医学部
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  2. 工藤 寿子

工藤 寿子

Kazuko Kudo

基本情報

所属
藤田医科大学 医学部 医学科 小児科学
学位
医学博士
J-GLOBAL ID
200901067857002933
researchmap会員ID
5000075863

研究分野

 1

論文

 120
  • Akira Morimoto, Yoko Shioda, Kazuko Kudo, Hirokazu Kanegane, Toshihiko Imamura, Katsuyoshi Koh, Yoshiyuki Kosaka, Yuki Yuza, Atsuko Nakazawa, Akiko M Saito, Tomoyuki Watanabe, Yozo Nakazawa
    International journal of hematology 118(1) 107-118 2023年7月  
    Chemotherapy with cytarabine, vincristine (VCR), and prednisolone has achieved low mortality rates in pediatric patients with Langerhans cell histiocytosis (LCH). However, relapse rates remain high, making event-free survival (EFS) rates unsatisfactory. A nationwide clinical trial, LCH-12, tested a modified protocol in which the early maintenance phase was intensified with increasing dosages of VCR. Patients newly diagnosed with multifocal bone (MFB) or multisystem (MS) LCH and aged < 20 years at diagnosis were enrolled between June 2012 and November 2017. Of the 150 eligible patients, 43 with MFB were treated for 30 weeks and 107 with MS LCH were treated for 54 weeks. One patient with MS LCH died of sepsis during the induction phase. The 3-year EFS rates among patients with MFB LCH, risk organ (RO)-negative MS LCH, and RO-positive MS LCH were 66.7% (95% confidential interval [CI], 56.5-77.0%), 66.1% (95% CI 52.9-76.4%), and 51.1% (95% CI 35.8-64.5%), respectively, similar to previously observed rates. EFS rates were significantly lower in patients with disease activity scores > 6 than in those with scores ≤ 6. The strategy that included more intense treatment with VCR was not effective. Other strategies are required to improve outcomes in patients with pediatric LCH.
  • Makito Tanaka, Hiroki Miura, Soichiro Ishimaru, Gen Furukawa, Yoshiki Kawamura, Kei Kozawa, Seiji Yamada, Fumitaka Ito, Kazuko Kudo, Tetsushi Yoshikawa
    Pediatric reports 15(2) 333-340 2023年5月26日  
    Central nervous system (CNS) involvement in anaplastic large cell lymphoma (ALCL) at diagnosis is rare and leads to poor prognosis with the use of the standard ALCL99 protocol alone. CNS-directed intensive chemotherapy, such as an increased dose of intravenous MTX, increased dose of dexamethasone, intensified intrathecal therapy, and high-dose cytarabine, followed by cranial irradiation, has been shown to improve survival in this population. In this paper, the authors describe a 14-year-old male with an intracranial ALCL mass at onset who received CNS-directed chemotherapy followed by 23.4 Gy of whole-brain irradiation. After the first systemic relapse, the CNS-penetrating ALK inhibitor, alectinib, was applied; it has successfully maintained remission for 18 months without any adverse events. CNS-penetrating ALK inhibitor therapy might prevent CNS relapse in pediatric ALK-positive ALCL. Next-generation ALK inhibitors could be introduced as a promising treatment option, even for primary ALCL with CNS involvement, which could lead to the omission of cranial irradiation and avoid radiation-induced sequalae. Further evidence of CNS-penetrating ALK inhibitor combined therapy for primary ALK-positive ALCL is warranted to reduce radiation-induced sequalae in future treatments.
  • Mami Akamatsu, Yoshiki Kawamura, Hiroki Miura, Erina Sugimoto, Kaoru Okamoto, Yoichi Nakajima, Kei Kozawa, Gen Furukawa, Makito Tanaka, Kazuko Kudo, Tetsushi Yoshikawa
    Pediatric dermatology 40(3) 582-583 2023年  
    Eczema herpeticum (EH) is a disseminated cutaneous infection with herpes simplex virus (HSV) that develops in patients with atopic dermatitis. The kinetics and clinical significance of HSV viremia in EH are poorly understood. Herein, we report HSV DNAemia in a child with EH 12 months after the completion of chemotherapy for Hodgkin lymphoma.
  • Akira Morimoto, Yoko Shioda, Kenichi Sakamoto, Ko Kudo, Toshihiko Imamura, Kazuko Kudo
    [Rinsho ketsueki] The Japanese journal of clinical hematology 63(5) 373-382 2022年  
    Langerhans cell histiocytosis (LCH) is characterized by immature dendritic cell proliferation, which is currently classified as an inflammatory myeloid neoplasm. Clinical features and outcomes vary from spontaneously regressing isolated bone disease to fatal liver, spleen, or hematopoietic system (risk organ) involvement-positive multisystem disease. LCH cells have the only mutation in the mitogen-activated protein kinase (MAPK) signaling pathway gene, represented by the BRAF V600E mutation, which is the driver mutation. The type of disease depends on the stage of hematopoietic cell differentiation at which the mutation occurs. LCH cells acquire anti-apoptosis and senescence-associated secretory phenotype by oncogene-induced senescence, with migration failure to lymph nodes. These cause LCH cell accumulation and various inflammatory cell recruitment in the lesion, resulting in severe inflammation. Tissue damage in LCH is due to this inflammation, not the LCH cell proliferation. Patients with a risk of organ involvement without the initial treatment response may be rescued by allogeneic hematopoietic stem cell transplantation after reducing the disease activity with MAPK inhibitors. Intravenous zoledronic acid and intrathecal cytarabine injections have been introduced into the ongoing clinical trial in Japan to reduce bone recurrence and prevent neurodegeneration as sequelae.
  • 工藤 耕, 土岐 力, 金崎 里香, 小林 明恵, 佐藤 知彦, 神尾 卓哉, 佐々木 伸也, 今村 勝, 今井 千速, 安藤 久美子, 角田 治美, 土居 岳彦, 川口 浩史, 入江 正寛, 笹原 洋二, 田村 彰広, 長谷川 大一郎, 板倉 陽介, 渡邉 健一郎, 深野 玲司, 坂本 謙一, 塩田 曜子, 加藤 元博, 工藤 寿子, 金兼 弘和, 伊藤 悦朗, 照井 君典
    日本血液学会学術集会 83回 OS2-2 2021年9月  
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MISC

 84
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書籍等出版物

 9
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講演・口頭発表等

 10
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所属学協会

 4

共同研究・競争的資金等の研究課題

 2
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