Hajime Yasuda

Juntendo University, Edo, Tōkyō, Japan

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Publications (14)18.83 Total impact

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    ABSTRACT: Micronutrient deficiencies such as vitamin A, iron, zinc, and selenium have been known to occur as a consequence of pancreaticoduodenectomy (PD), but vitamin B6 deficiency has not been previously reported. We report two post-PD patients who developed anemias attributed to vitamin B6 deficiency. Oral supplementations of vitamin B6 significantly improved anemias in both cases. Micronutrients including vitamin B6 should be monitored in post-PD patients, and supplementations should be carried out when necessary.
    Pancreatology 12/2014; · 2.04 Impact Factor
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    ABSTRACT: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy arising from plasmacytoid dendritic cell precursors. BPDCN typically manifests in the skin, but it can also evolve into a leukemic form or be complicated by acute myeloid leukemia, some cases with a preceding myelodysplastic syndrome (MDS). We herein report the first case of complete spontaneous regression of cutaneous BPDCN followed by acute monocytic leukemia evolving from MDS. This is also the first reported case of gastric BPDCN invasion.
    Internal medicine (Tokyo, Japan). 01/2014; 53(23):2717-20.
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    ABSTRACT: Treatment of patients with multiple myeloma (MM) has drastically changed with the introduction of novel agents such as thalidomide, lenalidomide, and bortezomib, but treatment outcome of elderly patients has remained dismal mainly due to toxicities. We report an 82-year-old MM patient attaining stringent complete response (sCR) at 12 months with a daily dose of 100 mg of thalidomide monotherapy. She remains on thalidomide monotherapy and presently maintains a normalized serum free light chain ratio at 18 months. This is the first case of MM achieving sCR with thalidomide monotherapy, and shows that single-agent thalidomide can be effective and concomitant use of dexamethasone may not be necessary in frail elderly patients.
    Internal Medicine 01/2012; 51(19):2781-3. · 0.97 Impact Factor
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    ABSTRACT: A 26-year-old female progressed to blastic crisis (BC) after three months administration of imatinib for chronic myelogenous leukemia (CML) chronic phase (CP) and was treated with a dasatinib containing chemotherapy regimen. After remission to second CP, she was hospitalized because of fever and hemorrhagic diarrhea during dasatinib maintenance therapy. She was diagnosed as having cytomegalovirus (CMV) colitis because CMV antigen in blood leukocytes was positive and CMV-positive cells were also detected on staining of an ileocecal mucosal biopsy specimen with an anti-CMV antibody. Although blood leukocyte CMV antigen and CMV staining in colonic mucosa became negative after ganciclovir treatment, hemorrhagic diarrhea did not improve. However, after discontinuance of dasatinib, hemorrhagic colitis drastically improved and did not recur after administration of nilotinib. It is possible that hemorrhagic diarrhea occurred due to dasatinib-related hemorrhagic colitis. Previous case reports have indicated that CD8-positive T-lymphocytes infiltrate the colonic mucosa in dasatinib-related hemorrhagic colitis, and the same pathological findings were seen in our case. Dasatinib may cause hemorrhagic colitis via immunological mechanisms in CML. Dasatinib-related gastrointestinal bleeding is less frequent in Japan compared to that in western countries, and Japanese cases diagnosed as having hemorrhagic colitis are extremely rare.
    [Rinshō ketsueki] The Japanese journal of clinical hematology 05/2011; 52(5):282-6.
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    ABSTRACT: Chronic myelogenous leukemia (CML) is a clonal hematological malignancy typically presenting with basophilia and massive proliferation of differentiating myeloid cells. We report an atypical case of CML in which mild basophilia was the sole manifestation at presentation, and the condition persisted for 27 months with no sign of progression. This case reconfirms the importance of basophilia as a clinical manifestation of CML, and BCR-ABL FISH analysis should always be applied to cases of basophilia, even when the basophilia is modest and no other features of CML are present.
    Internal Medicine 01/2011; 50(5):501-2. · 0.97 Impact Factor
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    ABSTRACT: We presented the case of diffuse large B-cell lymphoma initially manifesting in bone marrow without lymph nodes' swelling and other extranodal lesion. A 68-year-old woman was suffering from general fatigue and fever. Because atypical cells were identified in the peripheral blood, a bone marrow puncture and random skin biopsy were performed. In myelogram, it was suspicious for myelodysplastic disease because lymphoma cells resembled other atypical hematopoietic cell. In biopsy specimen of bone marrow, atypical cells diffusely infiltrated, which could be called "paced bone marrow". On the other hand no atypical cell identified in the vessels of dermis and subcutaneous tissue by random skin biopsy. Immunohistochemically, atypical cells in bone marrow were diffusely positive for B-cell marker (CD20). These results lead this case to be diagnosed as diffuse large B-cell lymphoma initially manifesting in the bone marrow. In this case, it was very useful that bone marrow biopsy and myelogram were evaluated simultaneously. Quick and accurate diagnosis is possible by combining immunohistochemical analysis using both myelogram and biopsy specimen.
    Rinsho byori. The Japanese journal of clinical pathology 12/2010; 58(12):1176-80.
  • Histopathology 10/2010; 57(4):648-50. · 2.86 Impact Factor
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    ABSTRACT: Extramedullary tumor (EMT) is a poor prognostic factor of multiple myeloma (MM). The majority of patients report poor efficacy of thalidomide in MM with EMT, and bortezomib is the preferred choice of treatment. We report two cases of MM with EMTs in which thalidomide was highly beneficial. Case 1 has been in remission for ten months with 100 mg every other day of thalidomide monotherapy, which is the lowest dose to be reported in a successfully treated case of MM with EMT. Case 2 eventually became refractory, but low dose thalidomide gave excellent disease control over a period of eleven weeks, despite the EMT being in a highly aggravated state. Some reports have speculated that EMT cases with preceding bone marrow transplantation (BMT) are an exception and have a good response to thalidomide, but the present two cases have no history of BMT. In conclusion, low dose thalidomide can be effective in MM with EMT and should be considered as a treatment option, especially in the elderly.
    Internal Medicine 01/2010; 49(23):2617-20. · 0.97 Impact Factor
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    ABSTRACT: Sorry, there is no abstract.
    Acta Haematologica 01/2010; 123(4):215-9. · 0.89 Impact Factor
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    ABSTRACT: Optimal salvage chemotherapy has not been established for lymphoid malignancy, which is refractory to the conventional cyclophosphamide, doxorubicin, vincristine, and prednisone regimen. To explore an effective regimen, we conducted a phase I pilot study of combination chemotherapy with methotrexate, ifosfamide, l-asparaginase and dexamethasone (MILD), which are unaffected by MDR1-encoded P-glycoprotein. A total of 18 patients with lethal lymphoid malignancy were enrolled over a 2-yr period. The median age was 63 yr. Eleven patients had T/NK-cell malignancies, six had B-cell malignancies, and one was diagnosed with a blastic plasmacytoid dendritic cell neoplasm. Patients aged ≥60 and <60 yr were planned to receive a set of starting doses of methotrexate and ifosfamide, which should induce myelosuppression. Eleven patients completed two courses of MILD therapy. Treatment-related death because of systemic mucormycosis was observed in one patient. Major treatment-related adverse events were grade 3 or more hematologic toxicities, which included lymphopenia corresponding to dose-limiting toxicity. The most common grade 3 non-hematologic toxicity was febrile neutropenia. Of the 14 evaluated patients, three achieved a complete response, and four showed a partial response. The overall response rate was 57%. It was very interesting that all of seven responders had T/NK-cell malignancies. MILD therapy was feasible and presented acceptable toxicity in patients with refractory or lethal lymphoid malignancies. The efficacy for T/NK-cell malignancies should be further evaluated.
    European Journal Of Haematology 12/2009; 84(4):310 - 315. · 2.55 Impact Factor
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    ABSTRACT: Nasal natural killer (NK)-cell lymphoma was resistant to various antitumor agents. Although high expression of p-glycoprotein has been reported, other molecular mechanism of the chemo-resistance is largely unknown. Activation of STAT3 and expression of major apoptosis-related proteins Bcl-2, Bcl-x, and Mcl-1 were analyzed by immunohistochemistry. Effects of STAT3 inhibitor AG490 on NK-YS cell line were analyzed by Western blotting and flow cytometric apoptosis assay. STAT3 was activated in six of the nine nasal NK-cell lymphomas (67%). In contrast, STAT3 activation was detected in 35% of diffuse large B-cell lymphoma (DLBCL) and in 10% of follicular lymphoma (FL). Frequent activation of STAT3 was significantly correlated with Mcl-1 expression in nasal NK-cell lymphoma, i.e., Mcl-1 was positive in five of six STAT3-active cases and negative in all three STAT3-inactive ones. In DLBCL, not only six out of seven STAT3-active cases (86%) but also eight out of thirteen STAT3-inactive cases (62%) were positive for Mcl-1 expression. Latent membrane protein-1 was positive in four nasal NK-cell lymphomas, among which three cases showed intermediate STAT3 activation. Inhibition of STAT3 activation by JAK inhibitor AG490 decreased Mcl-1 expression and induced apoptosis in STAT3-active NK-YS cells. Serum starvation rather increased the Mcl-1 level in NK-YS cells, and this effect was also canceled by AG490. These results suggest that activation of STAT3-Mcl-1 axis may play a role in the chemotherapy resistance of nasal NK-cell lymphoma. The pathway may be one of the future therapeutic targets of this intractable disease.
    International journal of laboratory hematology 11/2009; 32(4):419-26. · 1.30 Impact Factor
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    ABSTRACT: Based on the presence of the tumor-specific over-expression of Plk1 (polo-like kinases) in various malignancies, we examined Plk1 expression in nine cases of reactive follicular hyperplasia (RFH), 42 of diffuse large B cell lymphoma (DLBCL), 16 of follicular lymphoma (FL), and 10 of nasal NK/T lymphoma. There was no significant difference in the Plk1-positive cell percentage between RFH and DLBCL. The Plk1-positive cell percentage ranged from 6 to 20% with a median of 12.9% in DLBCL. In FL, Plk1-positivity was at most 7%. Plk1-positivity in nasal NK/T cell lymphoma (4.7-14.1% with a median of 9.2%) was significantly higher than that of FL and tended to be lower than DLBCL (p < 0.001, p = 0.05, respectively). Although a strong correlation between positive cell percentages for Plk1 and Ki-67 in these three lymphomas specified Plk1 as a proliferation marker (r = 0.83-0.91), the Plk1-positive cell percentage relative to the other proliferation markers tended to be particularly low in nasal NK/T cell lymphoma. In 41 cases of DLBCL, the positive cell percentages of Plk1 and Ki-67 were both correlated with overall survival. The 4-year overall survival rates by Kaplan-Meier analysis for Plk1-negative and positive patients were 80 and 38%, respectively (p = 0.02).
    International journal of hematology 06/2009; 89(5):673-8. · 1.17 Impact Factor
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    ABSTRACT: Nasal natural killer (NK)/T-cell lymphoma is characterized by chemo-resistance, angiodestruction, and aggressive tumor progression. Few studies exist on molecular characteristics of this disease entity. Expression levels of major apoptosis-related proteins Bcl-2, Bcl-x, Mcl-1, Bax, and a proliferative marker Ki-67 were analyzed in 11 nasal NK/T-cell lymphoma cases by immunohistochemical methods. Nine cases were of NK-cell lineage and two cases were of T-cell lineage. For comparison, 12 follicular lymphoma (FL) cases and 16 diffuse large B-cell lymphoma (DLBCL) cases were also studied. Bax expression was low in all nasal NK-cell lymphoma cases, which constitute the major population of nasal NK/T-cell lymphoma. Bax expression in nasal NK-cell lymphoma was similar to FL and significantly lower compared with DLBCL. Bcl-2 expression was significantly lower in nasal NK/T-cell lymphoma compared with that of FL and DLBCL. Bcl-x expression was high in all three lymphomas. Two distinct Mcl-1 expression groups existed for nasal NK/T-cell lymphoma (6.2 +/- 5.2% and 59.1 +/- 12.3%, 95% CI). Ki-67 expression was high in nasal NK/T-cell lymphoma, and worse prognostic groups tended to express higher levels of Ki-67. The results suggest a combination of impaired apoptosis and aggressive proliferation in nasal NK/T-cell lymphoma, and may provide explanations for its poor prognosis.
    European Journal Of Haematology 10/2008; 82(1):39-45. · 2.55 Impact Factor
  • European Journal Of Haematology 07/2007; 78(6):545. · 2.55 Impact Factor