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Volume 38, Issue 2
Displaying 1-10 of 10 articles from this issue
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Noriatsu SUZUKI, Tadashi KOIKE, Tatsuo FURUKAWA, Hiroe NIWANO, Sohichi ...1997 Volume 38 Issue 2 Pages 95-99
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSTo clarify the efficacy of allogeneic bone marrow transplantation (BMT) for adult ALL in first remission we retrospectively studied long-term outcomes of adult ALL patients of age between 15 and 44 years who were treated in our institute from 1980 to 1990. In this period thirteen patients with HLA compatible donors were offered allogeneic BMT during the first remission, while 16 patients without HLA-compatible donor were treated with maintenance chemotherapy (Cancer Chemoth Pharmacology 33: 359∼365, 1994). Patient and disease characteristics (age, leukocyte count at presentation, immunophenotype, Ph1 chromosome, and duration to first remission) in the two groups were not significantly different (chi-square test p>0.1). As causes of treatment failure, relapse was 90% for chemotherapy while relapse and therapy-related death were 67% and 33%, respectively, for transplantation. The leukemia-free survival (LFS) rates at 10 years were 52±13% for transplantation and 30±11% for chemotherapy (P>0.2, g-Wilcoxon, Logrank). The 10-year-LFS rates of Ph1-negative patients of 15 to 29 year-old were 67±15% for transplanation (n=9) and 62±15% for chemotherapy (n=8) (P>0.9). Although the present data are derived from a non randomized retrospective study and a relatively small number of patients, this study revealed no superiority of BMT over chemotherapy for the prolongation of first remission in adult ALL, especially, in a standard risk group such as young patients without Ph1 chromosome.View full abstractDownload PDF (388K) -
ANLL9205 Study by Children's Cancer and Leukemia Study Group (CCLSG)Jun-ichi MIMAYA, Yasuo HORIKOSHI, Hiroyuki SHIMIZU, Hidenori MAEDA, Sh ...1997 Volume 38 Issue 2 Pages 100-107
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSTreatment results were evaluated in 45 children with acute myeloblastic leukemia (AML) treated on the ANLL-9205 protocol of the Children's Cancer Leukemia Study Group (CCLSG, Japan). In this protocol, terarubicin (THP-ADR), vincristine and continuous infusion of cytosine arabinoside (Ara C) were applied for remission induction therapy (AVC), and VP16+high dose Ara C were used sequentially for 32 or 48 weeks. Eleven patients received stem cell transplantation.
Thirty-eight out of the 43 eligible patients (88.4%) achieved complete remission, and the overall 3-year event-free survival (EFS) was 55.6% (S.E., 10%). This favorable response was attributed mainly to the high induction rate of patients with the M5, M7 FAB subtypes and higher WBC counts (≥10×109/L). There was no difference in the 3-year EFS of these patients who discontinued treatment between 32 weeks and 48 weeks. Serious toxicities were not observed in this study.
These findings suggest that the ANLL-9205 protocol is an effective and safe treatment regimen for childhood AML. When comparing the treatment period of 32 or 48 weeks, the difference was not statistically significant.View full abstractDownload PDF (577K) -
Yasuo MORISHIMA, Masamitsu YANADA, Yoshihisa KAMIYA, Takayoshi SHIMOKA ...1997 Volume 38 Issue 2 Pages 108-116
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSThe effects of regimens on the prevention of infection in 42 adult leukemia patients receiving bone marrow transplantation was analyzed. Standard risk patients (transplantation in 1st remission of acute leukemia and chronic phase of chronic myelogeneous leukemia received marrow from HLA compatible sibling or autologous marrow) showed shorter febrile days than high risk patients (transplantation in more advanced stage of leukemia and transplantation from unrelated donor), 1.33 mean days vs. 4.93 mean days respectively. Poorer intake of non-absorved antiboitics resulted in higher rate of bacterial colonization in stool after transplantation. And that, the degree of gut sterilization correlated with the duration of febrile days during the period of less than 100/μl peripheral neutrophil count in high risk patients. Thus, prophylactic regimens of infection in bone marrow transplantation should be considered according to the risk of patient, that is, more practical and complete prophylaxis in risk patients and more conventional one in standard risk patients.View full abstractDownload PDF (774K)
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Kuniya KISHIMOTO, Tohru SAKATA, Katsurou ITOH, Kazunori TOMINAGA, Hiro ...1997 Volume 38 Issue 2 Pages 117-123
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe reported a 59-year-old woman who received a diagnosis of psoriasis vulgaris at the age of 35 and had been under medical treatment. She was admitted to our department on August 16, 1993 because of lymphadenopathy, arthralgia and neuralgia. We observed cervical and axillar lymphadenopathy 1∼3cm indiameter, anemia and leukothrombocytosis. Elevated levels of erythrocyte sedimention rate (ESR), C-reactive protein (CRP) and immunoglobulin G (IgG), but not M-protein were observed by immunological analysis of the serum. Bone marrow aspiration biopsy revealed hypercellularity with myeloid hyperplasia and slight increase in plasma cells. Elevated levels of serum interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF) were detected; IL-6 was 62.1 pg/ml and G-CSF was 66 pg/ml, but IL-1α, IL-1β and TNF-α were within the normal range. Idiopathic plasmacytic lymphadenopathy (IPL) with polyclonal hyperimmunoglobulinemia was diagnosed by lymphnode biopsy and the patient received folluing treatment with prednisolone and hydroxyurea. Leukosytes, platelets and skin eruptions increased again when the steroid dose was tapered, so we changed treatments to MP (melphalan, prednisolone) therapy. In addition, various neurological abnormalities such as convulsions, loss of consciousness and peripheral polyneuritis were observed. Despite treatment her condition deteriorated and she finally died. Very few reports show these neurological abnormalities in IPL or Castleman's disease therefore we think this is a very rare case.View full abstractDownload PDF (755K) -
Rishu TAKIMOTO, Yoshihiro MOGI, Toshiro KURA, Yoshiro NIITSU1997 Volume 38 Issue 2 Pages 124-128
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old woman was admitted with apoplexy after operation of mitral valve stenosis and gastrectomy due to a gastric ulcer. In June 1994, her condition gradually worsened after acute pneumoniae in her right lung. Intravenous hyperalimentation with cimetidine administaration was started to improve her undernourishment, because she had a history of gastric ulcer. However, after 10 days from the start of cimetidine therapy, anemia progressed rapidly. Biochemical examinations revealed that the serum indirect bilirubin and LDH levels were elevated and no serum haptoglobin was detected. These results indicated the development of hemolytic anemia, but at that time we could not clarify the reason. In October 1994, thrombocytopenia gradually progressed, and we halted the administration of cimetidine. Both hemolytic anemia and thrombocytopenia was dramatically improved after cessation of cimetidine administration. We then changed the drug from cimetidine to ranitidine, however the same phenomena have appeared again. The patient was in stable condition, after cessation of H2-blockers administration. The complication of hemolytic anemia and thrombocytopenia associated with H2-blocker is very rare. This is the first reported case of hemolytic anemia and thrombocytopenia associated with H2-blocker administration in Japan.View full abstractDownload PDF (353K) -
Chizuru KAWANO, Kazuo MUROI, Naoto KUBOTA, Masaaki TAKATOKU, Toshiyuki ...1997 Volume 38 Issue 2 Pages 129-134
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 27-year-old female was diagnosed as having atypical aplastic anemia in 1979 because of hypercellular bone marrow with abnormal erythroblasts and megakaryocytes. Afterward the diagnosis was corrected to myelodysplastic syndrome (RA) due to the reevaluation of the bone marrow smears. In March, 1995, thirst and polyurea occured. In April, 1995, bone marrow aspiration biopsy showed the proliferation of atypical blasts (28%), and two months later, the number of the blasts increased (30%) and leukemic progression was noticed. Only 0.5 percent of the blasts showed weak peroxidase activity, and most of the blasts had CD13, CD33 and several adhesion molecules as CD11a, CD11b, CD44, CD54 and CD56. Karyotype of the bone marrow cells was 45, XX, -7. Her polyurea was caused by central diabetes insipidus. She was also complicated by pleuritis, colon ulcer, sinusitis and hypothalamic dysfunction. The etiology of these signs was due to the leukemic cell infiltration. She died despite of receiving multi-drug chemotherapy.View full abstractDownload PDF (581K) -
Naoto TOMITA, Hiroyuki FUJITA, Hideyuki KOHARAZAWA, Atsuo MARUTA, Fumi ...1997 Volume 38 Issue 2 Pages 135-141
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 16-year-old boy was operated upon for synovial sarcoma of the right thigh and underwent chemotherapy consisted of adriamycin (320 mg), cisplatin (780 mg), etoposide (4,200 mg) and ifosfamide (30,000 mg). He developed secondary leukemia 18 months after the chemotherapy. Acute lymphoblastic leukemia (L3) was initially diagnosed because of poor staining of α-naphtyl butylate esterase and induction chemotherapy with the LVP regimen (L-asparaginase 5,000 U/m2 day 8-21, vincristine 1.5 mg/m2 day 1, 6, 11, 16, 21, 26, prednisolone 40 mg/m2 day 1-28) was performed. After the therapy was initiated, the leukemia was finally diagnosed as acute momocytic leukemia (M5a) because of the following data: blasts were positive for CD33 and HLA-DR and negative for CD10, CD19 and CD20; serum lysozyme was 104.0 μg/ml; re-evaluation revealed that blasts were strongly positive for α-naphtyl butyrate esterase in a small part of the slides; 95% of the bone marrow cells showed t(9;11) chromosomal aberration; gene rearrangement was positive for MLL and negative for JH, JK and TCR Cβ1. Nevertheless, complete remission was obtained after 1 course of LVP therapy. He received bone marrow transplantation from an unrelated volunteer donor after 3 courses of consolidation therapy. He has remained in complete remission for 16 months.View full abstractDownload PDF (613K) -
Tomoaki FUJISAKI, Hisashi GONDO, Naoyuki UCHIDA, Isamu MATSUO, Katsuto ...1997 Volume 38 Issue 2 Pages 142-145
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSCytomegalovirus (CMV) hepatitis refractory to ganciclovir treatment occurred after prolonged administration of ganciclovir in a 36-year-old woman with chronic myelogeneous leukemia who had undergone allogeneic bone marrow transplantation (BMT) from an HLA-identical unrelated donor. The number of CMV antigen-positive leukocytes in blood were well correlated with the serum levels of transaminases and the antigenemia assay was useful in monitoring CMV hepatitis. The patient was treated with foscarnet, a potent inhibitor of CMV DNA-polymerase, which led to rapid improvement of the CMV antigenemia and the transaminase concentrations. Foscarnet therapy should be considered for ganciclovir-resistant CMV disease in the setting of BMT.View full abstractDownload PDF (343K)
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Kyuhei KOHDA, Kazuhiko KOIKE, Shuji MATSUMOTO, Masaya KIDA, Osamu NAKA ...1997 Volume 38 Issue 2 Pages 146-148
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSSerum levels of soluble interleukin-2 receptor (SIL-2R) and C-reactive protein (CRP) were measured in 12 patients with interstitial pneumonia (IP) and 10 patients with bacterial pneumonia (BP) of hematological malignancies. Mean SIL-2R levels (U/ml) were 394±140 in normal controls, 755±320 in BP, and 2328±943 in IP. A significantly higher level was found in IP than BP (p<0.05). Moreover, the SIL-2R/CRP ratio which was over 260 in all cases of IP completely distingwished IP from BP. Levels of SIL-2R rose before the onset of IP and were closely associated with clinical course in most cases. From these results, measurement of serum SIL-2R may be useful for the diagnosis and monitoring of the clinical course of IP complicated with hematological diseases.View full abstractDownload PDF (222K)
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1997 Volume 38 Issue 2 Pages 149-151
Published: 1997
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (255K)
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