Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
Search
Advanced search
OR
Browse
Search
Volume 51, Issue 1
Displaying 1-13 of 13 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Feature articles: Current progress in diagnosis and management of DIC
Clinical Study
  • Clinical study of sequential high-dose chemotherapy with in vivo rituximab-purged stem cell autografting for mantle cell lymphoma
    Hirotaka TAKASAKI, Chizuko HASHIMOTO, Sachiya TAKEMURA, Shigeki MOTOMU ...
    2010 Volume 51 Issue 1 Pages 57-62
    Published: 2010
    Released on J-STAGE: February 04, 2010
    DOIhttps://doi.org/10.11406/rinketsu.51.57
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Sequential high-dose chemotherapy with in vivo rituximab-purged stem cell autografting was designed for previously untreated mantle cell lymphoma (MCL). The response rate, disease-free survival (DFS), overall survival (OS) and toxicity were investigated in this trial. Between November 2001 and August 2008, five patients younger than 65 years of age with MCL at diagnosis were enrolled in this study. Initial chemotherapy consisted of 3 cycles of CHOP regimen followed by four courses of high-dose chemotherapy. During the in vivo purging phase, the patient was administered high-dose cyclophosphamide and cytarabine, and then each administration was followed by two infusions of rituximab. Molecular monitoring of minimal residual disease was performed by assessing DNA samples from bone marrow and autografted cells using PCR amplification of the bcl-1/IgH rearrangement. The complete response rate was 100%, and the 3-year OS and DFS were 100% and 100%, respectively. PCR analysis of autografted cells from four evaluable patients, 75% lymphoma-negative harvests were achieved following in vivo purging. One patient relapsed 3.2 years after treatment. The principal toxicity in the study was hematologic but there were no treatment-related deaths. Intensive high-dose sequential chemotherapy with in vivo purged stem cell support can achieve long-term disease-free survival for MCL.
    View full abstract
    Download PDF (771K)
  • Cost benefit analysis for prophylactic use of itraconazole versus fluconazole after hematopoietic stem cell transplantation
    Shuichi OTA, Akinori WADA, Mizuha KOSUGI, Satomi MATSUOKA, Shinsuke AS ...
    2010 Volume 51 Issue 1 Pages 63-68
    Published: 2010
    Released on J-STAGE: February 04, 2010
    DOIhttps://doi.org/10.11406/rinketsu.51.63
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Systemic fungal infection (SFI) is now one of the main causes of death from infective complications after hematopoietic stem cell transplantation (HSCT) and the role of prophylaxis of fungal infection has been established. However, there is no evidence evaluating the cost-benefit ratio of SFI management in Japan. To estimate the medical costs on prophylaxis and treatment of SFI in HSCT, we embarked on a randomized control prospective study of the medical cost-benefit ratio comparing fluconazole with itraconazole for antifungal prophylaxis in 40 patients who received HSCT in our hospital. Despite the similarity of efficacy for prophylaxis, the median cost of itraconazole prophylaxis between Day−10 and Day+28 was significantly less than that of fluconazole. There are many patients who require an i.v. formulation because of non-compliance with oral administration after HSCT and these cases cause increased medical costs. Therefore, further investigation is needed not only regarding differences among prophylactic agents but also regarding differences in administration routes focusing on the cost-effectiveness of treatment.
    View full abstract
    Download PDF (752K)
Case Reports
  • Usefulness of serum plasminogen activator inhibitor-1 for diagnosis and monitoring of late-onset sinusoidal obstruction syndrome after allogeneic stem cell transplantation
    Satomi ITO, Jun TAGUCHI, Jun KATO, Aya NAKAYA, Takayoshi TACHIBANA, Sa ...
    2010 Volume 51 Issue 1 Pages 69-73
    Published: 2010
    Released on J-STAGE: February 04, 2010
    DOIhttps://doi.org/10.11406/rinketsu.51.69
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Sinusoidal obstruction syndrome (SOS) was originally defined as a clinical syndrome occurring by three weeks after transplantation; however, it occurs even after three or more weeks, and such cases are called late-onset SOS. We report here a case of late-onset SOS. The patient was a 17-year-old male with acute myeloid leukemia in second complete remission. He received a preparative regimen including busulfan followed by allo-peripheral blood stem cell transplantation from an HLA-matched sibling donor. On day 28 after transplantation, he developed hepatomegaly with pain. On day 33 PAI-1 level was increased. Two days later ascites developed, leading to a diagnosis of late-onset SOS. The symptoms improved with conservative therapy and the level of PAI-1 was normalized. When hepatic impairment appears three or more weeks after transplantation, late-onset SOS should be considered. PAI-1 is a useful marker for the diagnosis and follow up of late-onset SOS.
    View full abstract
    Download PDF (662K)
  • Five cases of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in adult
    Yasunobu ABE, Motoaki SHIRATSUCHI, Eriko NAGASAWA, Rie OHTSUKA, Junich ...
    2010 Volume 51 Issue 1 Pages 74-79
    Published: 2010
    Released on J-STAGE: February 04, 2010
    DOIhttps://doi.org/10.11406/rinketsu.51.74
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) is more common in children, and is characterized by pancytopenia, liver dysfunction and coagulopathy caused by interactions between EBV-infected T cells and activated macrophages. We describe here five adults with EBV-HLH. The median age was 17 years (range 16∼40). HLH developed in 4 patients within 2 months after the primary infection, and in the other one during the reactivation. All patients had a high EBV viral load in peripheral blood (2×102−3×106 copies/ml) and monoclonal proliferation of EBV-infected T cells. All patients received immunosuppressive therapy with or without etoposide, and two patients required plasmapheresis due to the severity. Three patients are alive in complete remission (follow up periods; 13, 19, 30 months), while two patients became refractory to chemo-immunotherapy and died despite multidrug chemotherapy. EBV-HLH should be more widely recognized in adults in order to achieve early diagnosis and appropriate treatment.
    View full abstract
    Download PDF (1386K)
A Short Report
  • CD5-positive B-cell prolymphocytic leukemia
    Tetsuya INOUE, Masaaki YOSHIDA, Kazuyoshi OOWASHI, Tadao YOSHIDA
    2010 Volume 51 Issue 1 Pages 80-82
    Published: 2010
    Released on J-STAGE: February 04, 2010
    DOIhttps://doi.org/10.11406/rinketsu.51.80
    JOURNAL RESTRICTED ACCESS
    Show abstractHide abstract
    CD5 is a T-cell marker that is expressed in mature B cell malignancies and other B cell chronic lymphoproliferative disorders, but the biologic function of CD5 is unknown. We report a 68-year-old woman with B-cell prolymphocytic leukemia (B-PLL) expressing CD5 antigen. On admission, jaundice and hepatosplenomegaly were noted. Hematological examination demonstrated a platelet count of 2.8×104/μl and a white blood cell count of 19,900/μl with 69% PLL cells. Surface marker analysis of the PLL cells was positive for CD5, CD19, CD20, sIgM, and was negative for CD23, and cyclin D1 was negative in immunostaining.
    View full abstract
    Download PDF (1188K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top