All issues
Volume 46, Issue 12
Displaying 1-5 of 5 articles from this issue
- |<
- <
- 1
- >
- >|
-
[in Japanese]2005 Volume 46 Issue 12 Pages 1263-1272
Published: 2005
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSDownload PDF (615K)
-
Hiroatsu IIDA, Masaki RI, Keiko NIIMI, Tomoko HARADA, Hiroshi SAO2005 Volume 46 Issue 12 Pages 1273-1278
Published: 2005
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSPulmonary complications are frequent and sometimes lethal in allogeneic hematopoietic stem cell transplantation recipients. In our hospital, 16 transplanted patients had pulmonary complications at post-mortem examination. We review the patients' clinical courses and histopathological findings of their lungs, and discuss the factors related to the onset of the pulmonary complications. In 16 patients, 10 had infectious lung diseases and the other 6 were non-infectious. Five of the patients with infectious diseases had fungal infections: 2 aspergillosis, 2 candidiasis and 1 mucormycosis. In the other 5, 2 had cytomegalovirus pneumonia, 1 had herpes simplex virus pneumonia and 2 had bacterial pneumonia. These ten patients were highly immunocompromised because of steroid therapy or neutropenia. The histopathological diagnosis of all 6 patients with non-infectious disease was diffuse alveolar damage (DAD). Most of the DAD patients were also complicated with other organ damage due to regimen-related toxicity (RRT), and their respiratory symptoms had appeared during the rapid tapering off of their immunosuppressant drugs. These results revealed that prevention of fungal infection was still important for highly immunocompromised patients. Efforts to reduce RRT such as using a reduced intensity regimen and careful tapering off of immunosupressants are expected to lead to a decrease in non-infectious pulmonary complications.View full abstractDownload PDF (846K) -
Shuichi MIYAWAKI, Nobuhiko EMI, Kinuko MITANI, Kazuma OYASHIKI, Kuniak ...2005 Volume 46 Issue 12 Pages 1279-1287
Published: 2005
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe evaluated the clinical course of acute myeloid leukemia (AML) and the levels of WT1 mRNA in 191 AML patients. Of 114 previously untreated patients with AML, 107 cases were positive for WT1 mRNA (93.9%: 107/114). WT1 mRNA expression-levels declined to below 50 copies/μg RNA (“negative”) after remission was achieved in all 66 patients who achieved remission and 84.8% (47/54) cases were “negative” at the end of the follow-up periods. On the other hand, WT1 mRNA was expressed in 87.0% of non-remission cases (47/54), maintaining 50 copies/μg of RNA or higher (“positive”). In all 29 cases who relapsed during the follow-up observation period after achieving remission, WT1 mRNA levels declined transiently approximately around the time of achieving remission and then rose again when the disease relapsed. Moreover, we determined the time of elevation of WT1 mRNA in 29 relapsed cases. In 79.3% of relapsed cases (23/29), WT1 mRNA levels rose above 200 copies/μg RNA, 43 days (median) before the diagnosis of “relapse”. Given the percent of the correct diagnosis, WT1 mRNA at 200 copies/μg RNA appeared to be a reasonable cut-off level for early detection of AML-relapse. The WT1 mRNA level reflected the clinical condition. Taken together, these findings indicate that WT1 mRNA levels allow us to detect the presence of so-called “minimal residual disease” (leukemic cells) that cannot be detected by morphological examination. Besides these promising data, this kit is suitable for routine monitoring of AML because this kit utilizes peripheral blood as a test specimen, reducing the patient's burden at the time of collection of clinical samples as compared with bone marrow aspirate.View full abstractDownload PDF (952K)
-
Izumi ISHIKAWA, Koichi MIYAMURA, Minami YAMADA, Osamu SASAKI, Hideo HA ...2005 Volume 46 Issue 12 Pages 1288-1292
Published: 2005
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSWe describe a 56-year-old woman with chronic myeloid leukemia (CML) and a past history of stroke, who underwent nonmyeloablative hematopoietic stem cell transplantation (NST) with conditioning consisting of fludarabine and cyclophosphamide. The regimen related toxicity was minimal and patient did not require transfusions of any blood products nor did she have any infections after the NST. Since mixed chimerism was observed in both lymphocytes (70% were donor type) and granulocytes (none were donor type) at 56 days after NST, donor lymphocyte infusion (DLI) was performed on day 68 and then immunosuppressant therapy was discontinued. DLI resulted in graft versus leukemia (GVL) effect, causing pancytopenia and bone marrow aplasia. A second hematopoietic stem cell transplantation was performed without conditioning on day 157, and complete donor type hematopoiesis and molecular remission of CML were achieved. Although engraftment of donor hematopoietic stem cells was not obtained after the first transplantation, donor lymphocytes were engrafted by nonmyeloablative conditioning and immunosuppression. That is, the same result might have been achieved even if the patient had received transfusion of only donor lymphocyte subsets in the first step. Based on this case report, a potential cell therapy is proposed composed of the preceding donor lymphocyte infusion alone, which induces GVL effects, and subsequent donor hematopoietic stem cell transplantation.View full abstractDownload PDF (839K)
-
Isao MATSUDA, Yuki MORI, Yasunori NAKAGAWA, Masakazu SAWANOBORI, Naoki ...2005 Volume 46 Issue 12 Pages 1293-1297
Published: 2005
Released on J-STAGE: July 28, 2009
JOURNAL RESTRICTED ACCESSStratification of patients with multiple myeloma (MM) may be important. We investigated 138 MM patients, focusing on correlations between CD20 expression, 11;14 translocation, morphology of MM cells, cyclin D1 immunostaining, and the prognosis. About 15% of patients (7/47 cases) were CD20-positive, small mature MM cells, with positive cyclin D1 in the nucleus and 11;14 translocation. Two color analysis of CD38×CD20 antigens may be necessary to investigate CD20 expression on MM cells. Rituximab may be effective for the treatment of CD20-positive MM.View full abstractDownload PDF (603K)
- |<
- <
- 1
- >
- >|