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Volume 25, Issue 12
Displaying 1-14 of 14 articles from this issue
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Kenji NISHINO, Naoki SADAMORI, Masuko TAGAWA, Eiichi YAO, Kenichiro KI ...1984 Volume 25 Issue 12 Pages 1903-1914
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSChromosome analysis was performed on 3 patients in preclinical state of adult T-cell leukemia (pre-ATL), who were asymptomatic ATL virus carriers and had abnormal T-lymphocytes with nuclear abnormalities in less than 10% of their peripheral leucocytes. The ATL associated antigen (ATLA) and anti-ATLA antibody were detected in all of these patients. Clonal abnormal karyotypes were found in all cases, but some of these disappeared spontaneously in the later periods, and another clonal abnormalities appeared. Other abnormal karyotypes had non-clonal variable changes with hyperdiploid or structural abnormalities. In case 3, karyotypic evolution was found concurrently with the clinical progression to overt ATL. The mechanism of leukemogenesis from pre-ATL is discussed from the chromosomal point of view.View full abstractDownload PDF (2307K) -
—Multipurpose Use of Central Venous Catheter—Norihiro UENO, Takaaki SHIKANO, Masahito OHKAWA1984 Volume 25 Issue 12 Pages 1915-1920
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSReliable venous access is often very valuable for the medical management in children with acute leukemia. The present paper dealed with the results on 23 central venous catheters which were placed in 12 acute leukemic children (mean age, 6 years) in the pediatric wards of the Hokkaido University Hospital in April 1981-March 1984. These catheters were utilized for blood drawing and the infusion of drugs, intravenous solutions and blood products. The mean duration of placement has been 26 days (range, 7-66 days). In 12 patients the catheter was used successfully during the period of treatment. Complications at catheter insertion site were minimal. The overall incidence of bacteremia was not increased in patients with the catheter, and 8 of the 12 bacteremia that occured while catheters were in place resolved without catheter removal. Multipurpose use of central venous catheter greatly facilitated patient's care and support, and minimised discomfort. The use of central venous catheter is a safe reliable measure for the improvement of venous access in children with acute leukemia.View full abstractDownload PDF (437K) -
Hideo TAKEYAMA, Kunio YANO, Takae KATAOKA, Eiji WATANABE, Masahide KOB ...1984 Volume 25 Issue 12 Pages 1921-1927
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSClinical effects of human lymphoblastoid interferon (HLBI) on multiple myeloma (MM), Waldenström's macroglobulinemia (WM), and non-Hodgkin's lymphoma (NHL) were studied. HLBI, 3 to 12×106 units/day, was administered to 25 patients by daily intramuscular or intralesional injections. Out of 21 evaluable patients, partial remission was observed in 3 cases (two MM and one WM), and minor response was shown in 5 cases (three MM and two NHL). More than half of patients experienced fever over 38°C. Mild leukopenia and thrombocytopenia were observed. Other side effects included anorexia, malaise, liver dysfunction and skin rash. Serum peak interferon level was observed about 6 hours after intramuscular injection of HLBI. There was a correlation between HLBI dose and maximum serum interferon concentration.View full abstractDownload PDF (471K) -
Kaori YASUDA, Keiji OKUBO, Yoshitatsu SEI, Mitsuo YOKOYAMA, Yasuhiko H ...1984 Volume 25 Issue 12 Pages 1928-1934
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSLymphocyte subpopulations of patients with hemophilia and of their healthy mothers were analysed and the results were compared with age and sex-matched controls. The patients had been receiving blood and blood products, including Factor VIII or Factor IX, for a number of years depending on the time of onset of the disease.
Heparinized peripheral blood was used for direct or indirect immunofluorescence tests for cell marker analysis with OKT4, OKT8, OKT10, OKT11, OKIa1 and B1 monoclonal antibodies. There were less OKT4+ cells in the hemophiliac blood as compared with the controls while the number of OKT8+ cells was found to be the same in both groups. As a result, the OKT4/OKT8 ratio was markedly depressed in the hemophiliac group and the conversion of the OKT4+/OKT8+ ratio was observed previously in the group of patients receiving long term therapy with antihemophiliac products. Increased percentages of OKT10+, OKIa1+ and B1+ cells were observed in the hemophiliac group. Thus the administration of antihemophiliac products may result in an increase in activated T cells. Alteration of lymphocyte subpopulations in patients with hemophilia in relation to antihemophiliac therapy was discussed.View full abstractDownload PDF (482K) -
Shuji YONEKURA, Tadami NAGAO, Hiroyuki NOZAKI, Kenichi NOGUCHI, Masaki ...1984 Volume 25 Issue 12 Pages 1935-1940
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSClinical observation have been made of 42 patients with aplastic anemia treated in our clinic. The results were summerized as follows;
1) During the past 10 years (1975∼1984), 42 patients with idiopathic aplastic anemia including one with aplastic anemia-PNH (unknown etiology 83.3%, drug-induced 14.3% and others 2.4%) were observed; 19 males and 23 females, aged 10∼70 years.
2) Outstanding hematological finding on presentation was pancytopenia.
3) Survival rate at 5 years was 38.1%. The mortality within one year was 14.3%.
4) Fourty-two patients were divided according to the degree of damage to blood constituents at the time of initial diagnosis into 3 groups, severe (10), moderate (25) and mild (7). The prognosis was poorer in the severe group than in the other 2 groups, but there was no significant difference between the latter 2 groups.
5) The main causes of death in 12 fatal cases were bleeding and infection.
6) Thirty-one of 42 cases responded to anabolic steroid.View full abstractDownload PDF (443K) -
Seiichi YORIMITSU, Isao TAKAHASHI, Kohichi KITAZIMA, Ikuro KIMURA, Mas ...1984 Volume 25 Issue 12 Pages 1941-1946
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSClinical effects of high dose cytosine arabinoside (H-D ara-C) therapy were studied in 4 cases of refractory acute leukemia. They were one acute myelocytic leukemia (AML: M1), one acute promyelocytic leukemia (APL: M3) and two acute lymphocytic leukemia (ALL: L2). The ratio of male to female was 3: 1 and age ranged from 26 y/o to 73 y/o with a median of 50 y/o. All patients except one ALL were previously treated with the conventional dose of ara-C in combination of anthracyclines and others. In a case of AML, H-D ara-C therapy was done at the time of the 1st and the 2nd relapse. Ara-C, 2.5 g∼2.8 g/m2, was administrated by intravenous drip infusion twice a day for 2∼5 days. The complete remission (CR) was obtained in 3 of 4 evaluable cases (75%). The days required to achieve CR ranged from 28 days to 63 days with a median of 47 days and the duration of CR ranged from 1.0 month to 3.5 months with a median of 1.5 months. The major side effects were myelosuppression and central nervous system (CNS) toxicity. Myelosuppression was severe and all patients were suffered from infections. CNS toxicities were observed in 2 cases. A case of AML, showing somnolence and urinary incontinence, completely recovered from these symptoms, however, another case of ALL died of pneumonia before the recovery from coma.
H-D ara-C therapy will be expected in the clinical management of refractory acute leukemia.View full abstractDownload PDF (430K)
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Osamu MIURA, Eri KAKITA, Ichiro KUBO, Hideo HIROSE, Kenichiro INOUE, J ...1984 Volume 25 Issue 12 Pages 1947-1953
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 62-year-old man was admitted to our hospital on September 1, 1982, because of ecchymosis and anemia. Physical examination revealed slight splenomegaly. Blood count showed: RBC 291×104/mm3, Hb 7.2 g/dl, Ht 24.2%, reticulocyte 1.3%, platelet 241.2×104/mm3, WBC 13,500/mm3 with 1% of blasts. The bone marrow was hypercellular with myeloid/erythroid ratio of 3.2 and 4.4% myeloblasts and 5.2% promyelocytes. The erythroid series showed increased sideroblasts (78%) but no ringed cells. Megakaryocytes were markedly increased in number and had abundant cytoplasm and nonlobulated nuclei. Ultrastructural examination of the megakaryocytes showed highly developed tubular system and reduced cytoplasmic granules. Platelet function test showed defective aggregation, and coagulation study revealed a slight prolongation of prothrombine time and a slight reduction in factor V activity. Bone marrow chromosomal analysis revealed 46, XY, del (5) (q22 or 23). A diagnosis of essential thrombocythemia was made, and the platelet count was controlled with the administration of busulfan.
Although frequently observed in hemopoietic dysplasia and leukemia, the 5q- anomaly has been rarely reported in essential thrombocythemia. We reviewed literatures and discussed about the relationship between the 5q- anomaly and the dysmegakaryocytopoiesis.View full abstractDownload PDF (793K) -
Yumiko UMEHARA, Masatomo TAKAHASHI, Kazuo OSHIMI, Hideaki MIZOGUCHI, K ...1984 Volume 25 Issue 12 Pages 1954-1958
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA case of new G6PD variant without chronic hemolysis is reported.
A 21-year-old Chinese male from Hong Kong was admitted to our hospital in March, 1983 because of jaundice, dark-colored urine, and general fatigue. On physical examination, the patient was anemic and icteric. Laboratory examination showed that RBC were 296×104/μl, Hb 9.7 g/dl, reticulocyte count 41‰, serum total bilirubin 2.3 mg/dl (indirect bilirubin 1.7 mg/dl) and LDH 1,138 mU/ml. The red cells of the patient contained extremely low level of G6PD activity (4% of normal controls). Biochemical characteristics of the affected enzyme were as follows; slow electrophoretic mobility, normal Km for G6P, normal Km for NADP, high Ki for NADPH, high utilization of deamino NADP, normal heat instability and pH optimum curve. Because chronic hemolysis was not detected after the episode, this case was classified as class 2 G6PD variant. This is a newly identified variant with unique characteristics and was designated as G6PD Shinjuku.View full abstractDownload PDF (350K) -
—Subsequent Analysis of Hemopoiesis—Eizaburo ISHII, Kuniaki NAGANUMA, Akira ISHIGURO, Kohichiro TSUJI, Osa ...1984 Volume 25 Issue 12 Pages 1959-1966
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA seven-year-old girl was diagnosed as severe aplastic anemia on November 1982. After conditioning with cyclophosphamide, she received 3.05×108/kg marrow nucleated cells from an HLA identical sibling (4-year-old boy) and viable donor buffy coat cells on March 1983. She also received intermittent methotrexate therapy for preventing graft-versus-host disease (GVHD). Although neither CFU-GM nor BFU-E both in the bone marrow and peripheral blood were detected before grafting, both hemopoietic progenitors increased significantly in bone marrow on day 7 after transplantation. On the other hand, mature blood cells such as neutrophils and red blood cells increased on day 35. She is surviving more than 15 months with normal hemopoiesis without GVHD. The in vitro colony forming assay was useful to predict the hemopoietic recovery after bone marrow transplantation.View full abstractDownload PDF (541K) -
Shinichiro TAKIZAWA, Masayoshi SANADA, Tsuneyasu TSUKADA, Tadashi KOIK ...1984 Volume 25 Issue 12 Pages 1967-1972
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA 79 year-old-male admitted in May 1981 because of slight splenomegaly, leukoerythroblastic anemia with tear drop poikilocytosis and highly elevated serum LDH. Hematological examinations showed RBC 322×104/μl, platelets 1.4×104/μl and WBC 4,400/μl with 4.0% blasts. Bone marrow aspirations resulted in a dry tap. A biopsied specimen was compatible with early stage of myelofibrosis. A diagnosis of primary myelofibrosis was made from these observations and the result of ferrokinetic study. Hepatosplenomegaly and pancytopenia progressed gradually and blasts increased in number (<20%) during 2 years after diagnosis. Cytochemical characteristics of blasts were as follows: PAS (-), myeloperoxidase <3%, α-naphthyl butyrate esterase (-), α-naphthyl acetate esterase (±), naphthol AS-D chloroacetate esterase (-) and acid phosphatase (+)∼(±). These blasts were identified as megakaryoblasts by platelet peroxidase reaction which was positive in the nuclear membrane and endoplasmic reticulum. A distinct myeofibrosis was proved by second marrow biopsy in Dec. 1983. From his long clinical course and these laboratory findings, he seemed to have been suffering from megakaryoblastic leukemia which has induced myelofibrosis.View full abstractDownload PDF (1439K) -
Shosaku NARUMI, Hiroyuki NOZAKI, Nobue KANAI1984 Volume 25 Issue 12 Pages 1973-1980
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThere have been reported some cases of thrombocytopenia associated with rubella, measles, mumps, chickenpox, and infectious mononucleosis. Hepatitis viruses are also known to cause transient hematological abnormalities due to bone marrow depression in the early course of acute hepatitis, and further fatal aplastic anemia, as seen after the convalescence of hepatitis A, but recently there have been reported some cases of acute hepatitis presenting severe thrombocytopenia due to increased destruction in the periphery with increased or normal megakaryocyte count in the bone marrow.
We experienced and reported 2 cases of acute hepatitis (one of which was hepatitis A), presenting severe thrombocytopenia due to the latter mechanism, and phagocytosis of platelets by macrophages in the bone marrow. In both cases, the platelet count led to minimum (one was 1.2×104/mm3, the other 3.1×104/mm3) before GOT and GPT reached the peaks, and with no treatment the platelet count became within the normal range in less than 1 week, while the enzymes of hepatobiliary system became within the normal ranges in less than 1 month. We did not find phagocytosis of platelets by macrophages in the bone marrow after the convalescence of both cases.View full abstractDownload PDF (1094K) -
Hitoshi SAKAKIBARA, Yumiko OHARA, Kenichi SUGITA, Mitsuoki EGUCHI, Tos ...1984 Volume 25 Issue 12 Pages 1981-1988
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSA ten-month-old male infant was admitted to the hospital because of bleeding tendency. Physical examination revealed petechiae on chest, extremities, periorbital, and buccal mucosa. Hematological examination on admission showed severe neutropenia (stab 0%, seg 0%, eosino 1%, baso 1%, mono 17%, lymph 79%) and thrombocytopenia (0.7×104/mm3). Bone marrow aspiration revealed moderate increase of cellularity (52.8×104/μl) and marked decrease of segmented neutrophils. Megakaryocyte count was normal.
Anti-leukocyte-antibody, anti-platelet-antibody and anti-DNA-antibody were not detectable.
Although the neutropenia and thrombocytopenia were not so much improved by prednisolone, the patient did not suffer from severe infectious disease, and the number of neutrophils and platelets normalized 9 months later.
Ultrastructural and ultracytochemical studies on bone marrow cells revealed several abnormalities in neutrophil and megakaryocyte. Abnormalities of neutrophil were as follows: (1) the degeneration of primary granules, (2) elongated mitochondria, (3) lamellar complex of endoplasmic reticulum in immature neutrophils, (4) decreased number of secondary granules in mature neutrophils, (5) asynchronous nucleocytoplasmic maturation in mature neutrophils, (6) decreased glycogen particles in cytoplasm.
Some of the megakaryocyte reduced their size to 20∼25 μm in diameter and platelet peroxidase reactive rough endoplasmic reticulum of megakaryocyte were irregular and poorly developed.View full abstractDownload PDF (1534K) -
—A Case Report and Review of Literature—Yuuichi HIROTA, Seiichi OKAMURA, Yoshiyuki NIHO, Masaru MIYAKE1984 Volume 25 Issue 12 Pages 1989-1993
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSWe treated a 54-years-old Japanese woman with hemolytic anemia and diarrhea. Obvious anemia developed after administration of mefenamic acid (0.5∼1.0g/day) for 20 months to control low back pain due to metastatic carcinoma of breast with a history of 5 years. Ten months before admission, she developed diarrhea. Later hemoglobin level fell to 7.9 g/dl, so 2,400 ml of whole blood were consecutively transfused. On admission to our hospital, physical examination revealed jaundice and mild splenomegaly.
Laboratory data were as follows: Hb 11.7 g/dl, reticulocytes 42‰, WBC 3,900/mm3, bone marrow; NCC 27.5×104/mm3, erythroid series 64%, total bilirubin 3.6 mg/dl, indirect bilirubin 2.7 mg/dl, LDH 1,090 WU, apparent half life of RBC (51Cr) 10.5 days. Both direct and indirect Coombs' tests were positive and autoantibody was of warm type in an IgG class. ANF, anti-DNA antibody and microsome tests were also positive.
Upon discontinuing the administration of mefenamic acid on admission, anemia and diarrhea improved rapidly and positive indirect Coombs' test and ANF converted to negative within three months.
We also reviewed 11 cases reported in the literature and discussed possible mechanisms involving autoantibody formation with mefenamic acid.View full abstractDownload PDF (335K) -
Masahiko KODAMA, Shuich HANADA, Kouichiro NISHIOKA, Kouichiro NONURA, ...1984 Volume 25 Issue 12 Pages 1994-2000
Published: 1984
Released on J-STAGE: January 26, 2009
JOURNAL RESTRICTED ACCESSThis is a case of 15 year-old boy with megaloblastic anemia due to congenital deficiency of intrinsic factor.
The patient was admitted to our hospital, complaining of severe anemia, slight fever, and general fatigue, but his first episode of anemia was recognized when he was 6 years old. He was treated with V. B12 before admission. The anemia was macrocytic and hyperchromic. Sternal puncture revealed presence of hypercellularity, erythroid hyperplasia, and a few megaloblasts. Schilling test was done with and without hog intrinsic factor, and showed the deficiency of V. B12 due to the lack of intrinsic factor. He had normal gastric mucosa with normal gastric acid secretion. Antibodies against intrinsic factor and parietal cells were not detected in the serum. His anemia responded well to the therapy of V. B12, and improved dramatically.
Up to now, 33 cases of megaloblastic anemia in childhood including the present case have been reported in Japan. We classified them based on these reports, and discussed their characteristics.View full abstractDownload PDF (477K)
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