Updated on 2025/04/15

写真a

 
NARITA Kotaro
 
Organization
Nagoya University Hospital Assistant professor of hospital
Title
Assistant professor of hospital

Degree 2

  1. 博士(医学) ( 2023.2   名古屋大学 ) 

  2. 学士(医学) ( 2010.3   名古屋大学 ) 

Research History 2

  1. Nagoya University   Assistant professor of hospital

    2022.5

  2. 厚生労働省   健康局がん・疾病対策課   課長補佐

    2021.4 - 2022.4

Education 1

  1. Nagoya University

    2004.4 - 2010.3

Professional Memberships 5

  1. 日本小児科学会

  2. 日本小児血液・がん学会

  3. 日本血液学会

  4. 日本がん・生殖医療学会

  5. 日本造血・免疫細胞療法学会

Committee Memberships 2

  1. 日本小児がん研究グループ   横紋筋肉腫委員会 委員  

       

  2. 日本造血・免疫細胞療法学会   小児再生不良性貧血WG メンバー  

       

 

Papers 22

  1. Successful Treatment with Sirolimus of a Patient with a Novel <i>CARD11</i> Germline Mutation in B-Cell Expansion with Nuclear Factor Kappa B and T-Cell Anergy: Case Report and Literature Review Open Access

    Nishinosono, T; Muramatsu, H; Wakamatsu, M; Yamashita, D; Fukasawa, T; Shirakawa, Y; Sajiki, D; Maemura, R; Tsumura, Y; Yamamori, A; Narita, K; Kataoka, S; Narita, A; Nishio, N; Miyajima, Y; Takahashi, Y

    JOURNAL OF CLINICAL IMMUNOLOGY   Vol. 45 ( 1 ) page: 78   2025.12

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    Language:English   Publisher:Journal of Clinical Immunology  

    Purpose: B-cell expansion with nuclear factor kappa B and T-cell anergy (BENTA) is an inborn error of immunity characterized by congenital polyclonal B-cell lymphocyte expansion. In this report, we present a case of a girl diagnosed with BENTA carrying a novel CARD11 germline mutation, aiming to clarify the clinical presentation of BENTA by conducting a literature review. Methods: Genetic analysis, including whole-exome sequencing, was performed using genomic DNA extracted from the patient’s peripheral blood, oral mucosa, and fingernails. Additionally, a comprehensive literature review of cases with BENTA was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A p.Leu251Pro germline variant in the CARD11 gene was identified in an 18-month-old girl with a genetic diagnosis of BENTA. She required adenoidectomy and tonsillectomy due to airway obstruction causing wheezing. Her symptoms improved with prednisolone and sirolimus. The literature review we conducted identified a total of 34 cases of BENTA. Among these cases, 15 were either asymptomatic or showed improvement without requiring any specific treatment. However, all six reported deaths were diagnosed before the age of 3 years, with two attributed to refractory hemophagocytic syndrome and four caused by opportunistic infections. Conclusion: We present a case of BENTA with life-threatening respiratory symptoms caused by a novel CARD11 germline mutation. The patient showed a positive response to immunosuppressive therapy, including sirolimus. While BENTA is typically regarded as a benign disorder, a literature review revealed that infants with BENTA are at high risk of severe outcomes and require therapeutic intervention.

    DOI: 10.1007/s10875-025-01872-4

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  2. THE UTILITY OF EXTRACORPOREAL ULTRASONOGRAPHY SCORE (HOKUS-10) IN PEDIATRIC SOS/VOD

    Narita, A; Muramatsu, H; Maemura, R; Yamashita, D; Sajiki, D; Tsumura, Y; Yamamori, A; Wakamatsu, M; Narita, K; Kataoka, S; Takahashi, Y

    BONE MARROW TRANSPLANTATION   Vol. 59   page: 563 - 564   2024.10

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  3. A Japanese retrospective study of non-tuberculous mycobacterial infection in children, adolescents, and young adult patients with hematologic-oncologic diseases Reviewed International journal Open Access

    Tsumura, Y; Muramatsu, H; Tetsuka, N; Imaizumi, T; Sato, K; Inoue, K; Motomura, Y; Cho, YK; Yamashita, D; Sajiki, D; Maemura, R; Yamamori, A; Imaya, M; Wakamatsu, M; Narita, K; Kataoka, S; Hamada, M; Taniguchi, R; Nishikawa, E; Narita, A; Nishio, N; Kojima, S; Hoshino, Y; Takahashi, Y

    HAEMATOLOGICA   Vol. 109 ( 9 ) page: 2988 - 2997   2024.9

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    Language:English   Publisher:Haematologica  

    Non-tuberculous mycobacterial infection (NTM) is rare in healthy children, with lymphadenitis being the most common presentation. Immunocompromised populations are known to be at high risk, but the clinical picture of NTM infection in pediatric hematology/oncology patients is unclear. In this nationwide retrospective analysis of patients under the age of 40 treated in Japanese pediatric hematology/oncology departments who developed NTM infection between January 2010 and December 2020, 36 patients were identified: 21 patients with hematopoietic stem cell transplantation (HSCT) and 15 non-transplant patients. Post-transplant patients were infected with NTM at 24 sites, including the lungs (N=12), skin and soft tissues (N=6), bloodstream (N=4), and others (N=2). Nine of 12 patients with pulmonary NTM infection had a history of pulmonary graft-versus-host disease (GvHD), and rapid-growing mycobacteria (RGM) were isolated from 5 of them. In non-transplant patients, the primary diseases were acute lymphoblastic leukemia (ALL; N=5), inborn errors of immunity (IEI; N=6), and others (N=4). All cases of ALL had bloodstream infections with RGM, whereas all cases of IEI were infected with slow-growing mycobacteria (SGM). In summary, 3 typical clinical scenarios for pediatric hematology/oncology patients have been established: RGM-induced pulmonary disease in patients with pulmonary GvHD, RGM bloodstream infection in patients with ALL, and SGM infection in patients with IEI. Our findings suggest that NTM must be regarded as a pathogen for infections in these high-risk patients, especially those with pulmonary GvHD, who may require active screening for NTM.

    DOI: 10.3324/haematol.2023.283636

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  4. Risk factors of bloodstream infection after allogeneic hematopoietic cell transplantation in children/adolescent and young adults Open Access

    Sajiki, D; Muramatsu, H; Wakamatsu, M; Yamashita, D; Maemura, R; Tsumura, Y; Imaya, M; Yamamori, A; Narita, K; Kataoka, S; Taniguchi, R; Narita, A; Nishio, N; Takahashi, Y

    PLOS ONE   Vol. 19 ( 8 ) page: e0308395   2024.8

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    Allogeneic hematopoietic cell transplantation (HCT) is a crucial treatment for various diseases, including hematological malignancies, solid tumors, and genetic disorders. Despite its curative potential, HCT is associated with severe complications, notably infections, graft-versus-host disease, and organ damage. Infections, particularly bloodstream infections (BSIs), pose a significant threat in the initial weeks post-HCT, necessitating effective management strategies. This retrospective study aimed to clarify the incidence, pathogens, and risk factors associated with BSI within the first 30 days after allogeneic HCT in children/adolescents and young adults (AYAs). The study included 115 patients aged <31 years who underwent 121 allogeneic HCTs at the Department of Pediatrics, Nagoya University Hospital between January 1, 2018, and March 31, 2022. Data encompassed demographic characteristics, HCT details, and BSI information. Overall, 27 of 121 patients developed BSI with the cumulative incidence of 23.5% (95% confidence intervals [CI]: 17.0%–30.6%) at 30 days after HCT. The median onset time of BSI was 7 (range, 4–26 days) after HCT. Gram-positive bacteria accounted for 89% of pathogens isolated from blood cultures, with Streptococcus mitis/oralis being the most common. In multivariable analysis, tandem HCT (subdistribution hazard ratio [SHR]: 5.67, 95% CI: 2.74–11.7, p < 0.001) and peripherally inserted central catheters (SHR: 2.96, 95% CI: 1.34–6.55, p = 0.007) were identified as independent risk factors for BSI. In patients receiving tandem HCT, the pathogens isolated from blood cultures were all gram-positive bacteria, with Streptococcus mitis/oralis accounting for up to 67% of the isolated pathogens. Tandem HCT and PICCs were identified as independent risk factors for BSI after allogeneic HCT in children/AYAs. The pathogens were commonly gram-positive, and Streptococcus mitis/oralis is important in patients who received tandem HCT. These data can provide valuable information for future studies to consider effective interventions to reduce the risk of BSI in high-risk patients.

    DOI: 10.1371/journal.pone.0308395

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  5. REFRACTORY CHRONIC GVHD IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS SUCCESSFULLY TREATED WITH IBRUTINIB: A REPORT OF FIVE CASES

    Yamashita, D; Narita, A; Yamamori, A; Wakamatsu, M; Narita, K; Kataoka, S; Taniguchi, R; Muramatsu, H; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 71   page: S51 - S52   2024.1

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  6. MOLECULAR PROFILING OF JUVENILE MYELOMONOCYTIC LEUKEMIA AND EXPLORATIONS OF NOVEL THERAPEUTIC AGENTS

    Wakamatsu, M; Muramatsu, H; Sajiki, D; Narita, K; Kataoka, S; Narita, A; Okuno, Y; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 71   page: S4 - S4   2024.1

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  7. HEMATOLOGIC RESPONSE IN A PEDIATRIC PATIENT WITH VERY SEVERE APLASTIC ANEMIA WHO RECEIVED EQUINE ANTI-HUMAN THYMOCYTE IMMUNOGLOBULIN

    Narita, K; Maemura, R; Yamamori, A; Wakamatsu, M; Kataoka, S; Narita, A; Muramatsu, H; Shimasaki, N; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 71   page: S31 - S31   2024.1

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    Authorship:Lead author  

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  8. Early chemotherapeutic intervention to avoid thyroidectomy in pediatric Langerhans cell histiocytosis with thyroid involvement accompanying tracheal stenosis: a report of two cases Reviewed International journal

    Aoyama, S; Fukuoka, K; Kubota, H; Narita, K; Kudo, K; Mitani, Y; Oshima, K; Mori, M; Arakawa, Y; Ichimura, K; Terui, K; Tanami, Y; Kawashima, H; Nakazawa, A; Niitsu, T; Takahashi, Y; Koh, K

    INTERNATIONAL JOURNAL OF HEMATOLOGY   Vol. 119 ( 1 ) page: 99 - 103   2024.1

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:International Journal of Hematology  

    Thyroid involvement is rare in pediatric Langerhans cell histiocytosis (LCH). It may cause airway narrowing, leading to acute-onset respiratory distress. Severe cases may require emergent surgical interventions such as thyroidectomy, which should be avoided in children due to higher rates of complication, particularly in infancy. There is currently no consensus on the indications for surgical treatment in LCH with thyroid involvement. In this report, we describe the cases of two children who presented with tracheal stenosis caused by thyroid LCH, both of which were successfully treated by early induction of chemotherapy, and one of which was also treated for a shorter duration. Mutation analysis detected in-frame deletions of BRAF exon 12 in both cases. These cases suggest that timely diagnosis and administration of chemotherapy may alleviate severe airway obstruction and reduce the need for thyroidectomy in pediatric patients with thyroid LCH.

    DOI: 10.1007/s12185-023-03662-3

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  9. Hematological abnormalities in Jacobsen syndrome: cytopenia of varying severities and morphological abnormalities in peripheral blood and bone marrow Reviewed International journal Open Access

    Yamashita, D; Muramatsu, H; Narita, A; Wakamatsu, M; Tsumura, Y; Sajiki, D; Maemura, R; Yamamori, A; Imaya, M; Narita, K; Kataoka, S; Taniguchi, R; Nishio, N; Okuno, Y; Fujita, N; Koh, K; Umeda, K; Morihana, E; Iwafuchi, H; Ito, M; Kojima, S; Hama, A; Takahashi, Y

    HAEMATOLOGICA   Vol. 108 ( 12 ) page: 3438 - 3443   2023.12

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Haematologica  

    DOI: 10.3324/haematol.2022.282513

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  10. Error-Corrected Next-Generation Sequencing Provides a Comprehensive Overview of the Subclonal Mutation Landscape and Its Prognostic Implications in Juvenile Myelomonocytic Leukemia Reviewed International journal

    Sajiki, D; Wakamatsu, M; Muramatsu, H; Tsumura, Y; Yamashita, D; Maemura, R; Yamamori, A; Narita, K; Kataoka, S; Narita, A; Shimasaki, N; Nishio, N; Takahashi, Y

    BLOOD   Vol. 142   2023.11

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    DOI: 10.1182/blood-2023-189160

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  11. SHORT TELOMERES BEFORE TRANSPLANT ARE ASSOCIATED WITH GRAFT FAILURE FOLLOWING HEMATOPOIETIC CELL TRANSPLANT FOR CHILDREN WITH APLASTIC ANEMIA

    Narita, A; Muramatsu, H; Imaya, M; Yamashita, D; Sajiki, D; Maemura, R; Tsumura, Y; Yamamori, A; Wakamatsu, M; Narita, K; Kataoka, S; Taniguchi, R; Nishio, N; Takahashi, Y

    BONE MARROW TRANSPLANTATION   Vol. 58 ( SUPP1 ) page: 185 - 185   2023.11

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  12. Vedolizumab for children with intestinal graft-versus-host disease: a case report and literature review Reviewed International journal

    Fukuta, T; Muramatsu, H; Yamashita, D; Sajiki, D; Maemura, R; Tsumura, Y; Yamamori, A; Imaya, M; Wakamatsu, M; Nishikawa, E; Narita, K; Kataoka, S; Taniguchi, R; Narita, A; Nishio, N; Takahashi, Y

    INTERNATIONAL JOURNAL OF HEMATOLOGY   Vol. 118 ( 3 ) page: 411 - 417   2023.9

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:International Journal of Hematology  

    Acute graft-versus-host disease (aGVHD) is a challenging complication of allogeneic hematopoietic stem cell transplantation, and alternative therapies for patients showing inadequate response to steroids are limited. Vedolizumab, an anti-α4β7 integrin antibody widely used for treating inflammatory bowel diseases, has recently been studied in adult patients with steroid-refractory intestinal aGVHD. However, few studies have examined its safety and effectiveness in pediatric patients with intestinal aGVHD. We report the case of a male patient with intestinal late-onset aGVHD treated with vedolizumab. He underwent allogeneic cord blood transplantation for warts, hypogammaglobulinemia, infections, and myelokathexis (WHIM) syndrome and developed intestinal late-onset aGVHD 31 months after transplantation. The patient was refractory to steroids; however, vedolizumab was initiated 43 months after transplantation (at the age of 7 years) and the symptoms of intestinal aGVHD were alleviated. Additionally, favorable endoscopic findings were observed, such as reduction of erosion and regenerative epithelial growth. We also evaluated the efficacy of vedolizumab in 10 patients with intestinal aGVHD (9 from the literature review and the present case). Six patients (60%) showed an objective response to vedolizumab. No serious adverse events were observed in any patients. Vedolizumab is a potential treatment option for steroid-refractory intestinal aGVHD in pediatric patients.

    DOI: 10.1007/s12185-023-03590-2

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  13. Human leukocyte antigen 7/8-matched unrelated bone marrow transplantation using anti-thymocyte globulin in children Reviewed

    Hamada, M; Muramatsu, H; Torii, Y; Suzuki, K; Narita, A; Yoshida, T; Imaya, M; Yamamori, A; Wakamatsu, M; Miwata, S; Narita, K; Kataoka, S; Kawashima, N; Taniguchi, R; Nishikawa, E; Nishio, N; Ito, Y; Kojima, S; Takahashi, Y

    INTERNATIONAL JOURNAL OF HEMATOLOGY   Vol. 118 ( 1 ) page: 125 - 130   2023.7

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    Human leukocyte antigen (HLA) mismatched unrelated donor transplantation is associated with an increased risk of graft-versus-host disease, graft failure, and infection, which increases post-transplant morbidity and mortality. In this single-center retrospective study, outcomes were evaluated in 30 consecutive children who underwent bone marrow transplantation (BMT) from HLA 1 allele-mismatched (HLA 7/8-matched) unrelated donors with rabbit anti-thymocyte globulin (rATG) as graft-versus-host disease (GVHD) prophylaxis. The 3-year overall survival (OS), event-free survival (EFS), and GVHD-relapse-free survival rates were 91.7% (95% CI 70.5%–91.9%), 88.3% (95% CI 67.5%–96.1%), and 73.9% (95% CI 52.4%–86.8%), respectively. Grade II–IV and III–IV acute GVHD occurred in 10 (33%) and 2 (7.0%) patients, respectively. The 3-year cumulative incidence of chronic GVHD was 7.8%. No fatal viral infections occurred. The study results show the feasibility of HLA 7/8-matched unrelated BMT with ATG to achieve favorable outcomes and acceptable GVHD, especially for patients who lack a fully matched donor.

    DOI: 10.1007/s12185-023-03571-5

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  14. Germline and somatic <i>RUNX1</i> variants in a pediatric bone marrow failure cohort Reviewed Open Access

    Yamamori, A; Hamada, M; Muramatsu, H; Wakamatsu, M; Hama, A; Narita, A; Tsumura, Y; Yoshida, T; Doi, T; Terada, K; Higa, T; Yamamoto, N; Miura, H; Shiota, M; Watanabe, K; Yoshida, N; Maemura, R; Imaya, M; Miwata, S; Narita, K; Kataoka, S; Taniguchi, R; Suzuki, K; Kawashima, N; Nishio, N; Iwafuchi, H; Ito, M; Kojima, S; Okuno, Y; Takahashi, Y

    AMERICAN JOURNAL OF HEMATOLOGY   Vol. 98 ( 5 ) page: E102 - E105   2023.5

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    DOI: 10.1002/ajh.26874

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  15. TREATMENT-RELATED TOXICITY OF ANTI-GD2 ANTIBODY IMMUNOTHERAPY AFTER ALLOGENEIC STEM CELL TRANSPLANTATION IN HIGH-RISK NEUROBLASTOMA PATIENTS Reviewed

    Kataoka, S; Yamamori, A; Imaya, M; Wakamatsu, M; Narita, K; Taniguchi, R; Narita, A; Muramatsu, H; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 69   2022.11

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  16. LI-FRAUMENI SYNDROME DIAGNOSED BY ONCOGENE PANEL TESTING FOR RHABDOMYOSARCOMA Reviewed

    Taniguchi, R; Narita, A; Muramatsu, H; Yamashita, D; Sajiki, D; Imaya, M; Wakamatsu, M; Narita, K; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 69   2022.11

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  17. RISK FACTORS FOR BLOOD STREAM INFECTIONS AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION IN CHILDREN Reviewed

    Sajiki, D; Muramatsu, H; Wakamatsu, M; Narita, K; Kataoka, S; Taniguchi, R; Narita, A; Nishio, N; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 69   2022.11

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  18. THE DISAPPEARANCE OF MINIMAL RESIDUAL DISEASE IN BONE MARROW DEMONSTRATES GRAFT VERSUS NEUROBLASTOMA EFFECT AFTER KIR-LIGAND MISMATCHED ALLOGENEIC CBT Reviewed

    Alahmadi, R; Nishio, N; Wakamatsu, M; Kataoka, S; Narita, K; Taniguchi, R; Narita, A; Muramatsu, H; Takahashi, Y

    PEDIATRIC BLOOD & CANCER   Vol. 69   2022.11

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  19. Whole-exome analysis of 177 pediatric patients with undiagnosed diseases Reviewed International journal Open Access

    Narita, K; Muramatsu, H; Narumi, S; Nakamura, Y; Okuno, Y; Suzuki, K; Hamada, M; Yamaguchi, N; Suzuki, A; Nishio, Y; Shiraki, A; Yamamori, A; Tsumura, Y; Sawamura, F; Kawaguchi, M; Wakamatsu, M; Kataoka, S; Kato, K; Asada, H; Kubota, T; Muramatsu, Y; Kidokoro, H; Natsume, J; Mizuno, S; Nakata, T; Inagaki, H; Ishihara, N; Yonekawa, T; Okumura, A; Ogi, T; Kojima, S; Kaname, T; Hasegawa, T; Saitoh, S; Takahashi, Y

    SCIENTIFIC REPORTS   Vol. 12 ( 1 ) page: 14589   2022.8

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    Recently, whole-exome sequencing (WES) has been used for genetic diagnoses of patients who remain otherwise undiagnosed. WES was performed in 177 Japanese patients with undiagnosed conditions who were referred to the Tokai regional branch of the Initiative on Rare and Undiagnosed Diseases (IRUD) (TOKAI-IRUD). This study included only patients who had not previously received genome-wide testing. Review meetings with specialists in various medical fields were held to evaluate the genetic diagnosis in each case, which was based on the guidelines of the American College of Medical Genetics and Genomics. WES identified diagnostic single-nucleotide variants in 66 patients and copy number variants (CNVs) in 11 patients. Additionally, a patient was diagnosed with Angelman syndrome with a complex clinical phenotype upon detection of a paternally derived uniparental disomy (UPD) [upd(15)pat] wherein the patient carried a homozygous DUOX2 p.E520D variant in the UPD region. Functional analysis confirmed that this DUOX2 variant was a loss-of-function missense substitution and the primary cause of congenital hypothyroidism. A significantly higher proportion of genetic diagnoses was achieved compared to previous reports (44%, 78/177 vs. 24–35%, respectively), probably due to detailed discussions and the higher rate of CNV detection.

    DOI: 10.1038/s41598-022-14161-6

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  20. Combination chemotherapy consisting of irinotecan, etoposide, and carboplatin for refractory or relapsed neuroblastoma Reviewed Open Access

    Imaya, M; Muramatsu, H; Narita, A; Yamamori, A; Wakamatsu, M; Yoshida, T; Miwata, S; Narita, K; Ichikawa, D; Hamada, M; Nishikawa, E; Kawashima, N; Nishio, N; Kojima, S; Takahashi, Y

    CANCER MEDICINE   Vol. 11 ( 9 ) page: 1956 - 1964   2022.5

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    Background: Patients with primary refractory and relapsed neuroblastoma have a poor prognosis since safe and effective chemotherapies for these patients are currently limited. The development of new chemotherapy regimens for these patients is imperative to improve survival outcomes. Methods: We retrospectively analyzed 40 patients with refractory (n = 36) or relapsed (n = 4) neuroblastoma who received irinotecan, etoposide, and carboplatin (IREC) as a second-line treatment. We evaluated their therapeutic response and the toxicity of IREC. We also assessed the impact of UGT1A1 gene polymorphisms, which are involved in irinotecan metabolism, on outcomes and toxicity. Results: A total of 112 cycles of IREC were administered to 40 patients with a median of 2 cycles per patient (range, 1–9). Six (15%) patients (UGT1A1 wild-type [n = 2] and heterozygous [n = 4]) showed objective responses, including partial response (n = 1), tumor shrinkage (n = 4), and improved findings on their MIBG scan (n = 1). Grade 4 neutropenia, grade 4 leukopenia, and grades 3–4 gastrointestinal toxicity were observed in 110 (98%), 88 (79%), and 3 (3%) cycles, respectively. There was no IREC-related mortality. Patients with UGT1A1 polymorphisms showed a higher frequency of grade 4 leukopenia, but these patients did not have increased treatment-related mortality or non-hematologic toxicity. Conclusions: IREC showed an objective response rate of 15% including 1 case with partial response. IREC was well tolerated regardless of UGT1A1 genotype. This study suggests that IREC is a promising second-line chemotherapy for refractory or relapsed neuroblastoma.

    DOI: 10.1002/cam4.4529

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  21. Short Report Nosocomial infection with rotavirus vaccine strain in paediatric patients with immunodeficiency Reviewed

    Miura, H; Taniguchi, K; Narita, K; Kawamura, Y; Kozawa, K; Muramatsu, H; Takahashi, Y; Ihira, M; Yoshikawa, T

    JOURNAL OF HOSPITAL INFECTION   Vol. 121   page: 9 - 13   2022.3

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    In infants with immunodeficiency, rotavirus (RV) vaccines can be continuously excreted in stool. We analysed nosocomial infection with RV vaccine strain in immunodeficient paediatric patients. RV1 RNAs were detected in stool and serum samples from case A, who was vaccinated with RV1, and case B, who was not. PAGE analysis of serial stool samples of case A revealed several rearrangements of the RV genome. In case B, the only band pattern detected was the same as a rearrangement detected in case A at the same time. In summary, RV vaccination of infants with immunodeficiency poses a risk of nosocomial infections.

    DOI: 10.1016/j.jhin.2021.12.009

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  22. Clinical Impact of Melphalan Pharmacokinetics on Transplantation Outcomes in Children Undergoing Hematopoietic Stem Cell Transplantation Reviewed Open Access

    Maemura, R; Wakamatsu, M; Matsumoto, K; Sakaguchi, H; Yoshida, N; Hama, A; Yoshida, T; Miwata, S; Kitazawa, H; Narita, K; Kataoka, S; Ichikawa, D; Hamada, M; Taniguchi, R; Suzuki, K; Kawashima, N; Nishikawa, E; Narita, A; Okuno, Y; Nishio, N; Kato, K; Kojima, S; Morita, K; Muramatsu, H; Takahashi, Y

    CELL TRANSPLANTATION   Vol. 31   page: 9636897221143364   2022

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    Language:English   Publisher:Cell Transplantation  

    Melphalan is widely used for hematopoietic stem cell transplantation (HSCT) conditioning. However, the relationship between its pharmacokinetic (PK) and transplantation outcomes in children has not been thoroughly investigated. We prospectively analyzed the relationship between melphalan area under the curve (AUC) and transplantation outcome and examined the development of a predictive model for melphalan clearance in children. This study included 43 children aged 0 to 19 years who underwent HSCT following a melphalan-based conditioning regimen from 2017 to 2021. In univariable analysis, high-melphalan AUC resulted in a significantly lower cumulative incidence of acute graft-versus-host disease and a higher cumulative incidence of thrombotic microangiopathy, although no significant difference was observed in survival. Regression analysis of a randomly selected derivation cohort (n = 21) revealed the following covariate PK model: predicted melphalan clearance (mL/min) = 6.47 × 24-h urinary creatinine excretion rate (CER, g/day) × 24-h creatinine clearance rate (CCR, mL/min) + 92.8. In the validation cohort (n = 22), the measured melphalan clearance values were significantly correlated with those calculated based on the prediction equation (R2 = 0.663). These results indicate that melphalan exposure may be optimized by adjusting the melphalan dose according to CER and CCR.

    DOI: 10.1177/09636897221143364

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KAKENHI (Grants-in-Aid for Scientific Research) 1

  1. 小児再生不良性貧血における自己抗体の探索

    Grant number:24K19222  2024.4 - 2026.3

    科学研究費助成事業  若手研究

    成田 幸太郎

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    Authorship:Principal investigator 

    Grant amount:\2080000 ( Direct Cost: \1600000 、 Indirect Cost:\480000 )

    近年、成人の再生不良性貧血(Aplastic Anemia; AA)において高い感度と特異度を有する自己抗体が報告されたが、小児AAでは疾患特異的な自己抗体は同定されていない。我々は、10例の小児AA患者の網羅的タンパ ク質アレイによる自己抗体スクリーニングを実施し、5例で抗NT5C1A抗体を検出した。さらに、抗NT5C1A抗体は血液悪性腫瘍、免疫不全症、 健常者の検体からは検出されなかったことから、小児AAに特異的な自己抗体である可能性が示唆された。多数例の小児AAにおける抗NT5C1A抗体の解析結果と臨床像との関連性を検討することにより、小児AAの病態機構の解明を目指す。