All issues
Volume 44, Issue 9
Displaying 1-9 of 9 articles from this issue
- |<
- <
- 1
- >
- >|
-
Minoru HASEGAWA, Toshimitsu TANAKA, Takayuki KII, Shinnya FUJIWARA, Na ...2003 Volume 44 Issue 9 Pages 933-939
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 42-year-old man was admitted with hematuria after a common cold. No purpura could be observed but there was oozing on the site of the forearm where blood had been taken in a previous hospital. Platelet count was 292×103/μl, examination of coagulation system showed abnormalities; prolonged prothrombin time: PT (99.7sec) and activated partial thromboplastin time: APTT (more than 200sec), which suggested deficiency of coagulation factor II (FII), factor V (FV) or factor X (FX). In fact, the FV activity was only 2% of the pooled normal plasma. Mixing test of patient's plasma with normal pooled plasma revealed the existence of an FV inhibitor (FVI), which was IgA with an activity levels of 3 Bethesda unit/ml. Although hematuria stopped soon after beginning treatment with steroids (PSL), the abnormalities in PT and APTT improved very slowly and incompletely. At the time of writing, FVI is still observed ten months after onset. The patient had no underlying disease, and in this case FVI appeared following a common cold. Previous reports have said that FVI can cause mild bleeding, and it disappear in a short time. This case showed the possibility of the hidden presence of FVI in patients with hematuria.View full abstractDownload PDF (362K) -
Takahiro HORIUCHI, Jun NOMURA, Mitsutaka OKUDA, Ryo ICHINOHASAMA2003 Volume 44 Issue 9 Pages 940-945
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSThe abscopal effect is characterized by the spontaneous regression of unirradiated tumors resulting from the effect of irradiation on remote tissue. We report a case of NK/T-cell lymphoma of the small intestine that achieved complete remission as a result of an abscopal effect. A 74-year-old Japanese woman was referred to our hospital because of ileus and suspected perforation of the gastrointestinal tract. An emergency operation was performed and a perforated ulcerative tumor in the small intestine and enlarged mesenteric lymph nodes were found. Histopathological examination of the resected small bowel showed infiltration of large lymphoid cells with irregular nuclei and they were positive for CD3, CD56, TIA-1 and granzyme B. Physical examination did not reveal any lymphadenopathy in the neck, axillary or inguinal regions, skin involvement or nasal infiltration. The CT scans revealed multiple tumors in her upper abdomen and an obstructing conglomerate of small intestinal tumors. The patient did not show any response to CHOP therapy and radiotherapy was delivered to the lower abdominal field for the treatment of the ileus at a total dose of 44 Gy. Two months after radiotherapy, abdominal CT scans showed the disappearance of not only the tumors in the irradiation field but also the upper abdominal tumors that had not been irradiated. The patient has remained in complete remission for 15 months.View full abstractDownload PDF (777K) -
Isao MATSUDA, Tsuyoshi NAKAMAKI, Hiroshi AMAYA, Masanobu KIYOSAKI, Kei ...2003 Volume 44 Issue 9 Pages 946-951
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 22-year-old female was diagnosed as having acute lymphoid leukemia (ALL) in February 1995, from the findings of peroxidase negative, CD10+, CD19+, TdT+ and rearrangement of IgH and TCRβ. AdVP (doxorubicin, vincristine and prednisolone) therapy achieved a complete remission (CR). Bone marrow transplantation had to be abandoned because of the lack of an HLA-identical donor. Intensification therapy was thus carried out repeatedly. In June 1998, myeloblast with Auer rods, peroxidase positive, CD13+, CD33+ and HLA-DR+, appeared. The patient was diagnosed as having lineage switch acute myeloid leukemia (AML) from ALL. Though A-DMP (cytosine arabinoside, daunorubicin, 6-mercaptopurine) therapy was resistant, AdVP therapy led to a CR. The patient died of cardiotoxicity from anthracyclines in February 1999. From the results of the Ramasamy method using the clonal rearrangements of the Ig heavy chain gene locus, the origin of the pathological cells of ALL and AML was indicated to be the same leukemia clone.View full abstractDownload PDF (325K) -
Ken OYAMA, Takao SUZUKI, Satoshi YOSHIMURA, Michiko IREI, Kumi OYAMA, ...2003 Volume 44 Issue 9 Pages 952-956
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 16-year-old female, who was diagnosed as having non-Hodgkin lymphoma following a biopsy of a tumor of her right breast, was admitted to our hospital. The diagnosis made by the referring hospital was not reconfirmed because of the pathological findings with suspicion of sarcoma. As another tumor appeared in the contralateral breast 10 days after hospitalization, a second biopsy of the tumor was performed. Touch preparations of the tumor were positive for myeloperoxidase and naphthol AS-D chloroacetate esterase staining. The diagnosis of granulocytic sarcoma (GS) was made. No abnormalities were found in the peripheral blood and bone marrow at this time. Chromosomal examination of the bone marrow was normal. The number of copies for WT-1 mRNA was high both in the bone marrow cells and the tumor cells. The expression of WT-1 mRNA in peripheral blood was not detected. She was treated with the same protocol as for acute myelogenous leukemia and the breast tumor disappeared. The titer of WT-1 mRNA in bone marrow slightly decreased but remained high. Taken together, these findings suggest that the GS seems to be bone marrow origin and the monitoring of WT-1 mRNA may be useful for early diagnosis of any relapseView full abstractDownload PDF (592K) -
Yasuo HIRAYAMA, Sumio SAKAMAKI, Yasushi TSUJI, Tamotsu SAGAWA, Hiroki ...2003 Volume 44 Issue 9 Pages 957-961
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 70-year-old woman was admitted for anemia, elevated serum total protein and a right axillary mass. Laboratory data showed monoclonal κ IgM with a decrease in serum IgG and IgA levels. An occipital punched-out lesion was detected on a cranial X-ray. A tumor lesion was detected on chest X-ray and computed tomography. Biopsy specimen revealed plasmacytoma with cytoplasmic IgM. Bone marrow aspiration revealed an elevated plasma cell count. An immunophenotype analysis of the plasma cells showed positivity of cytoplasmic IgM, κ, CD5, CD38, CD11a (LFA-1), CD44 (HCAM), CD49d (VLA-4) and CD54 (ICAM-1). From the above results, we diagnosed the patient as having IgM myeloma associated with plasmacytoma. Melphalan and prednisolone therapy were prescribed, their effect on the myeloma was short term, so we changed the chemotherapy to VAD (vincristine, adriamycin and dexamethasone), but this treatment had little effect. The patient developed bacterial pneumonia and died. IgM myeloma is a rare disease and reports of immunophenotype analysis are also rare. There is no case report of plasmacytoma associated with IgM myeloma.View full abstractDownload PDF (386K)
-
Waka SUGAWARA, Mikiya ENDO, Yukie NAKATUJI, Takahide HOSOKAWA, Shoichi ...2003 Volume 44 Issue 9 Pages 962-964
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 6-year-old girl with chronic myeloid leukemia (CML) was treated with imatinib 230 mg/m2/day and its pharmacokinetics were investigated. The patient had a complete hematologic response on day 21, but had a minor cytogenetic response and the CML progressed to a blast crisis on day 133. At present, she has maintained complete cytogenetic remission with allogeneic peripheral blood stem cell transplantation. The pharmacokinetics revealed that the maximum concentration (1.4μg/ml); time to maximum concentration (5.1h); half-life (11.0h); trough concentration (0.4μg/ml); and, area under the concentration-time curve (28.1μg·h/ml) were inferior to those for adult patients in the 400 mg/day group. This observation suggests that a suboptimal plasma concentration might be related to resistance to imatinib and/or blast crisis.View full abstractDownload PDF (184K) -
Yasuhiko MIYAZAKI, Naoto NAKAMICHI, Noriaki MATSUMOTO, Katsuhiro ZEN, ...2003 Volume 44 Issue 9 Pages 965-967
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSAn adult patient suffering from G-CSF-resistant very severe aplastic anemia received a cord blood transplantation from a three-loci HLA-mismatched unrelated donor after nonmyeloablative conditioning. Cord blood was infused after conditioning with fludarabine (180 mg/m2) and cyclophosphamide (100 mg/kg). Cyclosporin A and short-term methotrexate were used for prophylaxis against acute GVHD. Engraftment was achieved on day 23, and there was no serious GVHD. A full-donor type T-cell chimerism was obtained by day 30. Normal hematopoiesis and complete chimerism have been maintained 14 months after transplantation.View full abstractDownload PDF (302K) -
Takuji MIYOSHI, Chizuru KAWANO-YAMAMOTO, Takahiro NAGASHIMA, Tadashi N ...2003 Volume 44 Issue 9 Pages 968-970
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 35-year-old male with chronic myeloid leukemia in the accelerated phase received a peripheral blood stem cell transplant from his HLA-DR-mismatched mother. Graft-versus-host disease (GVHD) prophylaxis was with short-term methotrexate and tacrolimus. After transplantation, grade II skin acute GVHD occurred and was unsuccessfully treated with bolus methylprednisolone administration. The acute GVHD progressed to grade III of the skin, gut and liver, and mycophenolate mofetil (MMF) was accordingly administered at a daily dose of 2g. This treatment resulted in a dramatic improvement in the clinical features of the acute GVHD. The patient suffered from hemorrhagic cystitis and several episodes of cytomegalovirus antigenemia. MMF may be useful for steroid-resistant acute GVHD despite an increasing risk of viral infections.View full abstractDownload PDF (286K)
-
2003 Volume 44 Issue 9 Pages 971-983
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (692K)
- |<
- <
- 1
- >
- >|