, Nagafuji, K, Numata, A, Henzan, H, Takase, K, Ito, Y, Ohno, Y, Fujisaki, T, Eto, T, Takamatsu, Y, Teshima, T, Gondo, H, Akashi, K, Taniguchi, S, and Harada, M
- Published
- 2011
- Full Text
- View/download PDF
4. Long-term outcomes of autologous PBSCT for peripheral T-cell lymphoma: retrospective analysis of the experience of the Fukuoka BMT group
- Author
-
Numata, A, Miyamoto, T, Ohno, Y, Kamimura, T, Kamezaki, K, Tanimoto, T, Takase, K, Henzan, H, Kato, K, Takenaka, K, Fukuda, T, Harada, N, Nagafuji, K, Teshima, T, Akashi, K, Harada, M, and Eto, T
- Published
- 2010
- Full Text
- View/download PDF
5. Rituximab does not compromise the mobilization and engraftment of autologous peripheral blood stem cells in diffuse-large B-cell lymphoma
- Author
-
Kamezaki, K, Kikushige, Y, Numata, A, Miyamoto, T, Takase, K, Henzan, H, Aoki, K, Kato, K, Nonami, A, Kamimura, T, Arima, F, Takenaka, K, Harada, N, Fukuda, T, Hayashi, S, Ohno, Y, Eto, T, Harada, M, and Nagafuji, K
- Published
- 2007
- Full Text
- View/download PDF
6. Cidofovir for treating adenoviral hemorrhagic cystitis in hematopoietic stem cell transplant recipients
- Author
-
Nagafuji, K, Aoki, K, Henzan, H, Kato, K, Miyamoto, T, Eto, T, Nagatoshi, Y, Ohba, T, Obama, K, Gondo, H, and Harada, M
- Published
- 2004
- Full Text
- View/download PDF
7. Influence of transplanted dose of CD56+ cells on development of graft-versus-host disease in patients receiving G-CSF-mobilized peripheral blood progenitor cells from HLA-identical sibling donors
- Author
-
Yamasaki, S, Henzan, H, Ohno, Y, Yamanaka, T, Iino, T, Itou, Y, Kuroiwa, M, Maeda, M, Kawano, N, Kinukawa, N, Miyamoto, T, Nagafuji, K, Shimoda, K, Inaba, S, Hayashi, S, Taniguchi, S, Shibuya, T, Gondo, H, Otsuka, T, and Harada, M
- Published
- 2003
- Full Text
- View/download PDF
8. A possible role of recombinant thrombomodulin for a treatment of sinusoidal obstruction syndrome: P678
- Author
-
Kato, K., Miyamoto, T., Takenaka, K., Mori, Y., Saito, N., Takase, K., Henzan, H., Ito, Y., Kamimura, T., Iwasaki, H., Ohno, Y., Harada, N., Eto, T., Teshima, T., and Akashi, K.
- Published
- 2011
9. Infectious complications in patients receiving autologous CD34-selected hematopoietic stem cell transplantation for severe autoimmune diseases
- Author
-
Kohno, K., Nagafuji, K., Tsukamoto, H., Horiuchi, T., Takase, K., Aoki, K., Henzan, H., Kamezaki, K., Takenaka, K., Miyamoto, T., Teshima, T., Harada, M., and Akashi, K.
- Published
- 2009
- Full Text
- View/download PDF
10. Successful mobilization of peripheral blood stem cells in an acute promyelocytic leukemia patient after gemtuzumab ozogamicin
- Author
-
Muta, T, Kato, K, Oku, S, Nawata, R, Takase, K, Henzan, H, Arima, F, and Eto, T
- Published
- 2007
- Full Text
- View/download PDF
11. A phase I-II trial of autologous peripheral blood stem cell transplantation in the treatment of refractory autoimmune disease
- Author
-
Tsukamoto, H, Nagafuji, K, Horiuchi, T, Miyamoto, T, Aoki, K, Takase, K, Henzan, H, Himeji, D, Koyama, T, Miyake, K, Inoue, Y, Nakashima, H, Otsuka, T, Tanaka, Y, Nagasawa, K, and Harada, M
- Published
- 2006
12. The Confirmation of Safety for the Intensified Conditioning Regimens: A Retrospective Study of Allogeneic Hematopoietic Stem Cell Transplantation for Non-Remission Hematological Malignant Diseases
- Author
-
Yoshida, S., Henzan, H., Ueno, T., Shimakawa, T., Matsuo, Y., Kuriyama, T., Saito, N., Kawano, I., Akihiko Numata, Takase, K., Iino, T., and Eto, T.
- Subjects
Allogeneic hematopoietic stem cell transplantation ,Intensified conditioning ,Sequential and additional chemotherapy ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,lcsh:RC254-282 ,Non-remission diseases - Abstract
Background: The prognosis of allogeneic hematopoietic stem cell transplantation (HSCT) for non-remission hematological malignant diseases is usually unfavorable. The most uncontrollable factor is residual disease or relapse. To overcome this problem, intensified conditioning regimens- sequential and/or additional chemotherapy to the standard regimen- could be effective. However, increasing the intensity of conditioning might also lead to more complications. Materials and Methods: We retrospectively analyzed 81 patients with non-remission disease who received allogeneic HSCT in our institution between 2007 and 2011. Results: 55.6% in 36 myeloablative conditioning patients and 46.7% in 45 reduced-intensity conditioning patients received intensified conditioning. The 5-year probability of overall survival was 35.0% and 17.1% in the standard and intensified group, respectively (p=0.027). Relapse mortality was 30% in the standard regimen group and 36.6% in the intensified regimen group (p=0.54). Transplant-related mortality (TRM) at 30 and 100 days was 5%, 17.1% (p=0.086) and 27.5%, 34.2% (p=0.52) in the standard and intensified group, respectively. There was no difference in TRM between the 2 groups at 30 days and 100 days. Conclusion: The results of the study confirm the safety of the intensified conditioning regimen. Meanwhile, it could be considered as one of the few methods available to reduce the tumor burden before HSCT for refractory malignant diseases.
- Published
- 2018
13. Role of autotransplantation in the treatment of acute promyelocytic leukemia patients in remission: Fukuoka BMT Group observations and a literature review
- Author
-
Kamimura, T, primary, Miyamoto, T, additional, Nagafuji, K, additional, Numata, A, additional, Henzan, H, additional, Takase, K, additional, Ito, Y, additional, Ohno, Y, additional, Fujisaki, T, additional, Eto, T, additional, Takamatsu, Y, additional, Teshima, T, additional, Gondo, H, additional, Akashi, K, additional, Taniguchi, S, additional, and Harada, M, additional
- Published
- 2010
- Full Text
- View/download PDF
14. Case report. Phlegmonous gastritis in a haemodialysis patient with secondary amyloidosis.
- Author
-
Joko, T, Tanaka, H, Hirakata, H, Henzan, H, Hizawa, K, Hirakata, E, Higashi, H, Yonemasu, H, and Fujishima, M
- Published
- 1999
- Full Text
- View/download PDF
15. Phlegmonous gastritis in a haemodialysis patient with secondary amyloidosis.
- Author
-
Joko, T, Tanaka, H, Hirakata, H, Henzan, H, Hizawa, K, Hirakata, E, Higashi, H, Yonemasu, H, and Fujishima, M
- Published
- 1999
- Full Text
- View/download PDF
16. Factors influencing school re-entry among adolescents in Kenya.
- Author
-
Henzan H, Takeuchi R, Njenga SM, Gregorio ER Jr, Ichinose Y, Nonaka D, and Kobayashi J
- Subjects
- Adolescent, Adult, Child, Educational Status, Female, Humans, Kenya epidemiology, Pregnancy, Schools, Pregnancy in Adolescence, Students
- Abstract
Background: The number of out-of-school children and adolescents has been increasing globally. In sub-Saharan Africa, an estimated 23 million adolescents leave school due to poverty, teenage pregnancy, and unspecified illnesses. The reasons for absenteeism are well-known but the factors involved in the decision to return to school have not been analyzed. This study aimed to identify the factors that promote primary school re-entry among chronic adolescent absentees in rural sub-Saharan Africa., Methods: Qualitative data were gathered through participant observation, in-depth interviews, and focus group discussions involving nine pupils who returned to school after chronic absenteeism and 140 adult stakeholders in Mbita sub-county, Kenya. Data were analyzed using thematic analysis., Results: The thematic analysis results showed that four factors promoted school re-entry, namely: (1) social norms: "school for a better life"; (2) linkage of community and school; (3) supportive environment; and (4) using discipline to make adolescents serious about their education., Conclusions: School re-entry among chronic absentees in Mbita sub-county is promoted by both community and school factors. It was observed that social norms regarded an education as a "passport to a better life." Adolescents, teachers, and community leaders view education as a means of improving one's socio-economic status. Two essential elements of health-promoting schools, a supportive environment and a linkage with community, effectively promoted returning to the school among adolescents. The introduction of health-promoting schools was recommended to implement a school re-entry policy in Kenya effectively., (© 2021 The Authors. Pediatrics International published by John Wiley & Sons Australia, Ltd on behalf of Japan Pediatric Society.)
- Published
- 2022
- Full Text
- View/download PDF
17. A Phase I/II Multicenter Trial of HLA-Haploidentical PBSCT with PTCy for Aggressive Adult T Cell Leukemia/Lymphoma.
- Author
-
Tanaka T, Nakamae H, Ito A, Fuji S, Hirose A, Eto T, Henzan H, Takase K, Yamasaki S, Makiyama J, Moriuchi Y, Choi I, Nakano N, Hiramoto N, Kato K, Sato T, Sawayama Y, Kim SW, Inoue Y, Inamoto Y, and Fukuda T
- Subjects
- Aged, Cyclophosphamide therapeutic use, HLA Antigens, Humans, Prospective Studies, Hematopoietic Stem Cell Transplantation, Leukemia-Lymphoma, Adult T-Cell therapy, Lymphoma, Peripheral Blood Stem Cell Transplantation
- Abstract
Adult T cell leukemia/lymphoma (ATL) is a highly aggressive hematologic malignancy with a very poor prognosis, and most patients with ATL are elderly. Although post-transplantation cyclophosphamide (PTCy) has yielded promising results in various diseases, available data are limited regarding its outcomes in ATL. The aim of this study was to determine the safety and efficacy of reduced-intensity peripheral blood stem cell transplantation (PBSCT) from a human leukocyte antigen (HLA)-haploidentical donor using PTCy as graft-versus-host disease (GVHD) prophylaxis. This was a prospective, multicenter phase I/II study (UMIN000021783) conducted at 16 hospitals in Japan. The primary endpoint was the probability of survival with engraftment and without grade III/IV acute GVHD at day 60 after PBSCT. The expected probability of the primary endpoint was estimated to be 60%, and the threshold probability was set at 30% on the basis of previous studies. The conditioning regimen consisted of fludarabine (30 mg/m
2 /d from day -7 to -2), melphalan (40 mg/m2 /d on days -3 and -2), and total body irradiation (2 Gy on day -1). GVHD prophylaxis consisted of tacrolimus starting at 0.02 mg/kg/d on day -1, PTCy (50 mg/kg/d on days +3 and +5), and mycophenolate mofetil 2000 mg/d starting on day +6. Eighteen ATL patients underwent PBSCT. The probability of patients who met the primary endpoint was 89% (95% confidence interval, 65% to 99%). The cumulative incidences of grade II to IV acute GVHD, III/IV acute GVHD, and moderate-to-severe chronic GVHD were 39%, 11%, and 17%, respectively. The probabilities of overall survival were 83% at 1 year and 73% at 2 years. The cumulative incidences of non-relapse mortality and disease progression at 1 year were 11% and 28%, respectively. HLA-haploidentical PBSCT with PTCy as GVHD prophylaxis is a valid option for patients with aggressive ATL., (Copyright © 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)- Published
- 2021
- Full Text
- View/download PDF
18. Efficacy of prophylactic letermovir for cytomegalovirus reactivation in hematopoietic cell transplantation: a multicenter real-world data.
- Author
-
Mori Y, Jinnouchi F, Takenaka K, Aoki T, Kuriyama T, Kadowaki M, Odawara J, Ueno T, Kohno K, Harada T, Yoshimoto G, Takase K, Henzan H, Kato K, Ito Y, Kamimura T, Ohno Y, Ogawa R, Eto T, Nagafuji K, Akashi K, and Miyamoto T
- Subjects
- Acetates, Antiviral Agents therapeutic use, Cytomegalovirus, Humans, Quinazolines, Retrospective Studies, Cytomegalovirus Infections drug therapy, Cytomegalovirus Infections prevention & control, Hematopoietic Stem Cell Transplantation
- Abstract
A novel anti-cytomegalovirus (CMV) agent, letermovir (LMV), could reportedly improve the outcomes of allogeneic hematopoietic cell transplantation (allo-HCT) recipients because of its high potential to prevent CMV reactivation. Therefore, 685 Japanese allo-HCT recipients, of whom ~80% had a high risk of CMV reactivation, were retrospectively analyzed to assess the impacts of prophylactic LMV on the incidence of clinically significant CMV (csCMV) infection as well as their transplant outcome. By comparing 114 patients who received LMV prophylaxis for a median 92 days to 571 patients without prophylaxis, we observed that prophylactic LMV could significantly (1) reduce the 180-day cumulative incidence of csCMV infection (44.7 vs. 72.4%, p < 0.001), (2) delay the median time until initiation of CMV antigenemia-guided preemptive therapy (90 vs. 36 days, p < 0.001), (3) shorten the duration of anti-CMV preemptive treatment (21 vs. 25 days, p = 0.006), and (4) improve the overall survival rate at 180 days after transplant (80.4 vs. 73.0%, p = 0.033) with a trend of lower non-relapse mortality (8.9 vs. 14.9%, p = 0.052). Our findings demonstrate that prophylactic LMV treatment is highly effective in preventing the development of csCMV infection and ultimately reduces transplant-related mortality.
- Published
- 2021
- Full Text
- View/download PDF
19. Dynamics of Epstein-Barr virus after cord blood transplantation: A nationwide survey in Japan.
- Author
-
Sawada A, Taniguchi S, Takahashi S, Inoue M, Onishi Y, Tanaka M, Henzan H, Kubo M, Nishida A, and Kawa K
- Abstract
Epstein-Barr virus (EBV) is a common virus that latently infects most adults and has a tropism to B lymphocytes. In 1988, two cases of EBV infection were reported to be eradicated by hematopoietic stem cell transplantation from an EBV-negative donor. However, the dynamics of EBV after cord blood transplantation (CBT), namely, the kinetics of anti-EBV antibodies, the incidence of negative/adverse seroconversion (from positive to negative), and the clinical course of re-infection (second primary infection) by EBV, have not yet been characterized in detail. Therefore, we performed a nationwide survey that focused on the dynamics of EBV after CBT 1 year or later after CBT. Negative seroconversion occurred in 23% of previously EBV-infected patients. The incidence of late-onset EBV-associated events was 1.9% (13/674): 5 infectious mononucleosis, 2 hemophagocytic lymphohistiocytosis (HLH), and 6 remaining typical lymphoproliferative disease. HLH occurred in newly infected patients (primary or second primary) and also in those with reactivation and was fatal. The annual monitoring of anti-EBV antibody titers may facilitate the early detection of these late-onset EBV-associated events and treatment initiation before disease progression., Competing Interests: The authors declare no conflict of interest associated with this article. Disclosure forms provided by the authors are available here., (Copyright Ⓒ2021 APBMT. All Rights Reserved.)
- Published
- 2020
- Full Text
- View/download PDF
20. Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment.
- Author
-
Akiyama T, Njenga SM, Njomo DW, Takeuchi R, Kazama H, Mutua A, Walema B, Tomokawa S, Estrada CA, Henzan H, Asakura T, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, and Kobayashi J
- Subjects
- Educational Status, Health Promotion, Humans, Kenya, Schools, Students
- Abstract
There is growing evidence supporting the effectiveness of a comprehensive school health program. However, implementation in developing countries is a challenge. Furthermore, the available information on the association between a comprehensive school health program and students' academic attainment is limited. In Kenya, a project to verify the effects of a comprehensive school health program was carried out in Mbita sub-county, Homa Bay County from September 2012 to August 2017. This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
- Full Text
- View/download PDF
21. Examining the appropriateness and reliability of the strategy of the Kenyan Comprehensive School Health Program.
- Author
-
Tomokawa S, Asakura T, Njenga SM, Njomo DW, Takeuch R, Akiyama T, Kazama H, Mutua A, Barnett W, Henzan H, Shimada M, Ichinose Y, Kamiya Y, Kaneko S, Miyake K, and Kobayashi J
- Subjects
- Child, Health Knowledge, Attitudes, Practice, Humans, Kenya, Pilot Projects, Reproducibility of Results, School Health Services, Health Promotion, Schools
- Abstract
The Kenyan government established the Kenyan Comprehensive School Health Program (KCSHP) on the basis of Kenyan National School Health Policy. A KCSHP pilot project was carried out in eight primary schools in Mbita Sub-County of Homa Bay County in the Nyanza Region from 2012 to 2017. This pilot project provided health facilities and support for evaluation with a school health checklist, and organized teacher training on health education, a child health club, and school-based health check-ups. The present study aimed to examine the appropriateness and reliability of the strategy of the second KCSHP pilot project in Kenya. We analyzed data from self-administered questionnaires targeted at pupils in seventh-grade in the eight primary schools. The questionnaire consisted of questions on health-related knowledge, attitudes and practices, self-evaluated physical and mental health status, self-awareness of health control, subjective happiness, recognition on the importance of learning about health in school, absenteeism, and sense of school belongingness. The project contributed to improving health-related knowledge, attitudes and practices, self-evaluated health status, sense of school belongingness, recognition on the importance of learning about health in school, self-awareness of health control, and absenteeism. On the contrary, subjective happiness did not improve significantly.
- Published
- 2020
- Full Text
- View/download PDF
22. A Novel Hematopoietic Progenitor Cell Mobilization Regimen Comprising Bortezomib, G-CSF, and Preemptive Plerixafor for Multiple Myeloma.
- Author
-
Tanimoto K, Sakamoto K, Kawano I, Yamanaka I, and Henzan H
- Abstract
Adequate hematopoietic progenitor cell collection is critical for autologous peripheral blood stem cell transplantation. Conventionally, patients with multiple myeloma are treated with high-dose cyclophosphamide and granulocyte colony-stimulating factor (G-CSF) or G-CSF alone to mobilize their peripheral blood stem cells. However, some patients exhibit insufficient stem cell recruitment in response to these regimens. Recently, plerixafor has been approved for coverage by insurance in Japan. Combination treatment with plerixafor and G-CSF is now a standard procedure. In addition, treatment with bortezomib and G-CSF results in efficient stem cell recruitment. On the basis of the results from mouse studies, we hypothesized that combination treatment with bortezomib ensures efficient mobilization and mediates in vivo purging of malignant cells. Therefore, we administered a regimen of bortezomib, G-CSF, and preemptive plerixafor to 10 patients with multiple myeloma, and analyzed its efficacy and safety. The median patient age was 68 years. We collected CD34-positive cells (median: 4.9×10
6 /kg) in a single session of apheresis from all patients. We observed no obvious myeloma cell contamination in the collected product or serious toxicity during treatment and collection. After collection, we performed autologous peripheral blood stem cell transplantation and confirmed engraftment in all patients (median: day 10). We found that the regimen is safe and reliably facilitated the collection of sufficient autologous peripheral blood stem cells by apheresis from all patients in a single day. Despite the small patient group size, we conclude that the regimen is promising for safe and efficient collection of peripheral blood stem cells for autologous transplantation in patients with multiple myeloma., Competing Interests: The authors declare no conflict of interest. Disclosure forms provided by the authors are available here., (Copyright Ⓒ2020 APBMT. All Rights Reserved.)- Published
- 2020
- Full Text
- View/download PDF
23. Correction to: Measurable residual disease after the first consolidation predicts the outcomes of patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy.
- Author
-
Henzan H, Takase K, Kamimura T, Mori Y, Yoshimoto G, Iwasaki H, Nagafuji K, Ogawa R, Eto T, Uchida N, Fujisaki T, Kato K, Minami M, Kikushige Y, Akashi K, and Miyamoto T
- Abstract
In the original publication of the article, the "CNS involvement" in the last row under the column "Total N=50" has been published incorrectly. The correct Table 1 is given in this correction.
- Published
- 2020
- Full Text
- View/download PDF
24. Measurable residual disease after the first consolidation predicts the outcomes of patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy.
- Author
-
Henzan H, Takase K, Kamimura T, Mori Y, Yoshimoto G, Iwasaki H, Nagafuji K, Ogawa R, Eto T, Uchida N, Fujisaki T, Kato K, Minami M, Kikushige Y, Akashi K, and Miyamoto T
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cytarabine administration & dosage, Female, Forecasting, Humans, Idarubicin administration & dosage, Leukemia, Promyelocytic, Acute mortality, Male, Middle Aged, Neoplasm, Residual diagnosis, Prognosis, Prospective Studies, Recurrence, Survival Rate, Treatment Outcome, Tretinoin administration & dosage, Young Adult, Consolidation Chemotherapy, Leukemia, Promyelocytic, Acute drug therapy, Neoplasm, Residual mortality, Tretinoin therapeutic use
- Abstract
We stratified patients with newly diagnosed acute promyelocytic leukemia (APL) according to a white blood cell (WBC) count of ≥ 3 × 10
9 /L (high risk) or < 3 × 109 /L (low risk) before administering risk-adapted chemotherapy in combination with all-trans retinoic acid (ATRA). In total, 27 low-risk and 23 high-risk patients were assigned to receive induction and three courses of consolidation with ATRA and anthracycline, followed by 2-year maintenance regimen. High-risk group additionally received cytarabine during 1st consolidation and another one-shot idarubicin treatment during 3rd consolidation. We prospectively monitored measurable residual disease (MRD) after induction and each consolidation. In the low-risk and high-risk groups, 5-year disease-free survival (DFS) rates were 86.5% and 81.2% (p = 0.862), and 5-year overall survival rates were 100% and 84.8% (p = 0.062), respectively. In the MRD-negative and MRD-positive groups, 5-year DFS rates were 91.7% and 78.4% (p = 0.402) and 84.7% and 60.0% (p = 0.102) after induction and 1st consolidation, respectively. Relapse rates were 8.3% and 13.3% (p = 0.570) and 9.0% and 40.0% (p = 0.076) after induction and 1st consolidation, respectively. Achieving MRD-negativity after 1st consolidation, rather than after induction, was a potential predictor of relapse and DFS in patients with APL treated with ATRA + chemotherapy.- Published
- 2020
- Full Text
- View/download PDF
25. Effects of stem cell transplantation in patients with peripheral T-cell lymphoma not otherwise specified and angioimmunoblastic T-cell lymphoma.
- Author
-
Yamasaki S, Yoshida S, Kato K, Choi I, Imamura Y, Kohno K, Henzan H, Tanimoto K, Ogawa R, Suehiro Y, Miyamoto T, Eto T, Ohshima K, Akashi K, and Iwasaki H
- Subjects
- Adult, Aged, Aged, 80 and over, Feasibility Studies, Female, Humans, Immunoblastic Lymphadenopathy mortality, Lymphoma, T-Cell mortality, Lymphoma, T-Cell, Peripheral mortality, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Transplantation, Homologous, Treatment Outcome, Immunoblastic Lymphadenopathy therapy, Lymphoma, T-Cell therapy, Lymphoma, T-Cell, Peripheral therapy, Stem Cell Transplantation
- Abstract
The effects of stem cell transplantation (SCT) in patients with peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL) remain controversial. We analyzed the feasibility of SCT and risk factors associated with outcomes of PTCL-NOS and AITL patients to identify the potential clinical efficacy of SCT. We retrospectively analyzed the data of PTCL-NOS (n = 83) and AITL (n = 112) patients who received autologous (n = 10 and 16, respectively) or allogeneic (n = 12 and 4, respectively) SCT, or no SCT (n = 61 and 92, respectively) between 2008 and 2018. All PTCL-NOS and AITL diagnoses were reconfirmed by an experienced hematopathologist. Median age at PTCL-NOS and AITL diagnoses in the SCT group was younger than that in the no SCT group. Significant risk factors for lower overall survival were intermediate-high and high-risk international prognostic indexes in PTCL-NOS patients (P = 0.0052), and a > 2 modified prognostic index for T-cell lymphoma (P = 0.0079) and no SCT (P = 0.028) in AITL patients. Autologous or allogeneic SCT compared with no SCT in AITL patients resulted in 3-year overall survival of 68.6% and 100% vs. 57.2% (P = 0.018). Strategies should be developed to improve selection of PTCL-NOS and AITL patients suitable for SCT and/or additional novel therapies.
- Published
- 2020
- Full Text
- View/download PDF
26. Comparison of calcineurin inhibitors in combination with conventional methotrexate, reduced methotrexate, or mycophenolate mofetil for prophylaxis of graft-versus-host disease after umbilical cord blood transplantation.
- Author
-
Yoshida S, Ohno Y, Nagafuji K, Yoshimoto G, Sugio T, Kamimura T, Ohta T, Takase K, Henzan H, Muta T, Iwasaki H, Ogawa R, Eto T, Akashi K, and Miyamoto T
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Calcineurin Inhibitors administration & dosage, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Graft Survival, Graft vs Host Disease epidemiology, Graft vs Host Disease etiology, Hematologic Neoplasms therapy, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Incidence, Infections epidemiology, Infections etiology, Japan epidemiology, Kaplan-Meier Estimate, Leukocyte Count, Male, Methotrexate administration & dosage, Methotrexate adverse effects, Middle Aged, Mycophenolic Acid administration & dosage, Neutrophils, Platelet Count, Retrospective Studies, Treatment Outcome, Young Adult, Calcineurin Inhibitors therapeutic use, Cord Blood Stem Cell Transplantation adverse effects, Graft vs Host Disease prevention & control, Immunosuppressive Agents therapeutic use, Methotrexate therapeutic use, Mycophenolic Acid therapeutic use
- Abstract
Umbilical cord blood transplantation (UCBT) is a curative treatment for hematological malignancies. However, appropriate prophylaxis against graft-versus-host disease (GVHD), aimed at obtaining rapid and stable engraftment and avoiding toxicity, remains controversial in UCBT. We retrospectively compared outcomes in 409 patients who received calcineurin inhibitors (CIs) plus conventional-dose methotrexate (conv-MTX/CIs, n = 77; methotrexate, 10 mg/m
2 on day 1, 7 mg/m2 on days 3 and 6) with those who received CIs plus reduced-dose methotrexate (reduced-MTX/CIs, n = 209; methotrexate, 5 mg/m2 or 5 mg/body on days 1, 3, and 6) or CIs with mycophenolate mofetil (MMF/CIs, n = 123) for GVHD prophylaxis after UCBT. The cumulative incidence of neutrophil engraftment was significantly higher in the reduced-MTX/CI (82.3%) and MMF/CI (86.6%) groups than the conv-MTX/CI (71.4%) group (p = 0.014), although there were no differences in platelet recovery or infectious complications among the three groups. The incidence and severity of GVHD were comparable among the three groups, and there were no significant differences in transplantation-related mortality among the three groups. In conclusion, GVHD prophylaxis with reduced-dose methotrexate and MMF was closely associated with high incidence of neutrophil engraftment without an effect on the incidence and severity of GVHD, which was compared to GVHD prophylaxis with conventional-dose methotrexate.- Published
- 2019
- Full Text
- View/download PDF
27. HBV reactivation after hematopoietic stem cell transplantation and rituximab-containing chemotherapy: a 12-year experience at a single center.
- Author
-
Bae SK, Gushima T, Saito N, Yamanaka I, Matsuo Y, Yoshida S, Kawano I, Henzan H, Shimoda S, Eto T, and Takahashi K
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols adverse effects, Female, Hematopoietic Stem Cell Transplantation adverse effects, Hepatitis B virology, Humans, Male, Middle Aged, Rituximab administration & dosage, Rituximab adverse effects, Transplantation Conditioning adverse effects, Virus Activation, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Hematopoietic Stem Cell Transplantation methods, Hepatitis B virus physiology, Transplantation Conditioning methods
- Published
- 2019
- Full Text
- View/download PDF
28. Risk of secondary primary malignancies in multiple myeloma patients with or without autologous stem cell transplantation.
- Author
-
Yamasaki S, Yoshimoto G, Kohno K, Henzan H, Aoki T, Tanimoto K, Sugio Y, Muta T, Kamimura T, Ohno Y, Ogawa R, Eto T, Nagafuji K, Miyamoto T, Akashi K, and Iwasaki H
- Subjects
- Incidence, Lenalidomide therapeutic use, Multiple Myeloma mortality, Multiple Myeloma pathology, Risk Factors, Survival Analysis, Transplantation, Autologous methods, Hematopoietic Stem Cell Transplantation methods, Multiple Myeloma secondary, Neoplasms, Second Primary chemically induced, Neoplasms, Second Primary etiology
- Abstract
Outcomes for patients with multiple myeloma (MM) have improved through use of novel treatments, especially lenalidomide combined with autologous stem cell transplantation. However, because of their increased life expectancy, an increased risk of secondary primary malignancies (SPMs) has been observed in MM patients, particularly after lenalidomide maintenance in both transplant-eligible (TE) and transplant-ineligible (TI) patients. To evaluate the incidence and risk factors of developing SPMs, we identified 17 TE-MM and 12 TI-MM patients with SPMs among 211 TE-MM and 280 TI-MM patients, including seven TE-MM and four TI-MM patients with hematological malignancies and ten TE-MM and eight TI-MM patients with non-hematological cancers, respectively. The median follow-up time from diagnosis was > 4 years. Multivariate analysis identified a history of high-dose cyclophosphamide use for peripheral blood stem cell harvest in TE-MM patients and > 65 years of age at diagnosis, or a history of adriamycin, lenalidomide, or thalidomide use in TI-MM patients as independent risk factors for SPMs (P < 0.001). Patients with a history of lenalidomide use had a lower risk of death among both TE-MM (P = 0.0326) and TI-MM (P < 0.001) patients. The survival benefit of receiving lenalidomide outweighed the increased risk of SPMs in both TE-and TI-MM patients.
- Published
- 2019
- Full Text
- View/download PDF
29. Impact of pretransplant central nervous system invasion in patients with aggressive adult T-cell leukemia lymphoma.
- Author
-
Fuji S, Inoue Y, Utsunomiya A, Moriuchi Y, Choi I, Otsuka E, Henzan H, Kato K, Nakachi S, Yamamoto H, and Fukuda T
- Subjects
- Adult, Allografts, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Invasiveness, Survival Rate, Central Nervous System Neoplasms metabolism, Central Nervous System Neoplasms pathology, Central Nervous System Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Leukemia-Lymphoma, Adult T-Cell mortality, Leukemia-Lymphoma, Adult T-Cell pathology, Leukemia-Lymphoma, Adult T-Cell therapy
- Published
- 2019
- Full Text
- View/download PDF
30. Prospective randomization of post-remission therapy comparing autologous peripheral blood stem cell transplantation versus high-dose cytarabine consolidation for acute myelogenous leukemia in first remission.
- Author
-
Miyamoto T, Nagafuji K, Fujisaki T, Uchida N, Matsue K, Henzan H, Ogawa R, Takase K, Aoki T, Hidaka M, Teshima T, Taniguchi S, Akashi K, and Harada M
- Subjects
- Adult, Aged, Aged, 80 and over, Autografts, Female, Humans, Male, Middle Aged, Prospective Studies, Remission Induction, Treatment Outcome, Young Adult, Antimetabolites, Antineoplastic administration & dosage, Consolidation Chemotherapy, Cytarabine administration & dosage, Leukemia, Myeloid, Acute therapy, Peripheral Blood Stem Cell Transplantation
- Abstract
We prospectively compared outcomes of autologous stem cell transplantation (ASCT) versus high-dose cytarabine (HiDAC) consolidation as post-remission therapy for favorable- and intermediate-risk acute myelogenous leukemia (AML) in first complete remission (CR1). Two-hundred-forty patients under 65 years with AML-M1, M2, M4, or M5 subtypes were enrolled. After induction, 153 patients did not undergo randomization, while the remaining 87 who achieved CR1 were prospectively randomized to HiDAC (n = 45) or ASCT arm (n = 42). In the HiDAC arm, 43 patients completed three cycles of HiDAC, whereas in ASCT arm 22 patients completed two cycles of consolidation consisting of intermediate-dose cytarabine plus mitoxantrone or etoposide followed by ASCT. The three-year disease-free survival (DFS) rate was 41% in HiDAC and 55% in ASCT arm (p = 0.25). Three-year overall survival (OS) rates were 77 and 68% (p = 0.67). Incidence of relapse was 54 and 41% (p = 0.22). There was no significant difference in nonrelapse mortality between two arms (p = 0.88). Patients in the ASCT arm tended to have higher DFS rates and lower relapse rates than patients in HiDAC; however, there was no significant improvement in OS in patients with favorable- and intermediate-risk AML in CR1. Patients with AML are not benefited by the intensified chemotherapy represented by ASCT.
- Published
- 2018
- Full Text
- View/download PDF
31. Effect of cytogenetic risk status on outcomes for patients with acute myeloid leukemia undergoing various types of allogeneic hematopoietic cell transplantation: an analysis of 7812 patients.
- Author
-
Yanada M, Mori J, Aoki J, Harada K, Mizuno S, Uchida N, Kurosawa S, Toya T, Kanamori H, Ozawa Y, Ogawa H, Henzan H, Iwato K, Sakura T, Ota S, Fukuda T, Ichinohe T, Atsuta Y, and Yano S
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Graft vs Host Disease etiology, Graft vs Host Disease pathology, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Male, Middle Aged, Neoplasm Recurrence, Local etiology, Neoplasm Recurrence, Local pathology, Prognosis, Retrospective Studies, Risk Factors, Survival Rate, Transplantation Conditioning, Young Adult, Cytogenetic Analysis methods, Graft vs Host Disease mortality, Hematopoietic Stem Cell Transplantation classification, Hematopoietic Stem Cell Transplantation mortality, Leukemia, Myeloid, Acute therapy, Neoplasm Recurrence, Local mortality
- Abstract
This study aimed at determining how cytogenetic risk status affects outcomes for patients with acute myeloid leukemia (AML) after undergoing various types of allogeneic hematopoietic cell transplantation (HCT). Of 7812 patients eligible for analysis, cytogenetic risk was classified as favorable for 1088, intermediate for 5025, and poor for 1699. Overall, multivariate analysis showed significant intergroup differences in terms of relapse and survival, with the difference between poor- and intermediate-risk groups being greater than that between favorable- and intermediate-risk groups. Non-relapse mortality was identical for the three groups. Significant effects of cytogenetic risk status on survival were documented irrespective of donor type (related, unrelated, and umbilical cord blood), disease status at the time of transplantation (first or second complete remission, and more advanced disease status), and conditioning intensity (myeloablative and reduced-intensity). Our findings demonstrate robust and constant effects of cytogenetic risk status on survival after allogeneic HCT for patients with AML.
- Published
- 2018
- Full Text
- View/download PDF
32. Autologous hematopoietic cell transplantation for acute promyelocytic leukemia in second complete remission: outcomes before and after the introduction of arsenic trioxide.
- Author
-
Yanada M, Yano S, Kanamori H, Gotoh M, Emi N, Watakabe K, Kurokawa M, Nishikawa A, Mori T, Tomita N, Murata M, Hashimoto H, Henzan H, Kanda Y, Sawa M, Kohno A, Atsuta Y, Ichinohe T, and Takami A
- Subjects
- Adolescent, Adult, Aged, Antineoplastic Agents therapeutic use, Arsenic Trioxide, Arsenicals therapeutic use, Combined Modality Therapy, Female, Humans, Japan, Leukemia, Promyelocytic, Acute diagnosis, Leukemia, Promyelocytic, Acute mortality, Male, Middle Aged, Oxides therapeutic use, Recurrence, Remission Induction, Transplantation Conditioning, Transplantation, Autologous, Treatment Outcome, Young Adult, Hematopoietic Stem Cell Transplantation, Leukemia, Promyelocytic, Acute therapy
- Abstract
We conducted a retrospective registry-based study involving 198 patients with acute promyelocytic leukemia (APL) who underwent autologous hematopoietic cell transplantation (HCT) during second complete remission (CR2) from 1995 to 2012. Arsenic trioxide (ATO) became commercially available in Japan in December 2004, and a substantial increase in the annual numbers of transplantations has occurred since 2005. Patients transplanted after 2006 had significantly better relapse-free and overall survival than those transplanted before 2004 (p = .028 and p = .027, respectively). There was a significant difference in cumulative incidence of relapse in favor of those transplanted after 2006 (p = .008), whereas non-relapse mortality did not differ between the two groups (p = .683). Our findings suggest that the introduction of ATO may have reduced post-transplantation relapse without increasing non-relapse mortality, resulting in significant improvements in overall outcomes for relapsed APL patients undergoing autologous HCT during CR2.
- Published
- 2017
- Full Text
- View/download PDF
33. Comparison of cyclosporine and tacrolimus combined with mycophenolate mofetil in prophylaxis for graft-versus-host disease after reduced-intensity umbilical cord blood transplantation.
- Author
-
Miyamoto T, Takashima S, Kato K, Takase K, Yoshimoto G, Yoshida S, Henzan H, Osaki K, Kamimura T, Iwasaki H, Eto T, Teshima T, Nagafuji K, and Akashi K
- Subjects
- Adult, Aged, Disease-Free Survival, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local prevention & control, Transplantation Conditioning methods, Treatment Outcome, Antibiotics, Antineoplastic therapeutic use, Cyclosporine therapeutic use, Fetal Blood transplantation, Graft vs Host Disease prevention & control, Hematologic Neoplasms therapy, Immunosuppressive Agents therapeutic use, Mycophenolic Acid therapeutic use, Tacrolimus therapeutic use
- Abstract
Umbilical cord blood transplantation with a reduced-intensity conditioning regimen (RIC-UCBT) is used increasingly in patients who have comorbid organ functions and lack human leukocyte antigen-identical donors. We compared the outcomes in 35 patients who received mycophenolate mofetil plus cyclosporine (MMF/CSP, n = 17) or MMF plus tacrolimus (MMF/TAC, n = 18) for graft-versus-host disease (GVHD) prophylaxis after RIC-UCBT. Cumulative incidence of neutrophil engraftment was 94 and 89 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.34). The incidence of pre-engraftment immune reaction did not differ between the MMF/CSP (41 %) and MMF/TAC (39 %, p = 1.00) groups; however, patients in the MMF/TAC group tended to have a lower incidence of grade II-IV acute GVHD than those in MMF/CSP group (28 vs 53 %, p = 0.11). Overall survival (OS) at 1 year was 43 and 60 % in MMF/CSP and MMF/TAC groups, respectively (p = 0.39). Progression-free survival, non-relapse mortality, and relapse rate were comparable between the two groups (p = 0.76, 0.59, and 0.88, respectively). In multivariate analyses, MMF/TAC GVHD prophylaxis was closely associated with improved OS, but not with incidence of engraftment and acute GVHD. These results suggest that more intensive GVHD prophylaxis with MMF/TAC decreased acute GVHD without affecting other clinical outcomes, resulting in improved OS after RIC-UCBT.
- Published
- 2017
- Full Text
- View/download PDF
34. Pretransplantation Anti-CCR4 Antibody Mogamulizumab Against Adult T-Cell Leukemia/Lymphoma Is Associated With Significantly Increased Risks of Severe and Corticosteroid-Refractory Graft-Versus-Host Disease, Nonrelapse Mortality, and Overall Mortality.
- Author
-
Fuji S, Inoue Y, Utsunomiya A, Moriuchi Y, Uchimaru K, Choi I, Otsuka E, Henzan H, Kato K, Tomoyose T, Yamamoto H, Kurosawa S, Matsuoka K, Yamaguchi T, and Fukuda T
- Subjects
- Acute Disease, Adrenal Cortex Hormones therapeutic use, Adult, Aged, Antibodies, Monoclonal, Humanized therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Databases, Factual, Female, Graft vs Host Disease chemically induced, Graft vs Host Disease drug therapy, Graft vs Host Disease immunology, Hematopoietic Stem Cell Transplantation methods, Humans, Leukemia-Lymphoma, Adult T-Cell drug therapy, Leukemia-Lymphoma, Adult T-Cell mortality, Male, Middle Aged, Retrospective Studies, Survival Rate, Transplantation, Homologous, Young Adult, Antibodies, Monoclonal, Humanized adverse effects, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects, Leukemia-Lymphoma, Adult T-Cell therapy
- Abstract
Purpose: Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is one important treatment option for patients with aggressive adult T-cell leukemia/lymphoma (ATLL). Mogamulizumab (anti-CCR4 monoclonal antibody; Mog) was recently approved as a treatment for ATLL in Japan. Major concerns exist about the possible adverse effects of pretransplantation Mog because Mog depletes regulatory T cells for several months. We assessed the impact of pretransplantation Mog on clinical outcomes after allo-HSCT., Patients and Methods: We included 996 allo-HSCT recipients age 70 years or younger with aggressive ATLL who were given the diagnosis between 2000 and 2013 and who received intensive chemotherapy by multiple chemotherapeutic drugs as first-line therapy. Before allo-HSCT, 82 patients received Mog with a median interval of 45 days from the last Mog to allo-HSCT., Results: Pretransplantation Mog was associated with an increased risk of grade 3 to 4 acute graft-versus-host disease (GVHD; relative risk, 1.80; P < .01) and refractoriness to systemic corticosteroid for acute GVHD (relative risk, 2.09; P < .01). One-year cumulative incidence of nonrelapse mortality was significantly higher in patients with pretransplantation Mog compared with those without (43.7% v 25.1%; P < .01). The probability of 1-year overall survival was also significantly inferior in patients with pretransplantation Mog compared with those without (32.3% v 49.4%; P < .01). In particular, use of Mog with intervals < 50 days to allo-HSCT was associated with a dismal clinical outcome., Conclusion: Pretransplantation Mog was significantly associated with an increased risk of GVHD-related mortality, which supports the relevance of CCR4-expressing Tregs after allo-HSCT in humans. In clinical practice, Mog should be cautiously used for patients with ATLL who are eligible for allo-HSCT., (© 2016 by American Society of Clinical Oncology.)
- Published
- 2016
- Full Text
- View/download PDF
35. Mogamulizumab Treatment Prior to Allogeneic Hematopoietic Stem Cell Transplantation Induces Severe Acute Graft-versus-Host Disease.
- Author
-
Sugio T, Kato K, Aoki T, Ohta T, Saito N, Yoshida S, Kawano I, Henzan H, Kadowaki M, Takase K, Muta T, Miyawaki K, Yamauchi T, Shima T, Takashima S, Mori Y, Yoshimoto G, Kamezaki K, Takenaka K, Iwasaki H, Ogawa R, Ohno Y, Eto T, Kamimura T, Miyamoto T, and Akashi K
- Subjects
- Acute Disease, Adult, Aged, Antibodies, Monoclonal, Humanized therapeutic use, Female, Graft vs Host Disease mortality, Hematopoietic Stem Cell Transplantation mortality, Humans, Leukemia-Lymphoma, Adult T-Cell mortality, Leukemia-Lymphoma, Adult T-Cell therapy, Male, Middle Aged, Remission Induction methods, Retrospective Studies, Survival Analysis, Transplantation, Homologous, Antibodies, Monoclonal, Humanized toxicity, Graft vs Host Disease chemically induced, Hematopoietic Stem Cell Transplantation adverse effects, Leukemia-Lymphoma, Adult T-Cell complications, Leukemia-Lymphoma, Adult T-Cell drug therapy
- Abstract
Mogamulizumab (MOG), a humanized anti-CC chemokine receptor 4 (CCR4) monoclonal antibody, has recently played an important role in the treatment of adult T cell leukemia/lymphoma (ATLL). Because CCR4 is expressed on normal regulatory T cells as well as on ATLL cells, MOG may accelerate graft-versus-host disease (GVHD) by eradicating regulatory T cells in patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, there is limited information about its safety and efficacy in patients treated with MOG before allo-HSCT. In the present study, 25 patients with ATLL were treated with MOG before allo-HSCT, after which 18 patients (72%) achieved remission. The overall survival and progression-free survival at 1 year post-transplantation were 20.2% (95% CI, 6.0% to 40.3%) and 15.0% (95% CI, 4.3% to 32.0%), respectively. The cumulative incidence of acute GVHD was 64.0% (95% CI, 40.7% to 80.1%) for grade II-IV and 34.7% (95% CI, 15.8% to 54.4%) for grade III-IV. The cumulative incidence of transplantation-related mortality (TRM) was 49.0% (95% CI, 27.0% to 67.8%). Six of 7 patients with acute GVHD grade III-IV died from GVHD, which was the leading cause of death. In particular, a shorter interval from the last administration of MOG to allo-HSCT was associated with more severe GVHD. MOG use before allo-HSCT may decrease the ATLL burden; however, it is associated with an increase in TRM due to severe GVHD. Because MOG is a potent anti-ATLL agent, new treatment protocols should be developed to integrate MOG at suitable doses and timing of administration to minimize unwanted GVHD development., (Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
36. Significance of monitoring trough plasma concentration levels for invasive fungal infection prophylaxis with itraconazole oral solution in patients with hematological malignancies: a prospective study.
- Author
-
Kawano I, Matsumoto K, Jiromaru T, Jinnochi F, Semba Y, Sugio T, Sakamoto K, Saito N, Yoshida S, Henzan H, Takase K, Morita K, and Eto T
- Subjects
- Administration, Oral, Adult, Aged, Aged, 80 and over, Antifungal Agents administration & dosage, Female, Fungi isolation & purification, Humans, Itraconazole administration & dosage, Male, Middle Aged, Mycoses blood, Prospective Studies, Young Adult, Antifungal Agents therapeutic use, Itraconazole therapeutic use, Leukemia, Myeloid, Acute therapy, Mycoses prevention & control, Myelodysplastic Syndromes therapy
- Abstract
In this prospective study, we examined the prophylactic effect of itraconazole oral solution (ITCZ-OS) against invasive fungal disease in hematologic malignancy patients. The participants were 36 patients, at least 16 years of age, with hematologic malignancies treated at our hospital. ITCZ-OS 200 mg/day was administered orally twice a day with a target trough plasma concentration of 350 ng/ml. If the patient did not achieve the target trough plasma concentration, the dose was increased. The success rate of achieving the target trough plasma concentration of ITCZ with a dose of 200 mg/day was 63.9%. During the observation period, 2 patients (5.6%) were diagnosed with possible invasive fungal disease according to the EORTC/MSG 2008 criteria. Adverse events were observed in 2 patients (5.6%). The results showed administration of ITCZ-OS while monitoring ITCZ trough plasma concentrations to be effective for preventing invasive fungal disease, and no serious adverse events occurred. Since predicting trough levels in response to ITCZ administrations is difficult, its measurement is necessary to maintain the prophylactic effect of ITCZ.
- Published
- 2016
- Full Text
- View/download PDF
37. Effects of conditioning intensity in allogeneic stem cell transplantation for Philadelphia chromosome‑positive acute lymphoblastic leukemia.
- Author
-
Takashima S, Miyamoto T, Kamimura T, Yoshimoto G, Yoshida S, Henzan H, Takase K, Kato K, Ito Y, Ohno Y, Nagafuji K, Eto T, Techima T, and Akashi K
- Subjects
- Adolescent, Adult, Aged, Allografts, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Combined Modality Therapy, Dasatinib administration & dosage, Female, Graft vs Host Disease prevention & control, Humans, Imatinib Mesylate administration & dosage, Male, Middle Aged, Protein Kinase Inhibitors administration & dosage, Remission Induction, Retrospective Studies, Treatment Outcome, Young Adult, Philadelphia Chromosome, Precursor Cell Lymphoblastic Leukemia-Lymphoma genetics, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, Transplantation Conditioning methods
- Abstract
We retrospectively analyzed the outcomes of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) who underwent first allogeneic stem cell transplantation (allo-SCT) at complete remission (CR) with myeloablative conditioning (MAC, n = 31) or reduced-intensity conditioning (RIC, n = 15) between 2001 and 2012. All the patients had received tyrosine kinase inhibitor (TKI)-based chemotherapy prior to allo-SCT. Overall survival (OS) rates (57 vs 63%, p = 0.53), leukemia-free survival rates (50 vs 65%, p = 0.29), and non-relapse mortality rates (39 vs 35%, p = 0.62) at 2 years were similar between the MAC and RIC groups. The minimal residual disease (MRD) status evaluated by sensitive polymerase chain reaction prior to allo-SCT did not influence the OS rate (77 vs 54%, p = 0.28) and leukemia-free survival rate (69 vs 51%, p = 0.48), irrespective of the conditioning intensity. Our data suggest that the RIC regimen may represent a sufficient intensity of therapeutic pre-transplant conditioning for patients with Ph+ALL who have maintained a hematological CR with TKI-combined chemotherapy.
- Published
- 2015
- Full Text
- View/download PDF
38. Characteristics of patients with development of large granular lymphocyte expansion among dasatinib-treated patients with relapsed Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic stem cell transplantation.
- Author
-
Ito Y, Miyamoto T, Kamimura T, Aoki K, Henzan H, Aoki T, Shiratsuchi M, Kato K, Nagafuji K, Ogawa R, Eto T, Iwasaki H, and Akashi K
- Subjects
- Adult, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Biopsy, Bone Marrow pathology, Combined Modality Therapy, Consolidation Chemotherapy, Dasatinib administration & dosage, Dasatinib adverse effects, Female, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Induction Chemotherapy, Male, Middle Aged, Mutation, Neoplasm, Residual, Precursor Cell Lymphoblastic Leukemia-Lymphoma genetics, Protein Kinase Inhibitors administration & dosage, Protein Kinase Inhibitors adverse effects, Recurrence, Retrospective Studies, Transplantation, Homologous, Treatment Outcome, Antineoplastic Agents therapeutic use, Dasatinib therapeutic use, Lymphocytes pathology, Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy, Protein Kinase Inhibitors therapeutic use
- Abstract
Introduction: Widespread use of tyrosine kinase inhibitors (TKIs) in combination with chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-SCT) has totally changed the existing treatment strategies for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL). However, the prognosis after relapse after allo-SCT is still dismal., Patients and Methods: We analyzed the clinical outcome of therapy using dasatinib, a second-generation TKI, in 9 patients with relapsed Ph(+)ALL after allo-SCT. Dasatinib was initiated at a median time of 168 days after allo-SCT at dosages ranging from 20 mg to 100 mg daily., Results: Six of 9 patients manifested a marked increase in large granular lymphocytes (LGLs), but all 6 patients discontinued dasatinib because of adverse events (AEs) such as pleural effusion. Four of 6 patients resumed dasatinib, and 3 of them have been alive with molecular complete remission and a persistent increase of LGLs., Conclusion: Our results demonstrated that dasatinib therapy can induce LGL expansion accompanied by AEs, but this phenomenon can be associated with long-term survival benefit in a proportion of relapsed Ph(+)ALL patients after allo-SCT., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
39. High-dose chemotherapy with autologous stem cell transplantation for elderly patients with relapsed/refractory diffuse large B cell lymphoma: a nationwide retrospective study.
- Author
-
Chihara D, Izutsu K, Kondo E, Sakai R, Mizuta S, Yokoyama K, Kaneko H, Kato K, Hasegawa Y, Chou T, Sugahara H, Henzan H, Sakamaki H, Suzuki R, and Suzumiya J
- Subjects
- Aged, Carboplatin therapeutic use, Cyclophosphamide therapeutic use, Cytarabine therapeutic use, Etoposide therapeutic use, Female, Humans, Lymphoma, Large B-Cell, Diffuse immunology, Lymphoma, Large B-Cell, Diffuse mortality, Lymphoma, Large B-Cell, Diffuse pathology, Male, Melphalan therapeutic use, Middle Aged, Nitrosourea Compounds therapeutic use, Recurrence, Retrospective Studies, Survival Analysis, Transplantation, Autologous, Antineoplastic Combined Chemotherapy Protocols, Hematopoietic Stem Cell Transplantation, Lymphoma, Large B-Cell, Diffuse therapy
- Abstract
The number of elderly patients with diffuse large B cell lymphoma (DLBCL) continues to increase but the data regarding autologous stem cell transplantation (ASCT) for elderly patients are limited. We analyzed 484 patients, ages 60 years or over, diagnosed with relapsed/refractory DLBCL who received ASCT from 1993 to 2010 in the Japan Society for Hematopoietic Cell Transplantation database. Median age was 64 years (range, 60 to 78). To evaluate the impact of age at ASCT, patients were classified into 3 groups: those between the ages of 60 to 64, 65 to 69, and 70 years or over. Overall nonrelapse mortality (NRM) at day 100, 1 year, and 2 years was 4.1%, 5.9% and 7.7%, respectively. NRM did not significantly differ among age groups (P = .60). Two-year progression-free survival (PFS) and overall survival (OS) were 48% and 58%, respectively. PFS and OS were significantly longer in patients 60 to 64 years old; however, the survival rate was acceptable even in those 70 or over, with a 2-year OS of 46%. ASCT is feasible in selected elderly patients and age alone should not be a contraindication for ASCT. Eligibility should be individualized and identification of a subset of elderly patients at high risk of treatment-related morbidity or mortality warrants investigation., (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
40. The use of oral beclomethasone dipropionate in the treatment of gastrointestinal graft-versus-host disease: the experience of the Fukuoka blood and marrow transplantation (BMT) group.
- Author
-
Takashima S, Eto T, Shiratsuchi M, Hidaka M, Mori Y, Kato K, Kamezaki K, Oku S, Henzan H, Takase K, Matsushima T, Takenaka K, Iwasaki H, Miyamoto T, Akashi K, and Teshima T
- Subjects
- Adult, Aged, Bone Marrow Transplantation adverse effects, Cord Blood Stem Cell Transplantation adverse effects, Drug Therapy, Combination, Female, Gastrointestinal Diseases etiology, Graft vs Host Disease etiology, Humans, Japan, Male, Middle Aged, Peripheral Blood Stem Cell Transplantation adverse effects, Treatment Outcome, Beclomethasone administration & dosage, Gastrointestinal Diseases drug therapy, Glucocorticoids administration & dosage, Graft vs Host Disease drug therapy, Prednisone administration & dosage
- Abstract
Objective: We examined the therapeutic strategies for treating mild gastrointestinal (GI) graft-versus-host disease (GVHD) using oral beclomethasone dipropionate (BDP) in 15 Japanese patients based on the donor source. The primary objective was to determine the efficacy and toxicity of oral BDP combined with/without low-dose prednisone (PSL)., Methods: Oral BDP was administered with 1 mg/kg/d of PSL in patients undergoing bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT; n=11), and the dose of PSL was tapered off after 22 days. Oral BDP alone was administered in patients undergoing cord blood stem cell transplantation (CBSCT; n=4). The primary endpoint was the rate of treatment success on day 49, as measured according to the improvement or complete resolution of GI symptoms without additional treatment. The secondary endpoints included treatment-related toxicity according to the National Cancer Institute Common Toxicity Criteria version 3.0, the rate of treatment discontinuation due to toxicity, the rate of relapse of acute GVHD by day 100 and the incidence of bacterial, fungal or viral infection, including cytomegalovirus (CMV) antigenemia., Results: Treatment success was achieved in seven of the 11 (64%) patients undergoing BMT or PBSCT and in all four patients (100%) undergoing CBSCT. Subsequent adverse events included herpes zoster infection, catheter-associated sepsis and CMV enteritis; all affected patients responded well to treatment., Conclusion: The use of a risk-stratified treatment strategy with oral BDP depending on the stem cell source is effective in patients with mild GI-GVHD.
- Published
- 2014
- Full Text
- View/download PDF
41. Clinical outcomes of allogeneic stem cell transplantation for relapsed or refractory follicular lymphoma: a retrospective analysis by the Fukuoka Blood and Marrow Transplantation Group.
- Author
-
Ito Y, Miyamoto T, Kamimura T, Takase K, Henzan H, Sugio Y, Kato K, Ohno Y, Eto T, Teshima T, and Akashi K
- Subjects
- Adult, Aged, Cause of Death, Female, Follow-Up Studies, Graft Survival, Graft vs Host Disease etiology, Graft vs Host Disease prevention & control, Humans, Lymphoma, Follicular mortality, Lymphoma, Follicular pathology, Male, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation adverse effects, Lymphoma, Follicular therapy
- Abstract
Allogeneic hematopoietic stem cell transplantation (allo-SCT) is considered the only curative treatment for relapsed or refractory follicular lymphoma (FL), but it has a high treatment-related mortality rate. Only a few reports, however, have described the efficacy of allo-SCT for FL in the Japanese population. We retrospectively analyzed the outcome of allo-SCT in 30 patients with FL. Seventeen (56.7 %) patients were chemorefractory, whereas 13 (43.3 %) were chemosensitive. An estimated 2-year overall survival rate (OS) and relapse rate of all patients was 46.7 and 20.0 %, respectively. There were no significant differences in the estimated 2-year OS rate between patients who received myeloablative conditioning and those who received reduced-intensity conditioning (P = 0.98), and among the recipients of related bone marrow (BM)/peripheral blood stem cell, unrelated BM and umbilical cord blood (P = 0.20). In patients who were either chemosensitive or chemorefractory at allo-SCT, the 2-year OS rate was 69.2 and 29.4 % (P = 0.06). Patients with mild-to-moderate acute GVHD had better 2-year PFS rate compared with patients who had severe acute GVHD (P = 0.01), but not better PFS compared with patients who had no acute GVHD (P = 0.12). Our results suggest that the graft-versus-lymphoma effects of allo-SCT may provide survival benefits even in patients with chemorefractory FL.
- Published
- 2013
- Full Text
- View/download PDF
42. Quantitation of hematogones at the time of engraftment is a useful prognostic indicator in allogeneic hematopoietic stem cell transplantation.
- Author
-
Shima T, Miyamoto T, Kikushige Y, Mori Y, Kamezaki K, Takase K, Henzan H, Numata A, Ito Y, Takenaka K, Iwasaki H, Kamimura T, Eto T, Nagafuji K, Teshima T, Kato K, and Akashi K
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Bone Marrow Transplantation, Cord Blood Stem Cell Transplantation, Disease-Free Survival, Female, Graft vs Host Disease blood, Graft vs Host Disease mortality, Graft vs Host Disease therapy, Humans, Lymphocyte Count, Male, Middle Aged, Survival Rate, Transplantation, Homologous, Graft Survival, Hematologic Neoplasms blood, Hematologic Neoplasms mortality, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Precursor Cells, B-Lymphoid, Unrelated Donors
- Abstract
Unlabelled: Transient marrow expansion of normal B-cell precursors, termed hematogones, is occasionally observed after hematopoietic stem cell transplantation (HSCT). To understand the clinical significance of this phenomenon, we enumerated hematogones in 108 consecutive patients who received allogeneic HSCT for the treatment of hematologic malignancies, including acute myelogenous leukemia, advanced myelodysplastic syndromes, acute lymphoblastic leukemia, and non-Hodgkin lymphoma. Hematogone quantitation was performed at the time of complete donor engraftment (median day 25 and 32 in patients who received bone marrow and cord blood cell transplants, respectively). Hematogones were polyclonal B cells, and their frequencies correlated positively with blood B-cell numbers, and inversely with donors’ but not recipients' age, suggesting that hematogones reflect cell-intrinsic B-cell potential of donor cells. Interestingly, patients developing hematogones that comprised > 5% of bone marrow mononuclear cells constituted a group with significantly prolonged overall survival and relapse-free survival, irrespective of their primary disease or donor cell source. In addition, patients with > 5% hematogones developed severe acute graft-versus-host diseases less frequently, which may contribute toward their improved survival. We therefore conclude that the amount of hematogones at the time of engraftment may be a useful tool in predicting the prognosis of patients treated with allogeneic HSCT., Key Points: Quantitation of hematogones at engraftment is useful to predict prognosis of patients treated with allogeneic stem cell transplantation.
- Published
- 2013
- Full Text
- View/download PDF
43. Initial low-dose valganciclovir as a preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients.
- Author
-
Takenaka K, Nagafuji K, Takase K, Kamimura T, Mori Y, Ito Y, Nishi Y, Henzan H, Kato K, Harada N, Eto T, Miyamoto T, Teshima T, and Akashi K
- Subjects
- Adult, Aged, Antiviral Agents adverse effects, Cytomegalovirus Infections prevention & control, Cytomegalovirus Infections virology, Ganciclovir administration & dosage, Ganciclovir adverse effects, Humans, Middle Aged, Transplantation, Homologous, Treatment Outcome, Valganciclovir, Antibiotic Prophylaxis adverse effects, Antiviral Agents administration & dosage, Cytomegalovirus Infections drug therapy, Ganciclovir analogs & derivatives, Hematopoietic Stem Cell Transplantation
- Abstract
Preemptive therapy for cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplant (HSCT) patients is effective in decreasing the incidence of CMV disease. Intravenous ganciclovir is a commonly used preemptive therapy, but as we have recently shown, oral valganciclovir (VGC) is a useful alternative. However, the optimal dose of VGC has not been determined. We prospectively evaluated the efficacy and toxicity of an initial low-dose of VGC (900 mg QD) as preemptive therapy in 20 patients with low-level CMV antigenemia following allogeneic HSCT. Patients were screened weekly for CMV pp65 antigenemia after engraftment. Preemptive therapy with VGC (900 mg QD) was initiated if more than two CMV antigen-positive cells per 50,000 leukocytes were detected. CMV antigen-positive cells disappeared from all 20 patients after 14-29 days (median 20 days) of VGC treatment. None of the patients developed CMV disease nor did they require more than the conventional VGC dose (900 mg BID). Neutropenia (<500/μL) developed in three patients who required granulocyte-colony-stimulating factor support, but there were no other significant side effects. These observations suggest that the initial dose of VGC in preemptive therapy for CMV can be safely decreased to 900 mg QD for patients with low-level CMV antigenemia.
- Published
- 2012
- Full Text
- View/download PDF
44. [Clinical outcomes of allogeneic hematopoietic stem cell transplantation for adult primary myelofibrosis: retrospective analysis by Fukuoka BMT group].
- Author
-
Kamimura T, Yong C, Ito Y, Henzan H, Miyamoto T, Ohno Y, Eto T, Takenaka K, and Akashi K
- Subjects
- Adult, Female, Graft vs Host Disease drug therapy, Graft vs Host Disease prevention & control, Humans, Japan, Male, Middle Aged, Retrospective Studies, Survival Rate, Transplantation, Homologous, Treatment Outcome, Hematopoietic Stem Cell Transplantation mortality, Primary Myelofibrosis therapy
- Abstract
We retrospectively analyzed outcomes of eight evaluable patients with primary myelofibrosis (PMF) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT), using different graft sources; four patients received peripheral blood stem cells, three bone marrow, and one umbilical cord blood. The median age was 48 years (range, 43~64 years). Seven patients had an intermediate or high Dupriez score. Three patients underwent myeloablative conditioning, whereas five underwent reduced-intensity conditioning regimens. Engraftment was obtained in all of these recipients. The median days to reach a neutrophil count above 0.5×10(9)/l and platelet count above 20×10(9)/l were 20 and 35 days, respectively. No treatment-related deaths were observed within 100 days after allo-HSCT. Two patients died of sepsis or late-onset non-infectious pulmonary complications. Four patients developed grade I to II acute GVHD, and six patients developed chronic GVHD. The estimated 3-year overall survival was 75% with a median follow up time of 43 months (range, 6~127). Four of 5 patients who were transfusion-dependent became free from transfusion after allo-HSCT. In six of seven patients, a regression of fibrosis was confirmed by bone marrow biopsy. Despite the small number of cases, our results suggested that allo-HSCT is an encouraging curative strategy for treating PMF.
- Published
- 2012
45. Rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease.
- Author
-
Teshima T, Nagafuji K, Henzan H, Miyamura K, Takase K, Hidaka M, Miyamoto T, Takenaka K, Akashi K, and Harada M
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adult, Antibodies blood, Antibodies, Monoclonal adverse effects, Antibodies, Monoclonal, Murine-Derived, Chronic Disease, Female, Graft vs Host Disease etiology, Graft vs Host Disease immunology, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Immunologic Factors adverse effects, Male, Middle Aged, Prospective Studies, Rituximab, Transplantation, Homologous, Treatment Outcome, Young Adult, Antibodies, Monoclonal administration & dosage, Graft vs Host Disease drug therapy, Immunologic Factors administration & dosage
- Abstract
We prospectively evaluated the safety and efficacy of the anti-CD20 chimeric monoclonal antibody rituximab for the treatment of corticosteroid-refractory chronic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation. Seven patients were treated with 375 mg/m(2) rituximab weekly for 4 consecutive weeks. Rituximab was well tolerated with no severe toxicity observed during treatment. At 1 year, 3 patients showed a partial response to rituximab therapy, 3 had stable disease, and 1 had progressive disease. Rituximab allowed a reduction in the dose of steroids in 4 patients. Responsive manifestations included mild to moderate skin and oral lesions, and immune hemolytic anemia, and thrombocytopenia. Severe manifestations involving the skin, fascia, and eye did not respond to treatment. These observations suggest that rituximab therapy may be effective for select patients with corticosteroid-refractory chronic GVHD that is not advanced.
- Published
- 2009
- Full Text
- View/download PDF
46. Longstanding remission of adult onset Still's disease under imatinib therapy in a patient with chronic myelogenous leukemia.
- Author
-
Nagasaki Y, Miyamoto T, Henzan H, Nagafuji K, Harada M, and Akashi K
- Subjects
- Adult, Benzamides, Drug Resistance, Humans, Imatinib Mesylate, Leukemia, Myelogenous, Chronic, BCR-ABL Positive complications, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Male, Prednisolone therapeutic use, Remission Induction, Still's Disease, Adult-Onset complications, Still's Disease, Adult-Onset pathology, Treatment Outcome, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Piperazines therapeutic use, Protein Kinase Inhibitors therapeutic use, Pyrimidines therapeutic use, Still's Disease, Adult-Onset drug therapy
- Published
- 2009
- Full Text
- View/download PDF
47. Oral valganciclovir as preemptive therapy is effective for cytomegalovirus infection in allogeneic hematopoietic stem cell transplant recipients.
- Author
-
Takenaka K, Eto T, Nagafuji K, Kamezaki K, Matsuo Y, Yoshimoto G, Harada N, Yoshida M, Henzan H, Takase K, Miyamoto T, Akashi K, Harada M, and Teshima T
- Subjects
- Adult, Aged, Antiviral Agents therapeutic use, Ganciclovir therapeutic use, Hematopoietic Stem Cell Transplantation adverse effects, Humans, Middle Aged, Premedication, Transplantation, Homologous, Treatment Outcome, Valganciclovir, Cytomegalovirus Infections prevention & control, Ganciclovir analogs & derivatives, Hematopoietic Stem Cell Transplantation methods
- Abstract
Between March 2007 and January 2008, the safety and efficacy of oral valganciclovir (VGC) preemptive therapy for cytomegalovirus (CMV) infection was evaluated in ten consecutive patients who received allogeneic hematopoietic stem cell transplantation (HSCT). Patients were screened once or twice per week after engraftment using CMV pp65 antigenemia assay. When more than 2 CMV antigen-positive cells per 50,000 leukocytes were detected, preemptive therapy with oral VGC was initiated at a dose of 900 mg twice daily for 3 weeks. Nine patients (90%) completed the 3-week VGC treatment except for one patient who developed febrile neutropenia. There was no other significant toxicity. CMV antigen-positive cells were rapidly decreased in all nine patients and became undetectable by the end of the VGC treatment. None of the patients developed CMV disease. CMV infection relapsed in four of the ten patients (40%) after the VGC treatment. These observations suggest that preemptive therapy with VGC is effective for preventing CMV disease in allogeneic HSCT patients. Further studies with a large number of patients will be necessary to determine the optimal initial- and maintenance-dose of VGC.
- Published
- 2009
- Full Text
- View/download PDF
48. Successful stem cell transplantation without cryopreservation from a microchimeric haploidentical sibling for refractory acute myeloid leukemia complicated with critical thrombophlebitis and cellulitis.
- Author
-
Muta T, Kato K, Eto T, Oku S, Nawata R, Takase K, Henzan H, Arima F, Gondo H, Okamura T, and Shibuya T
- Subjects
- Acute Disease, Adult, Disease-Free Survival, Graft vs Host Disease, Granulocytes, Humans, Infections, Male, Siblings, Tissue Donors, Transplantation, Homologous, Twins, Monozygotic, Cellulitis etiology, Leukemia, Myeloid complications, Leukemia, Myeloid therapy, Peripheral Blood Stem Cell Transplantation methods, Salvage Therapy methods, Thrombophlebitis etiology
- Abstract
We describe the case of a 38-year-old male patient who had acute myeloid leukemia and developed prolonged neutropenia after induction chemotherapy. He developed thrombotic complications at multiple sites. Thrombophlebitis of the hemorrhoidal plexus became exacerbated and developed into critical cellulitis. Because the patient had no human leukocyte antigen-identical sibling, we considered an alternative donor. Because of the necessity for early neutrophil recovery to resolve the critical infection, we proceeded with allogeneic peripheral blood stem cell transplantation (PBSCT) from a microchimeric haploidentical sibling donor. We infused peripheral blood mononuclear cells directly into the patient without cryopreservation and thawing procedures. We aimed for the contaminating granulocytes to act as a granulocyte transfusion. Actually, the neutrophils increased to 1.6 x 10(9)/L on day 1, when the patient showed a temporary resolution of infection. Engraftment was achieved shortly after neutropenic nadir, and acute graft-versus-host disease (GVHD) has been well controlled. Although the patient experiences extensive chronic GVHD, he has been well as an outpatient with a 90% Karnofsky performance status score. The leukemia has been in complete remission for more than 1 year. These findings suggest the clinical utility of a salvage therapy with allogeneic PBSCT from a microchimeric haploidentical donor to treat refractory leukemia concurrent with life-threatening infection.
- Published
- 2007
- Full Text
- View/download PDF
49. Chronic myelogenous leukemia that occurred two years after the diagnosis of adult Still's disease.
- Author
-
Nakagawa Y, Furusyo N, Taniai H, Henzan H, Tsuchihashi T, and Hayashi J
- Subjects
- Adult, Cyclosporine therapeutic use, Drug Resistance, Genes, abl, Humans, Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics, Male, Steroids therapeutic use, Still's Disease, Adult-Onset diagnosis, Still's Disease, Adult-Onset drug therapy, Time Factors, Leukemia, Myelogenous, Chronic, BCR-ABL Positive complications, Still's Disease, Adult-Onset complications
- Abstract
A 25-year-old Japanese man was diagnosed with steroid-resistant Adult Still's Disease (ASD) in August 2000. No evidence of chronic myelogenous leukemia (CML) had been found during admissions in 2000 and 2001. In August 2002, he was diagnosed with CML with a peripheral white blood count of 69,940/microl and positivity for Philadelphia chromosome and BCR/ABL fusion gene on bone marrow aspiration. No case of CML was reported to develop from ASD. Because a diagnosis of ASD is based on the exclusion of other diseases, we must be cognizant of the possibility of the development of concurrent diseases.
- Published
- 2005
- Full Text
- View/download PDF
50. Mobilization of human lymphoid progenitors after treatment with granulocyte colony-stimulating factor.
- Author
-
Imamura R, Miyamoto T, Yoshimoto G, Kamezaki K, Ishikawa F, Henzan H, Kato K, Takase K, Numata A, Nagafuji K, Okamura T, Sata M, Harada M, and Inaba S
- Subjects
- Animals, Bone Marrow Cells cytology, Bone Marrow Cells immunology, Bone Marrow Cells metabolism, Cell Adhesion Molecules biosynthesis, Cell Culture Techniques, Cell Differentiation genetics, Cell Differentiation immunology, Cell Lineage genetics, Cell Lineage immunology, Flow Cytometry, Gene Expression Profiling, Gene Rearrangement, B-Lymphocyte, Heavy Chain, Humans, Immunoglobulin Heavy Chains genetics, Immunoglobulin Heavy Chains metabolism, Immunophenotyping, Lymphocyte Count, Lymphocyte Subsets metabolism, Mice, Mice, Inbred NOD, Mice, Knockout, Mice, SCID, Myeloid Progenitor Cells cytology, Myeloid Progenitor Cells immunology, Myeloid Progenitor Cells metabolism, Granulocyte Colony-Stimulating Factor pharmacology, Hematopoietic Stem Cell Mobilization methods, Hematopoietic Stem Cells cytology, Hematopoietic Stem Cells immunology, Lymphocyte Subsets cytology, Lymphocyte Subsets immunology
- Abstract
Hemopoietic stem and progenitor cells ordinarily residing within bone marrow are released into the circulation following G-CSF administration. Such mobilization has a great clinical impact on hemopoietic stem cell transplantation. Underlying mechanisms are incompletely understood, but may involve G-CSF-induced modulation of chemokines, adhesion molecules, and proteolytic enzymes. We studied G-CSF-induced mobilization of CD34+ CD10+ CD19- Lin- and CD34+ CD10+ CD19+ Lin- cells (early B and pro-B cells, respectively). These mobilized lymphoid populations could differentiate only into B/NK cells or B cells equivalent to their marrow counterparts. Mobilized lymphoid progenitors expressed lymphoid- but not myeloid-related genes including the G-CSF receptor gene, and displayed the same pattern of Ig rearrangement status as their bone marrow counterparts. Decreased expression of VLA-4 and CXCR-4 on mobilized lymphoid progenitors as well as multipotent and myeloid progenitors indicated lineage-independent involvement of these molecules in G-CSF-induced mobilization. The results suggest that by acting through multiple trans-acting signals, G-CSF can mobilize not only myeloid-committed populations but a variety of resident marrow cell populations including lymphoid progenitors.
- Published
- 2005
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.