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Volume 17, Issue 10
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[in Japanese]1976 Volume 17 Issue 10 Pages 1049-1070
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1872K)
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—Classification and Prognosis of Myelomonocytic Leukemia—Masaki MORIMOTO, Yoshio SHIMADA, Mizuho ASAKAWA, Masahiko YAMAMOTO, Ki ...1976 Volume 17 Issue 10 Pages 1071-1082
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSIn this study cytochemical activities of leukemic cells were determined in fiftyfour leukemic patients using α-Naphthyl-acetate esterase staining, Naphthol-AS-acetate esterase (N-AS-A esterase) staining, inhibition test of N-AS-A esterase with sodium fluoride (NaF), Naphthol-AS-D-chloroacetate esterase (N-AS-D-CL-A esterase) staining, peroxidase staining and acid phosphatase staining.
Combination of N-AS-A esterase staining, inhibition test of N-AS-A esterase and N-AS-D-CL-A eaterase staining with customary staining made the differential diagnosis of leukemia easier and surer. Normal monocytes, neutrophils and lymphocytes had their own distinguishing staining patterns of N-AS-A and N-AS-D-CL-A esterase. These staining patterns applied to leukemic cells of monocytic leukemia (AMoL), myelocytic leukemia (AML) and acute lymphocytic leukemia (ALL).
Leukemic cells of AMoL showed strong N-AS-A esterase intensity which was inhibited extremely by NaF. Leukemic cells of myelomonocytic leukemia (AMMoL) showed strong N-AS-A esterase intensity which was inhibited moderately. Leukemic cells of AML showed various N-AS-A esterase intensity which was less inhibited. Proportion of NaF sensitive N-AS-A esterase and NaF resistant N-AS-A esterase seemed to change according to the maturation process of 3 types of leukemia, namely AMoL, AMMoL and AML. In AMoL there was no correlation between N-AS-A esterase and peroxidase, and this fact may suggest that in AMoL NaF sensitive N-AS-A esterase may not be localized in granules with peroxidase but may be localized in organells specific for this cell type.
Two types of AMMoL, namely homogenous typed AMMoL (single, fairly homogenous pathological cell population which expressed simultaneously both neutrophilic and monocytic features) and two cell lines typed AMMoL (two cell lines simultaneously exhibited) were proved to exist by morphological and cytochemical findings.
Two cell lines typed AMMoL showed longer duration of survival than AMoL. Homogenous typed AMMoL, on the contrary, showed shorter duration of survival.View full abstractDownload PDF (1502K) -
2. Differentiation of Acute Phase CML CellsHiroshi UCHIDA1976 Volume 17 Issue 10 Pages 1083-1088
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSPeripheral leukocytes from a 32-year-old-male with blast crisis of CML were cultivated for nearly two months in Petri dishes using RPMI 1640 supplemented with 20% fetal calf serum. At the start of cultivation, the leukocyte sample contained 98% myeloblasts that were peroxidasenegative and 1% each of segmented neutrophils and mature lymphocytes. However, with time after explanation, the cells showed a marked maturation along the granulocytic cell series and after 46 days in vitro there appeared an increased percentage of segmented neutrophils. Some of them were peroxidase-positive. Chromosome analysis was performed on days 3, 19, 32 and 47. In each time, all the analyzable metaphases except one showed the presence of an identical karyotype of 46, XY, 9q+, i(17q), 22q-. The results clearly indicate that Ph1-positive myeloblasts in CML blast crisis can be induced to mature in an in vitro condition.View full abstractDownload PDF (630K) -
Toshihiko KAMIYA, Masakazu NITTA, Masao HIGAMI, Kazuo KOMATSUBARA, Mas ...1976 Volume 17 Issue 10 Pages 1089-1097
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSUrinary 4-amino-5-imidasole carboxamide (AIC), a key intermediate in purine biosynthesis, was studied in 56 leukemic adults in addition to 23 other hematologic disorders. Mean AIC in 15 healthy adults was 822 μg/day and AIC/creatinine (A/C) was 0.71 μg/mg creatinine/day, in leukemias AIC was 1670, A/C was 2.03. The differences of both mean AIC and A/C between healthy adults and leukemias were significant. (AIC: P<0.05, A/C: P<0.01)
The corelationship between AIC levels and leukemic cell count both in peripheral blood and bone marrow in 35 non-treated leukemias were not seen. AIC levels in 6 of 17 cases whose percentage of peripheral blast cells was more than 20% and 5 of 18 cases whose blast cells was less than 20% were elevated. AIC levels in 5 of 21 cases whose marrow blast cells was more than 40% and 5 of 13 cases whose blast cells was less than 40% were elevated. In 20 cases serial changes of AIC levels after treatment were observed. In 7 cases of them nearly parallel serial changes of AIC levels with blast cell counts were seen. AIC levels were measured in 14 cases at hypoplastic stage after treatment. In 5 cases of them AIC levels were elevated. 3 cases of them fell into relapse after 1 or 4 months. In other 9 cases of those 14 cases AIC levels were normal. 2 cases of them fell into relapse and 3 cases were induced into complete remission. 4 cases died of pneumonia.
It was noteworthy that AIC levels in 2 early stages of MoL were elevated.
AIC levels in 9 cases of aplastic anemia were normal except 1 case accompanied with pregnancy.
These results suggest that urinary AIC levels might be predictive of relapse and useful for diagnostic indicator of early stage of leukemia.View full abstractDownload PDF (684K)
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Hideo SHISHIDO, Hideo ENOKIBARA, Kenji SAITO, Sakae HAZAMA, Yasuji HIR ...1976 Volume 17 Issue 10 Pages 1098-1105
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 33-year-old man was admitted with chief complaint of jaundice. He had no remarkable past and family history. He had easy fatigability for about a half year with jaundice and occasional dark brown urine especially marked on a cold day. Cold agglutinin disease was suspected because of spontaneous agglutination on blood collection. Physical examination showed slight jaundice. Neither lymphadenopathy nor hepatosplenomegaly was noted. Examination of the peripheral blood disclosed no anemia, but slight reticulocytosis. Sternal marrow aspirations revealed erythroid hyperplasia. Liver function tests were within normal limits except moderate elevation of indirect bilirubin level. Serum cold agglutinin titer was 1: 8192 at 4°C. A hemolysin titer was low. The serological tests for syphylis, Donath-Landsteiner test and anti-nuclear antibody were negative. Chest and gastrointestinal examinations revealed no abnormality.
A diagnosis of primary cold agglutinin disease was made, and oral administration of 2 mg of melphalan daily was started. After two weeks a cold agglutinin was decreased to a titer of 1: 2048 and normalized after 3 months therapy. After discharge, he was maintained in remission on 2 mg of melphalan every other day for about two and a half years.View full abstractDownload PDF (545K) -
Tatsuhito TONOOKA, Takuji SATO1976 Volume 17 Issue 10 Pages 1106-1112
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSRenal involvement with leukemia is relatively frequent, but seldom occurs during hematological remission.
This paper reports a case of 7-year-old boy with ALL accompanied by enlarged kidneys and impairment of renal function.
On his first admission, November, 1973, the diagnosis of ALL was made. Leukemic cell was PAS-positive. Complete remission was attained by administration of steroid and vincristine. Thereafter, he often suffered from meningeal leukemia, but hematological remission continued until October, 1975 when he developed hypertension. He was admitted for thorough examination.
In the peripheral blood and bone marrow, leukemic cells were not detected. The IVP demonstrated bilateral strikingly enlarged kidneys and elongated calices. Leukemic cell infiltration was confirmed by renal biopsy.
Hypertension and kidney enlargement were improved soon after irradiation to bilateral kidneys and systemic chemotherapy consisted of adriamycin and vincristine.View full abstractDownload PDF (1076K) -
Motoharu KIMOTO, Yasuhiko MIYASAKA, Hisomu YAMAGUCHI, Ichitaro ASAI, T ...1976 Volume 17 Issue 10 Pages 1113-1121
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSThe occurrence of autoimmune hemolytic anemia in leukemias has been reported most commonly in chronic lymphocytic leukemia. The reports of this condition in acute myeloblastic leukemia had been regarded as rare. Recently the authors experienced the positive direct Coombs test in the four cases of acute myeloblastic leukemia.
Case 1. H. Y., 58-year-old female, Coombs test were repeatedly positive in the third, fourth and sixth relapses and turned negative several days after the commencement of the re-induction therapy in each occasions.
Case 2. S. H., 60-year-old male, while Coombs test was postive on the second relapse, it was negative 14 days after the re-induction therapy.
Case 3. C. I., 55-year-old female, Coombs test was weakly positive at the first admission. On the second admission, three months later, findings of the marrow aspirates were compatible with pure red cell aplasia and the Coombs test turned to be negative.
Case 4. K. M., 77-year-old female. At the first admission under the diagnosis of acute myeloblastic leukemia direct Coombs test was positive; it was negative after three days without any antileukemic therapy.View full abstractDownload PDF (688K) -
Akihiro TSUBOYAMA, Ryuhei SASAKI, Fumimaro TAKAKU, Hideaki MIZOGUCHI, ...1976 Volume 17 Issue 10 Pages 1122-1127
Published: 1976
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA twenty-six-year-old female, seven months pregnant, entered our hospital on September, 1974, with a chief complaint of general fatigue.
Severe malaise, palpitation and dizziness developed three days before admission. She underwent a thorough medical examination at a local hospital, and routine hematological study at that time showed a macrocytic hyperchromic anemia with a hemoglobin value of 3.0 g/dl, hematocrit 8%, and red blood cell counts of 71×104/cmm.
Physical examination on admission showed anemic conjunctiva and splenomegaly. Jaundice was not recognized. Total serum folic acid level was 0.94 mγ/ml and vitamin B12 level was 1.2 mγ/ml. LDH was 1285 unit. Peripheral blood smear showed anisocytosis, poikilocytosis and polychromasia. Hypersegmentation of granulocytes was also recognized.
Bone marrow aspirates disclosed hyperplasia of megaloblastic erythroid precursors and giant metamyelocytes. Etiology of this patient anemia was considered to be folic acid deficiency induced by pregnancy. After oral administrations of folic acid 15 mg daily a reticulocyte crisis was noticed and simultaneous increase of hemoglobin, RBC, WBC and platelets followed. Though hemoglobin concentration recovered to 10.0 g/dl, elevation of reticulocyte counts, about 100‰, still continued. We then suspected a presence of underlying hemolysis, and examined her for autohemolysis, osmotic fragility and life span of RBC. From the results of these examinations, she was diagnosed as hereditary spherocytosis.View full abstractDownload PDF (454K)
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