記述言語：日本語   出版者・発行元：日本神経感染症学会  

記述言語：日本語   出版者・発行元：(一社)日本血液学会-東京事務局  

症例は24歳男性。倦怠感や体重減少の精査のため実施した下部消化管内視鏡検査で回盲部潰瘍を認め,生検でびまん性大細胞型B細胞リンパ腫と診断された。その後の精査中にニューモシスチス肺炎を併発し,後天性免疫不全症候群(AIDS)の合併が判明した。回盲部潰瘍以外に明確な病変はなく,生検組織のin situ hybridization法により腫瘍細胞はEpstein-Barr encoding region(EBER)がびまん性に強陽性であったため,EBV陽性粘膜皮膚潰瘍(EBVMCU)と診断した。免疫再構築により病変が改善することを期待し,抗レトロウイルス療法(ART)を開始した。ART開始79日後には回盲部潰瘍の完全消失を確認し,その後3年以上にわたって寛解を維持している。EBVMUCは種々の免疫抑制状態を背景に発症することが知られておりAIDSもその一つであるが,ARTによる免疫再構築によってEBVMCUが寛解に至った初めての報告である。(著者抄録)

記述言語：日本語   出版者・発行元：一般社団法人 日本血液学会  

<p>症例は24歳男性。倦怠感や体重減少の精査のため実施した下部消化管内視鏡検査で回盲部潰瘍を認め，生検でびまん性大細胞型B細胞リンパ腫と診断された。その後の精査中にニューモシスチス肺炎を併発し，後天性免疫不全症候群（AIDS）の合併が判明した。回盲部潰瘍以外に明確な病変はなく，生検組織の<i>in situ</i> hybridization法により腫瘍細胞はEpstein-Barr encoding region（EBER）がびまん性に強陽性であったため，EBV陽性粘膜皮膚潰瘍（EBVMCU）と診断した。免疫再構築により病変が改善することを期待し，抗レトロウイルス療法（ART）を開始した。ART開始79日後には回盲部潰瘍の完全消失を確認し，その後3年以上にわたって寛解を維持している。EBVMUCは種々の免疫抑制状態を背景に発症することが知られておりAIDSもその一つであるが，ARTによる免疫再構築によってEBVMCUが寛解に至った初めての報告である。</p>

DOI： 10.11406/rinketsu.65.13

PubMed

CiNii Research

記述言語：日本語   出版者・発行元：European Journal of Haematology  

Essential thrombocythemia (ET) cases without canonical JAK2, CALR, or MPL mutations, that is, triple-negative (TN) ET, have been found in 10%–20% of ET cases. Owing to the limited number of TN ET cases, its clinical significance remains unclear. This study evaluated TN ET's clinical characteristics and identified novel driver mutations. Among 119 patients with ET, 20 (16.8%) had no canonical JAK2/CALR/MPL mutations. Patients with TN ET tended to be younger and had lower white blood cell counts and lactate dehydrogenase values. We identified putative driver mutations in 7 (35%): MPL S204P, MPL L265F, JAK2 R683G, and JAK2 T875N were previously reported as candidate driver mutations in ET. Moreover, we identified a THPO splicing site mutation, MPL*636Wext*12, and MPL E237K. Four of the seven identified driver mutations were germline. Functional studies on MPL*636Wext*12 and MPL E237K revealed that they are gain-of-function mutants that increase MPL signaling and confer thrombopoietin hypersensitivity with very low efficiency. Patients with TN ET tended to be younger, although this was thought to be due to the inclusion of germline mutations, hereditary thrombocytosis. Accumulating the genetic and clinical characteristics of noncanonical mutations may help future clinical interventions in TN ET and hereditary thrombocytosis.

DOI： 10.1111/ejh.13945

Scopus

PubMed

記述言語：日本語   出版者・発行元：(一社)日本検査血液学会  

記述言語：日本語   出版者・発行元：(一社)日本血液学会-東京事務局  

記述言語：日本語   出版者・発行元：Leukemia and Lymphoma  

Mogamulizumab (Mog), an anti-C-C motif chemokine receptor 4 (CCR4) antibody, is a therapeutic for adult T-cell leukemia/lymphoma (ATL). Injuries of normal regulatory T cells (Tregs) which express CCR4 by Mog could result in immune-related adverse events including graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). In this study, we retrospectively analyzed 25 patients among 39 patients with ATL who received allo-HSCT. We found that the risk of grade II to IV GVHD was higher in patients who received Mog before or after allo-HSCT (Mog+) than in those who did not (Mog−). The incidence of severe intestinal GVHD and cytomegalovirus (CMV) enteritis were significantly higher in Mog + patients and resulted in death from GVHD or CMV enteritis. Treg numbers were suppressed until Mog serum concentrations became undetectable. Measuring the concentration of Mog and/or the number of Tregs at the time of allo-HSCT might predict the risk of GVHD.

DOI： 10.1080/10428194.2022.2043300

Scopus

PubMed

記述言語：日本語   出版者・発行元：日臨技九州支部医学検査学会  

記述言語：日本語   出版者・発行元：(一社)日本血液学会-東京事務局  

記述言語：日本語   出版者・発行元：European Journal of Haematology  

Objectives: Adult T-cell leukemia/lymphoma (ATL) is an intractable T-cell malignancy caused by long-term infection with human T-cell leukemia virus type-1 (HTLV-1). While ATL pathogenesis has been associated with HTLV-1-derived oncogenic proteins, including Tax and HBZ, the contribution of genomic aberrations remains poorly defined. Methods: To elucidate the genomic basis of ATL, whole exome sequencing was performed on cells from 47 patients with aggressive ATL. Results: We discovered the novel mutation RLTPR Q575E in four patients (8.5%) with a median variant allele frequency of 0.52 (range 0.11-0.68). Despite being reported in cutaneous T-cell lymphoma, three ATL patients carrying RLTPR Q575E lacked skin involvement. Patients carrying RLTPR Q575E also harbored CARD11 (75%), PLCG1 (25%), PRKCB (25%), or IKBKB (25%) mutations related to TCR/NF-κB signaling. Jurkat cells transfected with RLTPR Q575E cDNA displayed increased NF-κB activity and significantly increased IL-2 mRNA levels under stimulation. RLTPR Q575E increased the interaction between RLTPR and CARD11, while RLTPR directly interacted with Tax. Conclusions: We identified, and functionally validated, a novel gain-of-function mutation in patients with aggressive ATL. During TCR activation by Tax or gain-of-function mutations, RLTPR Q575E selectively upregulates NF-κB signaling and may exert oncogenic effects on ATL pathogenesis.

DOI： 10.1111/ejh.13540

Scopus

PubMed