[Investigation of Anti-Cancer Drugs Suspected as Causative Agents of Allergy by Drug-Induced Lymphocyte Stimulation Test and Subsequent Re-Administration].

Twenty-one patients underwent a drug-induced lymphocyte stimulation test(DLST)withanti -cancer drugs suspected as causative agents of allergy between January 1, 2013, and December 31, 2017, at Ichinomiya Municipal Hospital, and 7 (33.3%)and 14 patients were positive and negative, respectively. Moreover, only 2 out of 21 people had a low value in lymphocyte blast transformation test induced by phytohemagglutinin, and their immune ability was maintained. Two patients suspected of drug eruption were re-administered after a positive determination. Letrozole was re-administered in 1 patient, but exemestane was administered after the patient relapsed. The other patient received lenalidomide in combination with dose-reduction and prednisolone(PSL), and the patient did not relapse. Seven patients were re-administered after negative determination, and none of them relapsed. These results confirmed that re-administration was possible depending on the type of side effects even in DLST positive cases; however, it was necessary to take various precautions. Moreover, DLST results were an index for finding the cause, and it is important to consider other diagnostic methods carefully during re-administration.

[Investigation and Measurement of Hypophosphatemia Induced by Tyrosine Kinase Inhibitors in Patients with Chronic Myeloid Leukemia].

We retrospectively investigated hypophosphatemia induced byty rosine kinase inhibitors(TKIs), in patients with chronic myeloid leukemia. Subjects evaluated were 14, 11, and 8 patients who received TKIs(imatinib, dasatinib and nilotinib), respectively, at the Department of Hematology in Ichinomiya Municipal Hospital, between 1st January 2006 and 31st Decem- ber 2016. The incidence of hypophosphatemia was 85.7%(12/14)for imatinib, 18.2%(2/11)for dasatinib, and 37.5%(3/ 8)for nilotinib, and hypophosphatemiaBgrade 3 occurred in 57.1%(8/14)of imatinib- and 9.1%(1/11)of dasatinibtreated patients. Instances of hypophosphatemiaBgrade 3 were not confirmed for nilotinib. Six patients received oral phosphate for hypophosphatemia, and all of these were patients who had been administered imatinib. We confirmed a significant improvement(p<0.05, 95%CI: 0.111-0.989)in serum phosphate levels after administration of oral phosphate, suggesting that it constitutes an effective measure against this situation.

[A Case of Hypophosphatemia Induced by Administration of Amrubicin in a Patient with Small Cell Lung Cancer].

A man in his 50s with small cell lung cancer received amrubicin as the fourth-line therapy from August 201X-1. Serum phosphorus levels before treatment were normal at 2.9mg/dL, but grade 2 hypophosphatemia(2.1mg/dL)was observed at the beginning of the 2nd course. He underwent laryngoplasty after the 4th course. Retreatment was initiated in June 201X due to disease progression. After reinitiating treatment, the disease developed to grade 3 hypophosphatemia. As we identi- fied lower levels(1.1mg/dL)at the start of the 10th course, a pharmacist proposed oral phosphate therapy to the attending physician, which we administered. After then, the levels improved to 2.2mg/dL; thus, oral phosphate therapy was interrupted. However, because of a decline in serum phosphorus levels to grade 3, we administered the therapy again, and observed favorable improvement. For hypophosphatemia in this case, general reasons in clinical practice were not applicable; thus, amrubicin is considered to be a most possible cause.

An efficient chemoenzymatic production of small molecule glucosides with in situ UDP-glucose recycling.

A one-pot system for efficient enzymatic synthesis of curcumin glucosides is described. The method couples the activities of two recombinant enzymes, UDP-glucose: curcumin glucosyltransferase from Catharanthus roseus (CaUGT2) and sucrose synthase from Arabidopsis thaliana (AtSUS1). UDP, a product inhibitor of UDP-glucosyltransferase, was removed from the system and used for regeneration of UDP-glucose by the second enzyme, AtSUS1. The productivity was increased several-fold and UDP-glucose initially added to the reaction mixture could be reduced to one-tenth of the normal level. The concept of enhancing glucosylation efficiency by coupling a UDP-glucose regeneration system with glucosyltransferases should be applicable to enzymatic production of a wide range of glucosides.