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Volume 34, Issue 6
Displaying 1-19 of 19 articles from this issue
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Tomoo TAKIGUCHI, Masaaki FUKUTOKU, Yuko HIROSE, Toshihide ARAI1993 Volume 34 Issue 6 Pages 689-696
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSHuman TCR γ/δ cell clones were produced from both CD2-depleted normal peripheral blood mononuclear cells (PBMC) and leukemia and lymphoma cell-predominant PBMC, effusion cells and lymph node cells in in vitro cultures with rIL-1 and rIL-2 and using limiting dilution techniques. These clones were then analyzed as to their cell morphology, phenotype and non-major histocompatibility-restricted cytotoxicity (NMRC) to K562. The results of the cloning from CD2-depleted PBMC showed 112 WT31+ γ/δ-1- clones, 62 WT31- γ/δ-1+ clones and 101 WT31- γ/δ-1- clones. These were produced in 17 serial experiments. The addition of EBV-infected B cell line cells as feeder cells resulted in better production of γ/δ-1+ and non-T cell clones than that of WT31+ clones. One typical example of the cloning from lymphoblastic lymphoma cell-predominant PBMC resulted in the production of 8 γ/δ-1+ and 3 WT31+ clones. Most of the clones proven to be γ/δ-1+ clones had the CD2+ CD3+ CD4-∼+ CD8-∼+ TCRδ-1+ βF1- αF1- and δTCS-1- phenotype, but few clones displayed CD2- or δTCS-1+ phenotype. These γ/δ-1+ clones were morphologically large granular lymphocytes, but functionally they did not have NMRC to K562. It is possible to say that TCR γ/δ clones were rather easily produced from TCRα/β cell-depleted PBMC and effusion cells, and can be used for the study of their nature and characteristics.View full abstractDownload PDF (615K) -
Heiwa KANAMORI, Juichi TANABE, Rie OKAMOTO, Tomohiko TAMURA, Hiroyuki ...1993 Volume 34 Issue 6 Pages 697-704
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSBetween 1981 and 1990, ACOMEP-BD regimen (adriamycin, cyclophosphamide, vincristine, methotrexate, etoposide, prednisolone, bleomycin, dacarbazine) was compared with VEPA regimen (vincristine, cyclophosphamide, prednisolone, adriamycin) in 66 newly diagnosed patients younger than 65 of age, with non-Hodgkin's lymphoma (NHL). The median age of the patients was 47.5 years (range 22∼64 years), 43 males and 23 females. One patients were in stage I, 6 were in II, 27 were in III, 32 were in IV. Twenty-seven patients received VEPA and 39 received ACOMEP-BD. The therapeutic results of 66 patients with ACOMEP-BD or VEPA were as follows: complete remission (CR) rate of 54% and 48%; relapse rate of 29% and 77%; CR duration of 2∼34 months (mean: 22 months) and 2∼74 months (16 months); freedom-from-relapse survival (at 3 years) of 71% and 38%; and overall survival (at 4 years) of 62% and 26%, respectively. In these results, only relapse rate was significant and the others were not. Prognostic factors were performance status (PS) and lactate dehydrogenase level for ACOMEP-BD, and PS and marrow involvement for VEPA. Received dose intensity was 0.85 in ACOMP-BD and 0.41 in VEPA. It was expected that outcome of patients with NHL can be improved by increasing dose intensity.View full abstractDownload PDF (534K) -
Nozomi ARAI, Tatsuo SHIRAI1993 Volume 34 Issue 6 Pages 705-711
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSIn order to elucidate focal immunity of the lung before and after treatment of malignant lymphoma, evaluation was made of peripheral blood (PB) and bronchoalveolar lavage fluid (BALF) before and after COP-BLAM therapy. Ten patients with untreated B cell lymphoma without any abnormal shadow in the lung fields were studied. After treatment, slight increases in the total cell counts and macrophages in BALF were observed. In patients with pulmonary complications after treatment, the CD4/CD8 ratio in PB did not change after treatment, but it did change in BALF after treatment in patients with lung disease. According to 2-color analysis, CD4+CD45RA+ cells and CD4+HLA-DR+ cells were lower in BALF before treatment in patients with lung disease, suggesting some relationship with lung complications. The CD4/CD8 ratio of lymphocytes within BALF increased after COP-BLAM therapy, probably owing to NHL itself or to chemotherapy.View full abstractDownload PDF (515K) -
Koichiro IKUTA, Kenichiro FUJIOKA, Hiroyuki TAKAHASHI, Hiroko SUMITA, ...1993 Volume 34 Issue 6 Pages 712-717
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe evaluated the clinical courses and laboratory features in 13 laterelapse cases of 55 children with acute lymphoblastic leukemia who had been in complete remission for longer than therr years. In 8 of 13 cases, leukemia relapsed in bone marrow; 2 with testicular, 1 with central nervous system and one with ovarian involvement. Further, extramedullary relapse not involving bone marrow occured in 5 cases (4 testicular and 1 CNS). Late-relapse was more frequently observed in boys (37.5%) than in girls (4.4%). Initial age and leukocyte counts were of no value in predicting laterelapse. The relapse rate in cases initially treated by the VPL regimen was twice that of those by a multi-drug regimen. A second prolonged remission was achieved in 5 of 10 cases by combinations of intensive chemotherapy (modified HEX) and irradiation to the testes or CNS. On the contrary, all late relapse patients initially treated by the multi-drug chemotherapy had a poor outcome. More intensive chemotherapy, including high-dose chemoradiotherapy and bone marrow transplantation, should be employed in this group of patients.View full abstractDownload PDF (547K)
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Yoshiaki HOSHINO, Kiyohiko HATAKE, Jun MIMURO, Yukio NAKAMURA, Norifum ...1993 Volume 34 Issue 6 Pages 718-722
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe report here a case of 33 year-old-man with refractory bilateral pneumothoraces during the treatment for interstitial pneumonitis 6 months after bone marrow transplantation (BMT). He was diagnosed as having acute myelogenous leukemia (AML) M1. He was treated with chemotherapy, and cerebral irradiation. BMT was performed in August 1989 from a sibling donor whose human leukocyte antigen was matched, ABO blood type mismatched. Preconditioning regimen was cyclophosphamide and total body irradiation (TBI). BMT was successful without major graft versus host disease. Thereafter he complained of respiratory symptom and was admitted on June 14 1990. Computed tomogram (CT) scan showed interstitial and alveolar shadows. We started the treatment against bacterial infection, Pneumocystis carinii, cytomegalovirus (CMV) and against interstitial pneumonitis with bolus dose of steroid. The transbronchial lung biopsy specimen revealed interstitial pneumonitis without typical CMV nor pneumocystis carinii pneumonia. Alothough a CT scan showed improvement of pneumonitis, bilateral pneumothoraces occurred. The adhesion therapy became successful after the reduction of steroid dosage. A pneumothorax rarely occurs after BMT. In this case it is speculated that TBI might be responsible for interstitial pneumonitis, and the steroid might have inhibited the adhesion therapy of pneumothorax.View full abstractDownload PDF (693K) -
Toshiko ONIZUKA, Seitetu SATOU, Michiaki KOIKE, Taijiro ISHIYAMA, Shig ...1993 Volume 34 Issue 6 Pages 723-727
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old female, clinically diagnosed as having parapsoriasis en plaque for ten years, was referred on June 1991 to the Department of Oral Surgery in the Dental School of showa University with a complaint of painless swelling of the left malar area. The swelling was found to have been caused by a tumor. Since the excised tumor was suspected to be a malignant lymphoma, she was admitted to our hospital. The specimen was subsequently confirmed to be a malignant lymphoma of the diffuse large cell type according to the LSG classification, and was immunologically confirmed to be a B cell lymphoma. In addition, the excised skin was suspected of incipient mycosis fungoides. She was classified as having stage IE disease according to her bone marrow biopsy and other examinations. she was treated with combination of chemotherapy (CHOP) and radiation therapy. This subject was interesting because her tumor probably resulted from a parapsoriasis en plaque skin lesion.View full abstractDownload PDF (667K) -
Masako KIKUCHI, Kazutoshi ONO, Yoshinori SHIMAMOTO, Masaya YAMAGUCHI1993 Volume 34 Issue 6 Pages 728-732
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSSpontaneous remission in a 50-year-old woman with adult T-cell leukemia (ATL) is presented. The patient was referred to our hospital because of generalized lymphadenopathy and the appearance of abnormal lymphocytes with convoluted nuclei in the peripheral blood. She was diagnosed as ATL because of the characteristic morphological ATL cells, cell surface marker analysis and the presence of serum antibody to human T-cell lymphotropic virus type-I (HTLV-I). However during the following weeks before admission, her leukocyte count and ATL cells in the peripheral blood decreased in number even though she received no therapy. After admission, abnormal lymphocytes in the peripheral blood disappeared and lymphadenopathy decreased in size, LDH level was normalized. Spontaneous remission had continued ten months without chemotherapy, but she developed recurrence thereafter and died two years later after onset with progressive disease. Gene analysis study by Southern blot analysis showed monoclonal integration of HTLV-I proviral DNA at the same positions both before regression and after recurrence. In this case, the trigger of spontaneous remission was unclear.View full abstractDownload PDF (621K) -
Atsushi KITABAYASHI, Ikuo MIURA, Toshihiro ITO, Masanori TAKAHASHI, Ak ...1993 Volume 34 Issue 6 Pages 733-737
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESS[Case 1] A 44-year-old female was referred to our hospital because of leukocytosis. The WBC count was 26400/μl and NAP score 21. As Ph1 chromosome was detected, she was diagnosed as CML and treated with busulfan. Because of the rapid decrease of WBC, we stopped busulfan. Progressive pancytopenia and an increase of myeloblasts and promyeloblasts in the bone marrow was observed. We started vincristine and prednisolone therapy. Ph1 chromosome was not detectable and southern blot analysis did not show rearranged bands of M-bcr three years after the last therapy. [Case 2] A 74-year-old female was referred to our hospital by reason of leukocytosis and thrombocytosis. The WBC count was 22,500/μl, the platelet 907,000/μl, NAP score 53, and Ph1 chromosome was found. The diagnosis of CML was made, and she was treated with busulfan. The WBC rapidly fell to 1,900/μl, when chromosome analysis revealed the presence of Ph1 negative clones (4/20). She was admitted due to thrombocytopenia and leukocytosis with the additional chromosome change of i (17q). Her peripheral blood and bone marrow pictures were consistent with blast crisis, and she died of cardiac tamponade. These two cases show the heterogeneity of CML patients, and also suggest the possibility that keeping the WBC count low may lead to a decrease of Ph1 positive clones.View full abstractDownload PDF (378K) -
Yoshimi HARADA, Teiko KATANO, Yoshitaka NAKAMURA, Yamao ADACHI1993 Volume 34 Issue 6 Pages 738-742
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old male patient was seen on December 15, 1980 because of right shoulder pain and leukocytosis. The spleen and the liver were enlarged, and palpable, 3 and 4 fingerbreadths below the costal margin respectively. The red blood cell count (RBC) was 899×104/μl, hemoglobin (Hb) 20.6 g/dl, reticlocyte (Ret) 7‰, platelets (Plt) 34.2×104/μl, the white blood cell count (WBC) 26,800/μl with 86% neutrophils. A bone marrow aspiration showed the nucleated cell count (NCC) to be 16.5×104/μl, and the myeloid/erythroid ratio (M/E) 2.0. The patient was treated with venesection and later with carboquone. Since September 1990 he has not been treated with any agents because of erythrocytopenia. In July 25, 1991, the spleen was enlarged, and palpated 8 fingerbreadths below the costal margin. The RBC was 456×104/μl, Hb 12.5 g/dl, Ret9‰, Plt24.2×104/μl, the WBC41,500/μl with 90% neutrophils. Bone marrow aspiration showed the NCC to be 16.5×104/μl, M/E14.3, with no atypical cells. Chromosome studies of marrow cells revealed no Ph1 chromosome. Many hematologic malignancies have been occasionally associated with polycythemia vera (PV), but chronic neutrophilic leukemia associated with PV is a very rare condition.View full abstractDownload PDF (758K) -
Shigeru TOMOYASU, Keiichiro KAWAKAMI, Toshiko ONIZUKA, Taijiro ISHIYAM ...1993 Volume 34 Issue 6 Pages 743-747
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 60-year-old female was admitted to our hospital because of macrocytic anemia with anisopoikilocytosis and thrombocytopenia. A bone marrow aspiration revealed hypolasia with nuclear deformity of neutrophils and decrease of megakaryocytic numbers. Karyotype analysis showed 47, XX, +8. A diagnosis of refractory anemia was made. The patient was treated with metenolone acetate without clinical response. Deferoxamine (2g/day) was given intravenously by continuous infusion. Ten days after deferoxamine treatment, the levels of RBC and platelet increased and the effect lasted 100 days after discontinuance of deferoxamine. Bone marrow aspiration showed normoplasia with normal megakaryocytes numbers. However, anisopoikilocytosis, abnormality of MCH and MCHC, and karyotype abnormality similar to the first medical examination remained. These data might suggest that deferoxamine induced differentiation of abnormal hemopoietic cells in refractory anemia. Retrobulbar neuritis which developed 30 days after initiation of treatment disappeared after halting deferoxamine treatment.View full abstractDownload PDF (425K) -
Kazuyo KUROSAWA, Shin AIZAWA, Hitoshi HOJO, Yoshikazu KAWANISHI, Yukih ...1993 Volume 34 Issue 6 Pages 748-752
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 36-year-old man was diagnosed as having acute non-lymphocytic leukemia (AML M5b) in 1985 and received allogenic bone marrow transplantation from an ABO-mismatched sibling in January 1987. Recovery of erythropoiesis in this patient was delayed, then the hemoglobin level improved in parallel with disappearance of anti-A antibody in the serum on day 260 post transplantation. However, as anemia occured again despite no relapse of leukemia on day 350, we tried to determine the presence of erythropoietic inhibitory factor in this patients. Erythroid colony formation was decreased when bone marrow cells were co-cultured with peripheral mononuclear cells from the patient. Further, erythroid colony inhibitory activity was found in conditioned medium of PHA-stimulated T cells from the patient. Sephadex gel fractionation showed that the molecullar weight of this inhibitory factor was approximately 11,000 and addition of a high concentration of EPO did not eliminate the inhibitory activity. These findings suggest that the novel inhibitor described in this manuscript, produced by T cells, was differed from previously reported inhibitors such as anti-EPO antibody, spermine and uremic toxins.View full abstractDownload PDF (357K) -
Hirohisa KASHIMA, Ken-ichi SUGITA, Hitoshi SAKAKIBARA, Mitsuoki EGUCHI ...1993 Volume 34 Issue 6 Pages 753-758
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA patient who developed hypo-γ-globulinemia and cerebral infarction during the treatment for acute lymphoblastic leukemia (ALL) is reported. In this patient fever and rash during radio-therapy for central nervous system (CNS) prophylaxis and nausea and vomiting were observed during maintenance therapy. On the laboratory findings high level of the protein level in the cerebrospinal fluid and the eosinophil count of the peripheral blood were found in every examination. We attempted to isolate various virusus in consideration of the possibility of infection, but no virus could be detected. The effects of methotrexate (MTX) and l-asparaginase were also suspected. Since nausea and vomiting disappeared after discontinuation of MTX administration, the drug may had some effect, and the possibility of cerebral damage by MTX can not be excluded. Complication of irradiation are reported to occur often more than 10 years after the treatment, but this patient had the onset only 2 years after the treatment. Therefore, irradiation was unlikely to be responsible for the symptoms. The relation between the hypo-γ-globulinemia and cerebral infarction was also unknown.View full abstractDownload PDF (913K) -
Kenji MURAOKA, Toshiro HARA, Tetsuro KAJIWARA, Yuichiro SIMODA, Yuichi ...1993 Volume 34 Issue 6 Pages 759-763
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 21-year-old man with hemophilia B and human immunodeficiency virus (HIV) infection was admitted with hematemesis and melena. After admission, esophagogram and endoscopy showed a single giant ulcer with ovoid shape and slightly irregular margins in the middle esophagus. Biopsy specimens of the esophageal ulcer showed non-specific granulation and etiology was unknown. Therapeutic trials of famotidine, sodium alginate, acyclovir, and amphotericin B did not result in favorable response. With a combination therapy of dexamethasone and sucralfate, the swallowing pain was rapidly disappeared with gradual improvement of the ulcer. To our knowledge, this is the first report of a giant esophageal ulcer in a HIV infected patient in Japan.View full abstractDownload PDF (1015K) -
Hiroshi FUJII, Hitoshi NAKAGAWA, Yoshiaki SONODA, Yuhko KUZUYAMA1993 Volume 34 Issue 6 Pages 764-768
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThis report deals with a case of RAEB in transformation (RAEB-T) who received peripheral blood stem cell transfusion (PBSCT) and has remained in complete remission for 15 months. A 51-year-old man was admitted to our hospital with abnormal hematological examinations in August 1991. Peripheral blood showed a WBC of 3,580/μl with 19% myeloblasts. Bone marrow aspirate revealed slight hypocel-lularity with 21.2% myeloblasts. Many of these myeloblasts contained Auer rods. He was diagnosed as having RAEB-T. He was treated with low dose Ara-C, followed by the BHAC-VEP regimen and complete remission was obtained 2 months later. After high dose Ara-C regimen, one leukapheresis was performed using CS-3000 during bone marrow recovery. The collected number of CFU-GM, BFU-E and CFU-mix were 4.3, 4.3 and 0.68×105/kg b.w., respectively and they were cryoreserved. In November 1991, 16mg/kg b.w. of busulfan, 120mg/kg b.w. of cyclophosphamide and rG-CSF were used as a conditioning regimen and PBSCT was performed. The infused number of CFU-GM, BFU-E and CFU-mix were 0.8, 0.9 and 0.14×105/kg b.w., respectively. The number of days to reach 500 neutrophils/μl and 5×104 platelets/μl was 17 and 63 days, respectively. He has remained in complete remission for 15 months after PBSCT. PBSCT appears to be one effective therapeutic choice for the treatment of RAEB-T.View full abstractDownload PDF (431K)
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Chiaki NAKASEKO, Hakumei OH, Katsuhiro KOGURE, Akihiro ISHII, Hideshi ...1993 Volume 34 Issue 6 Pages 769-772
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 39-year-old female with AML (M2) underwent allogeneic bone marrow transplantation (BMT) on July 8th, 1991. The post transplantation course had been going well until day 85 post BMT, when severe hemorrhagic cystitis with right hydronephrosis and ureter stenosis developed. Adenovirus type 11 was isolated from the urine. She received instillations of prostaglandin E1 (PGE1) directly into the bladder after the appearance of clots in the urine. Complete resolution of hematuria was obtained by two courses of this treatment. PGE1 bladder instillations seem to be effective for the control of hematuria caused by severe hemorrhagic cystitis after BMT.View full abstractDownload PDF (653K) -
Tomoyasu IKEGAMI, Hakumei OH, Hirotoshi NAKAMURA, Takayoshi ASAI, Sho ...1993 Volume 34 Issue 6 Pages 773-775
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSIt has been reported that serum levels of thrombomodulin (TM) reflect endothelial damages in various diseases. We measured serum TM levels between day—10 and day 100 in 6 patients receiving allogeneic bone marrow transplantation. Serum TM levels were increased when patients had transplant related complications including graft versus host disease, hemorrhagic cystitis and interstitial pneumonitis. In patient without complications, serum TM levels were within normal limits. These results suggest that the serum TM level serves as a useful marker of treatment related toxicity and a predictor of complications after BMT.View full abstractDownload PDF (201K)
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1993 Volume 34 Issue 6 Pages 776-786
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (992K)
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1993 Volume 34 Issue 6 Pages 787-790
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (356K) -
1993 Volume 34 Issue 6 Pages 791-794
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (397K)
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