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Volume 53, Issue 12
Displaying 1-11 of 11 articles from this issue
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Picture in Clinical Hematology No. 58
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...2012 Volume 53 Issue 12 Pages 1981
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSDownload PDF (940K)
Clinical Study
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Mutsumi TAKAHATA, Satoshi HASHINO, Katsuya FUJIMOTO, Tomoyuki ENDO, Na ...2012 Volume 53 Issue 12 Pages 1983-1990
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSCepharanthine (CEP), an alkaloid drug that has a cell membrane stabilizing effect and an immunomodulating effect, has been reported to improve symptoms and signs of chronic immune thrombocytopenia (ITP). In this study, we retrospectively assessed the clinical efficacy and adverse events of high-dose CEP for 47 patients with ITP. The response rate (elevation of platelet count>5×104/μl) was 44%, and CEP treatment was judged useful in clinical aspects by their attending doctors in 77% of the cases. Next, we made a comparative analysis between patients who were administered CEP as a single agent (22 patients) and those administered CEP in combination therapy with prednisolone (PSL) (20 patients). There was a marked increase in platelet count in both groups compared to the count before CEP treatment (P<0.01), and no significant difference was seen between the two groups. High-dose CEP was well tolerated, and in some patients single-agent CEP therapy resulted in a significant elevation of platelets, allowing a reduced dosage of PSL.View full abstractDownload PDF (1441K)
Case Reports
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Hanae SHIMURA, Yoichi IMAI, Midori ISHIYAMA, Kentaro YOSHINAGA, Masayu ...2012 Volume 53 Issue 12 Pages 1991-1996
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSIntracranial involvement of relapsed Hodgkin lymphoma (HL) is quite rare and its prognosis is very poor. We report a patient with relapsed HL with central nervous system (CNS) involvement after autologous stem cell transplantation successfully treated with allogeneic bone marrow transplantation with reduced intensity conditioning regimen. A standard therapy for relapsed CNS HL has not yet established. To the best of our knowledge, this is the first case report describing allogeneic stem cell transplantation for relapsed CNS HL in an elderly patient. Our results in this case suggest that allogeneic stem cell transplantation could be a useful therapeutic option in relapsed CNS HL patients, if their CNS lesions are controlled before stem cell transplantation.View full abstractDownload PDF (1651K) -
Naoko YASUI, Katsuyoshi KOH, Myoung-Ja PARK, Motohiro KATO, Makiko MOR ...2012 Volume 53 Issue 12 Pages 1997-2002
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSRecently, bone marrow transplantation from an unrelated donor has been recommended as an option for the treatment of very severe aplastic anemia (vSAA) refractory to immunosuppressive therapy (IST) in the absence of a human leukocyte antigen-matched related donor (MRD). For SAA patients with complications such as bacterial infections, prompt transplantation using either a mismatched related donor or cord blood (CB) becomes necessary. However, the former option is associated with graft-versus-host disease, whereas the latter option is associated with a more significant risk of graft failure. We report a patient with vSAA refractory to IST that was repeatedly complicated by bacterial infection. An MRD was unavailable for this patient, so we decided on emergent transplantation and successfully performed CB transplantation (CBT) using a low-dose TBI conditioning regimen. Although it may be necessary to examine more clinical cases in the future, a conditioning regimen such as that involving low-dose TBI may decrease the risk of graft failure, and CBT may become a treatment option for vSAA in the absence of a suitable donor.View full abstractDownload PDF (748K) -
Kenjiro KAMEZAKI, Yukiko HARADA, Nobuyuki SHIMONO, Koichi OHSHIMA, Koi ...2012 Volume 53 Issue 12 Pages 2003-2007
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSA 66-year-old man presented with a six-month history of periodic fever. A CT scan of the chest and abdomen performed at another hospital one month before admission disclosed no evidence of inflammation or tumor, and at admission he had no symptoms other than the periodic fever. FDG-PET/CT demonstrated increased FDG uptake in multiple vertebrae, ribs, scapulae, pelvis, and femurs. A core needle biopsy of the vertebra showing increased FDG uptake was performed, and he was diagnosed with primary osseous Hodgkin lymphoma. ABVD therapy was begun and the fever resolved immediately. After 6 cycles of ABVD, he achieved complete remission and has maintained remission for five years since diagnosis. Primary osseous Hodgkin lymphoma is rare and its lack of distinguishing clinical and radiological features makes it difficult to achieve an early differential diagnosis. FDG-PET/CT is a useful tool for detecting tumors when periodic fever suggests the possibility of malignant disease but when specific symptoms are absent.View full abstractDownload PDF (972K) -
Takayo NAGAO, Naoto TAKAHASHI, Hirobumi SAITOH, Shinsuke NOGUCHI, Yong ...2012 Volume 53 Issue 12 Pages 2008-2012
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSA 63-year-old woman was admitted to our hospital with high-grade fever, liver dysfunction, and pancytopenia. Computed tomography of the whole body revealed hepatosplenomegaly but no lymphoadenopaties. Bone marrow aspiration showed infiltrations of CD20-positive large atypical B-lymphocytes with severe hemophagocytosis. Although she was a human T-cell leukemia virus type 1 carrier, the atypical lymphocyte in bone marrow had IgH rearrangement but not TCR rearrangement. From these clinical and laboratory data, the patient was diagnosed as having B-cell lymphoma-associated hemophagocytic syndrome (B-LAHS) and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). After 4 cycles of R-CHOP, she had achieved complete remission. However, increased numbers of CD4+CD25+ flower cells were observed in peripheral blood and HTLV-1 provirus DNA was detected after 5 cycle of R-CHOP. The patient was diagnosed as adult T-cell leukemia-lymphoma (ATL) complicated by B-LAHS. Our observations suggest that continuous immunosuppressive statement for B-cell lymphoma or the chemotherapy against B-LAHS may induce the development of ATL in an HTLV-1 carrier.View full abstractDownload PDF (1419K) -
Norina TANAKA, Kentaro YOSHINAGA, Chihiro ASANO, Hiroshi KAZAMA, Takam ...2012 Volume 53 Issue 12 Pages 2013-2017
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSMany patients with POEMS syndrome have osteosclerotic plasmacytoma. Radiation therapy is useful for patients who have localized lesions, although chemotherapy is necessary for patients who have widespread lesions. Thus, evaluation of these lesions is important to determine the therapeutic strategy. We evaluated the activities of lesions in two patients with POEMS syndrome by 18F-FDG positron emission tomography (PET)/computed tomography (CT) scan. In the first patient, PET/CT scan revealed osteosclerotic lesions, which were not detected by Ga-scintigraphy or plain X-ray. It also detected residual disease activity and relapse. In the second patient, lymph node involvement was suggested by 18F-FDG uptake, and plasmacytoma was confirmed by subsequent biopsy. In the extramedullary lesions of this case, FDG uptake was as marked as in myeloma, whereas bone lesion was only detectable by CT scan. In POEMS syndrome, the PET and CT are complementary, and the combined PET/CT scan is considered to be very useful for evaluation of involved lesions.View full abstractDownload PDF (1274K)
Short Reports
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Mayumi HATSUSE, Shin-ichi FUCHIDA, Akira OKANO, Satoshi MURAKAMI, Haru ...2012 Volume 53 Issue 12 Pages 2018-2020
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSA 81-year-old man with a history of gastrointestinal stromal tumor (GIST) was admitted to our hospital due to increased level of LDH, and further testing revealed a serum sIL-2R level of 15,489 U/ml. CT scan demonstrated retroperitoneal fibrosis without lymphadenopathy, and bilateral hydronephrosis. He died of aspiration pneumonia, and post-mortem biopsy revealed diffuse infiltration of medium to large-sized lymphoid cells positive for CD20, CD79a, and BCL2 in the retroperitoneal space with mild fibrosis. These findings suggested a diagnosis of primary retroperitoneal diffuse large B-cell lymphoma (PRLBCL). PRLBCL is extremely rare, and should be included in the differential diagnosis in cases of retroperitoneal fibrosis.View full abstractDownload PDF (1679K) -
Emiko SAKANE, Hiroko TSUNEMINE, Hiroshi AKASAKA, Kiminari ITO, Taiichi ...2012 Volume 53 Issue 12 Pages 2021-2024
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSA 49-year-old man was diagnosed with pure red cell aplasia (PRCA) based on low reticulocyte count (0.1%) and near absence of erythroblasts in the bone marrow (BM). While a small number of CD20-positive large abnormal cells was observed in the BM, Multiplex PCR confirmed B cell monoclonality. Gallium scintigraphy showed abnormality only in the BM, and we made a diagnosis of PRCA secondary to BM-derived B-cell malignant lymphoma. He was treated with rituximab-combined CHOP therapy with subsequent resolution of both disorders. He was further treated with high dose chemotherapy with auto-PBSCT, sustaining complete remission of the PRCA and lymphoma.View full abstractDownload PDF (1251K) -
Shiro MATSUURA, Eriko OGUSA, Jun TAGUCHI, Noboru IMAI, Hiroyuki FUJITA ...2012 Volume 53 Issue 12 Pages 2025-2028
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSA 60-year-old male with POEMS syndrome received lenalidomide and high-dose dexamethasone combination therapy as an initial treatment, with no severe adverse events occurring during the treatment. Two cycles of the therapy led to significantly decreased serum VEGF level, and IgA-λ type M-protein was not detected by immunofixation electrophoresis. We next performed autologous stem cell transplantation, without severe complications such as engraftment syndrome. He improved enough to walk independently and now is being followed up without treatment. This case suggests that lenalidomide-dexamethasone therapy is highly effective and can be a good option for pre-transplant treatment for POEMS syndrome.View full abstractDownload PDF (754K)
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2012 Volume 53 Issue 12 Pages 2037-2054
Published: 2012
Released on J-STAGE: January 11, 2013
JOURNAL RESTRICTED ACCESSDownload PDF (947K)
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