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Volume 23, Issue 4
Displaying 1-19 of 19 articles from this issue
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[in Japanese]1982 Volume 23 Issue 4 Pages 425-432
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (631K)
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Soji KURITA1982 Volume 23 Issue 4 Pages 433-440
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSOut of 135 patients with acute leukemia treated in Aichi Cancer Center 13 patients (9.6%) with tumor formation were observed. Most tumors were found in childhood and adolescent patients. And tumors were 7 mediastina, 2 testes, 1 each of ovary, lacrimal gland, orbita and peritoneum. Of 29 patients with chronic myelogenous leukemia tumor formation was observed in 5 patients (17.2%) as a type of acute transformation: 1 humerus and 4 lymph nodes. The enlargement of lymph nodes was regarded as tumor only in chronic myelogenous leukemia.
The tumor formation in acute leukemia was analyzed from 267 patients reported in the Japanese literatures during 1960-1980. The tumor was most frequently observed in mediastinum and also found in skin, bone, testis, breast etc. Age distribution of the patients, types of leukemia and the time of occurrence of the tumor in tumor-forming leuklmia were studied 81 patients with chronic myelogenous leukemia associated with tumor formation were collected and analyzed. The histologic findings were myeloblastoma, reticulum cell sarcoma-like tumor, or tumor consisted of granulocytes with various degree of maturation. Ph1 chromosomes were found in these tumors. The pathogenesis of tumor formation in leukemia was discussed.View full abstractDownload PDF (631K)
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Part 2: Methods of Granulocyte Harvesting and Platelet Harvesting and Efficacies of the Components TransfusionHironobu TOKI, Morihiro ISHIKAWA1982 Volume 23 Issue 4 Pages 441-448
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe studied the methods of granulocyte harvesting and platelet harvesting using IBM 2997 blood cell separator and the efficacies of the component transfusions.
1) Mean value of 2.08x1010 of granulocytes was harvested from normal donors, who had been premedicated with betamethasone 8mg p. o., and in operation hydroxyethyl starch of 200,000 molecules was introduced in the separating channel.
2) Clinical benefits by granulocyte transfusions were seen on six cases out of eight.
3) Mean value of 6.2x1011 of platelets was harvested from normal donors.
4) Clinical efficacies of hemostasis were seen on 19 cases out of 20 with platelet transfusions.
5) Platelet transfusions by using IBM 2997 are efficient as a supportive therapy for patients with leukemias and other malignancies on chemotherapy.
6) Indications and limitations of granulocyte transfusion were discussed.View full abstractDownload PDF (579K) -
—Platelet Function—Hideki MUKAIYAMA1982 Volume 23 Issue 4 Pages 449-458
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe studies on platelets of 75 cases with MCLS were carried out, and the results were summarized as follows.
(1) Patients with abnormally high platelet count of more than 52.3×104/cmm (M±SD) were observed in 17.3% of the cases at their first visit to our hospital, and in 86.7% during the later courses. Platelet count more than 75×104/cmm was found in 1.3% of the first visit and in 37.3% during the later courses. In most cases marked thrombocytosis was observed between the 9th to 29th day after the onset, and recovered to normal level after 30 days. The average peak of thrombocytosis was on the 13th day. The platelet count in a group of the patients under one year old showed rather high value as compared with that in a group of the patients more than one year old.
(2) Platelet retention rate appeared normal.
(3) Platelet aggregation test using ADP, adrenalin, collagen, and ristocetin as aggregation inducers revealed hyperaggregability. This was often expected to occur in patients under one year old.
(4) Almost 70% of the cases examined at the first visit revealed high β-thromboglobulin level in thier plasma. All the patients under one year old showed high β-thromboglobulin level, but normal level more than 3 years. High β-thromboglobulin level was frequently found during the first month of the disease and it tended to decrease gradually thereafter.
(5) Platelet life span was measured in one case and the prolongation of life span was noticed.
These data suggested that the platelet function in the cases with MCLS was in the state of hyperfunction. The thrombocytosis found in this disease was suggested due to the increased platelet production or/and the decreased platelet destruction.View full abstractDownload PDF (678K) -
Y. L. LIN, R. SASAKI, T. AOKI, F. TAKAKU, T. KASAHARA, C. F. LIU1982 Volume 23 Issue 4 Pages 459-463
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSSialyltransferase is one of the glycosyltransferases which participate in the biosynthesis of the oligosaccharide chains of membrane glycoproteins and glycolipids. In this study, the optimum conditions for assaying sialyltransferase activity of human normal hemopoietic cells and leukemic cells were surveyed. Also, the relation between sialyltransferase activity and the differentiation of the leukocytes was investigated. In general, sialyltransferase activity of B lymphocytes from the peripheral blood of normal controls was higher than that of mature T lymphocytes from the peripheral blood. T and B lymphocytes from the enlarged tonsil contained higher sialyltransferase activity than that of T and B lymphocytes from the peripheral blood of normal controls. Mature lymphocytes from the peripheral blood of normal controls contained higher sialyltransferase activity than those of the lymphoblasts from acute lymphoblastic leukemia cases and of mature granulocytes from the peripheral blood of normal controls. In contrast, sialyltransferase activity of the myeloblasts from acute myeloblastic leukemia cases was higher than that of the granulocytes from the peripheral blood of normal controls.
Accordingly, these findings suggest the close relation between the change in sialyltransferase activity, the differentiation and the leukemic transformation of the leukocytes.View full abstractDownload PDF (350K) -
—Especially recent two families—Simeru KAMIHIRA, Yasuaki YAMADA, Kenichiro KINOSITA, Michito ICHIMARU, ...1982 Volume 23 Issue 4 Pages 464-471
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSAdult T-cell leukemia/lymphoma with peripheral T-cell phenotype have been frequently observed in Nagasaki district. The etiology of these endemic T-cell lymphoma is yet unknown. Because of finding out a pathogen we examined the clinicopathological features of malignant lymphomas diagnosed in Nagasaki Prefecture during 1964 to 1974, as the results more familial aggregations of these T-cell lymphoma were pointed out.
Recently, we experienced the two families consisting of four cases with T-cell lymphoma and one case with malignant lymphoma (marker: not done). These five patients with lymphoma possesed the characteristic clinical features such as bad prognosis, hypercalcemia, leukemic manifestation with convoluted and cerebriform nucleus and resistence to chemotherapy of peculial T-cell lymphoma described by authors.1-4)
We discussed the relationship with envioronmental and genetic factors.View full abstractDownload PDF (905K) -
Ryuhei SASAKI, Fumimaro TAKAKU1982 Volume 23 Issue 4 Pages 472-475
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTerminal transferase (TdT)-positive cells were surveyed in leukemia cases by indirect immunoperoxidase method. The presence or the absence of TdT and the ratio of TdT-positive cells assessed by immunoperoxidase method were consistent with those assessed by immunofluorescence of TdT. Peroxidase-positive substance was detected as the small granules in the nucleus or both in the nucleus and cytoplasm of the blasts from TdT-positive leukemia cases. Replacement of rabbit anti-TdT serum with PBS or with normal rabbit IgG gave negative staining in the slides from TdT-positive leukemia cases.
Immunoperoxidase method is an easy and excellent way to survey TdT in leukemia cases.View full abstractDownload PDF (626K) -
Akio TAWA, Keisei KAWA, Teruo IKEDA, Hidekazu OKUNI, Yujiro OKUBO, Tor ...1982 Volume 23 Issue 4 Pages 476-483
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTwenty one previously untreated children with acute nonlymphocytic leukemia were treated with a four-drug protocol consisting of daunorubicin, cytosine arabinoside, 6-thioguanine, and prednisolone. The incidence of complete remission was 63.2%. POMP (prednisolone, vincristine, 6-mercaptopurine, and methotrexate) was used for consolidation. Remission was maintained with a multiple-drug protocol including intrathecal methotrexate and every six months intensification with POMP. Among 12 children who entered complete remission, 3 remain in complete remission for 11.3-18.7 months. The median duration of complete remission was 8.4 months. The median survival of all the patients was 9.7 months, and that of those entering complete remission was 12.8 months.View full abstractDownload PDF (578K)
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Teruo INO, Minoru SAITO, Haruhi SHIGEMURA, Yoshihisa MORISHITA, Masami ...1982 Volume 23 Issue 4 Pages 484-492
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe experienced two cases of blastic crisis of CML with appearance of large, multinuclear, immature cells in the bone marrow, other organs, and infiltrative lesions, which seemed to be derived from the megakaryocytic series. Emperipolesis of nucleated cells were observed in some of these immature cells. The first case was 42 year-old and the second 45 year-old male. In both cases uncontrolable thrombocytosis with marked increase in the number of megakaryocytes in the bone marrow appeared during the terminal chronic phase. An osteolytic lesion of the right humerus in Case 1 and qadriplesia due to cervical compression in Case 2 were followed by the appearance of immature cells in the blood and bone marrow. Blast cells in both cases were peroxidase negative and PAS positive, and in Case 1 electron-microscopically some of blast cells had demarcation membrane systems in their cytoplasm. Both patients died within a month after the hematological blastic transformation. Postmortem examinations of both patients revealed multinuclear, large, immature cells with marked variation in size and shape infiltrating in the bone marrow, liver and tumorous lesions. A striking feature was engulfment of nucleated cells observed in some of these cells. Neither engulfing nor engulfed cells showed signs of degeneration and electron-microscopically immature cells had no lysosomes and phagosomes in their cytoplasms. This phenomenon was considered as emperipolesis rather than phagocytosis.View full abstractDownload PDF (1093K) -
Junkichi SHIMABUKURO, Takashi KANEKO, Nobuyuki TAGUCHI, Yukihiko MORIK ...1982 Volume 23 Issue 4 Pages 493-499
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSPediatrician rarely encounter the patient with acult type CML. Since we have experienced a pediatric case of adult type CML who developed lymphoid crisis with high TdT activity in the blast phase, and were able to identify blast cells with very primitive lymphoblast morphologically, cytochemically and immunologically. So, vindesine+prednisolone regimen was tried according as vincristine + prednisolone regimen. Vindesine is an analog of vinblastine, which is known less neurotoxicity than vincristine and has sometimes efficacy in the case of vincristine resistant. But it failed to obtain remission. Patient survived 19 months from the onset of disease, 69 days from the onset of blast crisis, respectively.View full abstractDownload PDF (607K) -
Yohichi TAKAUE, Osami NAKANO, Emiko ASANO, Tatsuo SHIMOKAWA, Hiroko KO ...1982 Volume 23 Issue 4 Pages 500-505
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of childhood autoimmune hemolytic anemia (AIHA) combined with idiopathic thrombocytopenic purpura (ITP) is reported. This clinical condition, known as “Evans' syndrome”, was associated with plural positive serologic data for systemic lupus erythematosus (SLE) with abscence of the physical signs proposed by American Rheumatism Association (ARA). The autoantibody on the patient's red blood cells was identified as panreactive IgG which contained both kappa and lambda light chains, but antiplatelet antibody was not detected. Pulse mode therapy using methylprednisolone was instituted in acute phase and was effective without side effects of steroid hormone. Although the urinalysis had been unremarkable, the percutaneous renal biopsy performed five-month later revealed the histopathological change compatible with proliferative glomerulonephritis. Both AIHA and ITP seem to have autoimmune characters and their pathogenetic mechanisms are reviewed. Diagnostic consideration of subclinical SLE is also described.View full abstractDownload PDF (607K) -
Hajime NAKAZAWA, Yoshio KASUGA, Rokuichi IGA, Masazumi KOMUKAI, Shinic ...1982 Volume 23 Issue 4 Pages 506-510
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 65-year-old man was admitted to the Shakaihoken Saitama Chuo Hospital on May 21, 1980 because of headache and blurred vision. Physical examination revealed anemia, visual impairment, bilateral central retinal vein occlusion and retinal hemorrhages. Laboratory findings showed the erythrocyte sedimentation rate 163 mm/hour, hemoglobin 6.8g/dl, WBC 3,100/μl, platelet count 166x103/μl and the serum total protein 15.7g/dl. Serum protein electrophoresis disclosed an M component, accounting for 61.1% of total protein. Immunoelectrophoresis defined the M component as IgG myeloma protein with kappa chains. The bone marrow aspirate revealed that 55.8% of the nucleated cells were immature plasma cells. Clinical and laboratory findings indicated that the patient had multiple myeloma of IgG-κ type and hyperviscosity syndrome. The chemotherapy with prednisolone, cyclophosphamide and vincristine was initiated, and plasma exchange using cellulose acetate hollow fibers was performed at the same time. Immediately after plasma exchanges of 2,600ml and 2,000ml on May 23 and June 4, remarkable improvement of clinical and laboratory findings was achieved. This simple method of the plasma exchange is safe, effective and useful for the treatment of hyperviscosity syndrome without any special instrument such as cell separators.View full abstractDownload PDF (500K) -
Toshiharu ITO, Hideki MORI, Akiomi TAKEDA, Hitoshi SUZUKI, Kieko SONOD ...1982 Volume 23 Issue 4 Pages 511-518
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSHe was eight year and eight month old and was diagnosed as acute lymphoblastic leukemia in January, 1980. In April, a complete remission was attained with the combination chemotherapy of daunorubicin (DNR), cytosine arabinoside (Ara-C), vincristine (VCR), 6-mercaptopurine (6-MP), and prednisolone (Pred.). Because of his relapse in June, he was given the same chemotherapy as above, but the therapy was not successful.
When high fever was observed in a severe leukocytopenia in July, sepsis work up was done resulting Candida albicans in his throat swab and urine. After this episode, a remittent fever (36°C-39°C) ran throughout the rest of the course.
In September, he had a phlegmonous cellulitis on the left lateral chest skin, but blood cultures were again negative. Carbenicillin (CB-PC), amikacine sulfate (AMK), and human immunoglobulin were administered intravenously and 5-fluorocytosine (5-FC) orally. After a transient cure of the phlegmonous cellulitis, he was suffering from a severe pain in October and inflammatory findings were noted on the region of the previous phlegmonous cellulitis. Two days later, the gangrenous ulcer developed in the center of the lesion, and the histopathological diagnosis was mucormycosis. Absidia corymbifera was isolated and identified from the punctured fluid obtained from the lesion by corn meal cultures. A diagnosis of cutaneous mucormycosis was confirmed. Potassium iodide was effective in the treatment of the cutaneous mucormycosis.
In November, a high-dose methotrexate and citrovorum factor (Leucovorin) rescue therapy was administrated in addision to the combination chemothrapy as above without much success. He died in January, 1981 but the autopsy was denied.View full abstractDownload PDF (976K) -
Yoneko CHIKU, Yuko SATO, Yasunori ABE, Yasuhiko KANO, Yasuko KURATOMI, ...1982 Volume 23 Issue 4 Pages 519-526
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe patient is a 30 years old housewife. Twenty-two years ago, she was admitted to a local hospital because of fever and nasal bleeding. Her hemoglobin was 15%, RBC 720,000/cmm, WBC 3,100/cmm, with relative lymmphocytosis and platelets 22,000/cmm. Examination of aspirated bone marrow revealed an aplastic marrow with an increase in lymphocytes and plasma cells. Therapy with prednisolone and blood transfusion with the diagnosis of aplastic anemia produced a remission, and she left the hospital 6 months later.
She continued to have mild pancytopenia without symptoms until December 1978, when she was found to have a few myeloblasts in the peripheral blood in another hospital. Percentage of myeloblasts was slightly increased in her bone marrow. She was admitted to our hospital on October 20, 1979, because of high fever. On admission, general physical studies showed the presence of hepatomegaly. Blood examination revealed a slight anemia, and WBC was 73,200/cmm with 10.6% myeloblasts, 52.0% basophilic cells and atypical erythroblasts 52/500, and platelets 118,000/cmm. Sternal marrow aspirate revealed myeloid hyperplasia. Ph1 chromosome was negative, but trisomy 8 was found. She was diagnosed as basophilic leukemia, but 3 months later, blood examination revealed an increase of atypical erythroblasts in place of basophilic cells. Despite of intensive antileukemic therapy, she died of sepsis on April 29, 1980.
It is widely accepted that patients with aplastic anemia may develop into leukemia, usually within several years after the onset of aplastic anemia. But it is extremely rare that the span of it extends more than twenty years.View full abstractDownload PDF (963K) -
Kenji ARASHI, Yoneyoshi HOSHIMOTO, Tomio INOUE, Toshiyuki AIBIKI, Nobo ...1982 Volume 23 Issue 4 Pages 527-532
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old woman with acute myeloid leukemia in preleukemic stage was reported. She was admitted to Kyorin University Hospital with complaints of general fatigue and purpura on limbs in July, 1978. On physical examination, frank anemia, purpura and hepatosplenomegaly were found. Hematological examination were showed: Hb 6.2g/dl, RBC 177x104/cmm, Ht 16.5%, reticulocyte 1,3%, platelets 0.9x104/cmm, WBC 1200/cmm (seg, 10%, eosino, 1%, mono, 4%, lympho, 85%, erythroblast was shown.). Anisocytosis and poikilocytosis were shown on the blood smesr. The bone marrow characterized by maturation arrest of myeloid series and megaloblast-like cells were found. Serum vitamin B12lebel was low (180pg/ml). Serum folic acid lebel was normal range. Initial impression diagnosis was pernecious anemia or aplastic anemia. On the 7th hospital day, vitamin B12therapy was started, but this therapy was not effective. A diagnosis of atypical aplastic anemia was made by clinical and cytological finding. On 28th hospital day, the oxymetholone therapy (90mg/day) was started. She was discharged in September 2, 1978. After the oxymetholone therapy, hematological finding was improved in November, 1978 (Hb 10.8g/dl, Ht 33%, RBC 304x104/cmm, platelets 4,4x104/cmm, WBC 3,800/cmm). In Janualy 1979, pancytopenia again developed, which showed only inadequate response to the oxymetholone therapy. In March of the same year, she was readmitted to our hospital with complaints of general fatigue and nasal bleeding. On the peripheral blood examination, myeloblast-like leukemic cells were shown (22%). The bone marrow was hyperplastic and peroxidase-positive leukemic cells were increased (30.2%). A diagnosis of acute myeloid leukemia was made. Remission induction therapy was started with DNR, Ara-C, 6-MP and prednisolone. Subsequently, the patient took a rapid downhill course, and died of lung bleeding. Her whole illness had lasted approximately 8.5 month.View full abstractDownload PDF (560K) -
Tadao SHIMIZU, Shigeki SEKI, Yoshikazu SUYAMA, Hiroshi FUJII, Kazuko Y ...1982 Volume 23 Issue 4 Pages 533-540
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 48 year-old man born in Saga Prefecture was hospitalized for treatment of giant gastric ulcer (10x6cm) on March, 1980. He was found to have lymphadenopathy and hepatomegaly. The white blood cell count was 15,500/cmm, including 10% abnormal cells with convoluted or segmented nuclei. These abnormal cells had T-lymphocyte membrane markers [E (+), γFcR (±), μFcR (-), C3bR (-), sIg (-), Ia (-), TdT (-)] and showed the pleomorphism. The biopsy specimens of the stomach and lymph node showed non-Hodgkin's lymphoma, diffuse type. The same abnormal cells in the peripheral blood smear were found in the touch smears of the stomach and lymph node, later in the ascites and the cerebro-spinal fluid. Seven months later, he died of cachexia despite of chemotherapy. Postmortem examination showed extensive infiltration of leukemic cells in the generalized lymph nodes, bone marrow, liver, spleen, stomach and adrenal gland.
The present case showed the geographical and pathological characteristics of adult T-Cell Leukemia (Takatsuki, 1976).View full abstractDownload PDF (968K) -
Hironori YAMADA, Hiroshi YAMAGUCHI, Koichi FURUKAWA, Kazuko YOSHIDA, Y ...1982 Volume 23 Issue 4 Pages 541-550
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTwo cases of acute non-lymphoblastic leukemia in early relapse, 33 years old male (Y.O.) with acute myelogenous leukemia and 40 years old male (E.K.) with acute monocytic leukemia, were successfully grafted with bone marrow from their HLA-identical sibling, respectively. They were conditioned with cyclophosphamide (CY)+total body irradiation (TBI) after E.D. Thomas et al. Infused cell number were 3.6x108/kg (Y.O.) and 2.7x108/kg (E.K.). Both cases didn't develop any graft-versus-host disease (GVHD). Anti-cytomegalovirus (CMV) antibody titer was elevated to 1,024 in Y.O. with eruption and diarrhea on day 105 and was elevated to 32 in E.K. with fever and liver dysfunction on day 108. CMV antibody titer decreased in both. Septic shock induced by E. coli developed in Y.O. on day 172 and also in E.K. septic shock induced by Pseudo. cepacia developed on day 48. Although Y.O. recovered from septic shock, interstitial pneumonia (IP) progressed and he died of respiratory failure on day 217. E.K. had hemorrhagic cystitis on day 73 and costal caries on day 127. PPD skin test was positive in also before marrow transplantation and the occasion of costal caries complicated. IP appeared on day 162 and E.K. died of respiratory failure on day 170. There were not detected CMV inclusion-body cell and leukemic cell on autopsy in any organ in both cases.View full abstractDownload PDF (933K)
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1982 Volume 23 Issue 4 Pages 551-572
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (2139K)
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1982 Volume 23 Issue 4 Pages 573-582
Published: 1982
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (879K)
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