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Volume 51, Issue 2
Displaying 1-9 of 9 articles from this issue
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The 69th Annual Meeting of the Japanese Society of Hematology/
The 49th Annual Meeting of the Japanese Society of Clinical Hematology
The 49th Annual Meeting of the Japanese Society of Clinical Hematology
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Keiyo TAKUBO2010 Volume 51 Issue 2 Pages 95-103
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSDownload PDF (3082K)
Clinical Study
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Yasuo HORIKOSHI, Ryoji KOBAYASHI, Mikiya ENDO, Arata WATANABE, Atsushi ...2010 Volume 51 Issue 2 Pages 104-113
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSWe conducted a multicenter postmarketing study to investigate the efficacy and safety of reinduction therapy with a high-dose cytarabine-containing regimen for pediatric patients with relapsed or refractory acute leukemia. Seven of 13 patients (53.8%) with ALL achieved complete or partial remission, and only 1 of 6 patients (16.7%) with AML achieved partial remission. The frequent non-hematologic adverse events were gastrointestinal toxicities, such as vomiting, diarrhea and abdominal pain, as well as pyrexia and headache. Infection appeared in 9 of 20 (45%) patients. There were two death during reinduction therapy. One died of invasive bronchopulmonary aspergillosis, and the other died of intracranial hemorrhage and renal failure. These results indicated that a high-dose cytarabine regimen is effective as reinduction therapy in pediatric patients with relapsed ALL, and supportive care is essential to prevent or control treatment-related adverse events, such as infection.View full abstractDownload PDF (898K) -
Taichi IKEBE, Masao OGATA, Miki MIYAZAKI, Yasuhiko MIYAZAKI, Eiichi OH ...2010 Volume 51 Issue 2 Pages 114-121
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSThalidomide is now recognized as an important agent for multiple myeloma. In this study, we retrospectively analyzed the effect of thalidomide therapy in 52 patients with relapsed/refractory multiple myeloma. Median age was 70 years. Eight patients were treated with thalidomide alone, 36 with dexamethasone, and 8 with chemotherapy. The maintenance dose of thalidomide was 100 mg/day in 42 cases. The probability of overall survival and progression-free survival one year after the start of thalidomide were 76.2% and 70.9%, respectively. Complete or partial response was obtained in 16 patients (31%). The probability of survival was better in patients who obtained a partial or complete response than in non-responders (P=0.04). Adverse effects (CTCAE criteria Grade 3-4) were somnolence (n=3), constipation (n=5), peripheral neuropathy (n=1), deep vein thrombosis (n=1), anemia (n=10), leukocytopenia (n=10), and thrombocytopenia (n=3). The high incidence of cytopenia in this study suggests that the Japanese population tends to display bone marrow suppression after thalidomide therapy. Some patients developed peripheral neuropathy at the early stage of administration and attention was necessary. In conclusion, thalidomide therapy is safe and effective in patients with refractory multiple myeloma.View full abstractDownload PDF (1489K)
Case Reports
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Tetsuya INOUE, Masaaki YOSHIDA, Kazuyoshi OOWASHI, Tadao YOSHIDA2010 Volume 51 Issue 2 Pages 122-126
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSA 66-year-old-woman was hospitalized with acute pancreatitis, obstructive jaundice, and tumor of the upper arm in September, 2008. At first, we diagnosed primary pancreatic cancer involving left lung and hilar lymph node, left brachial muscle metastasis and dissemination to the left pleura, but the histological diagnosis of the upper arm tumor was diffuse large B-cell lymphoma. In addition, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy from the pancreatic tumor showed diffuse large B-cell lymphoma, the same as the upper arm tumor. We experienced a rare case of multifocal extranodal non-Hodgkin lymphoma and EUS-FNA was useful for the diagnosis pancreatic tumor.View full abstractDownload PDF (2265K) -
Mayuko KOSHINO, Daisuke KUDOU, Yasushi OKOSHI, Naoshi OBARA, Seiichi S ...2010 Volume 51 Issue 2 Pages 127-131
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSWe report a patient with refractory idiopathic thrombotic thrombocytopenic purpura (TTP) who was successfully treated with rituximab. A 50-year-old woman was referred to our hospital with progressive psychoneurotic symptoms, hemolytic anemia and thrombocytopenia. The diagnosis of TTP was confirmed by the absence of ADAMTS13 activity with the presence of circulating ADAMTS13 inhibitor. High-dose steroid therapy and plasma exchange were performed. Despite 21 sessions of plasma exchange, however, there was no remarkable improvement. We then administered rituximab. Fifteen days after the first infusion of rituximab, she achieved complete remission and ADAMTS13 activity increased up to 14%. The patient has remained in remission for more than 9 months.View full abstractDownload PDF (809K) -
Koshi AKAHANE, Takeshi INUKAI, Atsushi NEMOTO, Itaru KURODA, Amane MIN ...2010 Volume 51 Issue 2 Pages 132-137
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSWe report a patient who developed multiple serositis during chronic graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation from a non-inherited maternal antigen (NIMA) -complementary sibling donor. The patient was a 9-year-old boy with myelodysplastic syndrome, who urgently underwent bone marrow transplantation from his NIMA-complementary HLA two-locus-mismatched sister following graft failure of cord blood transplantation. Engraftment was successfully confirmed and no acute GVHD developed. After withdrawal of tacrolimus to prevent recurrent viral infection, he developed pleural effusion, ascites and edema approximately 6 months after transplantation. His clinical symptoms were resolved by methylprednisolone pulse therapy, but he subsequently progressed to develop pericardial effusion, pneumothorax and truncal panniculitis. Pleural and pericardial effusion contained numerous lymphocytes, which gradually subsided with continuous drainage. His symptoms were thereafter controlled by the addition of mycophenolate mofetil (MMF) administration, and his current performance status is almost perfect by the administration of prednisolone (5 mg/day) and MMF at 6 years after transplantation. Although multiple serositis associated with GVHD is known to have a poor prognosis, the multiple symptoms of this patient improved gradually, probably owing to a lack of acute GVHD and the effect of MMF.View full abstractDownload PDF (1497K) -
Kenji TAJIKA, Hayato TAMAI, Taro MIZUKI, Kazutaka NAKAYAMA, Hiroki YAM ...2010 Volume 51 Issue 2 Pages 138-142
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSWe report here a rare case of EBV-related post-transplantation lymphoproliferative disorder (PTLD) localized to the skin. The patient was a 64-year-old man diagnosed with angioimmunoblastic T cell lymphoma (AITL). He underwent cord blood transplantation with a reduced intensity conditioning regimen during partial remission after chemotherapy. On day 70 after transplantation, subcutaneous tumors developed near the left scapula and in the left upper arm. Pathological examination of the skin tumor revealed that this tumor was composed of diffuse large centroblast-like cells, the majority of which were CD20 positive, CD 79a positive, CD30 positive and Epstein-Barr virus (EBV) latency-associated RNA (EBER) positive, and EBV-DNA was also detected in tumor cells. At that time, real-time polymerase chain reaction documented no evidence of the EBV genome in his blood. Chimerism analysis revealed that the tumor cells were derived from donor cells, which led to the diagnosis of EBV-related PTLD. For treatment, in addition to decreasing the dose of tacrolimus, we administered rituximab and local irradiation to skin lesions, which led to disappearance of the tumors followed by continued complete remission.View full abstractDownload PDF (3842K) -
Hiroaki TANAKA, Shinichiro HASHIMOTO, Chikara SAKAI, Daijiro ABE, Shio ...2010 Volume 51 Issue 2 Pages 143-147
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSA 68-year-old woman was referred to Oami Hospital for severe leukocytopenia. Laboratory data revealed severe leukocytopenia (0.8×109/l), severe neutropenia (0.22×109/l) and IgM-kappa monoclonal gammopathy. Granular lymphocytes accounted for more than 90% of leukocytes. Surface marker analysis revealed that these lymphocytes were CD3+, CD4-, CD8+ and CD16+, and monoclonal rearrangement of T-cell receptor genes was seen on Southern blot hybridization analysis. She was diagnosed with T-cell lineage granular lymphocyte proliferative disorder (T-GLPD). During 13-year follow-up without granulocyte-colony stimulating factor (G-CSF) administration, except for one hospitalization because of bacterial pneumonia, she has not experienced severe infection, despite severe neutropenia.
T-GLPD should be kept in mind as a cause of leukocytopenia with or without monoclonal gammopathy, and surface marker or Southern blot hybridization analysis should be considered for determining the diagnosis.
There are many reports about Caucasian patients with T-GLPD suffering from recurrent infections and dying of severe infection, but in Japanese T-GLPD patients, severe infection is very rare, as shown in the present case report.View full abstractDownload PDF (1817K) -
Tomonori NAKAZATO, Kazuhito SUZUKI, Ai MIHARA, Yukinari SANADA, Sachik ...2010 Volume 51 Issue 2 Pages 148-152
Published: 2010
Released on J-STAGE: April 02, 2010
JOURNAL RESTRICTED ACCESSA 47-year-old woman was admitted to our hospital complaining of persistent fever and dry cough in June 2007. CT scan showed hepatosplenomegaly. Laboratory data revealed pancytopenia and increased levels of LDH and soluble interleukin-2 receptor. Malignant lymphoma was suspected, but histological diagnosis was difficult because superficial lymph nodes could not be palpated. Histological examination of the bone marrow biopsy specimen demonstrated the proliferation of large atypical lymphoid cells positive for CD20 and CD79a in the small capillaries, leading to the diagnosis of intravascular large B-cell lymphoma (IVLBCL). Although the results of neurological examination and CSF analysis were normal, head MRI showed a T2-hyperintense lesion in the pons. We chose R-hyper-CVAD/R-MTX-Ara-C alternating therapy with MTX intrathecal injection because CNS involvement in IVLBCL was highly suspected, and she responded well. Head MRI showed the disappearance of the abnormal signal in the pons after one cycle of R-hyper-CVAD. Five cycles of R-hyper-CVAD/R-MTX-Ara-C were performed and complete remission was obtained. R-hyper-CVAD/R-MTX-Ara-C alternating therapy was effective in an IVLBCL patient with CNS involvement.View full abstractDownload PDF (3033K)
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