Details of a Researcher - Sakurai, Masatoshi

Papers - Sakurai, Masatoshi

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Impact of immunoglobulin G2 subclass level on late-onset bacterial infection after allogeneic hematopoietic stem cell transplantation

Yamazaki R., Kato J., Koda Y., Sakurai M., Tozawa K., Okayama M., Nakayama H., Watanuki S., Kikuchi T., Hasegawa N., Okamoto S., Mori T.

Transplant Infectious Disease (Transplant Infectious Disease) 21 ( 3 ) 2019.06

ISSN 13982273

Background: Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria and is found mostly in pediatric patients. However, its impact after allogeneic hematopoietic stem cell transplantation (HSCT) has not been fully assessed. Methods: We retrospectively evaluated the relationship between IgG2 subclass levels and bacterial pneumonia in 74 adult patients who survived longer than 2 years after allogeneic HSCT. Results: During the evaluation period, nine patients developed bacterial pneumonia. The median IgG2 level was significantly lower in patients with an infectious episode than in those without (143 mg/dL vs 287 mg/dL; P < 0.01). In multivariate analysis, a history of rituximab therapy and cord blood as a stem cell source were significantly associated with decreased levels of both IgG2 and IgG2/IgG ratios (P < 0.05). Conclusions: Suboptimal serum IgG2 levels could increase susceptibility to late-onset bacterial pneumonia after allogeneic HSCT. IgG2 levels should be considered carefully, especially in patients receiving cord blood transplantation and/or rituximab treatment.

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Renal dysfunction and anemia associated with long-term imatinib treatment in patients with chronic myelogenous leukemia

Sakurai M., Kikuchi T., Karigane D., Kasahara H., Matsuki E., Hashida R., Yamane Y., Abe R., Koda Y., Toyama T., Kato J., Shimizu T., Yokoyama Y., Suzuki S., Nakamura T., Okamoto S., Mori T.

International Journal of Hematology (International Journal of Hematology) 109 ( 3 ) 292 - 298 2019.03

ISSN 09255710

© 2019, Japanese Society of Hematology. Knowledge of the toxicity profile of long-term treatment with imatinib is limited. In the present study, we sought to evaluate renal function and hemoglobin levels during long-term imatinib treatment. Eighty-two patients with chronic myelogenous leukemia in chronic phase who had been on imatinib for over 5 years were retrospectively analyzed. The mean estimated glomerular filtration rate (eGFR) was significantly decreased over 5 years (77 ± 17 to 62 ± 14 ml/min/1.73m², P < 0.001). Higher age and lower eGFR value at initiation of imatinib were significantly associated with development of renal dysfunction by multivariate analyses. Mean hemoglobin levels also significantly decreased over the 5-year period (12.9 ± 1.7 to 12.4 ± 1.3 g/dl, P < 0.01). The rate of decrease in eGFR correlated significantly with hemoglobin levels (correlation coefficient = − 0.249, P < 0.05). Serum erythropoietin (EPO) levels did not increase in 16 patients with both renal dysfunction and anemia (median, 31.9 mIU/ml). In patients who participated in a clinical trial of imatinib discontinuation, mean eGFR (50.0 ± 6.5 to 56.0 ± 10.2 ml/min/1.73m², P < 0.05) and hemoglobin levels (12.0 ± 1.7 to 14.0 ± 1.6 g/dl, P < 0.01) improved significantly at 1 year after discontinuation. These findings suggest that long-term imatinib results in a partially reversible continuous decline in renal function and decreased hemoglobin levels.

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Geriatric screening tools predict survival outcomes in older patients with diffuse large B cell lymphoma

Sakurai M., Karigane D., Kasahara H., Tanigawa T., Ishida A., Murakami H., Kikuchi M., Kohashi S.

Annals of Hematology (Annals of Hematology) 98 ( 3 ) 669 - 678 2019.03

ISSN 09395555

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. The proportion of elderly patients with diffuse large B cell lymphoma (DLBCL) appears to be increasing, with outcomes varying widely because of the patients’ heterogeneity. Geriatric assessment is used to predict prognosis in elderly patients with DLBCL, but the utility of two simple screening tools for patients with DLBCL, the Flemish version of the Triage Risk Screening Tool (fTRST) and G8, has remained to be elucidated. We retrospectively assessed patients using fTRST and G8, and evaluated the impacts of the scores on survival outcomes in older patients with newly diagnosed DLBCL. A total of 59 patients aged 65 years or older and who were diagnosed with DLBCL were included. The median age was 77 years (range, 65–91 years), and the initial treatments were R-CHOP (63%) and R-THPCOP (31%). The estimated 2-year overall survival (OS) rate was significantly lower in patients with abnormal fTRST scores (≥ 2; N = 17) than in those with normal fTRST scores (< 2; N = 42): (50.5% (95% CI, 22.7–73.0%) vs. 82.2% (95% CI, 63.8–91.8%), P = 0.007). The estimated 2-year OS rate was significantly lower also in patients with abnormal G8 scores (≤ 14; N = 38) than in those with normal G8 scores (> 14; N = 21): (66.1% (95% CI, 46.7–79.5%) vs. 86.8% (95% CI, 55.7–96.7%), P = 0.03, respectively). These associations were independently significant after adjusting for other significant factors by multivariate analysis. These results suggest that the easy-to-use geriatric screening tools, fTRST and G8, have strong prognostic value for OS in older patients with DLBCL.

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Invasive hepatic mucormycosis: A case report and review of the literature

Karigane D., Kikuchi T., Sakurai M., Kato J., Yamane Y., Hashida R., Abe R., Hatano M., Hasegawa N., Wakayama M., Shibuya K., Okamoto S., Mori T.

Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy) 25 ( 1 ) 50 - 53 2019.01

ISSN 1341321X

© 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases Mucormycosis generally develops under immunocompromised conditions, including hematological malignancies and solid organ or hematopoietic stem cell transplantation. Although mucormycosis usually affects the lungs and paranasal sinuses, sporadic cases of invasive mucormycosis of the liver have been reported. We hereby report a patient with myelofibrosis who developed hepatic mucormycosis diagnosed by post-mortem examination. An extensive literature review identified 13 reported cases of hepatic mucormycosis, including ours, without lung involvement. Most of the underlying diseases or conditions were hematological malignancies and solid organ transplantation. Three cases had splenic lesions and four had gastrointestinal lesions, suggesting the possibility of translocation to the liver and/or spleen from the gastrointestinal tracts. Hepatic mucormycosis should be recognized as one of the presentations of invasive mucormycosis, especially when hepatic nodules are found in immunocompromised patients such as those with hematological malignancy or recipients of solid organ transplantation.

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Successful Steroid Therapy for Lipoid Pneumonia Developing After Allogeneic Hematopoietic Stem Cell Transplant: A Case Report

Sakurai M., Kato J., Toyama T., Hashida R., Yamane Y., Abe R., Koda Y., Kohashi S., Kikuchi T., Hayashi Y., Nukaga S., Ueda S., Fukunaga K., Okamoto S., Mori T.

Transplantation Proceedings (Transplantation Proceedings) 50 ( 10 ) 4096 - 4098 2018.12

ISSN 00411345

© 2018 Elsevier Inc. Lipoid pneumonia is an uncommon noninfectious inflammatory lung disease characterized by lipid deposition in the alveoli, and its etiology and treatment have not been elucidated. We report the case of a 32-year-old woman who developed lipoid pneumonia 9 months after allogeneic hematopoietic stem cell transplant for chronic myelogenous leukemia in lymphoid blast crisis. She complained of progressive cough and dyspnea shortly after discontinuation of immunosuppressive therapy given for graft-vs-host disease. Computed tomography demonstrated diffuse ground-glass opacities in the lungs, and pulmonary function test revealed restrictive impairment. Bronchoalveolar lavage fluid showed milky appearance, and transbronchial lung biopsy specimen revealed foamy macrophages infiltrating the alveoli. Based on these findings, she was diagnosed as having lipoid pneumonia. Prednisolone (1 mg/kg/d) promptly improved the symptoms, pulmonary shadows, and pulmonary function. The findings and clinical course of this case suggest that lipoid pneumonia should be recognized as one of the pulmonary complications of allogeneic hematopoietic stem cell transplantation.

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Very Late Relapse of Acute Promyelocytic Leukemia 17 Years after Continuous Remission

Sakurai M., Watanuki S., Kato J., Hashida R., Yamane Y., Karigane D., Mitsuhashi T., Murata M., Ueno H., Nakazato T., Okamoto S., Mori T.

Internal medicine (Tokyo, Japan) (Internal medicine (Tokyo, Japan)) 57 ( 22 ) 3299 - 3302 2018.11

ISSN 09182918

The prognosis of acute promyelocytic leukemia (APL) has been improved by the combination of all-trans retinoic acid (ATRA) with chemotherapy. Nonetheless, relapse occurs in a certain proportion of patients, mostly within three to four years after treatment. We herein report a patient treated with ATRA and chemotherapy achieving remission who relapsed approximately 17 years after the treatment. A literature review identified 5 additional reported cases of APL relapse after more than 10 years. None of them presented with generally established risk factors for relapse, such as a high leukocyte count. The potential for late relapse of APL occurring more than 10 years after treatment should be recognized.

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Recurrent bacterial pneumonia due to immunoglobulin G2 subclass deficiency after allogeneic hematopoietic stem cell transplantation: Efficacy of immunoglobulin replacement

Yamazaki R., Kikuchi T., Kato J., Sakurai M., Koda Y., Hashida R., Yamane Y., Abe R., Hasegawa N., Okamoto S., Mori T.

Transplant Infectious Disease (Transplant Infectious Disease) 20 ( 3 ) 2018.06

ISSN 13982273

© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Immunoglobulin (Ig) G2 subclass deficiency is known to be associated with recurrent bacterial respiratory infections caused by capsulated bacteria. We encountered a case of recurrent pneumonia due to Streptococcus pneumoniae after allogeneic hematopoietic stem cell transplantation (HSCT). IgG2 subclass level was specifically low, and prophylactic Ig replacement successfully prevented subsequent infections. However, the cessation of Ig replacement resulted in subsequent pneumonia. These findings suggested that IgG2 deficiency could be a cause of recurrent pneumococcal infection after allogeneic HSCT.

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Successful treatment of breakthrough disseminated Trichosporon asahii fungemia in a patient with acute myeloid leukemia receiving itraconazole prophylaxis

Karigane D., Sakurai M., Matsuyama E., Ide K., Yamamoto-Takeuchi S., Inazumi T., Kohashi S.

Medical Mycology Case Reports (Medical Mycology Case Reports) 20 1 - 3 2018.06

ISSN 22117539

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Comparison of fluorine-18 fluorodeoxyglucose positron emission tomography with gallium-67 scintigraphy in the initial clinical staging of diffuse large B-cell lymphoma

Sakurai M., Toyama T., Kikuchi T., Kato J., Shimizu T., Koda Y., Karigane D., Yamane Y., Abe R., Yamazaki R., Nakazato T., Nakahara T., Jinzaki M., Okamoto S., Mori T.

International Journal of Hematology (International Journal of Hematology) 107 ( 2 ) 194 - 200 2018.02

ISSN 09255710

© 2017, The Japanese Society of Hematology. Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been recommended as a complementary tool for the staging of various malignancies, including malignant lymphoma. PET findings often shift patients to higher stages and may affect treatment outcomes. In this study, we retrospectively compared staging and treatment outcomes of newly diagnosed diffuse large B-cell lymphoma (DLBCL) assessed by PET (n = 153) or gallium-67 scintigraphy (Ga) (n = 95). In total, Ga upstaged two (2.1%) of 95 patients, whereas PET upstaged 13 (8.5%) of 153 patients. Bone/bone marrow (15 vs. 4%, P = 0.01) and muscle lesion (5 vs. 0%, P = 0.03) were identified more frequently in the PET group than in the Ga group. The estimated 3-year overall and progression-free survival rates did not differ significantly in the two groups at any stage. However, patients with stage III disease tended to have better progression-free survival in the PET group than in the Ga group [92.3 (95% CI 56.6–98.9%) vs. 58.3% (95% CI 27.0–80.1%), P = 0.086]. These results suggest that PET has a greater potential in detecting musculoskeletal lesions of DLBCL as extranodal lesions than Ga, and may contribute to the optimal staging.

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Sinusitis caused by Exserohilum rostratum after cord blood transplantation for myelodysplastic syndrome: A case report and literature review

Kohashi S., Toyama T., Hashimoto N., Sakurai M., Kato J., Kikuchi T., Koda Y., Sugita K., Hasegawa N., Yarita K., Kamei K., Okamoto S., Mori T.

Transplant Infectious Disease (Transplant Infectious Disease) 20 ( 1 ) 2018.02

ISSN 13982273

© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Invasive fungal disease is a serious infectious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Exserohilum rostratum is a species causing phaeohyphomycosis, which rarely causes invasive disease in humans. We treated a case of sinusitis caused by E. rostratum after cord blood transplantation (CBT). A 60-year-old man with myelodysplastic syndrome, who had a medical history of an operation to correct deviation of the nasal septum, developed sinusitis caused by E. rostratum under prolonged profound neutropenia after a second CBT because of the graft rejection of the first transplantation. Liposomal amphotericin B improved the sinusitis. A literature review revealed nine reported cases of sinusitis caused by E. rostratum, including our case. Although five cases had severe neutropenia at onset (HSCT recipients, n = 2; aplastic anemia, n = 3), the remaining four had no preexisting immunosuppressive conditions. However, three of the four patients had preexisting nasal diseases with or without a history of surgery, as in our case. Excluding our case, the outcome was fatal in five neutropenic patients, whereas the four patients without neutropenia recovered. Although sinusitis caused by E. rostratum is rare, E. rostratum should be recognized as a possible pathogen causing sinusitis in highly immunosuppressed patients such as HSCT recipients. Preexisting nasal disease and/or nasal surgery could be risks for this infection.

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Impaired hematopoietic differentiation of RUNX1-mutated induced pluripotent stem cells derived from FPD/AML patients.

Sakurai M, Kunimoto H, Watanabe N, Fukuchi Y, Yuasa S, Yamazaki S, Nishimura T, Sadahira K, Fukuda K, Okano H, Nakauchi H, Morita Y, Matsumura I, Kudo K, Ito E, Ebihara Y, Tsuji K, Harada Y, Harada H, Okamoto S, Nakajima H.

Leukemia 28 ( 12 ) 2344 - 2354 2014.12

Research paper (scientific journal), Single Work

Tet2-mutated myeloid progenitors possess aberrant in vitro self-renewal capacity.

Kunimoto H, Fukuchi Y, Sakurai M, Takubo K, Okamoto S, Nakajima H.

Blood 123 ( 18 ) 2897 - 2899 2014.05

Research paper (scientific journal), Joint Work

Efficacy of aprepitant in preventing nausea and vomiting due to high-dose melphalan-based conditioning for allogeneic hematopoietic stem cell transplantation.

Sakurai M, Mori T, Kato J, Koda Y, Kikuchi T, Kohashi S, Saburi M, Toyama T, Aisa Y, Nakazato T, Beppu N, Tsuda S, Shigematsu N, Okamoto S.

International journal of Hematology 99 ( 4 ) 457 - 462 2014.04

Research paper (scientific journal), Single Work

Direct reprogramming of terminally differentiated B cells into erythroid lineage.

Sadahira K, Fukuchi Y, Kunimono H, Sakurai M, Ikeda Y, Okamoto S, Nakajima H.

FEBS Letters 586 ( 20 ) 3645 - 3652 2012.10

Research paper (scientific journal), Joint Work

Drug interaction between voriconazole and tacrolimus and its association with the bioavailability of oral voriconazole in recipients of allogeneic hematopoietic stem cell transplantation.

Mori T, Kato J, Yamane A, Sakurai M, Kohashi S, Kikuchi T, Ono Y, Okamoto S.

International Journal of Hematology 95 ( 5 ) 564 - 569 2012.05

Research paper (scientific journal), Joint Work

Tet2 disruption leads to enhanced self-renewal and altered differentiation of fetal liver hematopoietic stem cells.

Kunimoto H, Fukuchi Y, Sakurai M, Sadahira K, Ikeda Y, Okamoto S, Nakajima H.

Scientific Reports 2 273 2012.02

Research paper (scientific journal), Joint Work

Hypotension due to the drug interaction of voriconazole with eplerenone and nifedipine.

Kato J, Mori T, Nakamura Y, Sakurai M, Aisa Y, Ikeda Y, Okamoto S.

European Journal of Clinical Pharmacology 65 ( 3 ) 323 - 324 2009.03

Research paper (scientific journal), Joint Work

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