Publications by authors named "Atsuko Nakazawa"

Purpose: To evaluate the safety and efficacy of multimodality treatment with vincristine, actinomycin D, and cyclophosphamide (VAC) therapy, surgery, and radiotherapy according to the US Intergroup Rhabdomyosarcoma Study IV (IRS-IV), and to establish a central review system and standard treatment for intermediate-risk pediatric rhabdomyosarcoma in Japan.

Patients And Methods: The Japan Rhabdomyosarcoma Study-I (JRS-I) was a single-arm, phase II trial for intermediate-risk rhabdomyosarcoma treatment with open enrollment from June 2004 to March 2009. Patients received 12 cycles of VAC every 3 weeks for 42 weeks, with local therapy beginning after Week 12.

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T-cell receptor excision circle (TREC)-based newborn screening is a method for the early detection of severe combined immunodeficiency (SCID); however, undetectable TREC level results have also been reported in conditions other than SCID. To date, no studies have investigated the dynamics of TREC levels in patients with Langerhans cell histiocytosis (LCH). Here, we report a case of congenital multisystem LCH with thymic involvement diagnosed following a negative TREC result obtained through newborn screening.

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Background: Rosai-Dorfman-Destombes disease (RDD) is a rare form of histiocytosis, characterized by the accumulation of S100 protein-positive and CD1a-negative histiocytes with emperipolesis. Recently, oncogenic mutations in mitogen-activated protein kinase pathway genes were reported in nearly half of RDD patients.

Methods: We conducted a nationwide retrospective survey of childhood RDD in Japan.

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IKAROS, encoded by IKZF1, is a crucial transcription factor regulating hematopoiesis and B cell development. While IKZF1 haploinsufficiency variants are associated with various immunological disorders, inflammatory bowel disease (IBD) has been rarely reported. We report a case of IKZF1 haploinsufficiency presenting with an atypical IBD phenotype and its response to filgotinib.

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Background: Localized lymphoblastic lymphoma (LL) is rare in pediatric patients. The best treatment for patients with localized LL remains to be determined because of the rarity of the disease.

Methods: Between November 2004 and October 2019, 41 newly diagnosed patients up to 18 years of age with localized LL (Murphy stages I and II) were enrolled in the LLB-NHL03 trial.

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Article Synopsis
  • Epigenetic changes are crucial in tumor development, with Polycomb-group complexes like PRC1 playing a key role through histone modifications, particularly in neuroblastoma (NB).
  • The study focused on the role of L3MBTL2, a component of the PRC1.6 complex, finding that its knockout leads to decreased proliferation of NB cells and inhibition of tumor growth.
  • Results showed that L3MBTL2 depletion altered cell cycle and differentiation pathways, and its loss increased the expression of certain genes linked to cell growth, highlighting the importance of L3MBTL2 in regulating gene silencing in MYCN-amplified neuroblastoma cells.
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Background: Failure-free survival (FFS) rates of low-risk patients with rhabdomyosarcoma improved in Intergroup Rhabdomyosarcoma Study IV after the escalation of cyclophosphamide total dose to 26.4 g/m. However, this dose may increase the risk of adverse events, including infertility, in some patients.

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Article Synopsis
  • The study focuses on improving treatment for Langerhans cell histiocytosis (LCH), which, despite a generally good prognosis, has high recurrence rates and serious long-term effects like diabetes insipidus and neurodegenerative issues.
  • Researchers are evaluating the effectiveness of dexamethasone and intrathecal chemotherapy for multisystem disease, along with zoledronate for multifocal bone disease in previously untreated patients under 40.
  • The trial is officially registered and approved by the Central Review Board in Japan, with written consent required from participants or their guardians.
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Background: Biliary atresia (BA) is an intractable disease of unknown cause that develops in the neonatal period. It causes jaundice and liver damage due to the destruction of extrahepatic biliary tracts,. We have found that heterozygous knockout mice of the SRY related HMG-box 17 (Sox17) gene, a master regulator of stem/progenitor cells in the gallbladder wall, exhibit a condition like BA.

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Article Synopsis
  • This clinical trial aimed to assess the safety and effectiveness of a time-intensified treatment strategy for high-risk neuroblastoma, involving delayed local surgery following aggressive chemotherapy.
  • Seventy-five patients were enrolled, with a 3-year progression-free survival rate of 44.4% and an overall survival rate of 80.7%, indicating a significant response to therapy without any deaths during treatment.
  • However, there were high rates of adverse effects, with 48% experiencing severe complications and 25% facing major surgical issues, suggesting more research is needed to confirm findings and improve safety.
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Introduction: Children and adolescents with mature B cell non-Hodgkin lymphoma (B-NHL) are treated with short-intensive chemotherapy. The burden of short-term and long-term toxicity is highly relative to its high cure rate in good-risk patients. Although the addition of rituximab to standard lymphome Malin B (LMB) chemotherapy markedly prolongs event-free survival and overall survival in high-risk patients, the benefit of rituximab in good-risk patients remains to be elucidated.

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Background: Progressive familial intrahepatic cholestasis type 2 (PFIC2) is an ultra-rare disease caused by mutations in the ABCB11 gene. This study aimed to understand the course of PFIC2 during the native liver period.

Methods: From November 2014 to October 2015, a survey to identify PFIC2 patients was conducted in 207 hospitals registered with the Japanese Society of Pediatric Gastroenterology, Hepatology, and Nutrition.

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Background: The benefit of adding rituximab to standard lymphomes malins B (LMB) chemotherapy for children with high-risk mature B-cell non-Hodgkin lymphoma (B-NHL) has previously been demonstrated in an international randomized phase III trial, to which the Japanese Pediatric Leukemia/Lymphoma Study Group could not participate.

Methods: To evaluate the efficacy and safety of rituximab in combination with LMB chemotherapy in Japanese patients, we conducted a single-arm multicenter trial.

Results: In this study, 45 patients were enrolled between April 2016 and September 2018.

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Background: One of the most significant challenges in patients with medulloblastoma is reducing the dose of craniospinal irradiation (CSI) to minimize neurological sequelae in survivors. Molecular characterization of patients receiving lower than standard dose of CSI therapy is important to facilitate further reduction of treatment burden.

Methods: We conducted DNA methylation analysis using an Illumina Methylation EPIC array to investigate molecular prognostic markers in 38 patients with medulloblastoma who were registered in the Japan Pediatric Molecular Neuro-Oncology Group and treated with reduced-dose CSI.

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Thyroid involvement is rare in pediatric Langerhans cell histiocytosis (LCH). It may cause airway narrowing, leading to acute-onset respiratory distress. Severe cases may require emergent surgical interventions such as thyroidectomy, which should be avoided in children due to higher rates of complication, particularly in infancy.

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Hepatocyte-like cells (HLCs) generated from human pluripotent stem cells (PSCs) exhibit hepatocytic properties in vitro; however, their engraftment and functionality in vivo remain unsatisfactory. Despite optimization of differentiation protocols, HLCs did not engraft in a mouse model of liver injury. In contrast, organ-derived hepatocytes reproducibly formed colonies in the liver injury mouse model.

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A 4-year-old boy with an abdominal mass extending from the spleen to the lower umbilicus was diagnosed with Burkitt lymphoma stage III. Because the fluorodeoxyglucose uptake on positron emission tomography (PET)-computed tomography of the residual splenic tumor remained elevated, splenectomy was performed. The PET-positive area was composed of inflammatory infiltrates, whereas the PET-negative area was composed of a viable tumor surrounded by necrotic or dying tumor cells.

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Article Synopsis
  • This study aimed to identify genetic changes and potential treatment targets in advanced pediatric solid tumors through genomic profiling.
  • Conducted at the National Cancer Center in Japan, it analyzed tumor and blood samples from 142 pediatric patients with recurrent or refractory cancer, finding significant genetic alterations in 59% of those evaluable.
  • The research highlights the importance of genomic medicine in understanding tumor biology and developing new therapies, while also noting challenges in accessibility and a limited number of actionable treatment options.
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Background: The histology of the cardiac mucosa at the esophagogastric junction (EGJ) at birth is still a controversy. We conducted a histopathological study of the EGJ to clarify the morphology, and to determine the presence or absence of cardiac mucosa at birth.

Subjects: We examined 43 Japanese neonates and infants that are born prematurely or at full term.

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Anaplastic large cell lymphoma (ALCL) is a rare form of non-Hodgkin's lymphoma (NHL) in children, accounting for 10-15% of all NHL cases. ALCL is currently classified as follows: systemic anaplastic lymphoma kinase (ALK)-positive, systemic ALK-negative, primary cutaneous, and breast implant-associated ALCL. In children, systemic ALK-positive ALCL is the most common, and patients often present with extranodal involvement.

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