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Volume 39, Issue 3
Displaying 1-14 of 14 articles from this issue
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[in Japanese]1998 Volume 39 Issue 3 Pages 163-165
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese]1998 Volume 39 Issue 3 Pages 166-169
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese]1998 Volume 39 Issue 3 Pages 170-172
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese]1998 Volume 39 Issue 3 Pages 173-175
Published: 1998
Released on J-STAGE: April 28, 2009
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Masahiko TABATA, Minoru YOSHIDA, Toru IZUMI, Chizuru KAWANO, Ryoko KUR ...1998 Volume 39 Issue 3 Pages 176-184
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA retrospective analysis was performed on 76 consecutive elderly patients with acute leukemia aged 60 years or more (48 men, 28 women). Forty patients were 60∼69 years old, 28 were 70∼79 years old and 8 were ≥80 years old. There were 55 patients with acute myelogenous leukemia (AML), 13 acute lymphoblastic leukemia (ALL) and 8 AML from myelodysplastic syndrome (MDS/AML). Patinets were treated with the JALSG protocol, CAG regimen, or low-dose Ara-C regimen for AML and DVP/M-CHOP protocol for ALL. The complete remission (CR) rates were 52.7% (29 of 55) in AML, 61.5% (8 of 13) in ALL, and 0% in MDS/AML. The median CR durations were 226, 85, 0 days, and the median survivals were 204, 177, 99 days, respectively. CR rates were 65.3% for the JALSG protocol, 62.5% for the CAG regimen and 25.0% for low-dose Ara-C regimen. According to age, CR was obtained 62.5% in patients aged 60∼69 years and 33.3% in patients over 70 years old. Our results indicated that patients aged 60∼69 years should be treated with intensive chemotherapy.View full abstractDownload PDF (537K)
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Yozo NAKAZAWA, Kenichi KOIKE, Yumi KITAZAWA, Kazuo SAKASHITA, Nobukuni ...1998 Volume 39 Issue 3 Pages 185-192
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 19-year-old woman with acute lymphoblastic leukemia received an allogeneic bone marrow transplantation (BMT) from an HLA-identical sibling during the second remission, on September 28, 1993. The conditioning regimen consisted of total body irradiation and cyclophosphamide. Short term methotrexate and cyclosporin A were given for prophylaxis of graft-versus-host disease (GVHD). On day 771 after BMT, she complained of bilateral forearm pain, and developed sclerotic lesions on the skin of the abdominal wall, forearms and legs. The diagnosis of sclerodermatous GVHD was established by skin biopsy on day 834. The values of CRP and IgG were elevated, and both antinuclear antibody and anti-DNA antibody became positive. Flow cytometric analysis showed a significant increase in the number of CD57+ cells after appearance of sclerotic change. In addition, 65% of CD8+ cells were positive for CD57. Circulating level of transforming growth factor (TGF)-β1 was high. These results suggest that overproduction of CD8+ CD57+ T cells and high level of circulating TGF-β are related to the development of sclerodermatous GVHD.View full abstractDownload PDF (864K) -
Yasuyuki INOUE, Yasunori NAKAGAWA, Masakazu SAWANOBORI, Kenshi SUZUKI, ...1998 Volume 39 Issue 3 Pages 193-197
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 54-year-old woman, who had been given a diagnosis of idiopathic thrombocytopenic purpura (ITP) refractory to steroid therapy, was admitted to our hospital because of severe bleeding tendency. Splenectomy, high dose vitamin-C and interferon-α were not effective, although high-dose γ-globulin had some effect. Since high-dose glucocorticoid was effective temporarily, we decided to perform chemotherapy. Seven courses of CVP chemotherapies (CVP; CPM 500 mg, VCR 2 mg, PSL 50 mg) prevented severe bleeding and did not have serious toxicity. Chemotherapy can be indicated for refractory ITP reactive to immunosuppressive therapy such as high-dose glucocorticoid.View full abstractDownload PDF (341K) -
Hitoshi IWAMI, Akiko MISAWA, Kentaro TSUNAMOTO, Yasuo KASUBUCHI, Mayum ...1998 Volume 39 Issue 3 Pages 198-204
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report two cases of Epstein-Barr virus (EBV)-associated lymphoproliferative disorders (LPD) after allogenic bone marrow translantation which were conditioned with regimens including antithymocyte globulin (ATG). The first case was a 31 year-old man which severe aplastic anemia who was transplanted from HLA-matched unrelated donor conditioned with total lymphoid irradiation (TLI)/cyclophosphamide/ATG and prophylactic administration of ganciclovir Grade I acute GVHD improved in response to cyclosporine (CsA). LPD as a polyclonal epipharyngeal mass developed at day +53 and spontaneously regressed along with the withdrawal of CsA. Second case was a 11 year-old boy with acute myelomonocytic leukemia (FAB:M4E). He was transplanted from HLA B locus mismatched mother conditioned with total body irradiation (TBI)/busulfan/L-PAM/ATG. He showed grade IV acute GVHD, which was controlled by steroids and FK-506. LPD as a monoclonal intestinal lymphoma was diagnosed at day+82, and he was unsuccessfully treated with ganciclovir, acyclovir, chemotherapy and transfusions of EBV-specific cytotoxic lymphocytes in addition to discontinuation of immunosupressants, and died at day+18 due to sepsis and multiple cerebral infarction. Early detection and introduction of appropriate treatment for post bone marrow transplantation LPD is necessary.View full abstractDownload PDF (800K) -
Fumie HAMAMOTO, Tohru TAKAHASHI, Toshiaki HAYASHI, Takako SOMEKAWA, Ay ...1998 Volume 39 Issue 3 Pages 205-209
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 38-year-old woman who had been treated for refractory anemia was admitted with severe pancytopenia, persistent fever and splenomegaly in May 1995. The bone marrow biopsy revealed hyperplastic marrow with marked fibrosis. Shortly after admission, cardiac tamponade developed. Though low-dose Ara-C therapy successfully controlled the tamponade, no hematological recovery was obtained. Then a chemotherapy consisted of Ara-C, acrarubicin and M-CSF was done and the neutropenia was improved. However, progressive leukocytosis with monocytosis and splenomegaly subsequently developed. Thus, the disease was considered to progress to CMML. Localized pulmonary infiltrates associated with a cavity, a pulmonary artery aneurysm and a reccurent high fever developed in October 1995. Though invasive pulmonary aspergillosis was suspected, blood and sputa culture, as well as serological tests were negative. In February 1996, massive hemoptysis occurred and the patient died due to respiratory failure after an emergency right lobectomy of the lung. Pathological examination of the operated lung disclosed that the localized pulmonary infiltrates consisted of monocytoid cells. Infiltration of the monocytoid cells in the tissue surrounding the pulmonary aneurysm was also observed. However, no pathologic organisms were detected at all. Thus, the leukemic cells were considered to have infiltrated locally into the lung.View full abstractDownload PDF (747K) -
Koji IZUTSU, Kensuke USUKI, Kaoru INOUE, Mitsue ENDO, Seiko IKI, Shoji ...1998 Volume 39 Issue 3 Pages 210-215
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 62 year-old man had fever, splenomegaly, systemic lymphadenopathy and palpable petechiae. Laboratory studies showed leukocytosis (10,200/μl) with plasma cells (23%) and polyclonal gammopathy. Southern blot analysis of peripheral blood mononuclear cells showed no rearrangement of immunoglobulin genes, indicating polyclonal plasmacytosis in peripheral blood. A diagnosis of Castleman's disease was made by the cervical lymph node biopsy, which showed onion-skin structures in the germinal centers and plasmacytosis in the interfollicular region. A skin biopsy of the purpura lesion disclosed leukocytoclastic vasculitis. This is an unusual case of Castleman's disease presenting plasmacytosis in peripheral blood and leukocytoclastic vasculitis.View full abstractDownload PDF (796K) -
Hirohisa NAKAMAE, Masayuki HINO, Kensuke OHTA, Kenichi SUZUKI, Yasutak ...1998 Volume 39 Issue 3 Pages 216-220
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 22-year-old unmarried female student of nurse school was admitted to our hospital because of hypochromic anemia and fever of unknown origin. She was diagnosed as having iron-deficiency anemia and was treated with iron, but progressive anemia recurred periodically. In particular, rapidly progressive anemia was observed after the patient stayed overnight, so we strongly suspected factitious anemia. A search of her locker in the sickroom and her room at home revealed many syringes, injection needles and a bottle of blood. Factitious anemia was diagnosed and she confessed to self blood-drawing. After a psychiatric consultation, anemia tended to to resolve gradually. However she did not go to the hospital after 6 months from her discharge. Physicians should consider factitious anemia in a patient with severe chronic hypochromic anemia who dose not respond to adequate iron therapy, paticularly in a patient with medical training.View full abstractDownload PDF (390K) -
Katsuro ITOH, Wakako GOTOH, Fumiharu YAGASAKI, Yoshihiro ITOH, Nobutak ...1998 Volume 39 Issue 3 Pages 221-226
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 56-year old man was admitted to our hospital in September, 1996. Chromosomal translocation (15;17) and a PT-PCR study for PML-RARα mRNA were positive in bone marrow aspirates, and acute promyelocytic leukemia was diagnosed. After CR was obtained with all-trans retinoic acid (ATRA) followed up with chemotherapy, the RT-PCR became negative. When he was readmitted in April, 1997, skin eruption on his chest and extremities were observed. Specimens taken for biopsy revealed leukemia cutis, and RT-PCR became positive in the same specimen. Bone marrow PT-PCR was also positive without abnormal promyelocytes. Although he was treated with oral ATRA 80 mg/day again, no significant improvement in leukemia cutis was noted. After combined therapy with Ara-C and acularubicin, skin eruption disappeared and bone marrow RT-PCR became negative. A second CR was then obtained. Although it is unknown whether the administration of ATRA is related to extramedullary relapse or not, we recommend combined chemotherapy for such cases.View full abstractDownload PDF (677K) -
Takanori OKADA, Masako MOURI, Jun YAMANOUCHI, Atsuhiko HASEGAWA, Eisuk ...1998 Volume 39 Issue 3 Pages 227-231
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 81-year-old woman was admitted with fever, anemia and an elevation of serum LDH on September, 1995. She had anasarca and various abnormalities of the ocular fundus including Roth's spots. Skin eruption and psycho-neurological abnormalities were not seen. Laboratory data exhibited Hb 7.6g/dl, Plt 9.3×104/μl, WBC 6,300/μl and LDH 1932 IU/l. Antibiotics, antituberculotic drugs and steroids were not effective and she died on October, 1995 with heart failure. An autopsy revealed that the small vessels of lungs, kidneys and the mucosa of the bladder and the gastrointestinal tract were filled with large mononuclear cells. Immunohistochemically these cells were positive in LCA and L26 stains, and negative in UCHL-1 stains. There fore this case was finally diagnosed as neoplastic angioendotheliosis (NAE). Although there has been no case report of NAE with Roth's spots previously, there is the possibility that Roth's spots appeared as a sign of vascular occulusion due to NAE. Roth's spots may be noteworthy as a sign of NAE that has few clinical features.View full abstractDownload PDF (485K)
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Shin CHIYODA1998 Volume 39 Issue 3 Pages 232-234
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe accept blood donations from many people daily. It is important to clarify levels of serum iron (SI) in blood donors. We measured SI in 62,054 blood donors (37,989 male and 24,065 female) between 16 and 64 years of age. SI was 108.2±39.5 μg/dl in males and 88.5±35.7 μg/dl in female. SI did not differ significantly with age in females, although it is slightly lower in women aged≤19 than in women aged≤20 years. In men, SI decreased with age from 20 to 64 years old, although the course of the decrease is not clear. These data should be of use to blood programme.View full abstractDownload PDF (179K)
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