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The standard of care for diffuse large B-cell lymphoma (DLBCL) is rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). However, its ideal dose intensity varies among cases.This review provides the latest insights on the dose intensity of R-CHOP for DLBCL patients. Specifically, we discussed the optimal dose intensity for elderly patients, the optimal number of treatment cycles for limited or advanced-stage diseases, and the role of dose-intensified therapies or adding targeted inhibitors.Performing a comprehensive or simplified geriatric assessment can distinguish elderly DLBCL patients who will likely benefit from curative R-CHOP. Very elderly or medically unfit patients may need dose reduction in R-CHOP; the Age, Comorbidities, and Albumin index may aid decision-making. Four cycles of R-CHOP followed by two rituximab cycles comprise a new standard for low-risk, limited-stage DLBCL patients. Compared to eight cycles, six cycles of R-CHOP have similar efficacy and fewer toxicities for advanced-stage DLBCL. Dose-intensified therapy is not recommended in most DLBCL cases but may be considered for patients with double (or triple)-hit lymphoma. Applying targeted inhibitors and not merely escalating R-CHOP dose intensity through molecular subtyping will improve the treatment outcome for DLBCL.Diffuse large B-cell lymphoma (DLBCL) is one of the most common blood cancers. Patients with DLBCL are usually treated with a standard (immuno-) chemotherapy called R-CHOP, which stands for rituximab, cyclophosphamide, hydroxydaunorubicin (doxorubicin), Oncovin, and prednisone. Of these, cyclophosphamide and doxorubicin are particularly toxic but effective. Therefore, the dosages of these drugs are adjusted according to the patient’s body size. However, the ideal amounts of these drugs (dose intensity) can vary from case to case. For instance, the regular dose intensity of R-CHOP is too toxic for some people, such as very older patients. Furthermore, ideal total amounts of these drugs, that is, ideal cycle numbers of R-CHOP, are also different between patients with limited disease and advanced disease. Therefore, oncology/hematology researchers have been seeking the optimal dose intensity of R-CHOP in each patient with DLBCL for years. The goal of this review is to provide the latest insights on the ideal dose intensity of R-CHOP in DLBCL treatment. In this article, we discuss: how R-CHOP was established as the standard of care for DLBCL, how to identify candidates for standard R-CHOP among older patients, how to adjust the dose intensity of R-CHOP for patients who are not candidates for standard R-CHOP, optimal cycle number of R-CHOP for limited-disease DLBCL, optimal cycle number of R-CHOP for advanced DLBCL, how to treat patients with a large mass, and the role of more intensive therapies other than R-CHOP in DLBCL treatment. Finally, we demonstrate how experts determined the dose intensity of R-CHOP for some example cases with DLBCL.

Background: Some chemotherapeutic agents cause carnitine deficiency, which causes general fatigue. However, there is no study on carnitine deficiency in patients with chronic myeloid leukemia (CML) during tyrosine kinase inhibitor (TKI) therapy. Objective: In this study, we investigated carnitine concentrations in patients with CML receiving TKI therapy. Method: This study included patients with well-controlled CML. Total carnitine and free carnitine concentrations were evaluated using the enzyme cycling method. The brief fatigue inventory (BFI) and cancer fatigue scale (CFS) were used to assess general fatigue developed during TKI therapy. Results: Fifty-five patients on TKI therapy were included. Of these, 12 (21.8%) patients had low free carnitine concentrations. Free carnitine concentrations were higher in men than in women. Younger age was closely associated with lower free carnitine concentrations. TKI type, TKI dose, treatment response, or therapy duration were not associated with free carnitine concentrations. None of the scores (the global fatigue score with the BFI and CFS score) correlated with carnitine concentrations. Concentrations of free carnitine in patients in the treatment-free remission group were slightly higher than those in the TKI group, with only 9.1% having a low concentration of free carnitine. Conclusion: Carnitine deficiency is probably not a major cause of general fatigue but may occur in patients with CML receiving TKI therapy.

青木真美教授定年退職記念号(Special issue in commemoration of Prof. Mami Aoki's retirement)

We investigated the incidence, risk factors, and clinical outcomes of cytomegalovirus (CMV) disease in patients with B-cell lymphoma treated with a bendamustine-containing regimen. The incidence of CMV disease was analyzed after starting treatment with 139 regimens in 126 patients. Clinically significant CMV disease was observed in seven patients. The median duration between bendamustine initiation and the diagnosis of CMV disease was 69 d (range, 40-233), and the median of cycles completed at onset was 2 (range, 1-6). Furthermore, the incidence of CMV disease was significantly higher in the elderly patients than that in the younger patients. The target organs of CMV disease were the liver, gastrointestinal tract, lungs, and retinas. Antiviral therapy was administered to all patients. However, the recurrence of CMV disease was observed in two patients. This study provides information that could contribute to clinicians' decision-making on lymphoma therapy using bendamustine.

Surface treatment of cleaved graphene surfaces with UV/ozone exposure, O2 reactive ion etching, and Ar ion milling was studied by contact angle measurements and atomic force microscopy (AFM). The c...

Background/Aim: We assessed the prognosis of patients with refractory or relapsed multiple myeloma (RRMM) by focusing on the change in absolute lymphocyte counts (ALCs) after lenalidomide and dexamethasone (Ld) initiation. Patients and Methods: In total, 72 patients with RRMM were treated with Ld. ALCs were evaluated before treatment and at 1, 2, and 3 months after Ld initiation. The median ALCs in the entire cohort before and at 1, 2, 3 months after Ld initiation were 1,131, 1,059, 1,222, and 1,162/μl, respectively. Results: ALCs before Ld initiation did not affect time to next treatment (TNT) or overall survival (OS). However, the patients with ALCs equal to or greater than the median at 3 months showed relatively better TNT than those with lower lymphocyte counts, with a significant difference. OS was also significantly longer in patients with higher ALCs. Conclusion: Immunomodulation by lenalidomide may improve prognosis in patients with RRMM.

研究(Article)

In this study we demonstrate that organic radical photopolymerized resins hybridized with inorganic silica nanoparticles improve the mechanical strength of replica mold materials and that organic-i...

This study investigates the importance of surface free energy and chemisorption of substrates for the formation of a UV-cured thin film corresponding to a residual layer in UV nanoimprint lithography. Silicon substrate surfaces were modified with binary molecular layers which were prepared through photo-oxidation of a monomer-repelling monolayer and implantation of a reactive surface modifier with an acrylate polymerizable group. Laser-drilled screen printing enabled the placement of droplets of high-viscosity dimethacrylate UV-curable liquid on the modified substrates. UV nanoimprinting with a modified flat mold surface allowed the formation of UV-cured films with a square shape and a sub-100 nm thickness. The thickness of the UV-cured film was tuned precisely in the case of the substrate showing almost the same surface free energy value as the mold surface. The comparison with and without the reactive surface modifier revealed that the chemisorption was essential for the film formation on the substrates.

This study investigates photo-degradation of tridecafluoro-1,1,2,2-tetrahydrooctyltrimethoxysilane (FAS13) used for antisticking surface modifiers in nanoimprint lithography by exposure to vacuum UV light (VUV; λ = 172 nm) or UV/ozone (λ = 185 and 254 nm). The degradation of FAS13 molecules chemisorbed on silicon surfaces was monitored sensitively in the contact angle measurements using diiodomethane rather than water. Photo-oxidation made the contact angles of FAS13-modified surfaces after water wash lower than those of unwashed FAS13-modified surfaces. This suggested that photo-decomposition products were left on exposed FAS13-modified surfaces and removed with water. Time-of-flight secondary ion mass spectrometry defined that the FAS13 chemisorbed monolayer was detected as a characteristic parent anion of C8F13 −, whereas the decomposition products were detected as C6F13 − and C3F7 −. Further exposure made the decomposition products photo-degraded to low-molecular-weight species and finally disappear from the surface. With the photo-degradation mechanism, UV/ozone exposure in an ambient condition was essentially the same as VUV exposure.

The alignment process of ultraviolet (UV) nanoimprint lithography requires a further sophisticated method to detect infinitesimal misalignments between a synthetic quartz mold and a silicon substrate. Previously, we proposed a fluorescence-alignment method based on the analysis of the additive-type moiré fringes generated by the interferences of fluorescence emission from fluorescent UV-curable liquid filling the concave bar-mark arrays on a synthetic quartz mold and a silicon substrate. The proposed method significantly reduces the cost of mold fabrication and simplifies the in-liquid process compared to the conventional method based on multiplicative-type moiré fringes prevailing in the industry. This is because the fluorescence-alignment method is free from the problem of the refractive index matching between mold and UV-curable liquid materials. However, its position accuracy remains as large as sub-10 nm scales in principle. In this study, through simulation using image drawing and analysis software, we demonstrate that a sophisticated fluorescence alignment can realize atomic-scale precision for position accuracy by attempting the following concepts: (i) the application of the principle on position determination of a fluorescent single-molecule to that of an individual bar-mark fluorescence signal; (ii) effective use of high bit-depth of recent imaging devices; and (iii) accumulations of the information on the positions of multiple bar-marks with periodicities by fitting their fluorescence intensity profiles using a periodic function.

Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of B-cell lymphoma characterized by aggressive disease progression with a high incidence of central nervous system (CNS) involvement. We retrospectively analyzed 16 patients with de novo IVLBCL treated at our hospital between 2004 and 2018 with either standard therapy plus CNS-directed therapy or standard therapy alone. CNS-directed therapy was associated with a significantly better 2-year CNS-free survival (100% vs. 63%

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a pandemic threat worldwide and causes severe health and economic burdens. Contaminated environments, such as personal items and room surfaces, are considered to have virus transmission potential. Ultraviolet C (UVC) light has demonstrated germicidal ability and removes environmental contamination. UVC has inactivated SARS-CoV-2; however, the underlying mechanisms are not clear. It was confirmed here that UVC 253.7 nm, with a dose of 500 μW/cm2, completely inactivated SARS-CoV-2 in a time-dependent manner and reduced virus infectivity by 10–4.9-fold within 30 s. Immunoblotting analysis for viral spike and nucleocapsid proteins showed that UVC treatment did not damage viral proteins. The viral particle morphology remained intact even when the virus completely lost infectivity after UVC irradiation, as observed by transmission electronic microscopy. In contrast, UVC irradiation-induced genome damage was identified using the newly developed long reverse-transcription quantitative-polymerase chain reaction (RT-qPCR) assay, but not conventional RT-qPCR. The six developed long RT-PCR assays that covered the full-length viral genome clearly indicated a negative correlation between virus infectivity and UVC irradiation-induced genome damage (R2 ranging from 0.75 to 0.96). Altogether, these results provide evidence that UVC inactivates SARS-CoV-2 through the induction of viral genome damage.

The photoinduced reorientation of the side-chain mesogens in nematic liquid crystalline (LC) polymer thin films triggered by the axis-selective photo-Fries rearrangements of side-chain phenyl benzoate moieties is studied to understand the regulation of the anisotropic nanostructures supported by LC polymers. The influence of the substrate surface in anchoring the side-chain mesogens near the interfaces is examined by comparing the reorientation of 30- and 120-nm-thick films. Irradiation with linearly polarized ultraviolet (UV) light and subsequent annealing causes the side-chain mesogen reorientation to align perpendicular to the electric field of the incident UV light. The inplane order in the 30-nm-thick films is lower than that in the 120-nm ones. On the other hand, the annealing period required for mesogen alignment is independent of the film thickness. It is suggested that the substrate surfaces anchor the LC mesogens to fix their orientation, rather than slowing down the reorientational motion. In addition, it is demonstrated that small LC molecules miscible with the nematic LC polymer enhance photoinduced reorientation through cooperative molecular interaction with the side-chain mesogens, remarkably accelerating the orientation and improving the inplane order of the unidirectionally aligned mesogens.

We disclose that the viscosity of a polymerizable diacrylate monomer confined in a nano-gap between acryloyloxy-terminated monolayer surfaces exhibited exponential increase at a longer distance tha...

藤原秀夫教授古稀祝賀記念号, Honorable issue in commemoration of Prof. Hideo Fujiwara's 70 years of age

Background/Aim: Here, we investigated whether bortezomib as a maintenance therapy affected outcomes in transplant-ineligible patients with multiple myeloma (MM). Patients and Methods: Following induction therapy with bortezomib, maintenance therapy with bortezomib (1.3 mg/m2) and dexamethasone (20 mg) was administered once or twice every 4 weeks until disease progression. The endpoints of this study were time to next treatment and overall survival. Results: Seventy-six newly diagnosed, transplant-ineligible patients were treated with a bortezomib-based regimen; 28 discontinued induction therapy, 27 did not receive maintenance therapy after induction therapy (the non-maintenance group), and 21 did (the maintenance group). In the three groups, the median times to the next required treatment were 3, 14, and 37 months, respectively. The 3-year overall survival rates were 55%, 69%, and 85%, respectively. There were no significant differences in patient characteristics between the non-maintenance and maintenance groups, except for poorer estimated glomerular filtration rates in the maintenance group. Conclusion: Bortezomib maintenance therapy may be a useful option for transplant-ineligible patients with MM.

Individual authentication using artefact metrics has received increasing attention, as greater importance has been placed on the security of individual information. These artefact metrics must satisfy the requirements of individuality, measurement stability, durability, and clone resistance, in addition to possessing unique physical features. In this study, we proposed that nanostructures of synthetic quartz (SQ) deposited on an SQ plate may provide sophisticated artefact metrics if morphological changes could be intentionally introduced into the SQ nanostructures at certain positions. We fabricated SQ nanopillars using a mass-production method (ultraviolet nanoimprint lithography) and investigated their mechanical deformation using nanoindentation with a spheroid diamond tip through a loading and unloading cycle. The SQ nanopillars with an aspect ratio of 1 (i.e., diameters D of 100 and 200 nm with corresponding heights H of 100 and 200 nm, respectively) could be plastically deformed without collapsing within a specified pillar-array format at programmed positions. The plastically deformed SQ nanopillar arrays demonstrated multi-scale (sub-millimetre, micrometre, and nanometre) and multi-level (shape, area, diameter, and height) individuality authentication and clone resistance. Because SQ is physically and chemically stable and durable, individuality authentication can be a highly reliable tool on Earth and in space.

Ultraviolet (UV) nanoimprint lithography consists of molding–demolding and lithographic etching processes, which enable the shape transfer of molded resist patterns to underlying substrate surfaces. UV nanoimprint lithography has been applied in various fields, including optics, electronics, biology, and energy engineering. An important key to shape transfer through resist masks is to level the thicknesses of thin residual layers. To solve this issue, the region-selective placement of UV-curable droplets on a substrate is effective for leveling the thickness of the residual layer regardless of the differences in mold pattern density. Herein, we developed laser-drilled screen printing that allows the quantitative placement of high-viscosity UV-curable liquids on substrate surfaces via screen printing using a polyimide through-hole stencil mask prepared via ultrashort-pulse laser drilling. This review explains the practical demonstrations of UV nanoimprint lithography involving laser-drilled screen printing: nano/micro fabrication of Au split ring resonators, Au four-terminal electrodes, and silicon line patterns.

Ultraviolet (UV)-cured spin-coated resist films of 100 nm and thinner thicknesses made with bisphenol A-based dimethacrylate monomers on silicon substrates were hybridized by multiple-pulsed vapor infiltration of sequential trimethylaluminum (TMA) doses and a final H2O dose. Nondestructive x-ray reflectivity measurements without film shrinkage enabled characterization of the internal layer structures of the UV-cured films unmodified before hybridization and hybridized by TMA infiltration and chemical fixing. It was possible to determine the thickness, density, and interface roughness of each layer in the unmodified and hybridized UV-cured films. The TMA infiltration and chemical fixing resulted in the formation of the highest-density Al-rich layer near the film surface. The presence of the highest-density layer arising from the most abundant component, Al, was confirmed through energy-dispersive x-ray spectroscopy and time-of-flight secondary ion mass spectrometry. The increase in the cycle number of TMA dose from 100 to 150 and 200 cycles had little effect on organic–inorganic hybridization of the 100 nm-thick UV-cured films. The thickness of the outermost Al-rich layer near the film surface was approximately 30 nm, which was unchanged when the film thicknesses of 100, 75, and 50 nm were changed. The outermost skin layer suppressed the infiltration of TMA into the UV-cured films. The infiltration of TMA into the UV-cured films progressed as the film thicknesses decreased.

Background: After long-term analysis of the JALSG-APL204 study we recently reported that maintenance therapy with tamibarotene was more effective than all-trans retinoic acid (ATRA) by reducing relapse in APL patients. Here, the clinical significance of other important prognostic factors was evaluated with multivariate analyses. Patients and Methods: Newly diagnosed acute promyelocytic leukemia (APL) patients were registered with the study. Induction was composed of ATRA and chemotherapy. Patients who achieved molecular remission after consolidation were randomly assigned to maintenance with tamibarotene or ATRA. Results: Of the 344 eligible patients, 319 (93%) achieved complete remission (CR). After completing consolidation, 269 patients underwent maintenance random assignment&mdash, 135 to ATRA, and 134 to tamibarotene. By multivariate analysis, overexpression of CD56 in blast was an independent unfavorable prognostic factor for relapse-free survival (RFS) (p = 0.006) together with more than 10.0 &times, 109/L WBC counts (p = 0.001) and the ATRA arm in maintenance (p = 0.028). Of all phenotypes, CD56 was related most clearly to an unfavorable prognosis. The CR rate, mortality rate during induction and overall survival of CD56+ APL were not significantly different compared with CD56- APL. CD56 is continuously an independent unfavorable prognostic factor for RFS in APL patients treated with ATRA and chemotherapy followed by ATRA or tamibarotene maintenance therapy.