Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 53, Issue 4
Displaying 1-15 of 15 articles from this issue
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Picture in Clinical Hematology No.53
The 72nd Annual Meeting of the Japanese Society of Hematology
Special Award Received Lecture
The 73rd Annual Meeting of the Japanese Society of Hematology
Symposium 5
Symposium 9
Review
Clinical Study
  • Retrospective analysis of 157 patients with pediatric Hodgkin lymphoma in Japan: investigation by four pediatric cancer study groups
    Yuhki KOGA, Masaaki KUMAGAI, Tetsuya TAKIMOTO, Jun-ichi MIMAYA, Atsuko ...
    2012 Volume 53 Issue 4 Pages 443-449
    Published: 2012
    Released on J-STAGE: May 12, 2012
    DOIhttps://doi.org/10.11406/rinketsu.53.443
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    Hodgkin lymphoma is an easily curable malignancy in the pediatric age group and is less frequently observed in Japan. No study with a large sample size of Japanese patients has been conducted. From 1985 to 2000, 157 Japanese patients with Hodgkin lymphoma were retrospectively analyzed based on their clinical characteristics, treatment regimen, and treatment outcome by 4 pediatiric cancer study groups. There were 107 male and 50 female patients with a median age of 10 years 1 month (range: 1 year 8 months to 17 years 8 months). Clinical stage I lymphoma was observed in 37 patients, stage II in 62, stage III in 40, and stage IV in 18. Fifty patients presented with B symptoms (32%). Most patients (n=125, 82%) received more than 6 courses of combination chemotherapy mainly comprising cyclophosphamide, vincristine, procarbazine, prednisolone (COPP), doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). The 5-year overall and event-free survival rates were 81.5% and 94.8%, respectively. High-risk disease and age (>10 years) were considered to be poor prognostic factors.
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Case Reports
  • Successful treatment with rituximab in two cases of IgM-monoclonal gammopathy of undetermined significance (MGUS) neuropathy
    Michiaki KOIKE, Keiji SUGIMOTO, Miyuki TUSUI, Yuriko YAHATA
    2012 Volume 53 Issue 4 Pages 450-454
    Published: 2012
    Released on J-STAGE: May 12, 2012
    DOIhttps://doi.org/10.11406/rinketsu.53.450
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    A 66-year-old male was hospitalized with muscle weakness and gait disturbance. Examination revealed IgM 3,407mg/dl (IgM, κ-type M protein) and he was diagnosed as having IgM-MGUS neuropathy. He suffered from paralysis of respiratory muscles and required a respirator support. Plasmapheresis and intravenous immunoglobulin were performed and he was weaned from the respirator. Rituximab given as 8 weekly infusions improved gait disturbance. A 71-year-old male was hospitalized with lumbago, numbness of lower extremities and gait disturbance. Examination revealed IgM 1,553 mg/dl (IgM, λ-type M protein) and he was diagnosed with IgM-MGUS neuropathy. Rituximab given as 8 weekly infusions improved gait disturbance. It was concluded that rituximab is a well-tolerated treatment that may be effective in some patients with IgM-MGUS neuropathy.
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  • Successful treatment with prednisolone for air-leak syndrome following interstitial pneumonia after allogeneic hematopoietic stem cell transplantation
    Yuko HONDA, Ryosuke MIYAJI, Hiromi MORITA, Jiro INAGAKI, Koichi KUSUHA ...
    2012 Volume 53 Issue 4 Pages 455-459
    Published: 2012
    Released on J-STAGE: May 12, 2012
    DOIhttps://doi.org/10.11406/rinketsu.53.455
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    A 13-year-old boy with T lymphoblastic leukemia underwent allogeneic bone marrow transplantation from an HLA-matched sibling in the second remission phase. After the dose of cyclosporine (CyA) was reduced, dyspnea appeared on Day 117. CT revealed diffuse interstitial shadows on the bilateral lungs. The results of broncho-alveolar lavage suggested Pneumocystis jirovecii pneumonia. The dose of trimethoprim-sulfamethoxazole was increased, and steroid therapy was started. The symptoms transiently subsided, but exacerbated with a reduction in the steroid dose. On Day 139, mediastinal and subcutaneous emphysema appeared. We considered that non-infectious interstitial pneumonia was primarily involved in the pathogenesis for the following reasons: the boy was negative for β-D-glucan early after onset, and there was a correlation between the steroid-dose reduction and condition. The steroid dose was again increased to 80 mg and the symptoms promptly subsided. When late-onset non-infectious pulmonary complications after hematopoietic stem cell transplantation lead to air-leak syndrome, the mortality rate is very high. However, survival may be achieved by intensifying immunosuppressive therapy in the early stage.
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  • Treatment with a tyrosine-kinase inhibitor of for c-KIT mutation and AML1-ETO double positive refractory acute myeloid leukemia
    Jun-ichi UEYAMA, Akira KURE, Keisuke OKUNO, Hitoshi SANO, Naohiro TAMO ...
    2012 Volume 53 Issue 4 Pages 460-464
    Published: 2012
    Released on J-STAGE: May 12, 2012
    DOIhttps://doi.org/10.11406/rinketsu.53.460
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    Translocation (8;21)/AML1-ETO is considered a favorable cytogenetic abnormality in acute myeloid leukemia (AML). However, the outcomes associated with KIT mutations in AML1-ETO have not been elucidated. A 16-year-old boy was diagnosed with recurrent AML. Although he underwent hematopoietic stem cell transplantation (HSCT) twice, the leukemia relapsed and grew resistant to several chemotherapies. We began to treat him with imatinib, but stopped on the 31st day as it did not show any effects. Later, we administered dasatinib. However, we discontinued this because he showed severe nasal hemorrhage 87 days after administration of dasatinib. The therapeutic benefit of tyrosine-kinase inhibitor (TKI) was estimated by quantitative analysis of AML1-ETO and the patient's clinical impression. We did not conduct analyses to determine the effective concentration of TKI. The patient has not yet shown any major molecular response. Therefore, we conclude that TKI may be useful for slight palliation of symptoms in KIT-positive AML. However, patients with refractory AML associated KIT mutations in AML1-ETO should not be considered for TKI monotherapy.
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  • Immune-mediated encephalomyelitis following varicella-zoster virus infection after allogeneic stem cell transplantation
    Takayoshi TACHIBANA, Hirotaka TAKASAKI, Masatsugu TANAKA, Ayumi NUMATA ...
    2012 Volume 53 Issue 4 Pages 465-468
    Published: 2012
    Released on J-STAGE: May 12, 2012
    DOIhttps://doi.org/10.11406/rinketsu.53.465
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    A 40-year-old Japanese man with acute myeloid leukemia received allogeneic bone marrow transplantation. On day 101, varicella-zoster virus (VZV) infection occurred, but was improved by administration of acyclovir and immunoglobulin. On day 119, he complained of numbness and double vision, and he was admitted due to exacerbation of the symptoms. The findings of cerebrospinal fluid and magnetic resonance image examination were consistent with the diagnosis of immune-mediated encephalomyelitis (IMEM). Intravenous immunoglobulin therapy was effective and his neurological findings dramatically improved without recurrence. IMEM is a rare non-infectious inflammatory demyelinating disease that can occur after transplantation. We herein describe a case report with a review of the associated literature.
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A Short Report
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