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Acta Haematologica 06/2012; 128(2):110-2. · 1.35 Impact Factor
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Takuya Miyazaki,
Hiroyuki Fujita,
Katsumichi Fujimaki,
Takeshi Hosoyama, Reina Watanabe,
Takayoshi Tachibana,
Atsuko Fujita,
Kenji Matsumoto,
Masatsugu Tanaka,
Hideyuki Koharazawa,
Jun Taguchi,
Naoto Tomita,
Rika Sakai,
Shin Fujisawa,
Heiwa Kanamori,
Yoshiaki Ishigatsubo
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ABSTRACT: We analyzed minimal residual disease (MRD) by multidimensional flow cytometry (MFC) after allogeneic stem cell transplantation in 41 patients with acute myeloid leukemia (AML) (n=31) or acute lymphoblastic leukemia (ALL) (n=10). Aberrant antigen expression was compared with the results of quantitative PCR for WT1 mRNA (n=41) and leukemia-specific fusion transcripts (n=12; AML in seven, ALL in five). There was a significant correlation between detection of MRD by MFC and WT1 mRNA, as well as between MFC and fusion transcripts. Serial monitoring of MRD by the three techniques correlated in parallel to the clinical course in most of the patients, but three patients were only positive for WT1 during hematological remission. The overall survival time of patients with complete remission was significantly associated with the appearance of aberrant expression after transplantation. In conclusion, MFC is valuable for clinical management decisions after transplantation.
Leukemia research 04/2012; 36(8):998-1003. · 2.36 Impact Factor
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Naoto Tomita,
Masahiro Yokoyama,
Wataru Yamamoto, Reina Watanabe,
Yutaka Shimazu,
Yasufumi Masaki,
Saburo Tsunoda,
Chizuko Hashimoto,
Kayoko Murayama,
Takahiro Yano, [......],
Hirohiko Shibayama,
Rishu Takimoto,
Rika Ohshima,
Yoshihiro Hatta,
Yukiyoshi Moriuchi,
Tomohiro Kinoshita,
Masahide Yamamoto,
Ayumi Numata,
Yoshiaki Ishigatsubo,
Kengo Takeuchi
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ABSTRACT: Central nervous system (CNS) events, including CNS relapse and progression to CNS, are known to be serious complications in the clinical course of patients with lymphoma. This study aimed to evaluate the risk of CNS events in patients with diffuse large B-cell lymphoma in the rituximab era. We performed a retrospective survey of Japanese patients diagnosed with diffuse large B-cell lymphoma who underwent primary therapy with R-CHOP chemoimmunotherapy between September 2003 and December 2006. Patients who had received any prophylactic CNS treatment were excluded. Clinical data from 1221 patients were collected from 47 institutions. The median age of patients was 64 years (range, 15-91 years). We noted 82 CNS events (6.7%) and the cumulative 5-year probability of CNS events was 8.4%. Patients with a CNS event demonstrated significantly worse overall survival (P < 0.001). The 2-year overall survival rate after a CNS event was 27.1%. In a multivariate analysis, involvement of breast (relative risk [RR] 10.5), adrenal gland (RR 4.6) and bone (RR 2.0) were identified as independent risk factors for CNS events. We conclude that patients with these risk factors, in addition to patients with testicular involvement in whom CNS prophylaxis has been already justified, are at high risk for CNS events in the rituximab era. The efficacy and manner of CNS prophylaxis in patients for each involvement site should be evaluated further.
Cancer Science 11/2011; 103(2):245-51. · 3.33 Impact Factor
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Takayoshi Tachibana,
Masatsugu Tanaka,
Hirotaka Takasaki,
Ayumi Numata,
Satomi Ito, Reina Watanabe,
Rie Hyo,
Rika Ohshima,
Maki Hagihara,
Rika Sakai,
Shin Fujisawa,
Naoto Tomita,
Hiroyuki Fujita,
Atsuo Maruta,
Yoshiaki Ishigatsubo,
Heiwa Kanamori
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ABSTRACT: We retrospectively studied the association between iron overload and bloodstream infections (BSI) in the 100-day period following allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia or myelodysplastic syndromes. Serum ferritin was measured before transplantation to evaluate iron overload. Of 114 adult patients who underwent transplantation between 2000 and 2008, 36 (32%) developed BSI. Of the 44 isolates, 63% were Gram-positive bacteria, 32% were Gram-negative bacteria, and 4% were fungi. The median time to the onset of the first BSI was day 28 (range day 0-95) after transplantation. Univariate analysis revealed a significantly higher incidence of BSI in the high (≥ 1,000 ng/ml, n = 57) than in the low (< 1,000 ng/ml, n = 57) ferritin group (42.1 versus 21.1%, respectively, P = 0.017). Peripheral blood stem cell transplantation (PBSCT) (n = 23) showed a greater protective effect against BSI compared with bone marrow (n = 71) and cord blood (n = 20) transplantation. Pretransplantation serum ferritin (HR = 2.844, 95% CI: 1.180-6.859, P = 0.020) and PBSCT (HR = 0.135, 95% CI: 0.025-0.717, P = 0.019) were significant factors on multivariate analysis. In conclusion, pretransplantation serum ferritin significantly predicts BSI within the 100-day period after allo-HSCT.
International journal of hematology 02/2011; 93(3):368-74. · 1.17 Impact Factor
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ABSTRACT: Malignant lymphoma with central nervous system (CNS) involvement has an extremely poor prognosis. We retrospectively studied the risk factors for CNS involvement in patients with diffuse large B-cell lymphoma (DLBCL) treated by cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or rituximab (R) -CHOP chemotherapy.
We studied 375 consecutive patients who were newly diagnosed with DLBCL between 1996 and 2006. Patients with primary CNS involvement and patients who received CNS prophylaxis were excluded. All the patients received CHOP (n = 172) or R-CHOP (n = 203) chemotherapy. The following variables were assessed for their potential to predict CNS involvement: gender, age, serum lactate dehydrogenase (LDH) level, performance status, clinical stage, number of extranodal involvements, International Prognostic Index (IPI), bone marrow involvement, presence of a bulky mass, presence of B symptom, and treatment.
CNS involvement was observed in 13 cases (3.5%). In univariate analysis, LDH more than normal range, LDH more than twice as normal range, high IPI, bone marrow involvement, and systemic relapse were the predictors for CNS involvement. In multivariate analysis, no risk factors were detected for CNS involvement. The use of rituximab did not have an impact on CNS involvement.
The incidence of CNS involvement does not decrease in rituximab-era.
European Journal Of Haematology 03/2010; 85(1):6-10. · 2.61 Impact Factor
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Takuya Miyazaki,
Yohei Kirino,
Mitsuhiro Takeno,
Maasa Hama,
Ayumi Ushihama, Reina Watanabe,
Kaoru Takase,
Takayoshi Tachibana,
Kenji Matsumoto,
Masatsugu Tanaka,
Satoshi Yamaji,
Haruko Ideguchi,
Naoto Tomita,
Hiroyuki Fujita,
Shigeru Ohno,
Atsuhisa Ueda,
Yoshiaki Ishigatsubo
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ABSTRACT: Heme oxygenase (HO)-1, a heme-degrading enzyme inducible by various stimuli, plays a key role in the regulation of inflammatory response in monocytes/macrophages. The serum HO-1 level is remarkably increased in patients with secondary hemophagocytic syndrome (HPS) or adult-onset Still's disease. We measured serum HO-1 levels in patients with a variety of hematological diseases, including secondary HPS, by means of ELISA. Serum HO-1 levels were significantly higher in 22 patients with HPS (134.7 +/- 116.2 ng/mL, P < 0.0001) at diagnosis than in 80 patients with other hematological diseases. The most effective cutoff point between HPS and other conditions was 14.5 ng/mL, with 100.0% sensitivity and 96.3% specificity. In HPS patients, the serum HO-1 levels showed the highest correlation with serum ferritin (r = 0.682, P = 0.0005), which reflects the disease activity of HPS. Moreover, both HO-1 and ferritin levels were reduced in parallel after successful treatment in patients with HPS, irrespective of underlying diseases. However, HO-1 levels were not elevated in patients with other causes of hyperferritinemia. These data demonstrate that serum HO-1 can distinguish secondary HPS from other hematological diseases, including those associated with hyperferritinemia.
International journal of hematology 03/2010; 91(2):229-37. · 1.17 Impact Factor
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ABSTRACT: The maximum standard uptake value (SUVmax) of the whole body on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) reflects the tumor aggressiveness in non-Hodgkin lymphoma (NHL). To clarify the correlation between SUVmax at the biopsy site and the proliferation potential of tumor cells, we studied 36 patients with untreated NHL and five with untreated Hodgkin lymphoma (HL) by measuring the Ki-67 proliferation index (MIB-1 labeling index) in biopsy specimens. The measured MIB-1 labeling index was categorized into seven levels: nearly 0%, 5-20%, 21-40%, 41-60%, 61-80%, 81-95%, and nearly 100%. Twenty-four lymph nodes (LNs) and 17 extranodal (EN) sites were biopsied. The reviewed diagnosis was eight indolent lymphomas, two mantle-cell lymphomas, 26 aggressive lymphomas, and five HLs. A positive correlation was observed between the SUVmax at the biopsy site and the MIB-1 labeling index in the 36 patients with NHL (r = 0.69, p < 0.001). The correlations were also observed in LN group (r = 0.60, p = 0.006) and EN group (r = 0.87, p < 0.001), respectively. In the five patients with HL, the MIB-1 labeling index was uniformly categorized in nearly 100%. The SUVmax correlates with the proliferation potential in the case of NHL.
Leukemia & lymphoma 02/2010; 51(2):279-83. · 2.40 Impact Factor
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ABSTRACT: A 14-year-old girl was referred for a large tumor of the left kidney, with intraspinal and vertebral metastases. Left nephrectomy and intraspinal tumor resection were performed. The histology of both tumors was nephroblastoma with no anaplasia and favorable histology, and they were diagnosed as stage IV. The tumor bed and vertebras were irradiated. We started chemotherapy according to the DD-4A regimen of Japanese Wilms' Tumor Study Group. The vertebral metastasis was additionally irradiated. The patient has remained in disease-free remission for 45 months after the surgical resection. Intensive multimodality therapy including DD-4A regimen of National Wilms' Tumor Study can result in long-term disease-free remission.
Journal of Pediatric Hematology/Oncology 02/2009; 31(1):45-8. · 1.16 Impact Factor
