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Volume 24, Issue 12
Displaying 1-14 of 14 articles from this issue
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A New Protocol 811 for the Standard Risk Group of Acute Lymphocytic Leukemia (Phase III Study)Shoichi KOIZUMI, Takeo FUJIMOTO, Ototaka HIGASHI, Jiro UTSUMI, Junichi ...1983 Volume 24 Issue 12 Pages 1633-1640
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA new protocol 811 for a “standard risk group” of acute lymphocytic leukemia stratified by prognostic factors based on age and white blood cell count at diagnosis was presented in this study. After inducing remission with vincristine (VCR) and prednisolone (Pred), cranial irradiation (1,800 rads) and 1 T methotrexate (MTX) were given as a menigeal leukemia prophylaxis. Thereafter, patients were randomized to receive maintenance therapy of regimen A or B. Regimen A consisted of MTX 225 mg/m2 iv push alternating at 2 week-intervals VCR 2.0 mg/m2×1, Pred 120 mg/m2/day×5. Patients in regimen B received 6 MP 50 mg/m2 daily and MTX 20 mg/m2 p.o. weekly, concomitantly with periodic reinforcement of VCR 2.0 mg/m2×1 and Pred 120 mg/m2/day×5 every four weeks. Also, even numbered patients at randomization received vindesine (VDS) 3.0 mg/m2 instead of VCR. A late intensification therapy high-dose MTX (2,000 mg/m2) was given to all the patients who have been in continuous initial complete remission at 2-years.
Sixty seven patients were registered in this study between January 1981 and October 1982. Sixty four patients (95.5%) achieved complete remission, and then were randomized to regimen A (n=32) and regimen B (n=32). There was no difference on remission rate among patients receiving VCR or VDS. As of March 1983, continuous complete remission rates of regimen A and B were 77.9%±10.5% (mean±1 S.D.) and 84.4%±7.5%, respectively. There was no significant differences in continuous remission rates, toxicities and side effects between these two regimens. Twelve patients have been receiving high dose MTX with citrovorum factor rescue for late intensification, but a longer period of observation is needed to evaluate the efficacy of the late intensification therapy.
However, these preliminary results showed that the new protocol 811 seemed to be effective to a good prognostic group of acute lymphocytic leukemia in children.View full abstractDownload PDF (568K) -
Mitsuto JOGAMOTO, Takashi HANADA, Tsukasa ABE, Hitoshi TAKITA, Takeo N ...1983 Volume 24 Issue 12 Pages 1641-1644
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis paper describes a 29-year-old female with pernicious anemia who was found to be pregnant shortly after vitamin B12 injection was started. Intrinsic factor antibody and parietal cell antibody were detected in the mother's serum throughout the pregnancy. She delivered a full-term, female infant. The effects of transplacentally acquired gastric antibodies on the secretion of hydrochloric acid and intrinsic factor were studied. One week after birth, gastric antibodies were detected in the infant's serum and the serum vitamin B12 concentration was normal. The gastric antibodies gradually disappeared thereafter. The intrinsic factor antibody could not be detected 16 weeks, and the parietal cell antibody 22 weeks, after birth. The intrinsic factor activity in the gastric juice was detected one week after birth and it increased to a normal level in 16th week after birth. These findings suggest that the maternal gastric antibodies transferred transplacentally throughout the pregnancy did not severely damage the gastric mucosa of the infant.View full abstractDownload PDF (314K) -
—Use of Vinca Alkaloids and Prednisolone Alone—Kazumi SAMPI, Toshio HONDA, Yasuhide HAYASHI, Masao HATTORI1983 Volume 24 Issue 12 Pages 1645-1649
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThirteen patients with previously untreated adult acute lymphocytic leukemia (ALL) were treated with a combination of vinca alkaloids and prednisolone (PSL) in Saitama Cancer Center between February 1977 and January 1982. The first six patients were given 1.4 mg/m2 of vincristine (VCR) (maximum dose 2.0 mg) intravenously every one week and 40 mg/m2 of PSL orally every day until the attainment of complete remission. 3.0 mg/m2 of vindesine (VDS) were substituted for VCR in the subsequent 7 patients. Complete remission was attained in 3 of 6 patients treated with VCR+PSL, and 4 of 7 patients treated with VDS+PSL, with an over-all complete remission rate of 54%. The median duration of remission was 15 months and the median survival time for all patients was 18 months. Steroid diabetes occurred in 5 of 8 patients over 38 years old during induction phase and these required discontinuation of PSL. In conclusion a low complete remission rate in our study suggests the addition of an anthracycline to increase it.View full abstractDownload PDF (325K) -
Yoshinobu MATSUO, Hiroko KAMACHI, Mitsuo YOKOYAMA, Yoshihiko NAGATA, K ...1983 Volume 24 Issue 12 Pages 1650-1662
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThe monoclonal antibodies of the Coulter clone, T 11, T 4, T 8, B 1, I 2, Mo 2 and J 5 were assesed by indirect immunofluorescent assay using 31 cultured cell lines derived from various type of leukemia, lymphoma and normal B cell lines respectively. Peripheral blood cells including mononuclear cells and polymorpho-nulear cells from five normal adult subjects were also used for the analysis.
The Coulter clone was resulted with high specificity in reaction with human hematopoietic cell line cells and the normal human peripheral blood cells. However, the titer of the monoclonal antibodies were found difference among the cell line cells.
T cell differentiation antigens and functional subsets recognized by T 11, T 4 and T 8 were clearly demonstrated on the cell surface of the T cell lines. However, MT-1 cells derived from the tumor cells of Japanese adult T cell leukemia did not show positive reaction with T 4 and T 8 monoclonal antibodies. CCRF-CEM and RPMI-8402 cells were also negative with T 8 monoclonal antibody. All of the T cell lines were negative with B 1 monoclonal antibody and NALM-6, KOPN-1 and LAZ-221 cells were also negative. In the mature B cell line, Raji cells from Burkitt's lymphoma and U-266 from multiple myeloma were also showed negative with B 1 monoclonal antibody. I 2 monoclonal antibody showed a similar result with the specificity demonstrated by heteroantiserum specific to the Ia-like antigen.
J 5 showed high specificity to CALLA positive cell line cells recognized with anti-CALLA heteroantiserum, CCRF-CEM and NALM-16 cells demonstrated small percentages of positive cells with J 5. However, J 5 is considered to be a specific marker of common acute lymphoblastic leukemia cells including lymphoid precursor cells, Pre T cells, pre B cells and immature B cells.
Mo 2 monoclonal antibody showed specificity reacting with peripheral blood monocytes.
The monoclonal antibodies of the Coulter clone detect the differentiation antigen of human hematopoietic cells and the reagents could be useful for the elucidation for the origin of the malignant cells, the identification of differentiation stage and subset of human hematopoietic cells.View full abstractDownload PDF (827K)
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Kenji SHINOHARA, Hiroko SASAKI, Katsunori YAMADA, Yoji ISHIDA, Toshio ...1983 Volume 24 Issue 12 Pages 1670-1673
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSTwenty-six-year old woman developed wide ecchymoses in the arms 3 months after the second postpartum. The plasma of the patient had the inhibitor against factor VIII activity, and it was immunoglobulin G. She was first treated with prednisolone, but the effect was insufficient. She was subsequently treated with factor VIII concentrate. The inhibitor disappeared, and the activity of factor VIII returned to almost normal after 9 months.View full abstractDownload PDF (272K) -
Kimihiro SHIRAISHI, Hiroyuki EBATA, Katsuaki SATO, Masatoshi TANAKA, R ...1983 Volume 24 Issue 12 Pages 1674-1679
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 29 year-old woman was admitted to our hospital because of ovarian bleeding and diagnosed as von Willebrand's disease in 1978. Subsequently she suffered from ovarian bleeding twice in 1979 and in 1981. At the 3rd bleeding episode, enlarging hematoma was palpable in her right lower abdomen, and she was treated with DDAVP as follows.
Twenty μg of DDAVP was added to 100 ml of isotonic saline and administered by drip infusion intravenously over 20 to 30 minutes. For one to four hours after infusion, factor VIII complex showed marked increase as compared with its basal level: VIIIR: AG increased from 30% to 86%, VIIIR: WF from 37% to 100%, VIII: C from 7.2% to 33%. This treatment was applied every 12 hours for five days. Subsequently the hematoma was diminished in size and disappeared two weeks after the treatment. DDAVP was regarded as useful for hemostatic control of von Willebrand's disease.View full abstractDownload PDF (473K) -
Kazuhiko MATSUNO, Hiroaki NISHIYAMA, Hideo TERADA, Fumiaki SAGAWA, Kaz ...1983 Volume 24 Issue 12 Pages 1680-1685
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 17-year-old girl was admitted to our hospital complaining of lumbago. Blood examination revealed anemia and thrombocytopenia. Bone marrow biopsy showed marked necrotic foci and groups of abnormal cells.
The patient responded well to the combination chemotherapy consisting of cyclophosphamide, vincristine and prednisolone initially, but died of progressive infiltration of CNS after about one year.
Autopsy revealed a gray-whitish, soft, friable, irregular nodular, partially necrotic and hemorrhagic tumor of about fist size in the postrior wall of urinary bladder. Specimens of the tumor revealed the histological picture of neuroblastoma characterized by rosette-formation. There were metastatic infiltrations in the right temporal region of meninges, both lungs, liver, lymphnode and bone (femur, vertebra and rib). Necrotic change and reticulin fibrosis were noted in her bone marrow.
Bone marrow necrosis is rarely found in bone marrow samples obtained during life. So far, ther has been no report that bone marrow necrosis was confirmed in a case of neuroblastoma by a bone marrow biopsy.View full abstractDownload PDF (893K) -
Shinichiro OKAMOTO, Yasushi IWAO, Keisuke TOYAMA, Yasuhiro ENOMOTO, Yo ...1983 Volume 24 Issue 12 Pages 1686-1690
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of acute myelomonocytic leukemia with segmented neutrophil containing Auer bodies is reported. A 30 year-old male patient was admitted to the Keio University Hospital complaining of malaise and eruptions on the fingers and soles for three weeks. On admission, the white blood cell coumt was 8,200/cmm with 9% neutrophils, 29% monocytes, 23% blast cells and 1% promyelocytes. The leukocyte alkaline phosphatase score was very low. A bone marrow aspirate revealed replacement of the normal hematopoietic cells by blast cells. A diagnosis of acute myelomonocytic leukemia was made on the basis of the cytochemical findings of leukemic cells. Several Auer bodies were observed in the cytoplasm of some blasts and segmented neutrophils in the peripheral blood and bone marrow. On electromicroscopic study, mature segmentad neutrophils containing Auer bodies had no specific granules. These observations emphasized the leukemic origin of these cells.View full abstractDownload PDF (512K) -
Yasunori TOYODA, Ryoji HANADA, Hisato KIGASAWA, Atsuo IIZUKA, Hirokazu ...1983 Volume 24 Issue 12 Pages 1691-1698
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis seven-year-old girl was referred to the Kanagawa Children's Medical Center on May 15 1982, because of pallor and low grade feve. Blood counts on admission were follows: Hb 4.2 g/dl, WBC 2,900/mm3 with 10% neutrophils, platelets 16,000/mm3 and reticulocytes 0.1%. An aspirated bone marrow specimen revealed 12,000/mm3 nucleated cells. Both CFU-C and BFU-E were 0/2×105 bone marrow cells. A diagnosis of severe aplastic anemia was made on the criteria of International Aplastic Anemia Study Group.
After coditioned with cyclophosphamide 50 mg/kg/day for four days, she recived 3.3×108/kg bone marrow nucleated cells from an HLA and ABO blood group identical sibling (ten-year-old boy). She was treated with intravenous methotrexate for preventing graft versus host disease (GVHD) after Thomas' method.
On the 12th day after transplantation, recovery of CFU-C was noted preceding the recovery of more mature hemopoietic bone marrow cells.
Cytomegalovirus infection was documented about 50 day after transplantation, but no symptoms appeared. This infection was most probably induced by the platelet transfusions.
A reverse ratio of OKT4 and OKT8 continued till 9 month after transplantation.
She is doing well without GVHD and remained in full hematological remission for 14 month.
Sofar, in Japan, 17 patients with severe aplastic anemia have received allogeneic bone marrow transplantations, and 7 of them, including this case, are alive.View full abstractDownload PDF (527K) -
Tsuneo SASAKI, Takuhei MURASE, Tazuko IBUKA, Kuniyuki IMAI, Yasunobu S ...1983 Volume 24 Issue 12 Pages 1699-1703
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 27-year-old housewife with acute lymphocytic leukemia was brought to complete remission (CR) with the combination of L-asparaginase (A-ase), vincristine (VCR) and prednisolone. Allergic reactions (uriticaria and dyspnea) which appeared at the beginning of the second course therapy were promptly relieved with the high dose hydrocortisone. she was maintained with VCR, endoxan (EX), 6-mercaptopurine (6-MP) and prednisolone. After 11 months of CR, her leukemia relapsed. High dose methotrexate therapy was ineffective. Combination of A-ase, VCR and prednisolone was started again and proved to be effective in the reduction of leukemia cells. The severe uriticaria appeared soon after the A-ase administration of the second course. A-ase was stopped and it disappered. Plasma exchange by IBM 2997 Blood Cell Processor was attempted to remove the anti-A-ase antibody. Seven thousands ml of plasma were exchanged for three consecutive days. This therapeutic procedure brought about striking decrease of the anti-A-ase titer and disappearance of allergic reactions to A-ase. CR was obtaind once again with combiation of A-ase, VCR, EX and prednisolone.View full abstractDownload PDF (363K) -
Seiichi HORIE, Masakuni SUGIMOTO, Yoshihisa WAKABAYASHI, Yuichi SHIOKA ...1983 Volume 24 Issue 12 Pages 1704-1709
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of acute myelomonocytic leukemia following the therapy given to carcinoma of the maxilla was reported.
The patient was a 38-year-old man who was diagnosed as carcinoma of the maxilla in 1979. Postoperatively, he received 6840 rads of 60Co to the tumor from June to August 1979, and 10060 rads from November 1980 to March 1981. In February 1981 he received 1260 rads to metastasis of a node in the neck. The total dosis of the radiation comes to 18160 rads. He also received chemotherapy of 5-FU with a total dosis of 3500mg, and of bleomycin with a total dosis of 95mg.
In September 1981, he complained of malaise and fever. Hematological examination revealed that WBC count of peripheral blood was 68,000/mm3 with 35% blasts. Bone marrow smear showed a markedly increased myeloblast and monoblast. Bone marrow chromosome assay showed hyperdiploid cell line with a marker chromosome. He was diagnosed as AMMoL with chromosomal abnormality.
Although combination chemotherapy was given with success to induce complete remission, in Jaunary 1982 he died of cachexy due to carcinoma of the maxilla.
In this case, it is possible that chemotherapy and radiotherapy, especially the latter, may be causally related with the development of AMMoL. We considered this case is a therapy related leukemia.View full abstractDownload PDF (733K) -
A Case of Non-Hodgkin's Lymphoma Maintaining Long Term Remission Following TransplantationMikio UEDA, Mayumi YAMAMURA, Shintaro SHIOBARA, Shinji NAKAO, Kunio KO ...1983 Volume 24 Issue 12 Pages 1710-1717
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 38-yr-old female with diffuse lymphoblastic lymphom of clinical stage III was referred to us for receiving autologous marrow transplantation (Auto-BMT). After confirming no tumor involvement of the marrow, 1.88×1010 marrow nucleated cells were collected and cryopreserved. shortly after cryopreservation of autologous marrow, she developed relapse and was treated with cyclophosphamide, vincristine and prednisolone with no remarkable effect. Since her disease progressed and became resistant to chemoradiotherapy, marrow-ablative therapy using autologous marrow transplantation was planned. The days before transplantation (day-10), she was isolated in a conventional room facilitated with a “clean bed” and oral non-absorbable antibiotics (GVN: gentamicin. vancomycin and nystatin) were started for total intestinal decontamination. Then she was conditioned with a marrow lethal regimen consisting of high-dose cyclophosphamide (60mg/kg) on days-5 and-4 and 10Gy total body irradiation (CY-TBI regimen). Within 24 hr after conditioning, she was infused with 0.54×108/Kg frozen-thawed bone marrow cells containing 0.60×104/kg granulocyte/macrophage progenitor cells (CFU-C). Hematologic recovery was observed in 3 wk posttransplant and granulocytes recovered from nadir to more than 500/mm3 on day 25. Engraftment was assessed on day 33 by full recovery of hemaotpoiesis. Posttransplant complications including stomatitis due to herpes simplex virus, radiation-induced edema in the neck and mild liver dysfunction resolved with marrow recovery. Severe bacterial infections did not occur despite the use of a conventional room. Complete remission (CR) was confirmed 1 mo posttransplant by re-staging procedures. She is now surviving in unmaintained CR 26 mo after autologous marrow transplantaion (Auto-BMT). It is suggested from our experience that auto-BMT is one of the effective treatment approaches for advanced non-Hodgkin's lymphoma and this treatment procedure can be performed in a conventional room with acceptable risks.View full abstractDownload PDF (575K) -
Miyako CHANOKI, Kenichi NAGAI, Shiro NAKAYAMA1983 Volume 24 Issue 12 Pages 1718-1722
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe present a case of Waldenström's macroglobulinemia in 56-year-old woman. She had several nodules in the face and head. Histological examination of these lesion revealed an infiltration of lymphoid cells in the dermis. These cells were almost positive for intracellular IgM and κ-light chain by immunoperoxidase method (PAP method). Several investigators reported macroglobulinemia with specific skin lesion, but this is the third case in which intracellular monoclonal immunoglobulin was demonstrated by immunoperoxidase staining.View full abstractDownload PDF (603K) -
Eietsu OUCHI, Toshimi SUZUKI, Tooru NUNOKAWA, Ikuro SATO, Takashi SAWA ...1983 Volume 24 Issue 12 Pages 1723-1727
Published: 1983
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 81-year-old man was admitted to the hospital because of right sided hemiparesis and somnolena. Laboratory studies on admission revealed the presence of hyper γ-globulinemia and monoclonal gammopathy. Patient's serum kept at refrigerator for overnight resulted in strong precipitation which was easily solubilized at 37°C. Scapular CT demonstrated the presence of low density area in left temporal and right occipital region, indicating the presence of cerebral infarction. The UCG and UCG tomography demonstrated striking thickening of ventricular septum and narrowing of ventricular space. From above serological and UCG findings the diagnosis of mixed monoclonal cryoglobulinemia accompanied by hypertrophic cardiomyopathy was made. The autopsic finding of heart was consistent with the UCG finding. Co-existence of mixed monoclonal cryoglobulinemia and hypertrophic cardiomyopathy might suggest the same pathological agents of these disorders, but causal mechanism are remained unsolved.View full abstractDownload PDF (749K)
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