[Rinsho ketsueki] The Japanese journal of clinical hematology最新文献_第4页

[Advances in the treatment of thrombotic thrombocytopenic purpura]. [治疗血栓性血小板减少性紫癜的进展]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.567

Masahito Uchihara, Masayuki Kubo, Masanori Matsumoto

引用次数: 0

[Fulminant Clostridioides difficile infection during treatment with FLT3 inhibitor for acute myeloid leukemia]. [在使用 FLT3 抑制剂治疗急性髓性白血病期间出现难辨梭状芽孢杆菌感染】。］

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.153

Jotaro Yamamoto, Otoya Watanabe, Takashi Sako, Shinsuke Takagi, Daisuke Kaji, Yuki Taya, Aya Nishida, Hisashi Yamamoto, Yuki Asano-Mori, Go Yamamoto, Hideki Araoka, Naoyuki Uchida

{"title":"[Fulminant Clostridioides difficile infection during treatment with FLT3 inhibitor for acute myeloid leukemia].","authors":"Jotaro Yamamoto, Otoya Watanabe, Takashi Sako, Shinsuke Takagi, Daisuke Kaji, Yuki Taya, Aya Nishida, Hisashi Yamamoto, Yuki Asano-Mori, Go Yamamoto, Hideki Araoka, Naoyuki Uchida","doi":"10.11406/rinketsu.65.153","DOIUrl":"https://doi.org/10.11406/rinketsu.65.153","url":null,"abstract":"An 80-year-old man with FLT3-TKD mutation-positive acute myeloid leukemia (AML) relapsed during consolidation therapy with venetoclax/azacitidine and was started on gilteritinib as salvage therapy. On the day after treatment initiation, febrile neutropenia was observed, but the fever resolved promptly after initiation of antimicrobial therapy. On the fifth day after completion of antimicrobial therapy, the patient experienced fever and watery diarrhea over 10 times a day, and a diagnosis of Clostridioides difficile infection (CDI) was made based on stool examination. The patient was treated with intravenous metronidazole, but renal dysfunction, hypotension, and hypoxemia developed, and a CT scan showed pleural and intraperitoneal effusion, significant intestinal wall thickening, and intestinal dilatation. Fidaxomicin was started under general monitoring in the intensive care unit and response was achieved. The patient was discharged from the intensive care unit on the 18th day after the onset of CDI. We report this case not only due to the rarity of fulminant CDI during AML treatment, but also because it is a valuable example of effective treatment of fulminant CDI with fidaxomicin.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Supporting career development of female physicians and researchers]. [支持女医生和女研究员的职业发展]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.769

Mariko Eguchi

{"title":"[Supporting career development of female physicians and researchers].","authors":"Mariko Eguchi","doi":"10.11406/rinketsu.65.769","DOIUrl":"https://doi.org/10.11406/rinketsu.65.769","url":null,"abstract":"The proportion of female doctors among younger generations has increased in recent years, and support for reemployment after childbirth and childcare leave is important for maintaining stability of local healthcare. We conducted a questionnaire with doctors in the Department of Pediatrics at Ehime University School of Medicine and it's affiliated hospitals to identify issues in the career development of female doctors. Although many female physicians want to pursue career development by obtaining subspecialty qualifications and PhD degrees, a high percentage have not actually obtained them. This is not only due to interruptions in work caused by childbirth and childcare but also because they are busy with housework, childcare, and daily work, and lack sufficient information about career development. In this regard, it appears that beyond improving work-life balance, female doctors must always keep in mind their career design and future goals, as well as their social mission as a physician. For administrators of these departments, acceptance of diversity, providing adequate support for female physicians to return to work after maternity/childcare leave, and balancing childcare and work are important for expanding female doctors' opportunities and career development.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Future prospects for the development of novel agents for acute myeloid leukemia]. [开发治疗急性髓性白血病新型药物的未来前景]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.353

Naoko Hosono

引用次数: 0

[Current status and challenges of AML treatment with FLT3 inhibitors]. [FLT3抑制剂治疗急性髓细胞白血病的现状与挑战]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.684

Yuichi Ishikawa

{"title":"[Current status and challenges of AML treatment with FLT3 inhibitors].","authors":"Yuichi Ishikawa","doi":"10.11406/rinketsu.65.684","DOIUrl":"https://doi.org/10.11406/rinketsu.65.684","url":null,"abstract":"FLT3 mutation is one of the most frequent genetic mutations in AML, identified in approximately 30% of patients, and FLT3-ITD mutation is considered a poor prognostic factor. Based on these molecular and clinical backgrounds, FLT3 mutations are considered promising therapeutic targets in AML, and intensive development of targeted therapeutics has been ongoing for more than two decades. Recently, combination of FLT3 inhibitors with intensive chemotherapy for untreated AML patients with FLT3 mutations and FLT3 inhibitor monotherapy for relapsed/refractory patients have been approved. In Japan, the combination of quizartinib and intensive chemotherapy for untreated FLT3-ITD-positive AML was approved in 2023. Clinical use of FLT3 inhibitors shows strong promise for improving the clinical outcomes of these AML patients with an extremely poor prognosis. Meanwhile, various resistance mechanisms to FLT3 inhibitors have been identified, including the emergence of resistance-associated mutations, and attenuated inhibitory effects of FLT3 inhibitors involving the bone marrow microenvironment surrounding AML cells. Thus, future efforts should aim to optimize combination therapy based on the characteristics of each FLT3 inhibitor, develop biomarkers that could inform treatment selection, and to better understand these resistance mechanisms and develop methods for overcoming them.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Current state and future prospects of off-the-shelf allogeneic CAR NK therapy]. [现成的同种异体 CAR NK 疗法的现状和未来前景]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.668

Chihaya Imai

引用次数: 0

[Veno-venous extracorporeal membrane oxygenation for capillary leak syndrome during induction chemotherapy in acute myeloid leukemia]. [静脉-静脉体外膜氧合治疗急性髓性白血病诱导化疗期间的毛细血管渗漏综合征]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.169

Tadashi Okamura, Shogo Murata, Kyohei Miyamoto, Misato Tane, Yuka Okabe, Satomi Takeda, Shotaro Tabata, Hideki Kosako, Yoshikazu Hori, Yusuke Yamashita, Toshiki Mushino, Hiroki Hosoi, Takashi Sonoki

{"title":"[Veno-venous extracorporeal membrane oxygenation for capillary leak syndrome during induction chemotherapy in acute myeloid leukemia].","authors":"Tadashi Okamura, Shogo Murata, Kyohei Miyamoto, Misato Tane, Yuka Okabe, Satomi Takeda, Shotaro Tabata, Hideki Kosako, Yoshikazu Hori, Yusuke Yamashita, Toshiki Mushino, Hiroki Hosoi, Takashi Sonoki","doi":"10.11406/rinketsu.65.169","DOIUrl":"https://doi.org/10.11406/rinketsu.65.169","url":null,"abstract":"A 44-year-old woman was diagnosed with acute myeloid leukemia (RUNX1::RUNX1T1 translocation) and received induction chemotherapy with idarubicin hydrochloride and cytosine arabinoside. The pneumonia that had been present since admission worsened, and a drug-induced skin rash appeared. On day 17, she presented with respiratory failure and shock, complicated by hemoconcentration and hypoalbuminemia. This was considered capillary leak syndrome due to pneumonia and drug allergy, so she was started on pulse steroid therapy and IVIG, and was intubated on the same day. On day 18, venovenous-extracorporeal membrane oxygenation (VV-ECMO) was started due to worsening blood gas parameters despite ventilatory management. Bronchoalveolar lavage fluid was serous, and both blood and sputum cultures yielded negative. The patient was weaned from VV-ECMO on day 26 as the pneumonia improved with recovery of hematopoiesis. She was disoriented, and a CT scan on day 28 revealed cerebral hemorrhage. Her strength recovered with rehabilitation. After induction chemotherapy, RUNX1::RUNX1T1 mRNA was not detected in bone marrow. The patient received consolidation chemotherapy, and has maintained complete remission. Severe respiratory failure during induction chemotherapy for acute leukemia can be fatal, but VV-ECMO may be lifesaving.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Clostridioides difficile infection diagnosed by nucleic acid amplification test in a patient with Epstein-Barr Virus-related T-cell lymphoproliferative disorder]. [通过核酸扩增检验诊断出一名与爱泼斯坦-巴氏病毒相关的 T 细胞淋巴增生性疾病患者感染了艰难梭菌]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.732

Hideshige Seki, Megumi Yasunaga, Ken Morita, Mineo Kurokawa

{"title":"[Clostridioides difficile infection diagnosed by nucleic acid amplification test in a patient with Epstein-Barr Virus-related T-cell lymphoproliferative disorder].","authors":"Hideshige Seki, Megumi Yasunaga, Ken Morita, Mineo Kurokawa","doi":"10.11406/rinketsu.65.732","DOIUrl":"https://doi.org/10.11406/rinketsu.65.732","url":null,"abstract":"Steroid usage poses a risk of Clostridioides difficile infection (CDI), but high-dose corticosteroid treatment can lead to false-negative CD toxin test results. Moreover, CDI-induced nausea can complicate administration of oral antibiotics, which are typically the primary therapy for CDI. In the present case, a 43-year-old woman diagnosed with EBV-associated T-cell post-transplant lymphoproliferative disorder developed CDI during treatment with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). Following five cycles of CHOP, the patient presented with nausea and diarrhea. CT scans revealed swelling in the ileocecal to transverse area of the colon. While the glutamate dehydrogenase (GDH) antigen test result was positive, the CD toxin test result was negative. However, the nucleic amplification test (NAAT) result was positive, confirming the diagnosis of CDI. Oral treatment with fidaxomicin was initially impractical due to persistent nausea. Instead, treatment began with intravenous metronidazole, and was later switched to fidaxomicin pills. Symptoms improved notably within 10 days, and the patient ultimately made a complete recovery. This case underscores the significance of exploring alternative approaches to CDI management, particularly in immunosuppressed patients.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Histiocytic sarcoma derived from the same origin as splenic marginal zone lymphoma revealed by exome analysis]. [通过外显子组分析发现与脾边缘区淋巴瘤同源的组织细胞肉瘤]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.737

Daiki Komata, Mutsumi Takahata, Yoshinori Makino, Takashi Ishio, Hiroshi Iwasaki, Shin Ichihara, Masumi Tsuda, Shinya Tanaka, Makoto Ibata

{"title":"[Histiocytic sarcoma derived from the same origin as splenic marginal zone lymphoma revealed by exome analysis].","authors":"Daiki Komata, Mutsumi Takahata, Yoshinori Makino, Takashi Ishio, Hiroshi Iwasaki, Shin Ichihara, Masumi Tsuda, Shinya Tanaka, Makoto Ibata","doi":"10.11406/rinketsu.65.737","DOIUrl":"https://doi.org/10.11406/rinketsu.65.737","url":null,"abstract":"Histiocytic sarcoma (HS) is a rare aggressive hematological malignancy reported to occur secondary to B cell lymphoma. We report a case of HS secondary to splenic marginal zone lymphoma (SMZL) complicated by autoimmune hemolytic anemia (AIHA) in a 64-year-old man. He was referred to our department with anemia and was diagnosed as having AIHA. After starting treatment with prednisolone, atypical lymphocytes appeared in his blood tests, and a bone marrow biopsy revealed invasion by B cell lymphoma. A CT scan showed splenomegaly and a pancreatic mass, which confirmed the diagnosis of SMZL. The patient received bendamustine and rituximab as chemotherapy, which rapidly improved the anemia and splenomegaly and reduced atypical lymphocytes. However, left lumbar back pain appeared along with an increase in the pancreatic mass, and he died suddenly of acute renal failure. An autopsy revealed that the tumor had invaded several organs including the pancreas, and immunohistochemistry was positive for CD163, leading to the diagnosis of HS. Furthermore, the specimens of SMZL and HS were positive for IgH gene reconstitution, and exome analysis showed genetic abnormalities in 226 genes including CARD11, suggesting that the SMZL and HS had the same origin.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Successful induction therapy for acute myeloid leukemia under management with extracorporeal membrane oxygenation]. [使用体外膜氧合技术成功诱导治疗急性髓性白血病]。

[Rinsho ketsueki] The Japanese journal of clinical hematology Pub Date : 2024-01-01 DOI: 10.11406/rinketsu.65.330

Yusuke Takaki, Toshiyuki Yanai, Tatsuhiro Shibata, Takehiro Honma, Maki Otsuka, Yoshitaka Yamasaki, Shuki Oya, Takayuki Nakamura, Yoshimi Maehiro, Maki Yamaguchi, Kazutoshi Aoyama, Fumihiko Mouri, Yoshihiro Fukumoto, Koji Nagafuji

{"title":"[Successful induction therapy for acute myeloid leukemia under management with extracorporeal membrane oxygenation].","authors":"Yusuke Takaki, Toshiyuki Yanai, Tatsuhiro Shibata, Takehiro Honma, Maki Otsuka, Yoshitaka Yamasaki, Shuki Oya, Takayuki Nakamura, Yoshimi Maehiro, Maki Yamaguchi, Kazutoshi Aoyama, Fumihiko Mouri, Yoshihiro Fukumoto, Koji Nagafuji","doi":"10.11406/rinketsu.65.330","DOIUrl":"10.11406/rinketsu.65.330","url":null,"abstract":"A 53-year-old woman presented with shortness of breath and hyperleukocytosis and was admitted to our hospital. Shortly after, she went into cardiopulmonary arrest and was resuscitated. Her white blood cell count was 566,000/µl, with 94.5% cup-like blasts positive for MPO staining and FLT3-ITD positive, so she was diagnosed with acute myeloid leukemia (AML) M1. She also had disseminated intravascular coagulation and tumor lysis syndrome. Extracorporeal membrane oxygenation (ECMO) was started to manage bilateral pulmonary thromboembolism that had developed due to deep vein thrombosis, and induction therapy was performed under ECMO. On the third day of illness, the patient developed cerebral hemorrhage. Hematological remission was confirmed on the 39th day of illness. After consolidation therapy with chemotherapy and an FLT3 inhibitor, she underwent allogeneic hematopoietic stem cell transplantation, and remains alive. Case reports suggest strong evidence of mortality benefit from ECMO in patients with hematologic malignancies, particularly when ECMO served as a bridge through chemotherapy. Our patient suffered from cardiopulmonary arrest due to hyperleukocytosis and pulmonary thromboembolism, but was saved by induction of remission under ECMO. Improvements in supportive care should lead to reduction in early deaths during induction therapy.","PeriodicalId":93844,"journal":{"name":"[Rinsho ketsueki] The Japanese journal of clinical hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0