Faculty Profiles - MAEDA Yoshinobu

Vigorous inflammatory responses in noninfectious pulmonary complication induced by donor lymphocyte infusion

Miyuki Nishie, Nobuharu Fujii, Yusuke Mimura, Takeru Asano, Yuka Mimura-Kimura, Keisuke Aoe, Michinori Aoe, Hiromi Nakashima, Hideaki Fujiwara, Hisakazu Nishimori, Ken-Ichi Matsuoka, Eisei Kondo, Yoshinobu Maeda, Mitsune Tanimoto

TRANSFUSION 56 ( 1 ) 231 - 236 2016.1

Language：English Publisher：WILEY-BLACKWELL

BACKGROUNDDonor lymphocyte infusion (DLI) is used for treatment of hematologic malignancy relapse or mixed chimerism after allogeneic hematopoietic stem cell transplantation. Although graft-versus-host disease is well recognized as one of the adverse effects of DLI, there are limited reports on noninfectious pulmonary complications (NIPCs) after DLI.
CASE REPORTA 55-year-old woman with acute myeloid leukemia received DLI for conversion from recipient predominant to complete donor chimerism on Day +193 after allogeneic HSCT. Eight weeks later, she complained of dyspnea with fever; chest computed tomography revealed diffuse, bilateral, ground glass opacity and reticular appearance. She was diagnosed as having NIPC based on serum and bronchoalveolar lavage fluid (BALF) findings. She was successfully treated with prednisolone (PSL) and completely recovered.
DISCUSSIONWe analyzed the cell profile from the BALF and 27 cytokines and chemokines in the serum using the Bio-Plex platform. The cells consisted of recipient predominant macrophages and T cells. The serum cytokine and chemokine profile showed significant elevation of interleukin (IL)-1, IL-6, IL-8, tumor necrosis factor-, macrophage inflammatory protein (MIP)-1, and MIP-1, which declined with the improvement of symptoms after initiation of PSL treatment.
CONCLUSIONInflammatory effectors by recipient cells, rather than allogeneic responses by donor cells, played an important role in the pathogenesis of NIPCs after DLI in the present case.

DOI： 10.1111/trf.13283

Vigorous inflammatory responses in noninfectious pulmonary complication induced by donor lymphocyte infusion International journal

TRANSFUSION 56 ( 1 ) 231 - 236 2016.1

Language：English Publisher：WILEY-BLACKWELL

DOI： 10.1111/trf.13283

当院における65歳以上の高齢者同種造血幹細胞移植31例の検討

三道康永, 清家圭介, 猪股知子, 中村真, 廻勇輔, 吉田将平, 西森久和, 松岡賢市, 近藤英生, 藤井伸治, 前田嘉信, 谷本光音

日本造血細胞移植学会総会プログラム・抄録集 38th 2016

造血幹細胞移植期間中に下唇に発症した深在性真菌症に対する多職種連携による対応と経過-歯科衛生士の立場から

志茂加代子, 工藤値英子, 工藤値英子, 曽我賢彦, 佐伯恭昌, 佐伯恭昌, 橋本倫子, 高橋郁名代, 前田嘉信, 前田嘉信, 三浦留美, 岩月啓氏, 谷本光音, 谷本光音, 高柴正悟

日本造血細胞移植学会総会プログラム・抄録集 38th 2016

A New Prognostic Model for Elderly Patients with Diffuse Large B-Cell Lymphoma Treated with R-CHOP

Katsuhiro Miura, Jun Konishi, Takaaki Miyake, Makita Masanori, Atsuko Hojo, Yasufumi Masaki, Masatoshi Uno, Jun Ozaki, Chikamasa Yoshida, Daigo Niiya, Koichi Kitazume, Yoshinobu Maeda, Jun Takizawa, Rika Sakai, Yuichiro Nawa, Tomofumi Yano, Kazuhiko Yamamoto, Kazutaka Sunami, Yasushi Hiramatsu, Kazutoshi Aoyama, Hideki Tsujimura, Yoshihiro Hatta, Masatoshi Kanno

BLOOD 126 ( 23 ) 2015.12

Recombinant Thrombomodulin for the Treatment of Transplantation-Associated Coagulopathy after Allogeneic Hematopoietic Stem Cell Transplantation: A Multi-Center Study in Japan

Kazuyoshi Ishii, Shosaku Nomura, Shinya Fujita, Atushi Satake, Tomoki Ito, Yuta Katayama, Taiichi Kyo, Shuichi Ota, Masanori Seki, Shigeru Chiba, Yoshinobu Maeda, Mitsune Tanimoto, Takayuki Ikezoe, Hideo Yagi, Kunio Hayashi, Yoji Ishida, Naohito Fujishima, Kenichi Sawada, Masaya Okada, Hiroyasu Ogawa

BLOOD 126 ( 23 ) 2015.12

Primary Duodenal Follicular Lymphoma Treated With Rituximab Monotherapy and Followed-up for 15 Years

Anna Seki, Masaya Iwamuro, Masao Yoshioka, Nobuharu Fujii, Hiroyuki Okada, Soichiro Nose, Katsuyoshi Takata, Tadashi Yoshino, Kazuhide Yamamoto

ACTA MEDICA OKAYAMA 69 ( 5 ) 301 - 306 2015.10

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

A 41-year-old woman was diagnosed with duodenal follicular lymphoma. She had no other lesions and was assigned to a "watch and wait" policy. Swelling of the inguinal lymph nodes appeared 45 months later, and rituximab monotherapy resulted in complete remission. However, follicular lymphoma recurred in the stomach, rectum and mesenteric and external iliac lymph nodes 81 months after the therapy. The patient received rituximab monotherapy again and has remained in complete remission in the fifteenth year after the initial diagnosis. This case suggests the usefulness of rituximab monotherapy in the long-term management of intestinal follicular lymphoma.

DOI： 10.18926/AMO/53676

小・中・高生へのがん教育の現状と今後

西森久和, 前田嘉信, 谷本光音

日本癌学会総会記事 74回 J - 1307 2015.10

初発IV期および再発・難治の節外性NK/T細胞リンパ腫鼻型に対するSMILE療法第II相試験の5年追跡結果

鈴木律朗, Kwong Yok-Lam, 前田嘉信, 酒井リカ, Kim Won Seog, Suh Chulwon, 伊豆津宏二, 中村栄男, 鈴宮淳司, 山口素子

日本癌学会総会記事 74回 IS2 - 7 2015.10

Prognostic model for mantle cell lymphoma in the rituximab era: a nationwide study in Japan International journal

Dai Chihara, Naoko Asano, Ken Ohmachi, Tomohiro Kinoshita, Masataka Okamoto, Yoshinobu Maeda, Ishikazu Mizuno, Kosei Matsue, Toshiki Uchida, Hirokazu Nagai, Momoko Nishikori, Shigeo Nakamura, Michinori Ogura, Ritsuro Suzuki

BRITISH JOURNAL OF HAEMATOLOGY 170 ( 5 ) 657 - 668 2015.9

Language：English Publisher：WILEY-BLACKWELL

Mantle cell lymphoma (MCL) is essentially incurable with conventional chemotherapy. The MCL International Prognostic Index (MIPI) is a validated specific prognostic index, but was derived from patients with advanced-stage disease primarily in the pre-rituximab era. We analysed 501 MCL patients (median age, 67years; range 22-90) treated with rituximab-containing chemotherapy, and evaluated the prognostic factors adjusted by the treatment. Five-year overall survival (OS) in the low, intermediate and high MIPI groups was 74%, 70% and 35%, respectively. Additional to MIPI risk factors, multivariate analysis revealed that low serum albumin and bone-marrow involvement were also significantly associated with a poor outcome. The revised-MIPI (R-MIPI) was constructed using six factors, namely age, performance status, white blood cell count, serum lactate dehydrogenase, bone-marrow involvement and serum albumin, which is divided into four prognostic groups. Five-year OS in low, low-intermediate (L-I), high-intermediate (H-I) and high R-MIPI groups was 92%, 75%, 61% and 19%, respectively. Hazard ratio for OS of L-I, H-I and high risk to low risk patients were 54, 83 and 330, respectively. R-MIPI, a new prognostic index with easy application to the general patient population, shows promise for identifying low- and high-risk MCL patients in the rituximab era.

DOI： 10.1111/bjh.13486

Serum level of soluble interleukin-2 receptor correlates with CD25 expression in patients with T lymphoblastic lymphoma International journal

Tomohiro Toji, Katsuyoshi Takata, Yasuharu Sato, Tomoko Miyata-Takata, Eiko Hayashi, Toshiyuki Habara, Yoshinobu Maeda, Mitsune Tanimoto, Tadashi Yoshino

JOURNAL OF CLINICAL PATHOLOGY 68 ( 8 ) 622 - 627 2015.8

Language：English Publisher：BMJ PUBLISHING GROUP

Acute lymphoblastic leukaemia/lymphoma (ALL/LBL) is an aggressive form of non-Hodgkin's lymphoma (NHL) affecting B-cells or T-cells, respectively. The serum level of soluble interleukin-2 receptor (sIL-2R) is known to reflect the immune activity and tumour volume in aggressive NHL; however, the release of sIL-2R in LBL has not been extensively studied. Further, the relationship between sIL-2R release and the expression level of IL-2R alpha subunit (CD25) remains unknown.
In the present study, we examined the serum level of sIL-2R in 23 patients with T lymphoblactic lymphoma (T-LBL) and compared these with the levels in 20 patient with T acute lymphoblastic leukaemia (T-ALL), 40 patients with diffuse large B-cell lymphoma (DLBCL) and 40 patients with peripheral T-cell lymphoma (PTCL), not otherwise specified. The release of sIL-2R into the serum in patients with T-LBL was significantly lower than that for T-ALL, DLBCL and PTCL (p<0.001).
Immunohistochemistry revealed that CD25 expression was correlated with the serum level of sIL-2R in T-LBL (p=0.0069), whereas no correlation was found to exist between serum sIL-2R levels and CD25 expression in patients with DLBCL (p=0.348) and PTCL (p=0.266). Furthermore, double immunohistochemical analysis revealed that CD25-positive cells were also found to be Foxp3-positive non-neoplastic T-cells. In conclusion, CD25-positive non-neoplastic T-cells in T-LBL are presumed to be the primary source of sIL-2R, and the low number of cells present results in a lower level of sIL-2R released into the serum compared with the other aggressive and highly aggressive lymphomas.

DOI： 10.1136/jclinpath-2015-202934

Unmanipulated Haploidentical Reduced-Intensity Stem Cell Transplantation Using Fludarabine, Busulfan, Low-Dose Antithymocyte Globulin, and Steroids for Patients in Non-Complete Remission or at High Risk of Relapse: A Prospective Multicenter Phase I/II Study in Japan. International journal

Kazuhiro Ikegame, Takashi Yoshida, Satoshi Yoshihara, Takashi Daimon, Hiroaki Shimizu, Yoshinobu Maeda, Yasunori Ueda, Katsuji Kaida, Shinichi Ishii, Kyoko Taniguchi, Masaya Okada, Hiroya Tamaki, Hirokazu Okumura, Hiroyasu Kaya, Toshiro Kurokawa, Yoshihisa Kodera, Shuichi Taniguchi, Yoshinobu Kanda, Hiroyasu Ogawa

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 21 ( 8 ) 1495 - 505 2015.8

Language：English

This prospective, multicenter phase I/II study of unmanipulated HLA-haploidentical reduced-intensity stem cell transplantation using a low dose of anti-T lymphocyte globulin (ATG) and steroid was conducted in 5 institutions in Japan. Thirty-four patients with hematologic malignancies who were in an advanced stage or at a high risk of relapse at the time of transplantation were enrolled. Among them, 7 patients underwent transplantation as a second transplantation because of relapse after the previous allogeneic stem cell transplantation. The conditioning regimen consisted of fludarabine, busulfan, and ATG (Fresenius, 8 mg/kg), and graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus and methylprednisolone (1 mg/kg). All patients except 1 (97.1%) achieved donor-type engraftment. Rapid hematopoietic engraftment was achieved, with neutrophils > .5 × 10(9)/L on day 11 and platelets > 20 × 10(9)/L on day 17.5. Treatment was started for ≥grade I GVHD, and the cumulative incidences of acute grade I and grade II to IV GVHD were 27.5% and 30.7%, respectively. The incidence of chronic GVHD (extensive type) was 20%. Fourteen patients (41.2%) had a relapse. The cumulative incidence of transplantation-related mortality at 1 year after transplantation was 26.5%. The survival rate at day 100 was 88.2%. The survival rates at 1 year for patients with complete remission (CR)/chronic phase (n = 8) and non-CR (n = 26) status before transplantation were 62.5% and 42.3%, respectively. In the multivariate analysis, non-CR status before transplantation was the only factor significant prognostic factor of increased relapse (P = .0424), which tended to be associated with a lower survival rate (P = .0524). This transplantation protocol is safe and feasible, if a suitable donor is not available in a timely manner. As the main cause of death was relapse and not GVHD, more intensified conditioning or attenuation of GVHD prophylaxis and/or donor lymphocyte infusion may be desirable for patients with non-CR status.

DOI： 10.1016/j.bbmt.2015.04.012