Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 39, Issue 4
Displaying 1-18 of 18 articles from this issue
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  • TAL1 Gene Analysis in T-cell Malignancies
    Akira KIKUCHI, Shigetoshi KOBAYASHI, Ryoji HANADA, Koichi MORIWAKI, Ke ...
    1998 Volume 39 Issue 4 Pages 259-266
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.259
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    Site-specific recombination of the TAL1 gene was analyzed by Southern blotting and polymerase chain reaction (PCR) in 44 cases of childhood T-cell acute lymphoblastic leukemia (T-ALL), 20 cases of childhood T-cell non-Hodgkin's lymphoma (T-NHL) and 35 cases of adult T-cell malignancies. This recombination was found in 10 (22.7%) of 44 childhood T-ALL patients, but in none of the T-NHL or adult T-cell malignancies. Recombination of the TALI gene was therefore suggested to be specific for childhood T-ALL. The immunophenotypic features of the 10 T-ALL patients with this recombination were CD1-, CD2+, CD4-, CD7+, CD10-, and they had a significantly better outcome than other T-ALL cases without the recombination. The PCR technique revealed minimal residual disease (MRD) in 2 patients. One showed persistent MRD, while in the other MRD was recognized only at initial diagnosis. Further investigation is needed whether T-ALL with this recombination constitutes a distinct clinical subgroup among childhood T-ALL patients.
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  • EPOCH Therapy for Relapsed/Refractory Lymphoid Malignancies
    Nobuaki DOBASHI, Noriko USUI, Tadashi KOBAYASHI, Hiroyuki YAMAZAKI, Os ...
    1998 Volume 39 Issue 4 Pages 267-272
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.267
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    Patients with refractory or relapsed non-Hodgkin's lymphoma (NHL), acute T-cell leukemia (ATL), ATL lymphoma and acute lymphocytic leukemia (ALL) received EPOCH therapy. All were previously treated with doxorubicin (DOX), vincristine (VCR) and other drugs. The EPOCH treatment schedule is consisted with DOX (10 mg/M2/day, 5days c.i.v.), VCR (0.4 mg/M2/day, 4days c.i.v.), etoposide (50 mg/M2/day, 4days c.i.v.), cyclophosphamide (750 mg/M2/day, day 6 i.v.) and prednisolone (60 mg/M2/day, 5days p.o.). Twenty-one patients (ALL: 10, NHL: 8, ATLL: 2, ATL: 1) were assessable for response and toxicity. Two patients with ALL and NHL, respectively, achieved a complete remission and 3 patients obtained partial remission (NHL: 2, ATLL: 1). The hematological toxicity (grade>1) included neutoropenia, anemia and thrombocytopenia, which were observed in 83.3%, 76.7% and 76.7% respectively, of total 30 EPOCH courses. The major non-hematological toxicities were nausea/vomiting, constipation and infection, but most of the toxicity were tolerable with sufficient clinical supportive care. These results indicate that continuous infusion of DOX, VCR and ETP might be effective in patients who were treated with, and presumed to be resistant to the same drugs administrated by bolus infusion.
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  • Serum Levels of Carboxyterminal Propeptide of Type I Procollagen (PICP), Cross-Linked Carboxyterminal Telopeptide Region of Type I Collagen (ICTP) and Carboxyterminal Parathyroid Hormone-Related Protein (C-PTHrP) in Hematological Malignancies with Bone Lesions and Hypercalcemia
    Ken TANAKA, Kaori SHIRAISHI, Akihiko SAKAMOTO, Hiroto JOJIMA, Kumiko M ...
    1998 Volume 39 Issue 4 Pages 273-280
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.273
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    We measured the levels of carboxyterminal propeptide of type I procollagen (PICP), cross-linked carboxyterminal telopeptide region of type I collagen (ICTP) and carboxyterminal parothyroid hormone-related protein (C-PTHrP) in serum of patients with hematological malignancies. ICTP and C-PTHrP levels in serum of multiple myeloma (MM), non-Hodgkin's lymphoma (NHL) and adult T-cell leukemia (ATL) patients with bone lesions and hypercalcemia were significantly higher than those of patients without bone lesions and hypercalcemia. ICTP and C-PTHrP levels in ATL were significantly higher than in MM and NHL. There was a correlation between ICTP and C-PTHrP in serum of ATL patients, but no correlation in MM and NHL. Serum ICTP levels tended to correlate with serum β2-microglobulin and survival in paients with MM. Therefore, ICTP and C-PTHrP levels in serum may be useful in the diagnosis of bone lesions and hypercalcemia in hematological malignancies. In particular, ICTP may be a useful bone resorption marker in MM.
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  • Treatment of Children with Non-Hodgkin's Lymphoa with CCLSG NHL 855/890 Protocols long term Outcome and Incidence of Secondary Malignancies
    Masahito TSURUSAWA, Yosifumi YAMAMOTO, Naoyuki KATANO, Takahisa HIROTA ...
    1998 Volume 39 Issue 4 Pages 281-289
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.281
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    We report here on treatment results of consecutive CCLSG NHL studies (NHL855, 1985∼1989; NHL890, 1989∼1996). The NHL855 protocol consisited of an induction phase of five drugs (VCR, PRD, CPM, DXR, and high-dose MTX) and a maintenance phase of 7 drugs. The probabilities of EFS at 7 years were 78% (SE, 10%) for the patients with localized disease, and 38% (SE, 7%) for those with advanced disease. In the NHL 890 protocol, the patients were assigned to two different treatment groups according to their histology and received different consolidation therapy; non-lymphoblastic subtype was treated almost identically to NHL855 while LASP and VP-16 were newly added for the lymphoblastic subtype. The 7-year EFS improved to 91% (SE, 6%) for localized disease, and 61% (SE, 6%) for advanced disease. A remarkable improvement was particularly evident for lymphoblastic type with mediastinal mass. Optional trial of high-dose sequential chemotherapy and peripheral blood progenitor cell auto grafting resulted in an unfavorable outcome. The 7-year EFS according to main histological subgroups were as follows: 84% (10%) for large cell type, 67% (11%) for Burkitt's-type, 58% (10%) for lymphoblastic type. Secondary cancer occurred in two of the 163 patients studied. Both patients were AML (M0/M4) and MLL rearrangement was detected in the M4 case.
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  • Acquired Pure Red Cell Aplasia Associated with Relapsed Non-Hodgkin's Lymphoma: A Case Report-Improvement of PRCA After Acute Hepatitis
    Ken KURAMOTO, Kenji ODA, Shinya KATSUTANI, Teruhisa FUJII, Kazuhiro AB ...
    1998 Volume 39 Issue 4 Pages 290-296
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.290
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    a 47-year-old male patient was admitted because of anemia. He had been diagnosed as non-Hodgkin's lymphoma (Follicular mixed, B cell type, stage ISA) by splenectomy two years before. Bone marrow examination on admission revealed lymphoma cell infiltration and marked decrease in erythroid cells. These findings confirmed relapsed lymphoma with acquired pure red cell aplasia. After several courses of combination chemotherapy, lymphoma cells disappeared from bone marrow, but PRCA was not improved. In this case there were two times remission of PRCA. At first time, acute B type hepatitis occurred during the chemotherapy, anemia improved transiently. At the second time, mild acute hepatitis associated with herpes zoster occurred. Twenty days after hepatic injury, PRCA was improved, and continued in remission state till present day. To disclose the mechanism of PRCA in this case, erythroid colony assay of marrow cells was performed. This showed the presence of inhibitory factor in patient's serum at PRCA state, that was considered to be related to the occurrence of PRCA. These findings suggest that the improvement of PRCA was associated with the changes on immunological condition after acute hepatitis in this case.
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  • Primary Cardiac Non-Hodgkin's Lymphoma
    Yuko YAMAGUCHI, Nobuaki DOBASHI, Noriko USUI, Tadashi KOBAYASHI, Tadas ...
    1998 Volume 39 Issue 4 Pages 297-301
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.297
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    A 69-year-old man who initially presented with lumbago developed heart failure during an MRI scan on the day of admission. A chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiogram and computed tomography (CT) scan of the chest revealed a large tumor mass encompassing the heart with much pericardial effusion was demonstrated. The cytology of the effuion obtained by pericardiocentesis was consistent with non-Hodgkin's lymphoma, diffuse large B cell type. As CT scans of the abdomen and pelvis were negative, he was considered to have primary cardiac lymphoma. Although he responded remarkably to therapy with vincristine, cyclophosphamide and prednisolone and, he developed acute respiratory failure on the seventh month after admission. Although incidence of primary cardiac lymphoma is very low, it is necessary to investigate the mechanism of this disease in order to establish appropriate diagnostic and therapeutic approaches.
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  • Chronic Myelogenous Leukemia with long term Hypoplasia induced by α-Interferon and Hydroxyurea
    Shigeki MOTOMURA, Rika SAKAI, Naoto TOMITA, Katsumichi FUJIMAKI, Michi ...
    1998 Volume 39 Issue 4 Pages 302-307
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.302
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    A 48-year-old woman was admitted with chronic myelogenous leukemia in November, 1996 and was treated with hydroxyurea (HU), because of marked leukocytosis; WBC 404,000/μl. On January 29, 1997, administration of HU was stopped, and treatment of α-interferon (IFNα) was started with 6x106U, every day. However, the WBC count rose from 19,600/μl to 56,800/μl, and the combination of IFN and 2,000 mg of HU was started on February 4. The dose of HU was reduced to 500 mg on February 27, and the IFN administration was reduced to 3 times a week from April 4, because the WBC count was less than 10,000/μl. Pancytopenia was revealed in May. The bone marrow biopsy specimen demonstrated marked hypoplastic changes, and chromosome analysis of bone marrow cells showed Philadelphia chromosome in all 20 metaphases. Treatment was interrupted for 7 months, but hematologic parameters did not recover. There were 9 cases reported in detail with bone marrow hypoplasia induced by IFN. One patient received IFN alone and 8 patients received anti-cancer drugs before treatment of IFN. We concluded that great care must be taken for IFN treatment of CML.
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  • Hereditary Macrothrombocytopenia
    Kaoru KASAHARA, Tohru TAKAHASHI, Fumie HAMAMOTO, Toshiaki HAYASHI, Mas ...
    1998 Volume 39 Issue 4 Pages 308-313
    Published: 1998
    Released on J-STAGE: April 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.39.308
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    A 19 year-old male was referred to our department because of macrothrombocytopenia. His platelet count was 73,000/μl and giant platelets were observed in the peripheral blood smear specimen. Though he had been suffering from severe atopic dermatitis for four years, he seemed to be healthy without bleeding tendency. When he underwent a shunt operation for tetralogy of Fallot without any complication at nine-years old, thrombocytopenia was allegedly pointed out for the first time. Bone marrow aspiration revealed no abnormal findings with no chromosomal aberration. Normal platelet aggregation responses against adenosine diphosphate, epinephrine, collagen, and ristocetin were observed. The platelet adhesiveness (modified Salzman method) was slightly elevated. Unlike other reported syndromes associated with macrothrombocytopenia, his leukocytes had no inclusion bodies. His mother also had macrothrombocytopenia thus, this disorder was suspected to be hereditary.
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