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Volume 26, Issue 1
Displaying 1-18 of 18 articles from this issue
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Takuya HATTORI, Yorikazu ISHIKAWA, Motoi NISHI, Hisaya NAKADATE, Yoshi ...1985 Volume 26 Issue 1 Pages 1-6
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwenty-one patients with malignant lymphoma in childhood, aged 1 to 16 years, were treated with combination chemotherapy with or without irradiation.
Five cases with Hodgkin's disease were treated with irradiation, and two progressive cases were added to combination chemotherapy CHOP or ABVD. They were all alive for 3+ to 86+ months.
Five cases with stage I or II non-Hodgkin's lymphoma treated with combination chemotherapy CHOP and irradiation were all alive for 7+ to 71+ months. Of the remaining 11 children in stage III or IV six died of progressive disease, in spite of intensive chemotherapy. Bone marrow transplantation would be indicated for them.
Intrathecal 198Au-colloid was effective against meningeal involvement of malignant lymphoma.View full abstractDownload PDF (451K) -
Atsushi SHIBUYA, Takashi SHINOZAWA, Toshio YOSHIKAWA, Isao KATAYAMA1985 Volume 26 Issue 1 Pages 7-14
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSCell surface markers were studied on 38 cases of childhood leukemias and lymphomas using 10 cases of adult leukemias as controls. Tumor cells were isolated by Ficoll-Conray centrifugation from the bone marrow and lymphnodes. According to the results of E rosette formation, surface immunoglobulin, cytoplasmic immunoglobulin and cytotoxic assay with various monoclonal antibodies, tumor cells of lymphoid malignancy (42 cases) were phenotyped as T (8 cases; 5 children and 3 adults), B (6 cases; 4 cildren and 2 adults) and non T non B type (28 cases; 24 children and 4 adults). Non T non B type was further subtyped as common ALL type (23 cases; 21 children and 2 adults) and null cell type (5 cases; 3 children and 2 adults).
An interesting difference in the above phenotypes between children and adults was a considerably higher incidence of the null cell type ALL in adults than in children.
Contrary to earlier belief that common ALL antigen is specific to undiffrentiated non T non B ALL, this study demonstrated the antigen in relatively differentiated T and B cell lymphomas as well as in non T non B ALL. These results give an insight on common ALL antigen as possible marker of differentiation and maturation for lymphoid tumor cells.View full abstractDownload PDF (613K) -
Hiroshi SAITO, Akira SAITO, Hiroshi OGAWA1985 Volume 26 Issue 1 Pages 15-19
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSRed cell life span was determined before and after the administration of dilazep in 4 patients with chronic renal failure undergoing hemodialysis and in a patient with elliptocytosis. By computer analysis of 51Cr-RBC disappearance curve, mean red cell life span (MRCLS), half survival (t1/2), relative survival rate (RSR), and exponential 51Cr-disappearance rate (k) were obtained.
After the administration of dilazep, MRCLS and RSR were increased in 4 cases, T1/2 was increased in 3 cases, and k was decreased in 3 cases out of 5 cases. 51Cr-RBC disappearance curves obtained before and after administration of dilazep were superimposed for comparison. It was taken for the change of red cell destruction, when the two curves were visually separated beyond the width of ±1 standard deviation each. By the above method of differentiation, red cell destruction was decreased in 2, not changed in 3, and increased in none out of 5 cases.
The observed tendency of decrease of red cell destruction seems to be related to the effect of delazep.View full abstractDownload PDF (348K) -
Shunro KAI, Yoshiki SHINOHARA, Hideki IFUKU, Yokiko OHE, Mahito MISAWA ...1985 Volume 26 Issue 1 Pages 20-27
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFifteen patients suffering from severe aplastic anemia (SAA) (2 cases), acute leukemia (AL) (10 cases) and chronic granulocytic leukemia (CGL) (3 cases) received a bone marrow transplantation (BMT). The marrow donors were histocompatible siblings (14 cases) or isologous twin (1 case). Two patients with SAA are still alive, and the observation time is 11 Mo. and 48 Mo. In cases of AL, two of 5 patients received BMT during remission, and one of 5 received in relapse are alive, 19 Mo. 3 Mo. and 5 Mo. after transplantation. Of three CGL patients, only one who received syngeneic marrow is alive 27 Mo. after grafting.
Acute graft-versus-host disease (GVHD) occured in 7 of 11 (67%) patients who received allogeneic marrow and were documented the engraftment. Two patients developed severe acute GVHD (grade III and IV) and one of them died due to GVHD. Transient and significant increase of serum IgE levels was found during acute GVHD or just before the onset of it in four cases.
Chronic GVHD, resembling autoimmune collagen disease, developed in 5 of 6 long-term survivors. Four of them had experienced preceeding acute GVHD, one had a de novo late onset. Prednisolone plus azathioprine administered to three patients for treatment of chronic GVHD were effective. These 3 patients are now alive with Karnofsky scores of 90∼100%, 48, 19, and 11 Mo. after BMT.View full abstractDownload PDF (637K) -
Tadashi SATO, Tsutomu SHICHISHIMA, Keiji KOKUBUN, Hideo KIMURA, Shin M ...1985 Volume 26 Issue 1 Pages 28-35
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSProgressive process and hemopoietic changes based on the FAB classicfiation were studied in 7 cases of erythroleukemia (DiGuglielmo's syndrome). Diagnosis according to the FAB classification alterd in 5 cases during their clinical courses: RA→RAEB→RAEBIT in one case, RAEB→RAEBIT→M6 in one, RAEBIT→(M6)→M2 in two, and M6→M4 in one. Development to overt leukemia (AML) occured in 3 cases (60%). Percentages of the duration of 5 clinical stages were 20%, 13%, 19%, 8% and 40%, respectively, for RA, RAEB, RAEBIT, M6 and AML. The duration of M6 was short. Fifty percent survival of all cases was 8.5 month.
Ferrokinetic study showed a marked ineffective erythropoiesis in RAEB and RAEBIT stages. Abnormal erythropoiesis was suppressed transiently after blood transfusion (BT), and the similar phenomenon was also observed through M6 and initial stage of AML. Blast, granulocyte and platelet counts also decreased in some cases. In AML stage, blasts were rather increased after BT. CFU-E was responsive to erythropoietin (EP) added to culture. CFU-E level was slightly lower than normal before BT and suppressed after BT, suggesting that erythroid progenitors are physiologically regulated by EP in erythroleukemia.
In conclusion, natural course of erythroleukemia based on the FAB classification will be RA→RAEB→RAEBIT→M6, and final development to myeloid leukemia is common.View full abstractDownload PDF (597K) -
Hisato KIGASAWA, Hirokazu NISHIHIRA, Atsuo IIZUKA, Takeshi NAGAO1985 Volume 26 Issue 1 Pages 36-41
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThirteen children with acute nonlymphoblastic leukemia were treated with ACMP two step induction therapy and received consolidations every 5 weeks for 2 years if they did not relapse.
Eleven out of 13 patients (84.6%) achieved a complete remission (CR). Six out of 13 patients received granulocyte transfusions and two out of 6 patients died of septicemia without achieving CR.
Median remission duration and survival were 11 months and 24 motnhs. Four out of 11 patients (36.4%) still remain in CR for 35∼67 months.View full abstractDownload PDF (385K) -
Nobuo SHIMIZU, Toshiki OHKUBO, Hajime KAWASAKI, Tsutomu NOBORI, Hitosh ...1985 Volume 26 Issue 1 Pages 42-46
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESS6-Mercaptopurine (6-MP) has been used for the maintenance therapy of ALL in childhood. However its pharmacokinetics was not clarified because of the difficulties in measuring its plasma levels. Recently, the HPLC method for quantitation has been developed. Using this sensitive and specific method, we measured the plasma 6-MP levels in patients with ALL in complete remission.
The mean peak plasma level of 6-MP in 14 patients, administered 2 mg/kg orally, was 42.5 ng/ml with a mean time to the peak level of 1.64 hours. There was a 16.3 fold variation in the AUC (the area under the curve formed by plotting plasma concentration against time), in addition a 14.6 fold variation in peak plasma level among the patients.
This study suggests that plasma 6-MP levels should be monitered in its use. Especially, in patients with hepatic dysfunction, since plasma 6-MP was detectable so long, it is needed to moniter their plasma 6-MP levels as well as to decrease their dose.View full abstractDownload PDF (312K)
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Yutaka INAGAKI, Yasuhito TERADA, Eisuke TAKAZAKURA, Yuko HIROSE1985 Volume 26 Issue 1 Pages 47-51
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 81-year-old man was admitted to our hospital because of fever and body weight loss. He looked pale, and physical examination revealed hepatosplenomegaly and petechiae on the lower extremities. The white-cell count was 113,000 with 90 per cent small lymphocytes, and a bone marrow aspiration revealed hypercellularity with 80 per cent lymphocytes. X-ray examination showed diffuse osteolytic lesions throughout the skeletal system. Serum IgM was 1,656 mg/dl, and serum immunoelectrophoresis disclosed a marked monoclonal increase in IgM-κ. Immunofluorescence study showed that most lymphocytes carried the monoclonal IgM-κ on their surface, and a limited number of lymphocytes were also positive for intracytoplasmic IgM-κ. Using antiidiotypic antibody prepared against serum IgM, the idiotype of serum monoclonal IgM was proved to be identical with that of cell surface and intracytoplasmic IgM of the circulating lymphocytes. A marrow biopsy of the iliac bone disclosed nodular proliferation of the lymphocytes, but positive PAP staining for intracytoplasmic IgM-κ was restricted to a small number of plasma cells around the nodules.
This case was not only a rare one of leukemic macroglobulinemia associated with diffuse osteolytic lesions, but also interesting in point of the maturation and differentiation of B lymphocytes.View full abstractDownload PDF (920K) -
Hideyo NATORI, Koichiro EGAMI, Ken TANAKA, Eiji NAKAMURA, Kazuyuki NAT ...1985 Volume 26 Issue 1 Pages 52-57
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 61-year-old female was admitted to our hospital because of cough and fever. The lymph nodes, liver and spleen were not palpable. Haematological examinations revealed hemoglobin 10.2g/dl, platelets 70,000/cmm, and leukocytes 82,500/cmm with 93% leukemic cells with convoluted nuclei.
T cell subset analysis was done with monoclonal antibodies. Leukemic cells had T cell markers (OKT3: 89.7%, OKT4: 96.7%, OKT8: 92.9%, OKT9: 4.4%, OKT10: 18.7%, OKT11: 98.5%, B-1: 4.3%, SmIg: 12.3%, OKIa: 3.2%, OKM1: 2.6%, MCS-1: 0.8%, MCS-2: 0.9%, J-5: 0.3%, Tac: 49.3%).
The phenotype of leukemic cells showed both the helper/inducer and suppressor/cytotoxic subsets. The leukemic cells showed no helper and no suppressor functions. Leukemic cells did not respond to the three lectin mitogens (PHA, Con A and PWM). ATLA (adult T cell leukemia-associated antigen) and its antibody and HTLV (human T cell leukemia virus) provirus DNA were positive.
Although ATL cells previously reported were mature peripheral T cells with helper/inducer subsets and had a suppressor function, the ATL cells of our patient had both helper/inducer and suppressor/cytotoxic subsets without any functions.View full abstractDownload PDF (481K) -
Shosaku NARUMI, Hiroyuki NOZAKI1985 Volume 26 Issue 1 Pages 58-62
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSOccurrance of clinical and histological picture mimicking histiocytic meddulary reticulosis has been reported in association with some viral infections, miliary tuberculosis, typhoid fever and gastric cancer. Reported herein is a patient with lung cancer presenting with such a picture: A 75 year-old male was admitted on 1/25/'83 with productive cough, hemoptysis, anorexia and weight loss. A diagnosis of squamous cell carcinoma of the lung with metastasis to the right supraclavicular nodes and liver was made in the hospital. RBC and platelet counts were initially normal and WBC count was 22,700/μl with neutrophilia. However, following an episode of transient fever, RBC, WBC and platelet counts progressively decreased to 227×104/μl, 14,600/μl and 3.8×104/μl respectively within 3 weeks without use of any anti-mitotic agents. The patient died of general emaciation. Bone marrow aspiration performed shortly before death revealed normoplastic marrow without invasion of tumor cells. Characteristically, However, an increase in macrophage, displaying marked hemophagocytosis forming clumps in some areas was noted. Autopsy revealed no distinct histiocytosis in the bone marrow, liver, or spleen. We consider that this represents a case with reactive reticulosis possibly induced by tumor-associated antigen or the antigen-antibody complex.View full abstractDownload PDF (885K) -
Keisuke TOYAMA, Isao AOKI, Nobuko ABE1985 Volume 26 Issue 1 Pages 63-68
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 53-year-old male with autoimmune hemolytic anemia (AIHA) had been treated with prednisolone (PSL) since December 1975, and his hemoglobin level was 12.5 g/dl at the end of March 1976. At the beginning of April 1976, the patient developed hemoglobinuria with a sudden drop of hemoglobin level down to 5.0 g/dl.
Peripheral blood mononuclear cells (P-MNCs) from this patient at the stage of hemolytic attack markedly stimulated the proliferation of erythroid precursors (CFU-E) from the normal human bone marrow in vitro. This stimulatory effect of P-MNCs on CFU-E colony formation subsided when hemolysis ameliorated in this patient after treatment with an increased dose of PSL.
The effect of P-MNCs on CFU-E colony formation of the normal human bone marrow in vitro was also investigated in the other 5 patients with AIHA and in 9 patients with non-immunological hemolytic anemia consisting of 5 hereditary spherocytosis, 3 paroxysmal nocturnal hemoglobinuria (PNH) and 1 aplastic anemia-PNH syndrome. In none of these 14 patients, P-MNCs markedly stimulated normal CFU-E colony formation.
These observations suggest that P-MNCs may enhance CFU-E proliferation in certain conditions such as severe hemolysis in AIHA.View full abstractDownload PDF (444K) -
Yorikazu ISHIKAWA, Takuji SATOH, Takuya HATTORI, Takeo TAKEDA, Masahir ...1985 Volume 26 Issue 1 Pages 69-73
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 12-year-old boy was admitted in January 1981, because of high fever, left cervical lymphadenopathy, and massive splenomegaly. He was diagnosed as having Hodgkin's disease of mixed cellularity, stage IIIsB. By the treatment with CHOP and irradiation on the left neck, remission was achieved.
In July 1981, the disease relapsed. Following the ABVD therapy of two months and splenectomy, he began to complain of headache and vomiting. Lumbar puncture revealed a cell count of 500/cumm with 62% atypical lymphoid cells. He was treated with intracranial methotrexate and craniospinal irradiation, and achieved a remission in November 1981.
The spinal fluid obtained at a regular examination in September 1982 contained 539/cumm cells with 80% atypical lymphoid cells. Immunological markers of the spinal fluid cells were examined, which showed E-rosette formation (63%) and positive reaction against 80% for Leu 1, 10% for Leu 2, and 62% for Leu 3. These data were consistent with those of meningeal involvement of Hodgkin's disease. He got a remission again with intrathecal MTX and Ara-C, and 23 months after the last remission, he is completely free from the disease.View full abstractDownload PDF (444K) -
Setsuo HASEGAWA, Isamu NAKAO, Kazuo NIITANI, Takashi SUGIHARA, Kosuke ...1985 Volume 26 Issue 1 Pages 74-78
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA sporadic case of congenital high red cell membrane phosphatidyl choline hemolytic anemia (HPCHA) was described. The 36-year-old woman followed up as hemolytic anemia of unknown origin underwent splenectomy and cholecystectomy. The patient showed no improvement after splenectomy. Thereafter, red cell membrane metabolism was investigated. A marked abnormality was noted in red cell membrane lipids, specifically the elevation of phosphatidyl choline (PC) content despite of normal plasma lipids and LCAT activity. Sodium transport, both influx and efflux, was increased, and membrane ATP-ase activity was enhanced. Therefore, the diagnosis of HPCHA was confirmed. Splenectomy was effective only in one case of HPCHA among 4 reported cases. In our case, red cell ghosts were noted on the peripheral blood smears associated with hemosiderinuria, which indicates the presence of intravascular hemolysis.View full abstractDownload PDF (619K) -
Yoshinori KOYANAGAWA, Ken-ichi SAWADA, Shoki SAKURAMA, Noriaki FUKUOKA ...1985 Volume 26 Issue 1 Pages 79-85
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSBone marrow culture was performed in two cases of primary acquired sideroblastic anemia (PASA) to examine whether stem cell abnormalities existed or not, and it's clinical usefulness to predict the prognosis of the disease was evaluated.
The diagnosis of PASA was made on the basis of the following findings: (1) erythroid hyperplasia with ringed sideroblasts in marrow. (2) anemia refractory to Vit. B6 administration. (3) absence of the history of other diseases and drugs which were known to be associated with sideroblastic anemia.
The first patient was a 69-year-old man with severe ancmia. He required frequent blood transfusions and died of heart failure probably caused by hemochromatosis eight months after admission. Another was a 66-year-old woman with mild anemia and she maintained the same hemoglobin level without blood transfusion.
The bone marrow cultures revealed the decrease not only in CFU-E but also in CFU-C. CTU-E and CFU-C were much decreased in severe anemic case than in mild anemic case. Ringed sideroblasts were shown by the iron staining technique among erythroblasts in CFU-E culture and were found not in colonies but in clusters. All the colonies were consisted of non-sideroblastic cells.
These findings suggest that PASA is one of the disorders involved with pluripotent hemopoietic stem cells and that ringed sideroblasts in PASA are derived from abnormal clone which has not potency to form colonies. Furthermore it seemed that the level of CFU-E growth is helpful to predict the prognosis of PASA.View full abstractDownload PDF (782K) -
Kenji SHINOHARA, Katsunori YAMADA, Yasuhiko FUJII, Yoshiki YOSHIZAKI, ...1985 Volume 26 Issue 1 Pages 86-90
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAllogeneic bone marrow transplantation (BMT) from a HLA identical sister was done to a 20 years old female with severe aplastic anemia. Hematological recovery was noted after 2 weeks, and the engraftment of the donor's bone marrow cells were certified by the appearance of the donor's type red cells 40 days after BMT. The clinical course after BMT was favorable, with a little complications. Acute GVHD was of grade I, and chronic GVHD was limited. The patient is alive in complete health 1 year after BMT, though the immunological recovery is still incomplete, shown by decreased helper T cells, increased suppressor T cells, and decreased response to mitogens.View full abstractDownload PDF (581K) -
Katsunori YAMADA, Kenji SHINOHARA, Masamitsu INOUE, Yasuhiko FUJII, Yo ...1985 Volume 26 Issue 1 Pages 91-95
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe patient was a 13-year-old boy who had hepatomegaly, an abdominal mass, ascites, and paresthesia in the left thigh. A diagnosis of Burkitt's lymphoma was made after biopsy of the abdominal mass. After conventional chemotherapies, the patient received high doses of BCNU, cyclophosphamide, BH-AC, and 6-MP, followed by infusion of cryopreserved autologous bone marrow cells. Hematological recovery occurred 21 days after the transplantation, and the tumor was once thought to be eradicated. However, 73 days after the transplantation, lymphoma relapsed with leukemic manifestations. CNS involvement developed thereafter, and the patient died 140 days after the transplantation. Autopsy revealed the dissemination of lymphoma cells especially in the bone marrow, optic nerves, and prostate.View full abstractDownload PDF (436K) -
Kohji TANEICHI, Masataka DENO, Takahiko KONNO, Hidetoshi SHIBAKI1985 Volume 26 Issue 1 Pages 96-100
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 32-year-old male was admitted to the hospital with complaints of fever and lymphadenopathy in March, 1983. Hematological study showed the RBC, 240×104/mm3, platelets, 2.4×104/mm3 and WBC, 127,400/mm3 with 93 percent blastic cells. A bone marrow aspiration showed 91 percent blastic cells. Histochemical studies of leukemic cells supported a diagnosis myelomonocytic leukemia (M4 in FAB classification). He received the two-step treatment of DCMP (daunorubicin, cytarabin, 6-MP and prednisolone), and a complete remission was attained in May, 1983. A relapse occurred in October, 1983, and the DCMP treatment was given again. Twenty days after the beginning of treatment, he suddenly complained of fever, hemoptysis and chest pain. Chest X-ray showed abnormal shadow in the right upper pulmonary lobe. Pulmonary embolism due to mucormyces was suspected. The thrombolytic agents and antifungal agents were administered. Although complete remission was again obtained, the abnormal shadow on chest X-ray remained unchanged. Angiography was done to show pulmonary embolism, and lobectomy of the right upper lobe was performed. Histology of the resected pulmonary lobe showed a thrombosed vessel filled with hyphae of mucormyces.
He is presently well on oral amphotericin B.View full abstractDownload PDF (816K)
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1985 Volume 26 Issue 1 Pages 101-125
Published: 1985
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (2325K)
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