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Volume 18, Issue 8
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[in Japanese]1977 Volume 18 Issue 8 Pages 947-960
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1890K)
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Mitsuto HASEGAWA, Makoto AOKI, Tetsuhei OGAWA, Yukio IMAMURA, Shiro HI ...1977 Volume 18 Issue 8 Pages 961-972
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSEffect of Melphalan in the treatment of myelomatosis was studied in 235 clinical courses (234 cases) from 54 cooperative institutions.
The response to the treatment in which response parameters were applicable was as follows: 1) “subjective improvement” 114/209 courses (54.5%), 2) “improvement of peripheral bood findings” 56/209 (26.8%), 3) “improvement of bone marrow findings” 78/175 (44.6%), 4) “decrease of serum M protein” 96/209 (43.8%), 5) “decrease of urinary Bence Jones protein excretion” 48/96 (50.0%), 6) “improvement of bone X-ray picture” 11/174 (6.3%), 7) “decrease of serum calcium” 14/75 (18.7%) and 8) “improvement of renal function” 19/90 (21.1%).
The remission was attained in 63.3% of the courses.
The factors correlating the response rate to Melphalan therapy were analized and the following results were obtained.
“Subjective improvement” (p<0.01) and remission rate (p<0.05) were significantly greater in the group without previous therapy than in the group already treated. The group with κ-L-chain had significantly better response rate than the group with λ-L-chain in the parameter of “improvement of peripheral blood findings” (p<0.05). The response rate of the group receiving larger total doses of melphalan (≥201mg) was significantly higher than that of the group receiving smaller doses (≤200mg) in such parameters as “improvement of peripferal blood findings” (p<0.01), “decrease of serum M protein” (p<0.01) and “decrease of serum calcium” (p<0.05). The larger doses gave the better remission rate than the smaller doses (p<0.01) did. The bone marrow was much improved in the group treated with Melphalan and glucocorticoid than in the group treated with Melphalan alone (p<0.05).
Bone marrow suppression was observed in 143 courses and other features of toxicity were consisted of gastrointestinal disturbance (40), impairment of liver function (18), alopecia (16), skin rash (8) and stomatitis (1).View full abstractDownload PDF (1062K) -
Namio KONO, Tyen Po CHEN, Keisuke TOYAMA, Teppei OGAWA, Takashi MIZOKA ...1977 Volume 18 Issue 8 Pages 973-978
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSThe small bodies resembling platelets in urine of three patients with ITP were examined. The small bodies of a patient of ITP should be an asthenic platelet-ghost which consists of a swollen and sometimes lobulated matrix, very dense bodies and a small number of glycogen particles. The small bodies of a case treated with glucocorticoid et al. showed almost similar findings to platelets.View full abstractDownload PDF (1875K) -
Akihiko YAMAGUCHI, Kohsaku YOSHIDA, Mitsuyuki FUKUDA, Tikara SAKAI, Ak ...1977 Volume 18 Issue 8 Pages 979-984
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSCapacity of in vitro colony formation in patients with CML and cytochemical studies of colonies were examined.
Peripheral leucocytes of 4 patients and bone marrow cells of 9 patients were assayed by the method of Robinson and Pike.
Results obtained were followings.
1) Peripheral leucocytes of normal individuals formed no colonies, but many colonies were formed in 2 of 4 patients.
2) Bone marrow of patients formed fewer colonies than normal individuals.
3) Peripheral leucocytes and bone marrow of patients with CML in blastic phase formed few colonies.
4) Number of colonies of bone marrow tended slightly to increase after splenectomy in 3 patients.
5) Alkaline phosphatase activity of mature granulocytes in colonies of bone marrow was elevated in 1/4 patients.View full abstractDownload PDF (475K)
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Yasuo MORISHIMA, Kouhei KAWASHIMA, Masahide KOBAYASHI, Ryuzo UEDA, Ryu ...1977 Volume 18 Issue 8 Pages 985-993
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSSince April 1974, we have clinically applied bone marrow transplantation for the treatment of severe refractory aplastic anemia and acute leukemia.
A 27-year-old male with acute monocytic leukemia was successfully grafted with bone marrow from his HLA-A, B, D matched brother. At the time of transplantation, he was in progressive relapse and resistant to conventional chemotherapy, including combinations of daunomycin, cytosine arabinoside, 6-mercaptopurine and prednisolone. Prior to transplantation, he was conditioned for grafting with cyclophosphamide (CY), 60 mg/kg on each of two successive days, followed by 1000 rads total body irradiation (TBI). Marrow cells (1.4×1010) was infused 96 hr after the last dose of CY and within 24 hr of TBI. Successful engraftment has been accomplished, as documented by the appearance of graft-versus-host reaction (GVHR) and a rising WBC in the recipient. Marrow examination studied 20 days after transplantation showed a hypocellular marrow but all hemopoietic elements were present. He received intermittent methotrexate therapy aftergrafting to modify GVHR. However, associated with the gradually rising WBC, GVHR became apparent with an erythematous macropapular rash, increasing liver function abnormality and anorexia, complicated by a fever of unknown origin. In July, 1976, he developed localized periotonitis in the lower abdomen, associated with interstitial pneumonia. He died on day 68 with respiratory failure.
An autopsy showed cardiopulmonary failure secondary to disseminated cytomegalovirus infection leading to death. GVHR lesions were noted in the skin, liver and gut with severe lymphoid atrophy. There was normocellular marrow without leukemia cells.View full abstractDownload PDF (997K) -
Haruya YOSHIKAWA, Yozo YANO1977 Volume 18 Issue 8 Pages 994-1000
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA case of long-term survivor of acute promyelocytic leukemia is reported.
The 55-year-old male patient was admitted to the hospital on August 20, 1971 because of epistaxis and fever. On physical examination, ecchymoses and petechiae were present on both arms. Marked anemia, moderate leukocytosis and severe thrombocytopenia were noted. Differential counts revealed ninty-two per cent of atypical cells in the peripheral blood and eightysix per cent in the bone marrow. Morphological features of the atypical cells were consistent with those of acute promyelocytic leukemia, though the presence of disseminated intravascular coagulation was not revealed.
Combination chemotherapy (DCMP) was started immediately, with a large dose of antibiotics. After completing of two courses of DCMP therapy hematological complete remission was obtained, but high fever persisted and unfortunate mycotic infection of lungs was complicated. The shadow of “fungus ball” on chest X-ray dissapeared by using drip infusion of amphotericin-B. Sequential maintenance and intensification chemotherapy were continued till September, 1974.
Since then, the patient is still under complete remission for 5 yrs and 3 mos.View full abstractDownload PDF (890K) -
Mutsuo OHIRA, Toru ISE, Teruaki HONGO1977 Volume 18 Issue 8 Pages 1001-1006
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSA 5 year-old boy with cutaneous T cell lymphoma was reported. The patient was born in Okinawa prefecture and hospitalized because of tumors on the left submandibular and supraumbilical region. On admission 2 cutaneous ulcerated nodules were noticed. No mediastinal mass, lymphoadenopathy and organomegaly were found. Peripheral blood and bone marrow examination revealed no hematological abnormalities.
A tumor on the supra-umbilical region was resected for histological examination. It was interpreted as reticulum cell sarcoma, poorly differenciated type. Tumor cells had nuclei with irregular convolutions. These neoplastic cells had E receptors and formed rosettes with sheep erythrocytes. We also found the elevation in serum lactic dehydrogenase (LDH) activity. Analyses of isoenzyme pattern showed a predominance in the isoenzymes 1, 2, and 3.
VAMP chemotherapy resulted in a dramatic improvement for a submandibral cutaneous tumor. The patient is still alive one year from the treatment without any evidence of disease.
Human leukocyte antigen (HL-A) typing of the patient and his family was discussed.View full abstractDownload PDF (790K) -
Shigeyoshi MATSUDA, Isao AOKI, Masao KIKUCHI, Hiroyuki MURAKI, Keisuke ...1977 Volume 18 Issue 8 Pages 1007-1012
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSThe hereditary nature of von Willebrand's disease is well established. Recently more than 10 cases of acquired von Willebrand's syndrome were reported. This syndrome is characterized by acquired coagulation defects quite similar to those of von Willebrand's disease. It is of interest that this syndrome is frequently associated with immunological disorders such as SLE, monoclonal gammopathy and CLL.
In this paper, a 76 year-old female was described with clinical and laboratory evidence of von Willebrand's syndrome associated with IgG myeloma. She had no past or family history of abnormal bleeding suggestive of von Willebrand's disease. The laboratory findings revealed a long bleeding time with normal platelet counts, decreased platelet glass adhesiveness. Low factor VIII levels as determined both as coagulation activity and antigenicity and abscence of ristocetin-induced platelet aggregation were observed.
This is probably the first case of acquired von Willebrand's syndrome in Japan.View full abstractDownload PDF (515K)
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1977 Volume 18 Issue 8 Pages 1013-1014
Published: 1977
Released on J-STAGE: January 19, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (168K)
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