Publications by authors named "Ayumi Gomyo"
Talaromyces 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 PDFWe 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).
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- - 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.
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- An 84-year-old woman was diagnosed with acute promyelocytic leukemia (APL) and initially treated with all-trans retinoic acid (ATRA), achieving complete hematological remission.
- After refusing consolidation therapy, she experienced a hematological relapse and was treated with arsenite (ATO), resulting in complete molecular remission.
- Following further relapses and treatments, including tamibarotene and a combination of venetoclax and azacitidine, she ultimately succumbed to gastrointestinal hemorrhage, highlighting the complexities of treating CD56-positive APL resistant to standard therapies.
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.
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- 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
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- 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.*
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- 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.
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- 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.
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- - 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.
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- 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.
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- - 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.
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- 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.
A 60-year-old woman with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome and intractable ascites presented with acute renal failure and received hemodialysis (HD) therapy. Due to frequent intradialytic hypotension, ultrafiltration with cell-free and concentrated ascites reinfusion therapy (CART) was performed to adequately manage the body fluid status and massive ascites. During HD with CART, her blood pressure was maintained compared with that during HD without CART, and an ultrafiltration volume of 3.
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- 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.
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- 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.
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- 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.
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- - 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 (
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- A study compared high-dose cytarabine (HD-AraC) and anthracycline-containing chemotherapy as post-remission therapies for acute myeloid leukemia (AML) patients before undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- Out of 132 patients, those receiving HD-AraC had a lower cumulative dose of anthracyclines and slightly better selection for core-binding factor AML, with similar overall cardiac event rates between the two groups (9.1% for HD-AraC vs 11.0% for anthracycline).
- The event-free survival (EFS) rates three years post-transplant were comparable, with 40.9% for HD
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- 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
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- Chromosome analysis is significant in predicting outcomes for myeloid malignancies, especially after relapse following allogeneic hematopoietic cell transplantation.
- Recipients with clonal chromosomal changes at relapse had a shorter post-relapse survival (median 117 days) compared to those without these changes (median 275 days).
- Specific chromosomal abnormalities, like chromosome 7 changes, are linked to poorer survival outcomes, indicating the need for more research on how different chromosomal changes affect treatment effectiveness and patient prognoses.