Publications by authors named "Shun-Ichi Kimura"

To investigate the safety of total body irradiation-based myeloablative conditioning (TBI-MAC) in adolescent and young adult (AYA) Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) patients treated with pediatric protocols, treatment outcomes of 106 AYA patients aged 16-39 years old undergoing allogeneic stem cell transplant (allo-SCT) with TBI-MAC in the first remission were compared according to chemotherapy types before transplant. Pediatric and adult protocols were used in 56 and 50 of the patients, respectively. The cumulative incidence (CI) of non-relapse mortality (NRM) and the overall survival (OS) rates were not significantly different between the pediatric-protocol and adult-protocol group (NRM: 4 % vs.

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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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  • Ruxolitinib treatment has potential benefits for quality of life and survival in patients with primary myelofibrosis (PMF), leading to questions about the best timing for allogeneic hematopoietic cell transplantation (HCT) in this context.
  • A Markov model analysis revealed that delayed HCT after ruxolitinib failure generally offers better outcomes in terms of life expectancy and quality-adjusted life years (QALYs) compared to immediate HCT.
  • The study found that delayed HCT was particularly beneficial for patients aged 60 and older, while it was equivalent for those younger than 60, suggesting a more strategic approach to transplantation timing may enhance patient outcomes.
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Candida species are the second most frequent fungal pathogen of invasive fungal disease after hematopoietic cell transplantation (HCT) following Aspergillus species. Prolonged severe neutropenia and mucocutaneous barrier impairment resulting from the conditioning regimen or central venous catheter placement are major risk factors for invasive candidiasis in the early phase after HCT. Graft-versus-host disease (GVHD) and corticosteroid use affect the development of invasive candidiasis in the post-engraftment phase after allogeneic HCT.

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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 optimal bridge strategy at the decision for allogeneic hematopoietic stem cell transplantation (HSCT) in patients with myelodysplastic syndrome (MDS) is unclear. We performed a prospective observational study in which 110 patients with MDS who were decided to undergo HSCT were enrolled. Among these 110 patients, 77 patients were enrolled in this study within 1 month from the decision for HSCT.

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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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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.

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Adult T-cell leukaemia/lymphoma (ATL) is an aggressive malignancy of peripheral T cells caused by human T-cell lymphotropic virus type-1 (HTLV-1). Tax is the most important regulatory protein for HTLV-1. We aimed to reveal a unique amino acid sequence (AA) of complementarity-determining region 3 (CDR3) of the T-cell receptor (TCR)β and TCRα chains of HLA-A*02:01-restricted Tax -specific cytotoxic T cells (Tax-CTLs).

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A 34-year-old man with KMT2A-MLLT1 acute myeloid leukemia in first complete remission underwent allogeneic peripheral blood stem cell transplantation from his HLA-matched sister after conditioning with busulfan/cyclophosphamide. He did not have severe graft-versus-host disease, but he developed interstitial pneumonia six months after transplantation when his oral cyclosporine A (CsA) dose was reduced to 10 mg/day. He was given prednisolone (PSL), which temporarily improved his respiratory condition, but he quickly deteriorated when PSL was reduced.

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Background: α-mannan from reportedly induces Th17-mediated pulmonary graft-versus-host disease (GVHD) in mouse models. This study aimed to evaluate the association between candidemia and noninfectious interstitial pneumonia (IP) in allogeneic hematopoietic cell transplantation (HCT) recipients.

Methods: Using a Japanese transplant registry database, we analyzed 9143 pediatric and adult patients with hematological malignancies who underwent their first (n = 7531) or second (n = 1612) allogeneic HCT between 2009 and 2019.

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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.
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Objectives: Isavuconazole is a convenient triazole antifungal agent with a broad antifungal spectrum. A randomized, open-label study (ClinicalTrials.gov, NCT03471988) was conducted to evaluate the efficacy and safety of isavuconazole in Japanese patients with deep-seated mycoses.

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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 fatal pulmonary complication after allogeneic hematopoietic stem cell transplantation (allo-HCT). However, it is often difficult to diagnose IPS, since a considerable number of IPS patients are critically ill, which makes it difficult for them to undergo bronchoscopy. In this study, we explored the risk factors of IPS based on two definitions.

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Chromosome analysis is a powerful prognostic tool in myeloid malignancies. Recipients who experience relapse after allogeneic hematopoietic cell transplantation (allo-HCT) often show chromosomal changes between diagnosis and relapse. However, the clinical impact of chromosomal changes and the efficacy of post-relapse treatment according to chromosomal changes have not been fully investigated.

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