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Volume 29, Issue 8
Displaying 1-21 of 21 articles from this issue
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Yuzo IGUCHI, Keisuke TOYAMA1988 Volume 29 Issue 8 Pages 1143-1149
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe studied a clinical analysis of the cases with acute megakaryoblastic leukemia (M7 of FAB classification of acute leukemia) in Japan. Twenty six cases of M7 and 6 of “acute myelofibrosis (AMF)” were reported in questionnaires. Twenty one cases of M7 were treated with antileukemic chemotherapy and 47.6% of them achieved complete remmission with a median survival of 12 mos. The effective chemotherapy was myeloid defined regimen such as a combination with anthracycline, cytosine arabinoside and 6MP. None of 3 cases with AMF receiving treatment responded to antileukemic chemotherapy. Complete remmision rate was lower in the M7 cases with myelofibrosis than in those without myelofibrosis. Some cases with M7 had a long pretreatment duration and their complete remmision rate was lower than the other M7 cases, indicating that their clinical courses ressembled those of 4 cases with “AMF” having rather prolonged courses. It is suggested that these cases might be similar to myelodysplasia with myelofibrosis.View full abstractDownload PDF (539K) -
Yasuhiro ENOMOTO, Yonosuke WATANABE1988 Volume 29 Issue 8 Pages 1150-1162
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSImmature megakaryocytes have been identified by platelet peroxidase (PPO) and immunohisto-chemistry or immunoelectron microscopy using monoclonal antiplatelet membrane antibodies.
In this study, we attempted simultaneously to demonstrate at ultrastructure level peroxidase reaction due to PPO and the labelling of cell surface antigen with the immunogold method on leukemic megakaryoblasts and micromegakaryocytes.
Bone marrow or peripheral blood were studied in 12 cases which contained 2 of M7, 1 of suspected M7, 2 of CML blast crisis, 1 of myelofibrosis, 4 of AML involving megakaryocytic lineage and 2 of MDS. Immunoreaction was applied prior to fixation with tannicacid-paraformaldehydeglutaraldehyde mixture and subsequently incubated in DAB medium in order to demonstrate PPO activity.
Megakaryoblasts (MKB), micromegakaryocytes (MMK), and platelet (P1) were PPO positive and these cells also exhibited gold particles on their cell membrane, demarcation membrane system and surface canalicular system.
MKB, MMK and P1 were positive for P3 (platelet GPIb), AP2, P5, CP3 (platelet GP IIb/IIIa) and KOR-P77 (anti-platelet). In general, the deposition of gold particles on the cell membrane of MKB was less massive than on those of MMK or P1. The results of immunogold method and peroxidase cytochemistry are in good agreement, in that MKB and MMK were never labelled by monoclonal antibody in the absence of PPO activity.
IN one case of AML involving megakaryocytic lineage, PPO positive MKB and MMK exhibited several peroxidase (PO) positive granules in their cytoplasm. Immunolabelling of these cells with P3 and AP2 was positive. MY7 or MY9 were simultaneously expressed on the same MKB and MMK.
IN this case MKB and MMK are postulated to express two different markers for megakaryocytic lineage and granulocytic lineage, in both the cytoplasm and cell surface.View full abstractDownload PDF (5235K) -
Tadashi KOIKE, Sadao AOKI, Souichi MARUYAMA, Akira SHIBATA1988 Volume 29 Issue 8 Pages 1163-1169
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSBlasts from thirteen patients with acute megakaryoblastic leukemia were examined ultrastructurally and immunocytochemically. The criteria of acute megakaryoblastic leukemia in this study were as follows; 1) Blasts occupy more than 30% of nucleated cells in either bone marrow or peripheral blood. 2) More than 10% of blasts are reactive for either platelet peroxidase (PPO) or anti-platelet glycoprotein (PGP) IIb/IIIa monoclonal antibodies. The reactivity of PGPIIb/IIIa is tested by immunoalkaline phosphatase method. 3) Less than 5% of blasts are positive for myeloperoxidase optically or ultrastructurally.
According to reactivity for PPO and GPIIb/III, the patients were devided into three groups; (I) PPO»10%, PGPIIb/IIIa>10%; 5 patients, (II) PPO»10%, PGPIIb/IIIa<10%; 5 patients, (III) PPO<10%, PGPIIb/IIIa»10%; 3 patients.
In one patient whose blasts were positive for PPO but negative for PGPIIb/IIIa, some of PPO-positive blasts had ferritin-containing granules, and majority of blasts were positive for an anti-GPIV antibody. Therefore this case was diagnosed to be early erythroblastic leukemia.View full abstractDownload PDF (1069K) -
Toshiro NAGASAWA, Masaki NAKAZAWA1988 Volume 29 Issue 8 Pages 1170-1178
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe have studied both proliferating capacity and self renewal capacity of leukemic megakaryoblastic progenitors in six cases with acute megakaryoblastic leukemia (AMgKL). Enriched megakaryoblasts with over 85% purity were replated in a liquid culture three times in every two weeks using PHA-LCM. The proliferating capacity (plating efficiency 1: PE1) was assessed by increased total cells in a liquid culture and self renewal capacity (plating efficiency 2: PE2) was assessed by number of clonogenic cells in a liquid culture. Six patients (3 pure type and 3 mixed type) were classified into three groups: 1) low PE1 and PE2 (case 1 and 4), 2) low PE1 and high PE2 (case 2, 3, and 6), 3) high PE1 and PE2 (case 6). Two cases with low PE1 and PE2 had complete remissions by the protocol for acute myeloblastic leukemia (AML). Also two cases with low PE1 and high PE2 had remissions by the protocol for AML including large dosage of cytosine arabinoside. One case with high PE1 and PE2 showed strong resistance for various combination of chemotherapy. PE2 values in case 1 and 4 were enhanced during clinical courses. Above results indicate that self renewal capacity of megakaryoblastic progenitors predicts, an effect of chemotherapy and prognosis.View full abstractDownload PDF (583K) -
Jun-ichi KATAHIRA, Shigeru HOSHINO, Hideaki MIZOGUCHI, Hiroko SHIOZAKI ...1988 Volume 29 Issue 8 Pages 1179-1185
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe five patients with megakaryoblastic leukemia were treated with recombinant human gamma interferon (γIFN). γIFN of six million to twelve million U/day was given by drip infusion for 21 to 150 days. As a result, the absolute number of blasts in the peripheral blood, and/or bone marrow decreased, and neutrophils and monocytes increased in two patients who had transformed from refractory anemia with excess of blasts (RAEB). The number of blasts decreased transiently in a patient who had developed as acute myelofibrosis, but the blast increased rapidly while γIFN was given. In other two patients, the blasts also increased during the treatment with γIFN.
The influence of γIFN on leukemic megakaryoblastic colony formation was studied in vitro in these patients before therapy. The colony assay with methylcellulose method revealed that γIFN suppressed the proliferation of progenitors dose-dependently in the two patients who responded to the treatment with γIFN. The number of colonies increased according to the increase in γIFN in two patients out of three who did not respond to the treatment with γIFN. Furthermore, the receptor assay was performed using 125I-labelled γIFN. The number of receptors on the cell surface was around 8,000/cell in two patients who responded, although the number was below 1,400/cell in patients who did not. Kd was around 4×10-10M in all patients without difference.
Thus it is suggested that γIFN is effective in a part of patients with megakaryoblastic leukemia. The response of theray may be predicted by both colony assay and receptor assay.View full abstractDownload PDF (585K) -
Masao OKUMURA, Michinori OGURA1988 Volume 29 Issue 8 Pages 1186-1193
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA clonal human megakaryoblastic leukemia cell line, MEG-01s was investigated for the sensitivity to multiple chemotherapeutic agents and the differentiation induction effect by vincristine (VCR).
In in vitro experiments, proliferation of MEG-01s cells was inhibited by VCR (5nM), daunorubicin (DNR, 102nM), cytosine arabinoside (Ara-C, 103nM), mitomycin C (MMC, 103nM), etoposide (NK-171, 104nM) and cisplatinum (CDDP, 104nM).
Methotrexate (MTX) showed no inhibitory effect on MEG-01s cells in broad concentration (102∼106nM).
MEG-01s cells were successfully transplanted into athymic nude mice (KSN nu/nu), and megakaryoblastic sarcoma was developed in almost all transplanted nude mice. Chemotherapeutic effect of multiple agents utilized in in vitro was also investigated for MEG-01s tumor in vivo.
Intra venous injection of DNR (2 mg/kg) and MMC (0.4 mg/kg) clearly revealed the regression effect on MEG-01s tumor, while VCR showed no chemotherapeutic effect.
Immunologically and functionally, VCR possessed no differentiation induction activity on MEG-01s cells, although moderate morphological and cytochemical changes were demonstrated.
The possibility of chemotherapeutic effect of some antineoplastic drugs such as DNR and MMC to megakaryoblastic leukemia was suggested, and transplantable MEG-01s tumor in athymic nude mice may be a very useful in vivo model for the chemotherapy of human megakaryoblastic leukemia.View full abstractDownload PDF (931K) -
Shousuke SUNAMI, Takeyuki SATO, Akira FUSE1988 Volume 29 Issue 8 Pages 1194-1199
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe c-sis gene expression in leukemic cells from a patient of acute megakaryoblastic leukemia with Down's syndrome was studied. The leukemia blasts were identified as megakaryoblasts by the platelet peroxidase reaction and the reactivity against anti-platelet monoclonal antibody. The leukemic cells obtained from peripheral blood or bone marrow specimens before and after initiation of chemotherapy were analyzed for c-sis gene expression by the RNA-DNA dot blot hybridization. Although the level varied, the mRNA of c-sis gene was detected in all megakaryoblastic leukemia cells obtained at different clinical stages. The c-sis mRNA level in cells obtained after relapse was higher than that obtained before the initiation of therapy. The 25S c-sis mRNA was detected in a megakaryoblastic leukemia cell line established from this patient. The role of the expression of c-sis gene in acute megakaryoblastic leukemia cells is discussed.View full abstractDownload PDF (881K) -
Junko SUDA, Mitsuoki EGUCHI1988 Volume 29 Issue 8 Pages 1200-1206
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTransient abnormal myelopoiesis (TAM) accompanied by Down's syndrome has been characterized as exhibiting self-limiting hematological abnormalities.
We studied 8 patients suffering from this disorder in order to clarify the biological nature of their blast cells. The blast cells showed positive reactions for platelet peroxidase (PPO) and with monoclonal antibodies against platelet-megakaryocyte antigen (TP80 and TP82). Furthermore, ultrastractural studies of blast cells showed the presence of α-granules, θ-granules, ferritin granules and/or basophilic granules. These were not observed in megakaryoblastic cells of patients without Down's syndrome. In methylcellulose and liquid culture systems, high plating efficencies were observed, and various mature cells, mainly basophils developed in the presence of phytohemagglutinin stimulated leucocyte conditioned medium.
Chromosomal analysis of blast cells of the patient with constitutionally trisomy 21 mosaic (46, X, Y=89/47, X, Y, +21=11) showed exclusively trisomy 21. Simultaneous examination for morphology and chromosomal analysis on single colonies revealed that granulocyte-macrophage colonies and an erythroid colony contained only cells with trisomy 21 karyotype. In two other patients with TAM, we observed one or two sublines in addition to the stem line with trisomy 21. There might exist clonal instability and be a sign of leukemic transition.
These findings suggest that TAM represents a selective expansion of chromosome 21 trisomic cells, which often show PPO-positive reaction and a high capacity for differentiation into, particularly, basophils.View full abstractDownload PDF (809K)
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Naokazu TSURUMI, Hisatomo HAYASHI, Fumihiko ISHIMARU, Toshiaki FUJITA, ...1988 Volume 29 Issue 8 Pages 1207-1213
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe activities of antithrombin III (ATIII) and α2-plasmin inhibitor (α2-Pl) in bone marrow aspirates from 43 patients with blood disorders including 7 cases of acute promyelocytic leukemia (APL) with DIC were measured functionally and immunologically and compared with those of normal subjects.
The antigen levels of ATIII and α2-Pl in normal controls were both higher than their respective functional activities, the levels of which were the same as those of their peripheral activities.
Both inhibitors were functionally and immunologically normal in patients with AML, AMoL, ALL, CML and hypoplastic anemia, but the levels of their functional activities were significantly low in patients with polycythemia vera.
In patients with APL, both the activity and antigen levels of α2-Pl were lower than in normal controls. On the other hand, in spite of DIC, markedly high levels of ATIII antigen were found in comparison with the normal ATIII activity. The decreased levels of α2-Pl antigen and its activity and the increased level of ATIII antigen returned to normal levels in complete remission without DIC. This discrepancy in the ATIII level between antigen and functional activity in APL might be associated with some material from APL cells themselves cross-reacting with ATIII, rather than compensatory overproduction by DIC.View full abstractDownload PDF (513K) -
Kazuo DAN, Kenji TAJIKA, Toshiharu ITOH, Kouichi INOKUCHI, Kiyoyuki OG ...1988 Volume 29 Issue 8 Pages 1214-1218
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwenty-eight patients with myelodysplastic syndromes (MDS) were studied retrospectively and separated into two prognostically different groups. The first group was consisted of patients with stable diseases and the second group with poor prognostic patients evoluted to refractory anemia with excess blasts in transformation (RAEB-T) or acute leukemia. Analysis of prognostic factors at diagnosis such as age, peripheral blood pictures, physical findings, ferrokinetics, blood chemistry, neutrophil alkaline phosphatase activity and abnormal CFU-C growth showed no differences between the two groups. On the other hand, patients with trilineage dysplasia of bone marrow cells evoluted to RAEB-T or acute leukemia in significantly high probability. Chromosomal abnormalities were also highly detected in the second group. In patients having these prognostic factors, the early use of chemotherapy may be justifiable.View full abstractDownload PDF (367K) -
Hideo NAKAMURA, Naoki SADAMORI, Ippei SASAGAWA, Takahiro ITOYAMA, Ei-i ...1988 Volume 29 Issue 8 Pages 1219-1226
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSChromosomal banding studies were performed on 8 adults and 5 children with acute lymphoblastic leukemia (ALL), consisting of “null”, “common”, T, B, and Pre-B cell phenotypes.
All the three cases with B-ALL showed chromosomal translocations t(8;14)(q24;q32), t(6;14)(p21;q32), and t(8;22)(q24;q11). The 14q32 region is the locus of immunoglobulin (Ig) heavy chain gene, and the 22q11 region that of Ig λ-chain gene. These translocations bring the protooncogenes, c-myc on chromosome 8(q24), and hpim on chromosome 6(p21) to the chromosomal positions adjacent to Ig genes. One out of three cases with T-ALL showed inv (14)(q11q32) involving the 14q11 region, in which the T cell receptor α-chain gene exists.
In one out of 4 cases with common ALL and one case with Pre-B-ALL, t(1;19)(q23;p13) was observed. Although cytoplasmic immunoglobulin in the leukemic cells of the common ALL case with t(1;19) was not examined, it was suggested that this case was probably Pre-B-ALL, since almost all the ALL cases with this translocation in the literature are of Pre-B phenotype.View full abstractDownload PDF (658K) -
Nobutaka IMAMURA, Atsushi KURAMOTO1988 Volume 29 Issue 8 Pages 1227-1236
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIn the present article, peroxidase negative acute lymphoblastic leukemia (ALL), chronic lymphocytic leukemia (CLL) and malignant lymphoma (ML) were analysed by utilizing a panel of monoclonal antibodies which can define T or B cell-associated, and/or-restricted antigens by the use of a fluorescence activated cell sorter (FACS-IV). Immunophenotypically, ALLs were quite heterogeneous, and they were classified into 10 subgroups. Espe cially, we proposed that pre-pre-pre B ALL (Ia+, CD19+) and pre-T ALL (Ia+, CD38+) are independent disorder among ALLs. CLLs and MLs could also be classified into 4 groups of B-cell lineage tumors and 5 groups of T-cell lineage tumors. In addition, the author found the existence of non-T, non-B NK cell leukemia, which should be classified for the third lineage in lymphoid cells. It is noteworthy that several monoclonal antibodies have been applied for serotherapy of leukemias and in the purging of malignant and T cells at the time of bone marrow transplantation. Hence, a precise examination of cell-surface antigens by monoclocal antibodies in all ALLs, MLs and CLLs definitely very important, especially prior to such therapies utilizing monoclonal antibodies.View full abstractDownload PDF (899K)
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Masaharu HANANO, Tadashi KOIKE, Sadao AOKI, Hideo HIROSAWA, Akira HATT ...1988 Volume 29 Issue 8 Pages 1237-1243
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 56 year-old male was admitted to the Niigata University Hospital in April 1983 because of anemia and a bleeding tendency. Hematological study revealed pancytopenia and leukoerythroblastosis. A bone marrow biopsy specimen showed a marked increase of reticulin-fibers and a focal proliferation of blasts. He showed no lymphadenopathy or hepatosplenomegaly at presentation. In the following 8 months, generalized lymphadenopathy and hepatosplenomegaly developed with progression of pancytopenia and an increase in the number of blasts in the peripheral blood.
In addition, he suffered from a high fever and generalized bone pain. In January 1984, he developed hypercalcemia and died. Serum parathyroid hormone and prostaglandin E levels were within normal limit at that time. Autopsy revealed a marked infiltration of blasts in the bone marrow, liver, spleen and lymph nodes. The blasts were positive for α-naphthyl acetate esterase, acid phosphatase and platelet membrane glycoprotein IIb/IIIa complex. Platelet peroxidase (PPO) activity, however, was weakly positive in only 5% of the blasts.View full abstractDownload PDF (756K) -
Tetsuya TAGAMI, Kenichi SORACHI, Satoru TANAKA, Hayao MURAKAMI, Takao ...1988 Volume 29 Issue 8 Pages 1244-1249
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old man was admitted to the hospital because of leukocytosis and gastric ulcerous lesion. The white cell count was 53,300/μl with 91% lymphocytes, mostly matue small ones. In the axillae and inguina several small lymph nodes were touched, and hepatosplenomegaly was recognized. A bone marrow aspiration revealed a nucleate cell count of 31.4×10/μl and 57.2% lymphocytes, and these were identified as B cells (IgG, k). Abdominal CT scanning showed multiple masses in the liver. Gastric biopsy revealed papillary adenocarcinoma, and gastric resection was performed. It was an early gastric cancer (type IIa+IIc+III) and had no metastasis in lymph nodes. Moreover, a well differentiated adenocarcinoma (type 2) was found in the sigmoid colon, and was resected. In Western countries the frequency of CLL and its association rate with cancer are high, but in Japan CLL itself is found in a low frequency, and cases of CLL associated with cancer are few. Accordingly, association with two different types of cancer in patients with CLL is very rare.View full abstractDownload PDF (616K) -
Toru ISEKI, Haruki KONDO, Saori IWASA, Keiko OKUDA, Shoichiro KANAZAWA ...1988 Volume 29 Issue 8 Pages 1250-1255
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 17-year-old male was admitted because of severe anemia and polyclonal hypergammaglobulinemia and diagnosed as idiopathic plasmacytic lymphadopathy with polyclonal hyperimmunoglobulinemia (IPL).
IPL is a distinct new clinical entitiy of plasma cell dyscrasias, proposed by Mori et al in 19801). This disease is clinically characterized by systemic lymphadenopathy and marked polyclonal hypergammaglobulinemia and pathologically by specific histological findings of the lymphnodes including follicular hyperplasia and remarkable interfollicular mature plasmacytosis without evidence of malignant growth.
This 17 year old patient was the youngest in age and had the highest serum gammaglobulin level among previously published cases of IPL, and therapy with anticancer drugs was vequired because of hyperviscosity syndrome resulting from hypergammaglobulinemia and concomitant severe anemia.
In this report we describe the effectiveness of melphalan which seemed superior to other drugs judged from his clinical course. We also discuss the distinction of IPL from plasma cell types of giant lymphnode hyperplasia and from the other diseases that are similar to IPL but different hith regard to the sites of involvement which include the skin or lung.View full abstractDownload PDF (899K) -
Hiroo ONDA, Kunio ANNO, Hiroyuki MORIYAMA, Masayoshi SANADA, Kazue TAK ...1988 Volume 29 Issue 8 Pages 1256-1262
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 52-year-old woman, who had a 5-year history of SLE, showed a tendency to bleed during hemodialysis.
At the time of her second admission to our hospital in April 1986, both blood and urine FDP increased, and red cell fragmentation was in evidence. But APTT, PT and platelet count were normal. In June 1986, a hemostatic study revealed prolonged APTT and PT, and low value of TTo, which were normalized by administration of heparin, vitamin K2 and FFP, but increase in platelets was not obtained.
Approximately 7 weeks later, APTT was prolonged again, but each coagulation factor, with the exception of factor XII and Fletcher factor, was within the normal range. Von Willebrand factor (vWF: Ag, vWF: Rco) was rather higher. ADP, epinephrine and collagen failed to aggregate platelet-rich plasma. The patient's plasma showed a prolonged kaolin-PTT (KPTT) which failed to normalize, even when an equal volume of normal plasma was added. Factor II, IX procoagulant activities increased with patient's plasma diluted more than usual. These findings suggested the existence of lupus anticoagulant, which was further confirmed by TTI test and KPTT at both high and low phospholipid concentrations. Furthermore, this inhibitor was neutralized by anti-human IgG serum.View full abstractDownload PDF (465K) -
Takahisa YAMANE, Hitoshi SAGAWA, Atsuko SASAKI, Takuya KISHIDA, Takeo ...1988 Volume 29 Issue 8 Pages 1263-1266
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 43-year-old woman, who had been diagnosed as chronic lymphocytic leukemia, was admitted to our hospital because of abdominal distension. CT showed a large mass in the abdomen. She died of acute renal failure on the 7th hospital day. Needle biopsy of the mass disclosed histological features compatible with pleomorphic large cell lymphoma. Based on these findings, a diagnosis of Richter's syndrome was done. Immunological studies on this case were performed. The lymphoma cells carried SIg of the same isotype and light chain type as those of SIg detected on CLL cells. It is suggested that both lymphoma cells and CLL cells belonged to the same clone of B cell. Judging from the presence of intracellular Ig, it was thought that these lymphoma cells were derived from the cells that had transformed to more differentiated cells than CLL cells.View full abstractDownload PDF (349K) -
Toshio ITOH, Yoshihumi OOMAE, Shirou NAKAYAMA1988 Volume 29 Issue 8 Pages 1267-1271
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 72-year-old male was admitted for the evaluation of anemia. Peripheral blood on admission showed Hb 6.2 g/dl, platelet 16×104/μl and WBC 5,300/μl with an almost normal differentials. Bone marrow revealed normocellularity consisted of 48.8% erythroblasts with a few megaloblastoid forms and 11.4% blastic cells. Some of blastic cells contained Auer bodies. Seventy two % of erythroblasts were ringed sideroblasts. Levels of both urinary polyamine and its fraction putrescine were extremely elevated. He was diagnosed as having RAEB-T according to the FAB classification, and blood transfusions were instituted with subsequent rapid, but transient decrease of erythroblasts and gradual increase of blastic cells in the marrow. Several months later, bone marrow showed 25.2% blastic cells, thus being compatible with the diagnosis of AML, M6 by the revised FAB classification. It is of interest in this case that urinary polyamine levels declined to the normal value as the bone marrow erythroblasts decreased.
It is well known that AML, M6 usually progresses through 3 stages in the successive order of pure erythremic, erythroleukemic and leukemic picture. Therefore, pure erythremic stage might be difficult in distinguishing from MDS. In view of the reports that urinary polyamine levels are high in neoplasia including acute leukemia but not in MDS, it is able to infer from our case that bone marrow erythroblasts were possessed of possibly neoplastic disturbance already at the initial stage. Determination of urinary polyamine may be useful in distinguishing AML, M6 from MDS.View full abstractDownload PDF (366K) -
Atsuhiro IWABUCHI, Hitoshi HOHJOH, Hiromi FUJIEDA, Junko OHYASHIKI, Ka ...1988 Volume 29 Issue 8 Pages 1272-1276
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe report a case of multiple myeloma (MM) IgG (κ) treated with cyclophosphamide (CPA) in which bladder cancer (transitional cell carcinoma, grade III) appeared in the course. The patient was a 73-year-old male who had been diagnosed as having MM in 1973, and therapy with melphalan and later with CPA was started in 1977. In 1984 hematuria was evident, however, it had been diagnosed as CPA-induced hemorrhagic cystitis. In 1986 he admitted to the Tokyo Medical College Hospital and was treated with modified VAD therapy, since the disease progressed. During the therapy, bladder cancer was found, and he was treated with intra-bladder administration of adriamycin. However, he died of renal failure in June, 1987. All of the reported MM patients treated with CPA and bladder cancer were male, and the total doses of CPA were more than 100 grams in most of the cases.View full abstractDownload PDF (447K) -
Ken TAKEUCHI, Taijiro ISHIYAMA, Shinji SUZUKI, Yoshihisa WAKABAYASHI, ...1988 Volume 29 Issue 8 Pages 1277-1281
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 54 year-old woman was admitted because of acute progression of progressive systemic sclerosis (PSS).
Significant scleroderma on the face and extremities, limitation of range of movement and systolic murmur on the 3rd intercostal space at the left sternal border were observed. Cardiomegaly, bilateral pleuro-pericardial effusion were recognized by echocardiogram.
Under the diagnosis of PSS with pleulopericardial effusion, the prednisolone therapy (60 mg/day) was started. Soon later, thrombocytopenia, hemolytic anemia and marked red cell fragmentation appeared in her peripheral blood. Under the diagnosis of microangiopathic hemolitic anemia (MHA), the patient received prostaglandin E1 (PGE1), gabexate mesilate (FOY) and ticlopidine, but she died of a progressive acute renal failure.
The autopsy findings revealed thickened walls and fibrin thrombi in the arteries of the kidneys and the lungs.
These results may suggest that prednisolone played an important role in the occurence of hypercoagulable state in PSS.View full abstractDownload PDF (485K)
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1988 Volume 29 Issue 8 Pages 1311-1356
Published: 1988
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (4562K)
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