Publications by authors named "Nobuyuki Hyakuna"

Article Synopsis
  • - The AML-05 study focused on evaluating a risk-based treatment approach for children with acute myeloid leukemia (AML), determining that allogeneic hematopoietic cell transplantation (allo-HCT) wasn’t necessary for low- or intermediate-risk patients in their first complete remission.
  • - A retrospective analysis identified key prognostic factors for survival in 79 pediatric patients who underwent allo-HCT, highlighting umbilical cord blood (UCB) as a particularly favorable donor source for low-risk patients, along with late relapse being advantageous for intermediate-risk patients.
  • - The study found significant differences in three-year outcomes like overall survival (OS) and event-free survival (EFS) between low- and intermediate-risk groups, suggesting
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Severe congenital neutropenia (SCN) is characterized by chronic neutropenia with recurrent infections from early infancy and a predisposition to myelodysplastic syndrome/acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for patients with SCN who develop myelodysplastic syndrome/AML. We report an 8-year-old girl with SCN carrying an mutation that had been refractory to granulocyte colony-stimulating factor.

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Hematopoietic cell transplantation (HCT) is the only curative therapy for juvenile myelomonocytic leukemia (JMML). Meanwhile, an established conventional chemotherapy before HCT remains unavailable. Studies have shown that azacitidine (AZA), which is a DNA methyltransferase inhibitor, is clinically effective for JMML as a bridging therapy for HCT; a prospective clinical trial in Japan is ongoing.

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Background: In pediatric cancer patients, the estimated glomerular filtration rate based on serum cystatin C (CysC) was reported to be suitable for estimating kidney function because of low serum creatinine (Cr) and high serum β-microglobulin. Recently, however, serum CysC levels have been reported to be elevated in some cancer patients other than those with juvenile myelomonocytic leukemia (JMML), regardless of normal kidney function.

Case Reports: We describe two pediatric cases of JMML with an elevated serum CysC level.

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Article Synopsis
  • Allogeneic HSCT for infants with KMT2A-r ALL has uncertain benefits and risks, leading the MLL-10 trial to limit its use to high-risk patients only.
  • Out of 56 high-risk participants, most achieved complete remission, resulting in a 3-year event-free survival rate of 56.8% and overall survival rate of 80.2%.
  • While results were promising, there is concern over severe toxicities, suggesting that HSCT criteria might need to be further restricted in favor of newer, less harmful treatments.
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Although approximately 70% of pediatric hematological malignancies are curable, approximately 30% remain fatal. No standard treatment is available in patients showing relapse and those with refractory disease. Although different methods are adopted in different hospitals, its efficacy is extremely limited.

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Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative therapy for the hematologic manifestations of Diamond-Blackfan anemia (DBA). However, data regarding the optimal conditioning regimen for DBA patients are limited. We retrospectively compared the outcomes of DBA patients who underwent HSCT using either myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC) regimens.

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Background: Philadelphia-negative (Ph-negative) myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are exceptionally rare during childhood. Thus, clinical features of pediatric Ph-negative MPNs remain largely unknown. This study was therefore performed to address this.

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In the AML-05 clinical trial conducted by the Japanese Pediatric Leukemia/Lymphoma Group from 2006 to 2010, children with high-risk acute myeloid leukemia (HR AML) received allogeneic hematopoietic stem cell transplantation (allo-HSCT) at first complete remission (CR1). The aim of this study was to investigate the impact of allo-HSCT on the outcome of HR AML. Patients with either monosomy 7, 5q-, t(16;21), Ph1, FLT3-ITD, or induction failure after the first course of chemotherapy were eligible for transplant.

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Article Synopsis
  • A 3-month-old boy developed small papules on his trunk, prompting a diagnosis of Langerhans cell histiocytosis after pathological examination.
  • Initially, the papules were isolated to his skin with no organ involvement, classified as single-system, skin-limited LCH.
  • Treatment with topical steroids led to regression of the skin rashes, with all papules disappearing by 6 months, and involved understanding the role of genetic mutations, especially in the BRAF gene, contributing to the condition's development.
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Purpose: Pericardial effusion (PE) is a potentially life-threatening complication following hematopoietic stem cell transplantation (HCT). A higher incidence of early-onset PE, unrelated to graft-versus-host disease, before day 100 after HCT has been reported in pediatric patients, but the pathogenic mechanism is poorly understood. Aiming to determine the pathogenesis of early-onset PE in pediatric patients, we analyzed the cytokine concentration and cell population in the pericardial fluid of four pediatric patients with PE.

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Maffucci syndrome is a nonhereditary disorder caused by somatic mosaic isocitrate dehydrogenase 1 or 2 (IDH1 or IDH2) mutations and is characterized by multiple enchondromas along with hemangiomas. Malignant transformation of enchondromas to chondrosarcomas and secondary neoplasms, such as brain tumors or acute myeloid leukemia, are serious complications. A 15-year-old female with Maffucci syndrome developed B-cell precursor acute lymphoblastic leukemia (BCP-ALL).

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Chronic mucocutaneous candidiasis (CMC) is defined as recurrent or persistent infection of the skin, nails, and/or mucosae with commensal Candida species. The first genetic etiology of isolated CMC-autosomal recessive (AR) IL-17 receptor A (IL-17RA) deficiency-was reported in 2011, in a single patient. We report here 21 patients with complete AR IL-17RA deficiency, including this first patient.

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Background: Donor mixed chimerism (MC) is an increasing problem after hematopoietic stem cell transplantation (HSCT) for nonmalignant diseases.

Procedure: In this study, a self-administered questionnaire was used to retrospectively compare efficacy and safety in 49 patients undergoing second HSCT (n = 13) or donor lymphocyte infusion (DLI; n = 36) as treatment for MC.

Results: The response rate to DLI of patients with secondary graft failure (GF) (25.

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This report describes an unusual case of sarcomatoid carcinoma of the bladder in a 3-year-old girl. Although saving the patient's life is most essential, it is also essential to consider quality of life. The patient underwent neoadjuvant chemotherapy with gemcitabine and cisplatin for bladder preservation.

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Interleukin-1 receptor-associated kinase 4 (IRAK4) deficiency (OMIM #607676) is a rare primary immunodeficiency of innate immune defect. We identified 10 patients from 6 families with IRAK4 deficiency in Japan, and analyzed the clinical characteristics of this disease. Nine patients had homozygous c.

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Article Synopsis
  • A study of 105 pediatric patients with chronic graft-versus-host disease (cGVHD) post-hematopoietic stem cell transplantation (HSCT) revealed varying degrees of severity, with 25% mild, 29% moderate, and 47% severe cases.
  • Severe cGVHD patients faced a higher risk of non-relapse mortality and a lower chance of disease-free survival after 10 years compared to those with milder forms of the condition.
  • Among survivors, 34% of those with cGVHD experienced ongoing functional impairments, highlighting the need for improved treatments to reduce severe cases, especially given the increasing longevity of pediatric HSCT patients.
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Article Synopsis
  • - Bone marrow necrosis (BMN) is a rare condition in children with acute lymphoblastic leukemia (ALL), and the exact mechanism behind it remains unclear.
  • - In a study of seven BMN cases, significant elevations of certain cytokines and chemokines were found in the patients, but not for IFN-γ and IL-10, indicating a different cytokine response compared to other conditions.
  • - The analysis revealed an overexpression of proteins linked to the extrinsic pathway of apoptosis, suggesting that BMN may be related to these external death signals rather than massive necrosis or traditional apoptosis pathways.
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Background: Cyclosporine A (CsA) is used widely for graft-versus-host disease (GVHD) prophylaxis in hematopoietic stem cell transplantation (HSCT); however, the optimal schedule of its administration has not been established. Although comparative studies of adult patients undergoing HSCT have demonstrated enhanced efficacy and safety of twice-daily infusion (TD) compared with continuous infusion (CIF) of CsA, to our knowledge, similar studies have not yet been performed in pediatric groups.

Procedure: A self-administered questionnaire was used to retrospectively compare the clinical outcome and incidence of CsA-associated adverse events of 70 pediatric acute myelogenous leukemia patients who were receiving CsA by TD (n = 36) or CIF (n = 34) as GVHD prophylaxis for their first allogeneic HSCT.

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