Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 44, Issue 4
Displaying 1-11 of 11 articles from this issue
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  • Late appearance of Philadelphia chromosome with the p190 BCR/ABL chimeric transcript in acute myelogenous leukemia progressing from myelodysplastic syndrome
    Kazuhiko KAKIHANA, Daisuke MIZUCHI, Mitsuko YAMAGUCHI, Chizuko SAKASHI ...
    2003 Volume 44 Issue 4 Pages 242-248
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.242
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    We report a late appearance of the Philadelphia chromosome (Ph) with the p190 BCR/ABL chimeric transcript in a 69-year-old patient with acute myelogenous leukemia (AML) that had evolved from myelodysplastic syndrome (MDS). In July 1997, the patient was found to have pancytopenia caused by refractory anemia with excess of blasts, which evolved into AML in 4 months. The leukemic cells were positive for CD13, CD14, CD33, and HLA-DR and had a normal karyotype. The patient achieved a complete remission after combination chemotherapy. However, his leukemia relapsed in November 1999, with the appearance of leukemic cells positive for CD7, CD13, CD34, and HLA-DR with a 46, XY, add(18)(p11) karyotype. The patient failed to achieve the second remission after several courses of intensive chemotherapy. When the number of blastic cells, showing the same surface phenotypes, in the peripheral blood increased drastically in April 2000, chromosomal analysis of leukemic cells revealed a 46, XY, t(9;22)(q34;q11), add(18)(p11) karyotype. The fusion of the BCR and ABL genes was confirmed by fluorescence in situ hybridization analysis, and the reverse transcription-polymerase chain reaction analysis further revealed the presence of the p190 BCR/ABL chimeric transcript. The appearance of the Ph chromosome in the course of MDS transforming to AML is very rare and may be correlated to the disease progression.
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  • Successful treatment of splenic lymphoma with villous lymphocytes by rituximab and laparoscopic splenectomy
    Tomoko FUJITA, Kohsuke ASAGOE, Hiroto SAKODA
    2003 Volume 44 Issue 4 Pages 249-253
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.249
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    We report on a case of splenic lymphoma with villous lymphocytes (SLVL) which responded well to rituximab. A 50-year-old man was admitted because of splenomegaly. Abnormal lymphocytes of B cell lineage with moderately basophilic cytoplasm and unevenly distributed villi (villous cells) were found, both in the peripheral blood and bone marrow. CHOP and CHOP-E were performed, without any remarkable change in the size of the spleen. However, after infusion of rituximab (375 mg/m2, once weekly for 2 weeks), there was a marked reduction of the spleen size and the number of circulating villous cells. Splenectomy was performed afterwards, followed by 2 cycles of rituximab infusion. The patient is now followed on an outpatient basis without any sign of relapse.
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  • Successful treatment with imatinib mesylate for Philadelphia chromosome-positive refractory acute myeloid leukemia
    Mitsuhiro YAMAGUCHI, Ichiro KONISHI
    2003 Volume 44 Issue 4 Pages 254-256
    Published: 2003
    Released on J-STAGE: July 28, 2009
    DOIhttps://doi.org/10.11406/rinketsu.44.254
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    A 51-year-old man was diagnosed as having Philadelphia (Ph) chromosome-positive acute myeloid leukemia (AML) with major-BCR/ABL mRNA. He achieved complete remission after induction chemotherapy. Five months later, he was again positive for the Ph chromosome despite additional chemotherapy. He was therefore treated with imatinib mesylate, a specific inhibitor of BCR/ABL tyrosine kinase, at a dose of 600 mg/day. However, the treatment was interrupted because of thrombocytopenia, skin eruption and face edema. After the patient recovered from these side effects, imatinib was readministered at a dose of 400 mg/day and a complete cytogenetic response was achieved. Imatinib is expected to be an effective drug for Ph chromosome-positive AML.
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