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Volume 49, Issue 11
Displaying 1-11 of 11 articles from this issue
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Picture in Clinical Hematology No.31
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]2008 Volume 49 Issue 11 Pages 1523
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (174K)
The 68th Annual Meeting of the Japanese Society of Hematology/
The 48th Annual Meeting of the Japanese Society of Clinical Hematology
The 48th Annual Meeting of the Japanese Society of Clinical Hematology
Special Award Received Lecture
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Yorifumi SATOU, Jun-ichirou YASUNAGA, Mika YOSHIDA, Masao MATSUOKA2008 Volume 49 Issue 11 Pages 1525-1529
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (522K)
Clinical Study
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Itaru KATO, Katsutsugu UMEDA, Hiroshi MATSUBARA, Hidefumi HIRAMATSU, K ...2008 Volume 49 Issue 11 Pages 1530-1535
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSWe retrospectively evaluated the incidence of renal insufficiency (RI) and risk factors involved in RI in 27 pediatric cases that underwent their first hematopoietic stem cell transplantation (HSCT) in our hospital. Median patient age was 7 years (7 months-16 years); 19 cases demonstrated hematological malignant disease and 8 cases showed non-malignant disease, respectively. Nineteen cases were transplanted from unrelated donors. The incidence of acute and chronic RI was 51.9% and 22.2%, respectively. The intensity of the conditioning regimen, the dose of TBI, GVHD prophylaxis, and the grade of GVHD did not significantly affect the incidence of either acute or chronic RI. Patients over 13 years old were at high risk for chronic RI. Furthermore, the incidence of chronic RI was significantly higher in patients showing a serum creatinine increase during the acute phase of HSCT that was more than three times the pre-HSCT level. RI prophylaxis such as ACE inhibitors or AII receptor antagonists is needed for older children and for those demonstrating severe RI at the early stage after HSCT.View full abstractDownload PDF (386K)
Case Reports
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Souichi SHIRATORI, Takeshi KONDO, Kanako KUBOTA, Kentarou WAKASA, Mako ...2008 Volume 49 Issue 11 Pages 1536-1540
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSSeveral studies have confirmed that CD20 is expressed in about 20% of multiple myeloma (MM) cases. This is closely related to a chromosomal translocation between chromosome 11 and chromosome 14, which results in the expression of CyclinD1. The use of rituximab (RIT) in the treatment of CD20-positive MM has been reported, however its effectiveness is still not well established. We encountered a case of CD20-positive/CyclinD1-positive MM; interestingly, CD20 expression could not be detected in MM cells following RIT-combined chemotherapy, while it gradually recovered when RIT therapy was discontinued. This is the first report in which the transition of CD20 expression was accurately analyzed by flow cytometry and immunohistochemical staining before, during and after RIT treatment. Consequently, this case provides insight regarding the mechanism through which CD20 expression is lost following RIT therapy for CD20-positive lymphoid neoplasm, as well as the efficacy of RIT in CD20-positive MM.View full abstractDownload PDF (421K) -
Kensaku IDUTSU, Yasunobu ABE, Takamitsu MATSUSHIMA, Eriko SADA, Rie OH ...2008 Volume 49 Issue 11 Pages 1541-1547
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSHemophagocytic lymphohistiocytosis (HLH) is a rare but severe complication of Epstein-Barr virus (EBV) infection. Interactions between EBV-infected T cells and activated macrophages cause several conditions such as pancytopenia, liver dysfunction and coagulopathy. We describe here two young adults with EBV-associated HLH with monoclonal proliferation of EBV-infected T cells within a short period after infectious mononucleosis as a primary infection. One patient was a 16-year-old man who developed severe pancytopenia and liver dysfunction two months after infectious mononucleosis. Bone marrow examination showed hemophagocytosis, and laboratory data demonstrated monoclonal proliferation of EBV-infected T cells. Several treatments such as immunosuppressive therapy, chemotherapy and hematopoietic stem cell transplantation were not effective, and the patient died of progressive disease. The other patient was a 19-year-old woman who developed thrombocytopenia and liver dysfunction two months after infectious mononucleosis. Findings of hemophagocytosis and monoclonal proliferation of EBV-infected T cells were similar to those in the first case. Clinical signs and symptoms were resolved completely by immunosuppressive therapy containing methyl-prednisolone and cyclosporine. Since these two cases each demonstrated a distinct clinical course, an investigation of the prognostic factors and treatment strategies for EBV-HLH is warranted.View full abstractDownload PDF (588K) -
Hiroaki TANAKA, Akira YOKOTA, Masahiro ONODA, Taeko UEHARA, Takashi TE ...2008 Volume 49 Issue 11 Pages 1548-1551
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSA 58-year-old man was admitted to a general hospital to undergo total hip replacement arthroplasty for idiopathic osteonecrosis of the right femoral head. Pre-operative screening examination demonstrated isolated prolonged aPTT. Factor VIII (FVIII) activity was mildly decreased but there was no detectable FVIII inhibitor, so he was diagnosed as having congenital hemophilia. Surgery was performed safely with administration of FVIII preparation but 33 days postoperatively bleeding from the right hip joint appeared. It was not controllable with FVIII preparation and he was therefore admitted to our hospital.
Laboratory examination at admission demonstrated prolonged aPTT (111.1 sec), reduced FVIII activity (3.0%), and the presence of FVIII inhibitor (17.0 B.U./ml). He was diagnosed with acquired hemophilia and administered Factor IX complex concentrates, prednisolone and cyclophosphamide. However, these treatments had only a temporary effect. Rituximab was administered every week and his condition soon improved. This case suggests that acquired hemophilia, in which there was no detectable FVIII inhibitor, may change to refractory disease after surgery. As a result, surgeons should pay careful attention to the preoperative presence of any mild coagulation abnormalities.View full abstractDownload PDF (328K) -
Moritaka GOTOH, Toshihiko KITAHARA, Tomotaka IGUCHI, Miki IZUMI, Kiyos ...2008 Volume 49 Issue 11 Pages 1552-1555
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSA 35-year-old man was admitted with continuous general fatigue and low grade fever. He was HIV-positive, and had gastric diffuse large B-cell lymphoma and renal T-cell anaplastic large cell lymphoma (T-ALCL). We diagnosed double lymphomas related to AIDS. The patient received anti-retroviral therapy, and started the CHOP regimen for the double lymphomas, resulting in transient improvement. However, fever again appeared during HAART and CHOP treatment, and a right inguinal subcutaneous lesion appeared. Biopsy specimen demonstrated null cell ALCL, and this patient demonstrated multiple lymphomas. This case suggested that cancer generation was promoted by low immunity, although it is known that ambivalent tumors such as non-Hodgkin lymphomas can occur frequently.View full abstractDownload PDF (411K) -
Takashi ABE, Toshiki KITAJIMA, Keiichiro HONMA, Tori KURASAKI, Kiyoshi ...2008 Volume 49 Issue 11 Pages 1556-1561
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSA 26-year-old woman with acute lymphoblastic leukemia (ALL) relapsed three times after HLA-matched related bone marrow transplantation. Initially, ALL relapsed in the central nervous system (CNS) 1 year after transplantation. Then, ALL relapsed as a single bone tumor involving the CNS and pelvis 4 years after transplantation. Finally, multiple bone tumors in the pelvis and lumbar bones were found as well as spread to the bone marrow 5 years after transplantation. Bone marrow aspiration also showed ALL relapse. Flow cytometry analyses detected CD20-positive cells in the bone tumor. Though the initial bone tumor was resistant to hyper CVAD, radiation was effective and this patient achieved complete remission. At that time, the total radiation dose had already reached the upper limit. After the third relapse, bone marrow achieved complete remission with the administration of pirarubicin, vincristine, prednisolone, and Lasparaginase (arranged DVP-L), though this combination chemotherapy itself was not effective in multiple bone tumors. Thereafter, arranged DVP-L plus rituximab was administered, which resulted in significant tumor reduction. Biweekly rituximab administration as maintenance therapy has completely prevented the regrowth of bone tumors. Rituximab for relapsed CD20-positive ALL patients after stem cell transplantation could be beneficial.View full abstractDownload PDF (453K)
Short Reports
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Kosuke TSUBOI, Hiroshi KAWADA, Rikio SUZUKI, Hiromichi MURAYAMA, Ken O ...2008 Volume 49 Issue 11 Pages 1562-1565
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSA 71-year-old man presented with progressive dysuria. Several imaging examinations indicated possibility of prostate tumor, therefore he underwent prostate biopsy. This resulted in a diagnosis of granulocytic sarcoma of the prostate. Since bone marrow appeared normal on aspiration biopsy, he was treated with local irradiation. Prostate swelling then markedly diminished and his symptoms disappeared. However, four months later he progressed to AML. He then received systemic chemotherapy and achieved complete remission. We discuss the management of granulocytic sarcoma when findings do not indicate overt leukemia at the time of diagnosis.View full abstractDownload PDF (235K) -
Tsunayuki KAKIMOTO, Tomonori NAKAZATO, Reiko MIURA, Hanako KURAI, Dais ...2008 Volume 49 Issue 11 Pages 1566-1568
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSLinezolid is an effective and well-tolerated antibiotic for the treatment of infections caused by Gram-positive pathogens. Some reports have shown that linezolid treatment for more than 2 weeks has been associated with reversible bone marrow suppression, especially thrombocytopenia and anemia. We encountered a case of sideroblastic anemia following prolonged linezolid therapy in a laryngeal cancer patient. He received linezolid therapy for multiple abscesses due to MRSA. Before treatment, the Hb level was 12.5 g/dl and then slowly decreased to 5.9 g/dl for 2 months during treatment. Ringed sideroblasts were detected in the bone marrow. Linezolid was discontinued and the Hb level was slowly increased. This case was considered to reflect a rare complication of linezolid therapy.View full abstractDownload PDF (270K) -
Makoto SAITO, Akio MORI, Tatsuro IRIE, Masanori TANAKA, Masanobu MORIO ...2008 Volume 49 Issue 11 Pages 1569-1571
Published: 2008
Released on J-STAGE: November 28, 2008
JOURNAL RESTRICTED ACCESSAt present, the etiologic relationship between pernicious anemia and H. pylori infection remains unknown because different rates of positivity have been reported. To investigate the relationship of these two entities, 16 Japanese patients diagnosed with pernicious anemia were examined for H. pylori infection. Serological tests for H. pylori-IgG antibody and gastric biopsy were performed. These 16 patients ranged in age from 34 to 93 years, with a mean age of 68.1 years. They were all negative for H. pylori-IgG antibody and H. pylori on gastric biopsy. Considering that the H. pylori-positive rate in the Japanese population of the same age (60 years) is 70-80%, the findings of this study suggest that the rate of H. pylori positivity in patients with pernicious anemia is low.View full abstractDownload PDF (154K)
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