Publications (14) View all
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Article: Successful treatment with sorafenib for primary refractory acute monoblastic leukemia with FLT3-ITD.
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ABSTRACT: A 6-year-old boy was diagnosed with FLT3-ITD+acute monoblastic leukemia (AMoL). He showed resistance to 2 cycles of induction chemotherapy with etoposide, cytarabine, and mitoxantrone or idarubicin performed according to the Japan Pediatric Leukemia/Lymphoma Study Group (JPLSG) AML-05 protocol. His condition was also refractory to salvage FLAI-GO (fludarabine, cytarabine, idarubicin, and gemtuzumab ozogamicin) chemotherapy. Sequential administration of sorafenib at doses of up to 300 mg/day resulted in the first remission. He underwent bone marrow transplantation from his HLA 2-locus mismatched father. Recurrence was observed on post-transplantation day 71. A sustained partial response was observed after alternate-day readministration of sorafenib 150mg/day. In spite of a donor lymphocyte infusion, his blast cell count increased on day 245. Chemotherapy with an increased dose of sorafenib reduced the blast cell count. Although a second HLA-mismatched allogeneic peripheral blood stem cell transfusion was performed, the patient died of regimen-related toxicity. Herein, we report a pediatric case of primary refractory FLT3-ITD+ AMoL. Further prospective studies are necessary to validate the efficacy of sorafenib treatment.[Rinshō ketsueki] The Japanese journal of clinical hematology 11/2012; 53(11):1932-6. -
Article: Severe hemorrhagic colitis caused by dasatinib in Philadelphia chromosome-positive acute lymphoblastic leukemia.
Pediatric Hematology and Oncology 10/2009; 26(6):448-53. · 0.89 Impact Factor -
Article: Retrospective analysis of non-anaplastic peripheral T-cell lymphoma in pediatric patients in Japan.
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ABSTRACT: Reports of non-anaplastic peripheral T-cell lymphoma (PTCL) in pediatric patients are relatively rare. We performed a retrospective analysis in patients with PTCL over an 18-year period (1991-2008). We could analyze clinical data in 21 patients with non-anaplastic PTCL; 10 were female and 10 male. Median age of onset was 11 years (range: 1-21 years). There were nine patients with PTCL, not otherwise specified (PTCL-NOS); ten with extranodal NK/T-cell lymphoma, nasal type; one with angioimmunoblastic T-cell lymphoma; and one with subcutaneous panniculitis-like T-cell lymphoma. Initial lesions involved cervical lymph nodes in five patients, and the skin in five patients. In five patients, hemophagocytic syndrome (HPS) was the initial clinical feature. There were 12 patients with advanced stage disease (stages III and IV). Chemotherapy and radiation was administered in 18 and 2 patients, respectively. Among the two patients who did not receive chemotherapy and radiation, one patient died while being treated for HPS but another improved spontaneously. Although 5 patients relapsed, 18 of 21 patients remained alive without disease at last follow-up. Five-year overall survival rate was 85.2%. Generally, the outcome results of conventional chemotherapy for high-risk PTCL are poor in adult patients. However, the excellent results in our study suggest that PTCL of childhood is quite different from that of adulthood. Although this study is first report about PTCL of Asian children, the number of patients was small in this study. Larger studies are needed to confirm these findings.Pediatric Blood & Cancer 10/2009; 54(2):212-5. · 1.89 Impact Factor -
Article: Retrospective analysis of relapsed or primary refractory childhood lymphoblastic lymphoma in Japan.
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ABSTRACT: To assess the clinical course with response to second-line treatment and to evaluate the role of hematopoietic stem cell transplantation (SCT) in children with relapsed or primary refractory lymphoblastic lymphoma (LBL), we analyzed data of 48 patients with relapsed/primary refractory diseases among 260 LBL patients identified in a national survey of 1996-2004. Twenty-six patients achieved second complete remission; 9 achieved partial remission. Of 13 patients who showed progression despite first and second line therapy, only one patient was alive on the second relapse after unrelated cord blood transplantation. Among 40 relapsed patients, the median time between initial diagnosis and relapse was 12.5 months (range 3-56 months). The sites of relapse were isolated BM (n = 9), primary local site with BM (9), primary local site (6), isolated CNS (4), local site with mediastinum (4), primary local site with other site (4), and others (4). Of all 48 patients, 3 were alive after chemotherapy alone. Of the 33 patients, 14 were alive after high dose chemotherapy (HDC)/SCT. With a 27.5-month median follow up period, the 3-year OS rate was 43.2 +/- 7.4% (estimate +/- SE). Univariate analysis identified two features (relapse within 12 months, T cell phenotype) as significant variables that predicted poor survival. Multivariate analysis showed novel statistically significant variables including relapse within 12 months from initial diagnosis (Hazard ratio 3.60) and absence of HDC/SCT (2.64). Outcomes of patients with relapsed/primary refractory LBL were poor, but HDC/SCT for these patients was associated with good results.Pediatric Blood & Cancer 02/2009; 52(5):591-5. · 1.89 Impact Factor -
Article: The role of hematopoietic stem cell transplantation with relapsed or primary refractory childhood B-cell non-Hodgkin lymphoma and mature B-cell leukemia: a retrospective analysis of enrolled cases in Japan.
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ABSTRACT: There have been excellent treatment results for children with B-cell non-Hodgkin lymphoma (B-NHL) and mature B-cell leukemia (B-ALL) in the last few decades. However, a small subset of relapsed or refractory patients, after first-line therapy, still have a poor prognosis. Thirty-three patients with relapsed or primary refractory B-NHL/B-ALL among 327 newly diagnosed patients between 1996 and 2004 were analyzed retrospectively. After salvage therapy, 18 patients were chemotherapy-sensitive and 15 patients suffered from progression. Among 18 patients who had a chemotherapy-sensitive disease, 4 of 5 patients who underwent hematopoietic stem cell transplantation (HSCT) during remission survived without progression, while 3 of 12 patients who did not receive HSCT were alive without disease progression. Fifteen patients never sensitive to salvage therapy died. Patients with relapsed/primary refractory B-NHL/B-ALL have a poor prognosis with current treatment approaches, while the patients sensitive to salvage therapy have a respectable chance to achieve a sustained complete second remission with HSCT.Pediatric Blood & Cancer 09/2008; 51(2):188-92. · 1.89 Impact Factor
