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Volume 39, Issue 5
Displaying 1-15 of 15 articles from this issue
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[in Japanese], [in Japanese]1998 Volume 39 Issue 5 Pages 337-338
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1998 Volume 39 Issue 5 Pages 339-341
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1998 Volume 39 Issue 5 Pages 342-344
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1998 Volume 39 Issue 5 Pages 345
Published: 1998
Released on J-STAGE: April 28, 2009
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[in Japanese], [in Japanese]1998 Volume 39 Issue 5 Pages 346-347
Published: 1998
Released on J-STAGE: April 28, 2009
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Yasunori UEDA, Shinichirou MORI, Tomoki ITO, Yoshitomo MAESAKO, Hirosh ...1998 Volume 39 Issue 5 Pages 348-354
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSCytarabine ocfosfate (SPAC) is rapidly transformed into cytarabine (ara-C) when orally administered. The pharmacokinetics of SPAC was studied in six patients with acute non-lymphocytic leukemia (ANLL) and/or myelodysplastic syndromes (MDS) after oral administration of SPAC at 100 to 400 mg/day for 14 days. Plasma ara-C concentrations reached a plateau in 48 to 96 hours after initiation of SPAC administration, remained at this or a little higher level until one day after its termination and were less than 1 ng/ml 8 days after the termination. From all of pharmacokinetic data, the oral administration of SPAC at 150 to 300 mg/m2/day was pharmacokinetically concluded to be comparable to the continuous infusion of ara-C at 20 mg/m2/day. All of the patients could receive SPAC for 14 days. SPAC is considered to be useful for consolidation or maintenance chemotherapy of ANLL or MDS outpatients who are unable to undergo intensive chemotherapy.View full abstractDownload PDF (530K) -
Tadanobu OHTA, Takuya KISHIDA, Tarou HASEGAWA, Manabu HIRAI, Takahisa ...1998 Volume 39 Issue 5 Pages 355-362
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSOf 36 patients with malignant tumors who had been subjected to peripheral blood stem cell harvests (PBSCHs), 22 had undergone peripheral blood stem cell transplants (PBSCTs) since 1993. Flow cytometry recorded higher CD34+ cell yields in the PBSCHs of those patients with high white blood cell (WBC) counts as well as those who hed been under intensive chemotherapy. Also, higher CD34+ cell yields were recorded in patients whose peripheral blood WBCs recovered more rapidly from their nadir state. WBC counts recovered rapidly in patients who received transfusions of at least 2.0×106 CD34+ cells/kg. However, patients with acute non-lymphocytic leukemia (ANLL) demonstrated a delayed recovery in their platelet counts following PBSCT. The mean disease-free survival rate and mean disease-free period were 60% and 12.8 months for the 5 patients with ANLL; and 100% and 11.3 months for the 4 patients with acute lymphocytic leukemia. These findings suggest PBSCT is a safe and effective treatment for patients with malignant tumors following high-dose chemotherapy, and can be performed in a private general hospital.View full abstractDownload PDF (574K)
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Masakazu SAWANOBORI, Yasunori NAKAGAWA, Yasuyuki INOUE, Kenshi SUZUKI, ...1998 Volume 39 Issue 5 Pages 363-368
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 64-year-old man who had taken acute myelogenous leukemia (AML-M2) in 1989 have relapsed with t(12;17)(p13;q11.2-21) chromosomal abnormality and presenting marked infiltration to the skin in 1994. Blasts were seen on his peripheral blood smear (15%) and bone marrow examination showed increased leukemic cells (56%), with maturation. Leukemic cells expressed CD13 and CD33 antigen but not HLA-DR. Although leukemic cells had not promyelocytic feature morphologically, detection of PML/RAR α infusion signal of peripheral leukemic cells were positive for 8% (1% for control) by fluorescence in situ hybridization method. Because he did not response to standard combination chemotherapy and because we considered the possibility that t(12;17)(p13;q11.2-21) observed in this case are t(15;17) variant, we tried all trans retinoic acid (ATRA) to him. Interestingly, ATRA was very effective for skin lesion but hematologically it had no effect at all, and he died because of bacterial pneumonia.View full abstractDownload PDF (557K) -
Hiroshi FUJII, Hitoshi NAKAGAWA, Makoto NAKAO, Yoshiaki SONODA, Shigea ...1998 Volume 39 Issue 5 Pages 369-373
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSThree patients with non-Hodgkin's lymphoma of intermediate-grade histologies, who had failed to achieve a complete remission (CR) after more than several courses of conventional chemotherapy were treated with two cycles of high-dose chemotherapy with autologous peripheral blood stem cell transplantation (double PBSCT). All patients received regimen A with carboplatin 1 g/m2, etoposide 1.2 g/m2 and cyclophosphamide 120 mg/kg prior to 1st PBSCT and obtained a partial remission. One patients received regimen A and two patients received regimen B with MCNU 500 mg/m2, etoposide 750 mg/m2 and L-PAM 140 mg/m2 prior to 2nd PBSCT and all patients obtained CR. Second PBSCT was performe 3 to 5 months after the 1st PBSCT. At a median follow-up of 36 (range; 29 to 54) months, all patients remained in continuous CR. The period after reinfusion of PBSCT to achieve a neutrophil count more than 500/μl ranged between 7 and 9 days and to achieve a platelet count more than 5×104/μl ranged 12 and 22 days. Grade 3 nonhematologic toxicity (mucositis) was seen in one patient after 2nd PBSCT. Double PBSCT could be well tolerated with a high response rate in patients with malignant lymphoma of primary induction failure.View full abstractDownload PDF (379K) -
Yoshinobu SEKI, Hoyu TAKAHASHI, Yoshifusa AIZAWA1998 Volume 39 Issue 5 Pages 374-378
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 94-year-old man who had been admitted to our hospital for the treatment of senile dementia and restless behavior exhibited consciousness disturbances, acute respiratory failure, high fever, and thrombocytopenia the day after receiving haloperidol as prescribed by a psychiatrist. On the fourth day following administration of haloperidol, acute renal failure with rhabdomyolysis and disseminated intravascular coagulation (DIC) developed in the patient, who was accordingly given a diagnosis of haloperidol-induced neuroleptic malignant syndrome (NMS) associated with DIC. He was then given heparin and antithrombin III, and his DIC symptoms improved soon thereafter. Elevated plasma levels of tissue factor and tumor necrosis factor-α (TNF-α) were sustained during this therapy course. Other cytokines, including interleukin IL-1β, IL-2 and IL-6, were not elevated. There are activation of extrinsic coagulation and an elevated level of TNF-α during acute renal failure and rhabdomyolysis associated with NMS, which is thought to trigger the onset of DIC.View full abstractDownload PDF (375K) -
A Fatal Case of Aggressive-Phase Multiple Myeloma with Ileus and Invasion into Extramedullary OrgansNorihide TAKAYA, Shigesaburo MIYAKOSHI, Kanae KUBO, Yoshitomo MUTOU, Y ...1998 Volume 39 Issue 5 Pages 379-385
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 62-year-old woman with IgA-λ type monoclonal gammopathy had been followed up since January 1988. In March 1991, multiple myeloma (IgA-λ) was diagnosed on the basis of bone marrow biopsy findings and increased serum IgA levels. She was treated intermittently with melphalan and prednisolone over a perioa of about 6 years, but was eventually admitted due to renal dysfunction, hypercalcemia, increased serum IgA and the formation of subcutaneous masses. During chemotherapy she underwent emergency surgery for obturative ileus. Histological examination of the resected tissues revealed invasion of myeloma cells into the small intestine and peritoneum. Despite continued chemotherapy, the patient's soft tissue masses enlarged, and new lesions appeared in other organs. In the terminal stage, lower serum IgA levels were observed despite an increase in Bence-Jones protein levels in urine. The patient died five months after admission. An autopsy found infiltration by atypical myeloma cells in multiple organs. An immunohistochemical examination revealed an increase in λ-light chain positive cells relative to the number of α-heavy chain positive cells. The terminal course was considered to be representative of aggressive phase multiple myeloma. The case was rare in that the patient's ileus was caused by invasion of myeloma cells into the small intestine.View full abstractDownload PDF (915K) -
Naohi SAHARA, Sadahiro TAMASHIMA, Michio IHARA1998 Volume 39 Issue 5 Pages 386-391
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSThis is a report about two cases of hereditary spherocytosis complicated by severe hypophosphatemia, while recovering from aplastic crisis. Case #1: A 31-year-old male, who had jaundice and splenomegaly since the age of 15 and who has a son diagnosed with hemolytic anemia, was admitted because of fever, lymphadenopathy, and jaundice. A diagnosis of hereditary spherocytosis was made based on microspherocytes observed in his peripheral blood smear. After admission, the anemia became more serious for a few days and he was considered suffering from bone marrow aplastic crisis. His serum phosphorus level fell to 0.5 mg/dl on the second day, but it rapidly returned to normal as reticulocyte counts rose. Case #2: A 29-year-old male with known transient jaundice and splenomegaly suffered from fever, anemia and jaundice, but recovered two weeks later. Laboratory examination revealed positive human Parvovirus B19 (HPV-B19) DNA, anti-HPV-19 IgM and IgG-antibody. His serum phosphorus level fell to 1.2 mg/dl on the eighth day, but it rose in the same manner as seen in case #1. The fall in serum phosphorus is probably due to its shift to the erythroblasts during erythroid hyperplasia.View full abstractDownload PDF (647K) -
Akiko YASHIMA, Yasushi NARIGASAWA, Yoji ISHIDA, Toshiyuki UCHIYAMA, Ta ...1998 Volume 39 Issue 5 Pages 392-397
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report a 63 year-old female with aplastic anemia (AA) who was complicated with hemophagocytic syndrome induced by systemic miliary tuberculosis. Two years before admission to our hospital, she was diagnosed as AA and had been treated with granulocyte colony-stimulating factor, erythropoietin and methenolone acetate. In May, 1996, She was transferred to our hospital because of high fever and exacervation of pancytopenia. She showed severe pancytopenia, and an increase in macrophages showing remarkable erythrophagocytosis and decrease in hemopoietic cells in the bone marrow. In initial examination, high titer of IgM antibody to herpes simplex virus type I was identified and methylprednisolone pulse therapy was started under the diagnosis of virus associated hemophagocytic syndrome. Ten days later, however, she died for intestinal hemorrhage followed by multiorgan failure. In autopsy, multiple epitheloid cell granulomas with acid-fast bacilli were found in bone marrow, lungs, liver, spleen and kidneys.View full abstractDownload PDF (729K)
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Takeo KUMURA, Takahisa YAMANE, Kensuke OHTA, Takahumi NAKAO, Masayuki ...1998 Volume 39 Issue 5 Pages 398-401
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 27-year-old male with acute myelogenous leukemia received an allogeneic bone marrow transplantation (allo-BMT). Pneumocystis carinii pneumonia developed on day 65 after the allo-BMT. The patient was intravenously treated with pentamidine. This resulted in a prompt improvement of his dyspnea and fever, but hyperkalemia occured during the pentamidine therapy. Treatment with pentamidine was stopped and emergent treatment was started. Neverthless, the serum potassium level rose to 7.7 mEq/L. Urgent dialysis was performed and the serum potasium level fell to 5.0 mEq/L after treatment. Careful monitoring of the serum potasium level is recommended during intravenous therapy with pentamidine.View full abstractDownload PDF (276K) -
Tadashi KAMIYA, Takeshi NAGAO, Akira YOSHIOKA1998 Volume 39 Issue 5 Pages 402-404
Published: 1998
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSIn this report, we discuss the findings of a 1994 retrospective study concerning the rate of inhibitor formation in Japanese hemophiliacs. The study was the second of its kind, following on the first in 1991 (Kamiya et al. 1995 Int. J. Hematology1). The records of 77 medical institutions were examind. Inhibitors were found in 6.50% (140 of 2154) of the patients with hemophilia A (HA), and 5.21% (22 of 422) of those with hemophilia B (HB). The median age for antibody formation was 10.7 years in patients with HA, and 4.5 years in those with HB. The median period (exposure period) from initial plasma factor concentrates exposure to inhibitor formation was 46 days and 20 days, respectively, in the HA and HB patients. Among the HA inhibitor patients, those with a large deletion or a nonsense mutation were aged 17.4 years or less (0.58, 1.7, 3.5, 5.5, 7.0 and 17.4), whereas those with intron 22 inversion were aged 55.7 years or less (1.3, 1.3, 1.8, 33.0, 36.1, 37.7, 43.9, 47.9 and 55.7).View full abstractDownload PDF (235K)
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