Hiroko Fukushima

Publications (2)2.06 Total impact

• Article: Persistent Low Level Epstein-Barr Virus DNAemia in Childhood Cancer Survivors.

  Shaza S A Mahmoud, Takashi Fukushima, Takashi Shimizu, Tomohei Nakao, Ryoko Yamaguchi, Hiroko Fukushima, Hiroki Wada, Toru Nanmoku, Ryo Sumazaki
  [show abstract] [hide abstract]
  ABSTRACT: Background. Clinical observation of Epstein-Barr virus (EBV) status has not documented in childhood cancer survivors (CCSs) sustaining long-term remission of malignant diseases. Thus, the aim of this study was to evaluate the EBV status in children with various malignant diseases after they completed their treatments. Patients and Methods. Thirty consecutive children with various malignant diseases previously received treatment at the University of Tsukuba Hospital. Nine cases had acute lymphoblastic leukemia (ALL), 10 had solid tumors, 4 had lymphoma, 4 had CNS tumors, and 3 had acute myeloid leukemia (AML). EBV DNA in 328 whole blood samples were monitored by real-time QPCR for all cases after treatment. Clinical records and laboratory data were also reviewed. Results. There were 6/30 (20%) cases with continuous detection of EBV DNA while there were 24/30 (80%) cases without continuous EBV DNA. EBV DNAemia was persistently observed in 4/9 (44.4%) cases with ALL and in 2/4 (50%) cases with lymphoma. Persistent EBV DNAemia can be observed for >5 years without any EBV associated symptoms or diseases. Conclusions. Childhood cancer survivors have persistent EBV DNAemia more frequently, which is thought to be observed in cases with ALL and lymphoma with higher tendency for >5 years after treatment. Persistent EBV DNAemia is frequent in CCSs aged 5-10 years. Any immunological alteration is speculative in a pathophysiology of persistent EBV DNAemia.
  Pediatric Hematology and Oncology 01/2013; · 0.89 Impact Factor
• Article: Central nervous system lesions due to juvenile myelomonocytic leukemia progressed in a boy undergoing first line chemotherapy.

  Hiroko Fukushima, Takashi Fukushima, Akiyoshi Hiraki, Ryoko Suzuki, Shaza S A Mahmoud, Ai Yoshimi, Tomohei Nakao, Keisuke Kato, Chie Kobayashi, Kazutoshi Koike, Masakatsu Fukasawa, Yukio Morishita, Sayoko Doisaki, Hideki Muramatsu, Ryo Sumazaki
  [show abstract] [hide abstract]
  ABSTRACT: Juvenile myelomonocytic leukemia is a rare malignancy that occurs in pediatric patients. Previous reports, have described leukemic cells may infiltrate many organs, such as the lungs, skin, liver, spleen, and intestines, but not the central nervous system, although central nervous system infiltration remains a point of concern in every patient with acute leukemia. Here, we present one case of a boy with juvenile myelomonocytic leukemia who developed multiple lesions in the brain while undergoing chemotherapy with 6-mercaptopurine and cytarabine. We diagnosed the central nervous system involvement by magnetic resonance imaging, cerebrospinal fluid cytology, and the patient's clinical course. He was treated with a high dose of cytarabine and intrathecal chemotherapy, then with unrelated cord blood stem cell transplantation. He has been in a first complete remission for more than 18 months after cord blood stem cell transplantation without any neurological sequelae. In conclusion, we encountered a boy with juvenile myelomonocytic leukemia who developed central nervous system lesions under standard chemotherapy. We subsequently switched treatment to central nervous system-oriented chemotherapy, which resulted in a good clinical condition and successful cord blood stem cell transplantation.
  International journal of hematology 03/2012; 95(5):581-4. · 1.17 Impact Factor