巻号一覧
24 巻, 10 号
選択された号の論文の21件中1～21を表示しています
- |<
- <
- 1
- >
- >|
臨床研究
-
—特にLH-RH analogueの使用について—八木田 正人, 杉山 裕之, 安本 均, 知念 良教, 高橋 隆幸, 中井 義勝, 井村 裕夫, 星野 孝1983 年 24 巻 10 号 p. 1295-1302
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありHypermenorrhea in female patients with severe thrombocytopenia has been one of the most difficult complications to manage. In this study, administration of LH-RH analogue (200 μg/day, subcutaneous injection) was tried to control hypermenorrhea in three patients with aplastic anemia, Evans' syndrome and acute myelofibrosis, respectively.
LH-RH analogue suppressed the menstrual cycle and subsequently stopped menstruation with certainty and safety in these three patients. The amenorrhea induced by LH-RH analogue was reversible even after long term administration. Occasionally, a short term administration of estrogen-progestin combinations in addition to LH-RH analogue was helpful to reduce the genital bleeding immediately, since it took a few weeks to accomplish the amenorrheal status by LH-RH analogue alone.
During the treatment by LH-RH analogue, the suppression of menstrual cycle was confirmed by poor response of LH and FSH to regular LH-RH.
So far no noticable side effect of LH-RH analogue has been noted.
LH-RH analogue appeared most useful to treat the hypermenorrhea caused by thrombocytopenia.抄録全体を表示PDF形式でダウンロード (514K) -
宮坂 康彦, 長村 重之, 西信 真, 山崎 徹, 大屋敷 純子, 大竹 忠裕, 大高 正裕, 伊藤 健次郎, 蜂谷 哲也1983 年 24 巻 10 号 p. 1303-1312
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありTwenty two cases of hypoplastic leukemia among atypical leukemia were diagnosed by the findings of bone marrow tissue sections at the first examination of patient's visit of the clinic, and the following results were obtained from clinical findings and the course of treatment.
(1) The average fatty area rate of biopsied tissue sections taken from 22 hematologically normal persons by aspiration-biopsy instrument (Miyasaka's needle) was 52.2±9.8%. Therefore, over 63% fatty area rate of biopsied tissues were determined as hypoplastic. The average fatty area rate of biopsied bone marrow in 8 cases on hypoplastic leukemia was 72.1±4.2%.
(2) The incidence of hypoplastic leukemia was 22 cases (4.2%) among 517 cases of acute leukemia, of which 12 cases (54.5%) were over 60 years old.
(3) The blast of peripheral blood was 2.7% (range 1 to 8%), and the sum of the blasts and promyelocytes of the bone marrow on 22 cases showed 21.7% (range 4.6 to 37%).
(4) The nests of immature cells in the biopsied tissue were detected in almost cases. So, the examination of biopsy is thought to be necessary for the diagnosis of hypoplastic leukemia.
(5) As for the treatment of hypoplastic leukemia, intermittent administration of multi-chemotherapeutics, such as 4 agents with 1/3 to 1/2 doses, was suggested to be necessary when the sum of the blasts and promyelocytes was over 30%. The two cases treated with interferon showed extension of the blood transfusion period and the temporary erythrocytosis.抄録全体を表示PDF形式でダウンロード (737K) -
(2) Adult T-cell Leukemiaにおける高Ca血症木下 研一郎, 親川 幸信, 鳥谷 和彦, 樅田 三郎, 尼崎 辰彦, 山田 恭暉, 池田 柊一, 市丸 道人, 上平 憲1983 年 24 巻 10 号 p. 1313-1320
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証あり1. Out of 162 malignant lymphoma cases examined for T and B cell surface markers, hypercalcemia was demonstrated in 46 cases (54.8%) out of the 84 ATL, 19 case (34.0%) out of the 56 T-cell lymphomas and 2 cases (9.1%) out of the 22 B-cell lymphomas, respectively.
2. There were no significant differences in leukocyte counts, serum LDH levels, histologic subtypes at admission and duration of survival between the ATL-patients with and without hypercalcemia.
3. However, when the courses of individual cases were followed, serum calcium levels tended to be elevated as the disease progressed.
4. Morphologic examinations of bone marrow samples from 18 out of 23 hypercalcemic patients with ATL showed numerous osteoclasts on bone resorbing surfaces adjacent to areas of ATL-cell infiltration.
Leukemic infiltration to the bone marrow appeared to cause the osteoclast proliferation and the concomitant hypercalcemia.抄録全体を表示PDF形式でダウンロード (1162K) -
青柳 愛孝, 高橋 益広, 青木 定夫, 品田 章二, 服部 晃, 柴田 昭, 根本 啓一, 塚田 恒安, 宮腰 秀夫, 小出 裕子, 青木 ...1983 年 24 巻 10 号 p. 1321-1330
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありEight patients with adult T-cell leukemia (ATL) were treated in our Department for last 7 years. Six patients out of eight were the native residents of Sado Island who showed characteristic clinical features, e.g. longer survival than that of the patients in other endemic areas and a variety of skin lesions. In view of the fact that the total population of this island is about 80,000, the incidence of ATL patients in this island is thought to be high.
All patients tested possessed both ATL-associated retrovirus (ATLV)-antigens in peripheral blood lymphocytes after short-time culture and natural antibody in serum against ATLV. The findings agreed with the results of virological analysis for patients with ATL in other areas of Japan. From the point of view of the similarity of ATLV, the route and clustering of ATLV were discussed. Furthermore, it was speculated that the characteristics of clinical features of the patients in Sado Island may due to mutation of ATLV and/or the immunological change of these residents against ATLV.抄録全体を表示PDF形式でダウンロード (1264K) -
橋本 孝二, 三宮 祐一, 吉川 岳男, 吉川 智加男, 荒木 純子, 朴 勤植, 瓦林 佳子, 巽 陽一, 紙谷 富夫, 任 太性, 巽 ...1983 年 24 巻 10 号 p. 1331-1341
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありAn investigation method of ultrasonic echography of linear type electrical scan is an useful diagnostic way with high quality on the abdominal diseases. We investigated the echographic findings on the abdominal lymphnodes and splenomegaly which were pointed out for two years experience in our laboratory on the 87 cases with haematological diseases such as Malignant lymphoma (29), Leukemia (16), Anemia (20), Multiple myeloma (8), ITP (6). As for 10 cases of abdominal lymphnode swelling, an-, or hypo-echoic patterns over 2cm were detectable by this method. Some figures were found “pseudokidney sign” or “sandwitch sign”. Several cases were able to observe the changes in size of the tumor. Splenomegaly was evaluated with Spleen Index. This investigation method seemed to be an useful way to detect enlargement of speen, even though which was unable to be picked up by the method of palpation. Thus it is concluded that the above way might be a beneficial one for a screening test and a further examination in haematological diseases.抄録全体を表示PDF形式でダウンロード (2388K) -
村山 直樹, 浅野 泰, 細田 瑳一, 前沢 政次, 斉藤 政樹, 高久 史麿, 杉原 尚, 宮島 厚介, 八幡 義人1983 年 24 巻 10 号 p. 1342-1348
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありRed cell membrane metabolism in familial LCAT deficiency was investigated. The family presented here was the third case in Japan. In addition to the marked abnormalities in lipid composition of red cell membranes, osmotic fragility of the red cells was decreased. Red cell surval (51Cr T 1/2) was 15 days. Sodium influx was markedly decreased, although sodium efflux, both ouabain-sensitive and-insensitive, was normal. The activity of acetylcholinesterase was decreased, while the activity of glyceraldehyde-3-phosphate dehydro-genase was normal. No abnormalities in red cell membrane proteins were observed.
These results suggest that the alterations of membrane permeability as well as increased membrane rigidity by accumulation of cholesterol and phosphatidyl choline might be related to the early demise of the red cells in this disoder.抄録全体を表示PDF形式でダウンロード (577K) -
神崎 暁郎, 森 博雄, 橋本 正志, 萬納寺 正清, 戸川 敦, 柴田 進, 八幡 義人1983 年 24 巻 10 号 p. 1349-1354
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありPreventive effects were compared between the conventional procedure (“gown technique”) and the laminar flow portable air purifier (Enviracaire) in patients with hematological malignancies under chemotherapy. The incidence of respiratory infections were markedly reduced in the patients with Enviracaire. The numbers of viable and non-viable particles around the patient's head area were decreased (upto class 100 based on the NASA standard) with Enviracaire. Instead of the results with respiratory infections, the incidence of other infections (so called “fever of unknown origin”) was not significantly reduced even with Enviracaire. Other procedures should be considered for these non-respiratory infections.抄録全体を表示PDF形式でダウンロード (465K)
症例
-
工藤 雄爾, 佐藤 雄一, 対馬 徳武, 横山 〓, 松本 一仁, 高松 秀悦1983 年 24 巻 10 号 p. 1355-1360
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of cyclic thrombocytopenia suspected to have occurred during the incubation period of measles is reported in a young boy aged 1-year 9-months.
No antiplatelet antibody could be detected; the life span of the platelets was normal; treatment with corticosteroids had no influence upon the course of the disease; thrombopoietic stimulating factor was positive; electron microsopic findings of platelet and megakaryocyte were normal.
In this patient platelet survival time excludes the possibility of excessive peripheral platelet destruction. The hypothesis of cyclic inhibition of megakaryocytopoiesis is suggested and the literature on this cyclic phenomenon is discussed.抄録全体を表示PDF形式でダウンロード (559K) -
高橋 文雄, 池田 晃, 高後 裕, 笹川 裕, 福島 誠, 熊井 良司, 新津 洋司郎, 漆崎 一朗1983 年 24 巻 10 号 p. 1361-1366
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 58-year-old male was admitted with complaints of general fatigue and abdominal fullness on Feb. 1980. Physical examination revealed anemia and hepatosplenomegaly. Peripheral blood examination showed: RBC 341×104/cmm, Hb 9.3 g dl, Ht 30.5, WBC 12,100/cmm with leukorythroblastosis and tear drop cells and platelets 25.2×104/cmm. Bone marrow puncture, tried twice, was dry tap and a bone marrow biopsy of ileac crest showed a diffuse fibrosis and an increase of megakaryocytes. Ph1 chromosome was negative and the score of neutrophil alkaline phosphatase was 232. The diagnosis of primary myelofibrosis was made because of the lack of other causetative diseases for fibrosis. The patient was discharged on July, 1980 and followed up in the out-patient department. Two months later, a cutaneous hard nodule appeared on his forearm and disseminated to his breast and abdominal wall. Moreover, the number of peripheral white blood cell counts and the percentage of myeloblasts increased (WBC 94,800cmm, Myeloblast 32). The patient died of respiratory failure on Oct. 11, 1980. The findings of autopsy were; (1) primary myelofibrosis (2) extramedullary hematopoiesis in liver, spleen and skin, and (3) leukemic conversion. This is the second reported case of primary myelofibrosis associated with extramedullary hematopoiesis in the skin.抄録全体を表示PDF形式でダウンロード (786K) -
田中 葉子, 斉藤 譲, 福本 哲夫, 佐々木 道子, 榎本 康弘, 中沢 真平, 恒松 由記子, 小出 亮1983 年 24 巻 10 号 p. 1367-1372
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 9-year-old girl visited our hospital because of nosebleed in December, 1980. There was no hepatosplenomegaly or lymphadenopathy, but thrombocytopenia and monocytosis were observed. In April, 1981, her bone marrow aspirate was hypercellular with involvement of all hemopoietic cell lines. In addition to the increase of myeloblasts and atypical monocyte-like cells, giant platelets and atypical multinucleated red cell precursors were noticed. Chromosome analysis of bone marrow cells showed an abnormal karyotype of 49, XX, +A, +2 E. She was admitted to the hospital with a diagnosis of acute myelomonocytic leukemia (AMMoL). With progression of her disease, HbF and serum-lysozyme increased and subcutaneous nodules appeared. Despite VAMP and DCVP-therapy she did not achieve a complete remission, and died one year after diagnosis. Autopsy showed leukemic infiltration in the bone marrow, spleen, rectum, lungs, and subcutaneous nodules. Cytochemical studies showed a positive α-naphtyl acetate esterase reaction, and inhibition by NaF was observed. The α-naphthyl butyrate esterase reaction was negative, but both specific and nonspecific esterase activities were observed in 13% of the leukemic cells. By electron-microscopy, monocyte-like cells and intermediate cells were observed besides myeloblasts. Mean size of the primary granules was 0.02∼0.04 μm2. These leukemic cells had Fc-receptor, C3 receptor and phagocytic activity. From these results, we concluded that the patient had AMMoL with α-naphthy butyrate esterase deficiency.抄録全体を表示PDF形式でダウンロード (626K) -
能勢 圭之助, 田中 一男, 池田 弓子, 敏田 進, 北村 創1983 年 24 巻 10 号 p. 1373-1377
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 46 years old female who had been taking hemodialysis due to acute renal failure was admitted to our hospital because of newly appearance of fever up, hemorrhagic diathesis and of leukopenia.
On physical examination slight abdominal distension and tenderness, prolapse and hardness of anterior rectal wall were observed.
Laboratory data showed pancytopenia with significant myeloblast count in periferal blood.
Biopsied bone marrow revealed the increase of myeloblasts and of atypical myelocytes which were positive in peroxidase staining.
Renal echography presented hydronephrosis and hydroureter at both sides.
These data lead us to diagnose this case as acute myelogenous leukemia and probably a post nephrotic renal failure due to leukemic cell infiltration.
The patient had been treated with antitumor agents (cytosine-arabinoside, 6-mercaptopurine and predonisolon).
However, after the gradual development of ileus and then of hemorrhagic diathesis such as melena and hematochesia, the patient died at the 27 th day of the admission.
Autopsy showed leukemic infiltration with hard tumor formation on the bladdar involving ureters which were almost obstructed and a portion of ileum which were partly necrotized. Pathologically this was diagnosed as granulocytic sarcoma.抄録全体を表示PDF形式でダウンロード (568K) -
—自験例6例と文献例の核型と予後の検討—石川 順一, 佐藤 琢司, 武田 武夫, 今野 武津子, 今井 敏夫, 千葉 章子, 富安 孝文1983 年 24 巻 10 号 p. 1378-1385
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありSix cases of childhood acute myeloblastic leukemia (AML) with t(8q-; 21q+), three boys and three girls aged from 4 to 14, are reported. Of these, three cases had t(8q-; 21q+) plus a missing sex chromosome. Five cases achieved complete remission. Twenty-nine cases of childhood AML with t(8q-; 21q+), including our cases, were reviewed from the literature. Seventy-one percent of the cases reviewed had a missing sex chromosome, and seventy-nine percent obtained complete remission. The overall survival rate was 66% at one year, and 25% at 2 years.
Thus, childhood AML with t(8q-; 21q+) seemed to have a better prognosis than that without t(8q-; 21q+).抄録全体を表示PDF形式でダウンロード (2599K) -
大坂 顕通, 斉藤 政樹, 吉田 稔, 坪山 明寛, 武藤 良知, 坂本 忍, 三浦 恭定, 松本 三郎, 斉藤 建, 高久 史麿1983 年 24 巻 10 号 p. 1386-1391
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありWe report a case of disseminated necrotizing leukoencephalopathy in a 43-year-old male with acute promyelocytic leukemia (APL). He was diagnosed as having APL in Sep. 22, 1980 and entered into a complete remission with administration of daunomycin, 6-MP and predonisolone. Because of meningeal relapse, he received several courses of intrathecal methotrexate, cytosine arabinoside and hydrocortisone. In addition, he received 2800 rad of whole skull irradiation over the period of 4 weeks. He developed rapidly progressive neurological symptoms such as salivation, dysarthria and dementia at the termination of whole skull irradiation. Brain CT scan films revealed diffuse low density area in cerebral white matter. Brain scintigram showed slightly ill-defined uptake of 99mTcO4- in bilateral frontal and temporal areas. EEG showed slow waves predominantly in frontal lobes. About one month after the termination of whole skull irradiation, he died of respiratory failure due to the disturbance of central nervous system.
The neuropathological examination of autopsied materials revealed the discrete, coalescent foci of coagulative necrosis in the cerebral white matter, pons, midbrain and cerebellar white matter. These lesions were accompanied by calcification and fibrinoid necrosis of the blood vessel walls. Striking axonal swellings and fragmentation were also noted.
In the prophylaxis and/or treatment of meningeal leukemia of adult patients with acute nonlymphocytic leukemia, we should always keep in mind the hazard of the development of disseminated necrotizing leukoencephalopathy related to therapy.抄録全体を表示PDF形式でダウンロード (617K) -
碓井 芳樹, 杉本 正邦, 若林 芳久, 塩川 優一1983 年 24 巻 10 号 p. 1392-1397
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 28-year-old female was admitted to our hospital with pyrexia and localized lymphnode enlargement in Nov. 1980. A diagnosis of chronic idiopathic neutropenia (CIN) was made from chronic neutropenia, absence of drug intake and detectable underlying illness, and normal bone marrow cellularity.
To investigate the pathogenesis of CIN in this case, we used in vitro culture to assay her bone marrow granulocytic progenitor cells. 2×105 bone marrow nucleated cells were cultured in a single layer of agar gel with 10% of human placental conditioned medium by means of CFU-C assay at 37°C containing 5% CO2 in air for 7 days.
CFU-C derived colony formation from human bone marrow was inhibited by her mononuclear cells, however CFU-C from patient's marrow increased by addition of prednisolone in this assay system.抄録全体を表示PDF形式でダウンロード (411K) -
高田 加寿子, 高橋 正知, 押味 和夫, 溝口 秀昭1983 年 24 巻 10 号 p. 1398-1402
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of multiple myeloma associated with asbestosis is reported. A 57-year-old male having history of exposure to asbestos for at least 2 to 3 years was admitted because of paraplegia. The patient noticed sudden onset of gait disturbance in July 1981. He was found to have epidural tumor around Th 9 vertebra and received operation. Histological examination revealed plasmacytoma and the patient was transferred to our hospital because of suspected diagnosis of multiple myeloma.
On admission, serum IgG was increased and IgG-κ type M protein was found in serum and urine by immunoelectrophoresis. Bone marrow aspiration disclosed 27.9% of myeloma cells. Chest X-ray showed the typical findings of asbestosis and the asbestos body was found by the transbronchial lung biopsy. From these findings he was diagnosed as having asbestosis and multiple myeloma. He was treated with local irradiation to the vertebrae and then combination chemotherapy. On immunological examination cellmediated immunity was retained except for the lower response to T-cell mitogens. Interestingly natural killer cell function was markedly suppressed and the function was not enhanced by the addition of interferon in vitro. From these immunological findings, relationship between asbestosis and myeloma was discussed.抄録全体を表示PDF形式でダウンロード (475K) -
高木 省治郎, 武藤 良知, 大田 雅嗣, 須田 啓一, 平井 久丸, 小沢 敬也, 楠本 一生, 加藤 英行, 渡辺 千絵子, 元吉 和夫 ...1983 年 24 巻 10 号 p. 1403-1407
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA 48-year-old Japanese man with advanced non-Hodgkin's lymphoma (clinical stage IIIs B) was treated with high dose combination chemotherapy consisted of adriamycin, ACNU, cytosine arabinoside, bleomycin and cyclophosphamide, followed by the infusion of cryopreserved autologous bone marrow. Peripheral blood returned to normal on Day 16. On Day 24, the patient became febrile and developed an erythematous maculopapular skin rash with lymph node enlargement. Although skin rash improved transiently, it reccurred on Day 40. Biopsy specimens of the skin showed a finding indistinguishable from that of grade II acute cutaneous graft versus host disease. Administration of prednisolone 30 mg daily resulted in the disappearance of skin rash. Subsequently, the patient remains disease-free for 20 months without additional chemotherapy.抄録全体を表示PDF形式でダウンロード (527K) -
荒川 洋一, 井嶋 裕子, 岡部 一郎, 山本 佳史, 鞭 煕1983 年 24 巻 10 号 p. 1408-1414
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of chronic myelogenous leukemia initiating as lymphoid crisis is reported. A 11-year-old girl was admitted because of fever, lenkocytosis and hepatosplenomegaly on November 10th, 1981. The patient was diagnosed into high risk acute lymphoblastic lenkemia because of her age (older than ten years), high leukocyte count (14,500/cmm with 98.8% blasts), hepatosplenomegaly, and leukemic cells being peroxidase negative and PAS positive. The surface marker studies and enzyme activities of the leukemic cells revealed the characteristics of non-T, non-B acute lymphoblastic leukemia. She was treated with vincristine, L-asparaginase, daunomycin, and prednisolone and complete remission was achieved five weeks after the initiation of therapy. It must be noted, however, that the karyotype of the bone marrow cells was 46, XX, t (9; 22; 12) at the time of hematological complete remission as well as at onset. Three months after the patient relapsed and died of septicemia on December 10th, 1982 in spite of vigorous chemotherapy.
She was classified into adult type chronic myelogenous leukemia because of the persistent predominance of Ph1 positive cells while in hematological complete remission. The authors concluded that cytogenetic findings have preference to morphological appearance of lymphoid cells. Besides, the patient had unusual chromosome pattern such as t (9; 22; 12), which has not seen in previous reports regarding to leukemia and chromosome.抄録全体を表示PDF形式でダウンロード (596K) -
谷脇 雅史, 西田 一弘, 津田 昌一郎, 前川 平, 枝川 潤一, 薗田 精昭, 今西 仁, 三沢 信一, 阿部 達生, 瀧野 辰郎1983 年 24 巻 10 号 p. 1415-1422
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of RAEB “in transformation” with complicated chromosome abnormalities is reported. With the sequential Q and C banding using base specific antibiotics and fluorochrome, such as actinomycin D, distamycin A, and DAPI, a subtelocentric complicated marker chromosome found in this case was analysed to be der (11) trip t(11; 7; 9) (q 13; q11 q33; q11). In addition, the deletion of the long arm of chromosome 5, 5q-anomaly, was demonstrated to be del (5) (q15).
Among preleukemic states, a specific entity associated with an interstitial deletion of the long arm of No.5 seems to constitute a well delineated syndrome, and it was suggested that 5 q-refractory anemia might terminate in acute myelogenous leukemia which was usually associated with other chromosome aberrations.
In the present case, dyserythropoiesis with ringed sideroblasts and low percentage of blasts in the bone marrow were characteristic. A diagnosis of RAEB “in transformation” was made by these clinical and cytogenetic findings. We discussed the role of 5 q-anomaly in leukemogenesis of the eukaryotic cells and showed the usefulness of the sequential staining.抄録全体を表示PDF形式でダウンロード (1745K) -
武内 令子, 久藤 真, 片山 直之, 神尾 典彦, 津田 雅之, 長野 正, 留奥 誠, 和田 英夫, 村嶋 正幸, 出口 克已, 白川 ...1983 年 24 巻 10 号 p. 1423-1429
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of metastatic carcinomatosis of the bone marrow with microangiopathic hemolytic anemia (MHA) and disseminated intravascular coagulation (DIC) is reported. The patient was a 43-year-old male who had undergone partial gastrectomy because of gastric carcinoma 12 years ago. At the time of admission, besides anemia and bleeding tendency, laboratory data showed hypofibrinogenemia, thrombocytopenia, increased FDP and positive paracoagulation tests, suggesting DIC. In addition, a hemolytic anemia with fragmented red cells and a leukoerythroblastic blood picture were found. The bone marrow was infiltrated by carcinoma. MFC chemotherapy with heparin induced remission of both MHA and DIC; recurrence of the DIC was accompanied by reappearance of the bleeding tendency. The autopsy findings in the patient, in whom no signs of carcinoma except for the bone marrow had been detected clinically or radiologically, revealed a small poorly differentiated adenocarcinoma only in the mucosa of the remaining stomach with widespread metastasis to the bone marrow.
In the past 10 years, 5 patients including this case were experienced who developed well-marked MHA with DIC. The tumors originated in the stomach in 4 cases, and in the prostate in 1 case. All the patients had adenocarcinoma; in 4 patients, the tumor cells were mucin-forming. The time between first hospitalization and death was from 7 to 193 days (the present case, 193 days). The death cause of all the patients was associated with DIC, especially with intracranial bleeding as seen in the present case. From our experience, in patients with MHA and DIC a search for metastatic adenocarcinoma should be performed and vice versa.抄録全体を表示PDF形式でダウンロード (589K) -
中尾 真二, 大竹 茂樹, 三沢 利博, 近藤 邦夫, 上田 幹夫, 尾高 和亮, 末永 孝生, 佐賀 務, 吉田 喬, 舟田 久, 原田 ...1983 年 24 巻 10 号 p. 1430-1436
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありTwo patients with chronic myelogenous leukemia (CML) in blast crisis, 32 year-old male and 19 year-old female, received bone marrow grafts from their HLA identcial siblings. Bone marrow biopsy performed just before administration of cyclophosphamide (CY) as a conditioning showed markedly hypercellular marrow with leukemic cells in the both cases despite intensive chemotherapy in a short period. They were conditioned with CY, 120 mg/kg and total body irradiation, 1000 rad in a single dose at 21 rad/min for the first patient, 1500 rad with lung shielding in fractionated doses (300 rad/day×5 days) at 10 rad/min for the second patient. The first patient achieved engraftment of donor marrow and developed acute graft-versus-host disease on day 26 post grafting. He relapsed on day 92 and died of intestinal bleeding on day 116. Peripheral blood leukocyte count reached 1000/ul on day 20 in the second patient, but idiopathic interstitial pneumonia appeared on day 30 and she died of respiratory failure on day 42. Marrow reconstitution with normal cellular components was shown in the second patient, but the eradication of leukemic cells could not be confirmed because of her early death. From these observations, it is stressed that allogeneic bone marrow transplantation for the patients with CML should be performed in chronic phase rather than in blast crisis.抄録全体を表示PDF形式でダウンロード (632K) -
萩原 誠久, 赤星 雅, 押味 和夫, 溝口 秀昭, 田中 道雄1983 年 24 巻 10 号 p. 1437-1441
発行日: 1983年
公開日: 2009/01/26
ジャーナル 認証ありA case of T-cell chronic lymphocytic leukemia (T-CLL) showing surface markers of OKT11+, OKT3-, OKT4-, OKT8- and OKM1- is reported. Electron microscopic study revealed that the leukemic cells had nuclear convolution, well-developed hetero-chromatins and cluster of dense bodies, indicating that the cells were mature T cells in morphology. The leukemic cells lacked helper and suppressor function for B cell differentiation and the induction of allo-reactive killer T cells was unsuccessful. Also the cells lacked natural killer function and antibody-dependent cell-mediated cytotoxicity. The onset of the disease was visual disturbance and the cause of death was cerebral hemorrhage. An autopsy disclosed the diffuse infiltration of leukemic cells within the optic nerves and around the cerebral vessels.
As far as we know, thi is the first report of T-CLL having the adove-mentioned surface markers and the diffuse cerebral infiltration of leukemic cells.抄録全体を表示PDF形式でダウンロード (420K)
- |<
- <
- 1
- >
- >|