慶應義塾研究者情報データベース

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• Peripheral Blood Stem Cell Transplantation

  Yamazaki R., Watanabe-Okochi N., Concise Manual of Apheresis Therapy, 2026年01月

  　概要を見る

  Peripheral blood stem cell transplantation (PBSCT) is an indispensable treatment option for progressive malignant diseases. Autologous PBSCT (auto-PBSCT) is usually performed on patients with malignant disease without residual malignant cells in bone marrow. Allogeneic PBSCT (allo-PBSCT) is usually performed on patients with progressive hematological malignancies. In 2022, a total of 976 related and 310 unrelated allo-PBSCT procedures were performed in Japan.

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• 日常外来で遭遇する 感染症診療ガイド

  山崎　理絵，　森　毅彦，　岡本 真一郎, 永井書店, 2006年04月

  担当範囲: 341-351

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• Evaluation of peripheral blood stem cell collection in the Japan Marrow Donor Program (JMDP)

  Yamazaki R., Yakushijin K., Yoshihara S., Ikeda K., Ishida A., Kajiwara M., Kikuta A., Takagi N., Nagamura-Inoue T., Namba N., Haraguchi K., Fujimori Y., Fujiwara S.i., Yamada-Fujiwara M., Okuyama Y., Tanosaki R., Ueda Y.

  Transfusion 65 （ 12 ） 2345 - 2353 2025年12月

  ISSN  00411132

  　概要を見る

  Background: For peripheral blood stem cell (PBSC) collection of unrelated donors, the Japan Marrow Donor Program (JMDP) sets the target CD34+ cell dose as the minimum of 2 × 10⁶ cells/kg of recipient body weight (RBW) and recommends a processing blood volume (PBV) as high as 200 mL/kg of donor body weight (DBW) with ≤250 mL/kg per day within two consecutive days. Here, we retrospectively reviewed this guideline. Study Design and Methods: We analyzed 1656 unrelated donor PBSC collections between January 2012 and November 2022 from the JMDP database. Results: The target CD34+ cell dose was achieved within 2 days in all but 40 cases (2.4%), suggesting that the current JMDP guideline largely meets its objectives. The distribution of PBV per DBW showed three peaks. The most prominent peak, consisting of 834 (50.4%) cases, occurred around the recommended PBV (180–220 mL/kg of DBW), whereas 659 (39.8%) cases were in the lower PBV range (<180 mL/kg), and, notably, there was no significant difference between these groups in the collected CD34+ cells/kg RBW. On the other hand, among the 163 (9.8%) cases in the higher PBV group (>220 mL/kg), the number of collected CD34+ cells/kg of RBW was significantly lower than in the other two groups. Discussion: These results suggest that the target PBV in the lower and higher PBV groups was determined using CD34+ enumeration before or during apheresis procedure. CD34+ enumeration may help reduce the burden on donors, although further investigations are needed to confirm.

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• Risk factors for CAR-T cell manufacturing failure among DLBCL patients: A nationwide survey in Japan

  Jo T., Yoshihara S., Okuyama Y., Fujii K., Henzan T., Kahata K., Yamazaki R., Takeda W., Umezawa Y., Fukushima K., Ashida T., Yamada-Fujiwara M., Hanajiri R., Yonetani N., Tada Y., Shimura Y., Nishikii H., Shiba N., Mimura N., Ando J., Sato T., Nakashima Y., Ikemoto J., Iwaki K., Fujiwara S.i., Ri M., Nagamura-Inoue T., Tanosaki R., Arai Y.

  British Journal of Haematology 202 （ 2 ） 256 - 266 2023年07月

  ISSN  00071048

  　概要を見る

  For successful chimeric antigen receptor T (CAR-T) cell therapy, CAR-T cells must be manufactured without failure caused by suboptimal expansion. In order to determine risk factors for CAR-T cell manufacturing failure, we performed a nationwide cohort study in Japan and analysed patients with diffuse large B-cell lymphoma (DLBCL) who underwent tisagenlecleucel production. We compared clinical factors between 30 cases that failed (7.4%) with those that succeeded (n = 378). Among the failures, the proportion of patients previously treated with bendamustine (43.3% vs. 14.8%; p < 0.001) was significantly higher, and their platelet counts (12.0 vs. 17.0 × 10⁴/μL; p = 0.01) and CD4/CD8 T-cell ratio (0.30 vs. 0.56; p < 0.01) in peripheral blood at apheresis were significantly lower than in the successful group. Multivariate analysis revealed that repeated bendamustine use with short washout periods prior to apheresis (odds ratio [OR], 5.52; p = 0.013 for ≥6 cycles with washout period of 3–24 months; OR, 57.09; p = 0.005 for ≥3 cycles with washout period of <3 months), low platelet counts (OR, 0.495 per 10⁵/μL; p = 0.022) or low CD4/CD8 ratios (<one third) (OR, 3.249; p = 0.011) in peripheral blood at apheresis increased the risk of manufacturing failure. Manufacturing failure remains an obstacle to CAR-T cell therapy for DLBCL patients. Avoiding risk factors, such as repeated bendamustine administration without sufficient washout, and risk-adapted strategies may help to optimize CAR-T cell therapy for DLBCL patients.

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• Simultaneous quantification of dasatinib, nilotinib, bosutinib, and ponatinib using high-performance liquid chromatography–Photodiode array detection

  Yokoyama Y., Nozawa E., Morita M., Ishikawa E., Mori T., Sakurai M., Kikuchi T., Matsuki E., Yamazaki R., Kataoka K., Jibiki A., Kawazoe H., Suzuki S., Nakamura T.

  Journal of Clinical Laboratory Analysis （Journal of Clinical Laboratory Analysis）  36 （ 8 ）  2022年08月

  ISSN  08878013

  　概要を見る

  Background: Dasatinib, nilotinib, and bosutinib, second-generation tyrosine kinase inhibitors (TKIs), and ponatinib, a third-generation TKI, are approved pharmaceuticals used in the treatment of chronic myeloid leukemia (CML). Although liquid chromatography-tandem mass spectrometry assays for simultaneous quantification of the four TKIs in human serum have been reported in the literature, a high-performance liquid chromatography (HPLC) assay that simultaneously quantifies these compounds has not yet been developed. This study aims to establish and validate an efficient HPLC analytical method using a photodiode array (PDA) detector for the simultaneous quantification of the four TKIs. Methods: Calibration standards were prepared by serial dilution of serum samples containing the four TKIs, followed by solid-phase extraction. The four TKIs were eluted in order within 10 min using a binary HPLC gradient system. Results: The calibration ranges were 2–500 ng/ml for dasatinib, 100–5000 ng/ml for nilotinib, and 10–500 ng/ml for bosutinib and ponatinib. Intra-day and inter-day precision and accuracy values were found to be in accordance with the U.S. Food and Drug Administration guidelines. The recovery rates were 92.9%–96.0%, 80.7%–86.1%, 91.6%–99.0%, and 86.4%–92.6% for dasatinib, nilotinib, bosutinib, and ponatinib, respectively. Conclusion: To the best of our knowledge, this is the first report of an HPLC-PDA analytical method that allows efficient simultaneous quantification of the four TKIs in the serum of patients with CML. We believe that the method developed herein can improve the efficiency of therapeutic drug monitoring in patients with CML in clinical practice.

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• Comparison of cryoprotectants in hematopoietic cell infusion–related adverse events

  Ikeda K., Minakawa K., Yamahara K., Yamada-Fujiwara M., Okuyama Y., Fujiwara S.i., Yamazaki R., Kanamori H., Iseki T., Nagamura-Inoue T., Kameda K., Nagai K., Fujii N., Ashida T., Hirose A., Takahashi T., Ohto H., Ueda K., Tanosaki R.

  Transfusion （Transfusion）  62 （ 6 ） 1280 - 1288 2022年06月

  ISSN  00411132

  　概要を見る

  Background: The standard cryoprotectant for human cellular products is dimethyl sulfoxide (DMSO), which is associated with hematopoietic cell infusion-related adverse events (HCI-AEs) in hematopoietic stem cell transplantation including peripheral blood stem cell (PBSC) transplantation (PBSCT). DMSO is often used with hydroxyethyl starch (HES), which reduces DMSO concentration while maintaining the postthaw cell recovery. The cryoprotectant medium CP-1 (Kyokuto Pharmaceutical Industrial) is widely used in Japan. After mixture of a product with CP-1, DMSO and HES concentrations are 5% and 6%, respectively. However, the safety profile of CP-1 in association with HCI-AEs has not been investigated. Study Design and Methods: To compare CP-1 with other cryoprotectants, we conducted a subgroup analysis of PBSCT recipients in a prospective surveillance study for HCI-AEs. Moreover, we validated the toxicity of CP-1 in 90 rats following various dose administration. Results: The PBSC products cryopreserved with CP-1 (CP-1 group) and those with other cryoprotectants, mainly 10% DMSO (non-CP-1 group), were infused into 418 and 58 recipients, respectively. The rate of ≥grade 2 HCI-AEs was higher in the CP-1 group, but that of overall or ≥grade 3 HCI-AEs was not significantly different, compared to the non-CP-1 group. Similarly, after propensity score matching, ≥grade 2 HCI-AEs were more frequent in the CP-1 group, but the ≥grade 3 HCI-AE rate did not differ significantly between the groups. No significant toxicity was detected regardless of the CP-1 dose in the 90 rats. Conclusions: Infusion of a CP-1-containing PBSC product is feasible with the respect of HCI-AEs.

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• Novel Indicators of Transplant Outcomes for PhALL: Current Molecular-Relapse-Free Survival

  Nakasone H., Kako S., Tachibana T., Tanaka M., Onizuka M., Takahashi S., Yokota A., Fujiwara S.I., Sakura T., Sakaida E., Fujisawa S., Yamazaki R., Gotoh M., Hagihara M., Aotsuka N., Tsukada N., Hatta Y., Shimizu H., Usuki K., Watanabe R., Mori T., Yano S., Kanamori H., Kanda Y.

  Transplantation and Cellular Therapy （Transplantation and Cellular Therapy）  27 （ 9 ） 800.e1 - 800.e8 2021年09月

  ISSN  26666367

  　概要を見る

  Molecular relapse after allogeneic hematopoietic cell transplantation (allo-HCT) has been thought to predict clinical relapse in patients with Philadelphia chromosome–positive acute lymphoblastic leukemia (PhALL). Tyrosine kinase inhibitor (TKI) administration after allo-HCT may dynamically change the status from molecular relapse to molecular remission, but these state changes cannot be accurately represented by conventional survival indicators such as relapse-free survival, where events are usually considered irreversible. We aimed to develop novel indicators of transplant outcomes for allo-HCT recipients with PhALL and to visualize current molecular-relapse-free survival (CMRFS) and current on-TKI status (CTKI), treating molecular relapse or TKI administration after allo-HCT as a reversible event. We retrospectively analyzed 286 patients with PhALL who received allo-HCT between 2000 and 2016 in order to develop the indicators. CMRFS was defined as the probability of molecular remission without clinical relapse or death at any time after allo-HCT. Similarly, CTKI was defined as the probability of TKI administration without clinical relapse or death at any time after allo-HCT. The 1- and 5-year CMRFS rates were 67% and 59%, respectively, whereas the 1- and 5-year conventional molecular relapse-free survival rates were 42% and 37%. The 1- and 5-year CTKI rates were 14% and 8%, respectively. In a post hoc analysis focusing on patients who had achieved a molecular complete remission within 6 weeks (n = 201), the 5-year CMRFS rate (71%) was similar to the 5-year conventional molecular relapse-free survival (molRFS) rate (70%) in the non-TKI group. On the other hand, the 5-year CMRFS rate in the TKI group was 61%, whereas the 5-year conventional molRFS rate was only 38%. CMRFS and CTKI might become useful indicators of transplant success in terms of survival, leukemia-free status, and treatment-free status at any time point. Future extension of these survival models to other clinical situations is warranted.

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• ABO血液型不適合同種造血幹細胞移植後の血液型変化のメカニズムの探索

  山崎, 理絵

  学事振興資金研究成果実績報告書 （慶應義塾大学）  2020年

• 同種造血細胞移植後ヒトヘルペスウイルス6型再活性化の免疫機構の解明と予防法の確立

  山崎, 理絵

  科学研究費補助金研究成果報告書 2019年

• 同種造血細胞移植後ヒトヘルペスウイルス6型の再活性化の免疫学的機序の解明

  山崎, 理絵

  学事振興資金研究成果実績報告書 （慶應義塾大学）  2019年

• 同種造血幹細胞移植後のヒトヘルペスウイルス6型再活性化の免疫学的機序の探索

  山崎, 理絵

  学事振興資金研究成果実績報告書 （慶應義塾大学）  2018年

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• Germline RUNX1 translocation in familial platelet disorder with propensity to myeloid malignancies

  Sakurai M., Nannya Y., Yamazaki R., Yamaguchi K., Koda Y., Abe R., Yokoyama K., Ogawa S., Mori T.

  Annals of Hematology （Annals of Hematology）  101 （ 1 ） 237 - 239 2022年01月

  ISSN  09395555

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• Long-term remission of cryopyrin-associated periodic syndrome after allogeneic haematopoietic stem cell transplantation

  Mori T., Saburi M., Hagihara M., Mori M., Yamazaki R., Kato J.

  Annals of the Rheumatic Diseases 80 （ 4 ） 542 - 543 2021年04月

  ISSN  00034967

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• Evaluation of the platelet-specific antibody response in thrombocytopenia following allogeneic hematopoietic stem cell transplantation.

  Yamazaki Rie, Mori Takehiko, Kuwana Masataka, Okazaki Y., Kawakami Yutaka, Ikeda Yasuo Okamoto Shinichiro

  [国際会議]  ASBMT/IBMTR Tandem BMT Meetings （Orlando, Florida） , 

  2004年02月

  , 

  ポスター発表

• Allogeneic stem cell transplantation using high-dose cytarabine combined with G-SCF and TBI as conditioning for chronic myelogenours leukemia (CML) in advanced stage

  Yamazaki Rie, Mori Takehiko, Shimizu Takayuki, Aisa Yoshinobu, Ikeda Yasuo, Okamoto Shinichiro

  [国際会議]  ASBMT/IBMTR Tandem BMT Meetings, 

  2003年01月

  , 

  ポスター発表

• Cytomegalovirus (CMV) gastrointestinal disease in allogeneic hematopoietic stem cell transplant recipients under preemptive therapy based on CMV antigenemia or polymerase chain reaction

  Mori Takehiko, Shimizu Takayuki, Aisa Yoshinobu, Nishida Hiroko, Yamazaki Rie, Ikeda Yasuo, Okamoto Shinichiro

  [国際会議]  ASBMT/IBMTR Tandem BMT Meetings, 

  2003年01月

  , 

  ポスター発表

• Allogeneic stem cell transplantation using high-dose cytarabine combined with G-SCF and TBI as conditioning for chronic myelogenours leukemia (CML) in advanced stage

  Yamazaki Rie, Mori Takehiko, Shimizu Takayuki, Aisa Yoshinobu, Ikeda Yasuo, Okamoto Shinichiro

  [国際会議]  ASBMT/IBMTR Tandem BMT Meetings, 

  2003年01月

  , 

  ポスター発表

• 同種造血幹細胞移植において検出される同種抗原特異的T細胞と認識抗原の同定－選択的GVLに向けて－

  山崎理絵，河上裕

  [国内会議]  第2回臨床免疫研究会, 

  2002年06月

  , 

  口頭発表（一般）

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• 同種造血細胞移植後ヒトヘルペスウイルス6型再活性化の免疫機構の解明と予防法の確立

  2017年04月

  -

  2020年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 山崎　理絵, 基盤研究(C), 補助金,  研究代表者

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• 輸血臨床実習

  2025年度

• 内科学（血液）講義

  2025年度

• 内科学演習

  2025年度

• 内科学実習

  2025年度

• 内科学特論

  2025年度

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