Article: Lymphocytosis in Idiopathic Thrombocytopenic Purpura Patients Infected by Helicobacter pyloriNaoki Takezako, Naohiro Sekiguchi, Akira Tanimura, Chiho Homma, Tateki Shikai, Yayoi Takezako, Noboru Yamagata, Akiyoshi Miwa[show abstract] [hide abstract]
ABSTRACT: Background and Objectives: Several recent reports have demonstrated a close linkage between idiopathic thrombocy-topenic purpura (ITP) and Helicobacter pylori (H. pylori) infection in some patient's populations. However, the patho-genetic mechanisms of H. pylori-induced thrombocytopenia remain obscure. Therefore, we investigated the prevalence of H. pylori infection pylori and performed a comparative analysis of a subset of H. pylori-infected patients (group A) with non-infected patients (group B) using the standard statistical methods. Design and Methods: From December 2001 to October 2002, we investigated the presence of gastric H. pylori infection in 30 adult ITP patients and 19 pa-tients were treated with standard antibiotic therapy for H. pylori eradication (amoxicillin and clarithromycin plus lanso-prazole combination). We used the standard statisticsto analyze the difference between group A and group B. Results: H. pylori eradication was achieved in 17/19 (89.4%) H.pylori-infected patients. An improvement of platelet count was observed in 14/19 patients (73.6%) who achieved the eradication. Five of these patients achieved CR (two patients were with the acute ITP) and nine patients reached PR. The difference between the mean platelet count ± S.D. before and after H. pylori therapy was statistically significant in patients with successful decontamination (65 ± 48 × 10 9 /L vs. 200 ± 140 × 10 9 /L; p = 0.018). Lymphocyte counts at the diagnosis of H. pylori infected cases were significant higher than those of non-infected cases (1.58 ± 0.13 × 10 9 /L vs. 0.86 ± 0.20 × 10 9 /L; mean ± standard deviation; p = 0.010). In ad-dition, the mean lymphocyte count after H. pylori eradication was significantly lower than that of before eradication (1.58 ± 0.13 × 10 9 /L vs. 1.02 ± 0.43 × 10 9 /L; p = 0.012). Interpretation and Conclusions: To our knowledge, this is the first report of the relation between H. pylori infected ITP and the lymphocytosis. We suggest that the lymphocytes might play an important role in the pathogenesis of several cases of ITP with H. pylori infection. We conclude that the further investigation is needed to elucidate the mechanism of lymphocytosis in idiopathic thrombocytopenic purpura patients infected with H. pylori.Open Journal of Blood Diseases 02/2013; 3(1):32-35.
Article: Successful Treatment of Life-Threatening Cerebral Bleeding Associated with Disseminated Intravascular Coagulation Using Recombinant Human Soluble Thrombomodulin in a Patient with Mixed Phenotype Acute Leukemia with t (9; 22) (q34; q11.2); Bcr-Abl1[show abstract] [hide abstract]
ABSTRACT: Recently, mixed phenotype acute leukemia (MPAL) with t (9; 22) (q34; q11.2); bcr-abl1 was described as one kind of acute leukemia of ambiguous lineage in the 2008 World Health Organization Classification of Tumors of Hematopoi-etic and Lymphoid Tissues. However, treatment strategy remains difficult for this uncommon MPAL. In addition, this type of MPAL is at high risk of tumor lysis syndrome (TLS) because of high chemo-sensitivity. Here, we report a MPAL with t (9; 22) (q34; q11.2); bcr-abl1 case that suffered from life-threatening cerebral bleeding associated with disseminated intravascular coagulation (DIC) with TLS after bcr-abl positive acute lymphoblastic leukemia (ALL) type induction therapy who was successfully treated with recombinant human thrombomodulin (rhTM). This case reached complete remission without additive cerebral bleeding. In conclusion, bcr-abl positive ALL type induction therapy was effective for MPAL with t (9; 22) (q34; q11.2); bcr-abl1 and rhTM was effective against DIC with TLS.International Journal of Clinical Medicine 01/2013; 4:52-57.
Article: Successful Treatment of Elderly Diffuse Large B-Cell Lymphoma with Central Nervous System Recurrence by Rituximab, Ranimusutine, Ifosfamide, Procarbazine, Dexamethasone, and Etoposide TherapyJunya Miyahara, Naoki Takezako, Miyuki Wagatsuma, Kiyoe Midorikawa, Ichiro Fukuda, Satoshi Noto, Ikuo Saito, Kazuaki Yamada, Akiyoshi Miwa, Naohiro Sekiguchi[show abstract] [hide abstract]
ABSTRACT: The prognosis of CD20-positive (CD20+) diffuse large B-cell lymphoma (DLBCL) with central nervous system (CNS) recurrence is still poor. A standard treatment for CD20+ DLBCL with CNS recurrence in elderly patients has not been established mainly due to adverse effects. We previously reported the efficacy and safety of MIND-E (ranimustine, ifosfamide, procarbazine, dexamethasone, and etoposide) therapy for elderly CD20+ DLBCL patients with CNS recur- rence. Here, we report the use of R-MIND-E therapy (rituximab, ranimustine, ifosfamide, procarbazine, dexamethasone and etoposide) in an elderly CD20+ DLBCL patient with CNS recurrence. The patient achieved a complete response according to Revised Response Criteria for Malignant Lymphoma, and treatment-related toxicity was tolerable. R-MIND-E therapy may be a feasible and useful treatment option for elderly CD20+ DLBCL patients with CNS recur- rence.Journal of Cancer Therapy 01/2013; 4:448-451.
Article: Clinicolopathological, Cytogenetic, and Radiographical Analysis of Waldenstrom Macroglobulinemia in Japan: Unique Disease ManifestationNaohiro Sekiguchi, Naoki Takezako, Miyuki Wagatsuma, Chen A. Kunihiro, Akihisa Nagata, Ichiro Fukuda, Satoshi Noto, Ikuo Saito, Kazuaki Yamada, Akiyoshi Miwa[show abstract] [hide abstract]
ABSTRACT: Waldenström macroglobulinemia (WM) is a rare lymphoid malignancy. Many studies, including clinicopathological,cytogenetic, gene expression profile, and therapy studies have been reported from the US and Europe, although only a few reports are available from East Asia, including Japan. To further clarify the clinicopathological, radiological, and cytogenetic features of WM in Japan, we performed a retrospective analysis of WM in our institute between March 2007 and January 2012. Clinical data, laboratory data, the results of flow cytometric analysis (FCM), and chromosomal abnormalities were analyzed, and a radiological review was performed. The treatment regimen, response, and survival were also estimated. Six patients were enrolled in this study. The median age was 71 years. All patients were symptomatic, 3 had hyperviscosity syndrome, 1 had bone lesions, and 1 had an extra-medullary mass. FCM data showed that all patients were positive for CD38, while 2 were positive for CD56. Four had chromosomal abnormalities including some abnormalities also reported in myeloma. On radiological review, four showed diffuse invasion of the retro-peritoneum. Five patients received treatment, 4 of which achieved a response. At a median follow-up of 527 days, 4 were alive and 2 died because of disease progression. The present study revealed that WM in Japan might be heterogeneous and have a unique disease manifestation. Invasion sites other than bone marrow were very common, and the results of clinical, FCM, and cytogenetic studies revealed that WM in Japanese cases might have manifestations of both myeloma and B-cell lymphoma.Journal of Cancer Therapy 12/2012; 3:1037-1044.
Article: Deletion of the TNFAIP3/A20 gene detected by FICTION analysis in classical Hodgkin lymphoma.Junko Nomoto, Nobuhiro Hiramoto, Motohiro Kato, Masashi Sanada, Akiko M Maeshima, Hirokazu Taniguchi, Fumie Hosoda, Yoshitaka Asakura, Wataru Munakata, Naohiro Sekiguchi, Dai Maruyama, Takashi Watanabe, Hitoshi Nakagama, Kengo Takeuchi, Kensei Tobinai, Seishi Ogawa, Yukio Kobayashi[show abstract] [hide abstract]
ABSTRACT: BACKGROUND: The TNFAIP3 gene, which encodes a ubiquitin-modifying enzyme (A20) involved in the negative regulation of NF-kappaB signaling, is frequently inactivated by gene deletions/mutations in a variety of B-cell malignancies. However, the detection of this in primary Hodgkin lymphoma (HL) specimens is hampered by the scarcity of Hodgkin Reed-Sternberg (HR-S) cells even after enrichment by micro-dissection. METHODS: We used anti-CD30 immunofluorescence with fluorescence in-situ hybridization (FISH) to evaluate the relative number of TNFAIP3/CEP6 double-positive signals in CD30-positive cells. RESULTS: From a total of 47 primary classical Hodgkin lymphoma (cHL) specimens, 44 were evaluable. We found that the relative numbers of TNFAIP3/CD30 cells were distributed among three groups, corresponding to those having homozygous (11%), heterozygous (32%), and no (57%) deletions in TNFAIP3. This shows that TNFAIP3 deletions could be sensitively detected using our chosen methods. CONCLUSIONS: Comparing the results with mutation analysis, TNFAIP3 inactivation was shown to have escaped detection in many samples with homozygous deletions. This suggests that TNFAIP3 inactivation in primary cHL specimens might be more frequent than previously reported.BMC Cancer 10/2012; 12(1):457. · 3.01 Impact Factor