Publications by authors named "Yoshikazu Utsu"

Background: Wilms' Tumor (WT1) mRNA is a non-specific marker of measurable residual disease in acute myeloid leukemia (AML). Few studies have focused on the prognostic value of WT1 mRNA after initial remission induction of patients with AML who have received transplant treatments.

Objective: Thus, we retrospectively analyzed the clinical features and prognostic impact of WT1 mRNA reduction in patients with AML after initial remission induction at our hospital.

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  • * A case involving a 71-year-old woman with lymphoma resulted in fatal anaphylactic shock following her first dose of rasburicase, leading to multiple complications including heart compression and significant bleeding.
  • * This case highlights that while it’s uncommon, rasburicase can cause deadly anaphylaxis even in patients who have not previously been exposed to the drug.
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Due to the proliferation of genetic testing, pathogenic germline variants predisposing to hereditary hematological malignancy syndrome (HHMS) have been identified in an increasing number of genes. Consequently, the field of HHMS is gaining recognition among clinicians and scientists worldwide. Patients with germline genetic abnormalities often have poor outcomes and are candidates for allogeneic hematopoietic stem cell transplantation (HSCT).

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  • The study investigates the effects of Epstein-Barr virus (EBV) reactivation in 121 patients who underwent allogenic hematopoietic stem cell transplantation (allo-HSCT), focusing on the clinical characteristics and outcomes related to EBV viral load.
  • Patients were categorized based on their EBV DNA levels, with 50 showing levels above 1000 copies/mL and 71 below that threshold, revealing that higher EBV levels were linked to specific clinical factors like graft versus host disease (GVHD).
  • Results indicated that there was no significant difference in overall survival (OS) and disease-free survival (DFS) between the two groups, but rapid reduction of immunosuppressants in patients with high EBV levels showed
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  • Pulmonary tumor thrombotic microangiopathy is a severe condition where tumor cells block small blood vessels in the lungs, leading to symptoms like difficulty breathing and heart failure, often seen in advanced cancer cases.
  • A 68-year-old woman with non-small cell lung cancer, who was responding well to treatment, suddenly experienced worsening breathlessness and fatigue, despite no signs of tumor progression on imaging.
  • An autopsy revealed that while her primary tumor had shrunk, tumor clusters still caused significant blockage in lung vessels, highlighting that this condition can occur even with effective cancer treatment.
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  • A multicenter study in Japan, HM-SCREEN-Japan 01, focused on detecting genetic mutations in acute myeloid leukemia (AML) patients using paraffin-embedded bone marrow clot samples, which is a less invasive method than using bone marrow fluid.* -
  • The study involved 188 patients and found actionable genetic mutations in 38% of them, which could guide treatment decisions, while also detecting a high rate of genetic alterations and fusion transcripts.* -
  • Key mutations, such as those in KIT and WT1, were linked to overall survival rates, highlighting the potential of comprehensive genomic profiling in identifying effective therapeutic targets for newly diagnosed and relapsed AML patients.*
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Introduction: Cowden syndrome is a rare autosomal dominant disease characterized by the development of hamartomas and increased risks of other tumors, including breast, thyroid, and uterine cancers. Most patients with Cowden syndrome show mutations of the phosphatase and tensin homolog (PTEN) gene on chromosome 10; however, some patients with mutations do not show clinical symptoms, while patients with clinical symptoms may not have detectable PTEN mutations.

Case Presentation: A 39-year-old woman with macrocephaly had previously been diagnosed with Cowden syndrome at another hospital, when she presented with the onset of breast cancer.

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Comprehensive genomic profiling examinations (CGPs) have recently been developed, and a variety of tumor-agnostic mutations have been detected, leading to the development of new molecular-targetable therapies across solid tumors. In addition, the elucidation of hereditary tumors, such as breast and ovarian cancer, has pioneered a new age marked by the development of new treatments and lifetime management strategies required for patients with potential or presented hereditary cancers. In acute myeloid leukemia (AML), however, few tumor-agnostic or hereditary mutations have been the focus of investigation, with associated molecular-targeted therapies remaining poorly developed.

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Background: Catheter-related bloodstream infection (CRBSI), caused by rapidly growing mycobacteria (RGM), is a rare infectious complication in hematopoietic stem cell transplant (HSCT) recipients and can often be misdiagnosed as Gram-positive rod (GPR) bacteremia.

Case Presentation: We present a case of CRBSI caused by Mycobacterium wolinskyi, a rare RGM, in a 44-year-old female patient who received an umbilical cord blood transplant.

Conclusions: Rapidly growing mycobacteria can stain as GPRs and may grow in routine blood culture media after 3-4 days of incubation.

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A 69-year-old man with advanced small-cell lung cancer achieved partial remission after 3 courses of immunochemotherapy that included atezolizumab. Ten days after the last treatment, he developed paraneoplastic opsoclonus-myoclonus syndrome and required mechanical ventilation. Serology testing detected anti-Hu and anti-SOX-1 antibodies.

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A 60-year-old woman was diagnosed with simultaneous double cancer of the inguinal lymph node(squamous cell carcinoma) and the right lung(combined small cell carcinoma; cT3N0M0, Stage ⅡB)after observing and reporting a right inguinal swelling. Both were local lesions, and standard definitive treatments were administered. Right inguinal malignant tumor resection and right femoral arteriovenous resection with artificial blood vessel replacement and pedicled transverse rectus abdominis musculocutaneous flap were performed for the unknown primary cancer.

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Objective A central venous catheter (CVC) is often needed to treat hematologic diseases, but it is accompanied by many complications. Ultrasound guidance (USG) or a peripherally inserted central venous catheter (PICC) can reduce such complications. Meterials We collected data of patients with attempted CVC placement in our hematology unit in 2012 (before introduction of USG and PICC) and 2018 (after introduction) and compared both periods.

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  • * Out of 64 patients treated, 62 were analyzed; results showed a 77.4% survival rate with neutrophil engraftment by day 28 and a quick recovery time for both neutrophils and platelets post-transplantation.
  • * Adverse events related to the injection were mild, and acute graft-versus-host disease occurrences were manageable with steroid therapy, indicating the procedure's potential for enhancing early engraftment while effectively managing complications.
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Cord blood transplantation (CBT) is associated with delayed hematopoietic recovery and graft failure. To overcome these problems, we conducted a prospective, multicenter phase II study of intrabone marrow transplantation in which patients received reduced-intensity conditioning without anti-thymocyte globulin (ATG). The primary endpoint was the probability of full donor engraftment.

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The aim of this randomized phase II study was to improve the treatment delays and discontinuations associated with bendamustine use by comparing the effect of Benda-14 (intravenous bendamustine, 120 mg/m on days 1 and 15, repeated every 4 weeks for a total of 6 cycles) with those of the standard treatment in relapsed indolent lymphoma and/or mantle cell lymphoma. Forty-six patients were randomly assigned to the treatments from September 2012 to February 2016. Treatment accomplishment rate and median relative dose intensity were similar in both arms: 38 and 63.

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Dose intensity (DI) of chemotherapy affects prognosis of diffuse large B cell lymphoma (DLBCL). Myelotoxicity is the major dose-limiting toxicity (DLT) of most cytotoxic agents for hematological malignancies, whereas DLT of vincristine (VCR) is mainly neurological toxicity. Although VCR is a key drug and its combination with other cytotoxic agents needs consideration, studies focused on relative DI (RDI) of VCR have not been done before.

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A 51-year-old woman diagnosed as having left breast cancer with axillary lymph node and liver metastases seven years earlier was seen in our office because of severe pancytopenia. She had received chemotherapy including several cycles of doxorubicin plus cyclophosphamide and docetaxel followed by hormone therapy containing leuprorelin and tamoxifen over four years. For management of bone pain due to metastasis, she had also undergone stereotaxic radiation therapy of the neck one and a half years earlier and unsealed internal radiation therapy with (89)Sr injection five months prior to the current presentation, Subsequently, myelosuppression progressively worsened and she finally required a blood transfusion.

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