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Volume 45, Issue 11
Displaying 1-11 of 11 articles from this issue
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[in Japanese]2004 Volume 45 Issue 11 Pages 1151-1159
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 11 Pages 1160-1167
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 11 Pages 1168-1176
Published: 2004
Released on J-STAGE: July 28, 2009
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Hiroshi SAITO, Hideaki MAEDA2004 Volume 45 Issue 11 Pages 1177-1180
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSThis is to introduce a new method for determining the amount of blood loss by measuring the storage iron decrease rate (SID), as obtained by following serum ferritin after intravenous iron therapy in a patient with iron deficiency anemia due to intestinal blood loss. The patient was followed from the day S, when iron therapy started, to the day E, when serum ferritin decreased to 12μg/l, indicating the exhaustion of the iron stores. The SID was calculated from the formula: SID=(T-R)/D, where, T mg=total amount of injected iron, R mg=the difference in the iron in the hemoglobin (ΔHb) between day S and E, and D=days from S to E. The SID was thought to be iron loss only, as the contribution of iron absorption and iron loss to the SID, with the exception of bleeding, was believed to be negligible and as the serum ferritin decrease curve was exponentially linear. Using the formula, V=iron loss/iron in mean Hb, the amount of blood loss: V=29 ml/day was obtained. This method can also be used for the quantitation of blood loss in other patients with chronic blood loss, because the SID could also be determined in 12 cases of post-treatment iron deficiency anemia with chronic blood loss.View full abstractDownload PDF (279K) -
Chiharu TANAI, Seiko IKI, Fumio NAKAHARA, Kimiko IIJIMA, Kensuke USUKI ...2004 Volume 45 Issue 11 Pages 1181-1186
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 75-year-old woman had an episode of sudden nasal and oral bleeding. After that, petechiae appeared on her entire body. She received a platelet transfusion, and was referred to our hospital. On admission, the platelet count was as low as 1.2×104/μl, and the PAIgG level was slightly elevated. Bone marrow cellularity was low, with a normal count of megakaryocytes. Anti-glycoprotein IIb/IIIa antibody-secreting B cells in the peripheral blood and platelet-associated anti-glycoprotein IIb/IIIa antibodies were significantly high, and the patient was diagnosed as having idiopathic thrombocytopenic purpura (ITP). She failed to respond to corticosteroids, splenectomy and other therapies, so we administered rituximab, anti-CD20 monoclonal antibody, 375 mg/m2 weekly for four weeks. After the second infusion of rituximab, the platelet count began to increase. The platelet count continued to rise until a peak count (15.0×104/μl) observed after 2 weeks from the fourth infusion, and the response was maintained for 8 more weeks. The levels of anti-glycoprotein IIb/IIIa antibody-secreting B cells and platelet-associated anti-glycoprotein IIb/IIIa antibodies decreased after the administration of rituximab. Rituximab was effective in this case of refractory ITP.View full abstractDownload PDF (341K) -
Kiyoshi HIRUMA, Yoshiki OKUYAMA, Akimichi OSAKA, Masaharu KASAI, Hidek ...2004 Volume 45 Issue 11 Pages 1187-1192
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe carried out a survey on platelet transfusions performed in nine general hospitals. We evaluated 303 adults who received a total of 24455 units over 1864 platelet transfusions. The underlying diseases were hematologic disorders with chemotherapy (59.7%), hematologic disorders without chemotherapy (15.5%), hematopoietic stem cell transplantation (18.5%), and others (2.0%). The patient platelet count before transfusion (platelet trigger value) was measured in only 77.1%. The platelet trigger value differed greatly between the hospitals, with an average of 2.2×104/μl, a minimum of 1.3×104/μl, and maximum of 3.2×104/μl. Only 55.3% of the platelet transfusions carried out complied with the Platelet Transfusion Guideline published by the Ministry of Health, Labour and Welfare. The hospitals surveyed could be divided into those who gave mainly around 10 units and those who gave over 10 units. The total dose of platelets transfused was more in the hospitals that used mainly 15 or more unit-PCs than in the hospitals that used mainly 10 unit-PCs. These results indicate that platelet transfusion may be greatly reduced by complying with the 2×104/μl of platelet transfusion threshold and by selecting less than 10 units of PC per transfusion.View full abstractDownload PDF (343K)
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Young-Dong PARK, Masaaki HAMADA, Banryoku HIGUCHI, Tomoko KISHIMOTO, J ...2004 Volume 45 Issue 11 Pages 1193-1197
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report the case of 13-year-old boy who had been diagnosed as having anaplastic large cell lymphoma (ALCL) when he was 11 years old. He suffered a relapse despite the chemotherapy regimens he had been subjected to. Since anaplastic lymphoma kinase (ALK), one of the important prognostic factors of ALCL, was not expressed in the tumor cells, allogeneic peripheral blood stem cell transplantation (PBSCT) from his HLA-matched elder brother was performed. Eleven months after PBSCT, the patient developed nephrotic syndrome as a consequence of chronic graft-versus-host disease (GVHD). He was diagnosed as having membranous nephropathy (MN) based on the results of histological examinations. Soluble interleukin-2 receptor and anti-nuclear antibody closely reflected the clinical course of MN, therefore some immune mechanisms closely related to chronic GVHD seemed to contribute to the occurrence of MN after PBSCT.View full abstractDownload PDF (405K) -
Seiko HONDA, Yoshikazu ITO, Tomotaka IGUCHI, Seiichi OKABE, Goro SASHI ...2004 Volume 45 Issue 11 Pages 1198-1202
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 31-year-old woman was given a diagnosis of aplastic anemia (AA) in 2000 and was treated with anti-thymocyte globulin (ATG) (horse serum), cyclosporine and granulocyte-colony stimulating factor (G-CSF). In 2002, she came to our hospital. The laboratory data revealed severe cytopenia according to the criteria by Camitta. A cytogenetic study revealed a normal female karyotype. We demonstrated CD55-negative and CD59-negative clones in her erythrocytes and granulocytes. HLA-DR 1501 was negative. After corticosteroid pulse therapy, the del(13q)(7/21 cells) was noted in her marrow cells. She was re-treated with ATG (rabbit serum), cyclosporine and G-CSF without particular cytogenetic changes after the therapy. Deletion of the 13q anomaly is rarely detected in patients with AA and its clinical significance in this disease is not well known. In the literature, AA patients with the del(13q) responded well to immunosuppressive therapy, irrespective of the timing of the appearance of the del(13q) anomaly. Further investigation will be needed to clarify the significance of del(13q) in AA.View full abstractDownload PDF (304K) -
Kazuya SATO, Masaki MORI, Akiko MEGURO, Takuji MIYOSHI, Tadashi NAGAI, ...2004 Volume 45 Issue 11 Pages 1203-1207
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 16-year-old male was referred to our hospital in April 2003 due to severe knee joint pain from five months previously. Lymphoblasts were identified in his peripheral blood, resulting in a diagnosis of acute lymphoblastic leukemia (ALL). Bone marrow examination revealed massive necrosis with clusters of lymphoblasts and the bcr/abl fusion gene. Magnetic resonance imaging (MRI) of the knee joint showed low signal intensity on T1-weighted images, and peripheral rim enhancement on Gd-DTPA enhanced fat suppression images, which was compatible with bone marrow necrosis. After the patient achieved complete remission (CR), the knee joint pain has disappeared. He was treated with an allogeneic bone marrow transplantation (BMT) from an HLA-identical unrelated donor and has been in CR for 26 months after the diagnosis of ALL. In the knee joint, the replacement of fatty marrow after BMT has been confirmed with MRI. Hematological malignancies including ALL should be considered in the cases of bone marrow necrosis and adequate treatment may improve necrosis.View full abstractDownload PDF (392K)
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Yasuhiro NAKASHIMA, Yasunobu ABE, Rie OHTSUKA, Yoshimichi TACHIKAWA, E ...2004 Volume 45 Issue 11 Pages 1208-1210
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSMalignant lymphomas are often associated with immunological disorders. We describe here a 54-year-old woman with follicular lymphoma, simultaneously complicated with autoimmune hemolytic anemia and pure red cell aplasia. The patient had bilateral cervical, axillar and inguinal lymph node swellings. Peripheral blood analysis revealed severe anemia (Hb 3.4g/dl) and reticulocytopenia (2260/ml), and then the bone marrow showed erythroid hypoplasia. Furthermore, a direct Coombs test was positive and the serum haptoglobin level was undetectable. After treatment with CHOP followed by 1 mg/kg of prednisolone daily, the patient obtained complete remission and her anemia improved to the normal level.View full abstractDownload PDF (304K) -
Yuko ISHII, Akihiko GOTO, Tomoko KATAGIRI, Keisuke MIYAZAWA, Kazuma OH ...2004 Volume 45 Issue 11 Pages 1211-1213
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 77-year-old man was diagnosed as having essential thrombocythemia (ET) in 1994. He had been treated with hydroxyurea (HU) for six years, and 9 years after the diagnosis of ET, he then developed acute myelomonocytic leukemia (AMMoL) following myelodysplastic syndrome (MDS). Since he suffered from ischemic heart disease, we chose the ara-C+VP-16 therapy. Two courses of the ara-C+VP-16 therapy resulted in partial remission in the bone marrow and a prolonged hematological response. This case seemed rare, since in previous reports, prognosis of ET patients developing MDS and AML was very poor and most of the patients expired within six months.View full abstractDownload PDF (235K)
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