Browsing by Author "Aizawa, Keiko"

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    Exocrine Pancreatic Insufficiency Possibly Related to Atypical Chronic Graft-versus-Host Disease
    (Karger, 2023-09-06) Hosokawa, Yuka; Toubai, Tomomi; Ohya, Koichi; Nagano, Yusuke; Ishizawa, Yuki; Hosokawa, Masashi; Sato, Ryo; Watanabe, Shotaro; Yamada, Akane; Suzuki, Takuma; Aizawa, Keiko; Ito, Satoshi; Onozato, Yusuke; Peltier, Daniel; Ishizawa, Kenichi; Pediatrics, School of Medicine
    We report the case of a 66-year-old woman who presented with diarrhea and weight loss approximately 14 months after unrelated allogeneic bone marrow transplantation for acute myeloid leukemia. Her early post-transplant course was notable for mild acute skin graft-versus-host disease (GVHD) and biopsy-proven upper gastrointestinal (GI) acute GVHD, both of which resolved with treatment. She then developed weight loss and diarrhea treated with prednisolone for what was thought to be GI late acute GVHD. However, her diarrhea and weight loss persisted. Colonoscopy showed a grossly intact mucosa, and stool studies only confirmed steatorrhea. However, an atrophic pancreas was found on an abdominal computed tomography (CT) scan. Exocrine pancreatic enzymes, such as lipase and pancreatic amylase, were markedly decreased, yet pancreatic endocrine function remained intact. The patient’s diarrhea and weight loss improved upon treatment with pancrelipase. Therefore, we suggest that her exocrine pancreatic insufficiency was likely partly caused by atypical chronic GVHD.
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    How does transfusion-associated graft-versus-host disease compare to hematopoietic cell transplantation-associated graft-versus-host disease?
    (Elsevier, 2022) Aizawa, Keiko; Peltier, Daniel; Matsuki, Eri; Toubai, Tomomi; Pediatrics, School of Medicine
    Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare life-threatening complication of blood transfusion caused by donor T cells that escape rejection by the recipient immune system. These donor T cells drive recipient tissue damage in response to host antigens. On the other hand, GVHD occurring after allogeneic hematopoietic cell transplantation (HCT-GVHD) is also caused by donor T cells, but its pathophysiology is more complex and differs due to the effects of tissue damage caused by pre-HCT conditioning and profound immunosuppression. Both TA-GVHD and HCT-GVHD can be fatal; however, mortality is higher with TA-GVHD due to the paucity of treatment options. Here, we compare and summarize the presentation, diagnosis, pathophysiology, prevention, and treatment of TA-GVHD and HCT-GVHD.
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    Refractory Subcutaneous Panniculitis-Like T-Cell Lymphoma with Hemophagocytic Syndrome Treated with Romidepsin and Allogeneic Hematopoietic Cell Transplantation
    (Karger, 2025-02-18) Ishizawa, Yuki; Toubai, Tomomi; Ichikawa, Tsubasa; Himuro, Masahito; Kato, Mikiya; Nagano, Yusuke; Takahashi, Ryo; Hosokawa, Masashi; Hosokawa, Yuka; Yamada, Akane; Suzuki, Takuma; Aizawa, Keiko; Ito, Satoshi; Peltier, Daniel; Yokoyama, Hisayuki; Ishizawa, Kenichi; Pediatrics, School of Medicine
    Introduction: Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous T-cell lymphoma (CTCL) that when refractory or complicated by hemophagocytic syndrome (HPS) has a poor prognosis. Romidepsin is a histone deacetylase inhibitor, but its efficacy for SPTCL is unknown. The efficacy of allogeneic hematopoietic cell transplantation (allo-HCT) is also unclear. Herein, we report a case of refractory SPTCL with HPS that was successfully treated with romidepsin followed by consolidation with allo-HCT. Case presentation: A 26-year-old female presented with fever, generalized painful erythema, pancytopenia, and hemophagocytosis. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET) showed diffuse PET-avid infiltration of the subcutaneous adipose tissue found to be SPTCL via skin biopsy. Her SPTCL was refractory to conventional chemotherapy but complete metabolic response was achieved after romidepsin. An allo-HCT was used for consolidation, and she remains in complete remission 3 years later. Conclusion: Romidepsin with allo-HCT consolidation may be an effective approach for refractory SPTCL.