Publications by authors named "Tanihara A"
Article Synopsis
- - 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.
Article Synopsis
- 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.
Article Synopsis
- 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
Article Synopsis
- 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.*
Article Synopsis
- 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.
Article Synopsis
- Adult T-cell leukaemia/lymphoma (ATL) is a serious cancer linked to the HTLV-1 virus, with Tax being the key regulatory protein.
- Researchers identified specific amino acid sequences in the T-cell receptor of Tax-specific cytotoxic T cells (Tax-CTLs), which showed unique characteristics across patients, particularly motifs that correlated with better patient outcomes.
- Gene expression profiles of these Tax-CTLs indicated that those from long-term survivors had preserved immune response genes, highlighting potential for improved understanding and application of T-cell therapies in treating ATL.
Article Synopsis
- 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.
Article Synopsis
- - 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.
Article Synopsis
- 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.
Low-Intensity Immunosuppressive Therapy for Chronic Graft-versus-Host Disease.
Transplant Cell Ther
September 2022
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- 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.
Article Synopsis
- - 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 (
Article Synopsis
- Idiopathic pneumonia syndrome (IPS) is a serious complication that can occur after patients receive allogeneic hematopoietic stem cell transplantation (allo-HCT), making diagnosis challenging, especially in critically ill patients.
- In a study involving 444 allo-HCT recipients, researchers identified 30 cases of definite IPS diagnosed through bronchoscopy, and 54 cases of clinical IPS diagnosed based on clinical criteria without mandatory bronchoscopy.
- Key risk factors for definite IPS included high ferritin levels, while clinical IPS was linked to older age, a history of myeloablative conditioning (MAC), low %DLCO, and undergoing a second allo-HCT due to graft failure, all of which can aid in
Article Synopsis
- Chromosome analysis is significant in predicting outcomes for myeloid malignancies, especially after relapse following allogeneic hematopoietic cell transplantation.
- Recipients with clonal chromosomal changes at relapse had a shorter post-relapse survival (median 117 days) compared to those without these changes (median 275 days).
- Specific chromosomal abnormalities, like chromosome 7 changes, are linked to poorer survival outcomes, indicating the need for more research on how different chromosomal changes affect treatment effectiveness and patient prognoses.
Article Synopsis
- Disease relapse post-allogeneic hematopoietic cell transplantation is a key issue, especially in a patient with chronic myelomonocytic leukemia who experienced relapse after receiving cells from his daughter.
- Whole-exome sequencing of isolated monocytes revealed 8 common CMML mutations at HCT, along with a new PHF6 nonsense mutation identified at relapse.
- The study highlights that the loss of PHF6 may enhance tumor survival under stress by downregulating the TNF-α signaling pathway, which could contribute to treatment failure.
Article Synopsis
- * Research shows specific gene traits and receptor features of CMV-specific T-cells, including a preference for certain BV7 genes and unique amino acid motifs, highlighting their roles in fighting CMV.
- * By using single-cell and bulk RNA-sequence analyses, findings indicate that individual T-cells show similar gene expression, while differences among patients correlate with CMV reactivation, cytokine production, and cell division, paving the way for enhanced immunotherapy strategies.
Chronic graft-versus-host disease (cGVHD) of the liver is often observed in allogeneic hematopoietic stem cell transplantation (allo-HSCT) during tapering or after stopping calcineurin inhibitors (CI). We conducted a retrospective analysis of 242 allo-HSCT recipients whose CI dose was reduced to less than 40 mg of cyclosporin A or 0.4 mg of tacrolimus to clarify the clinical characteristics of liver GVHD in patients on low-dose CI.
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- Recipient cytomegalovirus (CMV) seropositivity correlates with a heightened risk of CMV reactivation post-allogeneic hematopoietic stem cell transplantation (allo-HCT), particularly in high-titer patients.
- A study involving 309 patients demonstrated that those with high CMV-IgG levels experienced the highest rates of reactivation (81% at 180 days), while negative titer patients had the lowest rates (16%).
- Although overall survival was slightly lower in high-titer patients, CMV reactivation emerged as a significant risk factor for nonrelapse mortality, warranting further research into its implications.
Article Synopsis
- Most acute leukemia patients undergoing intensive chemotherapy face gastrointestinal issues that can lead to malnutrition and significant body weight loss before stem cell transplantation.
- A study of 182 acute leukemia patients found that a weight loss of more than 13.2% negatively impacted survival rates, with higher body weight loss correlating to worse outcomes in nonrelapse mortality (NRM) and overall survival (OS).
- The analysis revealed that infections were a more frequent cause of death in patients with greater weight loss, emphasizing the added risk posed by weight loss alongside body mass index in predicting survival post-transplant.
Large outbreaks of measles or rubella occasionally occur around the world, and measles infection can be severe and even fatal in transplant patients. However, limited data are available on immunity to measles, mumps, and rubella (MMR) in adult patients after allogeneic stem cell transplantation (allo-HCT). The aim of this study was to evaluate the immune status against MMR and the effects of vaccination against MMR in adult patients after allo-HCT.
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- The study analyzed how two measures, L_AOC (area over the lymphocyte curve) and L_AUC (area under the lymphocyte curve), affect the reactivation of cytomegalovirus (CMV) in patients after receiving stem cell transplants.
- Out of 394 patients, 301 were included, and the researchers found that both L_AOC and L_AUC were independent predictors of CMV reactivation, along with factors like age and CMV serostatus.
- While the area-based measures were not better than measuring lymphocyte counts alone for predicting CMV reactivation, they may better indicate which patients will need longer antiviral treatment.
Article Synopsis
- The pulmonary function test (PFT) is crucial for assessing risk before allogeneic transplantation (allo-HCT), but during COVID-19, it poses a risk of virus transmission due to aerosol generation.
- A study involving 390 allo-HCT patients aimed to predict normal PFT results using lung CT imaging, showing that abnormal CT findings were significantly less common in those with normal PFT results.
- The analysis indicated a strong association between normal CT results and normal PFT, leading to a predictive model with high specificity, suggesting that PFTs may be unnecessary for patients with normal CT scans prior to allo-HCT.
Article Synopsis
- This study analyzed how the D-index, a measure of neutropenia's depth and duration, relates to the occurrence of invasive fungal disease (IFD) shortly after allogeneic hematopoietic stem cell transplantation (HSCT) in 394 patients.
- Out of 19 cases of early IFD, most occurred despite patients receiving antifungal treatments, highlighting that both the cumulative D-index and lower performance status are significant risk factors for IFD.
- The research concluded that the c-D-index can effectively predict IFD risks, with a determined cutoff value of 10,644, although its predictive advantage over cumulative days of neutropenia was minimal.