This study aimed to elucidate the motivations of middle-aged patients who received allogeneic hematopoietic stem cell transplantation (hereafter referred to as allo-HSCT), with the goal of examining nursing approaches that help them maintain their will to continue treatment despite experiencing distress. Semi-structured interviews were conducted with eight middle-aged patients who underwent allo-HSCT between April 2020 and March 2023, and the data were analyzed using qualitative inductive analysis. The participants included four men and four women, with an average age of 49. The key motivations identified among these middle-aged patients who received allo-HSCT were; [Dedicating themselves to achieving the best possible treatment outcome], [Believing that they are saved by those around them], [Managing daily schedules in a way that reduces burden], and [Holding onto the vision of curing their disease]. These findings suggest the importance of providing nursing support that helps patients consistently maintain the perspective that they are actively engaged in their own treatment while also alleviating the burdens associated with allo-HSCT.
2.
Mizuki Yoshimoto, Shin-ichiro Yanagiya, Hiroki Takanari, Takeshi Honda, Yusaku Maeda, Ryohei Sumitani, Masahiro Oura, Kimiko Sogabe, Takeshi Harada, Shiro Fujii, Shingen Nakamura, Yoshimi Bando, Koichi Tsuneyama, Itsuro Endo, Masahiro Abe, Ken-ichi Matsuoka and Hirokazu Miki : Development of a rapid and novel diagnostic technique for cardiac amyloidosis using Raman spectroscopy., Research Square, 2025.
(Summary)
Although the prognosis of cardiac amyloidosis has improved with the development of therapies, the time required for disease typing remains a critical issue. We investigated the potential of Raman spectroscopy for the more rapid diagnosis and typing of cardiac amyloidosis. Heart biopsies were collected from patients with the AL (4) and ATTR (4) types of cardiac amyloidosis, and tissue sections were subjected to Raman microscopy. A principal component analysis (PCA) of spectral data was performed and receiver operating characteristic (ROC) curves were created to confirm the accuracy of discriminating between amyloid-deposition and non-deposition sites, and between AL and ATTR. The steep peak at 1680 cm-1, reflecting the β-sheet structure, was useful for detecting the amyloid-deposition region. By restricting the spectral analysis to amyloid-deposition sites, AL and ATTR were discriminated by principal components with a characteristic broad peak at 1520-1540 cm-1, which was also observed in the Raman spectrum of AL, but not ATTR. The area under ROC curve discriminating AL and ATTR was 0.78. PCA of the Raman spectra of cardiac biopsies has the potential not only to detect amyloid-deposition sites in tissue but also to rapidly discriminate between the AL and ATTR types of cardiac amyloidosis.
Kazuko Akashi, Yoshie Imai, Shingen Nakamura, Yusaku Maeda, Ryohei Sumitani, Masahiro Oura, Kimiko Sogabe, Mamiko Takahashi, Shiroh Fujii, Takeshi Harada and Hirokazu Miki : Preparedness for the future in patients with relapsed or refractory hematopoietic malignancies in the treatment process: a qualitative study, Annals of Palliative Medicine, 14, 1, 43-56, 2025.
(Summary)
This study aims to clarify how patients with relapsed or refractory (R/R) hematological malignancies prepare for the future and set treatment goals. R/R hematological malignancies often require intensive therapies, including stem cell transplantation and CAR-T cell therapy, which pose high risks of adverse events. Many patients continue aggressive treatment until the end of life for pain relief or even a potential cure, despite the significant symptom burden. Understanding each patient's treatment motivations and preferences is essential to aligning care with their individual values. By examining their experiences, current health status, and treatment goals, this study seeks to provide a basis for holding early discussions on future care, contributing to individualized decision-making support for patients facing limited treatment options and uncertain prognoses. A qualitative descriptive study design was used to conduct semi-structured interviews with 16 patients with relapsed/refractory hematopoietic malignancies who were hospitalized for chemotherapy. The four main themes expressed by the participants were (I) I want to live through the treatment until the end of my life because I know recovery is difficult; (II) my current treatment depends on how much my body can endure; (III) I want to keep trying, but I am at the limit of what I can do now; and (IV) I want to continue even if the treatment is limited because I think it will help someone else. Patients with hematopoietic malignancies who are undergoing treatment may be motivated by a variety of different factors to continue with treatment. Discussing patients' goals and wishes with respect to treatment is critically important to ensure that such treatment is aligned with patients' preferences.
(Keyword)
Humans / Hematologic Neoplasms / Male / Female / Middle Aged / Qualitative Research / Adult / Aged / Palliative Care
Yusuke Inoue, Hirofumi Tenshin, Jumpei Teramachi, Ryohei Sumitani, Asuka Oda, Yusaku Maeda, Masahiro Oura, Kimiko Sogabe, Tomoko Maruhashi, Mamiko Takahashi, Shiroh Fujii, Shingen Nakamura, Hirokazu Miki, Tomoyo Hara, Itsuro Endo, Kumiko Kagawa, Shuji Ozaki, Masahiro Hiasa, Takeshi Harada and Masahiro Abe : Elotuzumab-mediated ADCC with Th1-like Vγ9Vδ2 T cells to disrupt myeloma-osteoclast interaction., Cancer Science, 116, 2, 559-563, 2024.
(Summary)
Multiple myeloma (MM) cells and osteoclasts (OCs) activate with each other to cause drug resistance. Human Th1-like Vγ9Vδ2 (γδ) T cells, important effectors against tumors, can be expanded and activated ex vivo by the aminobisphosphonate zoledronic acid in combination with IL-2. We previously reported that the expanded γδ T cells effectively targeted and killed OCs as well as MM cells. Because the expanded γδ T cells expressed CD16 on their surface, we investigated the utilization of the expanded γδ T cells for antibody-dependent cellular cytotoxicity (ADCC). Although the expanded γδ T cells alone induced cell death in MM cell lines, the addition of the anti-SLAMF7 monoclonal antibody elotuzumab (ELO) further enhanced their cytotoxic activity only against SLAMF7-expressing MM cell lines and primary MM cells. Intriguingly, ELO was also able to enhance γδ T cell-induced cell death against OCs cultured alone, and against both MM cells and OCs in their coculture settings. SLAMF7 was found to be highly expressed in OCs differentiated in vitro from monocytes by receptor activator of nuclear factor-κ B ligand and M-CSF, although monocytes only marginally expressed SLAMF7. These results demonstrate that SLAMF7 is highly expressed in both MM cells and OCs, and that the ex vivo-expanded γδ T cells can exert ELO-mediated ADCC against SLAMF7-expressing MM cells and OCs besides their direct cytotoxic activity. Further study is warranted for the innovative utilization of γδ T cells.