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Volume 47, Issue 12
Displaying 1-8 of 8 articles from this issue
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Picture in Clinical Hematology
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[in Japanese], [in Japanese], [in Japanese]2006 Volume 47 Issue 12 Pages 1491
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (883K)
Review
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Masao MATSUOKA2006 Volume 47 Issue 12 Pages 1493-1501
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
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Atae UTSUNOMIYA2006 Volume 47 Issue 12 Pages 1502-1513
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
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Clinical Study
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Hidefumi KATO, Makoto HANDA, Shigeru TAKAMOTO2006 Volume 47 Issue 12 Pages 1514-1520
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSWe carried out a survey on platelet transfusions performed in hospitals certified by the Japanese Society of Hematology. The average values of the pretransfusion platelet count (trigger value) for the day on which the transfusion was ordered, and the values on each day in the interval between the order and actual transfusion, were compared with the Guidelines. The average trigger value in aplastic anemia and myelodysplastic syndrome patients (A group) (1.41×104/μl) for the same day on which the transfusion was ordered was higher than the Guideline, whereas those patients with hematological disorders undergoing chemotherapy (B group) and hematopoietic stem cell transplantation (C group), namely 2.08×104/μl and 2.1×104/μl, respectively, were acceptable values when compared with the Guidelines. On the other hand, in all groups, the transfusion trigger values at one or two days after ordering were higher than the Guidelines, being 2.56×104/μl in the A group, 3.15×104/μl in the B group, and 2.59×104/μl in the C group. We have tried to formulate platelet count criteria for ordering a transfusion based on one day before the actual transfusion, because these platelet counts on ordering were relatively high. The criteria are 1.0∼1.5×104/μl in group A, 3.0×104/μl in group B, and 3.0×104/μl in group C. In order to perform platelet transfusion according to the Guidelines, the platelet count on ordering should be decreased as we proposed.View full abstractDownload PDF (1088K) -
A Questionnaire-based Report from the “Lung Injury by Bortezomib” Joint Committee of the Japanese Society of Hematology and the Japanese Society of Clinical HematologyAkihiko GOTOH, Kazuma OHYASHIKI, Kazuo OSHIMI, Noriko USUI, Tomomitsu ...2006 Volume 47 Issue 12 Pages 1521-1527
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSBortezomib is a proteasome inhibitor that can be effective in the treatment of refractory and relapsed multiple myeloma. Recently, severe pulmonary complications associated with bortezomib therapy have been reported in Japan. Because bortezomib has not yet been approved for general use in Japan and is imported by attending physicians on the request of patients, The Japanese Society of Hematology and The Japanese Society of Clinical Hematology sent urgent questionnaires to the councilors of both societies in order to explore the situation and details of pulmonary complications associated with bortezomib therapy. Clinical details were available for 46 patients who had been treated with personally imported bortezomib in Japan. Seven patients (15.2%), including 3 who died from respiratory failure, showed complications definitely or probably caused by bortezomib. Of the 7 patients, 6 had a prior history of stem cell transplantation (SCT), whereas only 14 of 39 patients without lung injury had received SCT treatment (p=0.033 by Fischer's exact test). Multivariate analysis revealed that the concomitant use of corticosteroids might reduce the risk of lung injury (p=0.024; odds ratio=0.055) and that a previous SCT might increase the risk (p=0.042; odds ratio=13.140). We summarized these data from questionnaires for a limited Japanese cohort and therefore do not know the precise incidence of lung injury linked to fatal progression. Thus, future verification concerning these matters is warranted after the approval of bortezomib for use in Japan. Clinicians should be aware of the possibility of severe pulmonary complications associated with bortezomib therapy.
Note that this report has the same contents as the article appeared in the International Journal of Hematology (vol. 84, p406∼412, 2006) by permission of both the editorials of the Japanese Society of Hematology and the Japanese Society of Clinical Hematology, and should be considered as the Japanese translation of the article.View full abstractDownload PDF (564K)
Case Reports
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Hyunsoo HONG, Yasutaka AOYAMA, Ryousuke YAMAMURA, Tadanobu OHTA, Atsuk ...2006 Volume 47 Issue 12 Pages 1528-1532
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSWe report a patient with severe thrombotic thrombocytopenic purpura (TTP) refractory to plasmapheresis who was successfully treated with rituximab. A 57-year-old male patient was referred to our department for further differential diagnosis and treatment of anemia and severe thrombocytopenia. Progressive psychoneurotic symptoms, hemolytic anemia, thrombocytopenia, renal function insufficiency and fever led us to the diagnosis of TTP. ADAMTS13 activity was below 3% and an inhibitor for ADAMTS13 was detected. Treatment with plasmapheresis and high-dose steroid was initiated but without clinical benefit. Two weeks following the initiation of plasmapheresis, we decided to treat the patient with 7 cycles of rituximab. No severe rituximab-related adverse effects were observed. After treatment with rituximab, the disease remitted, and the ADAMTS13 activity level increased. The patient has remained in complete remission for more than 1 year. Our data suggest that rituximab may be the optimal immunosuppressive therapy for refractory thrombotic thrombocytopenic purpura caused by an anti-ADAMTS 13 inhibitor.View full abstractDownload PDF (670K) -
Akihide YOSHIMI, Kazuki TAOKA, Hideki NAKASONE, Kimiko IIJIMA, Michiko ...2006 Volume 47 Issue 12 Pages 1533-1538
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSSuperior sagittal sinus thrombosis (SSST) has been reported to be caused by coagulopathy following oral contraceptive therapy, DIC, infection around the sinus, compression from a tumor, infiltration of tumor, and an inherited deficiency of proteins C and S, but SSST associated with hematological malignancies and L-asparaginase (L-Asp) therapy is rare. We report a case of an adult patient with acute lymphoblastic leukemia (ALL) who developed SSST during the remission induction therapy. A 25-year-old man was admitted with left facial nerve palsy and, following bone marrow aspiration and lumbar puncture, he was diagnosed as having T-ALL with CNS involvement. He received a 1-AdVP regimen as remission induction therapy and intrathecal administration of methotrexate and cytarabine. On day 29, he had a generalized convulsion and SSST was demonstrated by imaging tests. Lymphoid malignancy (ALL in particular), the use of L-Asp, CNS involvement, and intrathecal chemotherapy might be risk factors for the occurrence SSST. When a patient with those factors develops any neurological symptoms, we should pay attention to the occurrence of SSST, as well as stroke or CNS involvement, though SSST is rare.View full abstractDownload PDF (812K) -
Hideo KOH, Takahisa YAMANE, Takahiko NAKANE, Yasunobu TAKEOKA, Erina S ...2006 Volume 47 Issue 12 Pages 1539-1543
Published: December 30, 2006
Released on J-STAGE: March 14, 2008
JOURNAL RESTRICTED ACCESSAn 18-year-old female with myelodysplastic syndrome underwent an allogeneic cord blood transplantation in May 2005. The conditioning regimen consisted of total body irradiation, cytarabine and cyclophosphamide. The day of the cord stem cell transfusion was counted as Day 0. For acute GVHD prophylaxis, cyclosporine A (CsA) and methotrexate were used. Engraftment was achieved on Day 30, acute GVHD grade II developed on Day 45 and treatment with methylprednisolone for acute GVHD was started. On Day 68 the patient had generalized seizures accompanied by loss of consciousness, hypertension and left hemiparesis, and was intubated. A cranial CT scan showed a mass effect on the right basal ganglia, and high signal intensities on the T2-weighted and FLAIR images of a MR examination were detected in the bilateral basal ganglia and posterior lobes, the findings of which were compatible with a brain tumor or infectious disease. Since an increased level of apparent diffusion coefficient (ADC) values on the bilateral basal ganglia was noted, we suspected that vasogenic edema had caused the mass effect. She went into remission immediately after CsA treatment was discontinued. Therefore, this case was diagnosed as atypical reversible posterior leukoencephalopathy syndrome (RPLS) associated with CsA. CsA-induced encephalopathy presenting a mass effect in clinical imaging findings is very rare, and an ADC map may be useful for the diagnosis of RPLS.View full abstractDownload PDF (774K)
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