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Volume 38, Issue 1
Displaying 1-13 of 13 articles from this issue
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Yutaka TAKAHASHI, Hiroshi UMADOME, Yoichiro OHONO1997 Volume 38 Issue 1 Pages 1-8
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSIneffective erythropoiesis was evaluated in 100 studies in 87 patients with myelodysplastic syndromes (MDS) applying newly deviced parameters based on ferroerythrokinetic (FEK) data including erythron transferrin uptake (ETU). The efficiency ratio (R-Ef) was calibrated with V-2, the second canonical discriminant variate which underwent axis rotation. Based on discriminated FEK patterns, as previously reported, the patients were classified into five types i.e. I-z, ineffective, H-z, hemolytic hyperplastic, O-z, hypoplastic, I-H-z and I-O-z, combination of these, groups. The proportion of I-z group was 48% and that of I-H-z and I-O-z groups was 30%. Significant correlations were obtained in I-z group between R-Ef and ETU (r=-0.628), unclear abnormality scores (R=0.664) or ringed sideroblast scores (R=0.742), scored by dummy variables regression. In the other groups, significant deviation from these correlations was observed, indicating that there is an obvious heterogeneity in MDS patients concerning association or dissociation of morphological abnormality, in addition to hyperplasia of erythroblasts, with or from ineffective erythropoiesis.View full abstractDownload PDF (595K) -
Kyoko MIYAMOTO, Teruhisa OTSUKA, Shin-Ichi MIZUNO, Kiyoka FUNATSU, Ryo ...1997 Volume 38 Issue 1 Pages 9-13
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSIn this study, we investigated CDw90 (Thy-1) expression in CD34+ cells and hematopoietic colony-forming ability in purified CD34+ Thy-1+ and CD34+ Thy-1- fractions in the peripheral blood at the PBSCH. The high proliferative potential colony-forming cells (HPP-CFC), which are considered to be more primitive hematopoietic stem cells, were found more frequently in the purified CD34+ Thy-1+ fraction than in the puridied CD34+ Thy-1- fraction. Thus, it is useful to decide the optimal time of PBSCH to measure the CD34+ Thy-1+ cells as well as CD34+ cells in the peripheral blood by flow-cytometry.
In CD34+ acute myeloblastic leukemia (AML) cells, the co-expression rate of CD34 and Thy-1 was negative, suggesting that it may be possible to estimate the contamination of CD34+ AML cells by the Thy-1 expression rate in CD34+ cells at PBSCH.View full abstractDownload PDF (389K)
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Hiroshi WATANABE, Osamu ASAI, Norimichi TADA, Shingo YANO, Akinori KAT ...1997 Volume 38 Issue 1 Pages 14-20
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old woman with chronic myelogenous leukemia received allogeneic bone marrow transplantation from an unrelated human leukocyte antigen (HLA) matched (but mixed lymphocyte culture (MLC) positive to graft-versus-host disease (GvHD) donor. The blood type of the recipient was A type Rh (+) while the donor blood type was B type Rh (+). The patient received busulfan 8 mg/kg, cyclophosphamide 120 mg/kg, and total-body irradiation 10 Gy before bone marrow transplantation. Short-term administration of methotrexate and cyclosporin was given for prophylaxis of GvHD. The mononuclear cells harvested from the donor were concentrated by COBE Spectra before bone marrow transplantation. Although engraftment of transplanted bone marrow in the recipient was confirmed on day 11, the patient suffered from severe anemia on day 10. Since the direct Coombs' test to A type red blood cells was positive, and anti-A antibody titer increased 16-fold, we diagnosed her anemia as hemolytic anemia caused by ABO mismatched transplantation. In addition to hemolytic anemia, she had skin symptoms of acute GvHD grade II, microangiopathic hemolytic anemia, and died of multiple organ failure on day 44. This experience indicated that some allogeneic transplant recipients are at risk of severe hemolytic anemia in the early stage after unrelated ABO miamatched donor and that it is necessary to establish proper treatment and prophylaxis.View full abstractDownload PDF (777K) -
Takeshi HARA, Hisashi TSURUMI, Toshiki YAMADA, Michio SAWADA, Tomoo NA ...1997 Volume 38 Issue 1 Pages 21-27
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 63-year-old male was admitted because of pneumonia. Peripheral blood findings showed pancytopenia with increase of blasts. A bone marrow specimen showed hypocellular marrow with increase of blasts. The blasts were positive for CD7, CD34, and HLA-DR and negative for other lymphoid antigens and myeloid antigens involving myeloperoxidase. Rearrangement of immunoglobulin heavy chain was demonstrated by Southern blotting analysis. T cell receptor β, T cell receptor γ and immunoglobulin light chain rearrangement were negative. A diagnosis of stem cell leukemia was made. In vitro, the blasts did not respond to recombinant human granulocyte colony-stimulating factor (rhG-CSF), cytarabine (Ara-C) and all-trans retinoic acid (ATRA). However, in the blasts of culture without cytokeins, CD33 expression was newly induced. Remission was not obtained by chemotherapies with cyclophosphamide, etoposide, prednisolone and Ara-C. Four months later, marrow specimens showed hypoplasty wtih myelofibrosis. One year later, the blasts showed CD33 expression with negative myeloperoxidase. The leukemia was transformed to minimally differentiated myeloid leukemia from stem cell leukemia. This condition was thought to be “smoldering leukemia” because of the slow development and refractoriness to chemotherapy. Nineteen months later the patient died due to respiratory failure by pneumonia and pulmonary bleeding despite therapy.View full abstractDownload PDF (532K) -
Toshiki YAMADA, Hisashi TSURUMI, Nobuo MURAKAMI, Hisataka MORIWAKI, Ya ...1997 Volume 38 Issue 1 Pages 28-32
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old man with Werner's syndrome was admitted with epigastralgia and body weight loss. The peripheral blood findings showed anemia, thrombocytosis and eosinophilia. Bone marrow aspiration and biopsy revealed increases in eosinophils and megakaryocytes, myelodysplastic change with 6.6% myeloblast, and myelofibrosis. Chromosomal analysis revealed 46, XY, +der(1;7), -7, del(20). He was diagnosed as having myelodysplastic syndrome with myelofibrosis or essential thrombocythemia. Three months later, pancytopenia appeared with a relative increase of blasts positive for CD41 and negative for myeloperoxidase. He died of respiratory failure due to pneumonia. An autopsy revealed severe myelofibrosis with proliferation of megakaryocytes and blasts. A final diagnosis of acute megakaryoblastic leukemia was made. Werner's syndrome is rare, and it is even more unusual to have the complieation of acute leukemia with der(1;7) seen in this case.View full abstractDownload PDF (478K) -
Masaaki TOYOSAWA, Kenji SHINOHARA, Kouichi ARIYOSHI, Toshihiko ANDO, M ...1997 Volume 38 Issue 1 Pages 33-40
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 18-year old female with acute myelogeneous leukemia (AML), M2 had translocation: t(6;9)(p23;q34). The patient entered into hematological complete remission after two courses of BHAC-DMP chemotherapy with disappearance of cytogenetic abnormality. However, minimal residual disease (MRD) detected with DEK/CAN chimeric m-RNA by reverse transcription polymerase chain reaction (RT-PCR) was continuously observed, although decreased quantitatively, following several courses of cosolidation and intensification chemotherapies. MRD was detected also in the harvested peripheral blood stem cells (PBSC). Leukemia relapsed with the reappearnce of t(6;9) 2 months after the subsequent peripheral blood stem cell transplantation (PBSCT). Leukemia became refractory to chemotherapy, and the patient died 5 months thereafter.View full abstractDownload PDF (564K) -
Yohko ONO, Shigeki ITO, Kazunori MURAI, Yasuro MIYAIRI, Sanae ENOMOTO, ...1997 Volume 38 Issue 1 Pages 41-46
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report a case of 53-year-old man with acute myelogenous leukemia (M2) showing a karyotype of t(7;11)(p15;p15), del(10)(q11;q12), who was complicated with perforation of a duodenal ulcer during the antileukemic chemotherapy using behenoyl ara-C, daunorubicin, 6-mercaptopurine and prednisolone. As his bone marrow still showed high cell density and leukemic proliferation at the time of intestinal perforation, the therapeutic regimen was changed to a combination of behenoyl ara-C and mitoxantrone, and daily rhG-CSF was concurrently administered for the purpose of early establishment of bone marrow hypoplasia. On the 8th day after the therapeutic regimen had been changed, his bone marrow became nearly aplastic, and complete remission was obtained on the 24th day. This case may indicate that the concurrent administration of cell-cycle specific antileukemic drugs and rhG-CSF is available for AML patients with emergent need of leukemic cell reduction.View full abstractDownload PDF (485K) -
Takayuki TANAKA, Youichi AKIFUJI, Masaki MORI, Juichi UEKI, Shu NAKAMO ...1997 Volume 38 Issue 1 Pages 47-51
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 21-year-old Japanse woman was referred to our hospital because of severe anemia and thrombocytopenia. Bone marrow aspiration showed a hypercellular marrow with 91.5% promyelocytes. Cytochemical study and surface marker a diagnosis of acuate promyelocytic leukemia. Because leukocyte count elevated, she was treated with all-trans retinoic acid (ATRA) after conventional chemotherapy. After 11days of ATRA therapy, the patient started to develop severe headache, nausea and diplopia. Ophthalmologic examination revealed bilateral papilledema. Computed tomography and magnetic resonance imaging of the head showed no intracranial lesion. ATRA was discontinued because it was suspected to couss intracranial hypertension. Her symptoms were relived and patilledema improved gradually. ATRA is safe and well-tolerated, if the retinoic acid syndrome can be prevented or managed. As the tolerable dose of ATRA in adults is higher than that in children, the side effects tend to occur in children. In Japan, only two childhood cases of intracranial hypertension during ATRA therapy have been reported. We must remember the possibility of intracranial hypertension during ATRA therapy, even in adults.View full abstractDownload PDF (399K) -
Koichi KITAZUME, Kensuke USUKI, Mitsue ENDO, Mayumi OSAWA, Seiko IKI, ...1997 Volume 38 Issue 1 Pages 52-57
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe present a man with non-Hodgkin's lymphoma who had false positive FDP test results and who had monoclonal IgM and IgG. At admission, laboratory examinations showed elevated FDP levels and prolonged PT and APTT, which did not improve by anti-coagulation therapy. Although coagulation system data returned to normal levels after steroid pulse therapy, the FDP level increased. Positive pregnancy test and results of dilution analyses on FDP assay lyielded a diagnosis of false positive FDP test results due to serum latex agglutinin. The addition of anti-immunoglobulin antibody inhibited latex agglutination by serum. FDP levels positively correlated with serum IgM concentrations. These data suggest that the false positive FDP test in this case was due to latex agglutination by monoclonal IgM.View full abstractDownload PDF (457K) -
Tetsuya KUROSU, Chizuko SAKASHITA, Koh YAMAMOTO, Shuji TOHDA, Tohru MI ...1997 Volume 38 Issue 1 Pages 58-63
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 49-year-old man was admitted with swelling in the left lower extremity, and a mass in the left lower abdomen. Laboratory findings showed an increased WBC of 15,000/μl with 41% plasma cells, and immunoglobulin (Ig) A of 2,557 mg/dl with a monoclonal component. A roentgenogram and computed tomograph of the abdomen revealed that a 5×10 cm mass with calcification located in the iliopsoas muscle. Plasma cell leukemia with extramedullary plasmacytoma was diagnosed, and the patient was treated with high-dose dexamethasone (40 mg/day for 4 days), resulting in a good response with the disappearance of plasma cells in peripheral blood and a marked decrease in serum Ig A. However, the patient's condition deteriorated in spite of various treatments, and he died of heart failure 5 months after admission. With informed consent from relatives, a necropsy was performed and infiltration of plasma cells in the mass in the iliopsoas muscle was noted. We reported this case because plasma cell leukemia with amyloid deposition and osteogenesis at the site of extramedullary plasmacytoma is very rare.View full abstractDownload PDF (635K) -
Atsushi SHINAGAWA, Takayoshi ITOH, Takuya KOMENO, Tsunehiko KOMATSU, Y ...1997 Volume 38 Issue 1 Pages 64-71
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe reported a rare case of pancytopenia caused by allopurinol. A 61-year-old man was first admitted in May 1993, because of thrombocytosis. He had suffered from chronic glomerulonephritis. He was administered allopurinol for hyperuricemia from March 1993. On first admission the laboratory findings revealed leukocytosis (10,100/μl) and thrombocytosis (971×103/μl) in the peripheral blood. Myelofibrosis was strongly suspected due to increased number of MgK and reticular fiber in the bone marrow. Two months later, he readmitted due to pancytopenia (WBC 1,300/μl, Hb 6.2 g/dl, Plt 10×103/μl). His bone marrow showed markedly hypocellular. Because we suspected that pancytopenia was induced by allopurinol, we discontinued allopurinol and administered oxymetholone, G-CSF, and EPO. WBC, RBC, and platelet count had been recovered about one and half months later. In vitro co-culture indicated that CFU-G, E, and Meg in the bone marrow cells after recovery from pancytopenia were markedly suppressed in the presence of patient's serum and oxipurinol. Pancytopenia due to allopurinol was reported to be rare, and some authors showed that it will sometimes be fatal. Because pancytopenia of this case had been recovered in a relatively short time with cytokine therapy, it was thought to be effective for pancytopenia due to drug like this case.View full abstractDownload PDF (599K)
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Shigemi HASHIMOTO, Motofumi HIYOSHI, Masayuki HINO, Takahisa YAMANE, T ...1997 Volume 38 Issue 1 Pages 72-74
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSChronic myelogenous leukemia (CML) expresses two types of bcr-abl chimeric mRNA. One is b3a2 type in which bcr exon 3 binds to abl exon 2. the other is b2a2 type that bcr exon 2 binds to abl exon 2. Either bcr-abl is normally expressed, but both types of bcr-abl mRNA can be expressed at the same time in a patient. We report here a rare case of CML expressing two types of bcr-abl mRNA and discuss the possibility that this double expression would help to monitor the clinical course of CML.View full abstractDownload PDF (232K)
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1997 Volume 38 Issue 1 Pages 75-85
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1014K)
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