Sudden Hearing Loss in a Young Patient with Chronic Myelogenous Leukemia

Hyperleukocytosis is a typical presentation of chronic myelogenous leukemia (CML). It sometimes induces leukostasis, the symptoms of which include visual change, headache, tinnitus, dizziness, and occasional disturbance of consciousness. In the present study, a 26-year-old male patient visited a general physician, who observed marked hyperleukocytosis and referred the patient to our hospital. The patient was diagnosed with CML and treated with a tyrosine kinase inhibitor and hydroxycarbamide. On the fourth day after admission, the patient suddenly complained of left-sided hearing loss. An audiogram revealed profound left sensorineural hearing loss. Magnetic resonance imaging of the head showed no lesions in the inner ear, cerebellum, or brain stem; therefore, we diagnosed sudden hearing loss due to leukostasis. Subsequently, his hearing did not improve, despite a decrease in leukocytes. The pathophysiology of leukocytosis involves increased leukocytes and thrombi, which induce high blood viscosity in the microcirculation. Leukostasis-related infarction and hemorrhage can lead to occlusion of the labyrinthine artery, causing deafness. Physicians should be aware that deafness can develop when diagnosing marked leukocytosis because such deafness is irreversible in most cases

T cells bearing anti-CD19 and/or anti-CD38 chimeric antigen receptors effectively abrogate primary double-hit lymphoma cells

Abstract Patients with B cell lymphomas bearing MYC translocation combined with translocation involving other genes, such as BCL2, BCL3, or BCL6, defined as double-hit lymphoma (DHL), have a poor prognosis. Recent studies expanded the concept to include double-expressing lymphoma (DEL) that co-overexpresses MYC protein with either of those proteins. Accordingly, we defined cytogenetic DHL and DEL as primary DHL. An adoptive T cell immunotherapy with a chimeric antigen receptor (CAR) has been clinically shown to exhibit cytotoxicity in refractory neoplasias. We revealed the marked cytotoxicity of anti-CD19- and/or anti-CD38-CAR T cells against primary DHL cells from patients. CD19- and/or CD38-specific T cells were co-cultured with cytogenetic DHL (n = 3) or DEL (n = 2) cells from five patients for 3 days. We examined whether T cells retrovirally transduced with each vector showed cytotoxicity against DHL cells. Anti-CD19- and/or anti-CD38-CAR T cells were co-cultured with primary DHL cells at an E:T ratio of 1:2 for 3 days. Anti-CD19- and anti-CD38-CAR T cells completely abrogated these DHL cells, respectively. Anti-CD19-CAR T cells synergistically exerted collaborative cytotoxicity against these primary DHL cells with anti-CD38-CAR T cells. Therefore, refractory DHL cells can be efficiently abrogated by the clinical use of T cells with anti-CD19- and/or anti-CD38-CAR

Successful combination treatment with azacitidine and venetoclax as a bridging therapy for third allogenic stem cell transplantation in a patient with 11q23/MLL‐rearranged complex karyotype acute myeloid leukemia

Abstract Translocation t(6;11) occurs in approximately 5% of patients with acute myeloid leukemia (AML) corresponding to 11q23/mixed lineage leukemia (MLL) rearrangement. The AF6 gene on chromosome 6q27 is the fusion partner of the MLL gene on 11q23 in t(6;11), which results in a poor prognosis. The case of a patient with 11q23/MLL‐rearranged AML who successfully underwent a third allogeneic stem cell transplantation after treatment with azacitidine (AZA) and venetoclax (VEN) is presented in this article. This report suggests that a combination of AZA and VEN is an effective therapeutic approach for relapsed and refractory MLL‐rearranged AML

Additional file 1: Figure S1. of T cells bearing anti-CD19 and/or anti-CD38 chimeric antigen receptors effectively abrogate primary double-hit lymphoma cells

Morphology of cells in the specimens on hematoxylin-eosin staining is shown. MYC expression is shown in lymph node specimens from patient 3. LPF, MPF, and HPF denote low-power, middle-power, and high-power fields, respectively. (PPTX 1063 kb

Data_Sheet_3_Evaluation of a creatinine clearance correction equation based on body fat mass in older Japanese patients with diabetes.docx

BackgroundThe estimation of creatinine clearance (CCr) in older adult patients with diabetes is subject to deviations from the results of actual measurements because of changes in body composition. In the present study, we aimed to create a correction for the equation used for the estimation of CCr in older adult Asian patients with diabetes using body composition parameters.MethodsWe enrolled 50 older Japanese patients with diabetes in whom the measured values of CCr were compared with values estimated using the Cockcroft-Gault equation. The relationships between the error in the estimated CCr and body composition parameters were investigated, and the Cockcroft-Gault equation was corrected using the appropriate parameters. To evaluate the generalizability of the corrected equation, the utility of the Cockcroft-Gault equation, which was corrected on the basis of body composition measured using a household body composition meter, was also investigated.ResultsBody fat mass (BFM) was closely correlated with the error in the estimated CCr. The BFM-corrected Cockcroft-Gault equation was more accurate than the original equation. Similarly, the error became smaller using BFM measured with a household body composition meter.ConclusionThe BFM-corrected Cockcroft-Gault equation may provide an accurate method of estimating CCr that can be used in general practice.</p

Data_Sheet_2_Evaluation of a creatinine clearance correction equation based on body fat mass in older Japanese patients with diabetes.docx

BackgroundThe estimation of creatinine clearance (CCr) in older adult patients with diabetes is subject to deviations from the results of actual measurements because of changes in body composition. In the present study, we aimed to create a correction for the equation used for the estimation of CCr in older adult Asian patients with diabetes using body composition parameters.MethodsWe enrolled 50 older Japanese patients with diabetes in whom the measured values of CCr were compared with values estimated using the Cockcroft-Gault equation. The relationships between the error in the estimated CCr and body composition parameters were investigated, and the Cockcroft-Gault equation was corrected using the appropriate parameters. To evaluate the generalizability of the corrected equation, the utility of the Cockcroft-Gault equation, which was corrected on the basis of body composition measured using a household body composition meter, was also investigated.ResultsBody fat mass (BFM) was closely correlated with the error in the estimated CCr. The BFM-corrected Cockcroft-Gault equation was more accurate than the original equation. Similarly, the error became smaller using BFM measured with a household body composition meter.ConclusionThe BFM-corrected Cockcroft-Gault equation may provide an accurate method of estimating CCr that can be used in general practice.</p

Data_Sheet_1_Evaluation of a creatinine clearance correction equation based on body fat mass in older Japanese patients with diabetes.pdf

BackgroundThe estimation of creatinine clearance (CCr) in older adult patients with diabetes is subject to deviations from the results of actual measurements because of changes in body composition. In the present study, we aimed to create a correction for the equation used for the estimation of CCr in older adult Asian patients with diabetes using body composition parameters.MethodsWe enrolled 50 older Japanese patients with diabetes in whom the measured values of CCr were compared with values estimated using the Cockcroft-Gault equation. The relationships between the error in the estimated CCr and body composition parameters were investigated, and the Cockcroft-Gault equation was corrected using the appropriate parameters. To evaluate the generalizability of the corrected equation, the utility of the Cockcroft-Gault equation, which was corrected on the basis of body composition measured using a household body composition meter, was also investigated.ResultsBody fat mass (BFM) was closely correlated with the error in the estimated CCr. The BFM-corrected Cockcroft-Gault equation was more accurate than the original equation. Similarly, the error became smaller using BFM measured with a household body composition meter.ConclusionThe BFM-corrected Cockcroft-Gault equation may provide an accurate method of estimating CCr that can be used in general practice.</p