Peripheral leukocytes from a male patient with chronic myelogenous leukemia in blastic crisis were implanted directly into the intraperitoneal cavity of seven newborn hamsters treated with antilymphocyte serum. At sacrifice 17 to 19 days after implantation, three hamsters were found to have disseminated tumors. The four other hamsters were cannibalized. Chromosome analysis of cells from the enlarged lymph nodes revealed the presence of a human male karyotype. Most metaphase cells were pseudodiploid with the Ph¹ chromosome and isochromosome 17, while a few metaphase cells were classically diploid. Identical chromosome constitutions were observed in the original peripheral leukocytes of the patient. The results indicate simultaneous heterotransplantation of Ph¹-positive leukemic and normal leukocytes.

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Bone marrow hemosiderin is one of the most useful tests in the practice of hematology. However, it has not been popular in Japan. The purpose of this report is to evaluate this test for the diagnosis of iron deficiency anemia.
Marrow hemosiderin was absent in all 27 cases of iron deficiency anemia which responded to oral iron by increment of more than 2 gm/dl of hemoglobin. The lack of marrow hemosiderin combined with characteristic red cell morphology was found to be more accurate parameter than serum iron, total iron binding capacity, and red cell indices for the diagnosis of iron deficiency anemia.
The lack of marrow hemosiderin was also found in a small number of subjects who had no anemia. Therefore, this finding alone does not indicate the iron deficiency anemia. High incidence of the lack of marrow hemosiderin in rheumatoid arthritis (12 out of 20 cases) and ITP (6 out of 7 cases) was noted, and considered to be due to the associated iron deficiency anemia.
Above data confirmed the importance of marrow hemosiderin as a diagnostic tool for the iron deficiency anemia.

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The in vitro colony forming capacity of bone marrow and the colony stimulating activity (CSA) of peripheral white blood cells (WBC) were studied in 11 children with aplastic anemia and in 30 children with normal bone marrow as the control.
The culture was carried out according to the method of Robinson and Pike. To assay CSA, normal bone marrow cells were used as the target cells.
The results obtained were as follows:
1) In children with normal bone marrow, the colony counts per 2×10⁵ cells ranged from 100 to 450 with the average count of 218±100; the majority of colonies consisted of more than 500 cells at 10-14 days of cultivation.
2) In children with aplastic anemia, the colony counts reduced remarkably; 7 out of 10 non-treated patients had no colony and only 3 patients had a few colonies. In eleven treated patients, the colonies with the average count of 6±6 were formed. Most of the colonies consisted of 200 or less cells.
3) The colony stimulating activity in aplastic anemia decreased in almost all patients. Mainly, the decrease of compact colony and relative increase of loose colony were observed on the patients' WBC feeder layers.
4) There was a significant correlation between WBC and CSA.
These results suggested that there would be a decrease of the colony forming cell (CFC) in the bone marrow, a defect of intrinsic proliferative ability of CFC in children with aplastic anemia. Furthermore, an abnormality of CSA producing cells was suggested.

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The coagulation and fibrinolysis systems were studied in 78 patients with obstructive jaundice. Elevated plasma fibrinogen level, shortend r and r+k, and increased ma in thrombelastogram, prolonged serial thrombin time, increased fibrin (ogen) degradation products (FDP) and positive ethanol gelation test were observed. As to fibrinolysis systems, increase in antiplasmin activity and serum α₁-antitrypsin level, and decrease in plasminogen activator activity were observed. All of these changes were statistically significant as compared with normal controls. These data showed the presence of hypercoagulable state with decreased fibrinolytic activity in obstructive jaundice.
From the clinical analysis of the patients, significant increase in fibrinogen level was observed in the cancer group in this series as compared with non-cancer group. In the group complicated with cholangitis, significant increase in fibrinogen, FDP and α₁-antitrypsin level, and significant decrease in antithrombin III level were observed as compared with non-complicated group. Positive ethanol gelation test was also statistically significant. Severe bleeding tendency was seen in 19 of the 78 cases. Six of the 19 cases were suspected to be complicated with disseminated intravascular coagulation (DIC) from the laboratory data and clinical findings.
Significance of cancer and bacterial infection in the development of hypercoagulable state which may be leading to DIC in obstructive jaundice is discussed.

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The correlation between lymphocytic surface markers and clinical course was discussed in eight cases of acute lymphocytic leukemia (ALL).
The T and B lymphocytic surface markers were identified by spontaneous formation of rosettes with sheep erythrocytes for T cell, and by cell surface immunoglobulin, receptor for the third component of complement, and the Fc portion of IgG for B cell. In two cases, 70-80 percent of lymphoblasts formed nonimmune rosettes with sheep erythrocytes. However, in six cases, lymphoblasts had no detectable markers.
All of eight cases were easily induced to remission by the combination of vincristine and prednisone, but two cases of them with T-lymphoblasts relapsed in the CNS 1-2 months later and subsequently in the bone marrow and died within 7 months from the diagnosis. The results from this study suggest that the presence of T-lymphoblasts is correlated with a poor prognosis, so we think it is necessary to intensify the prophylactic therapies such as craniospinal irradiation or intrathecal medications.

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Eighteen patients with advanced primary untreated reticulum cell sarcoma were treated with a combination of vincristine sulfate (0.04 mg/kg once a week intravenously), cyclophosphamide (15 mg/kg once a week, intravenously), procarvazine hydrochloride (2 mg/kg daily, orally) and prednisolone (0.6 mg/kg daily, orally), given as treatment of remission induction, consolidation and intensification.
Thirteen patients (72.2%) achieved complete remission and four had a partial response. Median remission duration was 166 days. Median survival from onset of disease was 403+ days and from the beginning of therapy was 234+ days.
The combination chemotherapy was also used in three patients with Hodgkin's disease and one with advanced lymphosarcoma all of whom were inducted into complete remission.
At the time of reaching remission, anemia and thrombocytopenia were not a common problem but some degree of leukopenia developed in all patients and below 4000/cmm in nine of eighteen patients. Neurotoxity occured in twelve patients (66.7%) and alopecia in eight patients (44.4%).

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In malignant lymphoma eosinophilia is not necessarily rare. We observed that it occurred at any stage, and in about 20-30% of cases during the whole course. Eosinophilia in Hodgkin's disease, though frequently mentioned, was less often found than in lymphosarcoma. And various lesions of the skin were observed in about 20% of cases of maligdant lymphoma with eosinophilia. In Hodgkin's disease and lymphosarcoma, males were more frequently accompanied with eosinophilia than females. An interesting feature was the fact that the age-specific incidence curves for malignant lymphoma with eosinophilia were bimodal, in spite of a rather lower proportion of malignant lymphoma under the age of 40 years. The immune deficiency was not so severe in malignant lymphoma with eosinophilia, and eosinophilia per se did not appear to carry a prognosis different from that for malignant lymphoma itself. Immunological aspects of eosinophilia in malignant lymphoma are discussed from the observation of cutaneous lesions, cellular immunity and serum IgE level.

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An autopsy case of 40-year-old male with thymic lymphosarcoma is reported. A biopsy specimen of bone marrow showed nodular proliferation of atypical lymphoid cells surrounded by marked leukemoid reaction. Malignant lymphoma was suspected. The tumor cells in the bone marrow showed surface characteristics of T-lymphocytes as determined by spontaneous formation of rosettes with sheep erythrocytes. The tumor was classified as malignant lymphoma of T-cell origin. Shortly before death the lymphoma cells were found in the circulation.
At autopsy, a primary tumor was present in the thymic region. The Hassall's corpuscles were distributed in the tumor tissue. The tumor involved pleura, pericardium, diaphragm and ribs. The metastases were found in bone marrow, kidneys, liver and spleen. The tumor cell infiltration in the spleen was limited to the subendothelial region of trabecular veins. Lymph nodes examined were free of metastasis. Electron microscopic study demonstrated that the tumor cells were composed of immature lymphoid cells with smooth cell surface.

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The hemostatic management for tonisillectomy in a patient with hemophilia A is described. This report seems to be the first successful case in Japan.
A 6 years old boy, severely affected with hemophilia A, had swelling of tonsils and snoring at night from the age of 4 years repeatedly as a result of tonsillitis, and of late he developed tonsillar bleeding.
Under a general anesthetic, the tonsils were dissected on November 27, 1974. Twenty-five units of cryoprecipitate per kg body weight was given preoperatively, additionally 13 units/kg under operation, and 13-20 units/kg every 6 hours post-operatively for the next 14 days. The blood level of Factor VIII was assayed 40% of normal value at the beginning and end of this operation and between 13 and 72% post-operatively.
There was no undue hemorrhage during operation but three episodes of mild one after operation. Hemorrhage occurred under the blood level of F. VIII below 30% of normal value.
In conclusion, tonsillectomy required raise of the blood level of F. VIII over 40% throughout the operation and for next 2 days thereafter, and then its continuous maintaining at least 30% for following two weeks.
Some side effects such as post-infusion hepatitis, hyperfibrinogenemia, and severe vascular pain, were observed due to the replacement therapy, totally 149 vials of cryoprecipitate-AHF.

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A 16-year-old boy with an erythroleukemia in blastic phase has been successfully treated with an intensive combination chemotherapy (DCNP+ACNU), an isogeneic bone marrow graft (1.2×10¹⁰ bone marrow cells from identical twin) and an active immunotherapy (cell wall skeleton of BCG and 10,000 rad irradiated autologous leukemic cells).
The complete remission was confirmed on 21st day after the grafting, and since then, the patient has been treated only with the active immunotherapy with no signs of relapse and/or immune deficiency for more than 8 months.
These events suggest that bone marrow graft may make it possible to overcome the refractoriness of some leukemias to conventional chemotherapy with widened possibilities for dosage-increment of chemotherapeutic agents and/or for some another combinations of them.

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The case reports of autoimmune cold agglutinin hemolytic anemia associated with Mycoplasma pneumonia have still been uncommon.
A55-year-old female, who had been well for 2 years after recovery from aplastic anemia, was admitted on April 10, 1975, with the chief complaints of fever and cough. On admission, there were clinical and radiological signs of pneumonia in the left lung. The ESR was 164 mm/hr and her hemoglobin level being previously 13.0 gm/100 ml fell down to 6.5 gm/100 ml. The reticulocyte count was 13.8%, the indirect serum bilirubin 1.3 mg/100 ml and the serum haptoglobin undetectable. The direct Coombs' test was positive and antibodies on the erythrocytes were found to be IgM and C₃. The titer of serum cold agglutinin was elevated to 1 in 32768 on the twelfth day of admission, and the Mycoplasma pneumonia CF titer rose from 1 in 8 to 1 in 128 within 10 days. From these data the diagnosis of autoimmune cold agglutinin hemolytic anemia associated with Mycoplasma pneumonia was made. On discharge 12 weeks after admission, the hemoglobin level was 11.7 gm/100 ml, the reticulocytes 1.3%, the direct Coombs' test negative, and the cold agglutinin titer 1 in 1024. The chest X-ray showed no abnormalities and the Mycoplasma pneumonia CF titer was 1 in 64.

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