Publications by authors named "Itonaga H"

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.

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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.

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  • A 63-year-old man with relapsed acute myeloid leukemia underwent a third stem cell transplant and was given voriconazole to prevent fungal infections.
  • On day 42 post-transplant, he developed septic arthritis without the typical skin signs associated with fungal infections.
  • Despite surgery and treatment with liposomal amphotericin B, he died due to a resistant fungal infection, highlighting the need to consider azole-resistant infections as potential causes of septic arthritis in similar patients.
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  • * A retrospective analysis of 32 patients aged 70 and older showed that those treated with MOG-containing chemotherapy had a median survival time of 18.1 months and a 2-year overall survival rate of 45%, indicating improved outcomes compared to previous treatments.
  • * Adverse events from MOG treatment were similar to those seen in past studies, and while comorbidity impacted survival, the intensity of MOG treatment did not, suggesting a different action mechanism compared to
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  • The study investigates the effectiveness of the fludarabine/intravenous busulfan (FB4) regimen in patients with myelodysplastic syndrome (MDS) undergoing stem cell transplantation from unrelated donors, comparing FB4 alone, FB4 with anti-thymoglobulin (ATG), and FB4 with low-dose total body irradiation (TBI).
  • Results show that the combination of FB4 with low-dose ATG significantly improved overall survival (OS) and reduced nonrelapse mortality (NRM) compared to FB4 alone, whereas the FB4 with TBI did not demonstrate notable advantages over the FB4 regimen.
  • The study highlights that using FB4 plus low-dose ATG is associated with better outcomes
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  • Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can lead to long-lasting remission in adult T-cell leukemia/lymphoma (ATL) patients, but there's a lack of research on post-transplant outcomes for younger patients (≤49 years).
  • A study found that patients aged <40 years had a significantly better overall survival rate (61.8%) compared to those aged 40-49 years (43.1%), indicating younger patients fare better post-transplant.
  • Moreover, while there were no major differences in survival outcomes between different conditioning regimens, the reduced-intensity conditioning (RIC) regimen resulted in lower non-relapse mortality compared to the myeloablative conditioning (MAC) regimen
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Atypical chronic myeloid leukemia (aCML) is a rare disease classified as a myelodysplastic/myeloproliferative neoplasm (MDS/MPN). Recent advances in gene mutational profiling have clarified the characteristics of aCML as a disease entity relative to other MDS/MPNs. Although some studies suggest the efficacy of DNA demethylating agents and tyrosine kinase inhibitors, data about these agents are limited due to the small number of patients.

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Super-enhancers (SEs) play an important role in regulating tumor-specific gene expression. JQ1, a Bromodomain-containing protein 4 (BRD4) inhibitor, exerts antitumor effects by disrupting SE-mediated regulation of gene expression. We investigated the anti-adult T-cell leukemia/lymphoma (ATL) effects of JQ1.

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  • Allogeneic haematopoietic stem cell transplantation (allo-HSCT) is the main treatment for adult T-cell leukemia/lymphoma (ATL) and is influenced by individual human leukocyte antigens (HLAs).
  • A study analyzed data from 829 ATL patients who received transplants, identifying HLA-B62 as linked to lower mortality risk and HLA-B60 with higher mortality risk after transplantation.
  • The findings suggest that specific HLAs can help predict treatment outcomes for ATL patients undergoing allo-HSCT, with potential implications for patient management.
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  • * A study analyzed post-transplant outcomes of 1,229 MDS-Lo patients, revealing that the reduced-intensity conditioning (RIC) group had better chronic graft-versus-host disease (GVHD)- and relapse-free survival compared to the myeloablative conditioning (MAC) group, although MAC showed better overall survival in low-comorbidity index patients.
  • * The research suggests that RIC and non-myeloablative conditioning (NMAC)
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Cytomegalovirus (CMV) reactivation is a prominent complication associated with adverse outcomes in allogeneic hematopoietic stem cell transplantation (HSCT). However, CMV reactivation after allogeneic HSCT may be associated with a lower incidence of relapse in some hematological malignancies. This study analyzed the Japanese registry data from 1082 patients with myelodysplastic syndrome (MDS) who underwent their first allogeneic HSCT and survived for 100 days after transplantation without graft failure or disease relapse to investigate this association.

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An important epigenetic component of tyrosine kinase signaling is the phosphorylation of histones, and epigenetic readers, writers, and erasers. Phosphorylation of protein arginine methyltransferases (PRMTs), have been shown to enhance and impair their enzymatic activity. In this study, we show that the hyperactivation of Janus kinase 2 (JAK2) by the V617F mutation phosphorylates tyrosine residues (Y149 and Y334) in coactivator-associated arginine methyltransferase 1 (CARM1), an important target in hematologic malignancies, increasing its methyltransferase activity and altering its target specificity.

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Background And Objectives: Geographical limitations in remote island medical facilities result in excessive wastage of blood products. To address this, we explored the feasibility of a novel blood rotation system, which enables the return and redelivery of blood products to/from the blood bank while ensuring the management of product quality, including temperature control. This study aimed to enhance the supply of blood products to these facilities.

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Chronic myelomonocytic leukaemia (CMML) is a haematological malignancy with a poor prognosis. Allogeneic haematopoietic stem cell transplantation remains the only curative approach. Without human leucocyte antigen-matched related sibling donors, the optimal alternative donor has yet to be established.

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  • This study compared lower-dose melphalan (80 mg/m) and higher-dose melphalan (140 mg/m) for patients with myelodysplastic syndrome (MDS) receiving stem cell transplants.
  • Ninety-two patients were analyzed, revealing that those on the higher-dose FM140 had a significantly better overall survival rate at three years (63.9%) compared to the lower-dose FM80 group (54.2%).
  • The results indicate that higher-dose melphalan may be more effective, particularly for patients with poor cytogenetic risk, although the difference in relapse rates and nonrelapse mortality between the two groups was not statistically significant.
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Allogeneic hematopoietic cell transplantation (allo-HCT) is the sole curative therapy for myelodysplastic syndrome (MDS). In the absence of an HLA-matched sibling donor, an HLA-matched unrelated donor (MUD) is considered the leading candidate. However, in recent decades, the alternative donor pool has been extended to HLA-haploidentical donors, especially with the development of graft-versus-host disease (GVHD) prophylaxis using post-transplantation cyclophosphamide (PTCy).

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  • Allogeneic hematopoietic stem cell transplantation (HCT) is a potential curative treatment for patients with myelodysplastic syndrome with a complex karyotype (CK-MDS), although there are limited studies focusing on this specific group.
  • In a study involving 691 CK-MDS patients, the overall survival (OS) rate after 3 years was found to be 29.8%, with various factors impacting survival rates.
  • Key risk factors linked to reduced OS included older age, male sex, poor comorbidity index, a need for red or platelet blood transfusions, incomplete remission, a high number of karyotype abnormalities, and the presence of a monosomal karyotype.
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  • * A study compared outcomes from 999 adult MDS patients who received either matched sibling donor (MSD) HCT or single-unit unrelated cord blood (UCB) HCT, finding no significant differences in overall survival or disease-free survival between the two groups.
  • * UCB recipients experienced lower neutrophil and platelet recovery but had a reduced incidence of chronic graft-versus-host disease (GVHD) compared to MSD recipients, highlighting different recovery profiles despite similar survival outcomes.
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During emergency hematopoiesis, hematopoietic stem cells (HSCs) rapidly proliferate to produce myeloid and lymphoid effector cells, a response that is critical against infection or tissue injury. If unresolved, this process leads to sustained inflammation, which can cause life-threatening diseases and cancer. Here, we identify a role of double PHD fingers 2 (DPF2) in modulating inflammation.

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  • A Japanese study examined the effects of transplanting HLA-mismatched unrelated donors in adult T-cell leukemia-lymphoma patients from 2000 to 2018, comparing three donor types: matched related donors (MRD), fully matched unrelated donors (8/8MUD), and one allele-mismatched unrelated donors (7/8MMUD).
  • Out of 1191 patients, those receiving transplants from 7/8MMUD donors showed a higher risk of non-relapse mortality (31.5%) but a lower risk of cancer relapse (34.4%) compared to the MRD group.
  • The findings suggest that 7/8MMUD donors can serve as a viable option when fully
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Human leukocyte antigen (HLA)-matched sibling donors (MSDs) are the preferred choice for allogeneic hematopoietic cell transplantation (HCT). However, as myelodysplastic syndrome (MDS) is most frequently diagnosed in the elderly, MSDs are also likely to be of advanced age. It is unclear whether an MSD should be considered the primary choice for allogeneic HCT in elderly patients with MDS.

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A 55-year old female patient was treated with methotrexate (MTX) and infliximab (IFX) for rheumatoid arthritis (RA). She experienced unknown fever, generalized lymphadenopathy, and liver tumors. Histological examination of the inguinal lymph node and a liver tumor resulted in the pathological diagnosis of classic Hodgkin lymphoma, with many Reed-Sternberg cells with the positivity of Epstein-Barr virus (EBV).

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