6 results on '"Atsushi Wake"'
Search Results
2. Retrospective analyses of other iatrogenic immunodeficiency-associated lymphoproliferative disorders in patients with rheumatic diseases
- Author
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Aya Nishida, Keiichiro Hattori, Shinsuke Takagi, Naoyuki Uchida, Mitsuhiro Yuasa, Yasuhito Suehara, Yasunori Ota, Yuki Asano-Mori, Go Yamamoto, Shigeru Chiba, Manabu Kusakabe, Kazuya Ishiwata, Hisashi Yamamoto, Yoshifumi Ubara, Kosei Kageyama, Daisuke Kaji, Takashi Mitsuki, Koji Izutsu, Mamiko Sakata-Yanagimoto, Shuichi Taniguchi, Kenichi Makishima, Yuki Taya, and Atsushi Wake
- Subjects
Adult ,Male ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,Herpesvirus 4, Human ,Lymphoma ,medicine.medical_treatment ,Iatrogenic Disease ,Lymphoproliferative disorders ,Kaplan-Meier Estimate ,Gastroenterology ,Tacrolimus ,hemic and lymphatic diseases ,Internal medicine ,Rheumatic Diseases ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Immunodeficiency ,Tumor Necrosis Factor alpha-Induced Protein 3 ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Autoimmune disease ,Aged, 80 and over ,Chemotherapy ,business.industry ,Immunologic Deficiency Syndromes ,Hematology ,Histone-Lysine N-Methyltransferase ,Middle Aged ,medicine.disease ,Prognosis ,Hodgkin Disease ,Progression-Free Survival ,Discontinuation ,Immunosuppressive drug ,Methotrexate ,Female ,Lymphoma, Large B-Cell, Diffuse ,Erratum ,business ,Receptors, Tumor Necrosis Factor, Member 14 ,Immunosuppressive Agents ,Myeloid-Lymphoid Leukemia Protein ,medicine.drug - Abstract
Other iatrogenic immunodeficiency-associated lymphoproliferative disorders (OIIA-LPDs) occur in patients receiving immunosuppressive drugs for autoimmune diseases; however, their clinicopathological and genetic features remain unknown. In the present study, we analysed 67 patients with OIIA-LPDs, including 36 with diffuse large B-cell lymphoma (DLBCL)-type and 19 with Hodgkin lymphoma (HL)-type. After discontinuation of immunosuppressive drugs, regression without relapse was achieved in 22 of 58 patients. Spontaneous regression was associated with Epstein-Barr virus positivity in DLBCL-type (P = 0·013). The 2-year overall survival and progression-free survival (PFS) at a median follow-up of 32·4 months were 92·7% and 72·1% respectively. Furthermore, a significant difference in the 2-year PFS was seen between patients with DLBCL-type and HL-type OIIA-LPDs (81·0% vs. 40·9% respectively, P = 0·021). In targeted sequencing of 47 genes in tumour-derived DNA from 20 DLBCL-type OIIA-LPD samples, histone-lysine N-methyltransferase 2D (KMT2D; eight, 40%) and tumour necrosis factor receptor superfamily member 14 (TNFRSF14; six, 30%) were the most frequently mutated genes. TNF alpha-induced protein 3 (TNFAIP3) mutations were present in four patients (20%) with DLBCL-type OIIA-LPD. Cases with DLBCL-type OIIA-LPD harbouring TNFAIP3 mutations had shorter PFS and required early initiation of first chemotherapy. There were no significant factors for spontaneous regression or response rates according to the presence of mutations. Overall, OIIA-LPDs, especially DLBCL-types, showed favourable prognoses.
- Published
- 2021
3. High incidence of haemophagocytic syndrome following umbilical cord blood transplantation for adults
- Author
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Shigeyoshi Makino, Naoyuki Uchida, Yoshiko Matsuhashi, Shuichi Taniguchi, Shigesaburo Miyakoshi, Hideki Araoka, Sachiko Seo, Tomoko Matsumura, Naofumi Matsuno, Shinsuke Takagi, Kazuya Ishiwata, Masanori Tsuji, Kazuhiro Masuoka, Kenichi Ohashi, Yasunori Ota, Daisuke Kato, Eiji Kusumi, Akiko Yoneyama, Atsushi Wake, and Hisashi Yamamoto
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Transplantation Conditioning ,Adolescent ,Graft vs Host Disease ,Antigens, CD34 ,Cord Blood Stem Cell Transplantation ,Umbilical cord ,Gastroenterology ,Lymphohistiocytosis, Hemophagocytic ,Young Adult ,Risk Factors ,Internal medicine ,medicine ,Humans ,Cumulative incidence ,Survival analysis ,Aged ,Transplantation Chimera ,Hematology ,Umbilical Cord Blood Transplantation ,business.industry ,Middle Aged ,Survival Analysis ,Surgery ,Transplantation ,medicine.anatomical_structure ,Hematologic Neoplasms ,Female ,business - Abstract
Umbilical cord blood transplantation (CBT) is widely accepted, but one critical issue for adult patients is a low engraftment rate, of which one cause is haemophagocytic syndrome (HPS). We aimed to identify the contribution of HPS to engraftment failure after CBT, following preparative regimens containing fludarabine phosphate, in 119 patients (median age, 55 years; range; 17-69 years) with haematological diseases. Graft-versus-host disease prophylaxis comprised continuous infusion of a calcineurin inhibitor with or without mycophenolate mofetil. Of the 119 patients, 20 developed HPS within a median of 15 d (cumulative incidence; 16.8%) and 17 of them did so before engraftment. Donor-dominant chimaerism was confirmed in 16 of 18 evaluable patients with HPS. Despite aggressive interventions including corticosteroid, ciclosporin, high-dose immunoglobulin and/or etoposide, engraftment failed in 14 of 18 patients. Of these 14 patients, four received second rescue transplantation and all resulted in successful engraftment. Overall survival rates significantly differed between patients with and without HPS (15.0% vs. 35.4%; P < 0.01). Univariate and multivariate analysis identified having fewer infused CD34(+) cells as a significant risk factor for the development of HPS (P = 0.01 and 0.006, respectively). We concluded that engraftment failure closely correlated with HPS in our cohort, which negatively impacted overall survival after CBT.
- Published
- 2009
4. Graft failure following reduced-intensity cord blood transplantation for adult patients
- Author
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Tamae Hamaki, Naoko Murashige, Masahiro Kami, Tomoko Matsumura, Yukiko Kishi, Shigesaburo Miyakoshi, Eiji Kusumi, Atsushi Wake, Koichiro Yuji, Hiroto Narimatsu, Yoshinobu Kanda, Shinichi Morinaga, Kazuhiro Masuoka, and Shuichi Taniguchi
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Neutropenia ,Adolescent ,Graft vs Host Disease ,Opportunistic Infections ,Umbilical cord ,Internal medicine ,medicine ,Humans ,Aged ,Cytopenia ,Hematology ,business.industry ,Histocompatibility Testing ,Graft Survival ,Middle Aged ,medicine.disease ,Surgery ,Pneumonia ,Haematopoiesis ,Treatment Outcome ,surgical procedures, operative ,Graft-versus-host disease ,medicine.anatomical_structure ,Hematologic Neoplasms ,Female ,Cord Blood Stem Cell Transplantation ,Complication ,business - Abstract
We reviewed the medical records of 123 adult reduced-intensity cord blood transplantation (RI-CBT) recipients to investigate the clinical features of graft failure after RI-CBT. Nine (7.3%) had graft failure, and were classified as graft rejection rather than primary graft failure; they showed peripheral cytopenia with complete loss of donor-type haematopoiesis, implying destruction of donor cells by immunological mechanisms rather than poor graft function. Three of them died of bacterial or fungal infection during neutropenia. Two recovered autologous haematopoiesis. The remaining four patients underwent a second RI-CBT and developed severe regimen-related toxicities. One died of pneumonia on day 8, and the other three achieved engraftment. Two of them died of transplant-related mortality, and the other survived without disease progression for 9.0 months after the second RI-CBT. In total, seven of the nine patients with graft failure died. The median survival of those with graft failure was 3.8 months (range, 0.9-15.4). Graft failure is a serious complication of RI-CBT. As host T cells cannot completely be eliminated by reduced-intensity preparative regimens, we need to be aware of the difficulty in differentiating graft rejection from other causes of graft failure following RI-CBT. Further studies are warranted to establish optimal diagnostic and treatment strategies.
- Published
- 2006
5. Impact of human leucocyte antigen mismatch on graft-versus-host disease and graft failure after reduced intensity conditioning allogeneic haematopoietic stem cell transplantation from related donors
- Author
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Masaharu Kasai, Fumio Kawano, Kazuo Hatanaka, Tetsuya Eto, Atsushi Wake, Masahiro Imamura, Yoshinobu Kanda, Takanori Teshima, Mitsune Tanimoto, Kosei Matsue, Masamichi Hara, Satoshi Takahashi, Yoichi Takaue, Yasunobu Abe, Yoshinobu Takemoto, Mine Harada, Keitaro Matsuo, Yoji Ishida, Shuichi Taniguchi, and Shinji Nakao
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Graft Rejection ,medicine.medical_specialty ,Transplantation Conditioning ,medicine.medical_treatment ,Graft vs Host Disease ,Hematopoietic stem cell transplantation ,Gastroenterology ,HLA Antigens ,Transplantation Immunology ,immune system diseases ,Internal medicine ,Humans ,Transplantation, Homologous ,Medicine ,Cumulative incidence ,Survival rate ,Proportional Hazards Models ,Retrospective Studies ,Hematology ,business.industry ,Incidence ,Hematopoietic Stem Cell Transplantation ,medicine.disease ,Tissue Donors ,Histocompatibility ,Survival Rate ,Transplantation ,surgical procedures, operative ,Graft-versus-host disease ,Hematologic Neoplasms ,Acute Disease ,Chronic Disease ,Immunology ,business ,Immunosuppressive Agents - Abstract
The impact of human leucocyte antigen (HLA) incompatibility between donor and recipient on graft-versus-host disease (GVHD) and graft failure after reduced-intensity conditioning stem cell transplantation (RICT) remains to be elucidated. We retrospectively analysed outcome in 341 patients who underwent RICT from related donors for haematological malignancies. The overall cumulative incidence of grade II-IV acute GVHD (aGVHD) was 40% for all subjects; 39% in recipients with HLA-matched donors, 44% in those with one-locus-mismatched donors, and 50% in those with two- to three-loci-mismatched donors. In a Cox regression model adjusted for potential confounders, the tendency for grade II-IV aGVHD (P=0.01), chronic GVHD (cGVHD) (P=0.05) and graft failure (P=0.033) increased with HLA disparity. Use of peripheral blood grafts instead of marrow was a risk factor for cGVHD. Use of antithymocyte globulin was associated with reduced aGVHD and cGVHD. Overall survival (OS) in recipients of two- to three-loci-mismatched RICT at 2 years (18%) was significantly worse than that in patients who received one-locus-mismatched RICT (51%) and HLA-matched RICT (48%) (P
- Published
- 2005
6. Rapid T-cell chimerism switch and memory T-cell expansion are associated with pre-engraftment immune reaction early after cord blood transplantation
- Author
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Aya Nishida, Koji Izutsu, Kazuhiro Masuoka, Akiko Yoneyama, Hiromitsu Nakauchi, Naoyuki Uchida, Atsushi Wake, Hisashi Yamamoto, Naofumi Matsuno, Masanori Tsuji, Nobuaki Nakano, Kazuya Ishiwata, Taichi Ikebe, Hikari Ota, Shuichi Taniguchi, Yuki Asano-Mori, and Nobukazu Watanabe
- Subjects
Adult ,CD4-Positive T-Lymphocytes ,Graft Rejection ,Time Factors ,Cell division ,T cell ,Graft vs Host Disease ,Transplantation Chimera ,CD8-Positive T-Lymphocytes ,Text mining ,T-Lymphocyte Subsets ,Medicine ,Humans ,Cell Lineage ,Lymphocyte Count ,Cord blood transplantation ,business.industry ,Graft Survival ,Hematology ,Flow Cytometry ,medicine.anatomical_structure ,Immunology ,Cord Blood Stem Cell Transplantation ,Immune reaction ,business ,Immunologic memory ,Memory T cell ,Immunologic Memory ,Cell Division ,Immunosuppressive Agents - Published
- 2012
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