Cytogenetic study on bone marrow cells of 37 patients with acute non-lymphocytic leukemia was performed at the initial examination of the patients using banding technique.
Acute myeloblastic leukemia (AML) was diagnosed in 19 patients, acute promyelocytic leukemia (APL) in 4, acute monocytic leukemia (AMoL) in 1, atypical leukemia (Aty-L) in 10, and erythroleukemia (EL) in 3.
Chromosomal abnormalities were observed in 11 patients of AML, none of APL, 1 of AMoL, 4 of Aty-L, and 3 of EL, totalling 19 patients.
Four cases of AML showed (8; 21) translocation and hematological findings in common. The median survival times were 7.6 months for patients with normal karyotype only, 3.2 months for patients with both abnormal and normal karyotypes, and 4.0 months for patients with abnormal metaphase only. However, there was no statistically significant difference among these three groups.

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Ten patients with chronic myeloid leukemia underwent splenectomy in order to prolong their survival, and its effects and postoperative hematological changes were studied.
The time from the onset of disease until operation ranged from 3 to 70 months, and the stages of the disease at splenectomy were uncontrolled (1 case), accelerated (2), or controlled (7). The operations were performed between October 1975 and March 1977.
Postoperative hematological changes: Marked postoperative increases were seen in white blood cell counts, platelet counts and NAP scores. Particularly, increases in platelet counts continued for several months, making postoperative control extremely difficult.
Postoperative complications: Duodenal ulcer, hemorrhage, infection, and thrombosis due to thrombocytosis were found. Particularly, the loss of conciousness and convulsions due to cerebral thrombosis were over an extended period, and significantly disturbed their lives.
There was, however, no death due directly to the surgery or complications.
Period of survival: Including the 3 current survivors, the mean survival from the onset was 41.5 months and the median survival being 36.5 months. One of the 3 survivors is currently in an acute stage and other 2 survivors are in state of remission 37 and 28 months after operation respectively.

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Activity of antibody-dependent cell-mediated cytotoxicity (ADCC) of peripheral blood leukocytes in a patient with adult T-cell leukemia was examined by ⁵¹Cr release assay using sheep erythrocytes as target cells.
ADCC activity of crude lymphocyte fraction (CLF) (36.4±9.4%) obtained from adult T-cell leukemia was statistically (p<0.05) lower than those of healthy controls (51.1±10.9%). It was proved that ADCC activity of CLF of this patient was mediated by phagocytes (monocytes and granulocytes), and then leukemic T-cells had no cytotoxic ability, because ADCC activity was eliminated by the treatment of CLF with carbonyl-iron and nylon-wool column, and ADCC activity of E rosette forming cell rich fraction separated from CLF was not detected. Additionaly decrease of lymphocytic K cells and its functional abnormalities in a patient with adult T-cell leukemia was suggest.

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Factor VIII was purified from normal human plasma by gel filtration. Purification was 2900 fold with the recovery rate of 5%. This highly purified F-VIII was successfully separated into two components by 0.25 M CaCl₂. One which was eluted in the void volume (high molecular weight protein, HMW), contained VWF and AGN. The other in later fraction (low molecular weight protein, LMW), showed only AHF activity.
Antisera against F-VIII and against HMW were produced in rabbits. Anti F-VIII antiserum had both AHF and VWF neutralizing effects, and formed a single precipitine line against normal cryoprecipitates. Anti HMW antiserum which inhibited only VWF revealed same immunoprecipitabilities as F-VIII antiserum, and it's inhibitory effect was strong as 8 time as Hoechst's antiserum. Antibody against LMW was not able to be detected.
Using this anti F-VIII antiserum, AGN was measured by Laurell methods and crossed immuno-electrophoresis. AGN showed very low level (0-16.5%) in 5 patients with von Willebrand's disease, and electrophoretic abnormality by CIEP was seen in acquired von Willebrand's syndrome (0.40). Abnormal electrophoretic mobility was also seen in 2 patients with liver disease (0.30, 0.43) suggesting the presence of functionaly abnormal F-VIII.
The fractions of F-VIII by author's methods would be useful to elucidate the pathophysiological mechanism of F-VIII and VWF in these intriguing group of disorders.

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Thirty-one adult patients with acute non-lymphocytic leukemia entered the chemotherapy protocol study. They had had no chemotherapy previously. Among them, sixteen patients were treated with DCTP two step therapy, composed of daunomycin (DNR), cytosine arabinoside (Ara-C), 6-thioguanine (6TG) and prednisolone. The other fifteen patients were treated with DCMP two step therapy, composed of DNR, Ara-C, 6-mercaptopurine (6MP) and prednisolone.
The incidence of complete remission was 68.8% in DCTP two step therapy and 66.7% in DCMP two step therapy, respectively, but 80% in both groups among patients under the age of 60.
With regards to side effects during these therapies, liver dysfunction occured in 40% of the patients and gastrointestinal bleeding in 26%. There were no differences between two regimens.
The high incidence of complete remission obtained in these two step therapies can be partly accounted for by the capability of having reduced leukemia cells remarkably through the 1st step therapy of DCMP or DCTP two step therapy.

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We have investigated platelet aggregation in myocardial infarction (MI) by the Filtragometer and obtained the following results:
1) The average aggregation time (T_A) in patients with MI was 110.9±89.9 seconds, and this was shorter than that of control subjects which was 264.8±53.9 seconds. These patients were classified into two groups by the change of T_A in the further clinical course. In the first group, T_A became longer up to the normal range, and in the second group, it was restored to reference range at 3∼4 day after MI episode and became shorter than the normal.
2) The mean of the platelet disaggregation time (T_D) in MI subjects, which was 60.5 seconds, was longer than that of the control subjects (47.0 seconds).
3) The T_A was not correlated with plasma factors, such as fibrinogen, lipids and sugar, and b/2 time in the Aggregometer.

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A case of B-cell malignant lymphoma associated with high titer of cold haemagglutinin (IgG-IgM mixed type) was reported. The patient was 60-year-old male whose chief complaints were fever, anemia, and epigastral discomfort. On admission, generalized lymphadenopathy, splenomegaly and mild jaundice were pointed out. Laboratory examinations revealed normochromic anemia (Hb 5.7g/dl) with erythroid marrow and elevated indirect bilirubin (1.5 mg/dl). Serum haptoglobin was 70.8 mg/dl. The direct Coombs test was positive and haemagglutination was intensed at 4°C particularly by anti-IgM antiserum and to lesser extent, by anti-IgG antiserum. The patient's serum agglutinated adult O-type RBC as well as RBC from cord blood. The biopsy of right inguinal lymphnode revealed poorly differentiated lymphoma. Population of EAC-and E rosette forming cells in this lymphnode were 10% and 9%, respectively. By cytotoxicity test with anti-B cell specific antiserum, 90% of these lymphocytes were positive. Most of cells in this lymphnode were stained with anti-B cell specific antiserum and anti-IgM antiserum using indirect immunofluorecent methods. Furthermore, the extracts of the lymphnode was demonstrated to agglutinate O-type RBC by indirect Coombs test using anti-IgM antiserum and this fact indicated that the cold haemagglutinin in this patient's serum was derived from the lymphoma tissues themselves.
The patient was treated with combination of Vincristin, Endoxan, 6MP, and Predonisolone (VEMP), and the clinical symptoms and lymphnode enlargement were remarkably subsided. At 12th day after the initiation of VEMP therapy, patient died of sudden massive bleeding due to multiple penetrating ulcers of the stomach.

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A 26 years old male with cholelithiasis was referred to our clinic because of marked leukocytosis. The hematological findings of peripheral blood and bone marrow and other signs such as a low score of neutrophil alkaline phosphatase and positive Philadelphia chromosome confirmed the diagnosis of chronic myelogenous leukemia (CML). A complete remission for 5 months was induced by busulfan therapy. After that, however, leukocytosis over than 50,000/cmm reappeared inspite of augmented dose of busulfan. The sternal aspirate of bone marrow showed a hypercellularity with granulocytic hyperplasia. There were 9 per cent myeloblasts, 3.5 per cent promyelocytes, 27.5 per cent myelocytes and 17.5 percent metamyelocytes, etc. Coagulation studies revealed slight decrease of fibrinogen in the plasma and positive FDP in the serum and thrombocytosis of 1,836,000/cmm. Under the diagnosis of early stage of blastic crisis of CML with subclinical disseminated intravascular coagulation (DIC), AAAP-therapy (Jap. J. Clin. Hemat., 19: 1332∼1340, 1978) was started immediately. On the 2nd day, coagulation studies showed further decrease of fibrinogen in the plasma, prolongation of prothrombin time and Kaolin partial thromboplastin time together with increased FDP in the serum, which suggested a deteriolation of DIC state. The combined treatment with heparin succeeded to subside the DIC and to introduce a complete remission, which was achieved after only one course of AAAP and maintained for two months and half.
It was suggested from the experience of this case that subclinical DIC may present inspite of thrombocytosis in CML, and the deteriolation of DIC should be estimated at vigorous chemotherapy for blastic crisis of CML.

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A case of chronic myelocytic leukemia (CML) associated with miliary tuberculosis was reported. The patient was a 61-year-old male who had been diagnosed as CML and was treated with Myleran from Nov. 1976 to May 1977 at another hospital. Since May 1977 he began to have continuous high fever, and generalized red eruption appeared after the treatment with antibiotics. In June 1977, he was transferred to our ward, and miliary tuberculosis was incidentally found by the bone marrow aspiration (clot section) and the biopsy of the supraclavicular lymph node. At that time, there were no typical hematologic signs of CML, such as leukocytosis and reduced neutrophil alkaline phospatase (LAP) activity. Gradually pancytopenia became evident and high fever continued for 6 months in spite of antituberculous therapy. In Dec. 1977, high fever subsided and his general condition and peripheral blood picture were improved. In Oct. 1978, leukocyte count was increased up to 126,100/mm³ with markedly low LAP score. The bone marrow showed myeloid hyperplasia with positive Philadelphia chromosome. Although the prognosis of CML associated with miliary tuberculosis has been regarded to be very poor, this patient is still alive under the treatment with Myleran and antituberculous drugs.

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A case of T-cell lymphoma achieved a complete remission by a single treatment with OK-432 is reported. A 73 years old female had a 3 months' history of progressive enlargement of generalized lymphadenopathy and numerous subcutaneous tumor formations. Histological picture of the biopsied lymph node revealed malignant lymphoma of diffuse and poorly differentiated type, of which cells were compatible to convoluted cells with T cell marker demonstrating E-rosettes. Skin tumor revealed infiltration of same cells as lymph nodes. The WBC count was 6,800 with 19% lymphocytes which were not morphologically pathological. An aspirated bone marrow revealed normal cellularity with a M/E ratio of 5.5, and contained 2.8% of pathological convoluted lymphocytes. The percent of T cells and blastogenic response to PHA of the circulating lymphocytes were 76.5% and 92.5%, respectively. Because the patient was a person of very advanced age, she was treated with single immunotherapy with intramuscular injection of OK-432 at a dosis of 0.2 to 2 KE 3 times a week. Following the therapy, a rapid lysis of tumors ensued with complete resolution of lymphadenopathy and skin nodules 6 and 10 weeks later, respectively. The number of T cells and blastogenic response to PHA of the circulating lymphocytes were both reduced after OK-432 therapy in pararell with the regression of tumors.
The dramatic response of this patient to OK-432 suggests a necessity and usefulness of further trial for this type of T cell lymphoma, which is usually refractory to chemotherapy.

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The occurrence of multiple myeloma in spouses is very rare, and has not been reported yet in our country. In this article, an almost simultaneous development of multiple myeloma in spouses is presented.
A husband, 78-year-old man, the proprietor of a farm, had been complaining of paresthesia on his fingers for about 10 years prior to the admission, and was hospitalized in February 1977 because of severe back pain of 6 months' duration. Physical examination showed pallor and paresthesia in the extremities. Serum electrophresis revealed a monoclonal protein (IgG 1, κ) of 5.8 g/dl, and serum IgG level was 6,500 mg/dl. Hb content was 10.1 g/dl, and the bone marrow smear showed 14.8% immature atypical plasma cells. A skeletal survey showed osteopoprosis of the lumbar spines. A wife, 69-year-old womam, noticed general fatigue, numbness of fingers and muscular weakness on extremities since January 1977. Six months later, she was hospitalized because of low back pain and gradual progression of muscular weakness. Physical examination revealed pigmentation of the skin, paresthesia in the fingers, and muscular atrophy of the extremities. The serum contained a monoclonal protein (IgG 1, κ) of 4.5 g/dl, and serum IgG level was 6,400 mg/dl. Hb content was 10.0 g/dl, and bone marrow aspirate showed 13.6% abnormal immature plasma cells. Roentgenograms showed lytic lesions of the lumbar spines. EMG findings were interpreted as polyneuropathy.
The spouses had no past history of exposing to radioactive substances or chemical agent except that they had worked agricultural occupation using a large amount of benzene chloride (BHC) for about 30 years. Almost simultaneous occurrence along with an extreme similarity of clinical pictures, predominance of neuropathy, suggests that certain common cause might play in the pathogenesis of the diseases in spouses. Based on the conception that a protracted stimulation to the reticuloendothelial system, such as chronic inflamation, neoplasma and drug allergy or toxication, is important in the development of plasmacytic dyscrasia in man, it is suspected that BHC, known to be neurotoxic and carcinogenic in animals, is at least responsible for triggering or accelerating the development of multiple myeloma in our patients.

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Adult T-cell leukemia is rather commonly seen in the south of Shikoku district as in Kyushu. Seven cases were experienced during a year in our hospital. Clinical studies revealed a high association rate of ascites, gastric ulcer, hypercalcemia and relatively poor response to a combination chemotherapy consisting of Adriamycin, vincristine, cyclophosphamide and prednisolone.
Immunological studies confirmed T cell nature of the abnormal lymphocytes, unresponsiveness to PHA or PWM in the blastogenesis studies of lymphocytes, diminished ability as a stimulator or a responder in the mixed lymphocyte culture test, and normal levels of immunoglobulins.
Prophylactic use of trimethoprim-sulfamethoxazole for pneumocysitis carinii pneumonia was tried.
Necessity of proper naming and classification as a T-cell type malignant lymphoma was discussed.

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A 56-year-old female patient was admitted to our hospital because of fever, shortness of breath and edema of lower extremities. Physical examination revealed diminished breath sounds over the right lung field, marked hepatosplenomegaly and inguinal lymphadenopathy. A roentgenogram of the chest disclosed a large tumor shadow in the right lung field. The white blood cell count was 64,400/mm³ with 90% mature neutrophilic granulocytes and bone marrow aspiration from the sternum demonstrated myeloid hyperplasia. The histological diagnosis of the tumor on thoracotomy was squamous cell carcinoma of the lung. Colony stimulating factors (CSF) and stimulating activity for colony stimulating factor (CSF-SA) were investigated using normal human bone marrow cells as the target cells. The serum from the patient had no CSF activity but CSF-SA. High CSF were, however, demonstrated in the tumor extract and the medium conditioned with the tumor tissue. The concentration of CFU-C in the bone marrow cells from the patient was also increased. Moreover, nude mice which were transplanted with the tumor tissue showed a marked neutrophilic granulocytosis. From these findings, it could be considered that the tumor tissue produced CSF or CSF-SA functioning in vivo.

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