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Volume 44, Issue 7
Displaying 1-12 of 12 articles from this issue
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[in Japanese]2003 Volume 44 Issue 7 Pages 437-445
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (1434K)
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Tomomi TOUBAI, Shuichi OTA, Manabu ONODERA, Urara BABA, Fumie FUJISAWA ...2003 Volume 44 Issue 7 Pages 446-450
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 23-year-old female patient was diagnosed as having Hodgkin lymphoma (mixed cellularity type, clinical stage III B) in September 2000. She underwent ABVD chemotherapy and irradiation of a mediastinal lesion, resulting in complete remission. However, the disease reccurred three month after the completion of initial treatment. She was admitted to our hospital for allogeneic stem cell transplantation. Thoratic vertebra, lumbar vertebra and iliac bone lesions were detected by FDG-PET, and a diagnosis of bone marrow infiltration was made. She received re-induction chemotherapy but did not achieve complete remission. A residual lesion in her bone marrow was detected by FDG-PET. She underwent unrelated allogeneic bone marrow transplantation in May 2002. Preconditioning was VP-16, CY and TBI. Engraftment of white blood cells was on day 15. Skin GVHD was detected at the same time and she was treated with steroid hormones, resulting in improvement. No residual mass could be detected by FDG-PET on day 60. However, she suffered from fever on day 80. Aggravation of the disease was revealed and she died from progression of the disease on day 120. FDG-PET is useful for the monitoring disease status and for determining the optimal timing of various treatments.View full abstractDownload PDF (540K) -
Yasutaka AOYAMA, Ryousuke YAMAMURA, Etsuko SHIMA, Hirohisa NAKAMAE, Ka ...2003 Volume 44 Issue 7 Pages 451-455
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSVisceral disseminated varicella-zoster virus (VZV) infection occurred with acute graft-versus-host disease in a 33-year-old Japanese male with non-Hodgkin lymphoma who had undergone allogeneic stem cell transplantation from an HLA-identical sibling after reduced intensity conditioning chemotherapy. Although ganciclovir and acyclovir treatment was effective temporarily, the number of VZV-DNA copies in the blood remained at a high level, and the hepatitis was prolonged. The patient was treated with foscarnet, which led to improvement of the VZV viremia and the hepatic dysfunction. Foscarnet therapy should be considered for acyclovir-resistant VZV infection in the setting of allogeneic hematopoietic stem cell transplantation.View full abstractDownload PDF (323K) -
Motoaki SHIRATSUCHI, Satoru SUEHIRO, Youko SUEHIRO, Kenzaburo TANI, Ko ...2003 Volume 44 Issue 7 Pages 456-461
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 40-year-old man was admitted to our hospital suffering from abdominal pain. He revealed marked splenomegaly, lymphadenopathy and pancytopenia. Lymph node biopsy showed diffuse proliferation of medium to large atypical lymphoid cells. Immunohistochemically the cells were positive for T-cell markers. He was diagnosed as having peripheral T cell lymphoma (PTCL) with involvement of the spleen and bone marrow. Because of refractoriness to combination chemotherapies and splenic irradiation, we performed allogeneic peripheral blood stem cell transplantation from an HLA-identical sister. Conditioning was consisted of conventional doses of total body irradiation and cyclophosphamide, and GVHD prophylaxis was performed with cyclosporine and methotrexate. After the patient developed grade III graft-versus-host disease, his splenomegaly improved dramatically. Although the effectiveness of allogeneic hematopoietic cell transplantation in the treatment of malignant lymphoma is controversial, we should consider this as a second-line therapy to refractory subsets of PTCL.View full abstractDownload PDF (758K) -
Kazue TAKAI, Kouji NIKKUNI, Masayoshi SANADA, Hiroyuki SHIBUYA2003 Volume 44 Issue 7 Pages 462-467
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 72-year-old woman was admitted with left cervical lymphadenopathy, high fever, pancytopenia and liver dysfunction. Bone marrow aspiration showed infiltration of large atypical lymphoid cells and hemophagocytic histiocytes, thus suggesting a diagnosis of lymphoma associated hemophagocytic syndrome (LAHS). An abdominal CT scan revealed multiple low-density areas in the liver, and the patient's liver function rapidly deteriorated. Histologically, the cervical biopsy showed lymphoma cell infiltration with prominent necrosis and karyorrhectic debris. The lymphoma cells expressed CD3+, CD4−, CD8+, CD20−, CD56+/−, TIA-1+, granzyme B+, and EBER was positive using in situ hybridization. DNA analysis of the TCR β and γ chain gene with the Southern blot showed rearranged bands. These findings were compatible with those of EB-virus associated peripheral T-cell lymphoma. After chemotherapy with the THP-COP regimen, the patient's liver dysfunction improved rapidly, but she died from bacterial peritonitis due to perforation of a recurrent duodenal ulcer. Post-mortem examination of the liver showed multiple irregular massive necroses of the hepatocytes, where no lymphoma cell infiltration was present. Hemophagocytic histiocytosis was remarkable in the bone marrow, spleen, lymph nodes, and liver. Marked elevation of serum levels of cytokines such as TNF-α or IFN-γ suggests that these cytokines played an important role in the pathogenesis of the hepatic cell necrosis.View full abstractDownload PDF (665K)
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Tomohisa YOKOYAMA, Keisuke MIYAZAWA, Masahiko OTAWA, Ken KAWAKUBO, Yuz ...2003 Volume 44 Issue 7 Pages 468-470
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 46-year-old woman visited our hospital in January 1998 because of a painful palate mass. In the ten years previous to presenting, she noticed dryness of the mouth and occasionally had conjunctivitis. The pathological findings of the biopsy from the hard palate revealed that she had an extranodal marginal zone B cell type lymphoma (MALT type). Results of the Schirmer test, rose-bengal test and a gum test all supported the diagnosis that she had also Sjögren syndrome. However, complete self-remission of the hard palate lymphoma was observed 4 months after the diagnosis, and no relapse has been seen in a follow-up of over 2.5 years. Watch and wait should be emphasized for a patient having a palate MALToma at an early stage accompanied by Sjögren syndrome.View full abstractDownload PDF (350K) -
Hiro TATETSU, Norio ASOU, Miki NAKAMURA, Yasuhiro KOH, Tetsuya TAJIRI, ...2003 Volume 44 Issue 7 Pages 471-473
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report two cases of an allergic reaction to HCO-60, which is used as an emulsifien for Multamin and enocitabine. A 55-year-old woman with M 4 Eo developed a high fever, urticaria and erythema after induction chemotherapy. After stopping the administration of Multamin, her fever and eruptions subsided. A 51-year-old woman with L2 developed erythema and hypotention 30 minutes after the third administration of Multamin. When the patient was given enocitabine, she developed anaphylactic shock. During chemotherapy in patients with leukemia, it is important to distinguish the allergic reaction against Multamin-containing HCO-60 from infection and allergies to other drugs.View full abstractDownload PDF (209K) -
Takayuki TSUJIOKA, Hideho WADA, Kenichiro YATA, Sinichiro SUEMORI, Osa ...2003 Volume 44 Issue 7 Pages 474-476
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 69-year-old man was diagnosed as having acute promyelocytic leukemia (APL) and was treated with all-trans retinoic acid (ATRA) and idarubicin plus cytarabine. He achieved cytogenetic complete remission (CCR). Relapse occurred 1 year after CCR. Treatment with Am80 gave him a second CCR. However, a second relapse occurred. Re-induction therapy with ATRA was started at 70 mg per day. On day 14, abdominal fullness rapidly increased and massive ascites appeared as a symptom of retinoic acid syndrome (RAS). We ceased the ATRA treatment and started administration of methylpred-nisolone. The ascites decreased, but an increase of ascites was recognized again temporarily after having re-started ATRA treatment. Thus we gradually increased ATRA administration from 40 mg/day to 70 mg/day of ATRA. RAS did not occur and the patient achieved a third CCR. This case indicates that a gradual increase in ATRA administration is beneficial for RAS occurring in APL patients.View full abstractDownload PDF (248K) -
Tadanobu OHTA, Kioyuki HAGIWARA, Kaori MAKITA, Atuko MUGITANI, Kensuke ...2003 Volume 44 Issue 7 Pages 477-479
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe describe an XXX female patient accompanied with essential thrombocythemia. To our knowledge this is the first case ever to have been reported. The patient was asymptomatic, but her platelet count had increased to 111.2×104/μl, and she was diagnosed as having essential thrombocythemia based on the diagnostic critearia of the Polycythemia Vera Study Group. At the same time, chromosome analysis of bone marrow cells revealed that she was an XXX female. The patient remained asymptomatic throughout the course of treatment.View full abstractDownload PDF (202K) -
Noboru ASAUMI, Kouzou MASUDA, Chikamasa YOSHIDA, Toru KIGUCHI, Masami ...2003 Volume 44 Issue 7 Pages 480-482
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report on case of a 52-year-old male with refractory idiopathic thrombocytopenic purpura. Treatment with prednisolone, vincristine, azathioprine, colchicine, danazol, diaphenylsulfone, and splenectomy were tried but all were ineffective and platelet counts mostly stayed below 5,000/μl. We finally tried eradicating Helicobacter pylori (HP) with the standard combination of amoxicillin (1,500 mg), clarithromycin (400 mg), and lansoprazole (60 mg) for 7 days, but it failed. We therefore gave the patient a second eradication therapy based upon a drug sensitivity test using HP obtained from his gastric mucosa. According to the drug sensitivity test, we treated him with minocycline (200 mg), levofloxacin (600 mg), and lansoprazole (60 mg) for 7 days. The platelet counts increased gradually and reached to 30,000/μl after the eradication, and the patient was spared extended hospitalization.View full abstractDownload PDF (288K)
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Kenji ISHITSUKA, Syuichi IKEDA, Youichiro IZUMI, Yutaka IMAMURA, Naoku ...2003 Volume 44 Issue 7 Pages 483-490
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSThe Kyushu Hematology Organization for Treatment Study Group (K-HOT) consisted of 22 institutions specializing in hematology in Kyushu. This study is aimed at reviewing the daily practice of infection control for the treatment of hematological malignancies in our group. Nominal questionnaires were mailed to the hematology department in each institution from November 2001 to April 2002. For the first general surveys, 19 of 22 (86%) institutions responded. The second survey was mailed to the 19 respondents and 17 answered the detailed questionnaires with a response rate of 89%. Prophylactic use of trimethoprim-sulfamethoxazole (ST) against Pneumocystis carinii and anti-mycobacterial drugs in patients who had a history of tuberculosis was routine especially for patients with adult T-cell leukemia/lymphoma (ATL). Furthermore, the neutrophil counts to start a granulocyte-colony stimulating factor appeared to be high in ATL as compared with other hematological malignancies. In the setting of autologous stem cell transplantation (SCT), prophylactic use of acyclovir, immunoglobulin and ST was not routine and was reduced in duration, if used at all, as compared with allogeneic SCT. For allogeneic SCT, the cumulative dose of immunoglobulin significantly varied from institutions to institutions. The benefit of this study is the ability to recognize practical management patterns for infection control.View full abstractDownload PDF (600K)
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2003 Volume 44 Issue 7 Pages 491-493
Published: 2003
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (290K)
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