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Volume 30, Issue 6
Displaying 1-21 of 21 articles from this issue
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Kazuyuki SHIMIZU, Kazuo HARA, Fumio MARUYAMA, Kazunori OHNISHI, Teruo ...1989 Volume 30 Issue 6 Pages 799-805
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSClinicopathologic analyses were performed on 11 patients with histopathologic diagnosis of Hodgkin's disease which was confirmed immunohistochemically with the use of anti-Leu M 1 which is known to be specific to Reed-Sternberg cells. Patients with clinical stage II developed infradiaphragmatic involvement after Mantle field irradiation and should have been treated with extended field irradiation or combined modality therapy because of the possibility of PSIII1. Maintenance VENP therapy seemed to sustain remission but may have caused opportunistic infections. There were no rearrangements in either immunoglobulin or T cell receptor genes studied in two patients.View full abstractDownload PDF (759K) -
Hideo NAKAMURA, Naoki SADAMORI, Ippei SASAGAWA, Takahiro ITOYAMA, Seij ...1989 Volume 30 Issue 6 Pages 806-814
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSChromosomal banding studies were performed on 13 patients with acute myeloid leukemia with maturation (M 2). Six patients revealed t (8;21) (q22;q22), five normal karyotype, and the remaining two +8 and inv (16) (p13 q22), respectively.
Apparent pseudo-Pelger-Huët anomalies in mature neutrophils were observed in all the 6 patients with t (8;21), but in only one of the 5 patients with normal karyotype. Neutrophil alkaline phosphatase (NAP) score decreased in all but one in the former group while it increased in all the patients in the latter group. The former group had a median follow-up of 20.8 months or more, whereas the latter group had a median survival of 4.4 months or more. Accordingly, it was suggested that two major chromosome subgroups may be present among patients diagnosed as having M 2: one subgroup with t (8;21) and the other with normal karyotype.
One patient with M 2 and inv (16) showed almost the same hematologic features as those observed in patients with acute myelomonocytic leukemia (M 4) and inv (16) except for a small population (6.8%) of monocytoid cells in the bone marrow.View full abstractDownload PDF (839K) -
Hiroyuki KAMBAYASHI, Hitoshi OHTO, Shigeo KARIYONE, Tetsugoro TANAKA1989 Volume 30 Issue 6 Pages 815-822
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSEvaluation of anti-HLA antibody (HLA-Ab) by lymphocytotoxicity test (LCT) was reviewed in 69 patients with hematopoietic diseases. Twenty-five (36.2%) of these 69 patients developed HLA-Ab at some time during their treatment course. In patient characteristics, eleven of 32 patients with ANLL (34.4%), one of ten patients with ALL (10%), four of nine patients with CML-BC (44.4%), six of seven patients with AA (85.7%), two of four patients with MDS (50%), and one of seven patients with other types (14.3%), who had random-donor transfusion, developed HLA-Ab. Transfused leukocytes count during two months from initial transfusion were compared between LCT positive group and LCT negative group. There were no significant differences between leukocytes count (13.8×109) of LCT positive group and that (14.2×109) of LCT negative group.
As the result, we can enumerate the following factors, which are important to develop HLA-Ab. The HLA phenotype and immunity of patients may have a more important role than total transfusion volume. The longterm and continuous transfusion may increase the possivility to develop HLA-Ab. The transfusion purging leukocytes may diminish the occasions of alloimmunization.
HLA-matched platelet transfusions were best against the patients who developed HLA-Ab and became refractory to platelet transfusion.View full abstractDownload PDF (528K) -
Shimeru KAMIHIRA, Hisasi SOHDA, Saburou MOMITA, Tatuhiko AMAGASAKI, Ya ...1989 Volume 30 Issue 6 Pages 823-829
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSHealthy carriers, patients with ATL and HTLV-I associated myelopathy (HAM) were examined for HTLV-I antibodies of IgG and IgM classes and anti-p 40X antibodies, using ELISA, western blot (WB) and particle agglutination (PA) techniques. IgG antibodies were almost always detectable in sera from all of patients with ATL and HAM and healthy carriers with high titer in the PA test (normal carriers), and the average value of OD 405 was 2.0±0.3, 1.6±0.6 and 1.3±0.7, respectively. In anti-p 40X antibodies, the detectable incidence of HAM, ATL, normal carriers and carriers with low titer of the PA (low-PA group) was 90%, 67%, 44%, and 3%; and, the average value of OD 405 of the antibodies was 2.3±1.0, 0.7±0.5, and 0.7±0.7, respectively. On the other hand, the incidence of IgM antibodies demonstrated in HAM, ATL, normal carriers and low-PA group was 90%, 41%, 33%, and 53%, respectively. Furthermore, the follow-up observation of these antibodies revealed that the antibody profile of individuals for a long time was constant, i.e. in each carrier the value with high OD remained high and the presence of anti-p 40X and/or IgM antibodies remained present.
These data has demonstrated that there are considerably differances among individuals in responsivilities for HTLV-I. Then, the antibodiy profile is mainly classified into 3 groups; hyper-, common- and hypo-immune patterns.View full abstractDownload PDF (559K) -
Naokuni UIKE, Michi HASHIMOTO, Naohisa TAKEICHI, Mitsuo KOZURU1989 Volume 30 Issue 6 Pages 830-834
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSSuperoxide (O2-) production by neutrophils was examined in 21 patients with myelodysplastic syndrome (MDS), including 13 with primary MDS (p-MDS) and 8 with therapy-related MDS (t-MDS). O2- production of MDS patients was significantly less than that of healthy controls (2.81±3.51 vs 6.19±2.41 nmol/min/106 PNMs, p<0.005). Although no relationship between pathogenesis (primary or therapy related), FAB type and levels of O2- production was observed, O2- production of 11 patients with abnormal bone marrow karyotypes was significantly reduced than that of 10 other patients with normal karyotypes. Furthermore, five t-MDS patients with monosomy for all or part of chromosome no. 7(-7 or 7q-) showed the lowest level of O2- production, which was significantly different from the level in the patients with other abnormal karyotypes (0.61±0.29 vs 1.80±0.31, p<0.001).
These results suggest that the long arm of chromosome no. 7 may in part play an important role for O2- production by neutrophils.View full abstractDownload PDF (406K) -
Hiromasa YAMAUCHI, Mitsuhiro OMINE, Norifumi TSUKAMOTO, Hitoshi KATAHI ...1989 Volume 30 Issue 6 Pages 835-839
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSUrinary methylmalonic acid (MMA) excretion in megaloblastic anemia due to vitamin B12 (B12) deficiency was studied using a colorimetric method. Average MMA excretion in 20 patients with untreated B12 deficiency was 164 mg/day, whereas it increased to 518 mg/day following oral adnimistration of 10 g L-valine. Urinary MMA correlated significantly with platelet number, erythroblast percentage and deoxyuridine suppression test, while no correlation was found with hemoglobin, leukocyte number, reticulocyte, serum LDH, serum B12 and folate concentration. Patients with neurological disturbances excreted significantly larger amounts of MMA than those without neurological disorders.
The results also indicated that MMA could be a useful adjunct for differentiation of megaloblastic anemia from myelodysplastic syndromes showing marked megaloblastic changes.View full abstractDownload PDF (379K)
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Satoki HOMMA, Kouichiro ASANO, Toshio FUKUI, Takuro SHIMBO, Taketo YAM ...1989 Volume 30 Issue 6 Pages 840-844
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 63-year-old man was admitted because of sudden paraparesis. Myelography revealed a complete block at the level of T-3. The spinal epidural tumor was histologically diagnosed as malignant lymphoma, diffuse large cell type and immunohistochemically B-cell type. A thorough work-up for metastasis including MRI was negative. He was postoperatively treated with combination chemotherapies (VEPA), followed by irradiation to the region. The residual tumor disappeared on chest-CT and the patient's neurological status rapidly improved. He is still in remission for 18 months and has full performance status. This case is a very rare lymphoma originated from spinal-epidural space.View full abstractDownload PDF (812K) -
Junji TOMIYAMA, Haruhiko NINOMIYA, Masaki NAKAZAWA, Toshiro NAGASAWA, ...1989 Volume 30 Issue 6 Pages 845-849
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA defective cell-mediated immunity was seen in a 62-year-old female with paroxysmal nocturnal hemoglobinuria (PNH). We studied the functional defect of the patient's lymphocytes and its relation to the deficiency of decay-accelerating factor (DAF) on the lymphocytes. T cells (CD 5+) and B cells (CD 20+) were obtained by cell-sorting using fluorescence-activated cell sorter (FACS-IV). These two types of cells from the patient were demonstrated to be deficient in DAF by the fluorometric measurement of DAF content using monoclonal anti-DAF antibodies. These cells were shown to be more susceptible to complement-mediated lysis than normal human lymphocytes by a complement-mediated lysis study. It was carried out by treatment of the lymphocytes with either anti-CD 5 or anti-CD 20 antibody plus rabbit complement. The lymphocytes became more susceptible to complement-mediated lysis by an additional treatment with an anti-DAF antibody both in PNH and in normal controls. From these results, we suggest that DAF plays an inhibitory role against complement activation on human lymphocytes.
The mononuclear cells of the patient responded poorly to phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). Skin tests both for PPD and for DNCB showed negative. From these findings, we suggest T cell function in the patient is impaired. Causative relations of the deficiency of DAF to the poor responses of the lymphocytes to lectins and to negative skin tests were discussed.View full abstractDownload PDF (789K) -
Chikara SAKAI, Masahiro FUJIWARA, Toshiyuki TAKAGI, Masao OGURO, Kohsh ...1989 Volume 30 Issue 6 Pages 850-857
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 78-year-old woman, who had axillary lymphadenopathy but no hepatosplenomegaly, was admitted because of lymphocytosis. The leukocyte count was 18.1×109/l with 72% abnormal cells. Neither anemia nor thrombocytopenia was present. Many abnormal cells and erythroblasts were seen in the bone marrow. These abnormal cells had irregular nuclei but no granules in the cytoplasm. The surface markers of these cells were positive for E-rosette, CD 2, CD 3, and Leu 7 but negative for CD 4, CD 8, CD 11 (OKM 1), CD 16 (Leu 11), and HLA-DR. The DNA analysis revealed the rearrangement of T-cell receptor β-chain genes. Direct Coombs test was positive and red-cell life-span (51Cr) was T 1/2=19.5 days. The patient was diagnosed as having T-CLL with mild autoimmune hemolysis and was followed without treatment. Seven months later, the leukemia cells of peripheral blood increased to 62.6×109/l and the frank autoimmune hemolytic anemia developed. After prednisolone, vincristine and cyclophosphamide were administered, leukemia cells of blood decreased. Anemia with reticulocytopenia, however, persisted and direct Coombs test became negative. In the bone marrow at that time, many neutrophils and megakaryocytes besides leukemia cells were preserved, but erythroblasts were hardly seen, namely a pattern of red cell hypoplasia was observed. The patient deteriorated rapidly and died 26 months after initial recognition of lymphocytosis.
When complement was added, the patient's serum obtained during red cell hypoplasia but not during autoimmune hemolysis inhibited BFU-E and CFU-GM in in vitro colony assays.
This case indicates that not only B-CLL but also T-CLL is accompanied by immune hematocytopenia.View full abstractDownload PDF (1196K) -
Akemi KUBO, Masaki KAWANAMI, Eiichi MATSUYAMA, Tadao TAMURA, Tadashi K ...1989 Volume 30 Issue 6 Pages 858-862
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 62-year-old woman with chronic neutrophilic leukemia (CNL) is described. She presented in February 1988 for evaluation of leukocytosis of 3 years' duration with no complaint. Physical examination was normal. The leukocyte count was 20,100/μl with 70% segmented neutrophils and 12% band forms. A myelogram showed marked myeloid hyperplasia and plasmacytosis (5.9%). Neutrophil alkaline phosphatase score, serum lysozyme and vitamin B12 levels were elevated. Cytogenetic analysis of the marrow aspirate showed normal karyotype, with no Philadelphia chromosome. Total serum protein (TP) was 7.5 g/dl with increased β-globulin (23.5%), identified as monoclonal IgA κ (3.3 g/dl) on immunoelectrophoresis. No activity of G-CSF was detected in the serum.
A retrospective study revealed that the β-globulin level was normal (6.3%, TP 6.9 g/dl) in 1980 and that it was slightly increased (11.6%, TP 7.0 g/dl) without leukocytosis (5,900/μl) in 1981. In 1985, when leukocytosis obviously existed (9,900/μl), the percentage of β-globulin was increased to 17.5% (TP 7.2 g/dl). The possibility that monoclonal gammopathy preceded the leukocytosis must be admitted.
On the basis of our observation, it is assumed that CNL and monoclonal gammopathy may be blood dyscrasias derived from a common precursor cell or that the immunological abnormality associated with monoclonal gammopathy may be implicated in the development of CNL.View full abstractDownload PDF (357K) -
Yuichi HASEGAWA, Junji TOMIYAMA, Haruhiko NINOMIYA, Tsukasa ABE1989 Volume 30 Issue 6 Pages 863-867
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSSweet's syndrome is known often to associate with non-lymphocytic leukemia (ANLL); however, there have been very few reports of Sweet's syndrome associated with myelodysplastic syndrome (MDS). It was reported that improvement and exacerbation of these two syndromes occurred simultaneously. We present here a 49-year-old male with Sweet's syndrome developed in RAEB in T. He complained of fever and infiltrative eruptions on the trunk and legs. At the time of admission to Tsukuba University Hospital, the peripheral blood showed leukocytopenia (WBC 2,000/μl: Blast 9%, PMN 51%) and anemia (Hb 6.5 g/dl). Pseudo-Pelger anomaly of neutrophils was found on the blood smear. From the hematological findings and the result of skin biopsy, the patient was diagnosed as having MDS (RAEB in T) complicated by Sweet's syndrome. Prednisolone was effective to improve his fever and eruptions. However, when treated with low-dose Ara-C and when transformed into acute myelogenous leukemia, there was no correlation between the condition of Sweet's syndrome and the percentages of blasts in the marrow. We suggest that eruptions of Sweet's syndrome associated with MDS are not always a good index of exacerbation of MDS.View full abstractDownload PDF (710K) -
Koko MIMORI, Kiyotaka KAWAUCHI, Haruo WATANABE, Hajime SUGIYAMA1989 Volume 30 Issue 6 Pages 868-873
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 74-year-old man was admitted on November 1986 because of general fatigue. His peripheral blood showed pancytopenia without immature cells since December 1985. Hematological data showed RBC 150×104/μl, PLT 7,000/μl, WBC 12,000/μl with 93.6% leukemic cells. The bone marrow smear revealed NCC 14.5×104/μl with 76% leukemic cells. The leukemic cells were characterized by faint staining with peroxidase stain and strong positivity for CD 13 antigen determined with immunoperoxidase method and flow cytometric analysis. The chromosomal analysis of tumor cells represented as follows: 44, XY, -3, -4, -9, -20, 2q+, 6p-, 7q-, 12q+, +2 mar. Although remarkable reduction of leukemic cells in peripheral blood was obtained one month after initiation of 19-days intravenous continuous infusion of N4-behenoyl-1-β-D-arabinofuranosylcytosine (BHAC), he suffered from severe systemic candida infection with severe leukopenia and died. Not only advanced age but also complex karyotypic abnormality would contribute to failure of treatment in this case. The significance of complex karyotypic abnormality in acute non-lymphocytic leukemia in discussed based on the current literature.View full abstractDownload PDF (752K) -
Toshitaro NAKAGAWA, Sion IMOTO, Mitsuhiro ITO, Katsushi TAOMOTO, Hiros ...1989 Volume 30 Issue 6 Pages 874-877
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 24 year-old female was admitted because of hypermenorrhea and petechiae. The peripheral blood tests on admission were consistent with acute promyelocytic leukemia complicated with DIC. BHAC-DMP therapy was started along with platelet transfusions and heparin adminisatration. On the day 9 of admission, on the contrary to the improvement of hematological data, the patient suffered from severe headache and nausea. The neurological examination revealed anisocoria. Right side chronic subdural hematoma was a diagnosis made by emergency CT scan and was treated with drainage of the hematoma. Post-operatively, the patient did well, and achieved complete remission on the day 43 of admission. Since intracranial hemorrhages due to DIC complicated with leukemia are often fatal, those patient are usualy treated conservatively. However, as shown in this case report, some cases might have an indication for the neurosurgical operation. It is important to check conditions carefuly whether the patient has an indication for the operation.View full abstractDownload PDF (386K) -
Akane MIZUTANI, Koich SAKATA, Toshihiro NAKAJIMA, Akira MORIMOTO, Kent ...1989 Volume 30 Issue 6 Pages 878-881
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSPeroneal nerve palsy developed in a patient with T cell-type acute lymphoblastic leukemia (ALL) is reported.
In the fifth month after starting of chemotherapy against ALL, the patient, a 7-year-old girl, developed drop foot on the left. Three posibilities were considerd as its pathogenesis; (1) VCR neuropathy, (2) neurotoxicity of intrathecal MTX, (3) leukemic invasion to the spinal canal. However, there was no evidence of leukemic invasion in any lumbar taps, and no improvement was obtained by cessation of VCR and intrathecal MTX.
Examination by CT scan revealed tumors in the intervertebral (L5∼S2) region, which was diagnosed to be neurofibromas by biopsy. The tumors compressed the left peroneal nerve and neurotoxicity of antineoplastic agents for ALL could be the cause of her drop foot.View full abstractDownload PDF (522K) -
Toshiyuki TAKESAKO, Satoshi MURAKAMI, Harue HARUYAMA, Nariaki OKU, Nob ...1989 Volume 30 Issue 6 Pages 882-886
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 71-year old male was admitted to our hospital because of general malaise and fever. Peripheral blood showed Hb 8.1 g/dl, platelet 7.0×104/μl, and WBC 18.100/μl with 64% leukemic cells. Bone marrow showed normocellularity with 73.4% leukemic cells. They were positive for peroxidase and α-naphthyl butyrate esterase stainings. Serum and urine lysozyme levels were elevated. He was diagnosed as having acute myelomocytic leukemia (M 4 in FAB classification). Chromosome analysis of bone marrow cells showed 45, XY, -17, t(9;17) (q22;p13) and double minute chromosomes (DMs) were observed in the 50 cells analyzed.
A complete remission (CR) was obtained by DCMP regimen, but he relapsed as acute monocytic leukemia (M 5 b in FAB classification) and died 5 months after diagnosis. DMs apper to be rare in acute leukemia and the clinical and etiologic implications of DMs are discussed.View full abstractDownload PDF (645K) -
Takuyuki KATABAMI, Hozumi ISOBE, Yoshimasa NAKAMURA, Kiyoshi IDE, Tats ...1989 Volume 30 Issue 6 Pages 887-891
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 59-yearold-male was admitted in September 1984 with fever and right hypochondrial pain.
On computed tomography, a bulky retroperitoneal tumor involving the intestine was detected.
Expolatory laparatomy yielded a diagnosis of non-Hodgkin's lymphoma. Although intensive and aggressive treatment combined chemotherapy and radiotherapy was administered, no conclusion could be drawn about its efficiency, and no remission was indicated by followup studies. He refused futher treatment because of bone marrow depression.
However, 9 months after the last treatment disappearance of the tumor was recognized on computed tomography examination. This phenomenon was confirmed by the second laparatomy performed in order to treat skin-colon fistula caused from diverculitis of the colon. It was recognized no evidence of malignant lymphoma in the resected colon specimen. He remains in excellent health 26 months after this events.
The clinical course of this case was probably compatible with the concept of spontaneous remission of malignant lymphoma.View full abstractDownload PDF (654K) -
Mitsutoshi KUROSAWA, Isao MAEKAWA, Tsugumichi KAWAMURA, Takayoshi MIYA ...1989 Volume 30 Issue 6 Pages 892-897
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old woman was admitted because of palpitation and conjunctival jaundice. Physical examination revealed hepatosplenomegaly and purpura without lymphadenopathy. Blood count showed 4.7 g/dl hemoglobin with increased reticulocytosis. The platelet count was 1.5×104/μl and the leukocyte count was 6,000/μl with 17% abnormal mononuclear cells (hairy cells). Hairy cells had nuclei of frequently folded shape and abundant cytoplasma with irregular edges on blood films. The hair-like cytoplasmic projections of the cells were clearly seen under the phase-contrast microscopy. Hairy cells were strongly positive for tartrate resistant acid phosphatase. Bone marrow aspiration was unsuccessful. The biopsy specimens showed small patchy and scattering infiltrations by hairy cells. Surface marker studies of hairy cells revealed that they were strongly positive for SmIg (IgGκ). They also reacted with α B 1, α Tac, α Leu-M 5 monoclonal antibodies and a rabbit anti-hairy cell serum (α HC-M). 53% of hairy cells were shown to react with α B 1 and α OKT 11 simultaneously by double labelling. The southern blot analysis of peripheral blood mononuclear cells showed IgH chain genes rearrangement and germ line patterns of T-cell receptor genes. Hemolysis was promptly disappeared after blood transfusion. Moreover, the red blood cells, platelets and leukocytes have spontaneously returned to normal levels with disappearance of circulating hairy cells and palpable spleen one year after admission.View full abstractDownload PDF (879K) -
Tadashi IKEGAMI, Yuichi HASEGAWA, Takashi HANADA, Masaki NAKAZAWA, Tsu ...1989 Volume 30 Issue 6 Pages 898-903
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDiagnostic significance of the megakaryocyte markers and clinical findings were evaluated in three cases with chronic myelogenous leukemia in megakaryoblastic crisis. Platelet peroxidase (PPO), glycoprotein IIb/IIIa, Ib, von Willebrand factor antigen (vWF: Ag) and demarcation membrane system (DMS) were examined as the megakaryocyte markers. Blast phenotypes were as follows: PPO- IIb/IIIa+ vWF: Ag+ DMS+ in Case 1, PPO+ IIb/IIIa± Ib- vWF: Ag± DMS± in Case 2 and PPO+ IIb/IIIa+ vWF: Ag± DMS± in Case 3 (-: 0%, ±: <10%, +: ≥10%). In Cases 1 and 3, no markers other than those for the megakaryocyte lineage were detected, but myeloperoxidasepositive blasts coexisted with PPO-positive megakaryoblasts in Case 2. Megakaryoblast phenotypes and involvement of other lineages were much different in each case. Therefore, marker study for cytological diagnosis should be performed in consideration of lineage heterogeneity.
As to the clinical findings, no clear features common to the three cases were present. However, multiple osteolytic lesions were demonstrated on bone survey in Case 1 and considered to be caused by the proliferation of megakaryoblasts.View full abstractDownload PDF (856K) -
Atsuo MARUTA, Michio MATSUZAKI, Heiwa KANAMORI, Hitoshi FUKAWA, Fumio ...1989 Volume 30 Issue 6 Pages 904-909
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 20-year-old man with acute myelofibrosis received ablative chemotherapy consisting of busulfan, Ara-C and cyclophosphamide followed by bone marrow transplantation from his histocompatible sister. There was a prompt engraftment with a rising WBC and platelet count and with donor karyotype in specimen of marrow. A bone marrow examination on day 29 showed a prominent decrease in marrow fibrosis. However, fibrosis was again exacerbated with leukemic relapse as overt acute megakaryoblastic leukemia on day 110, The patient died on day 126. Marrow fibrosis was found to be reversible by ablation of malignant cells and repopulation of normal hemopoietic cells after bone marrow transplantation.View full abstractDownload PDF (854K) -
Kazuhiro ABE, Nobutaka IMAMURA, Deodetus M. MTASIWA, Tominari INADA, K ...1989 Volume 30 Issue 6 Pages 910-914
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA case of a 70 years old female who developed multiple myeloma during a course of neutrophilia, and later on terminated with acute monocytic leukemia (AML, M5b) following Melphalan therapy for five years is reported.
This patient was first found to have neutrophilia in 1966, After six years, she developed monoclonal gammopathy, (IgG1 κ type) which coexisted with the neutrophilia.
She was put on Melphalan regimen for 5 years which was discontinued due to anemia, leukocytopenia and the reduction of serum IgG. By routine bone marrow examination, she was diagnosed as AMoL (AML, M5b) in July 1984.
Thereafter, a combination chemotherapy of BH-AC, 6-MP and prednisolone was started and complete remission for the AMoL was achieved after 2 months. Sixteen months later, she relapsed and a similar combination chemotherapy for reinduction regimen was administered. However, the AMoL was resistant and after 7 months, she died of pneumonia and multiple organ failure. The association of neutrophilia with multiple myeloma, the occurrence of AMoL after prolonged Melphalan therapy for the multiple myeloma and the strategy of therapy for secondary leukemia is discussed.View full abstractDownload PDF (365K)
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1989 Volume 30 Issue 6 Pages 915-927
Published: 1989
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1214K)
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