Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Yasuhiro Nakashima Last modified date:2020.06.23

Assistant Professor / 病態制御内科学 / Department of Clinical Medicine / Faculty of Medical Sciences


Papers
1. Yasuhiro Tsukamoto, Junichi Kiyasu, Ilseung Choi, Mitsuo Kozuru, Naokuni Uike, Hayato Utsunomiya, Akie Hirata, Eriko Fujioka, Hirofumi Ohno, Eriko Nakashima, Yasuhiro Nakashima, Kaname Miyashita, Yoshimichi Tachikawa, Taisuke Narazaki, Mariko Tsuda, Shojiro Haji, Akiko Takamatsu, Emi Tanaka, Tatsuro Goto, Hiroshi Takatsuki, Makoto Oyama, Hiroki Muta, Yu Yagi, Motohiko Ikeda, Takamitsu Matsushima, Yuji Yufu, Youko Suehiro, Efficacy and Safety of the Modified EPOCH Regimen (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Adult T-cell Leukemia/Lymphoma: A Multicenter Retrospective Study, Clinical Lymphoma, Myeloma & Leukemia, 2020.07.
2. Isao Yoshida, Akiko M. Saito, Shiro Tanaka, Ilseung Choi, Michihiro Hidaka, Yasuhiko Miyata, Yoshiko Inoue, Satoshi Yamasaki, Toshiya Kagoo, Hiroatsu Iida, Hiromasa Niimi, Takuya Komeno, Chikamasa Yoshida, Fumihito Tajima, Hideyuki Yamamoto, Ken Takase, Hironori Ueno, Takeshi Shimomura, Tatsunori Sakai, Yasuhiro Nakashima, Chikashi Yoshida, Shiro Kubonishi, Kazutaka Sunami, Shinichiro Yoshida, Aki Sakurai, Yukihiro Kaneko, Yoshitsugu Miyazaki, Hirokazu Nagai, Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever, Mycoses, 2020.05.
3. Narazaki T, Shiratsuchi M, Matsushima T, Tsuda M, Tsukamoto Y, Muta H, Masuda T, Kimura D, Takamatsu A, Yamamoto H, Oda Y, Miyoshi H, Ohshima K, Matsuda Y, Sakamoto R, Nakashima Y, Ogawa Y., Clinico-pathological characteristics of primary adrenal lymphomas - potential efficacy of autologous stem cell transplantation., Leuk Lymphoma., 2020 Feb 10:1-3., 2020.02.
4. Narazaki T, Nakashima Y, Tsukamoto Y, Nishida R, Tsuda M, Muta H, Kimura D, Masuda T, Takamatsu A, Kohashi K, Murakami D, Shiratsuchi M, Ogawa Y., Schizophyllum commune sinusitis after allogeneic bone marrow transplantation for myelodysplastic syndrome: A case report and literature review., Transpl Infect Dis., 10.1111/tid.13205., 2019.11.
5. Taisuke Narazaki, Yasuhiro Nakashima,Yasuhiro Tsukamoto, Mariko Tsuda, Toru Masuda, Daisaku Kimura, Akiko Takamatsu, Koichi Ohshima, Motoaki Shiratsuchi, Yoshihiro Ogawa , Transformation of follicular lymphoma to double‑hit lymphoma during adjuvant chemotherapy for concurrent ovarian carcinoma
, International Journal of Hematology , DOI 10.1007/s12185-019-02656-4, 2019.07, The frequency of multiple primary malignant neoplasms (MPMN) is increasing due to population aging. Since consensus guidelines for the treatment of MPMN are lacking, treatment strategies are determined by disease status on a per-patient basis. In this report, we describe a case of MPMN with follicular lymphoma (FL) grade 1 that transformed to double-hit lymphoma during adjuvant chemotherapy for concurrent ovarian carcinoma. A 64-year-old woman was diagnosed with MPMN of FL and endometrioid carcinoma by staging laparotomy and lymph node biopsy. She received four cycles of adjuvant chemotherapy (carboplatin and paclitaxel) for endometrioid carcinoma, but during chemotherapy, the FL grade 1 transformed to double-hit lymphoma. We speculate that adjuvant chemotherapy for endometrioid carcinoma may have triggered the transformation of FL in the present case..
6. Kato K, Uike N, Wake A, Yoshimitsu M, Tobai T, Sawayama Y, Takatsuka Y, Fukuda T, Uchida N, Eto T, Nakashima Y, Kondo T, Taguchi J, Miyamoto T1, Nakamae H, Ichinohe T, Kato K, Suzuki R, Utsunomiya A; ATL Working Group of the Japan Society for Hematopoietic Cell Transplantation., The outcome and characteristics of patients with relapsed adult T cell leukemia/lymphoma after allogeneic hematopoietic stem cell transplantation., Hematological Oncology, doi: 10.1002/hon.2558, 2019.02, Treatment options for patients with adult T cell leukemia/lymphoma (ATLL) who have relapsed disease after allogeneic hematopoietic stem cell transplantation (allo-HSCT) are limited. To clarify which patients with ATLL are likely to benefit from these treatment options and to define patient populations for novel treatments, we performed a nationwide retrospective analysis of 252 Japanese patients who had relapsed ATLL after allo-HSCT. Some long-term survivors remained after tapering and withdrawal of immunosuppressive agents. Thirty-six patients who received donor lymphocyte infusion had a better overall survival (OS) in comparison to those who did not [hazard ratio (HR), 0.63; 95% confidence interval (CI), 0.43-0.93; P = .02], suggesting the efficacy of a graft-versus-ATLL (GvATLL) effect even after relapse. Multivariate analysis demonstrated that skin lesions at initial relapse of ATLL were independently associated with higher OS (HR, 0.41; 95% CI, 0.22-0.74; P = .003), indicating that the skin is a susceptible target organ of GvATLL. This study suggested that enhancement of a GvATLL effect is a potential therapeutic option for relapsed disease after allo-HSCT. Further investigations of incorporation of immune-based approaches with new molecular target drugs into the therapeutic options of patients with ATLL before and after transplantation are warranted..
7. Tsuda M, Shiratsuchi M, Nakashima Y, Ikeda M, Muta H, Narazaki T, Masuda T, Kimura D, Takamatsu A, Matsumoto M, Fujimura Y, Kokame K, Matsushima T, Ogawa Y, Upshaw-Schulman syndrome diagnosed during pregnancy complicated by reversible cerebral vasoconstriction syndrome., Transfusion and Apheresis Science, https://doi.org/10.1016/j.transci.2018.10.023, 2018.12, Upshaw-Schulman syndrome (USS) is an inherited type of thrombotic thrombocytopenic purpura (TTP) that is extremely rare, but often diagnosed during pregnancy. Reversible cerebral vasoconstriction syndrome (RCVS) is the transient stenosis of several cerebral arteries that is frequently diagnosed post-partum. We describe a 28-year-old woman with USS complicated by RCVS after delivery that was treated by plasma exchange with a good outcome. She was referred to our hospital with thunderclap headache, anemia and thrombocytopenia that occurred immediately postpartum. She was diagnosed with TTP and multiple cerebral infarctions. Plasma exchange promptly improved her symptoms on hospital day 3. Moreover, multiple stenoses of cerebral arteries indicating RCVS were resolved. Since her sister also had an episode of thrombocytopenia during pregnancy, inherited TTP was suspected and genetic analyses confirmed USS. Pregnancy is a risk for not only TTP, but also RCVS. Endothelial damage might be an underlining cause and vasospasm after delivery is a trigger of RCVS. Plasma exchange was effective against both TTP and RCVS..
8. Taisuke Narazaki, Shojiro Haji, Yasuhiro Nakashima, Yasuhiro Tsukamoto, Mariko Tsuda, Akiko Takamatsu, Hirofumi Ohno, Takamitsu Matsushima, Tomoko Matsumoto, Keiji Nogami, Midori Shima, Motoaki Shiratsuchi, Yoshihiro Ogawa, Acquired hemophilia A associated with autoimmune pancreatitis with serum IgG4 elevation, International Journal of Hematology, 10.1007/s12185-018-2441-3, 1-4, 2018.09, A case of acquired hemophilia A (AHA) that developed in a patient with autoimmune pancreatitis (AIP) is presented. A 64-year-old woman was diagnosed with AIP in 2007. The symptoms resolved with prednisolone (PSL). Although the dose of PSL was tapered to 7.5 mg/day for maintenance, serum IgG4 levels remained high. She suddenly presented with subcutaneous bleeding in 2015. Her activated partial thromboplastin time was prolonged (80.0 s). A mixing test showed an inhibitor pattern, factor VIII (FVIII) activity was less than 1%, and FVIII inhibitor was 290 BU/mL. She was diagnosed with AHA. Her serum IgG4 was elevated to 133 mg/dL. She was treated first with PSL alone, but she developed bladder tamponade. Cyclophosphamide and activated prothrombin complex concentrate were combined with PSL. She then achieved hemostasis, and FVIII inhibitor disappeared. FVIII inhibitor had been detected since PSL was tapered and AHA recurred two months later. An enzyme-linked immunosorbent assay showed that the inhibitor was mainly IgG4 and IgG1. This case suggests that elevation of IgG4 may be associated with the development of both AHA and AIP..
9. Makoto Yoshimitsu, Ryuji Tanosaki, Koji Kato, Takashi Ishida, Ilseung Choi, Yoshifusa Takatsuka, Takahiro Fukuda, Tetsuya Eto, Michihiro Hidaka, Naoyuki Uchida, Toshihiro Miyamoto, Yasuhiro Nakashima, Yukiyoshi Moriuchi, Koji Nagafuji, Yasuhiko Miyazaki, Tatsuo Ichinohe, Minoko Takanashi, Yoshiko Atsuta, Atae Utsunomiya, Risk Assessment in Adult T Cell Leukemia/Lymphoma Treated with Allogeneic Hematopoietic Stem Cell Transplantation, Biology of Blood and Marrow Transplantation, 10.1016/j.bbmt.2017.11.005, 2017.11, Disease status at allogeneic hematopoietic cell transplantation (HCT) is an important pretransplant prognostic factor of HCT in adult T cell leukemia/lymphoma (ATL); however, other prognostic factors, including comorbidities, were not predictive in small cohort analyses. Several scoring systems (HCT-specific comorbidity index [HCT-CI]/modified European Group for Blood and Marrow Transplantation risk score [mEBMT]) have been adopted to predict HCT outcomes in other hematologic malignancies. We retrospectively evaluated HCT-CI and mEBMT to predict nonrelapse mortality (NRM) in 824 ATL patients registered in the Japan Society for Hematopoietic Cell Transplantation TRUMP database, from 2008 until 2013. A higher HCT-CI was associated with greater NRM when comparing HCT-CI 0 versus HCT-CI 1 to 3 and HCT-CI 0 versus HCT-CI ≥ 4. A higher mEBMT score was not associated with higher NRM when comparing mEBMT 0 to 3 with 4 to 6. Because ATL patients are older and consequently at risk of additional complications, we developed an optimized prognostic index for ATL (ATL-HCT-PI) using known risk factors: age, HCT-CI, and donor-recipient sex combination. The ATL-HCT-PI scores effectively predicted the 2-year NRM (22.0%, 27.7%, and 44.4%, respectively). Therefore, the newly developed ATL-HCT-PI, in combination with other risk factors, is more useful for predicting NRM in HCT for ATL patients..
10. Peng Xiong, Motoaki Shiratsuchi, Takamitsu Matsushima, Jiyuan Liao, Emi Tanaka, Yasuhiro Nakashima, Ryoichi Takayanagi, Yoshihiro Ogawa, Regulation of expression and trafficking of perforin-2 by LPS and TNF-α, Cellular Immunology, 10.1016/j.cellimm.2017.07.001, 320, 1-10, 2017.10, Perforin-2 is constitutively expressed in macrophages that are required for bacterial control. In this study, we found that perforin-2 is expressed in human macrophages with two isoforms: full-length perforin-2a and a splice variant, perforin-2b. Two isoforms show different subcellular distributions. Perforin-2a was predominantly localized to the membrane of endosome-like vesicles by a C-terminal transmembrane domain. In contrast, the short isoform perforin-2b lacking the transmembrane domain failed to localize to the membrane of vesicles. Furthermore, we determined that the pro-inflammatory stimuli LPS and TNF-α induced perforin-2a expression via the NF-κB pathway and triggered perforin-2a vesicles fusion with lysosomes. On the other hand, we detected the secretion of perforin-2b in response to LPS stimulation. Taken together, our data provide the evidence that membrane-bound and secretory isoforms of perforin-2 are present in human macrophages and may play important roles in immune defense..
11. Yasuhiro Tsukamoto, Junichi Kiyasu, Hayato Utsunomiya, Yasuhiro Nakashima, Ilseung Choi, Youko Suehiro, Yoshifusa Aratake, Yasunobu Abe, Danazol-induced peliosis hepatis accompanied by disseminated intravascular coagulation in a patient with myelodysplastic syndrome transformed from aplastic anemia, [Rinsho ketsueki] The Japanese journal of clinical hematology, 10.11406/rinketsu.57.1026, 57, 8, 1026-1031, 2016.08, Peliosis hepatis (PH) is a condition involving benign tumors pathologically characterized by multiple blood-filled cavities, mostly affecting the liver and spleen. Androgenic-steroids are widely used in patients with bone marrow failure syndromes (e.g.: aplastic anemia) and these patients are at increased risk of developing PH. Although patients with PH are generally asymptomatic, PH can progress to liver failure and even fatal spontaneous intraabdominal hemorrhage. Therefore, early diagnosis is critical in order to prevent life-threatening complications of PH. We herein report a patient with PH which had been treated with danazol, who presented with liver dysfunction and multiple hepatic lesions on imaging studies at the time of diagnosis. Although the patient presented with disseminated intravascular coagulation (DIC), a bone marrow biopsy revealed no evidence of leukemic transformation. The patient was diagnosed as having danazol-induced PH, and these abnormalities spontaneously resolved after the discontinuation of danazol. PH is one of the most important complications of long-term administration of androgenic-steroids. Although the mechanisms remain unclear, the multiple blood-filled cavities characteristic of PH may be responsible for the development of DIC. Therefore, monitoring of coagulation markers might also be a key strategy for early diagnosis of PH..
12. S. Haji, J. Kiyasu, I. Choi, Y. Suehiro, K. Toyoda, M. Tsuda, A. Takamatsu, Yasuhiro Nakashima, H. Miyoshi, Motoaki Shiratsuchi, S. Yamasaki, N. Uike, Y. Abe, Administration of an anti-CC chemokine receptor 4 monoclonal antibody, mogamulizumab, before allogeneic bone marrow transplantation for adult T-cell leukemia/lymphoma, Bone Marrow Transplantation, 10.1038/bmt.2015.254, 51, 3, 432-434, 2016.03.
13. Mariko Tsuda, Yasuhiro Nakashima, Motohiko Ikeda, Shingo Shimada, Masatoshi Nomura, Takamitsu Matsushima, Shunsuke Takahashi, Shinichi Aishima, Yoshinao Oda, Motoaki Shiratsuchi, Ryoichi Takayanagi, Intravascular Large B-Cell Lymphoma Complicated by Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis that was Successfully Treated with Rituximab-Containing Chemotherapy, Journal of clinical and experimental hematopathology : JCEH, 10.3960/jslrt.55.39, 55, 1, 39-43, 2015.01, A 64-year-old woman had suffered from painful livedo reticularis for 2 years and was referred to us due to fever, anasarca and paresthesia of the lower limbs. Serum proteinase-3-anti-neutrophil cytoplasmic antibody (ANCA) was positive. Abnormal lymphocytes were found in the cerebrospinal fluid and bone marrow. Skin biopsy revealed large atypical lymphoid cells with CD20 positivity lodged in the small vessels and neutrophilic infiltration into the arterial vascular wall with fibrinoid degeneration. A diagnosis of intravascular large B-cell lymphoma complicated by ANCA-associated vasculitis was made, and rituximab-containing chemotherapy followed by prednisolone was quite effective for both lymphoma and ANCA-associated vasculitis..
14. Yasuhiro Nakashima, Motoaki Shiratsuchi, Ichiro Abe, Yayoi Matsuda, Noriyuki Miyata, Hirofumi Ohno, Motohiko Ikeda, Takamitsu Matsushima, Masatoshi Nomura, Ryoichi Takayanagi, Pituitary and adrenal involvement in diffuse large B-cell lymphoma, with recovery of their function after chemotherapy, BMC Endocrine Disorders, 10.1186/1472-6823-13-45, 13, 2013.10, Background: Diffuse large B-cell lymphoma sometimes involves the endocrine organs, but involvement of both the pituitary and adrenal glands is extremely rare. Involvement of these structures can lead to hypopituitarism and adrenal insufficiency, and subsequent recovery of their function is rarely seen. The present report describes an extremely rare case of pituitary and adrenal diffuse large B-cell lymphoma presenting with hypopituitarism and adrenal insufficiency with subsequent recovery of pituitary and adrenal function after successful treatment of the lymphoma. Case presentation: A 63-year-old Japanese man was referred to our hospital due to miosis, ptosis, hypohidrosis of his left face, polydipsia and polyuria. 18F-fluorodeoxy glucose positron emission tomography / computed tomography revealed hotspots in the pituitary gland, bilateral adrenal glands and the apex of his left lung. Surgical biopsy from the pituitary lesion confirmed the diagnosis of diffuse large B-cell lymphoma, with lymphoma cells replacing normal pituitary tissue. Endocrine function tests revealed adrenal insufficiency and panhypopituitarism, including a possible affection of the posterior pituitary. Hormone replacement therapy with desmopressin and hydrocortisone was started. Chemotherapy consisted of six courses of R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) and two courses of high-dose methotrexate followed by autologous hematopoietic stem cell transplantation. Subsequently, his pituitary and bilateral adrenal lesions resolved, and serial endocrine function tests showed gradual improvement in pituitary and adrenal function. Conclusions: The present report describes an extremely rare case of diffuse large B-cell lymphoma with involvement of both the pituitary and bilateral adrenal glands. R-CHOP and high-dose methotrexate therapy followed by autologous hematopoietic stem cell transplantation was quite effective, and panhypopituitarism and adrenal insufficiency improved to almost normal values after successful treatment of the lymphoma with chemotherapy..
15. Eriko Nakashima, Motoaki Shiratsuchi, Emi Honda, Eriko Fujioka, Hirofumi Ohno, Yasuhiro Nakashima, Takamitsu Matsushima, Hiromi Iwasaki, Yasunobu Abe, Ryoichi Takayanagi, [Transfusion-related acute lung injury during the treatment of EBV-associated hemophagocytic lymphohistiocytosis]., [Rinsho ketsueki] The Japanese journal of clinical hematology, 54, 4, 378-382, 2013.04, Transfusion-related acute lung injury (TRALI) is a severe pulmonary complication following blood transfusions. We experienced a case of possible TRALI during the course of EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH). A 19-year-old woman was admitted to our hospital suffering from fever and abdominal pain. Her laboratory data revealed pancytopenia, liver damage, coagulopathy, and a high titer of EBV-DNA. Computed tomography showed hepatosplenomegaly and bone marrow aspiration revealed hemophagocytosis and the proliferation of atypical lymphocytes. A diagnosis of EBV-HLH was made and plasma exchange was performed. Severe hypoxia due to pulmonary edema developed two hours after starting the plasma transfusion. Methylprednisolone pulse therapy and non-invasive positive pressure ventilation ameliorated her respiratory condition. Anti-HLA class I and II antibodies were detected in donor sera and a cross-match test between patient lymphocytes and donor plasma was positive. To the best of our knowledge, this is the first case report of TRALI complicated with EBV-HLH. It is possible that hypercytokinemia accompanied by HLH was associated with the onset of TRALI..
16. Yuka Oshikawa, Satoshi Fukushima, Taiga Miyake, Takeshi Kawaguchi, Kenta Motomura, Yasuhiro Nakashima, Kenichi Nakamura, Masatoshi Jinnin, Hironobu Ihn, Photosensitivity and acute liver insufficiency in late-onset erythropoietic protoporphyria with a chromosome 18Q abnormality, Case Reports in Dermatology, 10.1159/000341111, 4, 2, 144-149, 2012.05, Late-onset erythropoietic protoporphyria (EPP) is rare, and it is usually associated with an acquired somatic mutation of the ferrochelatase gene secondary to hematological malignancy such as myelodysplastic syndrome or myeloproliferative disorder. In 0.5-1% of patients with EPP, deposition of protoporphyrin in the liver leads to progressive liver insufficiency. Herein, we report the case of a 67-year-old female who developed EPP with typical photosensitivity and hemolytic anemia. Six months later, she was admitted with acute liver damage with a rapidly progressing course, and developed liver insufficiency. She recovered from the liver insufficiency after undergoing plasmapheresis and red blood cell exchange transfusion. A bone marrow examination revealed normal features; however, a cytogenetic analysis identified an abnormal clone of cells with a translocation between chromosomes 13q12 and 18q21.1. This is the first report of a patient who recovered from liver insufficiency. The results of this report suggest that plasmapheresis and red blood cell exchange transfusion are effective for treating liver insufficiency in patients with late-onset EPP..
17. Kennosuke Karube, Masao Nakagawa, Shinobu Tsuzuki, Ichiro Takeuchi, Keiichiro Honma, Yasuhiro Nakashima, Norio Shimizu, Young Hyeh Ko, Yasuo Morishima, Koichi Ohshima, Shigeo Nakamura, Masao Seto, Identification of FOXO3 and PRDM1 as tumor-suppressor gene candidates in NK-cell neoplasms by genomic and functional analyses, Blood, 10.1182/blood-2011-04-346890, 118, 12, 3195-3204, 2011.09, Oligo-array comparative genomic hybridization (CGH) and gene-expression profiling of natural killer (NK) - cell neoplasms were used in an effort to delineate the molecular pathogenesis involved. Oligoarray CGH identified two 6q21 regions that were most frequently deleted (14 of 39 or 36%). One of these regions included POPDC3, PREP, PRDM1, ATG5, and AIM1, whereas the other included LACE1 and FOXO3. All genes located in these regions, except for POPDC3 and AIM1, were down-regulated in neoplastic samples, as determined by gene-expression analysis, and were therefore considered to be candidate tumor-suppressor genes. A20 and HACE1, the well-known tumor-suppressor genes located on 6q21-23, were included as candidate genes because they also demonstrated frequent genomic deletions and down-regulated expression. The Tet-Off NK cell line NKL was subsequently established for functional analyses. Seven candidate genes were transduced into Tet-Off NKL and forced re-expression was induced. Re-expression of FOXO3 and PRDM1 suppressed NKL proliferation, but this was not the case after re-expression of the other genes. This effect was confirmed using another NK cell line, SNK10. Furthermore, genomic analyses detected nonsense mutations of PRDM1 that led to functional inactivation in one cell line and one clinical sample. PRDM1 and FOXO3 are considered to play an important role in the pathogenesis of NK-cell neoplasms..
18. Noriaki Matsui, Kazuya Akahoshi, Yasuaki Motomura, Masaru Kubokawa, Shingo Endoh, Ryouhei Matsuura, Hiroyuki Oda, Yasuhiro Nakashima, Masafumi Oya, Kazuhiko Nakamura, Successful endoscopic ultrasound-guided fine-needle aspiration of the pelvic lesion through the sigmoid colon, Digestive Endoscopy, 10.1111/j.1443-1661.2010.01025.x, 22, 4, 337-340, 2010.10, Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a useful modality when the target is a lymph node located in the mediastinum, perigastric area or perirectum. Although it is difficult to carry out EUS-FNA of the colon using an oblique view linear scope, we report two cases of successful EUS-FNA of the lesions via the proximal sigmoid colon using a recently available new convex type EUS scope. Case 1 was a 77-year-old Japanese woman noted to have multiple lymph node swelling in the para-aortic area and in the pelvis. Case 2 was a 60-year-old Japanese woman noted to have a large mass in the left lower abdomen. In case 1, oral EUS showed no lymph node swelling. In both cases, EUS with forward-viewing radial echoendoscope was carried out via the anus, and multiple lymph-node swelling or a large mass was observed near the proximal sigmoid colon. In the EUS-FNA for these cases, we used a new convex-type EUS scope that has an oblique view, but with a wide-angled optical device giving a view similar to a forward one. EUS-FNA was successfully carried out on the lesions. The pathological specimen revealed diffuse large B-cell lymphoma in case 1 and gastrointestinal stromal tumor (GIST) in case 2..
19. Yasuhiro Nakashima, Yasunobu Abe, Yoshimichi Tachikawa, Rie Ohtsuka, Eriko Sada, Koichiro Muta, Ryoichi Takayanagi, Successful cyclosporine treatment for thrombocytopenia after salvage therapy with arsenic trioxide therapy followed by autologous hematopoietic stem cell transplantation in acute promyelocytic leukemia, [Rinsho ketsueki] The Japanese journal of clinical hematology, 48, 12, 1567-1569, 2007.12, A 55-year-old man with acute promyelocytic leukemia in the first relapse was treated with arsenic trioxide as salvage therapy. After obtaining molecular remission, he underwent autologous peripheral blood stem cell transplantation (PBSCT) with busulfan and melphalan conditioning. The transplant dose of CD 34-positive cells was sufficient, and engraftment was prompt. Platelet count increased to 320 x 10(9)/1 on day 21; however, it rapidly decreased to 27 x 10(9)/l on day 37. Despite treatment with corticosteroid, the platelet count decreased to 6 x 10(9)/l on day 55. About one month after cyclosporine administration, thrombocytopenia gradually improved. This clinical course suggests immune-mediated thrombocytopenia following autologous PBSCT..
20. Yasuhiro Nakashima, Hiroyuki Tagawa, Ritsuro Suzuki, Sivasundaram Karnan, Kennosuke Karube, Koichi Ohshima, Koichiro Muta, Hajime Nawata, Yasuo Morishima, Shigeo Nakamura, Masao Seto, Genome-wide array-based comparative genomic hybridization of natural killer cell lymphoma/leukemia
Different genomic alteration patterns of aggressive NK-cell leukemia and extranodal NK/T-cell lymphoma, nasal type, Genes Chromosomes and Cancer, 10.1002/gcc.20245, 44, 3, 247-255, 2005.11, Natural killer (NK) cell lymphomas/leukemias are highly aggressive lymphoid malignancies, but little is known about their genomic alterations, and thus there is an urgent need for identification and analysis of NK cell lymphomas/leukemias. Recently, we developed our own array-based comparative genomic hybridization (array CGH) with an average resolution of 1.3 Mb. We performed an array CGH analysis for 27 NK-cell lymphoma/leukemia cases that were classified into two disease groups based on the World Health Organization Classification (10 aggressive NK-cell leukemia cases and 17 extranodal NK/T-cell [NK/T] lymphomas, nasal type). We identified the differences in the genomic alteration patterns of the two groups. The recurrent regions characteristic of the aggressive NK-cell leukemia group compared with those of the extranodal NK/T lymphoma, nasal-type group, were gain of 1q and loss of 7p15.1-p22.3 and 17p13.1. In particular, gain of 1q23.1-q24.2 (P = 0.041) and 1q31.3-q44 (P = 0.003-0.047), and loss of 7p15.1-p22.3 (P = 0.012-0.041) and 17p 13.1 (P = 0.012) occurred significantly more frequently in the former than in the latter group. Recurrent regions characteristic of the extranodal NK/T lymphoma, nasal-type group, compared with those of the other group were gain of 2q, and loss of 6q16.1-q27, 11q22.3-q23.3, 5p14.1-p14.3, 5q34-q35.3, 1p36.23-p36.33, 2p 16.1-p16.3, 4q12, and 4q31.3-q32.1. Our results can be expected to provide further insights into the genetic basis of lymphomagenesis and the clinicopathologic features of NK-cell lymphomas/leukemias..
21. Yasuhiro Nakashima, Motoaki Shiratsuchi, Yasunobu Abe, Koichiro Muta, Kenzaburo Tani, Satoshi Shiokawa, Junji Nishimura, Sustained molecular remission by non-myeloablative stem cell transplantation after autologous hematopoietic stem cell transplantation in a patient with multiple myeloma, Leukemia and Lymphoma, 10.1080/10428190500096708, 46, 8, 1217-1222, 2005.08, Multiple myeloma (MM) is refractory to conventional chemotherapy. To achieve a sustained complete remission, we performed planned non-myeloablative allogeneic stem cell transplantation (NSTD after autologous hematopoietic stem cell transplantation (HSCT) in a patient with stage III MM. Autologous HSCT was performed using high-dose melphalan after conventional chemotherapy, followed by NST from an HLA-identical sibling using low-dose total body irradiation (200 cGy) for conditioning. Cyclosporine and mycophenolate mofetil were used for graft-vs-host disease (GVHD) prophylaxis. Acute GVHD was transiently seen in the skin and intestine, while, in addition, mild chronic GVHD was seen in the oral mucosa and skin. Complete donor chimerism was achieved and the disappearance of tumor-derived monoclonal B cells was confirmed based on an analysis of immunoglobulin light chain messenger signals on day 156 when chronic GVHD occurred. The clinical course in this case strongly suggested the existence of a graft-vs-myeloma effect..
22. Toyoki Maeda, Toshitaka Mutoh, Hiromi Muta, Masaharu Nakayama, Yasuhiro Nakashima, Takuya Ikuta, Mikihiko Yasuda, Tomoaki Etoh, Kanako Shimizu, Yukoh Nakazaki, Takashi Hiroyama, Shinichi Somada, Ryo Kurita, Kenzaburo Tani, Motoaki Shiratsuchi, Junji Nishimura, An 85-year-old Japanese woman with Philadelphia chromosome-positive chronic myelogenous leukemia with del (5q) successfully treated by intermittent imatinib therapy., Journal of the American Geriatrics Society, 52, 10, 1783-1784, 2004.10.
23. Yasuhiro Nakashima, Toshihiro Shimada, Y. Yamada, Ilseung Choi, Yuji Yufu, Naokuni Uike, Cladribine monotherapy for patients with relapsed or refractory indolent non-Hodgkin lymphoma, [Rinsho ketsueki] The Japanese journal of clinical hematology, 45, 7, 568-570, 2004.07, Cladribine is a purine analogue that is resistant to degradation by adenosine deaminase. We describe the efficacy of cladribine monotherapy in 8 patients with relapsed or refractory indolent non-Hodgkin lymphoma. The median age of the patients was 57 years. All patients were given 1-3 courses of cladribine monotherapy at 0.09 mg/kg/day continuous infusion for 7 days. Although all patients had been treated with rituximab and CHOP-like regimens, the response rate was excellent (85.7%). Thus we consider that cladribine is the first treatment of choice in the patients with relapsed or refractory indolent lymphoma..
24. Toyoki Maeda, Satoshi Shiokawa, Yasuji Yoshikawa, Takashi Hiroyama, Yasuhiro Nakashima, Hiromi Muta, Masaharu Nakayama, Yukoh Nakazaki, Shinichiro Akizuki, Kanako Shimizu, Toshitaka Mutoh, Shinichi Somada, Ryo Kurita, Motoaki Shiratsuchi, Naoki Makino, Junji Nishimura, Kenzaburo Tani, Successful treatment of pure red cell aplasia with cyclosporin A and erythropoietin after thymectomy in a 88-year old woman., Haematologica, 89, 6 Suppl, 2004.06, An 88-year old Japanese female with pure red cell aplasia was treated safely and effectively by a combination of thymectomy, cyclosporin A, and erythropoietin. The thymoma was histologically classified as lymphocytic type or cortical type, which are uncommon in cases of a thymoma accompanied by pure red cell aplasia. Immunohistochemical analysis of the thymoma and bone marrow revealed a predominance of CD8(+) cells. Thymectomy alone was ineffective, but cyclosporin A treatment subsequent to thymectomy was safe and effective and resulted in the disappearance of a Vbeta12 bearing T-cell clone in the bone marrow. Additional treatment with erythropoietin enhanced the effects of cyclosporin A and restored the patient's hemoglobin to normal levels. The beneficial effect of cyclosporin A may be attributed not to a broad immunomodulatory effect, but to a local effect on a limited T-cell subset..
25. Yasuhiro Nakashima, Yasunobu Abe, Rie Ohtsuka, Yoshimichi Tachikawa, Eriko Nagasawa, Junji Nishimura, Koichi Ohshima, Hajime Nawata, Koichiro Muta, Follicular lymphoma complicated with autoimmune hemolytic anemia and pure red cell aplasia, [Rinsho ketsueki] The Japanese journal of clinical hematology, 45, 11, 1208-1210, 2004.01, Malignant lymphomas are often associated with immunological disorders. We describe here a 54-year-old woman with follicular lymphoma, simultaneously complicated with autoimmune hemolytic anemia and pure red cell aplasia. The patient had bilateral cervical, axillar and inguinal lymph node swellings. Peripheral blood analysis revealed severe anemia (Hb 3.4g/dl) and reticulocytopenia (2260/ml), and then the bone marrow showed erythroid hypoplasia. Furthermore, a direct Coombs test was positive and the serum haptoglobin level was undetectable. After treatment with CHOP followed by 1 mg/kg of prednisolone daily, the patient obtained complete remission and her anemia improved to the normal level..