巻号一覧
19 巻, 4 号
選択された号の論文の16件中1～16を表示しています
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臨床研究
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—油性BLMと通常の水性BLMの比較—井上 雄弘, 下山 正徳, 竹中 武昭, 湊 啓輔, 北原 武志, 坂野 輝夫, 近田 千尋, 木村 禧代二1978 年 19 巻 4 号 p. 317-322
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありThe comparative study of clinical trials with depot-type bleomycin (oil bleomycin) and regular bleomycin in advanced lymphoma was performed. Oil bleomycin was administered 15mg i. m. weekly to 34 patients as a single agent and regular bleomycin 15mg i. v. weekly to 46 patients, all who had prior combination chemotherapy. The complete response rate in patients with reticulum cell sarcoma, lymphosarcoma and Hodgkin's disease treated with oil bleomycin was 36%, 20% and 60% respectively, and 15%, 20% and 55% respectively with regular bleomycin.
Oil bleomycin had a same response rate as regular bleomycin in Hodgkin's disease, but it had a higher complete response rate than regular bleomycin (36% in oil bleomycin vs 15% in regular bleomycin) in the treatment of non-Hodgkin's lymphoma.
Within 3 weeks from onset of therapy, the response had been achieved in 13 (86%) of 15 cases treated with oil bleomycin, but only in 10 (55%) of 18 with regular bleomycin. Rapid clinical effects were observed with smaller dose in oil bleomycin than in regular bleomycin. The mean total dose of oil bleomycin was smaller than that of regular bleomycin (87mg vs 128mg) with same degree of side effects.抄録全体を表示PDF形式でダウンロード (438K) -
出浦 喜丈, 下山 正徳, 湊 啓輔, 木村 禧代二, 柴田 洋一, 十字 猛夫1978 年 19 巻 4 号 p. 323-330
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありOne hundred seventy seven sera from 112 patients with acute leukemia, malignant lymphoma, other hematopoietic disorders or cancer were assayed for lymphocytotoxic antibody (LCT antibody) and 100 sera from 58 patients were assayed for antiplatelet antibody using mixed passive hemoagglutinative technique (platelet mixed passive hemoagglutinative antibody=P-MPHA antibody) recently developped by Shibata, et al.
Thirty three out of 112 patients (29.5%) had LCT antibody and 22 out of 58 patients (37.9%) had P-MPHA antibody.
About 90% of these antibodies was found to be generated after repeated transfusions from random donors. Twenty eight out of 74 patients (37.8%) who received blood transfusions from random donors developped LCT antibody, and 20 out of 44 patients (45.5%) developped P-MPHA antibody. The incidence of these antibodies was elevated with frequency of blood transfusions.
However, 40% of patients who had more than 100 units of blood transfusions failed to develop these antibody.
Sera from 57 patients were examined for both LCT and P-MPHA antibodies, and nine of them were proved to have both antibodies. Nine patients had only LCT antibody and 13 patients had only P-MPHA antibody.
Twenty six patients had no antibody.抄録全体を表示PDF形式でダウンロード (647K) -
林 滋, 目黒 嵩, 山田 兼雄1978 年 19 巻 4 号 p. 331-337
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA new method for detecting small amount of soluble fibrin was reported by Largo et al in 1976, which was visualized by an agglutination reaction of glutaraldehydetreated human erythrocytes coated with purified fibrin monomer. We examined the test conditions of Largo's method and compared it with staphylococcal clumping test (SCT) and hemagglutination inhibition test (HIT) in vivo as well as in vitro. An agglutination time was influenced by the degree of purification of fibrin monomer and by the amount of coated fibrin monomer, less influenced by fibrinogen and FDP. This method showed a sensitivity for fibrin monomer and soluble fibrin, whereas SCT was sensitive for fibrinogen, early FDP, fibrin monomer and soluble fibrin. HIT was not sensitive for detecting fibrin monomer and soluble fibrin. In various diseases such as nephritis, DIC, liver cirrhosis, hepatitis, coronary diseases, thrombosis and diabetes mellitus, soluble fibrin was detected in plasma by Largo's method. Especially nephritis was characterized by both high levels of SCT and large amount of soluble fibrin measured by Largo's method.抄録全体を表示PDF形式でダウンロード (594K)
症例
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—急性白血病における摘脾の効果と完全寛解基準としての脾腫の意義—厨 信一郎, 檀 和夫, 松井 良樹, 工藤 秀機, 川田 健一, 野村 武夫1978 年 19 巻 4 号 p. 338-344
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありThree adult cases of peroxidase-negative acute leukemia with splenomegaly during hematological remissions were reported.
In each case the first hematological remission lasted for a long period of time in spite of persistent splenomegaly after its induction. The survival periods after diagnosis were 55 and 65 months, respectively, in two patients, and the remaining patient is still alive in hematological remission 41 months after diagnosis. Two of the three patients underwent splenectomy during hematological remissions to reveal no leukemic cell infiltration in their spleens. Splenomegaly, weighing about 400 grams in both cases, was ascribed mainly to congestion. After splenectomy they could well tolerate to potent antileukemic chemotherapies as evidenced by unusually mild cytopenias.
Based on clinical features and histopathologic findings of resected spleens in these cases, the role of splenectomy in the management of patients with acute leukemia and the significance of splenomegaly as a criterion for complete remission were discussed.抄録全体を表示PDF形式でダウンロード (586K) -
蓑田 正豪, 西田 雅喜, 今田 聰雄, 岩永 隆行, 入交 清博, 堀内 篤, 伊藤 浩行, 橋本 重夫1978 年 19 巻 4 号 p. 345-350
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 34-year-old man was transferred to our hospital because of nausea, vomiting, fever, anuria and generalized lymphadenopathy on July 13, 1976, and died on the 240th hospital day. The histological diagnosis of axillary lymph node biopsy was reticulum cell sarcoma. On admission laboratory findings were as follows: Hb 10.1g/100ml, Ht 29.7%, WBC 8,200 (Neutro 97%, Lymph 2%), platelet 3.6×104, BUN 208mg/dl, creatinine 7.9mg/dl, uric acid 42mg/dl, Ca 6.7mg/dl, P 9.0mg/dl, PTH 1.1mg/dl. A chest roentgenogram shortly after admission showed diffuse bilateral reticulonodular shadow. He was treated with hemodialysis for acute renale failure, and with COP-Arac, Adriamycin, Bleomycin and radiation for reticulum cell sarcoma. Postmorten examination revealed the infiltrations of tumor cells in lymph nodes and kidney, and the marked calcium depositions in lung, heart and kidney. The parathyroid glands showed questionable hyperplasia of the chief cells. Pathogenesis and mechanisms of metastatic calcification have been discussed.抄録全体を表示PDF形式でダウンロード (709K) -
半田 誠, 根岸 昌功, 鈴木 洋司, 外山 圭助, 宇田川 康博, 根本 謙, 後藤 正道1978 年 19 巻 4 号 p. 351-355
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 22-year-old woman in the 28th week of her pregnancy was first admitted to the Keio University Hospital on July 21, 1976, because of severe anemia and leukocytosis. On admission, her hemoglobin was 6.1g/dl, platelets 239×103/μl, and WBC 23,400/μl with 42% blasts. The bone marrow smear demonstrated 70.8% of leukemic cells, and diminished erythroid cells and megakaryocytes. From these data the diagnosis of acute leukemia was made. Two weeks after initiation of treatment with vincristine and prednisolone, in the 31st week of her pregnancy, she gave birth of a female infant weighing 1,655g by induction delivery. Thereafter, daunorubicin and cytosine arabinoside were added on her treatment. The complete remission was obtained 40 days after delivery. She has been in complete remission for 10 months and her child has grown normally with no hematological or genetic abnormality. Reported cases of acute leukemia in literatures were reviewed with special reference to relationship between treatment for leukemia and pregnancy.抄録全体を表示PDF形式でダウンロード (421K) -
平林 憲之, 堀田 知光, 柴田 寿彦, 内海 真, 神谷 修, 森島 泰雄, 川島 康平, 上田 龍三, 大野 竜三, 山田 英雄, 山田 ...1978 年 19 巻 4 号 p. 356-360
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 16-year-old boy with recurrent erythroleukemia in blastic phase was successfully retransplanted with the identical twin marrow. He was found to have erythroleukemia in April 1975. Eight months remission was obtained with the first transplant from his identical twin donor after an intensive combination chemotherapy and active immunotherapy as a maintenance. Cyclophosphamide and total body irradiation were used for the conditioning of the second transplant. The donor was immunized with key hole limpet hemocyanin (KLH) and subsequent sensitization of the recipient gave an evidence for graft acceptance. The recipient died from an accident on the day 125 in a remission state.抄録全体を表示PDF形式でダウンロード (468K) -
村井 善郎, 白倉 卓夫, 松田 保, 井上 達1978 年 19 巻 4 号 p. 361-366
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 71-year-old woman with EDTA-dependent pseudothrombocytopenia was presented. When she was admitted to authors' clinic, the platelet count was 1.9×104/cmm, obtained on an electronic counter using EDTA as anticoagulant. The light microscopy of the peripheral blood smears revealed the agglutination of plentiful platelets like “rocks”, but “platelet satellitism” phenomenon was not observed. No special change was demonstrated by electron microscopy. Plasma from this patient agglutinated homologous as well as autologous platelets in the presence of EDTA. However, agglutination did not occur in the blood with heparin, oxalate or citrate. This antiplatelet activity (APA) depending upon EDTA was active at 37°C as well as 20°C and inactivated after incubating at 56°C for 60 minutes. APA decreased in high concentration of EDTA, and its effect was inhibited by prostaglandln E1, dipyridamole but not by aspirin or adenosine.
These findings are interesting, relating to a mechanism of EDTA-dependent agglutination of platelets.抄録全体を表示PDF形式でダウンロード (579K) -
榎原 英夫, 斉藤 憲治, 間 栄, 広瀬 康二, 小松 英昭, 古沢 新平, 宍戸 英雄1978 年 19 巻 4 号 p. 367-371
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありA 44-year-old man was admitted with chief complaint of painless tumor in the face. Since March 1974, he has had the tumor with neither pain nor itching, but in March 1975, he was pointed out eosinophilia by a doctor and required scrupulous examination. Physical examination showed no remarkable findings except for the presence of the tumors in the right cheek, cervical, axillar, elbow and inguinal regions. Examination of the peripheral blood disclosed marked eosinophilia, 5,940/cmm at the peak. Sternal marrow aspiration revealed moderate increase of eosinophilic series. Bone survey and laboratory data of blood chemistries, urine and stool are all within normal limits. Histological study of the tumor showed marked hyperplasia of lymph follicles with germinal center and infiltrations of lymphocyte and eosinophils.
A diagnosis of soft tissue eosinophilic granuloma was made and administration of 600mg of oxyphenbutazone daily was started. The response was good and the dose of the drug was tapered. Treatments for soft tissue eosinophilic granuloma with oxyphenbutazone and others in the literatures were discussed.抄録全体を表示PDF形式でダウンロード (455K)
第19回総会
シンポジウムIII 慢性骨髄性白血病治療の問題点
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小熊 信夫, 鎌田 七男1978 年 19 巻 4 号 p. 372-378
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証あり122 patients with chronic myelogenous leukemia were cytogenetically studied. 107 out of 122 patients were examined during the chronic phase and 47 both in chronic phase and in blastic phase.
The results were as follows:
1) All of them but one patient had Ph1 chromosomes.
2) During the chronic phase 4 patients had autosomal anomalies such as 46, XY, Bq+, Ph1 and 46, XX, Dq-, Ph1, and 3 had the lack of a Y chromosome.
3) Abnormal karyotypes other than Ph1 chromosome were found in the spleen cells from patients even in the early phase of the disease.
4) About 80% of patients in blastic phase showed chromosome abnormalities in addition to Ph1 chromosome.
5) Some patients with chromosome abnormalities other than Ph1 chromosome in the chronic phase were found to have the same abnormal karyotype in the blastic crisis.
6) 47 patients who had transformed to blastic phase were studied on possible relationship between chromosome aberrations and clinical types of blastic crisis. Blastic crisis was categorized into 4 types from the clinical and laboratory findings; abrutive type, accelerated type, type of tumor-formation, and type of “without chronic phase.” Most of the patients with tumor formation showed hyperdiploidy and double Ph1 chromosome. Patients with accelerated type of blastic crisis had a tendency to have pseudodiploidy.
7) There was no relations between the total dose of busulfan and type of chromosome aberrations at the time of blastic crisis.
These results, along with other findings reported in literatures, indicate that Ph1 positive cells involve primarily some nature to convert to other additional chromosome aberrations other than Ph1 at any stage of the disease.
Possible trial of chemotherapy for chronic myelogenous leukemia was discussed.抄録全体を表示PDF形式でダウンロード (564K) -
御供 泰治, 樋上 昌男1978 年 19 巻 4 号 p. 379-385
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありCellular kinetics in chronic myelocytic leukemia (CML) was studied by flow microfluorometry (F. M. F.) which showed DNA histogram and TLC separation of dansyl polyamines (Putresine, Spermidine and Spermine).
Normal blood, which consisted of mature cells alone, had monopeak of diploid (2N), and normal bone marrow, which consisted dividing compartment (myeloblasts, promyelocytes, myelocytes and immature erythroblasts), had two peaks of diploid and tetraploid (4N). AML, ALL and CLL had the same DNA histogram as normal blood and bone marrow, because leukemic cells in blood were long resting cells (nondividing compartment).
CML blood with splenomegaly had two peaks as bone marrow. But CML blood without splenomegaly or post-splenectomy had diploid peak alone as normal blood.
Leukemoid reaction and polycythemia vera blood, which contained immature cells as CML blood, had also diploid peak alone, but myelofibrosis blood had two peaks.
In some AML polyamine contents level were very high, but in CML and others not so high. In general, polyamine contents were higher in the bone marrow than in the blood (PB<BM), but in some cases with CML they were higher in the blood than in the bone marrow (PB>BM) at chronic phase and PB<BM at remission and PB>BM again at blastic crisis.
As a conclusion, it was guessed that dividing compartment of immature cells in CML blood came out of spleen and/or liver and nondividing compartment of immature cells and mature cells came out of spleen and/or liver and bone marrow.抄録全体を表示PDF形式でダウンロード (638K) -
喜多島 康一1978 年 19 巻 4 号 p. 386-391
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありComplete prevention of blast crisis of CML has never been achieved, and we have attempted to prolong the survival time of CML by the early diagnosis and treatment of blast crisis. First of all, through a retrospective analysis on past 23 cases of CML with blast crisis in our clinic, we decided the following parameters for early diagnosis of blast crisis. Major parameters consisted of (1) rapid reenlargement of the spleen, (2) myeloblasts in peripheral blood (P. B.) and/or bone marrow (B. M.) ≥5%, (3) promyelocytes in P. B. and/or B. M. ≥20%, (4) additional changes in Ph1 chromosome. Minor parameters consisted of (1) unknown fever of higher than 38°C (2) bleeding tendency (3) neuralgic pain in the lower extremities (4) RBC≤3×106 (5) platelets≤1×105 (6) basophils in the P. B. and/or B. M. ≥20% (7) dry tap in B. M. (8) positive CRP. (9) elevation of NAP-score and (10) extramedullary tumor formation. When any of the following combinations of these parameters are found, the early treatment for blastic crisis has been given immediately. (1) more than 3 majors only, (2) 2 majors plus more than 2 minors, (3) 1 major plus more than 3 minors and (4) more than 5 minors only. Median survival of 22 cases with CML treated early under these criteria was more than 8.3 months, while that of 9 cases treated after developing hiatus leukemicus was 3.7 months.抄録全体を表示PDF形式でダウンロード (487K) -
川島 康平, 緒方 完治, 渡辺 英二, 山田 一正1978 年 19 巻 4 号 p. 392-399
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありIn an attempt to determine if intensive treatment might alter the course of chronic myelogenous leukemia by eliminating the Ph1-positive leukemia cells and induce a state more analogous to the remission which can be attained in acute leukemia, an intensive program of therapy was employed in a few patients with Ph1-positive CML.
Following the induction of a clinical remission with standard therapy, the first group of the patients underwent splenectomy, the second group Cyto-DCMP therapy and the third group splenectomy followed by Cyto-DCMP therapy with cyclophosphamide (day 1) and subsequently daunomycin (day 4), cytosine arabinoside (days 4 to 10), 6-mercaptopurine (days 4 to 10) and predonine (days 4 to 10). It seemed unlikely that splenectomy increased likelihood of achieving a karyotypic conversion with Cyto-DCMP therapy. One of the splenectomized patients without intensive chemotherapy was noted to have developed a stepwise occurrence of successive cytogenetic changes (double Ph1-positive) 9 months after splenectomy.
In the patients treated with Cyto-DCMP, however, there were two conversions. One had a transient conversion in his marrow metaphases to predominantly Ph1-negative cells. The other was converted predominantly double Ph1-positive marrow to single Ph1-positive state which is identifiable as a karyotypic standard type of CML. In the remaining two patients, there has been no elimination of Ph1-positive cells. The present study indicated the ability of Cyto-DCMP therapy to convert the karyotipically abnormal marrow without the aid of splenectomy.
Thus, the finding which was capable of beneficially changing the additional aneuploid features in the chronic phase of CML suggested the possibility to prevent the occurrence of the fatal blast crisis.抄録全体を表示PDF形式でダウンロード (611K) -
（本邦における現状とその解析）柴田 昭1978 年 19 巻 4 号 p. 400-408
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありThe actual conditions and analytical results of splenectomy in the treatment of patients with chronic myelogenous leukemia (CML) in Japan were reported.
There were 58 splenectomized cases (including our ten cases) with CML until Aug. 1977 in Japan. Among them, 36 cases were still alive and 22 dead There was no cases over 60 years of age. Ninety percent of them were splenectomized after 1975, and these cases were splenectomized mainly as the treatment of this disease (prevention of blastic crisis).
All 58 cases were divided into three groups, that is chronic stage, accelerated stage and after blastic crisis.
Operative death occurred to only one case (1.7%) and it was due to bleeding from peptic ulcer. There was no problem during operation but occasionally we met with an unexpected bleeding like oozing.
Complications immediately after operation were bleeding and infection, but these were not severe. Generally speaking, splenectomy in CML was not dangerous at all. Thrombocytosis was an important problem as a long-term complication. Occasionally, there were attacks like transient ischemic attack (TIA) and these attacks were not prevented by platelet function inhibitory drugs.
As the effect of splenectomy, there was palliative effect that removes massive splenomegaly seen in the terminal stage and various discomfort due to splenomegaly. To evaluate whether splenectomy prolongs survival time or not, it is necessary to follow the patients more than three years.
From the results of this analysis, the indications for splenectomy in patients with CML might be summarized as follows;
(1) age under 60 years.
(2) within one year after definite diagnosis was made.
(3) hematologically well controlled cases in chronic stage.
(4) when adequate follow up could be assured.
(5) sufficient institutions and cooperation with skilled surgeons.抄録全体を表示PDF形式でダウンロード (577K)
教育講演
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小島 瑞1978 年 19 巻 4 号 p. 412-417
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (506K) -
林 昭1978 年 19 巻 4 号 p. 418-426
発行日: 1978年
公開日: 2009/01/19
ジャーナル 認証ありPDF形式でダウンロード (670K)
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