研究者詳細 - 鷲尾　佳奈

論文 - 鷲尾　佳奈

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Paediatric anaplastic large-cell lymphoma with cardiac tamponade. 国際誌

Takahiro Shiwaku, Kosuke Tamefusa, Hisashi Ishida, Kaori Fujiwara, Kana Washio, Hirokazu Tsukahara

British journal of haematology 2025年1月

Tectal glioma: clinical, radiological, and pathological features, and the importance of molecular analysis. 査読

Ryoji Imoto, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Shuichiro Hirano, Naoya Kemmotsu, Yasuki Suruga, Ryo Mizuta, Yasuhito Kegoya, Yohei Inoue, Tsuyoshi Umeda, Madoka Hokama, Kana Washio, Hiroyuki Yanai, Shota Tanaka, Kaishi Satomi, Koichi Ichimura, Isao Date

Brain tumor pathology 2024年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

Tectal glioma (TG) is a rare lower grade glioma (LrGG) that occurs in the tectum, mainly affecting children. TG shares pathological similarities with pilocytic astrocytoma (PA), but recent genetic analyses have revealed distinct features, such as alterations in KRAS and BRAF. We conducted a retrospective review of cases clinically diagnosed as TG and treated at our institute between January 2005 and March 2023. Six cases were identified and the median age was 30.5 years. Four patients underwent biopsy and two patients underwent tumor resection. Histological diagnoses included three cases of PA, one case of astrocytoma, and two cases of high-grade glioma. The integrated diagnosis, according to the fifth edition of the World Health Organization Classification of Tumours of the central nervous system, included two cases of PA and one case each of diffuse high-grade glioma; diffuse midline glioma H3 K27-altered; glioblastoma; and circumscribed astrocytic glioma. Among the three patients who underwent molecular evaluation, two had KRAS mutation and one had H3-3A K27M mutation. Our results demonstrate the diverse histological and molecular characteristics of TG distinct from other LrGGs. Given the heterogeneous pathological background and the risk of pathological progression in TG, we emphasize the importance of comprehensive diagnosis, including molecular evaluation.

DOI： 10.1007/s10014-024-00494-9

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Alectinib maintenance therapy following cord blood transplantation for relapsed pediatric anaplastic large cell lymphoma with central nervous system involvement. 査読国際誌

Kosuke Tamefusa, Hisashi Ishida, Daisuke Miyahara, Takahiro Shiwaku, Motoharu Ochi, Kiichiro Kanamitsu, Kaori Fujiwara, Yasuhisa Tatebe, Kana Washio, Tomoyuki Akiyama, Hirokazu Tsukahara

Annals of hematology 2024年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

Pediatric ALK-positive anaplastic large cell lymphoma is a rare subtype of non-Hodgkin lymphoma, and approximately 30% of patients relapse following treatment with conventional chemotherapy. Alectinib monotherapy has demonstrated excellent activity in relapsed and refractory ALCL, but its role as a maintenance therapy after hematopoietic cell transplantation is unclear. We experienced a relapse case of pediatric ALK-positive ALCL with central nervous system involvement treated with alectinib maintenance therapy following cord blood transplantation. The patient has maintained complete remission for more than 3 years after transplantation. There were no remarkable adverse effects that led to discontinuation of alectinib.

DOI： 10.1007/s00277-024-06000-7

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腎移植後リンパ増殖症に対して,rituximab反応性による治療層別化レジメンを使用した小児例

爲房宏輔, 石田悠志, 藤原かおり, 塩飽孝宏, 吉永香澄, 西村慎吾, 鷲尾佳奈, 荒木元朗, 塚原宏一

臨床血液 65 ( 5 ) 466 - 466 2024年5月

小児急性白血病患者における輸血療法の後方視的検討査読

鷲尾佳奈, 塩飽孝宏, 爲房宏輔, 石田悠志, 藤原かおり, 塚原宏一

臨床血液 65 ( 5 ) 459 - 459 2024年5月

当院で経験したDiffuse midline glioma,H3K27-alteredの臨床的特徴

外間まどか, 大谷理浩, 石田穣治, 梅田剛志, 井上陽平, 水田亮, 井本良二, 駿河和城, 劒持直也, 家護谷泰仁, 平野秀一郎, 冨田祐介, 藤井謙太郎, 鷲尾佳奈, 田中將太

小児の脳神経 49 ( 2 ) 209 - 209 2024年4月

当院で経験したDiffuse midline glioma,H3K27-alteredの臨床的特徴

小児の脳神経 49 ( 2 ) 209 - 209 2024年4月

Midline invasion predicts poor prognosis in diffuse hemispheric glioma, H3 G34-mutant: an individual participant data review. 査読国際誌

Yasuhito Kegoya, Yoshihiro Otani, Yohei Inoue, Ryo Mizuta, Fumiyo Higaki, Kana Washio, Shinichiro Koizumi, Kazuhiko Kurozumi, Joji Ishida, Kentaro Fujii, Norio Yamamoto, Yoshihiro Tanaka, Isao Date

Journal of neuro-oncology 2024年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: Diffuse hemispheric glioma, H3 G34-mutant (DHGs), is a newly categorized tumor in pediatric-type diffuse high-grade gliomas, World Health Organization grade 4, with a poor prognosis. Although prognostic factors associated with genetic abnormalities have been reported, few reports have examined the clinical presentation of DHGs, especially from the viewpoint of imaging findings. In this study, we investigated the relationship between clinical factors, including imaging findings, and prognosis in patients with DHGs. METHODS: We searched Medline through the PubMed database using two search terms: "G34" and "glioma", between 1 April 2012 and 1 July 2023. We retrieved articles that described imaging findings and overall survival (OS), and added one DHG case from our institution. We defined midline invasion (MI) as invasion to the contralateral cerebrum, brainstem, corpus callosum, thalamus, and basal ganglia on magnetic resonance imaging. The primary outcome was 12-month survival, estimated using Kaplan-Meier curves and logistic regression. RESULTS: A total of 96 patients were included in this study. The median age was 22 years, and the proportion of male patients was 48.4%. Lesions were most frequently located in the frontal lobe (52.6%). MI was positive in 39.6% of all patients. The median OS was 14.4 months. Univariate logistic regression analysis revealed that OS was significantly worse in the MI-positive group compared with the MI-negative group. Multivariate logistic regression analysis revealed that MI was an independent prognostic factor in DHGs. CONCLUSIONS: In this study, MI-positive cases had a worse prognosis compared with MI-negative cases. PREVIOUS PRESENTATIONS: No portion of this study has been presented or published previously.

DOI： 10.1007/s11060-024-04587-5

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Letermovir at a Prophylactic Dose for Cytomegalovirus Infection in Children Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: A Single-Center Retrospective Study in Japan. 査読

Yasuhisa Tatebe, Yohei Manabe, Yuta Tanaka, Takahiro Shiwaku, Motoharu Ochi, Kosuke Tamefusa, Hisashi Ishida, Kaori Fujiwara, Kana Washio, Hirofumi Hamano, Kiminaka Murakawa, Yoshito Zamami

Biological & pharmaceutical bulletin 47 ( 9 ) 1575 - 1582 2024年

記述言語：英語掲載種別：研究論文（学術雑誌）

Cytomegalovirus (CMV) infection is a major complication of hematopoietic stem cell transplantation (HSCT). Previous studies in adults demonstrated that letermovir prophylaxis for 100 d after HSCT reduces the occurrence of CMV infection; however, studies in children are limited. In this study, we aimed to examine the incidence of CMV infection in children who underwent allogeneic HSCT with prophylactic letermovir therapy. A single-center retrospective study was conducted among patients aged ≤17 who underwent allogeneic HSCT. We compared the cumulative incidence of CMV infection, mainly monitored by pp65-antigenemia, after HSCT between patients with and without letermovir prophylaxis (10-12 or 5-6 mg/kg/d when co-administered with cyclosporine) using Gray's test. We analyzed 79 patients with a median follow-up period of 126 d. The median age of these patients was 8.3 years (Interquartile range, 3.7-12.4). Prophylactic letermovir was used in 25 patients. Twenty-five patients developed CMV infection, and the cumulative incidence was 38.9% (95% confidence intervals, 25.0-52.5). The cumulative incidence of CMV infection was not significantly different between the letermovir and no-letermovir groups (33.1 vs. 36.6%, p = 0.228). Meanwhile, the cumulative incidence of CMV infection up to 100 d following HSCT was significantly lower in the letermovir group than in the no-letermovir group (8.0 vs. 32.8%, p = 0.026). Most patients experienced no noticeable adverse effects associated with letermovir; however, one patient discontinued letermovir because of nausea and anorexia. In conclusion, the results of this study suggest that letermovir prophylaxis against CMV infection may be effective in children without severe adverse effects.

DOI： 10.1248/bpb.b24-00217

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Delayed diagnostic interval and survival outcomes in pediatric leukemia: A single‐center, retrospective study 査読

Kosuke Tamefusa, Motoharu Ochi, Hisashi Ishida, Takahiro Shiwaku, Kiichiro Kanamitsu, Kaori Fujiwara, Yasuhisa Tatebe, Naomi Matsumoto, Kana Washio, Hirokazu Tsukahara

European Journal of Haematology 2023年12月

掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

Abstract

Objective

This study primarily focused on the diagnostic interval (DI), defined as the duration from the onset of leukemic symptoms to diagnosis. We investigated whether a prolonged DI is associated with the outcomes of pediatric leukemia.

Methods

We retrospectively collected data of children with newly diagnosed pediatric leukemia at Okayama University Hospital from January 2007 to December 2022. Survival analyses were conducted using Kaplan–Meier methods, and an unadjusted analysis to compare differences in survival was performed using the log‐rank test.

Results

In total, 103 children with leukemia were included in the analysis. The median DI was 20 days (interquartile range, 9.5–33.5 days). A prolonged DI (≥30 days) demonstrated no association with either 5‐year event‐free survival (70.1% for <30 days and 68.3% for ≥30 days, p = .99, log‐rank test) or overall survival (84.7% for <30 days and 89.4% for ≥30 days, p = .85, log‐rank test).

Conclusions

A prolonged DI was not associated with the survival of children with leukemia. If a precise classification of leukemia biology is provided for pediatric patients, a prolonged DI may have little impact on the prognosis of these patients.

DOI： 10.1111/ejh.14162

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造血細胞移植後の肝障害の鑑別にMRIが有用であった輸血後鉄過剰症の2小児例査読

鷲尾佳奈, 塩飽孝宏, 爲房宏輔, 越智元春, 石田悠志, 金光喜一郎, 藤原かおり, 塚原宏一

日本輸血細胞治療学会誌 69 ( 5 ) 605 - 609 2023年10月

担当区分：筆頭著者記述言語：日本語出版者・発行元：一般社団法人日本輸血・細胞治療学会

小児がん患者における輸血後鉄過剰症については，海外からは報告が散見される．成人と同様，白血病等における同種造血細胞移植患者において，移植前の血清フェリチン値と合併症の相関等が議論されているが，日本国内からはまだまとまった報告はない．我々は，肝障害を来し，輸血後鉄過剰症と肝移植片対宿主病（GVHD）との鑑別に磁気共鳴画像（MRI）が有用であった2例を経験した．2例とも急性骨髄性白血病であり，肝GVHDとして免疫抑制療法等を行ったにもかかわらず遷延する肝障害を呈していた．高フェリチン血症を認めたためMRI撮像したところ，高度鉄沈着を示唆する所見を呈した．輸血後鉄過剰症として鉄キレート療法を行って肝障害が改善した．小児がん患者において，骨髄抑制期間が長く頻回の輸血を要するような症例では，急性期に臓器障害を伴う輸血後鉄過剰症を示す可能性があるが，治療介入の指針や時期については明らかになっていない．今後日本国内でも大規模な調査が必要と思われる．

DOI： 10.3925/jjtc.69.605

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濃縮クエン酸溶液を使用し抗凝固比の変更を行ったアフェレーシスの安全性と有効性に関する後方視的解析

藤井敬子, 福見拓也, 阿部将也, 浦田知宏, 清家圭介, 藤原英晃, 淺田騰, 遠西大輔, 西森久和, 松岡賢市, 藤井伸治, 鷲尾佳奈, 前田嘉信

日本血液学会学術集会 85回 687 - 687 2023年10月

A Boy Safely Treated with Tyrosine Kinase Inhibitors for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Osteolysis. 査読

Takahiro Shiwaku, Hisashi Ishida, Yasuhisa Tatebe, Kosuke Tamefusa, Motoharu Ochi, Kaori Fujiwara, Toshihide Kubo, Eiji Nakata, Kana Washio, Hirokazu Tsukahara

Acta medica Okayama 77 ( 4 ) 439 - 442 2023年8月

記述言語：英語

A three-year-old boy with Philadelphia chromosome-positive B-cell precursor acute lymphoblastic leukemia (Ph+ALL) presented with an osteolytic lesion in his right upper arm. Tyrosine kinase inhibitors (TKIs) such as imatinib and dasatinib are an essential component throughout the course of treatment for Ph+ALL. However, TKIs are reported to affect the bone metabolism. In the treatment course of the current patient, the osteolytic lesion quickly improved despite the continuous use of TKIs, even during the concomitant use of corticosteroids. This suggests that TKIs can be safely given with concomitant corticosteroids to children with Ph+ALL, even when osteolytic lesions are present.

DOI： 10.18926/AMO/65757

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Optimizing transplantation procedures through identification of prognostic factors in second remission for children with acute myeloid leukemia with no prior history of transplant. 査読国際誌

Hisashi Ishida, Shin-Ichi Tsujimoto, Daisuke Hasegawa, Hirotoshi Sakaguchi, Shohei Yamamoto, Masakatsu Yanagimachi, Katsuyoshi Koh, Akihiro Watanabe, Asahito Hama, Yuko Cho, Kenichiro Watanabe, Maiko Noguchi, Masanobu Takeuchi, Junko Takita, Kana Washio, Keisuke Kato, Takashi Koike, Yoshiko Hashii, Ken Tabuchi, Moeko Hino, Yoshiko Atsuta, Yasuhiro Okamoto

Haematologica 2023年7月

Efficient granulocyte collection method using high concentrations of medium molecular weight hydroxyethyl starch 査読

Takumi Kondo, Keiko Fujii, Nobuharu Fujii, Yuichi Sumii, Tomohiro Urata, Maiko Kimura, Masayuki Matsuda, Shuntaro Ikegawa, Kana Washio, Hideaki Fujiwara, Noboru Asada, Daisuke Ennishi, Hisakazu Nishimori, Ken‐ichi Matsuoka, Fumio Otsuka, Yoshinobu Maeda

Transfusion 2023年6月

Utility of Comprehensive Genomic Profiling for Precise Diagnosis of Pediatric-Type Diffuse High-Grade Glioma. 査読

Keigo Makino, Yoshihiro Otani, Kentaro Fujii, Joji Ishida, Shuichiro Hirano, Yasuki Suruga, Kana Washio, Kenji Nishida, Hiroyuki Yanai, Shuta Tomida, Daisuke Ennishi, Isao Date

Acta medica Okayama 77 ( 3 ) 323 - 330 2023年6月

記述言語：英語

In the current World Health Organization classification of central nervous system tumors, comprehensive genetic and epigenetic analyses are considered essential for precise diagnosis. A 14-year-old male patient who presented with a cerebellar tumor was initially diagnosed with glioblastoma and treated with radiation and concomitant temozolomide chemotherapy after resection. During maintenance temozolomide therapy, a new contrast-enhanced lesion developed in the bottom of the cavity formed by the resection. A second surgery was performed, but the histological findings in specimens from the second surgery were different from those of the first surgery. Although genome-wide DNA methylation profiling was conducted using frozen tissue for a precise diagnosis, the proportion of tumor cells was insufficient and only normal cerebellum was observed. We then performed comprehensive genetic analysis using formalin-fixed paraffin-embedded sections, which revealed MYCN amplification without alteration of IDH1, IDH2, or Histone H3. Finally, the patient was diagnosed with pediatric-type diffuse high-grade glioma, H3-wildtype and IDH-wildtype. In conclusion, comprehensive genetic and epigenetic analysis should be considered in pediatric brain tumor cases.

DOI： 10.18926/AMO/65502

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下大静脈腫瘍進展を伴った左腎明細胞肉腫の一例

谷本光隆, 野田卓男, 尾山貴徳, 宮田将徳, 鷲尾佳奈, 越智元春

日本小児泌尿器科学会雑誌 32 ( 2 ) 333 - 333 2023年6月

Three Cases of Down Syndrome with Transient Abnormal Myelopoiesis who Underwent Liver Biopsy before Induction of Low-Dose Cytarabine. 査読

Kana Washio, Kosuke Tamefusa, Motoharu Ochi, Kiichiro Kanamitsu, Hisashi Ishida, Kaori Fujiwara, Kenji Nishida, Kei Tamai, Yosuke Washio, Junko Yoshimoto, Takuo Noda, Hirokazu Tsukahara

Acta medica Okayama 77 ( 2 ) 215 - 220 2023年4月

担当区分：筆頭著者記述言語：英語

Among patients with transient abnormal myelopoiesis (TAM) associated with Down syndrome, approximately 20% die within 6 months from multiorgan failure, especially liver fibrosis. We experienced three children with TAM who had low white blood cell counts but increased bilirubin levels. Here, we discuss the detailed clinical courses of these patients, including the pathological findings of liver biopsies. Our cases, together with previous literature, suggest that liver biopsy can be performed safely and provides useful information, especially regarding disease activities, and that low-dose cytarabine is a reasonable option to prevent early death in TAM patients with liver dysfunction.

DOI： 10.18926/AMO/65153

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Posttransplant gilteritinib maintenance therapy for pediatric acute myeloid leukemia with myelodysplasia-related changes with FLT3-internal tandem duplication. 査読国際誌

Kosuke Tamefusa, Hisashi Ishida, Kiichiro Kanamitsu, Motoharu Ochi, Kaori Fujiwara, Yasuhisa Tatebe, Michinori Aoe, Seishiro Nodomi, Kana Washio

Pediatric blood & cancer 70 ( 4 ) e30108 2022年12月

Neonatal hemochromatosis with εγδβ-thalassemia: a case report and analysis of serum iron regulators. 国際誌

Mitsuru Tsuge, Aya Kodera, Hiromi Sumitomo, Tooru Araki, Ryuichi Yoshida, Kazuya Yasui, Hiroki Sato, Yosuke Washio, Kana Washio, Kenji Shigehara, Masato Yashiro, Takahito Yagi, Hirokazu Tsukahara

BMC pediatrics 22 ( 1 ) 622 - 622 2022年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Neonatal hemochromatosis causes acute liver failure during the neonatal period, mostly due to gestational alloimmune liver disease (GALD). Thalassemia causes hemolytic anemia and ineffective erythropoiesis due to mutations in the globin gene. Although neonatal hemochromatosis and thalassemia have completely different causes, the coexistence of these diseases can synergistically exacerbate iron overload. We report that a newborn with εγδβ-thalassemia developed neonatal hemochromatosis, which did not respond to iron chelators and rapidly worsened, requiring living-donor liver transplantation. CASE PRESENTATION: A 1-day-old Japanese boy with hemolytic anemia and targeted red blood cells was diagnosed with εγδβ-thalassemia by genetic testing, and required frequent red blood cell transfusions. At 2 months after birth, exacerbation of jaundice, grayish-white stool, and high serum ferritin levels were observed, and liver biopsy showed iron deposition in hepatocytes and Kupffer cells. Magnetic resonance imaging scans showed findings suggestive of iron deposits in the liver, spleen, pancreas, and bone marrow. The total amount of red blood cell transfusions administered did not meet the criteria for post-transfusion iron overload. Administration of an iron-chelating agent was initiated, but iron overload rapidly progressed to liver failure without improvement in jaundice and liver damage. He underwent living-donor liver transplantation from his mother, after which iron overload disappeared, and no recurrence of iron overload was observed. Immunohistochemical staining for C5b-9 in the liver was positive. Serum hepcidin levels were low and serum growth differentiation factor-15 levels were high prior to living-donor liver transplantation. CONCLUSIONS: We reported that an infant with εγδβ-thalassemia developed NH due to GALD, and that coexistence of ineffective erythropoiesis in addition to erythrocyte transfusions may have exacerbated iron overload. Low serum hepcidin levels, in this case, might have been caused by decreased hepcidin production arising from fetal liver damage due to neonatal hemochromatosis and increased hepcidin-inhibiting hematopoietic mediators due to the ineffective hematopoiesis observed in thalassemia.

DOI： 10.1186/s12887-022-03706-3

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