Publications by authors named "Nagafuji K"

Umbilical cord blood transplantation (CBT) is accepted as an effective treatment for acute myeloid leukemia (AML), and reduced-intensity conditioning (RIC), rather than myeloablative conditioning (MAC) regimens allowed elderly patients to be treated safely. However, appropriate intensities of conditioning regimens are still unclear, especially for middle-aged patients. To compare outcomes after RIC and MAC regimens, we analyzed AML patients aged 16 years or older in the Japanese registry database, who underwent single cord unit CBT between 2010-2019.

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Background: Patients with adult T-cell leukemia/lymphoma (ATL) are considered to have worse outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT) than patients with other hematological malignancies, owing to high risk of relapse and immunocompromised status. However, no studies have compared transplant outcomes between patients with ATL and those with other hematological malignancies using a large-scale database.

Objectives: To compare transplant outcomes between patients with ATL and those with other leukemias and to identify factors contributing to worse transplant outcomes in ATL patients.

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  • * A study using data from the Japanese nationwide transplantation registry assessed 857 patients with relapsed or refractory non-Hodgkin lymphoma, with 169 receiving PTCY-haplo and 688 receiving uCBT, revealing no significant differences in overall survival, progression-free survival, or graft-versus-host disease-free/relapse-free survival between the two groups.
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Purpose: To report the outcomes of different therapies in patients with conjunctival mucosa-associated lymphoid tissue (MALT) lymphoma.

Patients And Methods: This retrospective study included patients diagnosed with conjunctival MALT lymphoma between August 2000 and April 2022. Patients were classified into three groups according to their treatment: an observation group, a radiation therapy (RT) group, and a rituximab group (rituximab with or without chemotherapy).

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Peptide-binding motif (PBM) model, a hierarchical clustering of HLA class I based on their binding specificity, was developed to predict immunopeptidome divergence. The effect of PBM mismatches on outcomes is unknown in HLA-haploidentical haematopoietic cell transplantation with post-transplant cyclophosphamide (PTCy-haplo). We therefore conducted a retrospective study using national registry data in PTCy-haplo.

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  • A study evaluated the effectiveness of high-dose cytarabine combined with gemtuzumab ozogamicin (GO) as a consolidation therapy in 20 patients with favorable- or intermediate-risk acute myeloid leukemia (AML) following first complete remission.
  • The median follow-up for patients was 62.0 months, showing a 72.2% overall survival rate and a 77.8% relapse-free survival rate, which were notably higher for those with NPM1-mutated non-CBF AML compared to wild-type NPM1 non-CBF AML.
  • Additionally, while CD33 single-nucleotide polymorphism affected CD33 expression levels, there was no significant difference in survival rates between different SNP variants, indicating
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The single-nucleotide polymorphism (SNP) rs12459419 is located at the intron/exon junction of CD33 exon2. When exon2 is skipped by this CD33 SNP, the full-length CD33 (CD33FL) is converted to a short CD33 isoform (CD33D2). Since gemtuzumab ozogamicin (GO) only recognizes CD33FL, the CD33 SNP may affect the clinical efficacy of GO.

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A 53-year-old woman presented with shortness of breath and hyperleukocytosis and was admitted to our hospital. Shortly after, she went into cardiopulmonary arrest and was resuscitated. Her white blood cell count was 566,000/µl, with 94.

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Introduction: In this multicenter clinical study, we aimed to investigate the efficacy and safety of the transhepatic arterial administration of granulocyte-colony stimulating factor (G-CSF)-mobilized autologous peripheral blood (PB)-CD34 cells compared with standard therapy in patients with decompensated cirrhosis type C.

Methods: Patients were randomly assigned (2:1) to the CD34 cell transplant (CD34 cell) or standard-of-care (SOC) group and followed up for 52 weeks. The primary endpoints were the non-progression rate of Child-Pugh (CP) scores at 24 weeks post-enrollment and the safety of the protocol treatment.

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  • * The results showed significant improvement in patient responses, with complete or better responses increasing from 19.9% after induction to 62.4% after maintenance, alongside a 3-year progression-free survival rate of 83.5% and overall survival rate of 92.5%.
  • * While the treatment was tolerable, around 30% of patients experienced severe side effects, and those with high-risk cytogenetics
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  • Haploidentical hematopoietic stem cell transplantation (haplo-HCT) is a viable treatment option for patients with acute myeloid leukemia when no suitable HLA-matched donor is available, particularly using post-transplant cyclophosphamide (PTCy) to manage graft-versus-host disease (GVHD).
  • A nationwide study analyzed 366 patients who underwent haplo-HCT between 2010 and 2019, identifying several key factors that negatively impact overall survival, including older age, donor-recipient gender mismatch, and cytogenetic risk.
  • The study developed a scoring system based on these factors to categorize patients into favorable, intermediate, or poor prognosis groups, showing significantly different 2-year overall survival
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A 62-year-old woman was diagnosed as a hemophilia A carrier (factor VIII activity 35%) on preoperative examination of an ovarian tumor. A total of 35,600 units of recombinant factor VIII products was administered perioperatively. On postoperative day 95, a subcutaneous hematoma formed and immunosuppressive therapy with prednisolone was started based on an APTT of 66 seconds, factor VIII (FVIII) activity of 3%, and FVIII inhibitor of 1 BU/ml.

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Silent inactivation of L-asparaginase (L-Asp) represents rapid clearance of L-Asp by anti-L-Asp IgG antibodies without clinical symptoms. Measurement of L-Asp activity is the gold standard for diagnosis of silent inactivation, but this test is not commercially available in Japan as of 2023. We evaluated ex vivo and in vivo ammonia production in relation to L-Asp activity.

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  • A study analyzed 465 lymphoma patients who received peripheral blood stem cell transplants using either HLA-haploidentical donors with post-transplant cyclophosphamide (PTCy-haplo) or HLA-matched sibling donors (MSDs).
  • Two-year survival rates showed that overall survival and progression-free survival were similar in both groups, but PTCy-haplo recipients had better outcomes regarding graft-versus-host disease-free survival (GRFS).
  • The findings suggest that while PTCy-haplo transplant recipients had slower blood cell recovery, they experienced less chronic GVHD, indicating PTCy-haplo could be a viable alternative to MSD transplants for lymphoma patients.
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Monitoring of hepatitis B virus (HBV)-DNA and HBV-DNA-guided preemptive therapy using nucleos(t)ide analogs (NAs) are recommended to prevent the development of hepatitis due to HBV reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in recipients with resolved HBV infection. However, little is known about the appropriate duration of NA treatment and the effect of NA cessation on the recurrence of HBV reactivation. This study aimed to clarify the consequences of NA cessation in allo-HSCT recipients with resolved HBV infection who experienced HBV reactivation following transplantation.

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  • The human leukocyte antigen (HLA) supertype classification is linked to the outcomes of viral infections and autoimmune diseases, but its significance in single-unit cord blood transplantation (sCBT) was unclear.
  • A study of 1603 sCBT patients in Japan found that mismatches in the HLA-B supertype were associated with worse patient prognoses, leading to higher relapse rates.
  • Despite the importance of HLA-B supertype matches for improving patient outcomes, these mismatches did not affect the incidences of acute or chronic graft-versus-host disease.
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Haploidentical haematopoietic cell transplantation (haplo-HCT) using post-transplant cyclophosphamide (PTCY) as graft-versus-host disease (GVHD) prophylaxis is the standard of care for various haematological malignancies. The original PTCY dose after haplo-HCT was 100 mg/kg, but no dose-finding studies have been performed to identify the optimal dose. We performed a retrospective analysis to compare standard-dose PTCY (100 mg/kg) with reduced-dose PTCY (80 mg/kg): 969 in the standard-dose group and 538 in the reduced-dose group.

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The treatment outcomes for adult Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL) have improved with the introduction of pediatric protocols. On assessing long-term survivors of chemotherapy who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), it was found that these patients had good performance status and few complications. Therefore, in the first complete remission (1CR) of ALL, allo-HSCT is indicated for patients in whom the results of chemotherapy are predicted to be poor.

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There is limited evidence regarding the association between graft-versus-host disease (GVHD) and reduced relapse in patients who undergo allogeneic hematopoietic stem cell transplantation from haploidentical donors (haplo-HSCT) using post-transplant cyclophosphamide (PTCY). We investigated the association between GVHD and transplant outcomes in 938 patients who received haplo-HSCT using PTCY. Overall survival (OS), relapse rate, and non-relapse mortality (NRM) were evaluated using landmark analysis at the landmark points at 100 and 360 days after HSCT for acute and chronic GVHD, respectively.

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This prospective observational study aimed to assess the serological response and safety after the third booster shot of SARS-CoV-2 mRNA vaccines in 292 hematopoietic cell transplant (HCT) recipients. In our patients, mild systemic reactions were present in 10-40% and GVHD aggravation in 1.1%.

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  • * Out of 2,340 patients, 43 developed SPMs, with a cumulative incidence rate of 2.5% at 60 months, indicating that while SPMs occurred, the risk was lower than mortality from multiple myeloma itself (36.5% at 60 months).
  • * Key risk factors for developing SPMs included the use of immunomodulatory drugs (IMiDs) and radiation, showing higher incidence rates in patients treated after the introduction of novel agents compared to
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Aims: Cancer treatment-related cardiovascular toxicity (CTR-CVT) is a growing concern in patients undergoing anticancer therapy. The Heart Failure Association (HFA) and International Cardio-Oncology Society (ICOS) risk assessment tools have been proposed for the baseline cardiovascular (CV) risk stratification of patients with cancer. This study investigated the incidence of CV adverse events in clinical practice, also using the HFA-ICOS risk tool.

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  • The study aimed to determine the prognostic significance of IKZF1 in adult patients with Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL).
  • A multicenter trial included 38 untreated Ph+ ALL patients, revealing high rates of complete hematological remission but no significant differences in survival rates based on IKZF1 status.
  • The findings indicated that IKZF1 status does not correlate with survival outcomes in Ph+ ALL patients treated with specific chemotherapy drugs, suggesting the need for further research on its prognostic value.
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