巻号一覧
30 巻, 12 号
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臨床研究
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高木 敏之, 三比 和美, 沢田 海彦, 倉石 安庸, 高木 敬三, 三方 淳男1989 年 30 巻 12 号 p. 2123-2128
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありClinical data of the 50 patients with nodal follicular lymphoma were collected from 4 institutions in Japan and were analysed retrospectively. A frequency of follicular lymphoma was 9.3% in the 364 patients with nodal lymphoma registered between 1981∼1986. Twenty-one patients (42%) were classified as follicular medium-sized cell type (F-medium; identical with follicular small cleaved cell type by Working Formulation criteria), 12 (24%) as follicular mixed (F-mixed), and 17 (34%) as follicular large (F-large). There were 31 (62%) patients with Stage III-IV disease involving bone marrow in 6 patients, liver in 2, bone marrow and liver in 2, stomach in 1. Overall five-and ten-year survival rates were 65% and 32%, respectively, in the 49 patients whose median follow-up period was 3 years, ranging from 2 to 11 years. Adriamycin-based combination chemotherapy [ADM (+) therapy] produced 10 (100%) complete response (CR) of 10 patients with F-large lymphoma and 8 (80%) of them were free from relapse. But, in the patients with F-medium lymphoma, ADM (+) therapy produced one (17%) CR of 6 patients and their survivals were not superior to those treated with ADM (-) therapy, single agents or radiotherapy alone. There was no difference in the natural history or therapeutic results between the patients in Japan and United States, although the frequency of follicular lymphoma was extremely lower in Japan. ADM (+) therapy can be accepted as the first-line chemotherapy for the patients with F-large lymphoma, but the best modality of treatment should be investigated for the patients with F-medium lymphoma.抄録全体を表示PDF形式でダウンロード (487K) -
武 弘典, 冨山 佳昭, 柴田 洋一, 本田 繁則, 古林 孝保, 水谷 肇, 西浦 哲雄, 椿尾 忠博, 倉田 義之, 米沢 毅, 垂井 ...1989 年 30 巻 12 号 p. 2129-2133
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありPlatelet membrane glycoprotein (GP) IIb carries not only the Baka alloantigen but also an autoantigen in some patients with chronic idiopathic thrombocytopenic purpura (ITP). We previously reported one ITP patient (RY) with anti-GPIIb autoantibody in her plasma. In this report, we investigated whether the epitope of the autoantigen on GPIIb (case RY) is identical to that of the Baka alloantigen or not. The anti-Baka antibody using in this study was obtained from a mother with a child suffering from neonatal alloimmune thrombocytopenic purpura as reported by Okada et al.
Immunoblotting showed that the anti-Baka antibody bound to GPIIb from Baka-positive platelets only. In contrast, the anti-GPIIb autoantibody in RY plasma bound to GPIIb, irrespective of Baka phenotype. In addition, after neuraminidase treatment of GPIIb on nitrocellulose paper, the anti-Baka antibody failed to bind to Baka-positive GPIIb, while the autoantibody still bound to GPIIb.
From these data, we conclude that the epitope of the autoantigen in RY patient is different from that of the Baka alloantigen.抄録全体を表示PDF形式でダウンロード (450K) -
中鉢 明彦1989 年 30 巻 12 号 p. 2134-2140
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありThe objective of this study is to demonstrate the diagnostic usefulness of flow cytometric analysis of surface immunoglobulin (S-Ig) light chains and monoclonal antibodies (MoAbs) in B-cell non-Hodgkin's lymphoma. For this purpose, the biopsied specimen (lymph nodes, tonsils, and spleens etc) cell suspensions from 44 patients were studied to detect the expression of S-Ig and several antigens recognized by MoAbs. A tumor was considered B-lineage if expression of pan B antigens and/or monoclonal light chains (S-Ig and/or cytoplasmic Ig) was detected in the absence of pan T antigens.
Monoclonal expression of S-Ig light chain was detectable in 37 of 44 (84%) patients with B-cell lymphoma. In two of three cases having polyclonal S-Ig light chain, monoclonal C-Ig light chain was detected in large cells on paraffin-embedded tissues with immunohistochemical technique. Pan B antigens were strongly positive in four cases with negative S-Ig light chain. In diffuse large cell lymphoma, expression of CD11b was restricted to non-cleaved cell type (DLN). CD10 was favorably expressed by non-cleaved cell type and to a lesser extent, by immunoblastic histology (LI), but was not detected on cases with cleaved cell type (DLC). Furthermore, relatively uniform expression of S-IgM was seen in DLC subgroup, and on the contrary, heterogenous S-Ig was shown in other histology groups (DLN, LI). Flow cytometry provides a rapid, objective technology to confirm the immunological diagnosis of B-cell non-Hodgkin's lymphoma.抄録全体を表示PDF形式でダウンロード (577K) -
清水 進, 小野寺 よう子, 中村 芳正, 井手 潔, 綾部 晃久, 磯部 穂積, 名越 温古, 染谷 一彦1989 年 30 巻 12 号 p. 2141-2147
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありMegakaryocytes in the peripheral blood in which leukoerythroblastosis was reconized were studied by electron microscopy on the vertically cut section of the buffy coat of the blood, and percentages of them in 10,000 nucleated cells distributed from the top to the bottom of the buffy coat were counted. In 15 of 31 patients, percentages of peripheral blood megakaryocytes ranging from 0.01% to 0.64% were seen. There was difference of the result among diseases shown peripheral blood megakaryocytes. Namely, in patients with myelofibrosis and CML, in whom extramedullary hematopoiesis was predominant, many cases ascertained peripheral blood megakaryocytes were demonstrated. Because of this result, the extramedullary hematopoiesis appears to play an important role to the presentation of megakaryocytes in the peripheral blood. On the other hand, patients indicating both megakaryocytes and abnormal sideroblasts in the peripheral blood had sideroblastic anemia marrow. This result seems to show that a part of megakaryocytes are directly flowed out from the marrow into the blood simultaneously accompanied with abnormal sideroblasts.抄録全体を表示PDF形式でダウンロード (994K)
症例
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渡辺 賢治, 新保 卓郎, 内藤 真礼生, 棚橋 紀夫, 小島 勝1989 年 30 巻 12 号 p. 2148-2151
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 34 year-old female was admitted because of anemia and leukopenia. Her bone marrow contained abundant blastic cells, which were histochemically positive for peroxidase and α-naphthyl butyrate esterase, but negative for ASD chloroacetate esterase. She was diagnosed as acute monocytic leukemia (FAB, M5a). Complete remission was achieved after the administration of BHAC, daunorubicin, 6MP and prednisolone, and she was discharged after consolidation therapies. But shortly later, she noticed hoarseness and erythematous nodules on her breast and abdomen. Though the examinations of peripheral blood and bone marrow did not show any abnormality, hoarseness rapidly worsened and she complained of dyspnea. X-ray and CT scan demonstrated narrowing of the trachea under the cricoid cartilage, and trans-tracheal biopsy revealed leukemic involvement. In addition, erythematous skin lesion showed the infiltration of leukemic cells by biopsy. Although radiation and chemotherapy was initiated, she died of pneumonia. We tried to discuss the laryngo-tracheal and skin involvement of acute monocytic leukemia as early symptoms of relapse.抄録全体を表示PDF形式でダウンロード (862K) -
高橋 稔, 茂木 良弘, 後藤 義朗, 対島 伸泰, 高橋 康雄, 藤川 幸司, 渡辺 直樹, 高後 裕, 杉山 貞夫, 新津 洋司郎1989 年 30 巻 12 号 p. 2152-2156
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 63-aged woman with cutaneous T cell lymphoma successfully treated with local administration of tumor necrosis factor (TNF) was reported. She was admitted to our hospital because of tumors and subcutaneous nodules on her bilateral inner thigh. A pathological study of her skin of right inner thigh showed mononuclear atypical cells with hyperlobulated nuclei. In peripheral blood the same lymphoid cells were found. Immunohistochemical staining of these cells was positive for OKT-3 and OKT-4, but negative for OKT-8. No lymph node swelling and no visceral involvement were detected by a CT scan and a Echography of the chest and the abdomen. A diagnosis of cutaneous T cell lymphoma was made (stage IIb TNM classification). Althogh the chemotherapy of VEPA and CHOP was done, about 70% (PR) of the bilateral inner thigh tumors were retracted. Owing to the interstitial pneumonia aroused in the period of bone marrow suppression and cardiomyopathy after chemotherapy, we gave up further systemic chemotherapy. And then the local administration of TNF was done and the disappearance of the bilateral inner thigh tumors was obtained. Our therapy with local administration of TNF for CTCL in the first report.抄録全体を表示PDF形式でダウンロード (654K) -
伊東 亮助, 河内 暁一, 土岐 力, 葛西 幹雄, 荒井 宏治, 斎藤 俊光, 宮野 孝一, 佐藤 雄一, 横山 〓1989 年 30 巻 12 号 p. 2157-2162
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 7-year-old boy was admitted to our department complaining pale face and subcutaneous bleeding in August, 1987. Peripheral blood analysis showed pancytopenia of WBC 2,600/μl, RBC 148×104/μl and platelets 5,000/μl. Bone marrow biopsy revealed hypocellularity. Granulocytes 104/μl, reticulocytes 4,290/μl and platelets 5,000/μl were compatible with the diagnosis of severe aplastic anemia based on the criteria of the Ministry of Pubric Welfare in Japan. Prednisolone (PDN) was initially indicated and bolus methylprednisolone, metenolone and ALG therapy followed with no hematological improvement.
Fifteen months after admission, in addition to 0.5∼1 mg/kg/day of metenolone, Cyclosporin A (CyA) was started at a dose of 12 mg/kg/day for a week and 6 mg/kg/day thereafter. After a week from administration of CyA, 1 mg/kg/day of PDN was given because his bleeding tendency became worse. But this combination was complicated with liver damage and hyperglycemia to discontinue both drugs. These adverse effects were subsided within 7 days by cessation of the drugs. CyA was started again at a dose of 6 mg/kg/day without any response for 4 weeks. Then PDN was added together at areduced dose of 0.5∼1 mg/kg/day. Hematological response was obtained promptly. Granulocytes reached 1,500/μl, hemoglobin 10.2 g/dl and platelets 26,000/μl after 3 months of therapy. Afterward the patient became transfusion independent.
The most effective method of CyA administration for aplastic anemia is still controvertial. Alternative use of CyA, considering combination of steroids or anabolic steroids, in patients who failed to respond to conventional immunosuppressive treatments should be further investigated.抄録全体を表示PDF形式でダウンロード (418K) -
杉田 完爾, 中澤 眞平, 斎藤 みどり, 権田 隆明, 楠本 裕, 綾 美咲, 小佐野 満, 清水 節, 岡崎 敏子, 稲葉 俊哉, 水谷 ...1989 年 30 巻 12 号 p. 2163-2168
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 7-year-old girl with an acute leukemia was reported whose blasts showed conversion from a T-lymphoid to a myeloid phenotype. At the onset of the disease, the blasts were negative for peroxidase and displayed FAB L1 morphology. Surface marker analysis revealed only CD7 antigen. Although complete remission was achieved, an extramedullary relapse was identified as having a several subcutaneus tumors 15 months later. Tumor cells showed the same marker expression as that of the blasts at the onset. After short term culture without an addition of any differentiation stimulators, the blast cells expressed CD2, CD3, CD4, CD8, and CD25 antigens. The karyotype was 46, XX, t(12;21) (p11;q22). The intensive chemotherapy and radiation therapy were carried out, however, a hematological relapse occurred 12 months later. At this time, the blasts were strongly positive for peroxidase and expressed HLA-DR and CD33 antigens with disappearance of the CD7 antigen. Chromosome analysis revealed the additional abnormalities (del (7) (p15), -17, +der (17) t(17;?) (p13;?)).抄録全体を表示PDF形式でダウンロード (595K) -
中村 典子, 粂 和彦, 森 真由美, 並木 真生1989 年 30 巻 12 号 p. 2169-2172
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありPortal hypertension in chronic lymphocytic leukemia (CLL) is rare. A 64-year-old woman with CLL for 5 years and increasing hepatosplenomegaly developed portal hypertension and bleeding gastric varices. There was no portal vein thrombus by abdominal echography and angiography. Following splenectomy and devascularization of the fornix, the gastric varices disappeared. The liver biopsy showed dense leukemic cell infiltration in portal triads, but no fibrosis. The portal hypertension in this case may be mainly due to increased portal flow from the enlarged spleen and leukemic cell infiltration in the liver. Previously reported cases are summarized.抄録全体を表示PDF形式でダウンロード (532K) -
畑江 芳郎, 武田 武夫, 中舘 尚也, 畑山 由起子, 佐竹 明, 遠藤 真理, 鹿野 高明, 今野 武津子1989 年 30 巻 12 号 p. 2173-2177
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありWe have experienced and treated seven patients of pre-B cell leukemia in childhood. Clinical, cytological and ultrastructual characteristics of them were studied. Most of them had higher counts of white blood cells, hepatosplenomegaly, high value of lactic dehydrogenase and various karyotype abnormalities at onset. The chromosomal translocation t(1;19) that is supposed to be specific to pre-B cell ALL was found in four of seven of our cases.
In the seven patients, survival was studied in comparison to that of 27 common ALL patients at our hospital that are common in childhood acute leukemia. Although no difference in remission duration and survival time between pre-B cell ALL patients and common ALL group, there have been seen the tendency that remission and survival were of shorter duration for patients with pre-B cell ALL.抄録全体を表示PDF形式でダウンロード (496K) -
対馬 葉子, 雪田 知孝, 三上 貴史, 高見 秀樹, 相原 守夫, 河村 節子, 吉田 豊, 千葉 陽一1989 年 30 巻 12 号 p. 2178-2182
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 21-year-old man was admitted to our hospital because of anorexia and general malaise in July, 1988. On admission, the white blood cell count of 18,600/μl with 72% leukemic cells. The bone marrow aspirate showed 76.8% immature monocytes, 10% mature and immature eosinophils. Leukemic cells were 66.6% myeloperoxidase positive cells, and 20.6% naphtylbutylate esterase positive cells. The lysozyme activity in urine was high. Cytogenetic analysis revealed the presence of 46 XY inv (16) (p13q22). Under the diagnosis of acute myelomonocytic leukemia with eosinophilia (M4Eo) associated with inv (16) (p13q22), one course of DCMP induction therapy was performed. After complete remission, the bone marrow aspirate showed disappearance of inv (16) (p13q22), and associated with decreased residual leukemic cells抄録全体を表示PDF形式でダウンロード (438K) -
高井 豊, 古谷 裕道, 姫井 成, 林 久智1989 年 30 巻 12 号 p. 2183-2188
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありAcquired inhibitor of von Willebrand factor-platelet interaction occurring in a 57 year-old female has been partially characterized. She had no personal or familial bleeding tendencies, but presented a subcutaneous hematoma of recent origin. She was diagnosed as having an acquired von Willebrand syndrome because she had low levels of FVIII complex in plasma, with platelet adhesiveness to glassbeads and RIPA decreased.
This inhibitor was classified as an IgA immunoglobulin, and had no activity against any component of FVIII complex. The purified IgA by the chromatographic technology interacted with normal platelets to inhibit RIPA. Following 1-deamino-8-D-arginine vasopressin (DDAVP) infusion, she had higher immediate rise in all components of FVIII complex in plasma, with no rapid decline. Plasma von Willebrand factor (vWF) multimers analyzed by 1.5% SDS-AGE technology revealed to be identical with those of normal plasma.
These studies suggest that the abnormality of ristocetin-induced vWF-platelet interaction by IgA RIPA inhibitor and the reduction of all vWF multimers (like type IA von Willebrand disease) may have a relationship with the pathogenesis of bleeding diathesis in this case.抄録全体を表示PDF形式でダウンロード (457K) -
—抗血小板・抗線溶療法の有用性について—留奥 誠, 中瀬 勉, 森田 孝一, 加藤 正美1989 年 30 巻 12 号 p. 2189-2193
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありCase 1: 75 years old male was admitted to our hospital with anterior chest subcutaneous bleeding. Coagulation study revealed that fibrinogen and α2-PI decreased, and FDP, FPA, Bβ 15∼42 and D-dimer increased. Case 2: 78 years old male was admitted to Shingu City Hospital with a left hip subcutanous hematoma. Coagulation study revealed that fibrinogen, ATIII and α2-PI decreased, and FDP increased. US and CT showed abdominal true aneurysm in both cases. Either severe infection or malignancy was not found. Ticropidine and T-AMCHA were medicated for 8 days in case 1, and for 18 monthes in case 2. Symptom and coagulation study improved in these cases. Due to some side effects such as appetite loss and liver dysfunction in case 1, and diarrhea in both cases, we changed the therapy to mini-dose heparin therapy. This therapy also proved effective. It is concluded that antiplatelet and anti-fibrinolytic therapy are effective for chronic DIC with abdominal true aneurysm.抄録全体を表示PDF形式でダウンロード (637K) -
石田 禎夫, 吉本 満, 小野 晃裕, 斉藤 丹羽子, 仲野 龍己, 東出 俊之, 杉山 敏郎, 日野田 裕治, 今井 浩三, 谷内 昭1989 年 30 巻 12 号 p. 2194-2198
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 38-year-old woman was diagnosed as acute lymphoblastic leukemia (L2) in Oct. 1985. After VP and AdVEMP therapy, complete remission was obtained. In Oct. 1987, she noticed bilateral breast tumors and leukemic cell infiltrations were shown in a biopsy specimen of the breast tumor. Bone marrow was occupied with 94 percent blasts. The second complete remission was achieved by the AdVP therapy.
In Nov. 1988, she developed double vision and photophobia. The examinations of CT and MRI showed cavernous sinus tumor, and 20 percent blasts were recognized in a bone marrow aspirate. The leukemic cells were negative for peroxidase, but were positive for both lymphoid and myeloid cell surface markers (CD2, CD5, CD7, CD33). The two color flowcytometry showed that CD5 and CD33 were simultaneously expressed on the leukemic cells.抄録全体を表示PDF形式でダウンロード (509K) -
高井 和江, 真田 雅好1989 年 30 巻 12 号 p. 2199-2204
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA case of peripheral T-cell lymphoma presenting with secondary myelofibrosis and meningeal involvement is described.
A 65-year-old female was admitted because of remarkable weight loss and pancytopenia. On admission, she was confused and showed tiny cervical lymph nodes but no hepatosplenomegaly. Bone marrow aspiration resulted in dry tap and its biopsy showed remarkable myelofibrosis with marked decrease of hematopoiesis and increase of lymphoid cells. Lymph node biopsy revealed diffuse medium sized cell lymphoma, which was diagnosed as CD3+4+8- peripheral T-cell lymphoma with immunohistochemistry (anti-HTLV-1 antibody negative). The lymphoid cells of bone marrow expressed the markers of T-cell lineage (LCA+ UCHL1+ MT1+ L26- MB1-). The cerebrospinal fluid examination revealed many lymphoma cells. She was treated with CHOP regimen and intrathecal injection of MTX. After three months, bone marrow biopsy showed recovery of hematopoiesis and disappearance of lymphoma cells and reticulin fibers.
Immunohistochemical analysis of bone marrow specimen was useful for the diagnosis of atypical myelofibrosis.抄録全体を表示PDF形式でダウンロード (848K) -
—vWfと血管内皮細胞障害の関与について—田中 英夫, 久住 静代, 竹本 元義, 前濱 修爾, 藤村 欣吾, 藏本 淳, 二宮 正則, 盛生 宏一, 奥原 種臣1989 年 30 巻 12 号 p. 2205-2209
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 49-year-old man with a one-week history of general fatigue and several other symptoms, including hematuria, numbness of the mouth, anemia and thrombocytopenia, was admitted because of an episode of convulsions and unconsciousness after blood transfusion. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was then made, and treatment with steroids, anti-platelet agents, transfusion of fresh frozen plasma was started. However, since no improvement was seen, on the third day of admission, treatment with plasma exchange was instituted (total plasma exchange volume was 18.1 l), and his clinical and hematological conditions improved markedly. Since then, he has been in a remission state for about three years. Laboratory examinations during the acute phase showed increase of vWf: Ag, decrease of RCof/vWf: Ag, increase of vWf large multimers and a high endothelial cell injury activity by the patient's serum. In the next day following the plasma exchange therapy, RCof/vWf: Ag improved, but not to the normal range. One and a half years later, while in the remission phase, the vWf multimers and endothelial cell injury activity normalized. Thus, these findings show further evidence on the involvement of endothelial cell injury and vWf in the pathogenesis of TTP.抄録全体を表示PDF形式でダウンロード (392K) -
小島 寛, 長谷川 雄一, 中澤 正樹, 長澤 俊郎, 依田 安弘, 阿部 帥, 森 尚義1989 年 30 巻 12 号 p. 2210-2214
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 32-year-old man with an 18-year history of protein losing enteropathy (PLE) was admitted to hospital for abdominal distention. On physical examination, he had massive pleural effusion, ascites and edema of the right leg, but no superficial lymphadenopathy or organomegaly. Laboratory studies revealed mild microcytic anemia and hypoproteinemia. α1-antitrypsin clearance was elevated (316 ml/day). Examination of ascites disclosed numerous lymphoblastoid cells of B cell phenotype with μ chain and λ light chain of immunoglobulin (Ig) in the cytoplasm. Southern blot analysis showed monoclonal rearrangement of μ chain and λ chain genes. No evidence of lymphomatous involvement of lymph nodes and non-lymphoid organs was found by CT scan, ultrasound echography and gallium scan of the chest and abdomen. Bone marrow biopsy was negative. Thus, a diagnosis of non-Hodgkin lymphoma (NHL) stage IVB limited in the pleural and peritoneal cavities was made. He was treated with the combination chemotherapy of BACOD with high dose ara-C or methotrexate followed by 4 doses of autologous LAK cell infusion resulting in no significant response. The massive pleural effusion, ascites and edema of the leg have not been improved. We consider this to be a rare case of NHL associated with PLE which is extremely resistant to chemotherapy or LAK therapy.抄録全体を表示PDF形式でダウンロード (459K) -
森 泰二郎, 安倍 隆, 中澤 真平, 橋本 倫太郎, 村田 佳代, 滝井 泰弘, 池田 稲穂, 小佐野 満, 横山 安伸, 森 茂郎1989 年 30 巻 12 号 p. 2215-2219
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA 16 year-old boy of non-Hodgkin's lymphoma (NHL) was reported. Although Hodgkin's disease was suspected by the presence of Reed-Sternberg-like cells and lacunar cells histologically, a diagnosis of NHL was made because of atypism and monoclonality of the background's cells as well as the morphology of invasive cells in the bone marrow. The tumor cells expressed, CD2, CD3, CD4, CD5 and CD7 antigens, which corresponded to the phenotype of helper-inducer T-lymphocytes. In the analysis of their karyotypes, 16 out of 24 cells revealed normal karyotype, while all the rest showed near-triploidy. Common abnormality was identified as trisomies of No. 1, 3, 5, 16, 21 chromosomes, tetrasomies of No. 10, 19, 20 chromosomes, and 4q+, 7q+, 14p+.
Multimodal chemotherapy was successful to induce the patient promptly into complete remission. He has been free from the disease for approximately 12 months.
Thus far, triploid clones in hematopoietic malignancies have rarely been described. More importantly, the appearance of them in pediatric lymphoid neoplasms has not yet been reported.抄録全体を表示PDF形式でダウンロード (798K) -
中村 秀男, 重橋 亨, 陣内 逸郎, 笹川 一平, 糸山 貴浩, 徳永 清治, 森内 幸美, 貞森 直樹, 市丸 道人1989 年 30 巻 12 号 p. 2220-2224
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありIn February 1986, a 68-year-old woman was diagnosed as having acute myeloblastic leukemia (FAB-M1). At the time of diagnosis, 86.0% of the bone marrow cells were myeloblastoid, and 15% of these myeloblastoid cells were positive to myeloperoxidase. Surface marker analysis by flow cytometry disclosed granulocyte-associated antigen (MY7) and also lymphocyte-associated antigen (CALLA) on the leukemic cells. Chromosomal banding studies of bone marrow cells revealed trisomy 11 in 6 of 19 metaphases examined and normal karyotype in the others. Complete remission was attained after intensive combination chemotherapy, and has remained for 38 months.
Only 19 patients with trisomy 11-associated acute nonlymphocytic leukemia (ANLL) including the present case have been reported. Morphologic analyses have revealed that the frequency of FAB-M1 is high. However, except for the present case, surface marker findings were apparent in only one M5a patient, in whom monocyte-macrophage-associated antigen was detected. Accordingly, careful surface marker studies will be needed to clarify the frequency of acute mixed lineage leukemia in such patients.抄録全体を表示PDF形式でダウンロード (405K) -
武地 美保, 田中 公夫, 重田 千春, 小熊 信夫, 鎌田 七男, 許 泰一, 土肥 博雄1989 年 30 巻 12 号 p. 2225-2229
発行日: 1989年
公開日: 2009/02/02
ジャーナル 認証ありA case of acute myelocytic leukemia (AML-M2) with a late appearance of Philadelphia chromosome (Ph1) is presented. Chromosome analysis revealed a normal karyotype at the time of diagnosis and for 23 months, when hematological relapse occurred, accompanied by abnormal clones, 46, XX, t(9;22)(q34;q11) (78%) and 45, XX, -16, t(9;22)(q34;q11), del(5)(q13q31)(22%). The patient died of GVHD after bone marrow transplantation. Molecular analysis confirmed bcr gene rearrangement in the cells with Ph1 coromosome. Acquisition of Ph1 chromosome during the course of hematological malignancies other than CML is extremely rare. This case is undoubtedly important for the understanding of leukemogenesis and the evolution of leukemia clones. The authors discussed possible mechanisms of Ph1 acquisition in the late stages of AML.抄録全体を表示PDF形式でダウンロード (441K)
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