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Volume 52, Issue 5
Displaying 1-9 of 9 articles from this issue
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The 72nd Annual Meeting of the Japanese Society of Hematology
Symposium 1
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Yoshihiro OKA, Akihiro TSUBOI, Sumiyuki NISHIDA, Naoki HOSEN, Jun NAKA ...2011 Volume 52 Issue 5 Pages 235-242
Published: 2011
Released on J-STAGE: June 04, 2011
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Hiroshi FUJIWARA2011 Volume 52 Issue 5 Pages 243-255
Published: 2011
Released on J-STAGE: June 04, 2011
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Symposium 5
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Masao MATSUOKA2011 Volume 52 Issue 5 Pages 256-262
Published: 2011
Released on J-STAGE: June 04, 2011
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Hiroyuki TAGAWA2011 Volume 52 Issue 5 Pages 263-271
Published: 2011
Released on J-STAGE: June 04, 2011
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Case Reports
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Koichiro MINAUCHI, Kazuki KOIZUMI, Makoto KONDO, Masayoshi TAKIGAMI, H ...2011 Volume 52 Issue 5 Pages 272-277
Published: 2011
Released on J-STAGE: June 04, 2011
JOURNAL RESTRICTED ACCESSA 43-year-old male renal transplant recipient, who received a living related renal transplant 7 years ago and had been maintained with tacrolimus, mycophenolate mofetil (MMF), and prednisolone, was admitted to our hospital complaining of headache and nausea. MRI showed a large mass in the right hemisphere with ring-enhancement indicating brain abscess, tumor or lymphoma. Open biopsy was performed and pathological examination demonstrated diffuse proliferation of polymorphic cells, positive for CD20, bcl-2, EBER, and LMP-1. Based on these findings, primary central nervous system post-transplant lymphoproliferative disorder (PCNS-PTLD) was diagnosed. MMF was discontinued and tacrolimus was tapered. After 2 weeks, MRI showed regression of the tumor size and after 9 months, the tumor had disappeared. Though many reports have shown the severity of PCNS-PTLD, and recommend aggressive treatments such as chemotherapy and/or radiotherapy, our case shows that reduction of immunosuppressant alone with close observation could be a choice of treatment.View full abstractDownload PDF (1896K) -
Takafumi NAKAO, Noriko YOSHIDA, Takahiko NAKANE, Yoshiki TERADA, Hiroh ...2011 Volume 52 Issue 5 Pages 278-281
Published: 2011
Released on J-STAGE: June 04, 2011
JOURNAL RESTRICTED ACCESSWe describe a patient with chronic myelogenous leukemia (CML) who developed drug-induced agranulocytosis. A 75-year-old female was diagnosed with CML in December 2001. She had been receiving imatinib therapy for more than five years. In August 2007, she was hospitalized due to a severe neutropenia 10 days after colonoscopy. She was diagnosed as having agranulocytosis induced by colonoscopy premedication including scopolamine butylbromide and flumazenil. Severe neutropenia was resolved by G-CSF treatment without CML progression. Agranulocytosis in patients with CML is rare, but potentially lethal. Here, we report the clinical course in this patient.View full abstractDownload PDF (775K) -
Yoshitaka SUNAMI, Eriko SATO, Kunimoto ICHIKAWA, Hajime YASUDA, Norio ...2011 Volume 52 Issue 5 Pages 282-286
Published: 2011
Released on J-STAGE: June 04, 2011
JOURNAL RESTRICTED ACCESSA 26-year-old female progressed to blastic crisis (BC) after three months administration of imatinib for chronic myelogenous leukemia (CML) chronic phase (CP) and was treated with a dasatinib containing chemotherapy regimen. After remission to second CP, she was hospitalized because of fever and hemorrhagic diarrhea during dasatinib maintenance therapy. She was diagnosed as having cytomegalovirus (CMV) colitis because CMV antigen in blood leukocytes was positive and CMV-positive cells were also detected on staining of an ileocecal mucosal biopsy specimen with an anti-CMV antibody. Although blood leukocyte CMV antigen and CMV staining in colonic mucosa became negative after ganciclovir treatment, hemorrhagic diarrhea did not improve. However, after discontinuance of dasatinib, hemorrhagic colitis drastically improved and did not recur after administration of nilotinib. It is possible that hemorrhagic diarrhea occurred due to dasatinib-related hemorrhagic colitis. Previous case reports have indicated that CD8-positive T-lymphocytes infiltrate the colonic mucosa in dasatinib-related hemorrhagic colitis, and the same pathological findings were seen in our case. Dasatinib may cause hemorrhagic colitis via immunological mechanisms in CML. Dasatinib-related gastrointestinal bleeding is less frequent in Japan compared to that in western countries, and Japanese cases diagnosed as having hemorrhagic colitis are extremely rare.View full abstractDownload PDF (2920K) -
Hideto TERANISHI, Michiyo SAKIYAMA, Yoshihisa NAGATOSHI, Yuko NOMURA, ...2011 Volume 52 Issue 5 Pages 287-292
Published: 2011
Released on J-STAGE: June 04, 2011
JOURNAL RESTRICTED ACCESSMeningitis or encephalitis by varicella-zoster virus (VZV) after hematopoietic stem cell transplantation (HSCT) is rarely reported. We encountered a case of meningoencephalitis with VZV re-activation 18 months after related bone marrow transplantation for recurrent acute lymphoblastic leukemia. The patient had been administered steroid and cyclosporine for chronic graft-versus-host disease. A high DNA copy number of VZV, 4.9×107 copies was detected in the cerebrospinal fluid. VZV also caused severe pneumonia and acute renal failure soon after the onset of meningoencephalitis. The patient was successfully treated with acyclovir, although he was left with persistent neurological sequelae. Both prompt diagnosis and early treatment of VZV reactivation are important to avoid a fatal outcome.View full abstractDownload PDF (1314K) -
Eriko SADA, Motoaki SHIRATSUCHI, Hirofumi OHNO, Eriko NAGASAWA, Emi HO ...2011 Volume 52 Issue 5 Pages 293-298
Published: 2011
Released on J-STAGE: June 04, 2011
JOURNAL RESTRICTED ACCESSWe report here a very severe case of thymoma-related aplastic anemia that developed after thymectomy. The patient was a 50-year-old man diagnosed with myasthenia gravis. Chest CT showed thymoma measuring 7.5 cm in diameter, and extended thymectomy was performed. Irradiation to the anterior mediastinum was added postoperatively. Thirteen months after surgery, hemogram showed severe neutropenia: leukocyte count 0.32×109/l with 11% neutrophils; Hb 10.7 g/dl; and platelet count 100×109/l. Although cyclosporine (CSP, 5 mg/kg/day) was administered, dose reduction was necessary because of renal damage. Cytopenia deteriorated to a leukocyte count of 0.71×109/l with 21% neutrophils; Hb 5.9 g/dl; and platelet count 24×109/l. However, addition of antithymocyte globulin (ATG, 15 mg/kg) led to hematopoietic recovery of all three lineages within one month. He is clinically stable with no transfusion requirement after 22 months with CSP maintenance therapy. Although thymoma-related aplastic anemia has been reported to have an extremely poor prognosis, high efficacy of CSP has been reported recently. In our case, ATG in combination with CSP was efficient. Adequate immunosuppressive therapy seems to be important for the clinical management of these patients.View full abstractDownload PDF (1157K)
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