巻号一覧
21 巻, 11 号
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臨床研究
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金子 晴生, 白井 達男, 山内 幹雄, 梅田 正法, 塚原 敏弘, 牧 一正, 渡辺 総一郎, 平畑 徹幸, 石川 至, 木我 豊, 高槻 ...1980 年 21 巻 11 号 p. 1637-1645
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありFew reports on the half-life of gammaglobulin in various diseases have been published. The authors measured its half-life by 131I-labelled plasmin-treated human immunoglobulin in various disorders, especially in blood and liver diseases.
The blood samples were drawn from a case or two cases of AML, AMoL, CML in blastic crisis, aplastic anemia, SLE, cancer of the lung and gall bladder and liver cirrhosis.
The half-life of immunoglobulin was 5.1, 6.9 and 5.8 days in the patients with AML, AMoL and CML in blastic crisis, respectively. The half-life tended to be shorter in cases of leukemia complicated by infections and/or with many leukemic cells. The half-life of immunoglobulin in two cases of aplastic anemia was 5.3 and 6.2 days. The half-life was shorter in the febrile cases. The half-life was 6.7 and 7.1 days in two patients suffering from cirrhosis of the liver, and 10.5 days in the case of severe liver impairment in association with cancer of the bile-duct.
These results suggested that the immunoglobulin half-life in blood depends on the disease and became shorter in patients under severe conditions with complicated serious infections. These changes seem to be influenced by the metabolism of the immunoglobulin.抄録全体を表示PDF形式でダウンロード (701K) -
平沢 康, 永岡 隆, 久藤 文雄, 徳弘 英生, 木川田 隆一1980 年 21 巻 11 号 p. 1646-1654
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありEffect of maintenance therapy with low-dose of melphalan on multiple myeloma was studied.
Sixteen cases were treated with melphalan alone at doses of 2 mg daily from the diagnosis (4 cases), or after the remission induction therapy (12 cases).
There were significant objective and subjective improvement and increased survival (over 36.2 months of 50% survival time).
Responders to this regimen were 10 of 16 cases or more with the remission duration of 6 to 63 months (mean: 22.4 months). There were no differences in the responsiveness of patients between the differnt groups of M-protein or light chain.
The occurence of relaps tolerant to melphalan were observed in 6 cases after the course of one to five years.
Serious toxicity had not been encountered. In one case who had a 63 months remission with this regimen, postmortem examination revealed myelo-monocytic proliferation in the bone marrow, spleen, liver and lymphnodes concurrent with some residual evidence of myeloma.
A possible etiologic role of melphalan therapy in the development of acute leukemia was suggested.抄録全体を表示PDF形式でダウンロード (843K) -
相原 守夫, 沢田 美彦, 木村 あさの, 千葉 陽一, 吉田 豊1980 年 21 巻 11 号 p. 1655-1663
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありThe levels of three components of F·VIII, ie, VIII: C, VIII R: AG and VIII R: WF were measured in 106 patients with liver diseases.
The values of VIII: C were variable, and there was only one patient having a weak VIII: C inhibitor (0.75 u/ml).
VIII R: AG levels were remarkably elevated in many cases, especially in hepatoma and decompensated liver cirrhosis.
The amount of VIII R: AG was correlated with γ-gl value in liver diseases. Abnormal electrophoretic mobility of VIII R: AG was seen in some patients with liver disease by crossed immunoelectrophoresis (0.27±0.4, Normal 0.24±0.02).
The value of VIII R: WF showed also high level as that of VIII R: AG, but two cases with persistent hepatitis were revealed to have similar data to von Willebrand's disease.
In vitro studies, VIII R: WF activity were neutralized dose dependently by γ-gl.
VIII: C/VIII R: AG ratio was about 0.5 in recovery stage of acute hepatitis, persistent hepatitis, chronic hepatitis and compensated liver cirrhosis. This low value was also found in hemophilia A carrier, so careful consideration should be paid in differentiating hemophilia A carriers and patients with liver diseases, particularly with combind affectious.
VIII R: WF/VIII R: AG ratio was inversely proportional to plasma γ-gl value, and this ratio could be employed to investigate functional abnormalities of HMW portion of F-VIII.抄録全体を表示PDF形式でダウンロード (695K) -
—文献的考察を含めて—安部 英, 風間 睦美, 糸数 憲二, 木下 忠俊, 大串 利弘, 田原 千枝子, 福井 弘1980 年 21 巻 11 号 p. 1664-1673
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 71 years old female patient with sigmoid cancer complained rapidly growing meteorism, abdominal pain and tarry stool and was proved to have acquired factor V inhibitor producibility together with severe anemia, depression of platelet aggregability and marked prolongation of Stypven time. This inhibitor was revealed to belong to IgG which showed its inhibitor activity on factor V in normal plasma rather slowly and diminished by a factor VIII inhibitor bypassing activity preparation from blood: FEIBA in vivo as well as in vitro.
She was administered FEIBA intravenously and her hemorrhage cured remarkably for some while, but she expired soon when melena and the other hemorrhagic symptoms reoccurred to put her in hemorrhagic shock state.
The action of FEIBA was prominently strengthened by the addition of phospholipid with tissue thromboplastin component and calcium ion; so thus prudent control of the phospholipid level in plasma at the clinical application of this preparation was evaluated to bring good clinical effect and to avoid serious side effects such as hemorrhage, shock, defibrination syndrome, etc.
The patient's plasma was found to suppress platelet aggregation.抄録全体を表示PDF形式でダウンロード (752K) -
—臨床的検討による考察—佐藤 功, 鈴木 隆城, 田島 剛一, 新井川 勝久, 堀野 豊, 高橋 克子, 佐々木 毅, 遠藤 一靖, 石田 秀一, 佐伯 重昭, 三 ...1980 年 21 巻 11 号 p. 1674-1682
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありThe surface makers and functions of human lymphocytes have been widely studied in various immunological diseases. Along with the progress in these investigations, a better classification of lymphoproliferative disoders has been also attempted.
Lutzner et al. suggested that the Sézary syndrome, mycosis fungoides, and related disoders were grouped together as “Cutaneous T-cell Lymphoma”.
Takatsuki et al. recently proposed the concept of “Adult T-cell Leukemia” based on their observations on patients natives of south Kyushu in Japan. They thought that “Adult T-cell Leukemia” was different from the classical Sézary syndrome.
We observed 16 similar cases including 4 probable cases, which were identical to, resemble with, or distinct from the Sézary syndrome. But it was very difficult to separate them from each other by a definite line. We thought that all these cases were essentially identical to Sézary syndrome.
It is suggested that Sézary syndrome, mycosis fungoides, adult T-cell leukemia and T-CLL or some of T-lymphomas with abnormal cells containing bizarre nucleus are the same disease.抄録全体を表示PDF形式でダウンロード (1595K) -
—VENAP療法—古川 鋼一, 藤原 義久, 中出 泰充, 田中 岑也, 田中 正夫, 広田 豊1980 年 21 巻 11 号 p. 1683-1691
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありSix patients with multiple myeloma and 2 patients with primary macroglobulinemia were treated with a combination chemotherapy, consisting of vincristine, cyclophosphamide, procarbazine, ACNU and prednisolone (VENAP therapy).
Four of 6 patients with myeloma had become resistant to melphalan and/or cyclophosphamide, and 2 macroglobulinemia patients had not responded to chlorambucil and melphalan, and melphalan respectively.
A partial response was obtained in 5 of 5 evaluable myeloma cases, 4 of which had not responded to prior therapy.
On the other hand, 2 macroglobulinemia cases were judged as stable, however the amount of M-protein decreased below 50% of that at diagnosis in one case.
Results support the value of combination chemotherapy with VENAP for remission induction in patients with refractory multiple myeloma and allied disease. This therapy may be tried as an initial induction therapy for the “B-lymphocytes” malignancies.抄録全体を表示PDF形式でダウンロード (618K) -
—小児特発性再生不良性貧血ならびにヒト胎盤培養濾液のBurst Promoting Activity—西平 浩一, 気賀沢 寿人, 飯塚 敦夫, 長尾 大1980 年 21 巻 11 号 p. 1692-1697
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありRecently, it became apparent in-vitro growth of very primitive erythroid progenitor, erythroid burst-forming unit (BFU-E), depended not on erythropoietin but rather on burst promoting activity (BPA).
In this study, sera of children with idiopathic aplasic anemia and human placental conditioned medium (HPCM) were tested for their effects on growth of human BFU-E in plasma clot cultures.
The sera were obtained from 3 children with aplastic anemia who aged in 3, 10, and 11 years, respectively. The patients' peripheral blood were pancytopenia and bone marrow findings showed hypocellularity.
HPCM were obtained by the method described Burgess et al. The Plasma clot cultures were done by the method of Tepperman et al with minor modifications.
The results obtained were as follows:
1) All sera from 3 children with aplastic anemia had high levels of BPA; in addition, mixed colonies composed of erythroblasts, granulocytes and probably macrophages or megakaryocytes were found in the culture added the serum.
2) BPA were detected in HPCM.抄録全体を表示PDF形式でダウンロード (764K) -
—治療成績を中心として—土屋 純, 東雲 正剛, 高桑 正道, 山内 博正, 谷田部 寛, 杉田 裕, 新井 利政, 野際 英司, 宮脇 修一, 三浦 卓二, 岩田 ...1980 年 21 巻 11 号 p. 1698-1706
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありThe clinical study on the multiple myeloma, especially with respect to the effects of treatments was conducted in 101 patients with the multiple myeloma who had visited our hospitals for past 18 years. The results are summarized as follows: (1) The median age at the time for the diagnosis was 60, and the equal frequencies in men and women were obsereved. (2) Since 1975, the annual incidence and the number of patients with low tumor mas (Stage I by the criteria of Durie and Salmon) increased progressively. (3) Forty two patients with IgG myeloma were treated with previously reported regimens such as MP (5 cases), CP (16 cases), CUP (16 cases), and COP (5 cases). There was no significant difference between these four regimens with respect to the response rate, and the good response rate in total cases was 59.5%. (4) The good response rates in the patients with Stage I and II were 81.8% and 71.4%, respectively, while that of patients with Stage III was 54.5%. (5) The median survival in the evaluable sixty five patients was 40 months from the onset of symtoms; 31 months from the time for the first diagnosis; 30 months from the initiation of treatment. The patients in the early stage of the desease had a high value for the incidence of long survival. (6) The median survival, calculated from the time for the first diagnosis, was 27 months for IgG; 30 months for IgA; 22 months for BJP. (7) Survival had no difference between patients treated with BUN<30 mg/dl and patients treated with BUN≥30 mg/dl.抄録全体を表示PDF形式でダウンロード (708K) -
目黒 定安, 倉石 安庸, 小林 直, 知念 俊昭, 市場 謙二, 磯貝 行秀, 阿部 正和1980 年 21 巻 11 号 p. 1707-1712
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありBiopsy, including liver biopsy, is an important procedure in order to evaluate the prognosis and the therapeutic effects on the disease. This is the clinical study using liver biopsy in patients with hematological neoplastic diseases who developed either hepatomegaly or hepatic dysfunction and/or both. Percutaneous liver biopsy was performed on 21 HB-antigen negative patients (12 non-Hodgkin's lymphoma, 2 Hodgkin's diseases, 3 acute leukemias, 2 chronic lymphocytic leukemias, 1 malignant reticulosis, and 1 mycotic fungoides).
Results obtained were as follows.
1) Of the 6 cases of malignant lymphomas only with hepatomegaly; 5 had normal liver and 1 lymphoma cell infiltration.
2) Of the 8 cases of malignant lymphomas both with hepatomegaly and liver function abnormalities; 4 chronic persistent hepatitis, 1 fatty liver, 1 cirrhosis, 1 intrahepatic cholestasis of unknown etilogy and 1 normal liver.
3) Of the 3 cases during complete remission of acute leukemias; all had acute viral hepatitis.
It seems that primary liver diseases are more common than neoplastic infiltration in the liver in patients with hematological malignant diseases.抄録全体を表示PDF形式でダウンロード (806K) -
絹巻 宏, 別所 文雄, 藤生 道子, 水谷 修紀, 小林 登1980 年 21 巻 11 号 p. 1713-1719
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありCytological examination of the cerebrospinal fluid (CSF) was performed in 24 children with acute lymphocytic leukemia at the time of initial diagnosis. In 11 cases (45.8%), including 7 cases with normal CSF cell count, leukemic cells were found on cytological examination. This incidence of central nervous system (CNS) involvement at diagnosis of leukemia was much higher than that reported previously. The factors related to the CNS involvement were organomegaly (liver, spleen and/or lymph node) and thrombocytopenia, but peripheral white blood cell count was not correlated.
The clinical significance of these findings was discussed, focussing on the significance of “CNS prophylaxis” in the initial treatment of acute lymphocytic leukemia.抄録全体を表示PDF形式でダウンロード (741K) -
—各種予防治療法の検討—横山 隆, 栗谷 典量, 日吉 保彦, 長谷川 恵子, 伊藤 正宣, 金 平栄, 藤本 孟男1980 年 21 巻 11 号 p. 1720-1728
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証あり153 children with previously untreated ALL who received preventive CNS-therapy were analyzed in relation to treatment regimens, age, sex and initial hematologic status.
After the achievement of remission induction, patients received CNS-prophylaxis with; Group I-three doses of intrathecal methotrexate (MTX 12 mg/m2) and hydrocortisone (HDC 12 mg/m2); Group II-same as in Group I followed by cyclic MTX and HDC; Group III-same as in Group I plus 2,400 rads cranial irradiation.
CNS-leukemia terminated complete remission 25 of 153 patients (16.3%). The cumulative incidence of CNS-leukemia at 4 year calculated by the technique of Kaplan and Meier was 40.5% in Group I, 26.9% in Group II and 14.5% in Group III.
In those of Group Ia who received intermittent high dose infusion of MTX (protocol 721-A), incidence of CNS-leukemia was less frequent than that in patients receiving sequential-complementary therapy without MTX (721-B) (P<0.05).
Development of CNS-leukemia was more frequent in male than in female (P<0.05). In patients whose initial WBC were more than 25,000/mm3, the incidence of CNS-leukemia was 32.6% at 3 year in spite of preventive CNS-therapy with cranial irradiation plus intrathecal medication.
These data suggested that more intensive CNS-prophylaxis should be needed for such a high risk patients in male with high initial WBC.抄録全体を表示PDF形式でダウンロード (629K) -
井嶋 裕子, 須田 年生, 鬼澤 信, 江口 光興, 溝口 秀昭, 三浦 恭定1980 年 21 巻 11 号 p. 1729-1736
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありIn order to study the pathogenesis of juvenile type chronic myelocytic leukemia (juvenile type CML), we examined the capacity of colony formation in the bone marrow (BM) and the peripheral blood (PB) from 2 children who filled the criteria for juvenile type CML. A new techique of cytochemical examination of all colonies grown in agar gel culture was applied. BM or PB cells were cultured in a single layer using 10% of human placental conditioned medium as the colony stimulating activity (CSA). At the end of culture, the agar gel was stained for esterase activity in response to naphthol AS-D chloroacetate which is positive for granulocytes and/or α-naphthyl acetate which is positive for macrophages.
Tremendously large number of colonies were formed by BM and especially PB cells from the patients. In BM from case 1, colonies exclusively consisting of macrophages (macrophage colonies) were 51% on day 7 of culture and 72% on day 14 respectively. When the leukocyte increased in case 1 from 13,100/mm3 to 30,800/mm3, the number of colonies in PB increased from 17±2 to 396±11/2×105 mononuclear cells and ratio of macrophage colonies to the whole granulocyte-macrophage colonies increased from 0% to 83%. Similar results were obtained from case 2. While macrophage colonies formed by normal BM cells were less than 5% of all colonies on day 7, and these colonies were small in size and of dispersed-type, the macrophage colonies observed in juvenile type CML were very large and of compact-type.
To study the CSA produced by BM cells, juvenile type CML or normal BM cells were embedded in feeder layer of the agar culture and the normal BM cells were superposed in overlayer. On day 7, they formed 1736±171 and 1850±49 clusters/2×105 cells respectively and 99% of clusters were granulocytic. Thus the abnomality of CSA of juvenile type BM was not noted. From these findings, juvenile type CML may be one of panmyelopathy similar to adult type CML. Predominant growth of macrophage in vitro, however, is in marked contrast to granulocytic predominance in adult type CML.抄録全体を表示PDF形式でダウンロード (852K) -
特にステロイド治療による影響について鈴木 信也, 天野 哲基, 太田 善介, 大藤 眞1980 年 21 巻 11 号 p. 1737-1746
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありIn vitro interaction between monocytes and complement-coated erythrocytes from two patients with immune hemolytic anemia was studied serially before and after corticosteroid treatment. Erythrocytes from one patient were coated with IgA warm antibodies and complement (C3), and bound to monocytes as rosette fashion in Hanks' solution, but were not phagocytized by monocytes. Erythrocytes from another patient who developed hemolytic anemia after taking Methyldopa were coated with IgG warm antibodies and C3, and were readily phagocytized by monocytes. Rosette formation of the erythrocytes of the former patient was completely inhibited by the addition of 0.01 M EDTA, but not inhibited by the addition of IgG (10 μg/ml) in the medium. Phagocytosis of the erythrocytes of the latter patient was completely inhibited by the addition of IgG and moderately inhibited by the addition of EDTA. Thus, it was suggested that the binding of the erythrocytes of the former patient was mediated via C3 receptors of monocytes and the phagocytosis of the erythrocytes of the latter patient was mediated via both Fc and C3 receptors. After prednisolone (PSL) administration, in vivo hemolysis improved in parallel to the decrease in C3 Coombs' titers of erythrocytes and in vitro C3 receptor-mediated binding of erythrocytes to monocytes. PSL treatment did not reduce significantly IgG Coombs' titers and in vitro IgG receptor-mediated phagocytosis of patient's erythrocytes. In vitro erythrophagocytosis via C3 receptor was not parallel to the in vivo hemolysis. PSL treatment rapidly reduced C3 on the sensitized erythrocytes and the inhibition of the C3 receptor mediated interaction between mononuclear phagocytes and erythrocytes seems to be an important mechanism of PSL induced remission of hemolysis.抄録全体を表示PDF形式でダウンロード (848K)
症例
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若林 芳久, 日比野 順子, 高久 史麿1980 年 21 巻 11 号 p. 1747-1752
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 69 year old male was admitted to our hospital because of the symptoms of low grade fever, cough and bloody sputum. Physical examination revealed moist rales in the left pulmonary field, dilated veins in the lower abdomen and hepatic enlargement without splenomegaly. A chest X-ray film showed a shadow of chronic bronchitis complicated with bronchiectasia. The hematological examination revealed a moderate anemia with 9.6 g/dl hemoglobin concentration, 299×104/cmm red blood cell count, 18×104/cmm platelet count, and mild leucopenia of 3,800/cmm leucocyte count with 56% of abnormal monocytes or monocytoid cells on peripheral blood smear. Neutrophil alkaline-phosphatase score was 62 (normal 240±60). These monocytes or monocytoid cells were relatively large with poor basophilic cytoplasma and distinct nucleolus in the nucleus. Histochemical studies of these cells showed the characters of monocytes with positive peroxidase, acid phosphatase, alpha-naphthyl acetate esterase, naphthol AS-D chloroacetate esterase, phagocytosis and negative alkaline phosphatase. However, in his bone marrow, only 2.8% of monocytes or monocytoid cells were counted. The nucleated bone marrow cell count was 26.3×104/cmm, and a marked hyperplasia in the granulocytic series was noted with no Auer body and negative Ph1 chromosome. From these clinical and laboratory findings, this case was diagnosed as the so called chronic myelomonocytic leukemia. This case was suggested to be a valuable case for the clarification of the pathogenesis of leukemia and the mechanism of monocyte and granulocyte differentiation, since evidences showing the presence of the common comimtted myeloid stem cell were abundantly demonstrated in recent studies.抄録全体を表示PDF形式でダウンロード (611K) -
泉 並木, 三宅 祥三, 間 栄, 古沢 新平1980 年 21 巻 11 号 p. 1753-1760
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA case of acute lymphocytic leukemia of B cell origin preceded by intra-uterine infiltration is reported. A 38 year-old woman was admitted to our hospital because of gingival bleeding and ecchymosis. She was well until the performance of a total hysterectomy under the diagnosis of uterine myoma 9 months before admission. Since histological examination of the removed myoma revealed neoplastic infiltration of the blood-forming cells, radiotherapy (8,000 rads) was performed to both her inguinal regions. During the therapy, no abnomalities were found in the numbers and shapes of leukocytes in the peripheral blood. Two weeks before admission, she was awared of ecchymosis of both her knees and gingival bleeding. On admission, physical examination showed hepatomegaly, but no splenomegaly nor lymphadenopathy was present. The hematological findings were as follows: RBC 257×104/cmm, WBC 1,800/cmm, and platelet 8,000/cmm. A blood differential showed 5% myelocytes, 2% metamyelocytes, 13% stab cells, 35% segmented granulocytes, 28% lymphocytes, 3% monocytes, and 14% pathological cells. Light microscopically, the leukemic cells had a fine chromatin structure of the nuclei with 1∼2 well defined nucleoli and some cytoplasmic vacuoles. Examination of surface markers disclosed that 62% of the cells had surface-associated mu-heavy chain and 53% kappa-light chain. Incidence of E-rosette and EAC-rosette forming cells were 8% and 35% respectively. Although the administration of large dose of prednisolone decreased dramatically the number of leukemic cells, the subsequent reduction of prednisolone dose, caused a prompt increase in the numer of the cells.
In review of literatures, there are 28 cases reported as ALL of B cell origin. We could find out no common characteristic findings in the reported cases with an exception of a character of poor prognosis. The reported cases showed a difficulty to achieve any clinical remission. In addition, there are no other cases reported with infiltration to female genital organs in ALL of B cell origin.抄録全体を表示PDF形式でダウンロード (894K) -
—大量血小板輸注・摘脾・開頭術にて救命し得た1小児例—深沢 啓治, 長尾 大, 桑名 信匡, 朴 信史, 十字 猛夫, 柴田 洋一1980 年 21 巻 11 号 p. 1761-1766
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありAntiplatelet iso-antibody and massive intracerebral hemorrhage (lt. occipital area) developed to a nine year old boy 12 months after the diagnosis of idiopathic aplastic anemia. Since there was no longer appreciable increase of platelet on ordinary platelet transtusions and there were no HLA matched donors for platelet transfusion, he was splenectomized to improve the effect of platelet transfusion, as suggested by Flatow and Freireich. Soon after the splenectomy, craniotomy and evacuation of intracerebral hematoma were performed successfully. After splenectomy, recovery rate of the platelets transfused was 48.7±29.5% (mean±1 S. D.). Although he is still pancytopenic, he has been in good condition and attending school for 12 months after the splenectomy and craniotomy.抄録全体を表示PDF形式でダウンロード (490K) -
神前 昌敏, 仙波 幹生, 甲斐 俊朗, 原 宏, 永井 清保, 薗田 精昭, 阿部 達生1980 年 21 巻 11 号 p. 1767-1772
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA case of 47 years old woman with chronic granulocytic leukemia who developped additional karyotype abnormalities at the last stage of the disease was reported in the present communication. She visited the hematological clinic in July 1977 after she was administered Busulfan for 2 years. In December 1977, she was admitted under the diagnosis of acute crisis of chronic granulocytic leukemia without any additional karyotype anomaly to the Philadelphia (Ph1) chromosome and received some cytostatic agents such as cytosine arabinoside (Ara-C), Daunorubicine (DNR), Vincristine (VCR), and so on as presented in Fig. 2, while she had only moderate anemia and thrombocytopenia for eight months. After then, she had severe anemia and thrombocytopenia and showed 17 isochromosomes in addition to the Ph1 chromosome.
Furthermore, we discussed the correlation of survival time and the type of additional chromosome anomalies to the Ph1 chromosome after the crisis of chronic granulorytic leukemia.抄録全体を表示PDF形式でダウンロード (464K) -
多田 豊曠, 岸本 英正1980 年 21 巻 11 号 p. 1773-1780
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 34-year-old Japanese woman consulted a doctor with complains of nasal bleeding, irregular genital bleeding and subcutaneous petechiae about 16 years before her death. Initially, she was suspected of ITP with anti-platelet antibody, but 15 years later, diagnosed as SLE.
At autopsy, microscopic examination revealed hyaline thrombi-like subendothelial deposits in small vessels of the heart, brain, lungs, kidneys and adipose tissues surrounding pancreas, adrenal glands and the right third rib, indicating the presence of TTP. Other major findings were lobular glomerulonephritis, onion-skin lesions of splenic arteries and Libman-Sacks endocarditis.
The pathogenesis of TTP, with special reference to immunohistochemical examinations and anti-platelet antibody, is discussed in the light of the literature.抄録全体を表示PDF形式でダウンロード (927K) -
伊藤 俊晴, 武田 章臣, 二宮 規郎, 森 秀樹, 猪又 とし子, 都 通彦, 大原 徳明1980 年 21 巻 11 号 p. 1781-1788
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありThe patient, one year and ten month old girl, whose diagnosis had been made as chronic benign neutropenia in childhood (CBN-childhood) at the age of seven month, was readmitted to Department of Pediatrics, Fukushima Medical College Hospital because of suddenly appeared hemorrhagic diathesis. The diagnosis of CBN-childhood had been made on the basis of following hematological findings; RBC 449×104/cmm, Hb 11.6 g/dl, Hct 35.5%, WBC 7,000/cmm (band 1%, segment 1%, monocyte 13%, lymphocyte 77.5%, absophil 0.5%, eosinophil 7%), platelet 41.4×104/cmm and bone marrow cellularity 7.99×104/cmm (myeloblast 1.4%, promyelocyte 2.2%, myelocyte 6.2%, metamyelocyte 13.4%, band 10.4%, segment 1.2%, lymphocyte 43.4%, erythroblast 15.0%, others 6.8%).
Laboratory findings on readmission revealed RBC 558×104/cmm, Hb 10.3 g/dl, Hct 32.9%, WBC 5,600/cmm (band 1%, segment 0%, monocyte 3.5%, lymphocyte 90.5%, basophil 3%, eosinophil 1.5%, erythroblast 0.5%), platelet 1.3×104/cmm and bone marrow cellularity 28.9×104/cmm with megakaryocyte 113/cmm with marked increase of immature megakaryocytes. On the diagnosis of CBN-childhood associated with thrombocytopenic purpura, oral administration of betamethasone (3 mg/day, total amount 100 mg) was performed for the purpose of reduction in hemorrhagic diathesis, which resulted in the hematological improvement not only in platelet (31.7×104/cmm at 18th day), but in neutrophil (10,675/cmm; band 4%, segment 57% at 12th day).
In this report, the possible mechanisms of steroid induced remissionin this case was discussed, and it was strongly suggested that this case belongs to the group of autoimmune neutropenia, though the classical test for detection of anti-neutrophil antibodies were not detected in our case.
To our knowledge, CBN-childhood associated with thrombocytopenic purpura was not reported previously.抄録全体を表示PDF形式でダウンロード (579K) -
浜重 直久, 福井 次矢, 寺田 秀夫, 新倉 春男, 松野 一彦, 毛利 博, 押村 光雄1980 年 21 巻 11 号 p. 1789-1795
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 48-year-old male was admitted to St. Lukes International Hospital, because of bleeding tendency and anemia. His peripheral blood showed pancytopenia with leukoerythroblastosis. A diagnosis of erthroleukemia was made from the finding of bone marrow, in which PAS-positive megaloblastoid cells were predominant. Chromosomal analysis of his bone marrow cells showed only abnormal cells with karyotypic instability and marked structual abnormality. He could not be induced to a remission after treatment with either DCcMP or DCcVP, instead marked neutropenia developed. Since the 49th hospital day, he displayed remittent fever and pulmonary interstitial infiltration. In spite of vigorous antibiotics treatment including sulfamethoxazole-trimethoprim, he died of respiratory failure on the 66th hospital day. Post-mortem lung specimen revealed pneumocystis carinii pneumonitis.抄録全体を表示PDF形式でダウンロード (734K) -
入交 清博, 橋村 俊一, 数田 康仁, 堀内 篤1980 年 21 巻 11 号 p. 1796-1801
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 56-year-old man was admitted to the Kinki University Hospital for further evaluation of suspicious of leukemia. He was well until ten months previously, when he became fatigued. Seven days before entry he was admitted to another hospital because of severe anemia, hemorrhagic tendencies and fever. The blood hemoglobin level was 2.7 g/100 ml; the white-cell count was 8,500/mm3, with 75 per cent lymphocytes, 5 per cent blast cells and 16 nucleated red-cells per 100 count of white-cells. No tear-drop shaped erythrocytes were found. A diagnosis of suspicious of leukemia was made, and he was treated with 2,200 ml of blood transfusions.
On admissoin to our hospital the liver was enlarged but the lymph nodes and spleen were not palpable. The blood hemoglobin level was 11.1 g/100 ml; the white-cell count was 3,200/mm3, with 88 per cent lymphocytes and 3 per cent blast cells. The platelet count was 5,000/mm3. Several attempts of aspiration from the bone marrow were unsuccessful. A needle-biopsy specimen of the bone marrow revealed severe myelofibrosis, with numerous megakaryocytes. Erythroblast and granulocyte elements were normal in number and in shape. The patient received blood transfusion in large quantities, but his clinical features showed no sign of improvement. He died on the 28th hospital day. At autopsy, the bone marrow disclosed a myelofibrosis that similar findings to the biopsy specimen. The spleen weighed 130 g. There were no infiltration with leukemic cells in all organs and no exhibition of extramedullary hematopoiesis in the liver and spleen.抄録全体を表示PDF形式でダウンロード (689K) -
岩田 純一, 田部 章, 三宅 和彦, 鎌倉 正英, 大橋 辰哉, 織田 敏次, 丹下 剛, 及川 達郎1980 年 21 巻 11 号 p. 1802-1807
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA 47-year old man was admitted to the Ohmori Red-Cross Hospital because of recurrent high fever associated with systemic bone and joint pain on September 25, 1978.
On admission, hematologic examination showed no anemia nor thrombocytopenia and moderate leukocytosis with appearance of immature granulocytes and erythroblasts in a low percentage.
Recurrent bone narrow aspiration was all dry tap. At the beginning of October, pancytopenia developed rapidly with transient remarkable elevation of serum LDH activity up to 26,000 IU/ml, and serum uric acid 27 mg/dl, previous to the initiation of antileukemic chemotherapy.
He died of sepsis on October 18. Autopsy showed diffuse proliferation of promyelocytes in the bone marrow and a diagnosis of acute promyelocytic leukemia was established.
Multiple bone marrow necroses were seen in the vertabrae, costae, sternum and iliac bone. The remarkalde elevation of serum LDH and uric acid in this case is attributed to the necrosis of leukemic cells in the bone marrow.抄録全体を表示PDF形式でダウンロード (720K) -
阿部 緑生, 金子 安比古, 林 泰秀, 三比 和美, 桜井 雅温, 服部 理男1980 年 21 巻 11 号 p. 1808-1813
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありA case of acute lymphoblastic leukemia (ALL) accompanied by massive leukemic pleural and pericardial effusions, is reported. A 27 year-old housewife, whose initial symptoms were edema of the face and dyspnea, had a hydrothorax of the right pleural cavity. Leukemic lymphoblasts were found in the pleural effusion as well as in the peripheral blood and bone marrow, and were revealed to be void of membrane markers for T and B cells. A partial remission was induced by courses of daunorubicin, ara-C, vincristine and prednisolone, and a continuous aspiration of the pleural effusion was followed by an intrapleural injection of adriamycin. After a few months, however, a frank relapse occurred, when a pericardial effusion was noted. The effusion, which contained numerous lymphoblastic cells, was successfully treated with pericardiocentesis and intrapericardial injection of methotrexate. Chromosome examinations of cells from the bone marrow and the pleural effusion at diagnosis revealed a leukemic clone with a karyotype of 45, X, -X, -1, -14, -17, t (11; 12) (p15; p11), +der (1), t (1; ?) (p34; ?), +i (17q), +mar 1. An evolved clone with 46 chromosomes was demonstrated in later examinations, which has replaced the original clone completely. The pericardial effusion contained only cells with the evolved karyotype. The karyotypic evolution seems to have affected the clinical picture of this patient.抄録全体を表示PDF形式でダウンロード (759K)
例会
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1980 年 21 巻 11 号 p. 1814-1841
発行日: 1980年
公開日: 2009/01/26
ジャーナル 認証ありPDF形式でダウンロード (2620K)
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