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Volume 49, Issue 2
Displaying 1-9 of 9 articles from this issue
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Picture in Clinical Hematology No.24
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[in Japanese], [in Japanese]2008 Volume 49 Issue 2 Pages 71
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (598K)
Review
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Hiroyuki TAGAWA2008 Volume 49 Issue 2 Pages 73-81
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (772K)
Clinical Study
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Akio SAITO, Yuri MIYAZAWA, Atsushi ISODA, Nahoko HATSUMI, Morio MATSUM ...2008 Volume 49 Issue 2 Pages 82-88
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSWe retrospectively analyzed the clinical course and prognosis of 11 patients with angioimmunoblastic T-cell Lymphoma (AILT). Median patient age was 62 years old (range 39 to 85). All patients were in clinical stage III or IV. Clinical features included B symptoms, hepatosplenomegaly, skin rushes, pleural effusion, ascites and polyclonal hypergammaglobulinemia. The disease can be classified into three categories based on histological findings: 3 cases of AILT with hyperplastic germinal centers, 4 cases of typical AILT, and 4 cases of AILT with numerous clear cells. As the initial therapy, 10 patients received combination chemotherapy and only 1 patient received autologous peripheral blood stem cell transplantation. Seven patients achieved CR and 4 showed PD. The response rate was 63% and the median survival time was 20 months. One patient survived in CR for 122 months. Patients with AILT demonstrating hyperplastic germinal centers and no bone marrow infiltration were able to achieve long-term survival. The survival time of AILT demonstrated a wide range. It was thought that further consideration of the prognostic factors and stratification was required.View full abstractDownload PDF (1166K)
Case Reports
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Rena MORITA, Satoshi HASHINO, Shojiro TAKAHASHI, Hiroe KANAMORI, Masah ...2008 Volume 49 Issue 2 Pages 89-93
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSWe report that granulocyte transfusion (GTX) was effective for prolonged pneumonia at allogeneic bone marrow transplantation.
A 58-year-old man with MDS-RAEB-2 was admitted to our hospital for allogeneic bone marrow transplantation. He was complicated with pneumonia, which was not improved with G-CSF and antibiotics. We therefore decided to perform a GTX transplantation. During the period of neutropenia, pneumonia did not deteriorate.
A combination of allogeneic stem cell transplantation and GTX is expected not only to improve transplantation results but also to expand the adaptation for transplantation. However, detailed investigation of the effect of GTX in allogeneic stem cell transplantation should be performed, and more cases should be accumulated.View full abstractDownload PDF (762K) -
Takayuki SAITOH, Takafumi MATSUSHIMA, Hiroyuki SHIMIZU, Yohei OSAKI, A ...2008 Volume 49 Issue 2 Pages 94-98
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSCandida guilliermondii (C. guilliermondii) are uncommon, representing approximately 1% of all Candida infections, but have been reported to show a higher rate of drug-resistance and mortality rate than C. albicans. Current guidelines for treatment of non-albicans candidemia in neutropenic patients now recommend the use of amphotericin B or voriconazole (VRCZ). We describe here the successful treatment for a 58-year-old male with azole-refractory C. guilliermondii fungemia by combination with liposomal (L-AmB) and micafungin (MCFG) therapy. He was diagnosed as having mantle cell lymphoma, and treatment with HyperCVAD (Rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) was started. Despite prophylactic treatment with fluconazole, he developed fungemia due to C. guilliermondii 41 days after the start of chemotherapy. Positive blood culture and high levels of (1→3)-β-D-glucan persisted despite changing the treatment from fluconazole to voriconazole. Although L-AmB was also added to VRCZ, the clinical symptoms worsened. When MCFG was combined with L-AmB, the symptoms and data dramatically improved. Thus, combination therapy consisting of MCFG and L-AmB might be more effective against candidemia that is refractory to azole than combination therapy with VRCZ and L-AmB.View full abstractDownload PDF (580K) -
Masakatsu YANAGIMACHI, Hiroaki GOTO, Tomoko YOKOSUKA, Ryosuke KAJIWARA ...2008 Volume 49 Issue 2 Pages 99-103
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSWe describe a 4-year-old-girl with familial hemophagocytic lymphohistiocytosis (FHL) who developed disseminated cutaneous nontuberculous mycobacterial (NTM) infection after unrelated cord blood stem cell transplantation (uCBSCT). After transplantation, the patient developed steroid-refractory acute graft-versus-host disease, and was given methylprednisolone, cyclosporin and mycophenolate mofetil. Six months after uCBSCT, cutaneous lesions that looked like insect bites appeared and spread widely over the thighs. NTM infection was diagnosed by skin biopsy although no organism could be identified. Minocycline (MINO) and sulfamethoxazole/trimethoprim (ST) were administered. However, the cutaneous disease followed a course of remissions and exacerbations. One month after the skin biopsy, mycobacterium chelonae was detected by bacteriological culture of abscess drainage. Ten months after uCBSCT, the cutaneous lesions quickly progressed and the inguinal lymph nodes became enlarged and painful. Then the antibiotics were switched from MINO and ST to amikacin and clarithromycin (CAM) based on the results of mycobacterial susceptibility test. The cutaneous lesions gradually improved after continuous administration of CAM. Cutaneous NTM infection is rare, but it may occur in immunocompromised patients after SCT.View full abstractDownload PDF (1192K) -
Rie OHTSUKA, Yasunobu ABE, Motoaki SHIRATSUCHI, Youko SUEHIRO, Kennosu ...2008 Volume 49 Issue 2 Pages 104-108
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSA 48-year-old woman was referred to our hospital because of fever and general fatigue. Peripheral blood analysis showed a hemoglobin level of 82 g/l, a white blood cell count of 1.95×109/l and a platelet count of 80×109/l. There were 9% CD5-positive B-cells in peripheral blood and 35% CD10-positive B-cells in bone marrow. The patient had a high serum soluble interleukin-2 receptor (SIL-2R) level of 5,185 U/ml and splenomegaly. Lymphoproliferative disease was suspected, however monoclonal rearranged band of immunoglobulin heavy chain was not detected. She also showed hyperthyroidism, Graves' disease and then treatment with thiamazole started. However, the treatment was stopped because of agranulocytosis and she received subtotal thyroidectomy. After treatment for hyperthyroidism, serum SIL-2R level decreased to 504 U/ml and pancytopenia gradually improved. Fifteen months postoperatively, the percentage of CD5-positive B-cells in peripheral blood and CD10-positive B-cells in bone marrow decreased to 8% and 2%, respectively. This clinical course suggests that polyclonal B-cell proliferation was caused by hyperthyroidism.View full abstractDownload PDF (817K) -
Yumiko HIGUCHI, Toshiro ITO, Kazuyuki MATSUDA, Tsukasa HIGUCHI, Eiko H ...2008 Volume 49 Issue 2 Pages 109-114
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSChimerism analysis by polymerase chain reaction amplification of short tandem repeats (PCR-STR) has become a routine diagnostic procedure for evaluating grafts and assessing the likeliness of original disease recurrence after allogeneic stem cell transplantation. Following a sex-mismatched hematopoietic stem cell transplantation (HSCT), we monitored the clinical course of a 61-year old male AML M6 patient with trisomy 8 using PCR-STR with a TH01 locus on 11p15 and fluorescence in situ hybridization (FISH) analysis specific for α satellite DNA on chromosome 8.
Ten months after HSCT, FISH analysis showed 24.8% recipient cells, but PCR-STR demonstrated 100% donor type chimerism. Further XY FISH analysis of May-Grünwald-Giemsa-stained bone marrow samples clearly demonstrated relapse of the original disease and G-banding analysis of bone marrow samples at relapse showed that an additional chromosomal abnormality, del(11)(p10), had deleted the PCR-STR detection site in all recipient type cells. As such, clinicians should consider the possibility that unexpected karyotype changes may invalidate PCR-STR analysis findings, especially when conflicting results appear among chimerism analyses.View full abstractDownload PDF (987K)
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2008 Volume 49 Issue 2 Pages 115-127
Published: 2008
Released on J-STAGE: September 05, 2008
JOURNAL RESTRICTED ACCESSDownload PDF (790K)
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