巻号一覧
27 巻, 12 号
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臨床研究
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土川 研也, 佐藤 功, 鈴木 千征, 遠藤 一靖1986 年 27 巻 12 号 p. 2221-2227
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありDescribed herein is a 57 year-old woman who had pure red cell aplasia (PRCA) associated with a multitude of disorders including thymoma, multiple myeloma, splenomegaly and presence of antinuclear antibodies. In vitro colony assay were carried out to clarify whether the patient's IgG or peripheral mononuclear cells suppressed erythropoiesis. Both the IgG (M protein) and peripheral mononuclear cells suppressed CFU-E colony formation in cultures of normal bone marrow cells. It is suggested that in this case PRCA and multiple myeloma have a close relationship.抄録全体を表示PDF形式でダウンロード (539K) -
竹中 武昭, 近田 千尋, 坂野 輝夫, 下山 正徳, 北原 武志, 湊 啓輔, 関 茂樹1986 年 27 巻 12 号 p. 2228-2233
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありNine adult patients with metachronous secondary acute leukemia, who had been treated at the National Cancer Center Hospital, were analyzed from a clinical hematology viewpoint.
The findings were as follows: 1) The interval period from primary cancer to secondary acute leukemia was 1 year and 4 months to 10 years and 6 months, and the median interval time was 5 years and 1 month. 2) The 9 cases consisted of 2 cases of uterine cancer, and one case each of skin cancer, tongue cancer, laryngeal cancer, gastric cancer, thyroid cancer, parotid cancer and seminoma. 3) They were divided into four groups by therapy used for the primary cancers. Four cases were treated with surgery alone and one case was treated with radiation alone. Three cases were treated with a combination of surgery and radiation. A further case was treated with a combination of surgery, radiation and chemotherapy. 4) The nine cases with secondary acute leukemia were divided into the following two groups by the initial treatment and the subtype of French-American-British group classification. One group was the surgical group. The other was the radiation ± surgery/chemotherapy group. The former group consisted of two L2 cases, one M2 case and one M3 case. The latter, including two cases who developed acute leukemia after myelodysplastic syndrome, consisted of three M2 cases, one M4 case and one M5 case. 5) In the secondary acute leukemia, the response rates were compared between the surgical group and the radiation ± surgery/chemotherapy group. Complete or partial remission rate was 50% or 50% in the former, and 20% or 0% in the latter, respectively. 6) The median survival time was 1 year and 1 month in the former and 2 months in the latter, respectively. 7) The main causes of death were pneumonia and/or cerebral hemorrhage.抄録全体を表示PDF形式でダウンロード (473K) -
—若年者との比較を中心に—吉田 喬, 大竹 茂樹, 小林 和美, 伊藤 恵子, 中村 忍, 松田 保, 斉藤 泰雄, 古川 仭, 宮崎 為夫, 松原 藤継, 名取 一 ...1986 年 27 巻 12 号 p. 2234-2242
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありOne hundred and three patients with non-Hodgkin's lymphoma treated in Kanazawa and Kurume university hospitals from September 1982 to October 1985 were analysed with respect to age, clinical stage, LDH and prognosis. Elder patients were conspicuous, so the median age of these patients was 60 yo. All patients were treated with same radiochemotherapy protocol. Complete remission (CR) rates in early stage were 95.8% (<60 yo.), 100% (60∼70 yo.) and 88.9% (>70 yo.), and these survival rates at 30 mos. were 94% (<60 yo.) and 79% (≥60 yo.). CR rates in advanced stage were 55% (<60 yo.), 42.9% (60∼70 yo.) and 50% (>70 yo.), and these survival rates at 25 mos. were 45%, 26% and 42%. Response to chemotherapy in elder patients was similar to that in younger patients. Full dose chemotherapy is avairable for elder patient as well as younger ones.抄録全体を表示PDF形式でダウンロード (579K) -
—三重県内統一臨床成績—和田 英夫, 鈴木 彦次, 森 美貴, 出口 晃, 大久保 伊都子, 津田 雅之, 長野 正, 出口 克巳, 白川 茂1986 年 27 巻 12 号 p. 2243-2248
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありFifty patients in pre-disseminated intravascular coagulation (DIC) state were treated with gabexate mesilate (FOY) or a combination of FOY and heparin. Pre-DIC state was diagnosed by changes of clinical symptoms as well as of laboratory data in cases with leukemia, solid cancer, bacterial infection, liver disease and so on.
The clinical and laboratory findings showed improvement in 22 out of 33 patients, treated with FOY only, and in 13 out of 17, treated with both FOY and heparin. Although aggravation of blood coagulation data was never seen in patients with leukemia when they were treated with FOY and heparin. In patients in pre-DIC state, plasma fibrinogen content, APTT, platelet count, ESR and FDP level frequently had abnormal values at the onset, but fibrinogen content, FDP level, platelet count, PT and STT showed response to the therapy. Therefore, those parameters should be used for the diagnosis, and when patients showed clinical symptoms in pre-DIC state, they should be treated by FOY in this state.抄録全体を表示PDF形式でダウンロード (481K) -
高木 敏之, 小黒 昌夫, 酒井 力1986 年 27 巻 12 号 p. 2249-2253
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありTwenty two patients with multiple myeloma were treated with “MEV (Ac) P Therapy”. All but 2 patients were classified as Stage III according to Durie-Salmon's criteria. Six patients have treated previously and the remaining 16 had no prior treatment. Nine patients were treated with MEVAcP Therapy which consisted of cyclophosphamide 200 mg/m2 i.v. and ACNU 30 mg/m2 i.v. on day 1, melphalan 6 mg/m2 p.o. and prednisolone 30 mg/m2 p.o. day 1 through day 4, and vincristine 1 mg/body i.v. on day 22. Thirteen patients were treated with MEVP Therapy which consisted of cyclophosphamide 500 mg/body i.v. on day 1, melphalan 10 mg/body p.o. and prednisolone 30 mg/body p.o. day 1 through day 4, and vincristine 1 mg/body on day 22. Clinical responses were evaluated according to Imamura's criteria after 4 courses of therapy. Partial responses were obtained in 15 patients, but no changes were observed in 5, and disease were progressive in 2, hence response rate was 68.2%. Median survival for responded patients and non-responder was 4 years and 1 year and 7 months respectively. There was no difference between MEVAcP and MEVP Therapy either in response rate or in survival. No severe side effects were seen except for in two patients treated with MEVP Therapy; one with severe pancytopenia and pneumonia, the other with fever and upper respiratory infection. Therefore, MEV(Ac)P Therapy was considered to be suitable treatment in multiple myeloma with usual growth pattern, however, further reseach is needed for best modality of treatment in multiple myeloma with various growth pattern.抄録全体を表示PDF形式でダウンロード (398K) -
宮崎 勢, 福田 光之, 三浦 亮1986 年 27 巻 12 号 p. 2254-2260
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありClinical, laboratory features, as well as the hematopoietic stem cells of 10 patients with essential thrombocythemia (ET) were used in a comparison study with another group of 12 patients with polycythemia vera (PV). Both diseases were diagnosed under PV study group's diagnostic criteria.
No significant differences were observed due to either the median age at diagnosis, the incidence of thrombo-hemorrhagic phenomena, the degree of hepato-splenomegaly or other clinical features. Some differences due to the sex of the patient, were noticed between the ET and PV groups, however.
On the other hand, the ET group revealed such hematological characteristics as mild anemia, markedly incresed platelet counts, decreased platelet adhesiveness, and positive spontaneous platelet aggregations.
In the colony formation by hematopoietic stem cells from bone marrow, the PV group had a significantly higher number of CFU-e than those of the ET group, and showed a higher number of CFU-e spontaneous colony formations in all patients.
However, the ET group showed PV-like numbers of CFU-e spontaneous colony formations in one paticular patient, but did not show CFU-e spontaneous colony formation in any other of 5 patients.
These results suggest that some patients, although diagnosed as ET and who show a markedly high incidence of CFU-e spontaneous colony formation, might possibly fall into the PV classification. Because the present diagnostic criteria for both diseases lack the specificity to differrentiate one from the other, the finding of hematopoietic stem cells are considered to be important criteria in the future.抄録全体を表示PDF形式でダウンロード (507K) -
田岡 輝久, 三井 秀紀, 中川 雅史, 矢倉 宏祐, 手島 博文, 植田 高彰, 平岡 諦, 中村 博行, 柴田 弘俊, 正岡 徹, 石上 ...1986 年 27 巻 12 号 p. 2261-2266
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありNine patients with chronic myelogenous leukemia (CML) including 6 in chronic phase, 1 in accelerated phase and 2 in blastic crisis were treated with high-dose chemoradiotherapy followed by bone marrow transplantation from 8 HLA-identical and 1 HLA-mismatched sibling donors. The patients ranged from 8 to 33 yr in age. Six patients who had not previously undergone splenetomy recieved radiotherapy to the spleen. To prevent acute GVHD, either cyclosporin-A or methotrexate was given to all patients. At the time of analysis (May, 1986), 5 transplant patients in chronic phase are alive after a median follow-up of 11 months (range 5 to 19). Other patients were died of complications. The complications were apparently more frequent in accelerated phase and blastic crisis than in chronic phase. The degree of acute GVHD was not so different between those in chronic phase and in more advanced disease (accelerated phase and blastic crisis). These observations suggest that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.
And then, we report one typical case with CML in chronic phase who received MCNU, which could rapidly reduce white cell count and increase % of lymphocytes, and so that could be tissue-typed early and easily. Therefore, MCNU can be used for efficient reduction of white cell count prior to tissue typing of patients with CML.抄録全体を表示PDF形式でダウンロード (422K) -
栗山 一孝, 前田 隆浩, 跡上 直, 糸山 貴治, 塚崎 邦弘, 河野 友子, 笹川 一平, 森内 幸美, 中村 秀男, 鳥谷 和洋, 樅 ...1986 年 27 巻 12 号 p. 2267-2273
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありWe modified the L-10M protocol which had developed for adult acute lymphoblastic leukemia (ALL) at the Memorial Sloan Kettering Cancer Center. The modified L-10M protocol is consisted of multi-drug induction chemotherapy with vincristine, prednisolone, cyclophosphamide and adriamycin plus an intensive consolidation phase and maintenace program. The complete remission (CR) rates for 16 patients treated by the modified L-10M protocol and 19 historical controls who had been treated by combination of daunomycin, cytosine arabinoside, vincristine and prednisolone (DCVP), were 75% and 79%, respectively. The median survival of CR cases was 7 months for the DCVP protocol, but has not yet been reached for the modified L-10M protocol (range: 2 months-2.5 years) (p<0.001). Three patients of the L-10M protocol group were died of septicemia in the induction phase, and CR cases well tolerated the protocol with minimal morbidity in the consolidation or maintenance phase. The modified L-10M protocol seems to be very effective to adult patients with ALL.抄録全体を表示PDF形式でダウンロード (497K) -
高木 省治郎, 須田 啓一, 小松 則夫, 大田 雅嗣, 加納 康彦, 北川 誠一, 坪山 明寛, 雨宮 洋一, 元吉 和夫, 武藤 良知, ...1986 年 27 巻 12 号 p. 2274-2280
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありFive patients with malignant lymphoma in whom primary chemotherapy had failed were treated with high-dose chemotherapy using AAABC regimen, total body irradiation, and transplantation of cryopreserved autologous marrow. Complete remission was achieved in all five patients. In these patients, the recurrence of malignant lymphoma did not occur during the follow up time of 2 to 59 months after autologous bone marrow transplantation. Three of them are alive in continuous remission for 33, 49, and 59 months, respectively. In one of these three patients, acute lymphoblastic leukemia developed 44 months after bone marrow transplantation. However, successful chemotherapy resulted in a complete remission of leukemia, he is alive in remission. The remaining two patients died of pneumonia and respiratory failure 72 days and 82 days after bone marrow transplantation, respectively. Our results show that intensive chemoradiotherapy and autologous-marrow transplantation can produce a prolonged remission in patients with malignant lymphoma in whom conventional chemotherapy has failed.抄録全体を表示PDF形式でダウンロード (511K) -
今井 康文, 矢原 靖之, 小野沢 康輔, 佐々木 常雄, 井深 田鶴子, 今井 邦之, 坂井 保信, 丹後 俊郎1986 年 27 巻 12 号 p. 2281-2290
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありFor the past 9 years, 86 patients with previously untreated adult acute leukemia [acute nonlymphocytic leukemia (ANLL) 65, acute lymphocytic leukemia (ALL) 21 cases] were treated with various chemotherapeutic regimens, and 11 of them (ANLL 9, ALL 2 cases) have survived more than 5 years after the achievement of complete remission (CR).
The over all CR rates were 75% in ANLL and 81% in ALL. The median remission duration and the median survival time were 12 months and 17 months in ANLL, and 9 months and 17 months in ALL, respectively. The patients with M2 morphology in the FAB classification, in general, appeared to have better prognosis than those with M1 in respect of CR rate, median remission duration and survival time.
Those 11 long-term survivors included 6 males and 5 females and, according to the FAB classification, 2 cases with M1, 6 with M2, 1 with M3, 1 with L1, 1 with L2, therefore 6 of 9 with ANLL being of M2 type. The combination of cyclocytidine (continuous infusion) and predonisolone (P) was the regimen used in 6 out of 9 ANLL long-term survivors during remission induction, and that of vincristine (V) and P in 2 ALL. After the achievement of CR, Daunomycin, Ara-C, V, and P were administered to the most of the 11 patients as intensification therapy every 2 to 3 months with oral 6 mercaptopurine and methotrexate in between as maintenance therapy. 5 of the 11 patients have relapsed, but all of them are free of the disease at present on other regimens.抄録全体を表示PDF形式でダウンロード (713K)
症例
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重清 俊雄, 小阪 昌明, 斎藤 史郎, 荒河 忠治, 井上 秀夫, 佐野 寿昭1986 年 27 巻 12 号 p. 2291-2297
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA case of IgG (λ) myeloma which occurred during the course of Weber-Christian disease was reported. The patient, 70-year-old male, had lumbar pain since 2 years in addition to a history of repeated developments of subcutaneous tumor on the hip and high fever for about 20 years. The histological finding of subcutaneous tumor was lobular panniculitis. Bence Jones protein was detectable in the urine (0.6 g/day). Serum T.P. was elevated to 8.4 g/dl with monoclonal IgG (λ), and the bone marrow puncture showed the increase of atypical plasma cells (24%). The examination of coagulation factors in the plasma disclosed the presence of lupus anticoagulant. On the other hand, the purified IgG (λ) from the patient's serum had a binding activity to cardiolipin, a sort of phospholipid, on enzyme-immunoassay. The binding site was demonstrated to be localized in Fc portion, not in F(ab')2 portion of the IgG (λ) by the experiment that the pepsin cleavage of IgG resulted in the loss of its binding activity. These results suggest that lupus anticoagulant activity in the plasma is due to a binding activity of monolonal IgG to cardiolipin, and that the panniculitis in Weber-Christian disease could be related with the occurrence of myeloma.抄録全体を表示PDF形式でダウンロード (879K) -
野田 裕, 大津 智子, 斎 敏明, 樋渡 克英, 岡 正行, 佐藤 昭彦, 飛内 賢正, 若狭 治毅1986 年 27 巻 12 号 p. 2298-2303
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 79-year-old female was admitted to Iwaki Kyoritsu General Hospital because of chest and back oppressive sense and vomiting. Nodular and diffuse skin lesions were found on her face, auricle, and toes. Serological examination revealed elevated monoclonal IgM. Histopathological study on the skin biopsy showed the picture of lymphoplasmacytoma. Cytoplasmic immunoglobulin of μ, κ type was detected in the lymphoma cells. Protein A plaque forming cell assay (PFC assay) was performed for skin, peripheral blood and bone marrow mononuclear cells, and markedly elevated production of IgM was found. A diagnosis of primary macroglobulinemia was made and COP (vincristine, cyclophosphamide and prednisolone) therapy was performed resulting in an improvement in the skin lesions.
This is the first case of primary macroglobulinemia with specific skin lesions where elevated production of IgM was shown by PFC assay.抄録全体を表示PDF形式でダウンロード (647K) -
赤保内 良和, 青木 繁雄, 武井 崇, 森 正光, 小林 壮光, 谷内 昭1986 年 27 巻 12 号 p. 2304-2308
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 51-year-old man with IgD (λ)-multiple myeloma associated with OKT4 epitope deficiency was reported. He complained of right gingival tumor and was admitted to our department on suspicion of extra-medullary plasmacytoma. Bone marrow aspiration on admission revealed nucleated cell count was 32.4×104/mm3 with 41.8% of myeloma cells. Immunoelectrophoresis of the patient serum and urine diclosed monoclonal IgD of λ type and Bence Jones protein of λ type, respectively, Moreover, more than 95% of OKT10+ cells and IgD positive cells were recognized on the surface of tumor cells obtained from gingiva. Surface marker analysis of peripheral blood cells demonstrated 85.9% of OKT3+ cells and 0.8% of OKT4+ cells although 45.3% of Leu 3a+ cells were recognized. It was interesting to note that only OKT4+ cells were remarkably decreased. Although the relations of OKT4 epitope dificiency to diseases including multiple myeloma were vague up to date, a possible clinical significance was dicussed from the literatures.抄録全体を表示PDF形式でダウンロード (455K) -
二宮 治彦, 中澤 正樹, 青木 泰子, 中村 治雄, 阿部 帥1986 年 27 巻 12 号 p. 2309-2312
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA case of multiple myeloma whose plasma cells showed hemophagocytosis is reported. A 70-year-old man was diagnosed having multiple myeloma with circulating plasma cells (15%). The plasma cells assumed the morphology of plasmacytoid lymphocytes and 22% of them showed phagocytosis of erythrocytes, platelets, or erythroblasts. Clinically, no osteolytic lesion was found. Immunological marker study revealed 34% of the plasma cells had receptors for C3.
The clinical features of patients with phagocytic plasma cell myeloma in the previous reports were compared with those of common myeloma patients. It is proposed that phagocytic plasma cells tend to migrate to peripheral blood from the bone marrow and have a decreased tendency to form tumor masses.抄録全体を表示PDF形式でダウンロード (314K) -
松林 祐司, 筧 隆子, 杉山 裕之, 八木田 正人, 高橋 隆幸, 井村 裕夫, 星野 孝, 富士原 彰, 矢田 満, 湧谷 純, 道上 ...1986 年 27 巻 12 号 p. 2313-2318
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 54-year-old woman was referred to our hospital because of paraproteinemia in November, 1975. Serum protein electrophoresis disclosed a monoclonal immunoglobulin which was identified as IgG-κ by immunoelectrophoresis, and the amount of the monoclonal IgG was 2.4 g/dl. Bence Jones protein in the urine was negative. Sternal marrow aspirate showed normocellularity with 6.8% (3% immature form) plasma cells. Hematological examination was non-specific, and no bone lesion was observed on skeletal X-ray films. A tentative diagnosis of monoclonal gammo-pathy of undetermined significance was made.
In December, 1980, the patient was found to have advanced stomach cancer (poorly differentiated adenocarcinoma) and subtotal gastrectomy was performed.
In August, 1981, a diagnosis of multiple myeloma was established based on increased amount of the monoclonal IgG over 3.0 g/dl and plasma cells over 20% (11% immature form) in the bone marrow. The patient was treated with melphalan or cyclophosphamide without noticeable response.
In October, 1982, the patient became anemic and Borrmann II rectal cancer was found. The tumor was surgically removed and the histological diagnosis was moderately differentiated adenocarcinoma. After the operation, myeloma became aggressive without beneficial effect of plasma exchange and chemotherapy.
In January, 1983, the patient developed pleural effusion of the left side. In the effusion, numerous atypical plasma cells were seen and the amount of the monoclonal protein was 4.8 g/dl. The patient died of renal insufficiency in February, 1983.
An autopsy revealed widespread plasma cell infiltration in the bone marrow, liver, kidney, spleen and systemic lymph nodes including mediastinal lymph nodes. No metastatic tumor of gastric or rectal cancer was found. The significance of associated carcinomas and pleural effusion was discussed.抄録全体を表示PDF形式でダウンロード (506K) -
井上 信正, 大槻 剛巳, 森 博雄, 杉原 尚, 八幡 義人, 萬納寺 正清1986 年 27 巻 12 号 p. 2319-2324
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 42-year-old woman admitted to our hospital because of superior vena cava syndrome in February, 1984, when she was pointed out of mediastinal tumor shadow in a chest X-ray film and M-component of IgG kappa type in serum. Neither bone marrow nor systemic X-ray bone survey revealed the evidence of myelomatosis. For both diagnosis and therapeutic purpose, the mediastinal tumor was surgically removed after irradiation and was examined histlogically. A diagnosis of extramedullary plasmacytoma (IgG κ) was made.
In December, 1984, a local recurrence occurred in the retroperitoneum. The patient has received chemotherapy (MPPO therapy). The tumor promptly subsided following chemotherapy, the M-component disappeared from serum, and tumor turned undetectable from the retroperitoneum. Neither M-component nor tumor has reappeared during 13 months after the first chemotherapy. During the whole course of the disease, there were no plasmocytosis in the bone marrow and no osteolytic lesions.抄録全体を表示PDF形式でダウンロード (658K) -
—自験例を中心として—原 純一, 河 敬世, 土居 悟, 勇村 啓子, 石原 重彦, 倉橋 浩樹, 薮内 百治1986 年 27 巻 12 号 p. 2325-2332
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありTo investigate cellular lineage of Tγ-lymphoproliferative disorder (Tγ-LPD), immunological and Southern blotting analysis was carried out in a 16-year-old girl with Tγ-LPD. Pathologic cells were large granular lymphocytes (LGL) and reacted with anti T10, T11, Ia and Leull. DNA extracted from these cells was hybridized to the probes of immunoglobulin heavy-chain and T-cell receptor β-chain (Tβ) genes. Because of no rearranged bands, LGL in this case dose not seem to be of lymphoid origin (T or B-lineaga). Among thirteen cases of Tγ-LPD in the literature, eleven cases expressing T3 antigens showed Tβ gene rearrangements. However, the other two cases, which lacked T3 antigens like our cases, had germline configuration of Tβ genes. These findings indicate heterogeneity of Tγ-LPD not only from surface phenotype but also at the DNA level.抄録全体を表示PDF形式でダウンロード (599K) -
浜野 晋一郎, 呉 太善, 井田 博幸, 広津 卓夫1986 年 27 巻 12 号 p. 2333-2339
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありThe patient presented at the age of 14 months because of gait disturbance. Her neurological examinations showed normal findings. A few petechiae on her extremities and pallor face were noted. Her laboratory findings on admission were as follows; Hb, 7.4 g/dl ; platelets, 12,000/mm3; serum lactic dehydrogenase, 1,292 mU/ml; serum muramidase, 58 μg/ml ; urine muramidase, 43 μg/ml. Total bone survey demonstrated periosteal reaction and metaphyseal lucency at bilateral femur and osteolysis at ribs. Bone marrow aspirations at multiple sites were unsatis-factory and yielded only a dilute sample with 22% blasts. In cytochemical examinations, a large number of blasts were α-naphthyl butyrate esterase negative, acid phosphatase homogeneously positive and myeloperoxidase negative. Additionally, a few blasts were myeloperoxidase positive, acid phosphatase negative and Sudan black B positive. Ultrastructural cytochemical examination also demonstrated the existence of two different types of blasts, most of the blasts were platelet peroxidase positive and some of them were negative. A definite diagnosis of acute megakaryoblastic leukemia with another type of blasts was made by cytochemical and EM investigations.
Chromosomal analysis revealed trisomy (+8, +10), translocation of 3p and other abnormalities in some cells.
She is in partial remission after BH-AC·AMP therapy and an autologous bone marrow transplantation was performed.
Determinations of serum lactic dehydrogenase, serum and urine muramidase levels were useful for the follow up studies of her clinical course, and they might be of diagnostic importance.抄録全体を表示PDF形式でダウンロード (927K) -
花田 尚, 小野 一朗, 中原 智子, 長沢 俊郎, 滝田 齊1986 年 27 巻 12 号 p. 2340-2343
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA thrombocytopenic neonate was born to the mother with chronic ITP splenectomized eighteen months before delivery with an increase in platelet count to the normal level. Passive ITP was suspected because the platelet-associated IgG of the mother around delivery was significantly high. High-dose immunoglobulin therapy was effective for thrombocytopenia of the neonate. The serum platelet-binding IgGs of both the mother and the neonate were significantly high and the diagnosis was confirmed.抄録全体を表示PDF形式でダウンロード (327K) -
篠原 慶希, 甲斐 俊朗, 若栄 喜文, 藤盛 好啓, 神前 昌敏, 金丸 昭久, 伊福 秀貴, 大江 与喜子, 原 宏, 永井 清保1986 年 27 巻 12 号 p. 2344-2349
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 34 year-old male with acute myelofibrosis was successfully treated with allogeneic bone marrow transplantation, who had suffered from myelodysplastic syndrome (FAB classification RARS) for two years prior to evolution of myelofibrosis. Combination chemotherapy of BHAC·DVP could give him only partial response and then allogeneic bone marrow transplantation was attempted with the conditioning of usual manner, which resulted in complete resolution of myelofibrosis and also complication of grade III acute graft versus host disease (GVHD; skin ( ?? ), liver (+), gut ( ?? )). Oral administration of ciclosporin A was not effective because of malabsorption due to severe diarrhea. But acute GVHD subsided somehow after methyl-prednisolone pulse therapy followed by ciclosporin A. Then, he suffered from obvious chronic GVHD including idiopathic pericarditis, scleroderma and chronic hepatitis after day 300, but these complications were overcomed by a treatment with azathioprine and ciclosporin A. Now he is still in complete remission with Karnofsky P.S. 80% for more than 800 days after bone marrow transplantation. This was a suggestive case from several aspects of the indication of bone marrow transplantation for acute myelofibrosis and the managements of acute and chronic GVHD.抄録全体を表示PDF形式でダウンロード (592K) -
宮城島 拓人, 黒川 美朝, 大饗 由之, 国枝 保幸, 髭 修平, 後藤田 泰也, 田中 淳司, 田村 康史, 樋口 晶文, 今村 博幸, ...1986 年 27 巻 12 号 p. 2350-2355
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 63-year-old male was admitted to Kushiro Rosai Hospital because of sudden onset of headache, nausea and vomiting. Pysical examination revealed disturbance of consciousness, nuchal stiffness and positive Kernig sign. There was also a subcutaneous abscess at the sacral region. Cerebro-spinal fluid examination did not disclose pleocytosis, but showed abundant gram positive cocci, which were identified as pneumococci later. The initial diagnosis, thus, was pneumococcal meningitis, but further hematological evaluation revealed that he also had AMoL. He then developed DIC and acute respiratory failure, and eventually succumbed to death within 24 hours after admission. Autopsy findings were compatible with infectious meningitis, and also revealed leukemic cells invading the subarachnoid space, especially around the veins. These findings were suggestive of early stage of meningeal leukemia.抄録全体を表示PDF形式でダウンロード (721K) -
服部 豊, 新保 卓郎, 大島 充一, 三方 淳男, 田村 昭蔵, 外山 圭助1986 年 27 巻 12 号 p. 2356-2360
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありWe report a case of ovarian non-Hodgkin lymphoma with brief review of the previously reported cases.
A 48 year-old woman complained of left flank pain for two years. She had been pointed out to have a myoma of the uterus on occasion of the routine health check. In July 1984, hysterectomy was carried out for the uterine myoma at Keio University Hospital. During operation, a left ovarian tumor was found incidentally, and adenexectomy was performed. Diagnosis of non-Hodgkin lymphoma (diffuse medium sized cell type) was made by pathological examination. Enzyme immunohistochemistry revealed cytoplasmic IgM (λ) staining in lymphoma cells. Since no other involvement was found with post-operative examinations such as abdominal CT scan, lymphangiography and total body Ga scinti scan, this case was diagnosed as a primary ovarian lymphoma. Following 6 courses of post-operative CHOP therapy, she has been maintaining complete remission for 17 months after the operation.
Reviewing literatures, we found primary ovarian lymphoma very rare. In addition, poor prognosis is suggested because of advanced stage of the disease at the time of diagnosis. In the present case, however, long survival would be expected as lymphoma was successfully excised as a small lesion.抄録全体を表示PDF形式でダウンロード (413K) -
高橋 隆幸, 二宮 宏, 平間 敏靖, 林田 済, 市場 茂樹, 奥野 芳章, 杉山 裕之, 井村 裕夫, 中村 紀士子, 伊保 澄子, 星 ...1986 年 27 巻 12 号 p. 2361-2365
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありA 71-year-old female was admitted because of fever and malaise. Physically marked pallor was noted. Laboratory investigation revealed severe leukopenia and anemia which required frequent blood transfusions. A bone marrow aspirate showed a markedly hypocellular marrow with 55.6% blast cells. Peroxidase activity and PAS reaction were negative in the blast cells. Surface markers of the blast cells, such as T, B, or myeloid antigens, were all negative except for the Ia like antigen.
A diagnosis of hypoplastic leukemia was made and in September, 1985, treatment with alfacalcidol (2-4 μg, daily) was started. Under this treatment the hemogram showed remarkable improvement and the patient became symptom-and transfusion-free. A bone marrow aspirate in November, 1985, demonstrated regeneration of normal hemopoietic cells with distinct reduction of blast cells (5.4%). From January, 1986, the leukemia became gradually refractory to alfacalcidol. The dosage of the drug was elevated up to 8 μg/day and administrated intermittently with a cycle of 5 days to minimize the side effects. However, this treatment was not helpful and the bone marrow examined in February, 1986, showed a recurrence of the leukemia. In March, 1986, the hemogram returned to pancytopenia and transfusions were needed. At the end of March, 1986, low dose Ara-C (7.5 mg/day) was started in addition to alfacalcidol (3 μg/day) without any benefitial effect.
During the treatment with alfacalcidol there was no hypercalcemia, although urinary calcium levels occasionally exceeded the normal range.
This patient is the first reported case of acute leukemia successfully treated with alfacalcidol alone.
Incubation of the bone marrow cells obtained in March, 1986, with 1α, 25 (OH)2D3 for 1 to 5 days, resulted in the dose-dependent reduction of absolute number of cells. While, no evidence of differentiation of leukemic cells was obtained, suggesting cytostatic effect of 1α, 25 (OH)2D3 rather than induction of differentiation in this patient.抄録全体を表示PDF形式でダウンロード (382K) -
酒井 泰征, 柴山 真介, 本定 晃1986 年 27 巻 12 号 p. 2366-2370
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありMetastatic lymphoma to the heart is difficult to diagnose antemortem. This report presents a patient with malignant lymphoma who developed cardiac tamponade when peripheral lymphonodes were not so much enlarged. Two-demensional echocardiography showed massive pericardial effusion. Cytological examinations of pericardial effusion were interpreted as class III a. Flow cytometric evaluation of pericardial effusion revealed abnormal monocyte-like cell group (OKIa1: +, Leu12: +, OKT3: -, OKM5: -, OKM8: -) and normal lymphocyte group. These results suggested metastatic B-cell lymphoma to the pericardium, which was identified by the axillary lymphonode biopsy.
Flow cytometric evaluation of pericardial effusion can be valuable for detection of metastatic lymphoma to the pericardium at an earlier stage when peripheral lymphonodes are not so enlarged or cause of pericardial effusion is not determined.抄録全体を表示PDF形式でダウンロード (421K)
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1986 年 27 巻 12 号 p. 2373-2379
発行日: 1986年
公開日: 2009/02/02
ジャーナル 認証ありPDF形式でダウンロード (636K)
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