Outcomes of patients aged 70 years or younger with aggressive ATL at core hospitals for ATL treatment in Tokyo.

Adult T-cell leukemia-lymphoma (ATL) is one of the most intractable peripheral T-cell neoplasms caused by human T-cell leukemia virus type I (HTLV-1) infection. Recently, the incidence of HTLV-1 infection and ATL has increased in non-endemic metropolitan areas in Japan. This retrospective study evaluated the clinical features and outcomes of patients with aggressive ATL aged 70 years or younger treated at a core hospital in Tokyo between 2004 and 2016.

Allogeneic hematopoietic stem cell transplantation for older patients with adult T-cell leukemia/lymphoma: A nationwide retrospective study.

Background: Adult T-cell leukemia/lymphoma (ATL) is an aggressive malignancy with a poor prognosis. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curative option but has been limited in older patients due to toxicity risks. With Japan's aging population and evolving treatment options, reassessing allo-HSCT in patients aged ≥65 is essential.

Bridging therapy with valemetostat to allogeneic hematopoietic cell transplantation for adult T-cell leukemia/lymphoma.

Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus-1. Patients diagnosed with aggressive ATL have a poor prognosis. As response duration to conventional multiagent chemotherapy is short, upfront allogeneic hematopoietic cell transplantation (allo-HCT) is recommended.

The degree of blastocyst re-expansion immediately after warming is a strong dynamic indicator of embryo quality.

Research Question: Does the degree of blastocyst re-expansion at 9-11 min after warming affect vitrified-warmed blastocyst transfer cycle outcomes, and could it be a quantitative measure suitable for clinical application in assessing embryo quality?

Design: This retrospective observational cohort study included 1356 cases of vitrified-warmed blastocyst transfer cycles at the Reproduction Center, Toho University Omori Medical Center between January 2017 and December 2022. The degree of re-expansion was calculated using image-analysis software. The degree of blastocyst re-expansion at about 9-11 min after warming and its association with cycles outcomes were evaluated.

[Prevention and treatment of post-transplant relapse in adult T-cell leukemia-lymphoma].

Aggressive adult T-cell leukemia-lymphoma (ATL) is a rare T-cell malignancy with a poor prognosis. Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative therapy, but the long-term survival rate is approximately 40%, which is poor compared to other hematopoietic tumors. The most common cause of death after allo-HCT is ATL relapse.

The optimal conversion ratio of tacrolimus switching from intravenous to oral tacrolimus administration in hematopoietic cell transplantation patients receiving posaconazole prophylaxis with and without letermovir.

Letermovir, a moderate inhibitor of CYP3A4 and inducer of CYP2C9 and CYP2C19, is used for cytomegalovirus prophylaxis following allogeneic hematopoietic stem cell transplantation (HCT). Posaconazole also inhibits CYP3A4, affecting tacrolimus metabolism. This study aimed to examine tacrolimus conversion ratios when switching from continuous intravenous to oral administration in HCT patients receiving posaconazole with and without letermovir.

Impact of health insurance coverage for assisted reproductive technology on multiple embryo transfers and multiple pregnancies in Japan.

Aim: To evaluate the impact of health insurance coverage for assisted reproductive technology (ART), introduced in Japan in April 2022, on the number of multiple embryo transfers (METs) and multiple pregnancies.

Methods: We analyzed Japanese ART registry data from over 600 registered ART facilities, comparing the rates and numbers of multiple pregnancies in 2022 with those in previous years. Furthermore, age-specific MET rates and proportions of blastocyst transfers in METs were examined separately for fresh and frozen-thawed embryo transfers.

Endometrial injection of embryo culture supernatant adversely affects assisted reproductive technology outcomes in frozen thawed embryo transfer cycles.

We assessed the effects of endometrial injection of embryo culture supernatants on assisted reproductive technology (ART) outcomes in frozen-thawed embryo transfer (FET) cycles. Hormone replacement therapy cycles with blastocyst transfer on day 5 after fertilization were included, excluding cycles potentially affecting implantation. The stimulation of endometrial embryo transfer (SEET) group (118 cycles) received endometrial injections of the embryo culture supernatant, while the blastocyst transfer (BT) group (878 cycles) did not.

Oral beclomethasone dipropionate therapy and prognostic plasma biomarkers for gastrointestinal graft-versus-host disease.

The real-world outcomes of oral beclomethasone dipropionate (BDP) for gastrointestinal graft-versus-host disease (GVHD) were evaluated in a single-center, prospective, observational study of 167 patients who developed histologically confirmed gastrointestinal GVHD. The median patient age was 55 years (range 10-71). The initial GVHD grade was mostly IIa (n = 138).

Fludarabine Plus Myeloablative Dose of Busulfan Regimen Was Associated with High Nonrelapse Mortality in Allogeneic Hematopoietic Stem Cell Transplantation for Malignant Lymphoma: A Propensity Score-Matched Comparison Study with Fludarabine Plus High-Dose Melphalan.

In recent years, there have been notable advancements in the treatment of malignant lymphoma. However, a certain percentage of patients are unlikely to achieve a cure through chemotherapy alone. Therefore, allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a crucial curative treatment for malignant lymphoma.

Concomitant letermovir affects the optimal concentration-to-dose ratio of tacrolimus after switching from intravenous to oral tacrolimus administration in hematopoietic cell transplantation patients receiving fluconazole prophylaxis.

Letermovir is often administered for cytomegalovirus prophylaxis after allogeneic hematopoietic cell transplantation (HCT). Concomitant use of letermovir and azole antifungals affects tacrolimus concentration. Therefore, in HCT recipients taking fluconazole, letermovir may affect the optimal tacrolimus conversion ratios when switching from continuous intravenous infusion to oral administration.

Increased Non-Relapse Mortality in Older People With Allogeneic Hematopoietic Stem Cell Transplantation Using Fludarabine and Myeloablative Dose of Busulfan-Based Regimen.

Fludarabine and myeloablative busulfan (FluBu4) in allogeneic hematopoietic stem cell transplantation (HSCT) for older people have not been adequately examined. This retrospective study analyzed data from a large-scale, nationwide database in Japan. Adult patients (> 15 years old, y/o) who received their first HSCT with FluBu4 for hematological malignancies were included.

Prognosis of aggressive adult T-cell leukemia/lymphoma with central nervous system infiltration and utility of CD7 versus CADM1 flowcytometric plots of cerebrospinal fluid.

The prognosis of adult T-cell leukemia/lymphoma (ATL) with primary central nervous system (CNS) involvement has been unclear since the advent of new therapies. Recently, we have shown that flow cytometric CD7/CADM1 analysis of CD4 + cells (HAS-Flow) is useful to detect ATL cells that are not morphologically diagnosed as ATL cells. We investigated the role of CNS involvement in ATL using cytology and HAS-Flow by analyzing cerebrospinal fluid (CSF) from 73 aggressive ATL cases.

Machine learning evaluation of intensified conditioning on haematopoietic stem cell transplantation in adult acute lymphoblastic leukemia patients.

Background: The advantage of intensified myeloablative conditioning (MAC) over standard MAC has not been determined in haematopoietic stem cell transplantation (HSCT) for adult acute lymphoblastic leukemia (ALL) patients.

Methods: To evaluate heterogeneous effects of intensified MAC among individuals, we analyzed the registry database of adult ALL patients between 2000 and 2021. After propensity score matching, we applied a machine-learning Bayesian causal forest algorithm to develop a prediction model of individualized treatment effect (ITE) of intensified MAC on reduction in overall mortality at 1 year after HSCT.

Outcome of donor lymphocyte infusion after allogeneic hematopoietic stem cell transplantation in relapsed myelodysplastic syndrome.

Background Aims: Allogeneic hematopoietic stem cell transplantation (HSCT) improves outcomes for myelodysplastic syndrome (MDS) patients, but relapse rates remain high, and postrelapse treatment options are limited. Therefore, this study aimed to identify the factors contributing to the response to donor lymphocyte infusion (DLI) in relapsed MDS patients post-HSCT.

Methods: This study included 107 patients with relapsed and DLI-treated MDS who underwent their first HSCT between 2002 and 2022 and were registered in the Transplant Registry Unified Program.

Comparing de novo chronic myeloid leukemia in blastic phase with Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic hematopoietic cell transplantation.

Background: De novo chronic myeloid leukemia in blastic phase (CML-BP) showing lymphoid immunophenotype mimics Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL). Although upfront allogeneic hematopoietic cell transplantation (HCT) is considered in both diseases, it is not yet clear whether the transplant outcomes are also similar.

Methods: Using a registry database, the transplant outcomes between de novo CML-BP and Ph-positive ALL in negative-minimal residual disease (MRD), positive MRD, and nonremission cohorts were compared, respectively.

Comparative outcomes of various transplantation platforms, highlighting haploidentical transplants with post-transplantation cyclophosphamide for adult T-cell leukaemia/lymphoma.

This study retrospectively compared outcomes of various allogeneic haematopoietic cell transplantation (allo-HCT) platforms in patients with adult T-cell leukaemia/lymphoma. Platforms included human leukocyte antigen (HLA)-haploidentical-related donors using post-transplant cyclophosphamide (PTCY), HLA-matched related donors (MRD), HLA-matched unrelated donors (MUD) and cord blood transplantation (CBT). Patients who underwent their first allo-HCT between 2016 and 2021 were included.

Endometrial congestion is the only hysteroscopic finding indicative of chronic endometritis.

Chronic endometritis (CE), an inflammatory condition characterized by plasma cell infiltration within the endometrial stroma, is prevalent among women experiencing unexplained infertility or recurrent miscarriages. CE is traditionally diagnosed by endometrial biopsy using CD138 immunohistochemistry staining. Despite some studies suggesting hysteroscopy as an alternative diagnostic tool, its reliability compared with biopsy remains controversial.

Flow cytometric profiles with CD7 and CADM1 in CD4+ T cells are promising indicators for prognosis of aggressive ATL.

Adult T-cell leukemia/lymphoma (ATL) is a poor prognosis hematological malignancy originating from human T-cell leukemia virus 1 (HTLV-1)-infected CD4+ T cells. Flow cytometric plots of CADM1 and CD7 in CD4+ T cells are useful for separating HTLV-1-uninfected T cells and ATL cells. They are indicators of clonal evolution of HTLV-1-infected cells and disease progression of asymptomatic carriers or indolent ATL.