Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 54, Issue 1
Displaying 1-18 of 18 articles from this issue
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Picture in Clinical Hematology No.59
Feature Articles: The future directions of clinical hematology in 2013—Erythroid diseases: focusing on MDS—
Feature Articles: The future directions of clinical hematology in 2013—Myeloid diseases—
Feature Articles: The future directions of clinical hematology in 2013—Lymphoid diseases—
Clinical Study
  • Effect of bortezomib-based induction therapy on the peripheral blood stem cell harvest in multiple myeloma
    Tsuyoshi MUTA, Toshihiro MIYAMOTO, Tomoaki FUJISAKI, Yuju OHNO, Tomohi ...
    2013 Volume 54 Issue 1 Pages 109-116
    Published: 2013
    Released on J-STAGE: February 08, 2013
    DOIhttps://doi.org/10.11406/rinketsu.54.109
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    A high dose of melphalan followed by autologous stem cell transplantation (ASCT) is considered as the standard therapy for multiple myeloma. For induction therapy, 78 patients received conventional regimens (control group) and 32 patients received bortezomib-containing regimens (bortezomib group). We retrospectively compared the yield of harvested CD34+ cells between the two groups. In order to mobilize CD34+ cells, 83% of the control group and 63% of the bortezomib group received a high dose of cyclophosphamide followed by G-CSF, and 12% of the control group received a high dose of etoposide instead of cyclophosphamide. Furthermore, 5% of the control group and 38% of the bortezomib group received G-CSF alone for CD34+ cell mobilization. Overall, the yield of CD34+ cells was higher in the control group than in the bortezomib group (7.4 vs. 5.2×106/kg, P=0.004). Regarding the patients mobilized by a high dose of cyclophosphamide followed by G-CSF, the rate of achieving CD34+ cells >2.0×106 cells/kg was similar. Bortezomib did not significantly affect the successful collection of at least CD34+ cells > 2.0×106 cells/kg after mobilization with a high dose of cyclophosphamide followed by G-CSF.
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Case Reports
  • Alleviation of carotid sinus syncope and removal of cardiac pacing after regression of cervical malignant lymphoma
    Yukinori MASHIMA, Manabu KAWAKAMI, Koji HASEGAWA, Masako TAKEMOTO, Hid ...
    2013 Volume 54 Issue 1 Pages 117-121
    Published: 2013
    Released on J-STAGE: February 08, 2013
    DOIhttps://doi.org/10.11406/rinketsu.54.117
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    A 68-year-old man developed a rapidly-growing right cervical tumor, a biopsy of which allowed for the diagnosis of diffuse large B-cell lymphoma, not otherwise specified. Magnetic resonance imaging demonstrated a right cervical mass lesion of 80 mm in diameter that extended from the medial region of the parotid gland to the posterior region of the neck. While undergoing a chest X-ray in an upright position, he lost consciousness and briefly fell. A transient loss of consciousness recurred while changing his position on the bed, and an electrocardiogram at that time revealed sinus arrest of a seven second duration. This syncope was considered to be a carotid sinus syncope (CSS) induced by the compression of the carotid sinus by his cervical bulky lymphoma. Temporary cardiac pacing was immediately started and rituximab was administered. Three days later, CHOP therapy was started. As his cervical tumor rapidly shrank, the frequency of sensed sinus arrests decreased to zero per day by day 9 of CHOP therapy, resulting into the removal of the pacemaker. In certain cases with CSS due to cervical lymphoma, cardiac pacing, if needed at the onset, is considered to become removable early after chemotherapy in association with tumor shrinkage.
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  • Usefulness of serum free light-chain assay for evaluation of therapeutic efficacy in non-secretory multiple myeloma
    Yumiko MARUYAMA, Toshiaki HAYASHI, Hiroshi IKEDA, Hiroshi YASUI, Tadao ...
    2013 Volume 54 Issue 1 Pages 122-126
    Published: 2013
    Released on J-STAGE: February 08, 2013
    DOIhttps://doi.org/10.11406/rinketsu.54.122
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    Non-secretory multiple myeloma (NSM) is characterized by the absence of detectable monoclonal proteins in serum and urine using an immunofixation assay; therefore, invasive bone marrow examinations are required for monitoring the disease activity. Recent studies reported that abnormal κ/λ ratios or elevated involved free light-chains were detected by the free light-chain (FLC) assay in 70∼80% of patients with NSM. Here we report a case of a 59-year-old male with NSM, in which the FLC assay was useful in monitoring the response to treatment. He was diagnosed with NSM and showed abnormal serum FLC. Serum kappa free light-chain levels were reduced to normal ranges immediately following the initial treatment and a complete response was confirmed by a bone marrow examination. During the clinical course, we observed a good correlation between serum FLC levels and the findings of the bone marrow examination. The FLC assay is noninvasive and has the potential to be useful for monitoring the disease activity of non-secretory multiple myeloma.
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A Short Report
  • False positive 18F-FDG PET/CT uptake by fat necrosis during chemotherapy for malignant lymphoma
    Hiroki AKIYAMA, Yoshihiro UMEZAWA, Yosuke NAKAMURA, Takashi KUMAGAI
    2013 Volume 54 Issue 1 Pages 127-129
    Published: 2013
    Released on J-STAGE: February 08, 2013
    DOIhttps://doi.org/10.11406/rinketsu.54.127
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    A 44-year-old man with advanced follicular lymphoma received 8 cycles of chemotherapy, which resulted in the complete disappearance of the original disease. However, a new abdominal mass with positive 18F-FDG PET/CT uptake appeared after 5 cycles and this was maintained until 3 weeks after the completion of 8 cycles. Open biopsy showed a benign mass with fat necrosis. Although PET/CT is useful in evaluating residual lymphoma after chemotherapy, various benign conditions such as a result of post-chemotherapy inflammation, even in new locations without prior disease, should be noted as causes of false positive uptake.
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