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Volume 36, Issue 8
Displaying 1-14 of 14 articles from this issue
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Mari ITO, Masahito TSURUSAWA, Susumu KAWAI, Takeo FUJIMOTO1995 Volume 36 Issue 8 Pages 713-719
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThe growth fraction of childhood acute leukemia was evaluated by the immunostaining with the monoclonal antibody “Ki-67”, which reacts with a nuclear antigen in proliferating cells. Ki-67 labeling rates (the percentage of Ki-67 positive cells in the total cells analyzed) greatly varied from patient to patient (0.0%∼49.2%). The mean value of the Ki-67 labeling rates was significantry higher in ALL than in ANLL (23.6% vs 5.6%, p<0.001). In ALL, the Ki-67 labeling rates correlated with the proportion of S-phase cells determined by DNA flow cytometry (FCM) (r=0.82) High Ki-67 labeling rates were preferably seen in ALL with favorable prognostic factors, although the correlation was not statisfically significant. These results suggest that Ki-67 labeling rates reflect the differences in proliferative activity of bone marrow blast cells in childhood acute leukemia and is useful to determine the treatment schedule of cycle specific drugs.View full abstractDownload PDF (436K) -
Kazuhiro FUJITA, Naoki TAKAHASHI, Jun-ichi TADA, Takakazu HIGUCHI, Toh ...1995 Volume 36 Issue 8 Pages 720-727
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSCytogenetic and morphological analyses were performed on 55 adult patients (34 males, 21 females) with acute non-lymphocytic leukemia (ANLL) diagnosed between 1986 and 1992, and the results were studied with regard to therapeutic response and prognosis. Eleven patients had M1 (20%), 14 had M2 (25.5%), 14 had M3 (25.5%), 7 had M4 (12.7%), 3 had M5 (5.5%), 5 had M6 (9.1%) and one had M7 (1.8%). The overall incidence of chromosomal abnormalities were 65.5% including 10 cases (18.2%) with t(8;21), 12 (21.8%) with t(15;17), 5 (9.1%) with pseudodiploid, 3 (5.5%) with hyperdiploid, 2 (3.6%) with hypodiploid and 4 (7.3%) with abnormalities of 5 or 7 chromosomes. Outcomes were analyzed in 45 patients. 36 patients (80%) achieved complete remission (CR). All 12 patients with M2 entered CR, and they showed a significantly longer median survival than M1. The median survival of 10 patients with t(8;21) was significantly longer than that of patients with t(15;17). However, therapeutic response and prognosis did not correlate with either chromosomal status (NN, AN, or AA) or with age-groups (≥60, <60). These results confirmed that morphological subtypes and certain types of chromosomal abnormality are important variables in determining the prognosis of adult patients with ANLL.View full abstractDownload PDF (504K) -
Chiaki NAKASEKO, Hakumei OH, Hiroshi SATO, Ryuko CHO, Akihiro ISHII, T ...1995 Volume 36 Issue 8 Pages 728-734
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSBetween July, 1990 and March, 1994, 31 patients with hematological malignancies or severe aplastic anemia underwent allogeneic bone marrow transplantation (BMT) at the Second Department of Internal medicine, Chiba University Hospital. Among the 29 evaluable patients who survived over 100 days after transplant, 11 patients (37.9%) developed late-onset hemorrhagic cystitis with a median time of onset of 57 days (range 11-205) from BMT. Adenovirus type 11 was isolated from the urine of 4 patients. Five patients recovered with fluid hydration and forced diuresis, while 6 patients had persistant gross hematuria with clot formation, 5 of whom also developed hydronephrosis. Seven-day courses of 500μg prostaglandin E1 (PGE1) bladder instillations was initiated to control hematuria in these 6 patients. Complete resolution of gross hematuria was achieved in 4, and partial response with decreased clot formation and partial clearing of the urine was observed after 4 of 9 courses of the treatment. Although all patients experienced bladder spasm or lower abdominal pain during the PGE1 instillations, these symptoms were manageable with sedative drugs and morphine. No systemic side effect was apparent. PGE1 bladder instillations is a safe and useful treatment for severe, life-threatening late-onset hemorrhagic cystitis after allogeneic BMT.View full abstractDownload PDF (554K) -
Rika SAKAI, Atsuo MARUTA, Jun TAGUCHI, Naoto TOMITA, Fumio KODAMA, Mas ...1995 Volume 36 Issue 8 Pages 735-741
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe investigated the relevance of cytomegalovirus (CMV) to interstitial pneumonitis (IP) using formalin-fixed and paraffin-embedded lung tissues obtained from 12 autopsy cases who died following bone marrow transplantation (BMT) from May 1985 to March in 1992. The lung tissues were examined by hematoxylin and eosin (H.E.) staining, immunohistochemistry with monoclonal antibodies (DDG9, CCH2) and polymerase chain reaction (PCR) for amplifying human CMV DNA. Eight of 12 cases were clinically diagnosed as IP. The 4 cases showed no signs of IP, and their tissues were used as controls. H.E. staining revealed inclusion bodies in two of the eight and only severe fibrosis in the other six. In 4 of the 6 cases, however, CMV was identified by immunohistochemistry or PCR. We concluded that the relevance of CMV in the genesis of IP is often overlooked by H.E. staining alone. Immunohistochemistry and PCR are useful in examining tissues which are suspected of CMV-IP.View full abstractDownload PDF (674K)
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Yoshihisa AKIMOTO, Taijiro ISHIYAMA, Keiichiro KAWAKAMI, Ken-ichiro HI ...1995 Volume 36 Issue 8 Pages 742-748
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 49-year-old man was admitted to our hospital with anemia and hypergammaglobulinemia. Physical examination revealed superficial lymph node swelling and no hepatosplenomegaly. Laboratory findings showed WBC 5,300/μl with normal hemogram, microcytic and hypochromic anemia. Total protein was 11.5 g/dl and immunoglobulinemia (IgG 10,100 mg/dl, IgA 295 mg/dl, IgM 160 mg/dl) was observed without M-component in serum and urine. The CD4/CD8 ratio of lymphocyte subsets was 0.58 and the tuberuculin skin test was negative. Urinary protein was positive and renal biopsy disclosed plasma cell infiltration. Lymph node biopsy revealed multiple lymphoid follicles and infiltration of plasma cells in the interfollicular areas. A diagnosis of multicentric Castleman's disease (MCD) was made baredon clinical findings and lymph node biopsy. After therapy with plasmapheresis and the CHOP regimen, he was given etoposide. Although discharged with clinical improvement and a decrease of serum IgG, he was readmitted because of pyrexia after 4 days and died of pneumonia with adult respiratory distress syndrome. The autopsy revealed lymphoid interstitial pneumonia. It seems important to notice that some of MCD have poor prognoses because of accompanying immunodeficiency.View full abstractDownload PDF (720K) -
Tomiko RYU, Kazunori ASAI, Gen SUGASAWA, Katsutaka SETA, Shigehiro KIT ...1995 Volume 36 Issue 8 Pages 749-754
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe report a case of rapidly spreading myeloma of immature cell morphology treated by peripheral blood stem cell transplantation (PBSCT). A 54-year-old man had a right orbital tumor, which subsequantly was removed and proved to be plasmacytoma. Three years later a mass lesion appeared in his left lung and bilateral kidneys. The specimen obtained at lung biopsy confirmed the diagnosis of plasmacytoma. Serum M-protein, IgG λ was increased, but there was no increase in plasma cells in the bone marrow. Since chemotherapy with VAD did not show any improvement, a high dose etoposide (500 mg/day, 4 days) was administered. When bone marrow suppression recovered, PBSCs were harvested (3.3×106/kg). After conditioning therapy with cyclophosphamide (2.0 g/day, 2 days), etoposide (200 mg/day, 3 days) and ranimustine (200 mg/day, 2 days), the stored PBSCs were injected. Minor response was abtained and he was discharged. 2 months thereafter, it was found that plasma cells increased in the bone marrow. He died of pulmonary bleeding soon. Autopsy revealed immature plasma cell infiltration in multiple organs including the heart, liver, spleen, kidneys, intestine, bone and bone marrow.View full abstractDownload PDF (551K) -
Akitoshi HANAMURA, Atsushi ICHIKAWA1995 Volume 36 Issue 8 Pages 755-761
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 64-year-old woman was diagnosed as having myelodysplastic syndrome (MDS) at 45 months after receiving radiotherapy for advanced carcinoma of the uterine cervix. We chose low dose therapy of SPAC and ACR because of the diagnosis as therapy-related MDS and the existence of radiation colitis. She obtained minor response, but two months later she transformed to AML (M2). The interval between low dose therapies was getting shorter and shorter, so we tried intensive chemotherapy consisting of BHAC, ACR and 6MP. Blast numbers were reduced, but she died of sepsis and intestinal bleeding. The patients of MDS with t(8;21) and the patients of therapy-related AML (tAML) with t(8;21) are very rare. According to the literature, only karyotype is a prognostic factor in AML/MDS with t(8;21). And diagnosis by the criteria of FAB classification is of little value regarding clinical progress. That is to say, if the patient has only t(8;21) or karyotipic abnormalities which are of little value in prognosis, such as the loss of a sex chromosome, it must be treated as de novo AML. but if patient has karyotipic abnormalities such as -5, 5q-, -7, 7q-, and/or multiple (complicated) abnormalities, we must accept that the prognosis is poor and must treat it as ordinary MDS/tAML.View full abstractDownload PDF (520K) -
Shigeki MOTOMURA, Shin FUJISAWA, Seiichiro ANZAI, Katsumichi FUJIMAKI, ...1995 Volume 36 Issue 8 Pages 762-767
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 50-year-old female was admitted with acute promyelocytic leukemia (APL) in August, 1988. She was treated with behenoyl-ara-C, daunomycin, 6-mercaptopurine and prednisolone (BH-AC·DMP), which led to a complete remission. Thereafter, she was treated with 2 courses of BH-AC·DM and discharged from hospital. Intensification therapy was performed twice a year, with 1 course of BH-AC·DM and 5 courses of intermittent-dose ara-C/mitoxantrone which ended in March, 1992. She had a relapse in September, 1993 and was treated with all-trans retinoic acid, which led to a second remission. A second relapse occured in May, 1994, and intermittent-dose ara-C/mitoxantrone, combinated with granulocyte colony-stimulating factor (G-CSF), led to a third remission. However, she had a third relapse in September, 1994. She was treated with a trial of G-CSF (300 μg/body, day 1-7), to stimulate dormant leukemic cells to enter the cell cycle, and cyclosporin-A (78 mg/kg, day 2-5), in order to overcome daunomycin resistance in refractory leukemia, combinated with daunomycin (45 mg/m2, day 3-5) and ara-C (1.4 g/m2, day 3-7), after obtaining informed consent. The fourth remission needed 46 days after combination chemotherapy because of severe myelosuppression. It was suggested that intermittent-dose ara-C/daunomycin therapy combinated with G-CSF and cyclosporin-A may be useful for relapsed and refractory leukemia.View full abstractDownload PDF (471K) -
Takumi KISHIMOTO1995 Volume 36 Issue 8 Pages 768-773
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSThrombocytopenia occurred after 17 days of administration of vancomycin (VCM) in 2 cases of MRSA pneumonia. The drug lymphocyte stimulation test using VCM and anti-platelet antibody were negative for these 2 cases. However, platelet bound IgG significantly increased and the total number of immature megakaryocytes in the bone marrow increased. Corticosteroid administration after VCM was very effective for thrombocytopenia. In case 1, thrombocytopenia occurred three times after using of VCM, suggesting to have been induced by VCM. The mechanism of thrombocytopenia was immunological destruction. It has been reported that VCM-induced neutropenia might be induced via an immunological mechanism. We reported here 2 cases of thrombocytopenia induced by VCM, which is frequently used for MRSA pneumonia.View full abstractDownload PDF (366K) -
Shun-ichi SHIMANO, Kayoko MURAYAMA, Akira OGAWA, Hitoshi KATAHIRA, Jun ...1995 Volume 36 Issue 8 Pages 774-779
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSA 75-year-old female, born in Tochigi Prefecture, was admitted because of lumbago in August of 1991. The leukocyte count was 11,800/μl with 22.5% atypical lymphocytes. We demonstrated a lymphocyte surface marker, ATL-associated antigen, and proviral DNA. We also identified 2.60 g/dl of serum monoclonal protein, found to be IgG, λ type, and punched out lesions in the skull. We made a diagnosis of ATL. She was also a HBV carrier. The patient was treated with a modification of CHOP therapy, because of increasing atypical lymphocytes in the peripheral blood in November of 1992. She died of acute hepatitis, suddenly, in March of 1993. Autopsy revealed multiple myeloma, fulminant hepatitis and occult thyroid cancer in addition to ATL.View full abstractDownload PDF (616K) -
Nozomi NIITSU, Michihiro NAKAYAMA, Masanori UMEDA1995 Volume 36 Issue 8 Pages 780-785
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSIntensive multidrug chemotherapy with concomitant IFN was performed in three hepatitis B virus (HBV) carriers with malignant lymphomas. All of the patients were HBsAg+, HBsAb-, HBcAb+, HBeAg- and HBeAb+ (mutant strain+). HBV-DNA polymerase (DNA-P) was normal at the begining of chemotherapy, and complete response was achieved with CO-BLAM chemotherapy (without PDN) in all cases. In case 1, a slight elevation of DNA-P and normal GOT and GPT was observed after IFN-α was started during the third course. IFN-α was administered twice a week. In case 2, elevation of DNA-P and normal GOT and GPT were noted at the end of the 5th course, then daily IFN-α was started. In case 3, daily IFN-α was started during the 3rd course because of elevation of DNA-P. It was possible to prevent severe liver damage by administering IFN immediately after the elevation of DNA-P, since DNA-P elevation is noted before GOT and GPT elevation. The detection of the HBV mutant strain could be helpful in the treatment of HBsAg+ and HBeAb+ patients. In all of three patients, DNA-P, serum GOT and GPT normalized quickly after the administration of IFN-α. Severe hepatitis did not develop.View full abstractDownload PDF (387K) -
Ken KAITO, Hiroko OTSUBO, Yoji OGASAWARA, Toru SEKITA, Akiko SAEKI, Ka ...1995 Volume 36 Issue 8 Pages 786-791
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSSevere aplastic anemia was diagnosed in a 58-year-old female because of pancytopenia with leukocyte count 700/μl, hemoglobin 3.4 g/dl, platelet count 4.2×104/μl and fatty hypoplastic bone marrow in August 1992. In January 1993, she was admitted with an abdominal skin infection caused by pseudomonas aeruginosa. After treatment of the infection, antilymphocyte globulin was given at a dose of 2,000 mg/day for four consecutive days in July 1993. This resulted in a gradual but steady improvement in her hematological data. In February 1995, her leukocyte count increased to 2,000/μl, hemoglobin to 15.2 g/dl and platelet count to 11.0×104/μl. Although no splenomegaly or myelofibrosis was found previously, from April 1993, the spleen enlarged and was palpable 10 cm below the costal margin. Her bone marrow biopsy in June 1993 revealed prominent myelofibrosis. Thereafter no changes were found in these features. Splenomegaly and myelofibrosis are characteristic of primary myelofibrosis and although the relationship is uncertain, there is no previous report on aplastic anemia with splenomegaly and myelofibrosis.View full abstractDownload PDF (468K)
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Torahiko MAKINO, Atae UTSUNOMIYA, Shinsuke SUZUKI, Kenji ISHIZUKA, Kat ...1995 Volume 36 Issue 8 Pages 792-794
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSWe have studied the incidence and characteristics of associated neoplasms in 210 ATL patients. Twelve patients had other primary neoplasms and the incidence of double cancer was 5.7%. The additional malignancies in ATL patients consisted of 4 cases of stomach, 3 cases of colon and one of each lung, ovary, uterus, liver and bladder cancer. In metachronous double cancer patients, the neoplasm was found before the time of diagnosis of ATL in 5 out of 6 patients.
Immunodeficiency due to HTLV-I infection as well as chemotherapy for the preceding neoplasm are suggested to be related to the leukemogenesis of ATL.View full abstractDownload PDF (189K)
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1995 Volume 36 Issue 8 Pages 795-808
Published: 1995
Released on J-STAGE: April 25, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1156K)
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