Publications by authors named "Yukiko Misaki"
Although the hematopoietic cell transplantation (HCT)-comorbidity index (HCT-CI) score is associated with an increased risk of mortality after allogeneic HCT, it remains unclear how pre-HCT liver dysfunction affects clinical outcomes. We retrospectively compared clinical HCT outcomes among four groups stratified according to the presence of HCT-CI liver and other organ scores, using a Japan transplant registry database between 2010 and 2020. Of the 14235 recipients, 1527 tested positive for an HCT-CI liver score including HBV or HCV hepatitis (n = 503).
View Article and Find Full Text PDFTalaromyces columbinus was previously reported in two patients with lung infections under the name Penicillium piceum and one case of dual infection with Aspergillus calidoustus was recently reported.; currently, no treatment has been established. We identified a 61-year-old woman with fatal pneumonia with repeated detection of T.
View Article and Find Full Text PDFRapid tapering of cyclosporine (CsA) in the early phase after allogeneic transplantation may induce a potent graft-versus-leukemia/lymphoma (GVL) effect. We retrospectively reviewed the outcomes of patients with high-risk hematological malignancies who underwent their first transplantation at our institution. The blood CsA concentration was maintained at around 300 ng/ml.
View Article and Find Full Text PDFRisk-Adapted Letermovir Prophylaxis Based on a Scoring System Predicting a Higher Burden of Cytomegalovirus Exposure After Allogeneic Hematopoietic Cell Transplantation.
Shunto Kawamura
,
Shin-Ichiro Fujiwara
,
Shun-Ichi Kimura
,
Junko Takeshita
,
Hideki Nakasone
,
Yukiko Misaki
Transplant Cell Ther
March 2025
We previously reported that the area under the curve of log-transformed cytomegalovirus antigenemia (CMV-AUC) until 100 days after allogeneic hematopoietic cell transplantation (allo-HCT) was associated with an increased risk of non-relapse mortality. We applied a risk-adapted letermovir (LTV) prophylaxis strategy guided by a risk score that predicts a higher CMV-AUC. First, we retrospectively analyzed 278 allo-HCT recipients between 2007 and 2017 (Period 1).
View Article and Find Full Text PDFArticle Synopsis
- - A study was conducted to assess whether changing antibiotics or adding glycopeptide antibiotics helps patients with persistent febrile neutropenia (FN) after autologous hematopoietic cell transplantation (auto-HCT) recover faster.
- - The analysis involved 208 patients, and it found no significant improvement in recovery time for those who switched antibiotics; in fact, adding glycopeptides was linked to a longer recovery time.
- - The conclusion suggested that routine changes in antibiotics might not be beneficial for treating persistent FN after auto-HCT, indicating a need to reconsider common antibiotic management practices in such cases.
Article Synopsis
- Ruxolitinib treatment has potential benefits for quality of life and survival in patients with primary myelofibrosis (PMF), leading to questions about the best timing for allogeneic hematopoietic cell transplantation (HCT) in this context.
- A Markov model analysis revealed that delayed HCT after ruxolitinib failure generally offers better outcomes in terms of life expectancy and quality-adjusted life years (QALYs) compared to immediate HCT.
- The study found that delayed HCT was particularly beneficial for patients aged 60 and older, while it was equivalent for those younger than 60, suggesting a more strategic approach to transplantation timing may enhance patient outcomes.
We report the case of a 65-year-old man who was diagnosed with Bickerstaff brainstem encephalitis prior to central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL). He was diagnosed with DLBCL of the paranasal sinus in June 2022. After treatment with 6 cycles of R-GCVP (rituximab, gemcitabine, cyclophosphamide, vincristine, prednisolone) and 2 cycles of high-dose methotrexate (HD-MTX), complete remission was confirmed.
View Article and Find Full Text PDFArticle Synopsis
- - A patient with FLT3-mutated acute promyelocytic leukemia (APL) relapsed despite treatment with all-trans retinoic acid (ATRA) and chemotherapy, as well as re-induction therapy with arsenic trioxide and high-dose cytarabine, which failed to achieve remission.
- - The leukemic cells resisted conventional therapies; therefore, the medical team opted for gilteritinib, a selective FLT3 inhibitor, as an alternative treatment option.
- - The patient achieved complete hematologic remission with gilteritinib, highlighting its potential effectiveness as a single-agent therapy for patients with resistant FLT3-mutated APL prior to transplantation.
Article Synopsis
- Clinical research on how physical function before transplantation affects outcomes in older adults is limited, prompting a study of 150 patients over 55 who underwent their first hematopoietic cell transplantation (HCT) from 2010 to 2021.
- The study found no differences in overall survival, non-relapse mortality, or disease relapse among different age groups, but higher pretransplantation physical function (measured by hand grip strength, knee extension strength, and a 6-minute walk test) suggested better overall survival and significantly lower non-relapse mortality.
- The results indicated that men and women require different thresholds for physical function assessments, and, while the overall incidence of disease relapse didn't vary significantly between groups, those with higher
Article Synopsis
- The study examines the replacement of calcineurin inhibitors (CIs) with corticosteroids in patients facing adverse effects like renal impairment after allogeneic hematopoietic cell transplantation (HCT).* -
- Among 42 patients evaluated, the main reasons for switching were renal issues, fluid overload, and thrombotic microangiopathy, with notable improvements in creatinine and body weight within four weeks.* -
- Despite a high 100-day non-relapse mortality rate of 57.1% and 24.4% of patients developing acute graft-versus-host disease (GVHD) post-switch, the switch provided benefits for certain patients' renal and fluid conditions.*
Article Synopsis
- Several biofluid biomarkers are promising for diagnosing and predicting outcomes in traumatic brain injury, but research on non-traumatic brain injury biomarkers is limited.
- This study focused on measuring UCH-L1 levels in patients who experienced neurological issues after hematopoietic cell transplantation, finding that levels were significantly higher in these patients compared to controls.
- The results suggest that elevated UCH-L1 levels may indicate neurological damage in non-traumatic brain injury patients, showing potential as a diagnostic tool that could merit further investigation with larger cohorts.
Article Synopsis
- Adult T-cell leukaemia/lymphoma (ATL) is a serious cancer linked to the HTLV-1 virus, with Tax being the key regulatory protein.
- Researchers identified specific amino acid sequences in the T-cell receptor of Tax-specific cytotoxic T cells (Tax-CTLs), which showed unique characteristics across patients, particularly motifs that correlated with better patient outcomes.
- Gene expression profiles of these Tax-CTLs indicated that those from long-term survivors had preserved immune response genes, highlighting potential for improved understanding and application of T-cell therapies in treating ATL.
Allogeneic hematopoietic cell transplantation between female donors and male recipients (female-to-male allo-HCT) is a well-established risk factor for inferior survival outcomes due to a higher incidence of graft-versus-host disease (GVHD). However, a clinical significance of anti-thymocyte globulin (ATG) in the female-to-male allo-HCT has not been elucidated. In this study, we retrospectively evaluated male patients who underwent allo-HCT between 2012 and 2019 in Japan.
View Article and Find Full Text PDF[Anti-MDA5 antibody-positive rapidly progressive interstitial lung disease after allogeneic hematopoietic cell transplantation successfully treated with triple immunosuppressive therapy].
Yuhei Nakamura
,
Shunto Kawamura
,
Shimpei Matsumi
,
Kazuhisa Matsumoto
,
Satona Tanaka
,
Yukiko Misaki
Rinsho Ketsueki
May 2023
Article Synopsis
- - A 34-year-old man with a type of leukemia underwent a stem cell transplant after going into remission, but developed interstitial pneumonia six months later after reducing his cyclosporine A dosage.
- - Initially treated with prednisolone for his lung condition, he improved temporarily but worsened when the medication was lowered; further tests revealed he had anti-MDA5 antibodies.
- - A combination therapy of intravenous cyclophosphamide, prednisolone, and cyclosporine A was started, effectively treating his pneumonia, and he ultimately received successful living-donor lung transplants from his siblings.
Clinical features of febrile neutropenia and bloodstream infection in autologous hematopoietic cell transplantation: Comparison to those in intensive chemotherapy for acute myeloid leukemia.
Nozomu Yoshino
,
Shun-Ichi Kimura
,
Akari Matsuoka
,
Tomohiro Meno
,
Takuto Ishikawa
,
Yukiko Misaki
J Infect Chemother
April 2023
Article Synopsis
- Autologous hematopoietic cell transplantation (HCT) leads to more severe myelosuppression and mucosal damage than conventional chemotherapy, but neutropenia lasts for a shorter duration due to stem cell rescue.
- A study of 208 patients who underwent autologous HCT revealed that the median neutropenic period was shorter compared to those undergoing intensive chemotherapy for acute myeloid leukemia (AML), but the incidence of febrile neutropenia (FN) was similarly high across both treatments.
- Despite the high rate of FN in autologous HCT patients, the incidence of bloodstream infections (BSI) was notably lower compared to AML consolidation chemotherapy, suggesting differences in infection profiles between the two treatments.
A Case of Diffuse Large B-Cell Lymphoma Complicated by Helicobacter Pylori-Negative Russell Body Gastritis.
Yasunobu Sekiguchi
,
You Nishimura
,
Hiroaki Kanda
,
Machiko Kawamura
,
Kazuhiko Kobayashi
,
Yukiko Misaki
Gan To Kagaku Ryoho
November 2022
Article Synopsis
- A 76-year-old woman with diabetes and Hashimoto's disease was diagnosed with diffuse large B-cell lymphoma (DLBCL) after discovering swollen neck lymph nodes.
- She also had Russell body gastritis (RBG), confirmed through upper gastrointestinal endoscopy, but there were no signs of lymphoma spread in her stomach, and tests for Helicobacter pylori were negative.
- After receiving 6 cycles of R-CHOP chemotherapy, she achieved complete remission by November of the same year, and a follow-up endoscopy showed no signs of RBG, indicating a potential link between the two conditions.
Fatal cardiac complications can occur from the early to late phases after hematopoietic cell transplantation (HCT). Herein, the Japanese transplant registry database was used to retrospectively analyze health records of 33,791 allogeneic HCT recipients to elucidate the pathogenesis and risk factors involved. Overall, 527 patients died of cardiac complications at a median of 130 (range 0-3924) days after HCT.
View Article and Find Full Text PDFChronic active Epstein-Bar virus infection complicated by pulmonary artery hypertension.
J Infect Chemother
February 2023
Article Synopsis
- - Chronic active Epstein-Barr virus infection (CAEBV) can lead to pulmonary artery hypertension (PAH) as a serious cardiovascular complication, but the exact mechanisms and treatment effects are not fully understood.
- - A study involving four adult CAEBV patients with PAH showed that treatment with a vasodilator improved heart pressure, and further enhancements were noted when CAEBV was treated, either through chemotherapy or allogeneic hematopoietic cell transplantation.
- - Autopsy results revealed EBV-infected cells contributing to vasculitis and PAH, indicating that the condition can improve with appropriate PAH medication and CAEBV treatment.
Article Synopsis
- Acute myeloid leukemia (AML) needs urgent treatment, but the factors predicting very early mortality (within 30 days) are not well understood.
- A study of 70 newly diagnosed AML patients found that older age and low scores on tests like the Glasgow Coma Scale (GCS) were linked to increased early death rates.
- Key predictors of early death included older age, lower hemoglobin levels, and low GCS scores, highlighting a need for further research to identify high-risk patients and improve their treatment.
Low-Intensity Immunosuppressive Therapy for Chronic Graft-versus-Host Disease.
Kazuki Yoshimura
,
Shun-Ichi Kimura
,
Hideki Nakasone
,
Yuhei Nakamura
,
Masakatsu Kawamura
,
Yukiko Misaki
Transplant Cell Ther
September 2022
Article Synopsis
- The initial treatment for chronic graft-versus-host disease (cGVHD) is commonly high doses of prednisolone, but patients without high-risk factors may be treated with lower doses or other immunosuppressants.
- A study evaluated 54 cGVHD patients treated with low-intensity immunosuppressive therapy, finding a failure-free survival (FFS) rate of 50% at 24 months, with certain risk factors affecting outcomes.
- By 36 months, the current failure-free survival (cFFS) rate improved to 67%, indicating that low-intensity treatment was beneficial for patients without significant risk features despite variations based on the severity of the condition.
Article Synopsis
- MDA5 antibody is linked to a rare form of dermatomyositis (DM) that causes rapid lung disease, similar to complications seen after allogeneic hematopoietic cell transplantation (allo-HCT).
- This study examines 4 cases of interstitial lung disease (ILD) with anti-MDA5 antibody following allo-HCT, where 3 out of 4 patients died despite receiving strong immunosuppressive treatments.
- The findings suggest that MDA5-DM-ILD may develop sub-clinically before respiratory failure, highlighting the need to differentiate it from other conditions like chronic graft-versus-host disease (GVHD) after allo-HCT due to its aggressive nature.
Pancreatic atrophy and recovery after allogeneic hematopoietic cell transplantation.
Yosuke Okada
,
Hideki Nakasone
,
Yuhei Nakamura
,
Masakatsu Kawamura
,
Shunto Kawamura
,
Yukiko Misaki
J Gastroenterol
August 2022
Article Synopsis
- Pancreatic atrophy is common in recipients of allogeneic hematopoietic cell transplantation (HCT) and is linked to chronic graft-versus-host disease (GVHD), affecting recovery of weight and pancreatic thickness.
- A study of 170 HCT recipients revealed that while 32.4% experienced pancreatic atrophy, only 20% of those showed recovery in pancreatic thickness, and recipients without atrophy regained body weight significantly more than those with it.
- Pancreatic atrophy is associated with worse survival outcomes and higher non-relapse mortality, indicating the need for ongoing monitoring and further research into its impact on post-transplant health.
Article Synopsis
- - TEMPI syndrome is a rare disease linked to plasma cell neoplasms, and while bortezomib is commonly used as a first-line treatment, some patients don’t respond to it.
- - Pomalidomide, an immunomodulatory drug, has been successfully used in a case of bortezomib-refractory TEMPI syndrome in a patient with renal issues, along with low-dose dexamethasone.
- - This case marks the first successful treatment of TEMPI syndrome with pomalidomide, suggesting it could be a viable option for patients who don't respond to conventional treatments like bortezomib, especially when followed by autologous hematopoietic stem cell transplantation (
Article Synopsis
- Idiopathic pneumonia syndrome (IPS) is a serious complication that can occur after patients receive allogeneic hematopoietic stem cell transplantation (allo-HCT), making diagnosis challenging, especially in critically ill patients.
- In a study involving 444 allo-HCT recipients, researchers identified 30 cases of definite IPS diagnosed through bronchoscopy, and 54 cases of clinical IPS diagnosed based on clinical criteria without mandatory bronchoscopy.
- Key risk factors for definite IPS included high ferritin levels, while clinical IPS was linked to older age, a history of myeloablative conditioning (MAC), low %DLCO, and undergoing a second allo-HCT due to graft failure, all of which can aid in