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Volume 45, Issue 2
Displaying 1-12 of 12 articles from this issue
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[in Japanese]2004 Volume 45 Issue 2 Pages 101-107
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 2 Pages 108-114
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 2 Pages 115-124
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 2 Pages 125-131
Published: 2004
Released on J-STAGE: July 28, 2009
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[in Japanese]2004 Volume 45 Issue 2 Pages 132-138
Published: 2004
Released on J-STAGE: July 28, 2009
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Yasunobu TAKEOKA, Ryousuke YAMAMURA, Satoru IWASAKI, Jyun MORIOKA2004 Volume 45 Issue 2 Pages 139-143
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report a case of benign intracranial hypertension (BIH) caused by all-trans retinoic acid (ATRA) in a patient with acute promyelocytic leukemia. A 21-year-old male was admitted to our hospital with pancytopenia. He was diagnosed as having acute promyelocytic leukemia due to increased promyelocytes, and PML-RARα chimeric mRNA was detected. The administraton of ATRA and idarubicin was started immediately. After 26 days of the chemotherapy, he complained of diplopia. Ophthalmologic examination revealed bilateral papilledema and hemorrhage. The cerebrospinal fluid showed an increase in pressure, but no other abnormalities. Computed tomography showed no intracranial abnormalities. The orbital MR imaging showed distension of the perioptic subarachnoid space and flattening of the posterior sclera. A diagnosis of BIH was made. After the discontinuation of ATRA, the symptoms improved and the MR abnormalities disappeared. As far as we know, there have been no reports illustrating MR abnormalities of BIH caused by ATRA, for the diagnosis and monitoring of which orbital MR imaging can provide important clues.View full abstractDownload PDF (503K) -
Masaaki TAKATOKU, Kaoru Noborio-HATANO, Satoko TAKAHASHI, Satoru KIKUC ...2004 Volume 45 Issue 2 Pages 144-148
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA proteasome inhibitor with a new molecular target (PS-341: bortezomib) was recently developed, and its efficacy in the treatment of refractory multiple myeloma has been reported in the United States. Here, we present a 54-year-old Japanese male patient with refractory multiple myeloma resistant to thalidomide. In 1998, the patient was diagnosed as having multiple myeloma (IgG-κ) and underwent chemotherapy, autologous hematopoietic cell transplantation and interferon therapy, but the disease recurred. In December 2002, thalidomide and high-dose dexamethasone therapy was initiated, and while this combination therapy was effective at first, the multiple myeloma became unresponsive. On 23 June 2003, bortezomib therapy with the following regime was therefore started: 2.2 mg (1.3 mg/m2) of bortezomib was injected intravenously on days 1, 4, 8 and 11, and after a one-week break, another cycle was performed. Starting on day 8 of the administration, the serum total protein, IgG, serum calcium and LDH levels decreased rapidly, and after day 45 of the administration, blood transfusion was no longer needed. Since this is the first report of the use of bortezomib in the treatment of refractory multiple myeloma in Japan, further monitoring of this patient will provide extremely valuable information for developing a therapy against this disease.View full abstractDownload PDF (751K) -
Shoko NAKAYAMA, Toshikazu AKIOKA, Taiji YOKOTE, Satoshi HARA, Satoko O ...2004 Volume 45 Issue 2 Pages 149-154
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 57-year-old woman was admitted with swelling of the femur. MRI showed that an intramedullary lesion had expanded from the trunk to the distal portion where it had formed an extramedullary tumor mass. An open biopsy showed diffuse proliferation of abnormal lymphoid cells. Immunohistochemical staining and flow cytometry demonstrated LCA+, CD3-, CD23-, CD79a+, CD5+, IgM+, IgD- and kappa+and cyclin D1-. FISH analysis did not detect t(11;14)(q13;q32). The final diagnosis was de novo CD5+ diffuse large B-cell lymphoma (DLBL) of the bone at clinical stage IEA. The patient suffered a pathological fracture in the femur after two courses of CHOP. The therapy was changed to ESHAP and irradiation. The result was assessed as a complete remission (CR). One month later, the patient presented with epigastric pain. MRI showed the tumor at the spleen and kidney and hydronephrosis due to pelvic lymphadenopathy, but did not show a tumor in the femur. An open biopsy of the pelvic lymph node showed relapse. The tumor and hydronephrosis disappeared and necrosis in the kidney was observed on MRI after ESHAP. De novo CD5+ DLBL appears to constitute a unique subset of DLBL with an aggressive clinical course and requires established therapeutic strategies.View full abstractDownload PDF (715K) -
Ichiro KAWANO, Junichi TSUKADA, Yoko TODA, Ryosuke OGAWA, Takehiro HIG ...2004 Volume 45 Issue 2 Pages 155-160
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSGraft-versus-lymphoma (GVL) effect has been described in patients with malignant lymphoma after allogeneic stem cell transplantation (alloSCT). The effect of interferon-α (IFN-α) on the GVL effect still remains unclear. Here we report on a 29-year-old woman with refractory diffuse large B-cell lymphoma (DLBL). Her clinical findings included multiple masses in the liver, stomach, bilateral kidneys, thyroid, vertebral bones and a bulky mediastinal mass. Since the patient did not respond to various combination chemotherapies and further developed superior vena cava syndrome, allogeneic peripheral blood stem cell transplantation (PBSCT) from a HLA-identical brother was carried out after a myeloablative TBI/CY-based conditioning regimen. DLIs have been also performed every 4 weeks since day +14. As a result, the lymphoma masses showed a partial response. In order to enhance the GVL effect, IFN-α was further given at a maximum of 3 MU four times per week. Although the patient only experienced graft-versus-host disease of the skin (grade II) even after both DLIs and IFN, complete clinical remission was observed. 200 days after transplantation, the patient is still disease-free and in good condition. This report suggests the curative potential of IFN-α combined with DLI after allogeneic SCT in refractory DLBL.View full abstractDownload PDF (767K)
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Masahiro ONOZAWA, Satoshi HASHINO, Koh IZUMIYAMA, Masakatsu YONEZUMI, ...2004 Volume 45 Issue 2 Pages 161-163
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSA 60-year-old woman was admitted to our hospital to receive treatment for relapse of biphenotypic leukemia 4 years after her initial presentation. Bone marrow examination revealed 53.5% lymphoblasts, which were classified as ALL-L2 with a normal karyotype. Lymphoblast surface markers were positive for cells of both B-cell and myeloid lineage. Immunoglobulin heavy chain and T-cell receptor gene rearrangements were investigated with PCR. Clonal rearrangement of TCRδ Vδ2-Dδ3 was detected. The same clonal rearrangement of TCRδ was found using frozen initial leukemic cells. Rather than secondary leukemia, the patient's leukemia was confirmed as relapse of the initial clone. Detection of the clonal rearrangement was also useful as a patient-specific marker for minimal residual disease.View full abstractDownload PDF (213K) -
Yoshihisa YAMAMOTO, Kazuyoshi ISHII, Shosaku NOMURA, Shirou FUKUHARA2004 Volume 45 Issue 2 Pages 164-166
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe report a case of chronic myeloid leukemia (CML) with clonal Philadelphia negative hematopoiesis arising after treatment with imatinib. A 45-year-old man was diagnosed as having Ph-positive CML. Therapy with MCNU and hydroxyurea was carried out for 12 days, and was then replaced by imatinib. A major cytogenetic response was obtained after 13 months of therapy with imatinib, but at the same time a new Ph-negative clone with trisomy 8 appeared in the bone marrow. Blood cell counts were still within normal limits. This observation indicates that patients on imatinib should be followed with bone marrow morphologic finding and routine cytogenetic testing, even after induction of a good response.View full abstractDownload PDF (325K) -
Eriko NAGASAWA, Yasunobu ABE, Takamitsu MATSUSHIMA, Ilseung CHOI, Yosh ...2004 Volume 45 Issue 2 Pages 167-169
Published: 2004
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe describe a 70-year-old woman with acute myelogenous leukemia with t(8;21) in the first relapse who underwent nonmyeloablative transplantation with conditioning of fludarabine and low-dose total body irradiation (2Gy). Myelosuppression was very mild, and the patient developed transient grade I renal and hepatic toxicities. Complete chimerism was achieved on day 120. The level of the AML1/MTG8 fusion gene in bone marrow decreased to an undetectable level on day 56 and the patient is alive and in complete remission with a follow-up at day 450. This transplant regimen might be well tolerated even by the elderly patients and bring a durable remission.View full abstractDownload PDF (292K)
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