Publications by authors named "Yuki Yuza"

Arsenic trioxide (ATO) in combination with all-trans retinoic acid (ATRA) has been shown to be effective in both adult and pediatric patients with acute promyelocytic leukemia (APL). Addition of ATO to conventional chemotherapy could lead to a reduction in the doses of cytotoxic agents, but the long-term safety of ATO is not fully understood, especially in children. The Japan Children's Cancer Group conducted a risk-stratified prospective study to investigate safety and efficacy of ATO in children with newly diagnosed APL by replacing all three intensification phases with ATO.

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Introduction: The number of nephrons is a critical determinant of renal health, because chronic kidney disease often results from a reduction in functional nephrons. Variability in the number of nephrons is influenced by genetic, racial, prenatal, and postnatal factors. Estimating the number of nephrons is crucial for establishing a baseline, before the onset of age-related nephron loss.

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Chronic myeloid leukemia (CML) is a rare disease during childhood, and accelerated phase (AP) and blast phase (BP) CML, also called advanced phases, are even rarer. We retrospectively collected and analyzed clinical data of children younger than 20 years with de novo advanced-phase CML between 1996 and 2017 in Japan. Median follow-up time was 8.

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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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  • A combination therapy of venetoclax (VEN) and azacytidine (AZA) shows promise for treating pediatric acute myeloid leukemia (AML), but limited clinical data exists for this age group.
  • Two young patients with recurrent AML received VEN/AZA, but their plasma concentrations of VEN were significantly lower than optimal levels at standard dosages.
  • Safe usage led to varying disease stability, with one patient maintaining stable disease for two months and the other for six months, highlighting challenges in achieving effective drug concentrations in pediatric cases.
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  • The case discusses X-linked thrombocytopenia (XLT) with a new variant of the WAS gene that allows normal WAS protein expression in lymphocytes.
  • Normally, XLT is associated with reduced WAS protein in both platelets and lymphocytes, but this case shows normal levels in lymphocytes.
  • The findings highlight the importance of testing for WAS protein in both cell types for more accurate diagnosis of XLT.
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Purpose: The JCCG ALL-B12 clinical trial aimed to evaluate the effectiveness of unvalidated treatment phases for pediatric ALL and develop a safety-focused treatment framework.

Patients And Methods: Patients age 1-19 years with newly diagnosed B-ALL were enrolled in this study. These patients were stratified into standard-risk (SR), intermediate-risk (IR), and high-risk (HR) groups.

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  • This study reviews the treatment of seven children with trisomy 18 who developed hepatoblastoma, highlighting the successful outcomes of multidisciplinary approaches.
  • Out of 69 patients, six had hepatoblastoma, with seven undergoing complete surgical resection and supportive treatments like chemotherapy.
  • The findings suggest that children with trisomy 18 and stable health conditions can benefit from aggressive treatment strategies, leading to disease-free outcomes in all observed cases post-surgery.
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  • Histiocytic necrotizing lymphadenitis (HNL) is a painful inflammatory disease with an unclear cause, and this study focused on the role of interferon (IFN)-α in its development and diagnosis.
  • The study involved 47 HNL patients and 43 others with similar conditions, using various techniques to measure IFN-stimulated genes and serum levels of IFN-α.
  • Results showed higher levels of ISG and serum IFN-α in HNL patients compared to those with malignant lymphoma, suggesting that IFN-α could be a key factor in HNL and a useful marker for its diagnosis and monitoring.
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  • Asparaginase is a key medication for treating T-cell acute lymphoblastic leukemia (T-ALL), but its effectiveness varies between T-ALL and T-cell lymphoblastic lymphoma (T-LBL), which raises questions about their classification as the same disease.
  • A study analyzed 199 T-ALL and 133 T-LBL patients to see how stopping asparaginase affects their event-free survival (EFS), finding that stopping it significantly harms EFS in T-ALL patients but not in T-LBL patients.
  • The researchers suggest that the differing effects may be due to how T-ALL and T-LBL respond to treatment, highlighting the need for better treatment strategies and more extensive studies to improve outcomes for
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  • A large-scale study in Japan aimed to evaluate the effectiveness of comprehensive genomic profiling (CGP) for diagnosing digestive cancers, including data from 547 patients with various cancer types.
  • The study developed a scoring system to identify significant genomic alterations, finding high detection rates for potentially actionable genomic changes (99.5%) and actionable alterations (62.5%).
  • The results highlighted that most digestive cancers were adenocarcinomas, and a proposed classification flowchart could help improve diagnosis, demonstrating CGP's clinical utility in managing digestive cancers.
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Background: The present study aimed to examine the effect of magnesium (Mg) supplementation on cisplatin-induced nephrotoxicity (CIN) in pediatric cancer patients.

Methods: The present phase-2, open-label, multicenter, randomized controlled trial enrolled patients aged less than 20 years who were scheduled to receive cisplatin-containing chemotherapy and randomly allocated them at a ratio of 1:1 to a Mg supplementation arm with even-numbered chemotherapy courses (arm AB) or another arm with odd-numbered courses (arm BA). Analysis objects were reconstructed into two groups depending on whether the chemotherapy course had Mg supplementation (group B) or not (group A).

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Background: Although positron emission tomography combined with computed tomography (PET-CT) plays an important role in detecting various types of childhood malignancy, it has low positive predictive value, owing to the nonspecific uptake of 18F-fluorodeoxyglucose (FDG) by normal tissue in various benign conditions.

Case Summary: A 5-year-old male patient with a malignant rhabdoid tumor originating in the left neck underwent primary tumor resection concurrently with ipsilateral lymph node dissection after receiving neoadjuvant chemotherapy consisting of cyclophosphamide, carboplatin, etoposide, vincristine, and doxorubicin. He later received the same adjuvant chemotherapy as well as proton therapy for the primary tumor.

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  • Recent studies indicate that caregivers of children with cancer often overestimate symptom burdens in Western countries; however, this dynamic may differ in Asian contexts, particularly Japan.
  • A secondary analysis involving children aged 7-18 years and their caregivers found that most symptom reports were consistent, but notable discrepancies existed, especially in younger children, where caregivers tended to underestimate symptoms.
  • The findings suggest that while caregiver reports can generally be trusted in Japan, addressing the reasons behind the significant differences is important for improving symptom management in pediatric cancer care.
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Acute lymphoblastic leukemia (ALL) is the most common disease in pediatric oncology. The history of developmental therapeutics for ALL began in the 1960s with the repetition of "unreliable" medical interventions against this lethal disease. By the 1990s, the development of multi-agent chemotherapy and various types of supportive care rendered ALL treatable.

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  • - Retinoids, which are derivatives of vitamin A like isotretinoin and bexarotene, have been researched for over 40 years as treatment options for neuroblastoma.
  • - Isotretinoin appears to significantly improve event-free survival in high-risk neuroblastoma patients, although its use in the US and EU is off-label.
  • - A clinical research team in Japan is planning to initiate a trial to officially test isotretinoin for neuroblastoma, and the article reviews the scientific background and potential of retinoid therapy.
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Survival rates of patients with Philadelphia chromosome-positive ALL (Ph+ALL) have improved considerably with the introduction of tyrosine kinase inhibitors (TKI); however, hematopoietic stem cell transplantation (HSCT) continues to play an important role. Reduced-intensity conditioning (RIC) regimens have been widely applied particularly for older patients, but their validity for children and adolescents with Ph+ALL has not been investigated. In this study, data from patients receiving HSCT for de novo Ph+ALL in first or second remission at ages younger than 25 years and with a history of pre-HSCT TKI therapy were retrospectively collected through the nationwide registry in Japan.

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Objectives: Adverse events (AEs) represent an important cause of morbidity and mortality for pediatric inpatients; however, reports on their epidemiology in pediatrics, especially outside Western countries, are scarce. We investigated the incidence and nature of AEs in pediatric inpatients in Japan.

Methods: Trained pediatrician and pediatric nurses reviewed all medical documents of 1126 pediatric inpatients in 2 tertiary care teaching hospitals in Japan, and potential incidents were collected with patients' characteristics.

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