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Volume 40, Issue 1
Displaying 1-11 of 11 articles from this issue
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Tetsuo YAMAZAKI, Yoshimasa KURA, Yasushi SATO, Tetsuya IRIE, Yoshitaka ...1999 Volume 40 Issue 1 Pages 1-8
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSTwenty-six patients with follicular small-cleaved lymphoma (FSCL) and 16 patients with follicular mixed lymphoma (FML) were treated at the Nichidai Itabashi Hospital between 1981 and 1995. The 5-year overall survival rate was 74.3% and 70.0% for the FSCL and FML patients, respectively. Of the patients with stage III-IV FSCL, 9 were assigned to a “watchful waiting” follow-up course and 13 were treated with a single alkylating agent or CHOP therapy. The 5-year failure-free survival rate was 66.7% and 33.0%, respectively. Of the patients with stage II-IV FML, 6 were treated with CHOP or MACOP-B protocol. The complete response rate for this group was only 33.3%, and none of the patients were in remission for more than 2 years. Histological transformation into diffuse aggressive lymphoma was observed in 7 patients, with the median time from diagnosis to transformation at 50 months. Three of those patients were successfully treated with intensive chemotherapy after transformation.View full abstractDownload PDF (538K) -
Naoki HOSEN, Hirofumi TESHIMA, Takahiro KARASUNO, Hidetoshi UJIIE, Tak ...1999 Volume 40 Issue 1 Pages 9-15
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSThe frequency of infection in recipients of allogeneic bone marrow transplants (BMT) who received oral new quinolones (NQ) was compared with that in BMT recipients who were given oral vancomycin/tobramycin (V/T). Between 1984 and 1997, our hospital treated 79 patients with V/T and 90 patients with NQ. Number of febrile days, duration of intravenous antibiotics administration, and frequency of documented infections were statistically the same for both groups. However, the frequency of grampositive bacterial infections, especially staphylococcal infections, was slightly higher in patients receiving NQ than in patients receiving V/T (p=0.12).
Of the patients who received NQ, those who underwent unrelated donor BMT procedures were generally febrile for slightly longer periods than those who underwent related donor BMT procedures (p=0.10).
These results suggest that oral NQ is as effective as oral V/T for the prevention of serious gramnegative bacterial infections in patients who undergo BMTs.View full abstractDownload PDF (499K) -
Akitaka SUZUKI, Keisuke MIYAZAWA, Tomoko KATAGIRI, Naoko SYOJI, Jirou ...1999 Volume 40 Issue 1 Pages 16-21
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe studied the possibility of performing peripheral blood stem cell (PBSC) harvests during the course of ABVD therapy by adding G-CSF to the treatment regimen. Six patients with high-risk Hodgkin's disease (HD) (5 untreated cases with bulky mass and 1 relapsed case) received G-CSF (5μg/kg) subcutaneously from day 8 to day 13 of their first course of ABVD treatment; the numbes of CD34+cells and CFU-GM were monitored. PBSC harvests were performed on day 12 and day 13 of subsequent ABVD plus G-CSF treatment courses. For all patients tested, we were able to harvest CFU-GM (3.78±1.19×105 colonies/kg) for peripheral blood stem cell transplants (PBSCT) by performing 2 to 4 cycles of apheresis, without any modification to the original ABVD protocol. These findings suggest that ABVD plus G-CSF therapy is a strong candidate for the treatment of patients with high-risk HD who may undergo autologous PBSCT.View full abstractDownload PDF (468K)
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Tetsuaki SEKIKAWA, Satsuki IWASE, Takeshi KAWANO, Shinobu TAKAHARA, [i ...1999 Volume 40 Issue 1 Pages 22-27
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSExtramedullary involvement of myelomas is common but invasion of myeloma cells into the pleural cavity and cerebrospinal fluid (CSF) is rare.
We report an aggressive case of multiple myelomas (Bence Jones λ type) with pleural and meningeal infiltration.
A 66-year-old man was referred to our hospital because of anemia, thrombocytopenia, and dyspnea. His peripheral blood contained 2% bizarre plasma cells. Bone marrow biopsy specimens and immunoelectrophoresis confirmed the diagnosis. A chest radiograph disclosed pleural effusion in both lungs containing M-protein and numerous abnormal cells. The patient also suffered from disorientation, speech disorder, and muscle weakness. A lumbar puncture revealed atypical plasma cells in CSF.
Four courses of chemotherapy (cyclophosphamide, doxorubicin, and prednisolone) and the intrathecal administration of methotrexate and cytarabine at 3-week intervals were effective in decreasing the pleural effusions and eliminating plasma cells from CSF. Nonetheless a chest wall tumor, pelvic mass, and pneumomia developed, and the patient died 5 months after initial presentation. Pleural infiltration of myeloma cells and multiple lesions with plasma cell involvement were discovered at autopsy.View full abstractDownload PDF (503K) -
Hitoshi SAWADA, Atsushi WAKE, Yoshihiro YAMASAKI, Yoichiro IZUMI1999 Volume 40 Issue 1 Pages 28-33
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSAllogeneic peripheral blood stem cell transplantation (Allo-PBSCT) has in recent years become an alternative to allogeneic bone marrow transplantation because it facilitates rapid hematopoietic reconstitution without an increase in the incidence of severe graft-versus-host disease (GVHD). We report on a 61-year-old man with myelodysplastic syndrome (MDS) and myelofibrosis who received an allo-PBSCT from his HLA-matched 68-year-old brother. The preparative regimen consisted of busulfan and cyclophosphamide. Cyclosporin A and methotrexate were administered for GVHD prophylaxis. The donor was treated with granulocyte colony-stimulating factor (G-CSF) at a dose of 10 μg/kg/day subcutaneously for 4 consecutive days. A preparation of 4.04×106 CD34+ cells/kg recipient weight was collected in a single apheresis and infused immediately. Engraftment times to a neutrophil count greater than 500/μl and platelet count greater than 2.0×104/μl were 15 days each. Acute GVHD of grade II developed, but was resolved with methylprednisolone. However, the patient died of thrombotic microangiopathy 97 days after his allo-PBSCT. Administration of G-CSF and apheresis in the donor were feasible and well tolerated. Allo-PBSCT may result in earlier engraftment and be especially beneficial to elderly patients with MDS.View full abstractDownload PDF (460K) -
Akihiko YOKOHAMA, Naoya MURATA, Shunichi SHIMANO, Masataka SAKURAYA, J ...1999 Volume 40 Issue 1 Pages 34-39
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 71-year-old man was given a diagnosis of pure red cell aplasia (PRCA) in May 1995. However, immunosuppressive agents, including prednisolone, azathioprine, and cyclosporin A, were not effective, and he required frequent red cell transfusions. In September 1995, leukocytosis and thrombocytosis developed (peaking at 10,100/μl white cells and 98.1×104/μl platelets, respectively, in November 1996). Conversely, the patient's peripheral blood count began to decrease in July 1996, and pancytopenia progressed thereafter i(17)(q10) chromosomal abnormality of bone marrow cells was detected in November 1996. The patient was readmitted due to the progression of thrombocytopenia (1.2×104/μl). His bone marrow has 16.6% blasts, and a diagnosis of myelodysplastic syndrome (MDS) was made. The patientdied in November 1997. His hematological state demonstrated significant changes in a relatively short period and severe hypoerythropoiesis and eosinophilia of the bone marrow persisted throughout the clinical course. These findings suggested that a common deranged stem cell was the origin of 3 different states; PRCA, chromic myeloproliferative disorder, and MDS. The i(17)(q10) anomaly may have caused the acute proliferation of blasts and pancytopenia.View full abstractDownload PDF (448K) -
Youko SUEHIRO, Koichiro MUTA, Tsukuru UMEMURA, Seiichi MOTOMURA, Junji ...1999 Volume 40 Issue 1 Pages 40-45
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSHematologic relapse of chronic myeloid leukemia developed in 37-year-old man 255 days after allogeneic bone marrow transplantation. The patient received a donor lymphocyte transfusion (DLT) twice at a dose of 5×106/kg T cells. He achieved complete cytogenetic response (CCR) 14 weeks after DLT, and has remained in a CCR state for 17 months. Neither acute nor chronic graft-versus-host disease (GVHD) was observed. Natural killer (NK) cell activity was elevated. Also, analysis of the T cell receptor (TCR) repertoire disclosed oligoclonal expansion of T cells of the TCR V β and J β subfamilies. These observations provide evidence for the clonal expansion of allogeneic T cells that are capable of mediating antileukemic activity without causing GVHD.View full abstractDownload PDF (451K) -
Itsuto AMANO, Takeshi MORII, Takayo YAMANAKA, Nobuhiko TSUKAGUCHI, Kiy ...1999 Volume 40 Issue 1 Pages 46-50
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 16-year-old female patient who had been given a diagnosis of severe aplastic anemia underwent 2 courses of a combined regimen of corticosteroid pulse therapy and androgen therapy. This proved ineffective. Antilymphocyte globulin therapy was also ineffective. The patient was then given lithium carbonate at a dose of 600mg/day in combination with an androgen derivative. This had a dramatic effect on her peripheral blood smear. Within 3 weeks after the first course of this treatment, she no longer required red blood cell transfusions.
Also, once the lithium carbonate dose was increased to 1,200mg/day, the patient no longer needed exogenous platelet transfusions. Approximately 6 months after the start of combination therapy, a peripheral blood smear showed entirely normal results.
However, 2 months after lithium carbonate was discontinued probably as a result of drug-induced liver dysfunction, both leukocytopenia and thrombocytopenia reappeared. Therefore, lithium carbonate was readministered at a dose of 400mg/day, and later at a dose of 800mg/day. Again, the patient showed improvements in 3 blood components without any adverse effects. We concluded that lithium therapy was remarkably useful for this patient with intractable and severe aplastic anemia.View full abstractDownload PDF (392K)
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Isao SANADA, Fumio KAWANO, Atsuko TSUKAMOTO, Tetsuyuki KIYOKAWA1999 Volume 40 Issue 1 Pages 51-54
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe report on two adult T-cell leukemia (ATL) patients whose levels of serum hyaluronic acid (HA) moved in parallel with the clinical activity of their disease. A 66-year-old man was admitted to our hospital because of unconsciousness and hypotension. Acute type ATL complicated by hypercalcemia and myelofibrosis was diagnosed. Before therapy, the level of patient's serum HA was 2,045 to 4,010 ng/ml (normal range: 50>). After he achieved complete remission (CR) through chemotherapy, his serum HA was 36 ng/ml. Several months later, however, his ATL relapsed, and his serum HA increased to 393 ng/ml. The other patient was an 80-year-old man who had been admitted on the suspected diagnosis of ATL. Before chemotherapy, his serum HA was high (3,420 ng/ml). After CHOP therapy, he entered CR and his HA decreased to 122 ng/ml. He remains in CR with slightly elevated levels of HA (127 to 212 ng/ml), and is being followed up on an out-patient basis.View full abstractDownload PDF (299K) -
Kazuya KODAMA, Tatsushirou TAMURA, Shuu YAMADA, Masahiko TABATA, Takef ...1999 Volume 40 Issue 1 Pages 55-58
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSWe compared the outcomes of autologous peripheral blood stem cell transplantation (auto-PBSCT) for two groups: one composed of 6 patients over 65 years of age, and the other, of 8 younger patients. Transfused CD34-positive cells and CFU-GM counts, days to achieve a neutrophil count of over 500/μl after transplantation, days to achieve a platelet count of over 50,000/μl, and blood transfusion times were similar in both groups. Organ toxicity also appeared similar in both groups, but no severe adverse reactions (WHO grade/4) were observed. Poor performance status due to advanced tumors improved in some patients after PBSCT. We concluded that PBSCT is tolerable in patients over 65 years of age and useful as salvage therapy.View full abstractDownload PDF (291K) -
Taichi AZUMA, Masamichi HARA, Kensuke KOJIMA, Yuichiro NAWA1999 Volume 40 Issue 1 Pages 59-62
Published: 1999
Released on J-STAGE: April 28, 2009
JOURNAL RESTRICTED ACCESSA 28-year-old man who had received an allogeneic bone marrow transplant 7 years earlier experienced a relapse of chronic myelogenous leukemia in an accelerated phase. He was unsuccessfully treated with vincristine (VCR) and interferon-α (IFN-α), and subsequently received a donor leukocyte transfusion (CD3+ cells: 1.5×107/kg). Rapid hematologic recovery was observed and a complete remission was obtained without graft-versus-host disease (GVHD) or bone marrow aplasia. It may be that the preceding regimen of chemotherapy (VCR+IFN-α) contributed to the patient's recovery by reducing the tumor burden.View full abstractDownload PDF (288K)
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