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Volume 34, Issue 12
Displaying 1-12 of 12 articles from this issue
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Yoshiki AKATSUKA, Sinobu TSUZUKI, Takurou SUGIHARA, Saburo MINAMI, Yos ...1993 Volume 34 Issue 12 Pages 1517-1524
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThe incidence of chronic GVHD, involved organs, and outcome were evaluated in 59 patients aged 15 years or more who survived for 2 months or more after HLA-matched bone marrow transplantation. The incidence of chronic GVHD was 65.3%. The incidence was not correlated with the age at the time of transplantation, underlying disease, or the method to prevent GVHD (group treated with MTX alone and CSP-treated group). Concerning the degree of organ involvement, the CSP-treated group more frequently showed slight involvement and, especially a significantly lower incidence of dryness of the eyeballs. According to organs, the oral cavity was most frequently involved (87%), followed in order by the liver (74%), skin (52%), and the eyes (30%). The oral cavity alone was involved in 6 patients, and the outcome was generally good. The outcome of multi-organ involvement of chronic GVHD was poor, and the major causes of death were interstitial pneumonia and sepsis. Even of patients who did not develop chronic GVHD, 25% showed dryness of the eyeballs and oral cavity. Biopsy and careful observation of the clinical course are needed for diagnosing GVHD.View full abstractDownload PDF (664K) -
Yuko KUZUYAMA, Yoshiaki SONODA, Hideaki SAKABE, Hitoshi NAKAGAWA, Hiro ...1993 Volume 34 Issue 12 Pages 1525-1531
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThe author evaluated the effectiveness of a combination of G-CSF with high-dose Ara-C (HD Ara-C) or high-dose etoposide based on the collection of peripheral blood stem cells (PBSC) during the recovery phase from myelosupression in 17 patients with various types of hematopoietic malignancies. Following therapy with HD Ara-C or HD etoposide, G-CSF (250μg/body) was administered from the nadir state and blood mononuclear cells were collected using a CS-3000 by processing 15 litres of blood at each apheresis. Stem cell-enriched fractions obtained from discontinuous Percoll gradients were collected and stored in liquid nitrogen. The mean numbers of granulocyte-macrophage colony-forming units (CFU-GM) obtained by the first apheresis were 10.9×105/kg after chemotherapy with HD Ara-C and 13.4×105/kg after HD etoposide therapy, respectively. In 14 out of the 17 first apheresis, more than 2×105 CFU-GM/kg were collected. Serial apheresis was performed in seven patients, at intervals ranging from 21∼79 days, and the progenitor yield in the second apheresis decreased in five patients. These results suggest that the use of either HD Ara-C or HD etoposide induces an effective mobilization of PBSC and enables large scale collection of PBSC for autotransplantation.View full abstractDownload PDF (572K) -
Shoichi MITSUHASHI, Haruhiko NINOMIYA, Akira SHIBUYA, Hiroshi KOJIMA, ...1993 Volume 34 Issue 12 Pages 1532-1539
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSBetween April 1990 and June 1992, a multicenter clinical trial of chemotherapy regimens was performed with patients, aged 65 years or more, suffering from malignant lymphoma. The total number of patients was 38 included 30 initial cases (median age: 72) and 8 relapsed cases (79). The chemotherapy regimen, administered every 3 weeks, included pirarubicin (30 mg/m2; day 1), cyclophosphamide (500 mg/m2; day 1), vindesine (1.5 mg/m2; day 1), and prednisolone (40 mg/m2; days 1∼5) for the initial cases, and etoposide (100 mg/m2; days 1∼5) in addition for relapse cases. The complete response and partial response rates were 50.0% and 40.0% in initial cases, respectively, and 50.0% and 0% in relapsed cases, respectively. The 50% survival period was 25.9 months in initial cases and 18.0 months in relapse cases. There were no serious side effects related to the regimens. Performance status deteriorated in only one case after chemotherapy. We concluded that the chemotherapy regimens were useful and safe for elderly patients with malignant lymphoma.View full abstractDownload PDF (564K) -
Kiyoshi KITAMURA, Shigetaka ASANO, Hideaki MIZOGUCHI, Fumimaro TAKAKU1993 Volume 34 Issue 12 Pages 1540-1549
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe administered granulocyte-macrophage colony stimulating factor (GM-CSF) to patients with aplastic aneina and myelodysplastic syndrome (MDS), as a phase III trial. The GM-CSF was given by 3hrs intravenous drip infusion daily for at least fourteen days. Twenty-five patients with aplastic anemia and nineteen patients with MDS were evaluable for efficacy. Peripheral blood granulocyte counts, especially neutrophil counts and eosinophil counts, increased markedly by the administration of GM-CSF in each disease. Fifteen patients with MDS and nineteen patients with aplastic anemia responded to the GM-CSF. Dose-related increase of granulocytes were seen in patients with MDS, but no relation was seen in patients with aplastic anemia. Adverse effects were observed in some patients and flu-like syndrome including fever, general fatigue and anorexia were seen most commonly but were transient. Our results showed that GM-CSF is a potent stimulator of hematopoiesis in patients with aplastic anemia and MDS.View full abstractDownload PDF (754K)
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Keita KIRITO, Hiroo SHINDOU, Naohiko CHIBA, Kensei TOBINAI, Masanori S ...1993 Volume 34 Issue 12 Pages 1550-1555
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe described a case of adult T cell leukemia (ATL) not associated with human T-cell leukemia virus type I (HTLV-I), a clinical entity that was first reported by Shimoyama et al. A 79-year-old male was admitted with anorexia and fever in October, 1989. Physical examination revealed marked hepatosplenomegaly and superficial lymphadenopathies. Hematological examination revealed marked leukocytosis (136,300/μl) with abnormal lymphoid cells showing highly lobulated nuclei. Hypercalcemia (11.2 mg/dl) and elevation of lactic dehydrogenase were also recognized. Surface marker analysis showed that the abnormal lymphoid cells in the peripheral blood were positive for CD2 and CD4 but negative for CD8. Southern blot analysis of the DNA from peripheral blood leukemic cells revealed monoclonal rearrangement of T-cell receptor β-chain gene. The clinical and hematological findings of the patient were compatible with those of acute type ATL, however, serum anti-HTLV-I antibody was negative and HTLV-I proviral DNA was not detected in the leukemic cells by Southern blot analysis. Furthermore, the polymerase chain reaction showed no integration of the HTLV-I proviral DNA in the leukemic cells.View full abstractDownload PDF (672K) -
Yoshiteru KONAKA, Shunzo NAMIUCHI1993 Volume 34 Issue 12 Pages 1556-1561
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 47-year-old man presented with fever, cough and chest pain in January, 1989. He was found to have mediastinal tumor and generalized lymphadenopathy. Peripheral blood and bone marrow findings were typical for the chronic phase of chronic myelogeneous leukemia (CML). Although the histological findings of a cervical lymph node were indistinguishable from those of malignant lymphoma, cytogenetic studies of the lymph node cells showed positive Ph1 chromosome and rearrangement of the bcr gene as well as bone marrow cells. Double fluorescence analysis of lymph node cells demonstrated co-existence of CD5, CD7 and CD33 positive cells and of cells sharing both CD5 or CD7 and CD33 antigens. These findings suggest that tumor cells originate from the stage at which the differentiation pathways of hematopoietic stem cells branch into precursor T and myeloid cells. Various combination chemotherapies had only partial effects on lymph node swelling. Chronic daily administration of low dose etoposide was very effective to control both lymphadenopathy and leukocytosis and the patient remained well for over 2 years until July, 1991 when hematological myeloid blast crisis developed. He died of pneumonia in October, 1991. This is a rare case of CML with extramedullary mixed crisis which survived for a long time.View full abstractDownload PDF (576K) -
Tatsuyuki HAYASHI, Hiroshi UTOH, Yasunobu NONAKA, Tsunemichi SUZUKI, T ...1993 Volume 34 Issue 12 Pages 1562-1567
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 59-year-old male, who was treated with artificial pneumothorax for pulmonary tuberculosis 42 years previously, presented with a painful mass in the left lateral chest wall and lymph node swelling in the left neck. A chest CT-scan revealed a tumor shadow extending from the outer chest wall to the pleural cavity containing pus surrounded by calcified pleura. 67Ga scintigraphy showed accumulation of the radionuclide in the left lateral chest and left neck. Biopsy specimen obtained from both the chest tumor and cervical lymph node revealed diffuse large cell lymphoma. Immunostaining failed to demonstrate CD1, CD3, CD4, CD8, CD13, CD20, immunoglobulin α, γ, μ, δ, κ and λ chains, indicating null cell characteristics. Chemotherapy consisting of cyclophosphamide, doxorubicin, vincristine, prednisolon and bleomycin and irradiation resulted in a temporary decrease of the tumor and lymph nodes, but the patient died of pneumonia 14 months after the onset of disease. Since the levels of serum lactate dehydrogenase and immunosuppressive acidic protein varied in parallel to the disease activity, they appeared to be useful for the assessment of therapeutic effects during the clinical course. Approximately 100 cases of non-Hodking's lymphoma developing after tuberculous pyothorax have been reported in this country, among which the incidence of null cell type is exceedingly rare.View full abstractDownload PDF (1150K) -
Hitoshi YOSHIDA, Yasuhiro MORIYAMA, Toyoshi TATEKAWA, Nobuhiko TOMINAG ...1993 Volume 34 Issue 12 Pages 1568-1572
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThis manuscript reports Bacillus cereus sepsis in two cases with acute myelogenous leukemia (AML) who suffered complications of fatal intracranial hemorrhage during remission induction therapy. The first case was 43-year-old male with AML (M0) receiving first consolidation chemotherapy who developed sudden diarrhea, abdominal pain and spiking fever. Two days later, he died of intracranial hemorrhage. The second case was 15-year-old male with AML (M5b) who was receiving first induction chemotherapy. He developed headache and vomitting following spiking fever and diarrhea. He died of subarachnoid hemorrhage the next day. In both cases, Bacillus cereus was isolated from blood culture. Fatal intracranial hemorrhage due to severe bleeding tendency caused rapid to death in both cases. These bleeding tendencies might have been induced by B. cereus sepsis. In addition, we should not overlook B. cereus as contamination, but rather consider it as a potential pathogen, when isolated from blood culture.View full abstractDownload PDF (380K) -
Masaaki SHIOHARA, Kenichi KOIKE, Nobukuni SAWAI, Shinji KASAI, Feng-Ch ...1993 Volume 34 Issue 12 Pages 1573-1578
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSSerum cytokines, lymphocyte subsets of peripheral blood and natural killer cell activity were serially assayed in a 3-year-old girl with hemophagocytic syndrome. Laboratory findings showed pancytopenia, increased levels of transaminases and hyperferritinemia and proliferation of histiocytes in bone marrow and pleural effusion. The administration of prednisolone resulted in a temporary improvement followed by a further exacerbation. The patient died in spite of the treatment with VP-16 and THP-adriamycin. Serum interferon-γ (IFN-γ) markedly increased in active phases. TNF-α, IL-1β and GM-CSF concentrations were normal or slightly elevated. The CD4/8 ratio of peripheral lymphocytes and natural killer cell activity also fluctuated according to clinical stage. These results suggested that IFN-γ was the most important cytokine to activate histiocytes in this case.View full abstractDownload PDF (468K) -
Junji TOMIYAMA, Takuya KOMENO, Toshihiro NANKI, Hiroshi KANEKO, Hideki ...1993 Volume 34 Issue 12 Pages 1579-1583
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 30-year-old woman was admitted to our hospital because of thrombocythemia during pregnancy. Her leukocyte count was 10,000/μl, Hb was 11.7g/dl, and platelet count 181.9×104/μl. Bone marrow aspirate showed an increase in megakaryocytes (255/μl). Both Ph1 chromosome and bcr rearrangement were negative. She was diagnosed as having essential thrombocythemia (ET) with pregnancy, and was treated with aspirin (150mg/day). Her pregnancy was uneventful, but she was readmitted because of overterm pregnancy. A caesarean section was performed, and a healthy male infant weighing 3,672g was delivered, with a platelet count of 25.5×104/μl. However, the uterine was atonic, and atonic hemorrhage occurred. Supravaginal hysterectomy was performed. Subsequently, intrabdominal gross hemorrhage occurred, but the bleeding was halfed by platelet transfusion. Microscopic examination showed uterine infarction. We suggest that platelet count should be reduced by means of plateletpheresis or interferon-α throughout pregnancy with ET.View full abstractDownload PDF (621K)
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Fumiaki URASE, Hiroyuki ISHIKAWA, Mari KANBARA, Shizuka HAZU, Kojiro T ...1993 Volume 34 Issue 12 Pages 1584-1586
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThe results of unrelated bone marrow transplantaion (BMT) is poor because of the rejection of bone marrow graft and graft versus host disease (GVHD). However, the rate of rejection has been reported to be decreased by intensive immuno-suppressive preconditioning regimens combined with total body irradiation (TBI). We report a case of an 18-year-old male with severe aplastic anemia who received a matched BMT from an unrelated donor. The pre-conditioning regimen included cyclophosphamide (50mg/kg) for 4 days, total lymphoid irradiation (TLI: 6Gy) and TBI (5Gy). GVHD (grade 1), hemorrhage cystitis and varicella occured afte BMT but were cured. His performance status is now 100% on the Karnofsky score at 10 months after BMT.View full abstractDownload PDF (206K) -
Kyoya KUMAGAI, Toshiyuki TAKAGI, Chikara SAKAI, Masao OGURO, Shigenobu ...1993 Volume 34 Issue 12 Pages 1587-1589
Published: 1993
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 48-year-old woman with malignant lymphoma, who was diagnosed as a hepatitis B virus (HBV) carrier because of positive HBs antigen, was admitted to Chiba Cancer Center Hospital. Complete remission was achieved by two courses of combination chemotherapy, but fulminant hepatitis developed after withdrawal of chemotherapy and she died of hepatic failure. Retrospective analysis of viral DNA disclosed a mutation in the precore region of HBV-DNA in her serum. We consider that the precoremutant virus was associated with the pathogenesis of severe hepatic failure after withdrawal of cytotoxic chemotherapy.View full abstractDownload PDF (284K)
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