Tanosaki, Ryuji

写真a

Affiliation

School of Medicine, Center for Transfusion Medicine and Cell Therapy (Shinanomachi)

Position

Professor

External Links

 

Research Areas 【 Display / hide

  • Hematology

Research Keywords 【 Display / hide

  • transfusion, hematology, cell therapy, hematopoietic stem cell transplantation, ATL

Research Themes 【 Display / hide

  • Blood requirement in minimally invasive cardiac surgery, 

    2016.08
    -
    2017.07

  • Establishment of infrastructure for processing, storage and quality management of cells used for hematopoietic stem cell transplantation, 

    2014.04
    -
    Present

 

Papers 【 Display / hide

  • Hematopoietic cell infusion-related adverse events in pediatric/small recipients in a prospective/multicenter study

    Ikeda K., Ohto H., Yamada-Fujiwara M., Okuyama Y., Fujiwara S.i., Muroi K., Mori T., Kasama K., Kanamori H., Iseki T., Nagamura-Inoue T., Kameda K., Kanda J., Nagai K., Fujii N., Ashida T., Hirose A., Takahashi T., Minakawa K., Tanosaki R.

    Transfusion (Transfusion)  60 ( 5 ) 1015 - 1023 2020.05

    ISSN  00411132

     View Summary

    © 2020 AABB BACKGROUND: Hematopoietic cell infusion-related adverse events (HCI-AEs) in hematopoietic stem cell transplantations (HSCTs) have been largely attributed to toxicity of dimethyl sulfoxide (DMSO) for cryopreservation, but HSC products also contain various cells and plasma components. Our recent prospective study of 1125 HSCT recipients revealed the highest overall HCI-AE rate in bone marrow transplantation (BMT) using fresh/noncryopreserved products, although products of peripheral blood stem cell transplantation and cord blood transplantation (CBT) are generally cryopreserved with DMSO containing smaller plasma volumes. We aimed to clarify if product volume and component effects are more substantial in small recipients including children. STUDY DESIGN AND METHODS: We performed subgroup analysis on 219 recipients of 45 kg or less body weight (whole small recipients), including 90 children (pediatric recipients), from the original cohort (general recipients). RESULTS: Whereas overall HCI-AE rates did not differ among hematopoietic stem cell sources in the general recipients, bradycardia most often occurred after CBT in whole small recipients. Conversely, whole small and general recipients shared the same trend of having the highest rate of hypertension in BMT. The overall HCI-AE rate was higher in allogeneic HSCT compared with autologous HSCT. Notably, pediatric recipients showed a 10-fold higher incidence of nausea and vomiting in allogeneic HSCT compared with autologous HSCT, suggesting a possible role of allogeneic antigens. Multivariate analysis identified a relatively large infusion volume per body weight as a significant factor correlating with HCI-AE in whole small recipients. CONCLUSIONS: We should be aware of product volume and specific HCI-AEs such as nausea and vomiting in small patients including children.

  • Prognostic importance of pretransplant disease status for posttransplant outcomes in patients with adult T cell leukemia/lymphoma

    Inoue Y., Fuji S., Tanosaki R., Inamoto Y., Tanaka T., Ito A., Okinaka K., Kurosawa S., Kim S.W., Nakagama H., Fukuda T.

    Bone Marrow Transplantation (Bone Marrow Transplantation)  53 ( 9 ) 1105 - 1115 2018.09

    ISSN  02683369

     View Summary

    © 2018, Macmillan Publishers Limited, part of Springer Nature. Adult T cell leukemia/lymphoma (ATL) is an aggressive T cell lymphoma with a poor prognosis. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) can be a curative treatment for ATL, a significant proportion of allo-HSCT recipients suffer from relapse/progression of ATL. Here we aimed to clarify the risk factors for and outcomes after posttransplant relapse/progression. We retrospectively reviewed 76 patients with ATL who received allo-HSCT at our institute. At the time of allo-HSCT, disease status was complete response in 17 patients, partial response in 29, stable disease (SD) in 18, and progressive disease (PD) in 12. In multivariate analysis, SD/PD at allo-HSCT, lymphoma subtype, reduced-intensity conditioning regimen, and time from diagnosis to allo-HSCT were associated with risk of relapse/progression. After allo-HSCT, 26 patients had relapse/progression at a median of 66 days (range, 13–2064 days). The 2-year overall survival rate after relapse/progression was only 19%. Compared with acute-type, lymphoma-type experienced local recurrence more frequently (1/15 acute vs. 7/11 lymphoma, P < 0.01) and had a significantly longer OS after relapse/progression (median; 112 days in acute vs. 554 days in lymphoma, P < 0.01). Since the prognosis of patients with ATL who experienced relapse/progression after allo-HSCT was poor, strategies to reduce the risk of these outcomes are warranted.

  • Adverse Events Associated With Infusion of Hematopoietic Stem Cell Products: A Prospective and Multicenter Surveillance Study

    Ikeda K., Ohto H., Okuyama Y., Yamada-Fujiwara M., Kanamori H., Fujiwara S.i., Muroi K., Mori T., Kasama K., Iseki T., Nagamura-Inoue T., Fujii N., Ashida T., Kameda K., Kanda J., Hirose A., Takahashi T., Nagai K., Minakawa K., Tanosaki R.

    Transfusion Medicine Reviews (Transfusion Medicine Reviews)  32 ( 3 ) 186 - 194 2018.07

    ISSN  08877963

     View Summary

    © 2018 The Authors Adverse events (AEs) associated with blood transfusions, including component-specific red cell, platelet, and plasma products, have been extensively surveyed. In contrast, surveillance of AEs associated with hematopoietic stem cell (HSC) products in HSC transplantation (HSCT) has been less rigorous, even though HSC products include a diversity of immature and mature hematopoietic cells, substantial plasma, and dimethyl sulfoxide (DMSO) in the case of cryopreserved HSC products. HSC infusion-related AEs have been attributed to DMSO toxicity, but AEs associated with the infusion of noncryopreserved HSC products are not uncommon. To quantify the frequencies, types, and risk factors of HSC infusion-related AEs, we implemented national surveillance for AEs observed within 24 hours after infusion. Herein we report on 1125 HSCTs, including 570 peripheral blood stem cell transplantations (PBSCTs) (290 autologous [auto-] and 280 allogeneic [allo-]), 332 allo-bone marrow transplantations (allo-BMTs) and 223 allo-cord blood transplantations (allo-CBTs). Unexpectedly, incidences of grade ≥ 2 AEs were most frequent in allo-BMTs (37.7%) with no DMSO in any product compared with auto-/allo-PBSCTs (20.9%, P <.001) and allo-CBTs (19.3%, P <.001) typically cryopreserved with DMSO. Hypertension was most often noted in BMTs, whereas nausea/vomiting, fever, and allergic reactions were most frequent in allo-PBSCTs. In a multivariate analysis, a history of transfusion reactions was a risk factor for overall AEs in all HSCTs (odds ratio [OR] = 1.459, P =.045). For grade ≥ 2 AEs in allo-HSCTs, a history of transfusion reactions (OR = 1.551, P =.044) for overall AEs, and high infusion volume (OR = 7.544, P =.005) and allo-PBSCTs (versus BMTs, OR = 9.948, P =.002) for allergic reactions were identified as risk factors. These findings suggest that some factors unrelated to DMSO, such as allo-antigens, contribute to HSC infusion-related AEs. As severe AEs, a total of 117 grade ≥ 3 AEs were reported in 1125 HSCTs, including life-threatening complications in 3 (0.3%) HSCTs: 1 allo-CBT (anaphylaxis) and 2 allo-PBSCTs (hypoxia, kidney injury) with cryopreserved product. Our data show that HSC infusion risks vary by product, can be severe, and should be monitored with the same rigor as modern transfusion hemovigilance programs.

  • Risk Assessment in Adult T Cell Leukemia/Lymphoma Treated with Allogeneic Hematopoietic Stem Cell Transplantation

    Yoshimitsu M., Tanosaki R., Kato K., Ishida T., Choi I., Takatsuka Y., Fukuda T., Eto T., Hidaka M., Uchida N., Miyamoto T., Nakashima Y., Moriuchi Y., Nagafuji K., Miyazaki Y., Ichinohe T., Takanashi M., Atsuta Y., Utsunomiya A.

    Biology of Blood and Marrow Transplantation (Biology of Blood and Marrow Transplantation)  24 ( 4 ) 832 - 839 2018.04

    ISSN  10838791

     View Summary

    © 2017 The American Society for Blood and Marrow Transplantation 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.

Research Projects of Competitive Funds, etc. 【 Display / hide

  • 造血幹細胞移植に用いる細胞の安全な処理・保存・品質管理体制の確立に関する研究

    2014.05
    -
    2017.03

    国立研究開発法人日本医療研究開発機構(AMED), 田野崎隆二, Research grant, Principal Investigator

 

Courses Taught 【 Display / hide

  • TRANSFUSION MEDICINE

    2021

  • LECTURE SERIES, INTERNAL MEDICINE (HEMATOLOGY)

    2021

  • LECTURE SERIES, INTERNAL MEDICINE

    2021

  • INTERNAL MEDICINE: SEMINAR

    2021

  • INTERNAL MEDICINE: PRACTICE

    2021

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