Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 39, Issue 1
Displaying 1-15 of 15 articles from this issue
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  • Efficacy of Granisetron, a 5-HT3 Antagonist, in the Prevention of Nausea and Vomiting Induced by Conditioning for Hematopoietic Stem Cell Transplantation
    Noriyuki HIRABAYASHI, Seiichi GOTO, Yasuo MORISHIMA, Hiroshi SAO, Taka ...
    1998 Volume 39 Issue 1 Pages 21-26
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.21
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    One hundred and eleven patients receiving conditioning regimens for hematopoietic stem cell transplantation (HSCT) were administered a single intravenous dose (40 μg/kg) of granisetron before chemo-radio therapy. The efficacy of the drug was assessed every 24 hours, rating the control of nausea and vomiting as complete, major, minor or failure. On day 1, 23 of 48 patients (47.9%) who received cyclophosphamide (60 mg/kg/day), achieved control of emesis with complete or major response. On day 2, 17 of 47 patients (36.2%) achieved control of emesis. During total body irradiation (TBI) (10∼12 Gy/2∼3 days), 21 of 33 patients (63.6%) achieved control of emesis on day 1 and 22 of 32 patients (68.6%) achieved control of emesis on day 2. During melphalan administration (60∼100 mg/m2/day), 20 of 28 patients (71.4%) achieved control of emesis on day 1. Adverse effects were observed in seven patients but were not serious. We concluded that granisetron has a major role in preparation for HSCT.
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  • Clinicopathological Study of Multiple Myeloma Associated with Hyperanmmonemia
    Souichirou FUJII, Shunichi FUKUDA, Tatsuo SEZAKI, Motomasa MURAKAMI
    1998 Volume 39 Issue 1 Pages 27-33
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.27
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    Of 5 multiple myeloma patients with hyperammonemia, autopsy was performed in 4 patients, while amino acid metabolism was examined in 3 patients. As a result they were classified into the following 3 types; A, liver dysfunction and severe liver infiltration of myeloma cells. B, severe liver infiltration without liver dysfunction. C, Neither liver dysfunction nor severe liver infiltration. In one type A patient, isoleucine decreased. In two patients without liver dysfunction (one type C patient and another patient in whom autopsy was not performed) valine, leucine and isoleucine decreased, and tyrosine decreased slightly. The Fischer ratio decreased in these 2 patients, while it decreased slightly in a type A patient. Clinically, in 4 patients hyperammonemia was observed during periods of poor general condition and when refractory to chemotherapy. In an aggressive type case, consciousness disturbance was developed rapidly and multiple myeloma was diagnosed. In all patients, consciousness disturbance was noted. Hyperammonemia might have been caused by hepatic failure or systemic-portal shunt in patients with liver infiltration. In those without liver infiltration, it was suggested that hyperammonemia was caused by myeloma related humoral factors that influence amino acid metabolism.
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  • Increased Erythron Transferrin Uptake Associated with Ineffective Erythropoiesis in Iron Deficiency State
    —The Common Factors to Iron Deficiency Anemia and Portal Hypertensions—
    Yutaka TAKAHASHI, Hiroshi UMADOME, Youichirou OHNO
    1998 Volume 39 Issue 1 Pages 34-43
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.34
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    We calibrated the erythron transferrin uptake (ETU) and efficiency ratio (R-Ef) in erythropoiesis on the basis of ferroerythrokinetic data in 90 patients with iron deficiency anemia (IDA) and 64 patients with noncirrhotic and cirrhotic portal hypertension with splenomegaly (PH). Then we analyzed the data to elucidate how iron deficiency (ID) status effects variation of these values.
    ETU was significantly higher and R-Ef was lower in IDA subgroup before treatment (n=71) than those with any recent treatment (n=19), and in PH with anemia of ID type (PH-ID n=39) than those without ID state (n=34). A remarkable inverse correlation was obtained between ETU and R-Ef in both IDA and PH-ID and iron replacement therapy effected synchronous improvement of these values.
    We deduced the quantitative parameter of ID status (ID-x) on blood chemistry data in IDA by multiple regression of ETU and of R-Ef respectively. These calibration formulae were extrapolated to the data in PH-ID. Thus we delineate the factor which represents ID status in common to these two diseases to increase ETU and decrease R-Ef, although the contribution of ID-x was greater in IDA than PH-ID. Additional factors to enhance or modify these values were shortened survival of erythrocytes, splenomegaly and hepatic dysfunction.
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  • The Oldest Case with X-linked Agammaglobulinemia in Japan Lacking Bruton-type Tyrosine Kinase Protein Detected by Flow Cytometory
    Fumihiro ISHIDA, Hikaru KOBAYASHI, Hiroshi SAITO, Takeshi FUTATANI, To ...
    1998 Volume 39 Issue 1 Pages 44-47
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.44
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    We report a case of sporadic X-linked agammaglobulinemia previously diasgnosed as variable immunodeficiency (VID). An 39-year-old male had recurrent episodes of respiratory tract infection since his early childhood. At the age of four, he developed partial paresis of the left limbs after polio immunization. After diagnosis of VID based on marked decrease of serum IgG, IgA and IgM levels and no antibody production against antigenetic stimuli at age 22 years old, he received intravenous immunoglobulin supplementation irregularly. We reexamined him and found marked decrease in B cells in the peripheral blood. In addition, we investigated the expression of Bruton-type tyrosine kinase on monocytes by flow cytometry and confirmed its deficiency. His mother was diagnosed as a carrier of XLA. The patient is probably the oldest case with XLA in Japan.
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  • Scrotum Exfoliative Dermatitis with Ulcers Associated with Treatment of Acute Promyelocytic Leukemia with All-trans Retinoic Acid
    Katsushi TAJIMA, Michio SAGAE, Akito YAHAGI, Jiro AKIBA, Keijiroh SUZU ...
    1998 Volume 39 Issue 1 Pages 48-52
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.48
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    All-trans retinoic acid (ATRA) induces complete remission (CR) in most cases of acute promyelocytic leukemia (APL). Toxicity of ATRA has been shown to be mild and consist of headache, dry skin, dermatitis, gastrointestinal disorders, and hypertriglyceridemia. We report three patients with APL treated with ATRA in combination with chemotherapy, who developed scrotum exfoliative dermatitis with ulceration. Their median age was 33 years (range, 25 to 37). All three cases developed scrotum erosions, and many small ulcers after 9 to 17 days of ATRA treatment. The scrotum exfoliative dermatitis with ulceration occurred repeatedly, but gradually resolved in about 8 weeks time. They developed no dryness of the lip or skin apart from the scrotum. All three cases continued to receive 45 mg/m2 of ATRA daily throughout induction therapy, and achieved CR. We suspected the scrotum exfoliative dermatitis with ulceration to be a side effect of ATRA. The scrotum lesions, which have been already reported may be common in patients receiving ATRA.
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  • Acute Abdomina Pain as a Presenting Symptom of Varicella-Zoster Virus Infection in an allogeneic Bone Marrow Transplant
    Tohru HAMANISHI, Hiroki NISHIKAWA, Masato KOBAYASHI, Taisei NAKAO, Sin ...
    1998 Volume 39 Issue 1 Pages 53-58
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.53
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    A 26-year old man was admitted because of acute abdominal pain. He had received an allogeneic bone marrow transplant (BMT) for aplastic anemia 6 months before. All physical, laboratory, roentgenographic, and ultrasonographic studies were perfomed but nondiagnostic. On the fourth hospital day the patient developed visual disturbance and on the followning day skin eruption appeared. Laboratory findings revealed severe liver dysfunction. We diagnosed this case as varicella-zoster virus (VZV) infection with visceral dissemination. Antiviral therapy with acyclovir was initiated and abdominal pain markedly reduced and visual acuity was recoverd after 4 days.
    In case of VZV infection, acute abdominal pain prior to skin eruptions is rare. However in such cases the patients are highly fatal due to visceral dissemination. Antiviral therapy begun before visceral dissemination of VZV is highly effective in preventing serious disease, whereas it is less effective after dissemination. We consider that earlydiagnosis and treatment of VZV infection is necessary for BMT recipients who are undergoing immunosuppressive therapy.
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  • Diffuse B-cell Lymphoma Associated with Hemophagocytic Syndrome
    Tsuyoshi SUZUKI, Yasunobu NONAKA, Tatsuyuki HAYASHI, Takeo NOMURA, Mak ...
    1998 Volume 39 Issue 1 Pages 59-65
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.59
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    The patient was a 49-year-old woman who came to our hospital with a chief complaint of fever. She was admitted due to hepatosplenomegaly and pancytopenia. We diagnosed hemophagocytic syndrome based on histological examination of the bone marrow. She was treated with antibiotics and the CHOP regimen, resulting in solution of her condition. Two months later, lymphadenopathy and pancytopenia were recognized. Pathological examination of a lymph node revealed diffuse large B-cell lymphoma. B-cell lymphoma with hemophagocytosis was diagnosed. We present here a rare case of B-cell lymphoma associated with hemophagocytic syndrome.
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