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Volume 51, Issue 12
Displaying 1-9 of 9 articles from this issue
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The 70th Annual Meeting of the Japanese Society of Hematology
Special Award Received Lecture
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Ritsuko SEKI, Koichi OHSHIMA, Takashi OKAMURA2010 Volume 51 Issue 12 Pages 1741-1747
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSDownload PDF (1263K)
Clinical Study
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Kunio KITAMURA, Yasuyuki NAKANO, Koichi WATAMOTO, Daisuke KOGA, Tomoki ...2010 Volume 51 Issue 12 Pages 1748-1755
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSThis study investigated the clinical value of monitoring peripheral blood (PB) WT1 mRNA levels in acute myeloid leukemia (AML) patients. We evaluated the correlation between PB and bone marrow (BM) WT1 mRNA levels in the follow-up period of the clinical course of 17 AML patients. The levels of fusion gene transcripts in PB were also monitored when detected before chemotherapy. Patients with sustained complete remission (CR) showed a trend toward a higher WT1 mRNA reduction rate by induction therapy than patients who relapsed after CR (p=0.09). Correlation between the WT1 levels of PB and BM samples obtained on the same day was relatively strong (R=0.87). Among the four fusion transcript-positive patients, the levels of fusion transcripts and WT1 showed a similar transition pattern. These findings suggest that WT1 mRNA is a useful marker to improve risk-stratification for post-induction therapy and to guide management of individual AML patients by monitoring minimal residual disease, especially for patients with no disease-specific marker. Since WT1 monitoring via PB sampling is simple and less invasive than BM sampling, the use of this marker also improves patient management.View full abstractDownload PDF (1163K) -
Rika OHSHIMA, Shigeki MOTOMURA, Chizuko HASHIMOTO, Takuya MIYAZAKI, Sa ...2010 Volume 51 Issue 12 Pages 1756-1761
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSFifty-eight newly diagnosed patients with Hodgkin lymphoma were treated with ABVD chemotherapy at Yokohama City University Hematology group from October 1996 to June 2005. The median age of patients age was 41 years old and ranged from 15 to 75. Thirty-eight patients were in the early stage and 20 patients were in the advanced stage. Patients in the early stage received 3 cycles of ABVD chemotherapy and involved-field radiation therapy, while those in the advanced stage received 6 cycles of ABVD chemotherapy. The overall response rate in patients was 100% (CR 87%, PR 13%) in the early stage and 95% in the advanced stage. With a median follow-up of 44 months, the 3-year progression-free survival and overall survival were 89% and 95% in the early stage, and 70% and 81% in the advanced stage, respectively. The results of this study were similar to those previously reported in Western countries.View full abstractDownload PDF (810K) -
Itaru MATSUMURA, Yasuhito NANNYA, Tadashi NAGAI, Kazuki TANIMOTO, Kazu ...2010 Volume 51 Issue 12 Pages 1762-1768
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSThe response criteria proposed by European Leukemia Net are useful to predict the prognosis of de novo chronic myeloid leukemia (CML) patients in the chronic phase (CP) treated with imatinib. However, the clinical significance of late suboptimal response, which is defined as the achievement of CCgR without MMR after 18 months, is controversial. In this study, we retrospectively analyzed the clinical courses of 16 CML-CP patients, who satisfied the criteria for late suboptimal response. The median duration of imatinib treatment was 62 (25∼87) months. The median starting dose of imatinib was 400 mg/day. Imatinib dose was escalated to 600∼800 mg/day in 10 patients for various reasons. Among 4 patients who continued high-dose imatinib for late suboptimal response, 2 patients subsequently achieved MMR, and BCR-ABL mRNA transcript levels were decreasing in 2 patients. However, imatinib was kept at 300 or 400 mg/day in 6 patients. Among these six patients, 4 patients achieved MMR, while 2 failed to achieve MMR. None of 16 patients progressed to the acute phase or blast phase. Imatinib dose escalation was effective for late suboptimal response. Furthermore, a second tyrosine kinase inhibitor such as nilotinib may be more potent to reduce the risk of disease progression by achieving earlier MMR.View full abstractDownload PDF (862K)
Case Reports
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Tsuyoshi MUTA, Yuichiro SAWADA, Yasunori MORIYAMA, Yasuko SEIKE, Takah ...2010 Volume 51 Issue 12 Pages 1769-1774
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSWe report a case of a 46-year-old female demonstrating general fatigue and visual disturbances with retinal bleeding. She had a white blood cell count of 419,300/mm. Thereafter, she developed vomiting associated with vertigo caused by cerebellar hemorrhage, deteriorating to acute hydrocephalus secondary to obstruction of the cerebral aqueduct. Emergency procedures for cerebral protection, such as hyperventilation, administration of mannitol, and barbiturate coma, were performed. Bone marrow examination showed a positive BCR-ABL/t(9;22)(q34;q11) chromosomal translocation detected by FISH and RT-PCR (masked Ph) and she was diagnosed as having chronic myeloid leukemia (CML) in the chronic phase (CP). She was administered Ara-C, together with imatinib 600 mg/d through a nasogastric tube. Eight days later, she underwent successful extubation and recovered without any neurological defect. She was maintained on imatinib 400 mg/d and demonstrated a major molecular response at 15 months. Physicians need to be aware that brain hemorrhage may develop as an initial symptom of CML patients in CP.View full abstractDownload PDF (1248K) -
Mizuki AIMOTO, Takahisa YAMANE, Atushi INOUE, Dai MOMOSE, Ran MORIGUCH ...2010 Volume 51 Issue 12 Pages 1775-1780
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSA 64-year-old man was diagnosed as having acute myeloid leukemia. We performed sequential treatment with chemotherapy and reduced-intensity stem cell transplantation from an unrelated donor while the patient was in partial remission. After engraftment, he developed acute graft-versus-host disease of the gut on day 42 and steroid therapy was started. Despite transient aggravation of diarrhea, his symptoms slowly improved and the dose of steroid was tapered. On day 159, he complained of acute left lower abdominal pain. A CT scan showed perforation of the digestive tract and ileectomy was performed. At surgery, multiple ulcers of the intestine were found and one of the ulcers was perforated. Pathologically, transmural and diffuse proliferation of atypical cells in the ulcer were confirmed. Since these cells were positive for CD20 and Epstein-Barr-virus (EBV) encoded RNA, we made a diagnosis of EBV-associated post-transplant lymphoproliferative disorder (PTLD). Reduction in the dose of immunosuppressive agents and rituximab led to complete remission of PTLD. PTLD after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is relatively rare, and the development of gastrointestinal perforation after allo-HSCT is very rare.View full abstractDownload PDF (1702K) -
Masayoshi ONO, Shunsuke OHNISHI, Reizo ONISHI, Shojiro TAKAHASHI, Yosh ...2010 Volume 51 Issue 12 Pages 1781-1785
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSA 70-year-old male, who had undergone resection of gastric malignant lymphoma in 1992, presented with cervical lymph node swelling in January 2008. Pathological examination of the lymph node biopsy demonstrated recurrence of malignant lymphoma, and he was treated with the R-CHOP regimen. Although he did not develop fever during the first through third course of R-CHOP, from the fourth course, he repeatedly demonstrated fever over 38°C for about one week after each course of chemotherapy, despite the absence of neutropenia. Helicobacter cinaedi infection was confirmed by blood culture each time. Although it is difficult to diagnose Helicobacter cinaedi infection by the standard culture method, increased numbers of recent reports especially in immunocompromised patients have emphasized the importance of diagnosing Helicobacter cinaedi infection.View full abstractDownload PDF (1944K)
Short Reports
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Ikuyo OTA, Yukitaka KATSURA, Chikashi YOSHIDA, Kazuo YOSHIZAWA, Haruo ...2010 Volume 51 Issue 12 Pages 1786-1788
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSA 74-year-old man, who had mantle cell lymphoma treated with several anticancer drugs including rituximab, was admitted to our hospital because of gait disturbance and progressive paralysis of the right lower limb. T2-weighted MR image showed multiple high intensity lesions in the left parietal lobe. Suspected of being cerebral invasion of lymphoma, high-dose methotrexate was begun, but the patient died of sepsis without neurological improvement. At autopsy, it was proven that neurological symptoms had been caused by progressive multifocal leukoencephalopathy (PML). PML should be considered as a possible complication of heavily treated lymphoma.View full abstractDownload PDF (2019K) -
Makoto SAITO, Akio MORI, Tatsuro IRIE, Masanori TANAKA, Masanobu MORIO ...2010 Volume 51 Issue 12 Pages 1789-1791
Published: 2010
Released on J-STAGE: January 18, 2011
JOURNAL RESTRICTED ACCESSSince the liver has a duplicate blood supply through the hepatic artery and portal vein, hepatic infarction is considered a rare disease. A 51-year-old male with acute myeloid leukemia and diabetes mellitus developed fulminant hepatic infarction only a few days after administration of FLAGM chemotherapy. Our case was considered to have been caused by the almost complete obstruction of both the hepatic artery and portal vein by thrombi during a short period. Hepatic infarction should be recognized as a complication that may develop after salvage chemotherapy such as FLAGM inducing marked myelosuppression. Hepatic infarction after chemotherapy requires further analysis by evaluating a larger number of cases.View full abstractDownload PDF (1968K)
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