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Yudistiro, Ryan ; Heryanto, Yusri Dwi ; Kodaira, Sayaka ; Higuchi, Tetsuya ; Arisaka, Yukiko ; Tokue, Azusa ; Taketomi-Takahashi, Ayako ; Tsukamoto, Norifumi ; Yokohama, Akihiko ; Handa, Hiroshi ; Koiso, Hiromi ; Ishizaki, Takuma ; Tsushima, Yoshito
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Yudistiro, Ryan ; Heryanto, Yusri Dwi ; Kodaira, Sayaka ; Higuchi, Tetsuya ; Arisaka, Yukiko ; Tokue, Azusa ; Taketomi-Takahashi, Ayako ; Tsukamoto, Norifumi ; Yokohama, Akihiko ; Handa, Hiroshi ; Koiso, Hiromi ; Ishizaki, Takuma ; Tsushima, Yoshiko
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Journal Article<br />Background and Aims: Radioimmunotherapy (RIT) appears as one of the most effective treatment option
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s for patientswith relapsed or resistant non-Hodgkin’s lymphoma (NHL). Our aim was to evaluate the role of pre-RIT 18F-fluorodeoxyglucose-positron emission tomography╱computed tomography (FDG-PET╱CT) as an early predictor of 90Y-Ibritumomabtiuxetan treatment response. Methods: We included consecutive 20 patients with relapsed NHL (10 males; meanage, 58.5 ± 8.9 years old) who were treated with 90Y-Ibritumomab tiuxetan. FDG-PET╱CT was performed before andafter treatment. Semiquantitative parameters of all measurable FDG-avid lesions were measured and averaged. Ameasurable FDG-avid lesion was defined as a lesion that showed FDG uptake higher than liver with a diameter morethan 1 cm. Treatment response was determined by visual assessment based on a five-point score criteria from FDGPET╱CT after treatment. Results: Fourteen patients (70%) were classified as responders and the other six patients(30%) as non-responders. All semiquantitative parameters except for MTV demonstrated significantly lower values inthe responders compared with the non-responders (p＜0.05). Conclusions: Semiquantitative evaluation by SUVmax,SUVpeak, and TLG before treatment were useful as early predictors of 90Y-Ibritumomab tiuxetan treatment response.
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Ishizaki, Takuma ; Yokohama, Akihiko ; Shimizu, Hiroaki ; Yanagisawa, Kunio ; Yoshiyuki, Ogawa ; Mitsui, Takeki ; Hiromi, Koiso ; Takizawa, Makiko ; Saitoh, Takayuki ; Murakami, Hirokazu ; Tsukamoto, Norifumi ; Handa, Hiroshi ; 石埼, 卓馬 ; 横濱, 章彦 ; 清水, 啓明 ; 小川, 孔幸 ; 三井, 健揮 ; 小磯, 博美 ; 滝沢, 牧子 ; 齋藤, 貴之 ; 村上, 博和 ; 塚本, 憲史 ; 半田, 寛
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Journal Article<br />再発難治悪性リンパ腫や若年者症候性多発性骨髄腫に対し，自家末梢血幹細胞移植が標準治療として行われている．移植後の速やかな生着には2.0×106╱kg のCD34 陽性細胞が必要とされ，末梢血幹細胞採
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取効率の向上が期待される．当科で2000 年12 月から2015 年3 月までに末梢血幹細胞採取（Peripheral blood stem cell harvest: PBSCH）を行った悪性リンパ腫と多発性骨髄腫の82 例のうち，動員化学療法としてetoposide 中等量療法（350 mg╱m2，4 日間）を施行した19 例を対象として，その有効性と安全性を検討した．15 例（79％）で必要量のCD34 陽性細胞の採取を達成した．白血球数1000╱μl 以下の期間中央値は5 日間（3 日～7 日）で，37.5 度以上の発熱は解析可能な13 例中9 例に認め，菌血症の1 例以外は発熱性好中球減少症で，全例抗菌薬治療が奏効した．Grade 3 の口腔粘膜炎を1 例に認めたが，それ以外に重篤な有害事象はなかった．Etoposide 中等量療法は有効で安全な動員化学療法と考えられた．
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Takei, Hisashi ; Mitsui, Takeki ; Sato, Naru ; Saito, Akio ; Hoshino, Takumi ; Koiso, Hiromi ; Takizawa, Makiko ; Yokohama, Akihiko ; Saito, Takayuki ; Tsukamoto, Norifumi ; Murakami, Hirokazu ; Handa, Hiroshi ; Nojima, Yoshihisa ; 武井, 寿史 ; 三井, 健揮 ; 佐藤, 成 ; 斉藤, 明生 ; 星野, 匠臣 ; 小磯, 博美 ; 滝沢, 牧子 ; 横濱, 章彦 ; 斉藤, 貴之 ; 塚本, 憲史 ; 村上, 博和 ; 半田, 寛 ; 野島, 美久
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Journal Article<br />症例は63歳男性. 血液検査, 骨髄検査から慢性骨髄性白血病慢性期(CML-CP) と診断した. 初診時よりHBV-DNA が検出され,HBVキャリアと診断した.チロシンキナーゼ阻害薬(TKI)投与
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によるHBV再活性化の可能性を考慮しentecavir 0.5mg/日の投与を先行した. HBV-DNA 量の低下を確認しdasatinib 100mg/日の併用を開始した. 投与3ヵ月後に細胞遺伝学的部分寛解, 12ヶ月後に分子生物学的大寛解を得た. 治療経過中HBV再活性化, 肝障害は認めず, 現在も併用療法継続中である. 近年, 免疫抑制作用を持つ薬剤によるHBV再活性化が報告されている. Dasatinibも免疫抑制作用を持つと考えられており, HBV再活性化の可能性が示唆される.HBVキャリアCML-CPに対し,entecavirとdasatinibを併用し安全に治療を継続し得た症例を経験したので報告する.
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Toyama, Kohtaro ; Mitsui, Takeki ; Yokohama, Akihiko ; Saitoh, Takayuki ; Uchiumi, Hideki ; Handa, Hiroshi ; Sakuraya, Masataka ; Murakami, Hirokazu ; Nojima, Yoshihisa ; Tsukamoto, Norifumi
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Journal Article<br />A 64-year-old woman,with more than a 20 year history of polycythemia vera(PV),developed portal\nhypertension,myelofibrosis and extramedullary hematopoiesis accompanied by massive ascites.
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Portal\nhypertension resulted not only from infiltration of the liver sinusoids by hematopoietic cells but also from\nnodular regenerative hyperplasia of the liver. Wright-stained smears of ascites samples consisted of\nmesothelial cells and macrophages. However,cultures of mononuclear cells from the ascites showed the\npresence of hematopoietic progenitor cells including megakaryocyte colony formation and burst forming\nunits. The JAK2-V617F mutation was positive in granulocytes. Contrary to other reports, radiation\ntherapy was not effective and severe myelosuppression continued for more than one month. We present\nthe unusual clinical course for this case of PV and discuss the pathophysiology of refractory ascites.
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Matsumoto, Kumiko ; Yokohama, Akihiko ; Yuzuriha, Akinori ; Toyama, Kohtarou ; Mitsui, Tateki ; Hashimoto, Yoko ; Koiso, Hitomi ; Saitoh, Takayuki ; Uchiumi, Hideki ; Handa, Hiroshi ; Karasawa, Masamitsu ; Murakami, Hirokazu ; Matsui, Hiroshi ; Suzuki, Kazuhiro ; Tsukamoto, Norifumi ; Nojima, Yoshihisa
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Iriuchishima, Hirono ; Handa, Hiroshi ; Takizawa, Makiko ; Yokohama, Akihiko ; Uchiumi, Hideki ; Matsushima, Takafumi ; Tsukamoto, Norifumi ; Karasawa, Masamitsu ; Murakami, Hirokazu ; Nojima, Yoshihisa
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application/pdf<br />Journal Article<br />An 18 year-old male was admitted to our hospital suffering from a large tumor which was located\nat the right frontal bone. He was diagnosed to have acute myeloid leukemia (AML) with
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granulocytic\nsarcoma (GS). A chromosomal analysis showed t(8; 21), and a flow cytometric analysis demonstrated\nthe leukemic cells to be positive for CD56.\nSystemic chemotherapy and radiation therapy to the GS, but the patient experienced a relapse in the\nlumbar vertebrae. He underwent an umbilical-cord blood stem cell transplantation, however, he died 7\nmonths thereafter. GS is a localized tumor consisting of leukemic myelolasts, which is generally\nobserved as a complication of either AML, myelodysplastic syndrome, or myelobproliferative disorders.\nWe herein report this case due to its rarity, even though various sites of GS have been reported.
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