Publications by authors named "Shinichiro Fujiwara"

We retrospectively evaluated the impacts of using granulocyte colony-stimulating factor (G-CSF) and its timing on posttransplant outcomes for 9766 adults with acute myeloid leukemia (AML) between 2013 and 2022 using a Japanese database. We separately evaluated three distinct cohorts based on graft type: 3248 received bone marrow transplantation (BMT), 3066 received peripheral blood stem cell transplantation (PBSCT), and 3452 received single-unit cord blood transplantation (CBT). Multivariate analysis showed that G-CSF administration significantly accelerated neutrophil recovery after BMT, PBSCT, and CBT.

View Article and Find Full Text PDF
Article Synopsis
  • 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
View Article and Find Full Text PDF

Rapidly progressing ALL, a potentially fatal disease, demands timely diagnosis and treatment. On the other hand, spontaneous remission/regression (SR) is reported in various cancers including aggressive tumors like ALL. Infection or trauma-mediated immune system activation is assumed to cause SR, with the duration in cases of ALL typically being short.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the effect of letermovir (LTV), an anti-CMV drug, on the incidence of HHV-6 encephalitis in patients who underwent hematopoietic stem cell transplantation (HSCT).
  • Among 7985 adult patients analyzed, the incidence of HHV-6 encephalitis at day 100 post-HSCT was found to be significantly lower in the LTV group (2.8%) compared to those receiving broad-spectrum antivirals (11.5%).
  • The analysis suggests that broad-spectrum antiviral prophylaxis is linked to a higher risk of HHV-6 encephalitis, indicating a need for further research to understand this unexpected association.
View Article and Find Full Text PDF

The tumor microenvironment's cells can promote or inhibit tumor formation, and there are no reports on the CD4/CD8 ratio's association with outcomes post allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively evaluated the pre-transplant peripheral blood CD4/CD8 ratio in 168 patients who underwent their first allo-HSCT for hematological malignancies at our institution. When patients were divided into two groups according to the median CD4/CD8 ratio 1.

View Article and Find Full Text PDF
Article Synopsis
  • The study analyzed the effects of the anti-CD38 antibody daratumumab (Dara) before autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients, involving 2,626 patients from 2017 to 2020.
  • Results showed that patients not receiving Dara (Dara- group) had better 1-year progression-free survival (87.4%) and overall survival rates (96.7%) compared to those receiving Dara (Dara+ group, with 77.3% and 90.0%, respectively).
  • Factors like younger age, low disease stage, and effective treatment response before ASCT were linked to better survival outcomes, while patients achieving good responses with Dara
View Article and Find Full Text PDF

Background: The number of CD34 cells in the graft is generally associated with time to engraftment and survival in transplantation using cord blood or allogeneic peripheral blood stem cells. However, the significance of abundant CD34 in bone marrow transplantation (BMT) remained unclear.

Methods: We retrospectively reviewed 207 consecutive adult patients who underwent their first BMT at Jichi Medical University between January 2009 and June 2021.

View Article and Find Full Text PDF
Article Synopsis
  • Guidelines suggest using rasburicase for high-risk AML patients to prevent tumor lysis syndrome (TLS), but there's limited data on TLS incidence and outcomes in these patients.
  • In a study of 145 AML patients undergoing treatment, 6 developed clinical TLS, with those at high risk primarily affected by elevated creatinine levels and WBC counts over 200,000.
  • The findings indicate that allopurinol alone might not be enough for high-risk patients, suggesting that they may benefit from rasburicase as a preventive treatment.
View Article and Find Full Text PDF
Article Synopsis
  • * Data from over 10,000 patients revealed no significant differences in overall survival or complications between the two methods, but PB recipients had a higher rate of chronic graft-versus-host disease (GVHD), impacting long-term survival quality.
  • * Findings suggest that while both sources are viable, BM might be more beneficial for certain patients, particularly those with specific types of cancers or higher comorbidity, emphasizing the need for personalized transplant strategies.
View Article and Find Full Text PDF
Article Synopsis
  • Acute myeloid leukemia (AML) is commonly treated with allogeneic hematopoietic cell transplantation (HCT), and new donor options are available for older patients lacking HLA-matched siblings.
  • This study analyzed outcomes from 5,704 AML patients over 50 years old who received HCT from various donor types between 2013 and 2021, focusing on survival and leukemia-free survival (LFS).
  • Findings revealed that donor type did not significantly affect overall survival, but 8/8 allele-matched and unrelated cord blood donors showed better LFS compared to matched sibling donors, while relapse rates were lower for these donor types.
View Article and Find Full Text PDF

Despite its promising outcomes, anti-BCMA chimeric antigen receptor T cell therapy (CAR-T) is the most expensive myeloma treatment developed to date, and its cost-effectiveness is an important issue. This study aimed to assess the cost-effectiveness of anti-BCMA CAR-T compared to standard antimyeloma therapy in patients with relapsed/refractory multiple myeloma. The model included myeloma patients in Japan and the United States who have received ≥3 prior lines of antimyeloma therapy, including immunomodulatory drugs, proteasome inhibitors, and anti-CD38 monoclonal antibodies.

View Article and Find Full Text PDF

Background: The early recovery of lymphocyte and monocyte cells is associated with a favorable prognosis after allogeneic stem cell transplantation (allo-HSCT); however, it is not clear whether the balance of lymphocyte and monocyte recovery affects the post-transplant prognosis.

Methods: We examined whether the time-point at which the number of lymphocytes exceeded the number of monocytes, which we termed lymphocyte-to-monocyte ratio reversal (LMRR), affected the prognosis after allo-HSCT. We retrospectively evaluated 235 patients who underwent their first allo-HSCT at our institution.

View Article and Find Full Text PDF
Article Synopsis
  • Late cytomegalovirus (CMV) disease is a significant complication affecting stem cell transplant recipients, occurring over 100 days after the transplant despite preventive measures like ganciclovir.
  • A study of 1,295 adult transplant patients revealed a 5-year incidence of late CMV disease at 1.6%, with specific risk factors identified including haploidentical related donors and preemptive therapy.
  • Late CMV disease is linked to higher non-relapse mortality and lower overall survival rates; thus, patients with identified risk factors need careful monitoring and management.
View Article and Find Full Text PDF

Chronic graft-versus-host disease (cGVHD) is a multiorgan syndrome with clinical features resembling those of autoimmune diseases. Thus, understanding commonalities in the pathophysiology of cGVHD and autoimmune diseases, such as the presence of disease-risk HLA alleles, is imperative for developing novel therapies against cGVHD. Alloantibodies against H-Y antigens encoded on the Y-chromosome are well-described risk factors for cGVHD in female-to-male transplantation.

View Article and Find Full Text PDF

The frequency of the manufacturing failure of chimeric antigen receptor (CAR)-T cell therapy in clinical practice is unknown. To clarify the current state of how likely CAR-T cell production is to succeed or fail for B-cell acute lymphoblastic leukemia (B-ALL), we analyzed cases in which the production of tisagenlecleucel was performed for patients with B-ALL at 15 facilities in Japan from October 2019 to March 2022. Total 81 patients (47 males and 34 females) were analyzed.

View Article and Find Full Text PDF

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

For successful chimeric antigen receptor T (CAR-T) cell therapy, CAR-T cells must be manufactured without failure caused by suboptimal expansion. In order to determine risk factors for CAR-T cell manufacturing failure, we performed a nationwide cohort study in Japan and analysed patients with diffuse large B-cell lymphoma (DLBCL) who underwent tisagenlecleucel production. We compared clinical factors between 30 cases that failed (7.

View Article and Find Full Text PDF

Objectives: Influenza virus infection (IVI) occasionally causes lower respiratory tract infection (LRTI) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Although the progression to LRTI entails a high mortality, the role of early antiviral therapy for its prevention has not been fully elucidated.

Methods: This was a multicenter retrospective study using an additional questionnaire.

View Article and Find Full Text PDF

The prognosis of multiple myeloma (MM) has dramatically improved with the development of new drugs, and it has become important to determine the appropriate combinations of these novel agents. This study was a systematic review and network meta-analysis (NMA) of randomized trials in patients with relapsed and/or refractory (RR) MM. The PubMed, Cochrane, and Embase databases were searched for randomized trials from 1 January 2002 to 28 February 2022 of patients treated for MM.

View Article and Find Full Text PDF

Cardiotoxicity after allogeneic stem cell transplantation (SCT) is associated with a high rate of mortality and worsening quality of life. The relation between daunorubicin dose and post- allogeneic stem cell transplantation (SCT) cardiotoxicity remains unclear. We retrospectively evaluated 171 patients with acute myeloid leukemia (AML) who underwent their first allogeneic SCT at our institution between 2005 and 2021.

View Article and Find Full Text PDF

Triplet regimens, such as lenalidomide, bortezomib, and dexamethasone (RVd) or thalidomide, bortezomib, and dexamethasone (VTd), are standard induction therapies for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM). The addition of daratumumab to RVd and VTd has been investigated in the GRIFFIN and CASSIOPEIA trials, respectively, resulting in improvement in the rate of minimal residual disease (MRD) negativity. In this study, we conducted a cost-effectiveness analysis with a 10-year time horizon to compare first-line and second-line use of daratumumab for transplant-eligible patients with NDMM.

View Article and Find Full Text PDF

A PHP Error was encountered

Severity: Warning

Message: fopen(/var/lib/php/sessions/ci_session8ckiblsduoq2m3vk964at8adk4340bdg): Failed to open stream: No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 177

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once

A PHP Error was encountered

Severity: Warning

Message: session_start(): Failed to read session data: user (path: /var/lib/php/sessions)

Filename: Session/Session.php

Line Number: 137

Backtrace:

File: /var/www/html/index.php
Line: 316
Function: require_once