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Volume 28, Issue 11
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Yoshikazu AKAHONAI, Masayuki ARASHI, Masamitsu MORI, Toshikazu HOSOKAW ...1987 Volume 28 Issue 11 Pages 1909-1915
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIt has been emphasized that a monoclonal IgA with a polymeric form frequently induced the hyperviscosity syndrome in patients with IgA myeloma. In the present study, the hyperviscosity syndrome was observed in two of 11 patients with IgA myeloma. We also demonstrated that high speed liquid chromatography was a useful tool in separating polymemic and monomeric IgA with more accuracy and ease than has been reported with any previous methods. By using this technique, it is suggested that the relative serum viscosity in patients with IgA myeloma may correlate well with serum monoclonal IgA concentration rather than with the polymeric form of the monoclonal IgA.View full abstractDownload PDF (578K) -
Hideki MITSUI, Yasufumi OHSUGA, Masashi NAKAGAWA, Hirofumi TESHIMA, Ta ...1987 Volume 28 Issue 11 Pages 1916-1921
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIn the last 10 years, we carried out allogeneic bone marrow transplantation (BMT) in 35 cases. The 2-year survival rates were 20% for the group of the first 20 cases (1976-May 1984) and 93% for the group of the remaining 15 cases (July 1984∼1986). There were several changes of the method of BMT among these two groups. One important change was the selection of patients for BMT; we came to transplant during the first remission of acute leukemia or the chronic phase of chronic myelocytic leukemia. Another important change was the prevention of interstitial pneumonitis (IP), i.e., selection of cytomegalovirus (CMV) seronegative donors for platelet transfusion, prophylactic administration of anti-CMV high titer gammaglobulines, lung shielding, and fractionated total body irradiation. Moreover, use of human urinary colony-stimulating factor for the stimulation of recovery of leukocytes count, and prophylaxis of graft-versus-host disease by the use of ciclosporin A have been started. By these changes, no death by IP or by infection, rapid engraftment of bone marrow cells, and no relapse were seen. Consequently, these changes were considered to have brought the marked increase in the survival rate after transplantation.View full abstractDownload PDF (481K) -
Masayuki SOMA, Yosihisa MAEDA, Masahiro MURAKAMI, Shinpei KASAKURA, Hi ...1987 Volume 28 Issue 11 Pages 1922-1927
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIn order to elucidate the reason for an age-related increase of thrombotic disorders, this study was designed to investigate age-related changes in the plasma levels of fibrinolysis factors including plasminogen, α2AP and t-PA antigen as well as the plasma PA activity.
The obtained results were as follows:
(1) The plasma plasminogen did not differ depending on age or sex.
(2) The plasma α2AP levels significantly declined in age-related manners in both sexes.
(3) The t-PA antigen concentration in plasma elevated progressively in an age-related manner in female, while it reached a maximum in middle-aged group in male.
(4) PA activity levels did not differ depending on age in both sexes.
In summary, these results suggest that age-related physiological changes in fibrinolysis activity do not play a major role in an age-related increase of thrombotic diseases.View full abstractDownload PDF (422K) -
Hideho WADA, Kazuyuki ATA, Lisa SHIRATO, Hiroo MORI, Takashi SUGIHARA, ...1987 Volume 28 Issue 11 Pages 1928-1934
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFive adult patients with refractory idiopathic thrombocytopenic purpura (ITP) were treated with slow infusions of Vinca-alkaloid (V-A), over a 6-hour period, at weekly intervals for at least 10 weeks. One patient had excellent response sustained for at least 3 months without any further maintenance therapy. Two patients had good response sustained by maintenance therapy. Two patients had fair response. Mild transient peripheral neuropathy was observed in five cases. Transient local pain at the site of infusion with vinblastine was observed in three out of four cases. The increased platelet-associated IgG (PAIgG), as measured by ELISA method, was not normalized even after the infusions in all five cases. The V-A slow infusion appears to be beneficial to ITP refractory to other therapies.View full abstractDownload PDF (411K) -
Yasuo YOKOMATSU, Hitoshi SAGAWA, Takahisa YAMANE, Motofumi HIYOSHI, At ...1987 Volume 28 Issue 11 Pages 1935-1940
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESS23 patients with acute leukemia and other related disorders were treated with “B-triple V” therapy, a combination protocol of VP-16, BHAC, vincristine and vinblastin. Twelve out of seventeen patients achieved complete remission (CR ratio: 70.6%) disregarding five patients died in the course of the chemotherapy. CR ratio in “typical leukemia” patients was 83.3% but the rate in “atypical leukemia” patients, those with leucopenia, bone marrow hypoplasia or acute leukemia related diseases, was 40.0%. Four out of nine patients with “atypical leukemia” were died in the course of the chemotherapy, having extremely low WBC count in Nadir state.
“B-triple V” therapy is thought to be a excellent initial induction treatment in typical leukemia patients, but in atypical leukemia patients, this therapy must be used with more carefullness.View full abstractDownload PDF (432K) -
Hiromu MUCHI, Takami SATOH, Yoko TANIGUCHI1987 Volume 28 Issue 11 Pages 1941-1947
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFourty-six children with acute lymphoblastic leukemia (ALL) were treated with intermediate dose methotrexate (patients admitted before 1981; and JPL750 and standard risk group; JPL810) or 18 Gy prophylactic cranial irradiation (high rist group; JPL811). For the evaluation of neurological complication in the treatment of ALL, electroencephalogram, CT scan, I.Q., evoked potentials, and soft neurological signs were examined on the 28 children who survived more than 2 years. The fact that five-year disease free survival rate was 90.9% in both JPL810 and JPL811 indicated the effectiveness of these protocols. Electroencephalogram and visual evoked potential were useful for the assessment of central nervous system abnormalities in the ALL children. Those who had central nervous system disease tended to have more serious CNS disability.View full abstractDownload PDF (515K) -
Masako KATOH, Tatsuo SHIRAI, Masanori UMEDA, Ryozo YAMAGUCHI, Haruo KA ...1987 Volume 28 Issue 11 Pages 1948-1955
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe O2- production with myristate stimulation from human neutrophils (PMNs), which were preincubated with ara-C, Behenoyl-ara-C (BHAC), DM, ADM, Aclacinomycin (ACM) and VCR was measured. BHAC agent and ACM were shown to depress O2- production by PMNs dose-dependently; Their 50% inhibition concentrations were about 6 μg/ml for BHAC agent and 20 μg/ml for ACM. Other drugs showed no such an inhibitory effect on it.
This inhibition on O2- production by ACM was independent on the preincubation time with PMNs. Since ACM and BHAC agent did not interfere with O2-, which was released by xanthine-xanthine oxidase system, their inhibitory effect should be directed to PMNs. ACM must inhibit the stimulating or activating mechanism of PMNs, because it did not inhibit the NADPH oxidase activity at all, which is thought to be a key enzyme of O2- formation in PMNs. As BHAC agent contains much detergent, this should be the main reason for inhibiting effect on O2- production by PMNs.
Since the patients with AML would be more susceptible to infection when treated with BHAC agent and ACM, it is important for us to avoid and prevent infection more strictly, whenever these drugs are used.View full abstractDownload PDF (527K) -
Shigeki MOTOMURA, Tahei NOGUCHI, Heiwa KANAMORI, Takashi MURATA, Hiros ...1987 Volume 28 Issue 11 Pages 1956-1962
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe effect of oral high-dose amphotericin B (AMPH) was studied in 11 patients with acute leukemia. All patients received 2,400 mg/day of AMPH. Concentrations of AMPH in serum were measured 4 hours after medication. The mean serum concentration was 0.16±0.11μg/ml on the first day and 0.23±0.11μg/ml on the third day. Fungi were detected in about 5% of the cultivation of stool and sputum from the patients who received 2,400mg/day of AMPH and no fungi were found in the blood culture. In addition, all patients didn't show symptoms or signs of systemic mycosis during high-dose administration of AMPH. On the other hand, fungi were detected in about 20% of the cultivation of stool and sputum from 29 patients who received 800 mg/day of AMPH. We concluded that oral high-dose AMPH had prophylactic effect for fungal infection and was useful for chemotherapy in acute leukemia.View full abstractDownload PDF (552K) -
Hideo NAKAMURA, Naoki SADAMORI, Ippei SASAGAWA, Takahiro ITOYAMA, Ei-i ...1987 Volume 28 Issue 11 Pages 1963-1970
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFive patients with erythroleukemia (EL), defined as M6 by the French-American-British (FAB) classification revised in 1985, were studied.
Chromosomal analyses of bone marrow cells revealed complex karyotypic abnormalities in two patients and normal karyotype in the others. The two patients with complex abnormalities were refractory to chemotherapy and had a very poor prognosis. On the other hand, two out of three patients having normal karyotype had a relatively long survival without remission, and the other one entered a complete remission after treatment.
Furthermore, erythroblasts of all the patients with normal karyotype were negative or weakly positive to periodic acid-Schiff (PAS) reaction, although those of many patients having EL with chromosomal aberrations in the literature were positive to PAS reaction. It was also suggested based on the data of patients in the literature that Auer bodies in myeloblasts might be specific to EL with normal karyotype.
Accordingly, we suggest that EL defined as M6 by the revised FAB classification is cytogenetically heterogeneous and that chromosomal finding is an important prognostic indicator in EL (M6).View full abstractDownload PDF (1427K) -
Naoyuki KATANO, Masahito TSURUSAWA, Makoto NIWA, Susumu KAWAI, Takeo F ...1987 Volume 28 Issue 11 Pages 1971-1977
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSCellular DNA content distributions of bone marrow blasts were determined by flow cytometry for 102 children with acute leukemia and the relationship between the proliferative fraction of leukemic blasts and the clinical features was studied. There was no significant difference of the percentage in S-phase cells between the patients with a normal DNA stemline and those with a hyperdiploid DNA stemline. In the groups with normal DNA stemlines, the percentage of S-phase cells was significantly higher in ALL than in ANLL. In both ALL and ANLL, no significant differences were detected between the patients being in a continuous complete remission and those who have failed to their treatment. The percentage of S-phase cells in ALL patients with a normal DNA stemline positively associated with the unfavorable prognostic factors (high WBC counts, age>6yr and absence of CALLA). When continuous complete remission curves in 24 common ALL cases with normal DNA stemline were compared for a proliferative fraction of leukemic blasts, the group with 14%< of S-phase cells showed a better treatment response than that with 14%> of S-phase cells. These findings suggest that the percentage of S-phase cells determined by flow cytometry is a biological prognostic factor in ALL and is useful to design the treatment schedule of the cycle specific drugs.View full abstractDownload PDF (517K) -
Minoru FUKUDA, Keizo HORIBE, Seiji KOJIMA, Takaharu MATSUYAMA, Tetsuyu ...1987 Volume 28 Issue 11 Pages 1978-1981
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTotal parenteral nutrition (TPN) was given to 20 children who underwent bone marrow transplantation during whole period of isolation. A few patients had metabolic imbalance during TPN, including serum total protein, blood sugar, serum potassium and serum zinc. However, TPN caused no significant nutritional trouble. In bone marrow transplantation for children, TPN can make nutritional management easier and keep patient cleaner than enteral nutrition by sterile foods.View full abstractDownload PDF (305K) -
Norifumi TSUKAMOTO, Masamitsu KARASAWA, Hiromasa YAMAUCHI, Eishi NOGIW ...1987 Volume 28 Issue 11 Pages 1982-1989
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAmong 134 patients with adult acute nonlymphocytic leukemia who achieved remission since 1973, 12 patients maintained continued remission for more than 5 years. Attempts were made to identify some clinical characteristics of such long-term disease-free survivors.
They included 4 males and 8 females. The average age at diagnosis was 44 years old. FAB subtype was M1; 1, M2; 8, M3; 2 and M4; 1. Various remission induction regimens were given; 1 patient with DP, 2 with AVCP, 4 with DCMP two-step and 5 with BH-AC·DMP. Four patients received cyclic maintenance therapy with COAP intensification, and 8 were maintained by araC/6MP regimen. The initial remission was maintained in 10 patients, while 2 cases relapsed after 9 months, and the second remission was maintained. One patient with M3 relapsed after 8 years.
The relatively low WBC count and low serum LDH level, and the presence of Auer bodies were extracted as statistically significant features of the long-term relapse-free survivors.View full abstractDownload PDF (598K) -
Tetsuo HASHIMOTO, Nanao KAMADA, Hiroshi UEOKA, Hisashi YAMAMOTO, Masak ...1987 Volume 28 Issue 11 Pages 1990-1999
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSRelationship among numerical and structural chromosome abnormalities in human hematopoietic neoplasms were statistically analysed. The data used in the analyses were the karyotypes listed in “Catalogue of Chromosome Aberrations in Cancer” edited by Mitelman (1983 and 1985).
Additional abnormalities, such as +22q-, +8, i (17q), +19, etc. were frequently observed in the patients of chronic myelocytic leukemia (CML) with t (9; 22). Significantly positive correlations were found between +22q- and other types of abnormalities except i (17q), -7, -Y. The combinations of two abnormalities, such as +22q- and +8, +22q- and +19, +8 and +19, +8 and i (17q), were positively correlated each other. In the patients of acute myelocytic leukemia (AML M2 of FAB classification), t (8; 21) had significant positive correlations to -X, -Y, and del (9q). In the patients of acute lymphocytic leukemia (ALL L1, L2), no relationship was observed between translocations of 9; 22 or 4; 11 and numerical abnormalities, such as +8, +18, +21.
These statistical analyses of chromosome abnormalities would be useful for the elucidation of carcinogenesis in several malignant neoplasms.View full abstractDownload PDF (698K)
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Akira SHIBUYA, Haruhiko NINOMIYA, Masaki NAKAZAWA, Toshiro NAGASAWA, Y ...1987 Volume 28 Issue 11 Pages 2000-2003
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of congenital antithrombin III (ATIII) deficiency is reported. An 18 year-old male was admitted to hospital because of convulsion in April, 1986, and diagnosed as superior sagital sinus thrombosis. Thrombosis of left leg veins and of inferior vena cava developed in May, and he was refered to the Tsukuba University Hospital in June, 1986.
Physical examination was almost normal. Laboratory examinations of blood count and blood chemistry showed no significant abnormality. ATIII concentration was 12.0 mg/dl using single radial immunodiffusion. The heparin cofactor activity was 35%; and the progressive antithrombin activity was 45% showing all remarkably low level. The ATIII level of his mother, aunt and cousins were also decreased. Both his mother and aunt each had a thrombotic episode of their leg veins; but not his cousins.
Two weeks after initiation of therapy with warfarin and oxymetholone, the ATIII level almost attained to the normal range and thrombosis of inferior vena cava disappeared. We conclude that therapy with warfarin and oxymetholone is useful for the acute phase of thrombosis in patients with congenital ATIII deficiency.View full abstractDownload PDF (301K) -
Masanori UMEDA, Zensei NOJIMA, Ryozo YAMAGUCHI, Masako KATO, Mikio YAM ...1987 Volume 28 Issue 11 Pages 2004-2009
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwo patients with acute promyelocytic leukemia (APL) with marked basophilia are reported. The first patient was a 53-year-old female, who was found to have 73.2% bone marrow blasts and 18% basophils in the peripheral blood; her blood histamine value was high. The second patient was a 57-year-old female. She also had a high serum histamine value, while her karyotype was 46, XX, t (15; 17).
In both patients, leukemic cells were myelo-peroxidase-strong positive, and the proportion of toluidine blue-metachromatic nucleated cells found in the bone marrow was 22% in the first patient and 60% in the second. Faggot cells were found in both patients. As for leukemic colony studies, most colonies contained basophils (May-Grünwald-Giemsa staining) as well as toluidine blue-metachromatic cells.
Both of these cases were a variant type of APL, whose leukemic cells have the ability to differentiate into basophils. Our results suggest that the leukemic colony study is a useful tool for the demonstration of the capacity of leukemic cells to differentiate into basophils in such APL cases.View full abstractDownload PDF (641K) -
Hisashi SAKAMAKI, Kanji WATANABE, Nobue WATANABE, Hiroyuki HAMAGUCHI, ...1987 Volume 28 Issue 11 Pages 2010-2016
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of pure red cell aplasia with erythropoietic maturation arrest was reported. A 28-year old housewife was admitted to our hospital in October 1983 because of shortness of breath. Normocytic anemia (Hb: 6.8g/dl ) with no reticulocytes was observed in the peripheral blood. Immature erythroblasts were increased in the bone marrow (10.8%), though mature erythroblasts were much decreased (1.0%). Granulocytic and megakaryocytic series were normal. Erythropoietin level was high in the serum.
Patient's serum and IgG but not her peripheral blood lymphocyte suppressed human CFU-E and BFU-E colony growth and heme synthesis in vitro. Her serum also produced erythroblast cytotoxicity depending on complement. Although prednisolone yielded only a partial response and azathioprine was not effective at all, complete remission was achieved by cyclophosphamide followed by high-dose intravenous bolus methylprednisolone.View full abstractDownload PDF (546K) -
Hideyo NATORI, Kazuyuki NATORI, Taishi NAKAGOSHI, Katunobu NAITO, Eiji ...1987 Volume 28 Issue 11 Pages 2017-2022
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 35-year-old male was admitted to our hospital because of fever. The lymph nodes, liver and spleen were not palpable.
Haematological examinations revealed leukocytes 1,600/μl with 13% leukemic cells and platelets 6,000/μl. Bone marrow smears revealed 72% leukemic cells. Leukemic cells in the bone marrow were classified into 43% small, 24% intermediate, 14% large cells, and 19% reticulum cells with phagocytosis. Intermediate cells were similar to monoblasts, and large cells to promonocytes. Small cells, monoblasts, promonocytes and reticulum cells had Auer rods.
Mature neutrophils with Auer rods were not rare, but mature reticulum cells with Auer rods rare. Reticulum cells have been thought to be derived from monocytes in the bone marrow in vitro. By the observation of this case, it is clear that monocytes could differentiate into reticulum cells in vivo.View full abstractDownload PDF (1108K) -
Takashi OKAMURA, Hiroshi HAYAKAWA, Ikuo SUMIDA, Motosuke HANADA, Sachi ...1987 Volume 28 Issue 11 Pages 2023-2028
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 64-year-old female was admitted to Karatsu Red Cross Hospital for further analysis of abnormal peripheral blood findings.
A peripheral blood examination showed Hb 9.0 g/dl, WBC 4,000/mm3 and platelets 670×103/mm3. Classification of leukocytes revealed 33% of blasts and many micromegakaryocytes (44/100W). A bone marrow examination revealed hypercellular and was occupied by 70% of blasts. Platelet producing megakaryocytes were increased in number.
Cytochemistry of the blasts revealed positive for PO and negative for nonspecific esterase, PAS and specific stainings for megakaryoblasts. OKIal and My 7 were positive in surface marker analysis. Chromosome study showed 46, XX, t (3; 7; 11) (q26; p22; q21), del (2) (p23). Decrease of the A antigenicity of the red blood cells was also found. These finings suggested that the leukemic blasts were grouped to AML (M1) in FAB classification and CFU-C committed myeloid progenitor cells. Abnormality of chromosome 3q may be responsible for marked thrombocytosis and megakaryocytosis.View full abstractDownload PDF (644K) -
Toshitaka KOBAYASHI, Takashi HANADA, Yuji SATO, Akira SHIBUYA, Haruhik ...1987 Volume 28 Issue 11 Pages 2029-2033
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report here a case of pure red cell aplasia (PRCA) with benign monoclonal gammopathy. The patient, an 82-year-old female, was treated on separate occasions with cyclophosphamide 100mg/day for 6 weeks and 11 weeks. Transient reticulocyte response occurred following each therapy. Inhibitory T cells to CFU-E were examined by pre-treatment of patient's own bone marrow cells with anti-lymphocyte globulin and complement and by their removal from the bone marrow cells. Activities of these T cells were detected before starting both therapies but were not during the first reticulocyte response. The inhibitroy activity of cryopreserved T cells to autologous CFU-E was serially assayed during hematological response. The inhibitory activity was closely correlated with the clinical status of erythropoiesis. Patient's serum and IgG taken on admission did not show inhibitory activity to CFU-E growth from her own bone marrow cells. M-protein did not disappear during both courses of therapy. It is suggested that further intensive immunosuppressive therapy is requried for complete remission of PRCA in this case.View full abstractDownload PDF (376K) -
Hiroto UEBA, Kunihiko ITO, Nobuhide TAKEDA, Naohisa FUJITA, Masao NAKA ...1987 Volume 28 Issue 11 Pages 2034-2038
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old female was admitted to our service with the relapse of acute myeloblastic leukemia (AML, M2). After BH-AC·AMP therapy, patient developed a high fever and it did not respond to antibiotics, and developed a right hypochondralgia. An ultrasonography showed diffuse hypoechoic areas in the liver and computed tomography also showed multiple low density areas. Furthermore, serum D-arabinitol level was elevated. Therefore, we suspected a complication of liver abscess due to candida infection and administered 600 mg/day of miconazole (total dose 9.0 g). Immediately after starting this therapy, clinical findings were improved and the sizes of multiple low density areas in the liver on computed tomography were markedly reduced, and a complete remission was attained. However, 4 months later, the exacerbation of inflammatory findings and the increase of low density areas in the liver were detected. Miconazole was started again (total dose 24g) and these findings were remarkably improved.
Through the analysis of this case study, we confirmed the utility of quantitative anlysis of serum D-arabinitol as the early diagnostic method of systemic candidiasis, and the usefulness of diagnostic imaging using both computed tomography and ultrasonography, and also it was proved that miconazole had few side effects and it was effective to the intractable systemic candidiasis.View full abstractDownload PDF (899K) -
Yasunori TOYODA, Tsutomu TONOUCHI, Jun-ichi MIMAYA, Minoru HAMAZAKI, S ...1987 Volume 28 Issue 11 Pages 2039-2044
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAn autopsy case of transient abnormal myelopoiesis (TAM) is reported. A 1-day-old male with Down's syndrome was referred to the Shizuoka Children's Hospital because of imerforated anus and generalized cyanosis. Labratory data showed leukocytosis with many blast cells, but anemia and thrombocytopenia were not recognized. We considered that TAM evoked leukocytosis and no therapeutic measurement was applied. The patient died 26-day old because of cardiac complication.
Fifty % of blast cells in peripheral blood were of megakaryocytic lineage which was determined by monoclonal antibody identification of cell-specific surface antigens, and platelet peroxidase staining observed by electron microscopy, and 10% of blast cells were found positive for myeloperoxidase staining observed by electron microscopy.
Chromosome analysis with and without PHA stimulation proved both 46XY, +21. On postmortern examination, extramedullary hematopoiesis or infiltration of blast cells were not revealed, but the infiltration of matur and immature megakaryocytes was revealed in many organs.
Cellular change from large mononuclear blast cell to mature megakaryocyte was considered in bone marrow histology.
Findings mentioned above indicate that TAM is a disorder of pulripotent stem cell level and blast cells in TAM tend to differentiate to megakaryocytic lineage in vivo.View full abstractDownload PDF (1111K) -
Hiroyuki NOZAKI, Keiko TANAKA, Masaki SHIMIZU, Mitsumoto KOMATSUDA, Ta ...1987 Volume 28 Issue 11 Pages 2045-2049
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSHemophilia A is a sex-linked, recessive hemorrhagic disorder caused by defect in the intrinsic clotting factor VIII. A 65-year-old apparently normal male with hemophilia A associated with syndactyly was admitted to our hospital for extraction of teeth. His parent had already died and no sib except him. He has four sons who have neither bleeding tendency nor malformations of the limbs. This patient showed syndactyly, in which only the skin was jointed, between the middle and ring fingers in both hands, and between the fourth and little toes in the left foot. Chromosome analysis by peripheral-blood leukocyte cultures showed a karyotype with normal 46 chromosomes (XY) and a karyotype comprised of 45 chromosomes with a single X chromosome (45, XO).View full abstractDownload PDF (577K) -
Shyuhei HIGE, Fumio ISHIZAKA, Teiichi HIRANO, Yoshitomo KUROKAWA, Taku ...1987 Volume 28 Issue 11 Pages 2050-2054
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 72-year-old Japanese man, who was born and grown in Hokkaido prefecture where is an ATL-non-endemic area, was admitted to Kushiro Rosai Hospital because of papular eruption on his extremities on August 6, 1986. He had been irradiated for laryngeal cancer the year before and had been free of recurrence. Admission laboratory findings showed that the WBC count was 42,400/μl, 45% of which was atypical lymphocytes, and anti-ATLA antibody was 1,024 times positive. Thus, the diagnosis of ATL was established. The serum IgG level was elevated and IgG-κ type monoclonal protein was identified by the immunoelectrophorasis. Bone marrow aspiration failed to show the proliferation of plasma cells, and no bone lesion was found. Based on these studies, the benign monoclonal gammopathy of this case seems to be related to ATL. Despite of the chemotherapy with Vincristine, Predonisolone and Adriamycin, the patient eventually expired of pneumonia about 8 weeks later.
HTLV-I infected lymphocytes are reported to alter immune function. Therefore, this case might indicate the possibility that HTLV-I infection is responsible for the association between ATL and monoclonal gammopathy or multiple primary malignant neoplasms.View full abstractDownload PDF (798K) -
—Identification by ABC Immunoperoxidase Technique Employing Monoclonal Antibody (HPL1 and HPL7) Reactive with GPIIb-IIIa and GPIb—Ryoichi KATO, Takashi OGURI, Mariko AIHARA, Yoshiro KATO, Yuzuru SUGAW ...1987 Volume 28 Issue 11 Pages 2055-2061
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old male was admitted to our hospital because of fever and bleeding diathesis in November 1985. The patient had pancytopenia with a low percentage of blasts in peripheral blood (PB), and high values of serum V.B12 and ferritin.
On cytochemistry of blasts in PB, myeloperoxidase and PAS were negative, ANAE was positive and acid phosphatase was slightly positive. Bone marrow puncture resulted in dry tap, and bone marrow (BM) biopsy showed almost normal cellularity with moderate proliferation of undetected blasts (possible myelo-and megakaryoblasts) and marked myelofibrosis.
Consequently, a diagnosis of acute myelofibrosis was made. Following combination chemotherapy of dialy SM108 and weekly VCR (1mg/body), the patient was treated with low dose Cytosine arabinoside (dialy 20mg/body) for 14 days. However, the treatment was ineffective.
The man died of pneumonitis and sepsis in March 1986. An autopsy showed that characteristics of the blasts in BM were more clearly positive surface GPIIb-IIIa (HPL1) than GPIb (HPL7) by means of ABC immunoperoxidase technique employing monoclonal antibody. These blastic cells infiltrated the liver, spleen, lymphnodes and kidneys.
Our findings led to the diagnosis of coexistent myelo-megakaryoblastic leukemia and acute myelofibrosis. Therefore, the relation between acute megakaryoblastic leukemia and acute myelofibrosis has been discussed for the past few years.View full abstractDownload PDF (1077K) -
Tsunehisa KAWASAKI, Yukitoki IKEHARA, Hiroshi NAKAYASHIKI, Hiroyuki SU ...1987 Volume 28 Issue 11 Pages 2062-2067
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old male was admitted to Kyoto Minamiteishin Hospital because of general fatigue and appetite loss in September, 1984. Physical examination disclosed generalized lymphadenopathy. A diagnosis of malignant lymphoma (pleomorphic type) was made by a cervical lymph node biopsy. The CBC showed a white cell count 42,900/mm3 with 91% neutrophils and a platelet count 79.9×104/mm3. A bone marrow aspirate from the sternum revealed marked granuloid hyperplasia and increased number of megakaryocytes. Bacteriologic examinations were always negative.
The conditioned medium from the primary culture of lymph node cells (LN-CM) from the biopsy specimen was obtained for the examination of detectable colony stimulating factor (CSF) and megakaryopoietic CSF (Meg-CSF) in it. The LN-CM clearly promoted both granulocytic and megakaryocytic colony formation of human bone marrow cells in vitro. Also CSF and Meg-CSF were detected in the patient's plasma obtained before treatment.
The patient was treated with prednisolone, adriamycin, cyclophosphamide and vincristine. Initially, the patient responded well to the treatment; the superficial lymphadenopathy disappeared and the white cell and platelet count returned to the normal level. However, after a short period of remission, the lymphadenopathy reappeared being accompanied by the granulo-thrombocytosis. The chemotherapy was not succesful and the patient died of pneumonia in April, 1985.
This patient is the first reported case of malignant lymphoma concomitantly producing CSF and Meg-CSF.View full abstractDownload PDF (492K) -
Fumi MIZOROGI, Yasumoto SUZUKI, Minako OHHASHI, Masaharu HORIGUCHI, To ...1987 Volume 28 Issue 11 Pages 2068-2072
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a case of right optic nerve infiltration as the only manifestation of recurrence of the leukemic process. A 63-year-old woman was diagnosed as acute myelocytic leukemia (M1 of FAB) in March 1984. Complete remission was achiedved and sustained by courses of combination chemotherapy and prophylactic intrathecal chemotherapy. In Sep 1984, right visual disturbance and optic disc edema developed, and systemic chemotherapy was effective in resolution. The disc edema recurred in May 1985, followed by loss of right vision. Then examinations of bone marrow and cerebrospinal fluid showed no abnormalities. Computed tomographic scan demonstrated an enlarged right optic nerve led to the diagnosis of leukemic infiltration of the optic nerve. She received irradiation of 60Co with resolution of fundal appearance and CT image, but visual acuity was not improved. Though this observation leads to the conclusion that the optic nerve does not belong to the pharmacological sanctuary, the radiation therapy for optic nerve involvement with leukemia should be initiated as soon as possible, because these infiltrations may result in irreversible loss of vision.View full abstractDownload PDF (989K)
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