All issues
Volume 35, Issue 6
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
Akemi SHIMASAKI, Tadahiko KATO, Yukio OZAKI1994 Volume 35 Issue 6 Pages 529-534
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSPeripheral blood count was performed by a Coulter Model S Plus STKR on six pseudothrombocytopenia patients (age: 16∼70, 2 men and 4 women) using three different anticoagulants. Treatment with ethylene diamine tetraacetate (EDTA, 1 mg/ml) or sodium heparin (25 U/ml) aggregated platelets, but sodium citrate (3.8%, 1:9) had no effect. Smear examination revealed much platelet clumping but the satellite phenomenon was not present. No specific pattern was elucidated concerning cell size distribution curves between treatment by EDTA and heparin. Theophylline (10 mg/ml) and prostaglandin I2 (1 μM) inhibited EDTA-induced platelet aggregation but aspirin (1.8 mM) did not. On the other hand, these three substances inhibited heparin-induced platelet aggregation. These findings, taken together, suggested that EDTA and heparin initiated platelet activation and EDTA-induced platelet aggregation might be a process unrelated to thromboxan A2 production. Heparin may not be a suitable anticoagulant since it aggregates platelets of some healthy individuals.View full abstractDownload PDF (439K) -
Nobumasa INOUE, Eiji MIYAZAKI, Masaya OKADA, Hiroshi WADA, Tomoko NISH ...1994 Volume 35 Issue 6 Pages 535-540
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSTwenty patients with previously untreated advanced aggressive or relapsed or refractory non-Hodgkin's lymphoma were treated with the MECHOP-BM regimen (MCNU, etopside, cyclophosphamide, adriamycin, vincristine, prednisolone, bleomycin and methotrexate).
Of the 18 patients treated with the MECHOP-BM, the response rate was 78% and complete response (CR) was attained in 33%. Among these CR patients, one patient relapsed, but the other patients continued to show CR (59∼243 days, medium 178 days). The most serious toxicity attributed to MECHOP-BM therapy was leukopenia. The mean white blood cell count dropped to 1,300/μl, and only four patients had white blood cell counts less than 500/μl. Our study suggests that MECHOP-BM therapy could be useful in the treatment for patients with untreated aggressive and advanced stage of non-Hodgkin's lymphoma as well as salvage therapy of relapsed cases.View full abstractDownload PDF (461K) -
Yasuyoshi MIYOSHI, Naoki TAKAHASHI, Junichi TADA, Takakazu HIGUCHI, Ts ...1994 Volume 35 Issue 6 Pages 541-546
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSNine patients with acute leukemia showing 10% or more positive blast cells with platelet peroxidase (PPO) or CD41b were diagnosed as megakaryoblastic leukemia. Three patients transformed from myelodysplastic syndromes or myeloproliferative disorders. The PPO positivity ranged from 7 to 55% (median 45%), and that for CD41b was 1.6 to 67.0% (median 16.4%). Because electron microscopic myeloperoxidase or glycophorin A were also positive in some patients, and also because CD41b positivity was often discordantly lower than PPO positivity, a possibility of mixed leukemia demonstrating myeloid or erythroid differentiation was suggested in 6 of these cases. As for the treatment results, all 3 pediatric cases who received combination chemotherapy achieved complete remission (CR). Among 6 adult cases CR was obtained in only one patient to whom low-dose cytosine arabinoside was administered. The remaining adult patients who received combination chemotheray died relatively early.View full abstractDownload PDF (631K)
-
Toshio ITOH, Yoshifumi OHMAE1994 Volume 35 Issue 6 Pages 547-551
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 65-year-old woman with a 25-year history of rheumatoid arthritis (RA) was admitted because of acute pneumonia in January, 1991. Then she was pointed out M proteinemia (IgG 3,220 mg/dl, IgA 139 mg/dl, IgM 216 mg/dl) for the first time. Serum IL-6 was below 4.0 pg/ml. She was followed up because of lack of bone change. Plasma cell count in bone marrow were 14.6%. She was re-admitted because of development of bone lesions March, 1992. There was no joint pains, and serum IgG, IgA and IgM were 5,148 mg/dl, 114 mg/dl and 106 mg/dl, respectively. CRP was negative. Serological tests of rheumatoid factor and antinuclear antibody were both positive. Serum IL-6 was elevated to 14.8 pg/ml. Bone marrow aspiration dislosed 30.6% myeloma cells. Serum IgG, A, and M were 5,148 mg/dl, 114 mg/dl and 106 mg/dl, respectively. Serum immunoelectrophoresis showed monoclonal IgG with κ type light chain. X-ray findings revealed radiolucent myelomatous foci. From these findings, IgG κ-type multiple myeloma with RA was diagnosed.View full abstractDownload PDF (488K) -
Kenji OHE, Takashi OKAMURA, Fumito ARIMA, Takumi KAMURA, Yasushi TAKAM ...1994 Volume 35 Issue 6 Pages 552-556
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 51-year-old man had suffered from massive pleural effusion due to invasion of malignant cells. The analysis of bone marrow asppiration showed the proliferation of myeloperoxidase-positive blasts. The surface marker analysis of the blasts revealed the positivities for CD7 and CD19 as well as CD13, CD33 and CD34, while the karyotypes of 20 cells were normal. Therefore, CD7 positive AML was diagnosed. The patient was treated with araC and daunorubicin as a remission induction therapy. Peripheral blood stem cells were harvested by leukapheresis after first and second consolidation therapies. Then, 3×104 cells/kg of CFU-GM were infused. Complete remission has been maintained for 8 months after autologous blood stem cell transplantatin. Pleural involvement as an initial manifestation is rare in AML. Extramedullary growth of AML cells may be related to their immaturity, indicated by the expression of the cell surface antigens.View full abstractDownload PDF (588K) -
Toshiyuki SATO, Hideo GOTO, Akihisa TORATANI, Noboru YAMAGATA, Eishi A ...1994 Volume 35 Issue 6 Pages 557-561
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 76-year-old woman with painful erythema on legs and right oculomotor disturbance was diagnosed as neoplastic angioendotheliosis (NAE, B cell type) by skin biopsy. Remission was obtained by 2 courses of VEPA regimen. But 3 months later, she relapsed with right oculomotor, optic, trochlear and trigeminal nerve disturbance which suggested that she had Tolosa-Hunt syndrome. Cerebrospinal fluid (CSF) revealed infiltration of lymphoma cells. She developed intraorbital tumor and died of respiratory failure due to tumor emboli. Autopsy revealed infiltration of tumor cells in the small vessels of systemic organs. This rare case presented intracerebrospinal and intraorbital tumor growth in addition to intravascular infiltration of tumor cells.View full abstractDownload PDF (438K) -
Yasufumi MASAKI, Shiro SHIMIZU, Shouichi TAKESHITA, Masaaki FUKUTOKU, ...1994 Volume 35 Issue 6 Pages 562-568
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSPlasma cell leukemia is a rare disorder with poor prognosis. We present a case of non-secretory primary plasma cell leukemia (Bence-Jones κ type), which was treated successfully by VEP-IFN-α therapy. A 82-year old man was admitted to Kanazawa Medical University in May 1991, because of emaciation and dehydration. Clinical findings showed decreased level of γ-globulin (IgG, IgA and IgM were all decreased armkedly), hypercalcemia, renal dysfunction and increased serum β-2 microglobulin. The peripheral blood leukocyte count was 30,100/μl with 64% plasma cells, and 80.4% plasma cells were also observed in the bone marrow. Only light chain-κ was detected in plasma cells by an immunohistochemical staining method, but immunoelectrophoresis showed no M-bow either in serum or urine. Electron microscopy revealed typical plasma cells with prominently developed rough endoplasmic reticulum. From these results, the diagnosis of non-secretory primary plasma cell leukemia was established. He was treated with VEP-IFN-α regimen, and plasma cells decreased markedly in both peripheral blood and bone marrow. Serum immunoglobulin recovered to within the normal range. After 6 courses of VEP-IFN-α, complete remission was achieved and the remission was maintained until he died of an unrelated event, bronchial obstruction due to misswallowing, in April 1992.View full abstractDownload PDF (725K) -
Hiroatsu IIDA, Hiroshi TAJI, Minako IIDA, Ritsurou SUZUKI, Takurou SUG ...1994 Volume 35 Issue 6 Pages 569-575
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThe 11q23 chromosomal abnormality is frequently observed in infantile leukemia and secondary leukemia, and the translocation associated gene in infantile leukemia is called mixed-lineage leukemia (MLL) gene. A 50-year-old man was admitted because of left axillar lymphadenopathy and IBL like T cell lymphoma was diagnosed by lymphnode biopsy. The patient responded to the LSG-9 protocol with complete remission. After 10 months he was readmitted because of fever and was diagnosed acute myeloblastic leukemia by bone marrow aspiration. Chromosome analysis revealed 11q23 abnormality, suggesting that the leukemia was induced by etoposide treatment. Southern blot analysis demonstrated DNA rearrangement in the MLL gene at 11q23. It was suggested that the breakpoint region of the MLL gene in secondary leukemia is the same as that of infantile leukemia.View full abstractDownload PDF (630K) -
Hiroyuki MARUSAWA, Kenjiro HAMAMOTO1994 Volume 35 Issue 6 Pages 576-580
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 57-year-old woman was admitted to our hospital because of fever and eruption. On admission, her white blood cell count was 1,600/ml, and platelet count 1.7×104/ml. Ferritin and lysozyme were elevated. Bone marrow aspiration showed 4% histiocyte with hemophagocytosis. The anti-rubella virus antibody titer was 1:64, and that at convalescence stage was 1:254. Therefore, she was diagnosed to have virus-associated hemophagocytic syndrome (VAHS). Steroid (methylprednisolone 1,000mg×3 days) and gamma globulin therapy were initiated. Her clinical condition and laboratory data were promptly improved. Thus, it was suggested that steroid-pulse and gamma globulin therapy are effective in the early stage of this syndrome in adult.View full abstractDownload PDF (475K) -
Motohiro KATO, Masanori UMEDA, Takaaki KOSUGE, Syuichi ANNO, Toshihiro ...1994 Volume 35 Issue 6 Pages 581-587
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe report a rare case of idiopathic myelofibrosis transformed to acute myelomonocytic leukemia associated with non-Hodgkin's lymphoma. A 64-years-old woman was admitted to our department because of anemia and leukocytosis. On admission, anemia and hepatosplenomegaly were noted. The hemoglobin content was 6.8g/dl, and WBC count was 26,200/μl with an increased number of inmature neutrophils. Bone marrow biopsy revealed an increased amount of reticulin fiber. Because she had no disease which causes secondary myelofibrosis, idiopathic myelofibrosis was diagnosed, and she was treated with prednisolone, anabolic steroid and blood transfusion. Fifteen months after the diagnosis of myelofibrosis, blast increased in her peripheral blood and her spleen and liver enlarged remarkably. A tumor of right parotic region was recognized at the same time. The pathological diagnosis of biopsied tumor was non-Hodgkin's lymphoma. The cytochemical study of blasts in her peripheral blood showed that she had acute myelomonocytic leukemia. In spite of intensive chemotherapy, she died from heart failure, respiratory failure and renal insufficiency.View full abstractDownload PDF (1340K) -
Junko FUKUDA, Toshio YOSHIHARA, Yukari ARAI, Takako KANEKO, Heng ZHENG ...1994 Volume 35 Issue 6 Pages 588-592
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 75-year-old man was admitted to our hospital on June 1st, 1993, because of nasal obstruction, epistaxis, fever, night sweats and weight loss. Examination disclosed a 2-cm white necrotic mass in the nasal septum, and a biopsy disclosed non-Hodgkin's lymphoma, diffuse, mixed-type. Imprint smears showed cytoplasmic azurophilic granules in the tumor cells. Dense granules were demonstrated by electron microscopy. The tumor cells were CD1-2+3-4-7+8-16+56+57-, and T cell receptor genes were in germline configuration. NK activity against K562 was strongly positive. Based on morphologic, phenotypic, immunogenotypic, and cytotoxic findings, the tumor cells seemed to be derived from activated NK cells. Because the tumor cells were positive for the EB virus and CD21 antigen, EB virus seemed to have infected CD21-positive NK cells and transformed them. MDR P-glycoprotein was also positive. This finding may explain why nasal lymphomas are resistant to chemotherapy and have a poor prognosis.View full abstractDownload PDF (562K) -
Yoshiki OKUYAMA, Kouichi KITAZUME, Koji IWABE, Kensuke USUKI, Akio URA ...1994 Volume 35 Issue 6 Pages 593-597
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 73-year-old man was admitted to our hospital with pancytopenia in December, 1992. The data of his peripheral blood were as follows: WBC 1,100/μl (stab 9.0, seg 11.5, eosino 3.5, mono 1.0, lymph 75.0), RBC 176×104/μl, Hb 6.6 g/dl, platelet 4.6×104/μl. Bone Marrow was hypocellular (cell count 1.4×104/μl) and consisted of 30% blasts (peroxidase positive). He was diagnosed as having hypoplastic leukemia. Oral administration of cytarabine ocfosfate (50 mg/day) was begun from the 5th of January, 1993. The dose of cytarabine ocfosfate was increased to 100mg/day since the 13th of January, 1993, and he was discharged from the hospital on the 23rd of January, 1993. Since then, he has been treated with cytarabine ocfosfate alone in the outpatient clinic. Pancytopenia began to improve in one month, and the data on the 7th of May, 1993 were as follows: WBC 3,500/μl (stab 2.0, seg 37.5, eosino 1.5, baso 1.0, mono 16.5, lymph 41.5), RBC 249×104/μl, Hb 10.4g/dl, platelet 15.4×104/μl. Bone marrow became normocellular (cell count 22.0×104/μl) and blasts decreased to 3.0%, and complete remission was confirmed. There were no adverse effects.View full abstractDownload PDF (380K) -
Tohru IZUMI, Kiyohiko HATAKE, Shigehiko IMAGAWA, Minoru YOSHIKDA, Masa ...1994 Volume 35 Issue 6 Pages 598-602
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 44-year-old woman was dianosed as having acute promyelocytic leukemia (APL) in April 1988. On her first admission, chromosomal translocation (15;17), +8, and +12 was detected. When she was readmitted to our hospital with the second relapse in May 1990, t(3;13) and +8 was detected, instead of t(15;17). Complete remission was reachieved with VP-16, MIT, and BHAC, but the third relapse occured in September 1990. After obtaining informed consent, she was given etretinate 40mg per day orally for 17 days, without any effect on leukemia. She was then given all-trans retinoic acid (ATRA) 60mg per day orally for 29 days. Although a mild granulocytic recovery was observed, no sufficient hematological recovery was obtained (minor response). Besides common side effects of ATRA, such as dry skin and hypertriglycedemia, she had a myeloblastoma in the oral cavity, but it is unknown whether the symptom was a complication of ATRA therapy or not.View full abstractDownload PDF (416K) -
Akira MASUMOTO, Yoshiaki OHBAYASHI, Hiroshi KAWADA, Kaori ARIMORI, Tam ...1994 Volume 35 Issue 6 Pages 603-608
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 42-year-old man was admitted to our hospital because of pancytopenia in April 1992. A diagnosis of refractory anemia was made. The karyotype was normal male type on the initial study. Subcutaneous administration of granulocyte colony-stimulating factor (G-CSF) initially increased the peripheral neutrophil count, bat in January 1993, although blast cells did not increase, neutrophils had decreased in spite of the continuation of G-CSF administration. Chromosome analysis showed 46XY, +Y, -7 at this point. By adding 50 mg of cytarabine ocfosfate (SPAC) daily, the peripheral neutrophil count again rose dramatically. However, anemia, thrombocytopenia and the chromosomal abnormality were unchanged. These results indicate that SPAC may upregulate the effect of G-CSF on granulopoiesis in patients with myelodysplastic syndrome.View full abstractDownload PDF (443K) -
Minoru FUKUDA, Keizo HORIBE, Yuji MIYAJIMA, Kimikazu MATSUMOTO, Takesh ...1994 Volume 35 Issue 6 Pages 609-615
Published: 1994
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 5-year-old girl was diagnosed as having idiopathic thrombocytopenic purpura (ITP) based on symptoms of nasal bleeding and purpura. The platelet count was 35,000/μl without anemia or leukopenia. Micromegakaryocytes were observed in normocellular bone marrow without dyserythropoiesis or dysgranulopoiesis. She had periosteal fibroma of the rib and atopic dermatitis with elevated serum IgE. Prednisolone and azathioprine were administered but with no response. The cumulative dose of azathioprine was 20g for 28 months. Nine years after the diagnosis of ITP, she was admitted because of dyspnea and anemia. The white cell count was 26,900/μl with 17% monocytes. The hemoglobin was 3.9g/dl and the platelet count was 9,000/μl. Dyserythropoiesis, dysgranulopoiesis and micromegakaryocytes were observed in hypercellular bone marrow. The chromosome analysis demonstrated 47, XX, +21. She was diagnosed as having chronic myelomonocytic leukemia (CMMoL) and received bone marrow transplantation (BMT) from an HLA-identical sibling conditioned with high-dose busulfan and melphalan. After 17 months of remission, the disease recurred with an abnormal karyotype of 47, XX, +21, 7q+. Despite a second BMT conditioned with high-dose etoposide, cyclophosphamide and total body irradiation, she died of the disease. Refractory thrombocytopenia as a subgroup of myelodysplastic syndrome, rather than ITP, might have preceded the development of CMMoL, with the possibility of azathioprine-induced leukemia.View full abstractDownload PDF (714K)
- |<
- <
- 1
- >
- >|