All issues
Volume 42, Issue 1
Displaying 1-9 of 9 articles from this issue
- |<
- <
- 1
- >
- >|
-
Tsunehiko KOMATSU, Keiko SHIMIZU2001 Volume 42 Issue 1 Pages 1-7
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSBased on analysis of data from 10 patients newly diagnosed as having acute myelogenous leukemia (AML), we developed a critical pathway (CP) to prevent infection and thus shorten the period of hospitalization. This CP shows laboratory test results, vital signs, chemotherapy regimen, concomitant supportive care and oral medications, gargling with antiseptic mouthwash, other anti-infection measures, diet, room conditions, patient education in anti-infection measures, outcome, and variance on the vertical axis and time on the horizontal axis. After introduction of the CP, 9 of the newly diagnosed AML patients did not experience severe treatment-related complications during a mean hospitalization of 29 days until remission and 95 days until discharge. These results suggest that the present CP makes it possible to shorten the hospital stay, reduce treatment costs, and improve the quality of life of AML patients.View full abstractDownload PDF (480K) -
Ying-Wei LIN, Ken-ichiro WATANABE, Keigo HAMAHATA, Souichi ADACHI, Yui ...2001 Volume 42 Issue 1 Pages 8-14
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSDespite the abundance of reports describing adult cases of t(8;21) acute myelocytic leukemia (AML), childhood cases have received little attention. We retrospectively investigated 14 childhood cases of t(8;21) AML, and compared their clinical characteristics with those of adult cases, focusing on the risk factors for poor prognosis. Seventy-one percent of the patients had fever. Their mean leukocyte count was 12,700/μl, and they showed decreased NAP activity. The cell surface showed positivity for CD13, 33, 19, 34, and HLA-DR. The complete remission rate was 100%, and relapse was observed in three of the patients. Bone marrow eosinophilia was present in a smaller proportion of the childhood cases than in the adult cases. Although an increased leukocyte count, tumor formation, and other risk factors have been reported in adults, there was no correlation between these factors and prognosis in our childhood cases. As children who showed AML relapse had TdT-positive blasts, detectable blast TdT activity may be a risk factor for relapse in childhood cases of t(8;21) AML. However, to confirm this, a study with a larger subject base should be conducted.View full abstractDownload PDF (437K) -
Yuko MATSUMOTO, Masaki MORI, Tetsuya OHTSUKI, Kazuo MUROI, Kiyohiko HA ...2001 Volume 42 Issue 1 Pages 15-22
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSIdarubicin (IDR) has been used as the main drug in induction chemotherapy for acute myelogenous leukemia (AML) in the USA and Europe. Between May 1995 and October 1998, we treated 41 cases of fresh AML using IDR induction chemotherapy and analyzed the clinical course, remission rate, relapse rate and prognosis. The results obtained in these cases were similar to those in 26 cases treated with daunorubicin (DNR) in our hospital according to JALSG-AML92. The outcome in cases with abnormal chromosomes and cases showing relapse was very poor. In particular, all 5 t(8;21) cases in our series relapsed, suggesting that t(8;21) cannot be considered a favorable prognostic factor in cases treated with IDR-containing regimens. However, 3 of the 5 t(8;21) cases were positive for CD56, which itself is an unfavorable prognostic factor. Thus it is possible that CD56 was related to the poor outcome. Intensive post-remission induction chemotherapies will be required in order to obtain prolonged disease-free survival.View full abstractDownload PDF (434K)
-
Minori NAGAHAMA, Hideo KAGAWA, Yoshio OZAKI, Shuji ONISHI, Tomoko ISHI ...2001 Volume 42 Issue 1 Pages 23-29
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSIn April 1996, a 77-year-old man initially presented with fever, rash and polyarthralgia, and was diagnosed as having low titer cold agglutinin disease with acute hemolytic anemia. The patient's condition and laboratory findings improved after administration of corticosteroid (prednisolone 60 mg). In June 1996, however, he developed acute cholecystitis and died due to sepsis, disseminated intravascular coagulation and multiple organ failure. During the course, the levels of inflammatory cytokines such as TNF-α and IL-6 were correlated with the pathology, and the disease was diagnosed as systemic inflammatory response syndrome (SIRS). Autopsy revealed necrotizing cholecystitis, erythrophagocytosis in the liver, and cytomegalovirus infection in the lung and gall bladder. This was considered to be a rare case of low titer cold agglutinin disease complicated by SIRS.View full abstractDownload PDF (494K) -
Ken-ichirou YONEDA, Itsuto AMANO, Haruyuki TANAKA, Hideo YAGI, Nobuhik ...2001 Volume 42 Issue 1 Pages 30-34
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 73-year-old man who had been receiving treatment for hypertension and angina pectoris was admitted to hospital following a transient ischemic attack. He was diagnosed as having chronic disseminated intravascular coagulation (DIC) complicated by a thoracoabdominal aortic aneurysm, and was treated with heparin sodium and a protease inhibitor. Although the DIC was controlled, the patient had to remain hospitalized in order to receive the medication by continuous infusion. Therefore, the heparin sodium and protease inhibitor were replaced by camostat mesilate, a drug suitable for oral administration and widely used for treatment of chronic pancreatitis. The drug proved effective for the chronic DIC, thus allowing the patient to receive regular treatment on an outpatient basis, and improving his quality of life.View full abstractDownload PDF (382K) -
Yasunobu ABE, Keiichi HARA, Motoaki SHIRATSUCHI, Ilseung CHOI, Takamit ...2001 Volume 42 Issue 1 Pages 35-40
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSB cell lymphoma-associated hemophagocytic syndrome (B-LAHS) is clinically characterized by hepatosplenomegaly and bone marrow invasion without lymphadenopathy and skin lesions. Several cases of B-LAHS have been reported to demonstrate histopathologic findings of intravascular lymphomatosis (IVL), which in Western countries is characterized by a high rate of skin involvement and, rarely, bone marrow involvement and hemophagocytosis. Here we describe two interesting cases of B-LAHS. One patient was a 52-year-old woman whose bone marrow showed proliferation of large CD20-positive cells and hemophagocytosis at presentation. Combination chemotherapy was not effective, and the patient died of progressive disease. At autopsy, the lymphoma cells showed extravascular proliferation in many organs such as the bone marrow and liver, whereas in the adrenal glands, the lymphoma cells showed intravascular proliferation. The other patient was a 50-year-old man who had swellings of the bilateral kidneys and adrenal glands at presentation. Skin involvement by large lymphoma cells, a rare complication of B-LAHS, was observed. At autopsy, there was no evidence of IVL. Both of these patients showed high fever and cytopenia, and the disease took an aggressive clinical course, as in other reported cases of B-LAHS.View full abstractDownload PDF (516K) -
Jiro TADOKORO, Hisako GUNJI, Tomoyuki HANDA, Masakuni AOYAGI, Yuichi N ...2001 Volume 42 Issue 1 Pages 41-46
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 25-year-old man was admitted to our hospital because of hematuria, anemia and thrombocytopenia. Laboratory examinations revealed an increased number of bone marrow megakaryocytes and an increased level of platelet-associated immunoglobulin G, suggesting immune thrombocytopenia. Computed tomography of the abdomen showed enlargement of the bilateral kidneys with multiple low-density areas, although neither lymphadenopathy nor hepatosplenomegaly was evident. After amelioration of the thrombocytopenia by prednisolone therapy, open renal biopsy was performed and a diagnosis of diffuse large B-cell non-Hodgkin's lymphoma was made. The patient achieved complete remission after CHOP therapy. This was thought to be a rare case of primary renal non-Hodgkin's lymphoma initially presenting as immune thrombocytopenia, which was treated successfully by chemotherapy.View full abstractDownload PDF (550K)
-
Akira MIYATA, Tadashi YOSHINO, Kensuke KOJIMA, Soichirou FUJII, Takesh ...2001 Volume 42 Issue 1 Pages 47-50
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe describe a case of T-cell prolymphocytic leukemia (T-PLL) in a 76-year-old man, who developed diffuse large B-cell lymphoma (DLBL) of the stomach, a previously unreported occurrence. The patient was referred to our hospital because of marked leukocytosis (40,000/μl) without clinical symptoms. He was diagnosed as having T-PLL on the basis of the characteristic cell morphology and immunophenotype (CD2+, CD3+, CD4+, CD5+, CD7+, CD8−, CD25−, TCRα/β+), but cytogenetic analysis showed no abnormalities. Fifteen months later, he developed a gastric tumor. Biopsy of the tumor revealed DLBL without features of MALT lymphoma; Helicobacter pylori was not detected. Chemotherapy eradicated the tumor, whereas the T-PLL was resistant to the therapy. The disease showed an indolent course for about 2 years thereafter. Immunological derangement due to T-PLL might have potentiated the development of DLBL in this case.View full abstractDownload PDF (459K) -
Shigeo TOYOTA, Norihiko NAKAMURA, Kazuo DAN2001 Volume 42 Issue 1 Pages 51-53
Published: 2001
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 30-year-old woman was admitted because of anemia and jaundice in 1999. She had been diagnosed as having idiopathic thrombocytopenic purpura (ITP) in 1996, but had shown no response to prednisolone (PSL). Subsequent splenectomy in 1998, followed by further treatment with PSL, had also been ineffective. On admission in 1999, the direct and indirect Coombs tests gave positive results, the cold agglutinin titer was high with anti-I specificity (IgM), and warm-type autoantibody (IgG) was positive. Autoagglutination of the patient's red blood cells was 3+ at 37°C. A diagnosis of mixed-type autoimmune hemolytic anemia (AIHA) associated with ITP was made. Mixed-type AIHA occurring after splenectomy for ITP is very rare, only one case having been reported to date.View full abstractDownload PDF (185K)
- |<
- <
- 1
- >
- >|