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Volume 29, Issue 6
Displaying 1-21 of 21 articles from this issue
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Kazunori WAKASUGI, Masataka SAKAMOTO, Hiroaki NAKAMURA, Kaoru IGARASHI1988 Volume 29 Issue 6 Pages 787-794
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSHuman T-cell lymphotropic virus type-1 (HTLV-I) is known to be associated with adult T-cell leukemia/lymphoma (ATL). We have investigated 10 cases of serotransmission by using particle agglutination and Western blotting method in which infections due to HTLV-I by blood transfusions were supposed. The changes of ATL-associated antibodies were analysed after serotransformation in three stages that is, the early-IgM type, the intermediate-changes in IgM to IgG type and the late-IgG type stage. We have also analysed the ATL-associated antibodies in 30 cases of healthy virus carriers as control.
The following results were obtained;
1) In most cases, antibodies of p 19, p 24 and p 53 were detected.
2) A core protein p 24 may be an early response in HTLV-I infections.
3) The elevated IgM type and the expression of IgG type antibodies to p 19/p 24 and p 53 in the early stage were detected and the synthesis of both IgM and IgG antibodies to p 28/p 32 and p 35 in the late stage were observed. IgM type antibodies were though to slowly decrease and switch to IgG type antibodies.
4) It was strongly suggested that these data could be characterized in each stage by HTLV-I infections.View full abstractDownload PDF (1145K) -
Junichi MIMAYA, Yasunori TOYODA, Tsutomu TONOUCHI, Takiko SUGIYAMA1988 Volume 29 Issue 6 Pages 795-801
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESS1. Among the 77 cases of hemophiliacs (61 hemophilia A patients and 16 hemophilia B patients), three types of HIV-I marker, for HIV-I antigen (p 24) and HIV-I antibody (gp 41, p 24), were examined. Periodical check was conducted from 1980 thru to 1982 on the 11 cases (3 ARC and 8 AC cases) of them to observe relation among HIV-I marker, clinical symptoms and immunity (CD4/CD8 ratio).
2. HIV-I antigen was found in 2 cases of the 77, each later diagnosis as ARC hemophilia B.
3. In the check on serum before seroconversion, 8 cases of asymptomatic carrier have shown no positive reaction to HIV-I antigen.
4. Of the 27 cases positive to HIV-I antibody, all the 27 cases proved to have envelope protein gp41 but the check for core protein p 24 resulted its absence in 3 cases of them.
5. Of the ARC cases, 1 case showed decrease in HIV-I antigen and recovery of HIV-I antibody (p 24) when the patient condition turned for the better. Whereas, ARC case in which symptoms were critically developed of HIV-I antigen and looses of HIV-I antibody (p 24).
6. Periodic observation on HIV-I infected persons for the change of quantity of HIV-I antigen (p 24) and HIV-I antibody (gp 41 and p 24) seems to be useful to judge the time of infection and prognosis.View full abstractDownload PDF (548K) -
Tatsumi UCHIDA, Mikio YOSHIDA, Kazuyoshi SAKAI, Takao SUZUKI, Tsuyoshi ...1988 Volume 29 Issue 6 Pages 802-806
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSRed cell volume distribution width as a mean for diagnosing iron deficiency by using Sysmex E-4000 and Coulder S-plus STKR was examined. RDW by S-plus STKR and RDW-CV by E-4000 showed larger values concomitant with the development of iron deficiency. More than 80% of iron deficiency anemia and 50% of iron deficiency could be screened by red cell distribution width without serum iron or ferritin measurements. All 14 patients with iron deficiency anemia had a single, microcytic population of red cells before treatment. In 12 of 14 patients, a new population was of normal size after the administration of iron. In 2 of 14, the new population was macrocytic. In a patient with megaloblastic anemia and 4 with polycythemia vera, red cell distribution curves were also taken during the treatment. RDW-CV had larger values due to relative iron deficiency associated with hypoferremia. It was discussed that red cell distribution width was clinically useful in the diagnosis of iron deficiency status and iron deficiency anemia.View full abstractDownload PDF (364K) -
Hayato SHIMADA, Eise TAKASHIMA, Masayuki SOMA, Masahiro MURAKAMI, Yosh ...1988 Volume 29 Issue 6 Pages 807-811
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThis study was designed to investigate a source of increased plasminogen activators (tPA and uPA) in plasma during pregnancy. Both tPA and uPA antigens increased after the third trimester of pregnancy and high levels of PAs persisted by the first stage of labor. The level of tPA antigen rose further for the first few hours post-partum, while the level of uPA antigen returned to normal immediately after termination of pregnancy.
To investigate whether uterus and/or placenta may be the source of the increased PAs in plasma, the levels of PAs were measured in uterine venous blood in cases of caesarian sections. At ante-partum period, the level of uPA antigen in uterine venous blood was higher than that in peripheral venous blood, while there was no significant difference between the levels of tPA antigen in peripheral and uterine venous blood. The level of tPA antigen in uterine venous blood rose after delivery. In contrast, the level of uPA antigen declined immediately after delivery.
These results suggest that (1) placenta is the major source of the increased uPA antigen during pregnancy, (2) the increased tPA antigen during pregnancy comes from vessels of whole body, (3) further increase of tPA after delivery is due to its release from involuting uterus.View full abstractDownload PDF (383K) -
Susumu SHIMIZU, Yoshimasa NAKAMURA, Kazuhiko SOMEYA1988 Volume 29 Issue 6 Pages 812-817
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSErythroblasts recognized in the peripheral blood of nine patients were electron microscopically studied by vertically cut sections of the buffy coat of the blood. These patients were found to have hematologic abnormalities associated with bone marrow metastatic carcinoma, erythroleukemia, hybrid leukemia, malignant lymphoma, primary myelofibrosis, bone marrow tuberculosis and myelodysplastic syndrome, resulting in leukoerythroblastosis. In eight out of nine cases, many masses constituted iron deposits were demonstrated within the mitochondria of erythroblasts from the peripheral blood. Myelodysplastic syndrome was only one for these sideroblasts to be negative in the peripheral blood. It appears, therefore, that sideroblastic changes play an important role for erythroblasts to come into the peripheral blood of these patients. However, a case with myelodysplastic syndrome detected negative study has produced a conflicting result.View full abstractDownload PDF (965K) -
Yasuo IKEDA, Makoto HANDA, Teppei OGAWA, Takeo NOMURA, Kazuo DAN, Keis ...1988 Volume 29 Issue 6 Pages 818-824
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe viability of platelet concentrates stored for either 48 hours (48 hrs-PCs) or 72 hours (72 hrs-PCs) at 22 to 24°C was evaluated by the large scale, multicenter co-operative study. PCs were transfused to 23 patients with severe thrombocytopenia due to decreased platelet production on 56 occasions (48 hrs-PCs on 25 occasions and 72 hrs-PCs on 31 occasions). Comparison of the recovery at immediately and 24 hours after transfusion showed no significant difference (59.1±37.9% in 48 hrs-PCs and 52.3±32.7% in 72 hrs-PCs immediately after transfusion and 31.6±34.1% in 48 hrs-PCs and 25.5±27.6% in 72 hrs-PCs at 24 hours after transfusion, respectively). Hemostatic effectiveness was also evaluated with no significant difference between 48 hrs-PCs and 72 hrs-PCs. In 10 patients, both 48 hrs-PCs and 72 hrs-PCs were given at short time intervals. There was no significant difference in recovery immediately and 24 hours after transfusion. Both PCs were negative for bacterial culture and Limulus test. These results indicate that extension of platelet storage to 72 hours is possible.View full abstractDownload PDF (558K) -
Noriko ESUMI, Shinjiro TODO, Shinsaku IMASHUKU, Masaru YOKOYAMA, Yuich ...1988 Volume 29 Issue 6 Pages 825-832
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSForty-four pediatric cases of histiocytic proliferative disorders, collected by survey from 21 hospitals in Japan, were studied as to serum ferritin level and clinical features. They consisted of 28 malignant histiocytosis (MH), 14 virus-associated hemophagocytic syndrome (VAHS) and 2 familial erythrophagocytic lymphohistiocytosis (FEL). Eighteen patients with MH (64%) and 11 with VAHS/FEL (69%) showed serum ferritin more than 3,000 ng/ml (group A). Furthermore, 11 cases of MH (39%) and 9 cases of VAHS/FEL (56%) demonstrated serum ferritin more than 10,000 ng/ml. There was a good correlation of serum ferritin to LDH (p<0.001), but no correlation to GPT, suggesting multiple tissue injury rather than a simple hepatic damage, as a cause of hyperferritinemia. Cases complicated with DIC were mainly observed in group A, 78% for MH and 82% for VAHS/FEL, compared with group B (serum ferritin less than 3,000 ng/ml), 30% and 0%, respectively (p<0.05). However, there was no significant difference in patient outcome.
These results confirmed our previous observation that serum ferritin in patients with histiocytic proliferative disorders is extremely increased at the DIC stage and is a useful indicator of disease activity in both neoplastic and reactive conditions.View full abstractDownload PDF (670K) -
3) Treatment of Advanced Bad-risk Lymphoma with the M-CHOP RegimenYusuke FURUKAWA, Shojiro TAKAGI, Akihiro TSUBOYAMA, Saburo TSUNODA, No ...1988 Volume 29 Issue 6 Pages 833-839
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFrom January 1984 to December 1986, 23 previously untreated or minimally treated patients with advanced bad-risk lymphoma were treated with 2 or 4 cycles of the M-CHOP regimen (methotrexate 1,000 mg/m2 on day 14, cyclophosphamide 600 mg/m2 on days 1 and 8, doxorubicin 50 mg/m2 on day 1, vincristine 1.4 mg/m2 on days 1 and 8, and prednisolone 100 mg on days 1∼5: folinic acid was given 24 hours after methotrexate at 50 mg/m2 every 6 hours for 6 doses intravenously).
Twelve patients (52%) achieved complete remission (CR) and 9 (39%) had partial remission. Complete remission rate was significantly higher in patients without prior therapy. The median duration of follow-up for the entire series was 23 monthes. Relapse from CR occurred in 5 out of 12 (42%), and 7 were remained in their first CR at the 28th months. Most cases of relapse occurred within one year. Relapse was observed more frequently in patients who entered CR with 2 cycles of M-CHOP than those with 4 cycles.
Overall survival was 59% at the 31st months. Survival was not correlated with age, histological subtype, stage and surface marker.
The major toxic effect was myelosuppression with severe leukopenia and fever. Alopecia was observed in almost all patients. Mucositis occurred in 20% of patients. No treatment-related deaths were observed. The M-CHOP regimen showed limited efficacy to patients with advanced bad-risk lymphoma.View full abstractDownload PDF (482K)
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Harue HARUYAMA, Naohisa FUJITA, Chihiro SHIMAZAKI, Shinobu NAKANISHI, ...1988 Volume 29 Issue 6 Pages 840-844
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old male who received thorotrast for angiography in August, 1939, developed RAEB in transformation in 1982. Chromosome analysis of the marrow cells by short-term culture technique indicated complex abnormalities such as 5q-, t(7;22)(q36;q11) and others. His illness was transformed into AML (M2) two months later, and he died of bronchopeumonia four months after the diagnosis inspite of the treatment with prednisolone, ACR and ACNU. It is suggested that Thorotrast may be related to leukemogenesis in this case because of the chromosome abnormalities and autopsy findings.
In Japan 18 patients who had received Thorotrast developed erythroleukemia or RAEB, while thorotorast-induced leukemias were mainly AML, ALL and CML in England and Germany. The difference between Japan and Europe may be due to difference in the dosage of thorotrast.View full abstractDownload PDF (876K) -
Shoji HAGIWARA, Sadamu OKADA, Yoshio TAKIZAWA, Hiraku MORI, Haruo NIIK ...1988 Volume 29 Issue 6 Pages 845-850
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThis paper contains a discussion of our three case histories of leukemia with symptoms of transvers myelopathy, and consideration of data collected from 34 other cases reported since 1980. The relationship between myeloblastoma and an 8;21 chromosome translocation was discussed. The following is a brief summary of each of our three case histories.
Case 1:
A 70-year-old man complained of low back pain and leg pain three years after diagnosis of AML (M1) with (8;21) translocation. Seven weeks later he was admitted because of paraplegia. Myelography showed complete obstruction from L3 to L5. He received a laminectomy, chemotherapy and irradiation, but neurological improvement was not excellent. He died six months after relapse. Autopsy showed myeloblastoma in the heart, liver, kidney and spinal cord.
Case 2:
A 36-year-old man complained of back pain seven months after diagnosis of AML (M2) with (8;21) translocation. Eight days later he was admitted because of paraplegia. Myelography showed complete obstructin at Th6. He received a laminectomy, chemotherapy and irradiation. He is still alive but neurological improvement is not excellent.
Case 3:
A 56-year-old woman complained of shoulder pain three years after diagnosis of CML. Three weeks later she was admitted because of paraplegia. Myelography showed complete obstruction at Th4. She received a laminectomy and irradiation, but she died of blastic crisis of CML 46 days after the operation.View full abstractDownload PDF (733K) -
Naoki SHIMOJO, Masahiko HATANO, Akira HOSHIOKA, Kimiyuki SAITO, Yoichi ...1988 Volume 29 Issue 6 Pages 851-854
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe examined a boy who revealed intermittent fever, enlarged lymph nodes and hepatosplenomegaly since infancy. He died of diffuse immunoblastic type malignant lymphoma at the age of 10. Virological studies showed that he had antibodies to Epstein-Barr virus (EBV) with extremely high titers of IgG to viral capsid antigen and early antigen, whereas those to EBV associated nuclear antigen were almost negative. Antibodies to other communicable viruses were not significantly different from those in healthy controls. Since his cellular and humoral immunities were almost normal, immunodeficiency specific to EBV seems to exist in this patient. Dot hybridization using 32P-labeled EBV genome probe revealed that lymph node cells obtained by autopsy contain several EBV genomes per each lymph node cell. These findings strongly suggest the relationship between EBV infection and the pathogenesis of the lymphoma.View full abstractDownload PDF (356K) -
Mitsuhiko SUGIMOTO, Shunsuke IMAI, Yoshihiko TSUBURA, Kenji HASHIMOTO, ...1988 Volume 29 Issue 6 Pages 855-861
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThree patients in a Japanese family with congenital protein S deficiency are reported.
The propositus (case 1), his niece (case 2) and his brother (case 3) had cerebral infarction due to intracranial thrombosis, and two of them (case 1 and case 3) had also recurrent venous thrombosis of the legs.
In these 3 patients, plasma proteins known to be associated with familial thrombotic disease, including AT-III, plasminogen, fibrinogen and protein C were normal except for protein S. The level of protein S antigen (PS: Ag) in case 1 and case 3 was about 40% respectively. By using enzyme-linked immunosorbent assay and crossed immunoelectrophoretic techniques, it was found that the plasma PS: Ag in these 2 patients exist as complexed form with C4b-binding protein (C4bp), and free PS: Ag and PS activity were undetectable. In case 2, the levels of total PS: Ag, PS: Ag complexed with C4bp, free PS: Ag and PS activity were all about half of normal values.
From these findings, it is considered that the thrombotic tendency in this family is associated with an inherited deficiency of PS activity. These patients are now being well controlled under the anticoagulation therapy with warfarin.View full abstractDownload PDF (833K) -
Tadashi NAKAMURA, Yasuhisa DAITOKU, Junko FUKUMORI, Naomichi ARIMA, Sa ...1988 Volume 29 Issue 6 Pages 862-867
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 32-year-old man was diagnosed to have acute myelogenous leukemia (M2) in January, 1983. Complete remission was achieved by the DCMP (Daunorubicin, Cytarabine, 6-Mercaptopurine, Prednisolone) therapy. In December, 1984, tumor forming leukemia as confirmed by CT scanning and biopsy developed in hematological partial remission to cause left facial nerve paralysis and a painful mass extending from the left retroperitoneum to peri-urinary bladder area. Irradiation was effective to reduce the size of the tumors and to improve symptoms. In May, 1985, acute complete paraplegia occurred below the 2nd thoracic level, which was proved by CT scanning, scintigraphy, and spinal tap to result from a spinal tumor. The neurological signs were not improved by any therapy, and the patient's condition gradually deteriorated with corresponding changes in signs and symptoms, and hematological findings. He died on May 26, 1985. A postmortum examination revealed a generalized invasion of leukemic cells, and compression necrosis and spongilosis of the spinal cord from the 2nd to the 7th thoracic level due to extradural tumor formation with leukemic cells.View full abstractDownload PDF (1207K) -
Tatsuya HIROTA, Yoshikazu IIZUKA, Jin TAKEUCHI, Akira HORIKOSHI, Toshi ...1988 Volume 29 Issue 6 Pages 868-873
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 70 year-old male diagnosed as refractory anemia with excess of blasts (RAEB) developed remarkable leukocytosis after 7 monthis. Leukocyte count was 30,000/μl at that time, and reached 228,800/μl 5 month later. It was strongly suggested that RAEB had transformed to Ph1 chromosome-negative myelocytic leukemia from the following findings: (1) leukocytosis was present, and most of leukocytes were neutrophils; (2) myeloblast in bone marrow did not exceed 10% of nuclear cells through out clinical course; (3) neutrophil alkaline phosphatase activities remarkably reduced according with the increase in leukocyte counts; (4) Ph1 chromosome and a gene rearrangement of breakpoint cluster region (bcr) were not present; (5) while leukocyte count was 166,000/μl, the number of granulocyte precursors (CFU-g) in bone marrow and peripheral blood 108.7±4.7 and 69.8±4.5 respectivly, remarkably increased compared with the number at the onset. The patient recieved a combination chemotherapy consisting of vincristin and prednisolone, which was ineffective. He died of DIC.View full abstractDownload PDF (525K) -
Shuji TOHDA, Hirohumi KOBAYASHI, Toshiya SUZUKI, Takatoshi KOYAMA, Tak ...1988 Volume 29 Issue 6 Pages 874-878
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 33-year-old male was admitted because of the right thigh pain. He was diagnosed as acute myeloblastic leukemia (FAB M2) from hematological examinations and treated with daunorubicin, 6-mercaptopurine and cytosine arabinoside. On the 10th hospital day, he complained of anterior chest pain. Chest X-ray examination, electrocardiography and echocardiography revealed acute pericarditis. Following pericardiocentesis, he gradually recovered from pericarditis and achieved complete remission from AML. The pericardial effusion was aseptic exdative fluid without leukemic cell infiltration. We considered his pericarditis was caused by subacute cardiotoxicity of daunorubicin. Although daunorubicin highly frequently induces cardiotoxicity such as acute myocardial injury and chronic cardiac failure, pericarditis as subacute cardiotoxicity of daunorubicin has been rarely reported.
We wish this case report calls attention to subacute cardiotoxicity of daunorubicin in AML treatment.View full abstractDownload PDF (359K) -
Akira MORIMOTO, Fumihiro FUJIWARA, Noriko ESUMI, Yoshihito MORIOKA, Sh ...1988 Volume 29 Issue 6 Pages 879-884
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 1 year and 2 month-old girl with fever, swelling of the cheek and exophthalmos was diagnosed having AMMoL (FAB, M4). The cytogenetic study of the blast cells showed an abnormal karyotype of 45, XX, -10, -11, +der (11) t(10;11) (10p 15→10q ter:: 11p ter→11q23). With ACMA-BHAC therapy, the patient attained partial remission. However, agranulocytosis and unremitting high fever continued and skin lesions developed throughout the body. The patient died of bowel perforation 5 weeks later. Autopsy revealed numerous fungal nodules in multiple organs including the perforated lesions, and candida tropicalis was identified by the culture of spleen and pleural effusion.View full abstractDownload PDF (609K) -
Akira NAKAI, Mishio KADOHARA, Toshio KAWATANI, Sadako YAMADA, Hiroatsu ...1988 Volume 29 Issue 6 Pages 885-888
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe erythrocyte membrane protein in a 54-year-old patient with march hemoglobinuria was examined by SDS-PAGE and no evidence of aberrant erythrocyte membrane components was found.
Since Banga discribed first in 1979, three reports were published and five patients with march hemoglobinuria were studied of erythrocyte membrane protein by SDS-PAGE. Comparison of these cases with ours reveals that the age of four cases with erythrocyte membrane protein anomaly ranges from 16 to 31 years old (mean 23 years old), while two cases without anomaly was seen in 43 and 53 years of age respectively. From these findings, it's susceptible that march hemoglobinuria with erythrocyte membrane protein anomaly occurs predominantly in younger patients and without anomaly occurs in elder patients.View full abstractDownload PDF (472K) -
Evidence for Leukemic Cells Reactlng With 3Al (CD7) and A2B5 Monoclonal AntibodiesNaokuni UIKE, Mitsuo KOZURU, Naohisa TAKEICHI, Keisuke SHIBATA, Tomi A ...1988 Volume 29 Issue 6 Pages 889-895
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old male complaining of nasal bleeding was admitted to the Kyushu University Hospital on August 25, 1986. On admission his hemoglobin was 7.4 g/dl, platelet count 0.3×104/μl, and white blood cell count 3,700/μl with 29% blasts. Bone marrow aspirates showed dysplasia of trilineage blood cells with increased blasts (24.4%). Bone marrow chromosome study revealed a karyotype of 48, XY, -2, -7, +19, +21?, +2 mar in all banded cells analyzed. He was diagnosed as having refractory anemia with exess of blasts, and was treated with aclarubicin and low-dose Ara-C. On September 16, the leukemic blasts increased to 54.8% in the bone marrow, suggesting progression to leukemia. He was then transferred to the Kyushu Cancer Center Hospital as an outpatient. On March 31, 1987, he was admitted to our hospital when his white blood cell count increased to 40,500/μl with 88% blasts. More than 80% of blasts were positive for platelet specific glycoproteins (Gp Ib, IIb/IIIa) and about 60% of blasts, on electron microscopic study, demonstrated to possess platelet peroxidase in the perinuclear space and endoplasmic reticulum. A diagnosis of acute megakaryoblastic leukemia (AMKL, M7 of FAB) was made. His blasts also reacted with 3Al (84%) and A2B5 (92%) monoclonal antibodies which detect antigens on early T cells and neuroblastoma cells, respectively. Using Southern blot analysis with JH, Cβ1 and Cγ probes, his blasts seemed to have the germ-line immunoglobulin and T cell receptor genes. Chromosome analysis of cells from the bone marrow and peripheral blood revealed 50, XY, +8, -9, -18, +19, +21, 1q-, t (2q-; 7p+), +3 mar as the main karyotype. He died of respiratory failure due to pneumonia and pulmonary bleeding on June 4, 1987. Postmortem examination revealed widespread megakaryoblastic infiltration of the bone marrow and other organs but there was no evidence for myelofibrosis.View full abstractDownload PDF (739K) -
Susumu MITSUTANI, Masanori KAMIO, Toshiaki KOHRIYAMA, Takafumi ISHIBAS ...1988 Volume 29 Issue 6 Pages 896-900
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA patient with Klinefelter's syndrome complicated with anemia was reported.
The presence of an ineffective erythropoiesis was suggested from the blood and bone marrow findings. The HbF level was markedly elevated. Following the androgen therapy, he was recovered from anemia and the HbF level was reduced.
These results may support the following hypotheses: 1) The condition of an arrested cell cycle in the erythroblasts (ineffective erythropoiesis) causes an elevation of the HbF level. 2) Androgen administration is capable of improving on ineffective erythropoiesis and of reducing the HbF level.View full abstractDownload PDF (443K) -
Yohichiroh OHNO, Hiroshi KAMESAKI, Hiroyuki AMANO, Takanobu IMANAKA, Y ...1988 Volume 29 Issue 6 Pages 901-906
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSMeningeal leukemia was observed in a patient with chronic stage of CMML. A 68-yr-old male was referred to our hospital for the evaluation of leukocytosis and anemia. Physical examination revealed mild hepatosplenomegaly. The laboratory data showed moderate anemia, thrombocytopenia and leukocytosis with preferential monocytosis. Urinary excretion of lysozyme and serum vitamin B12 were markedly elevated. Bone marrow showed marked hyperplasia with granulocytic predominance and dysplasia of three cell lines. Karyotypic analysis showed trisomy 19. Forty percent of peripheral monocytes showed positive staining of both specific and nonspecific esterases. Anemia and thrombocytopenia gradually progressed after the diagnosis was established. Two courses of low dose cytarabine therapy had no benefit. Six months after admission, the patient developed headache, visual disturbance, somnolence and neck stiffness. Pleocytosis of predominant mature monocytes with high protein content in the spinal tap established meningeal leukemia. Although intrathecal methotrexate injection was temporarily beneficial, the patients died from cerebral bleeding and sepsis of Candida albicans. CNS involvement has been reported only in two patients with CMML and can be a rare but serious complication of CMML.View full abstractDownload PDF (668K)
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1988 Volume 29 Issue 6 Pages 907-932
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (2367K)
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