Rinsho Ketsueki
Online ISSN : 1882-0824
Print ISSN : 0485-1439
ISSN-L : 0485-1439
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Volume 55, Issue 1
Displaying 1-22 of 22 articles from this issue
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Picture in Clinical Hematology
Feature Articles: Hematological disorders —Current therapeutic strategy—
Feature Articles: Hematological disorders —Current therapeutic strategy (Erythroid diseases)—
Feature Articles: Hematological disorders —Current therapeutic strategy (Myeloid diseases)—
Feature Articles: Hematological disorders —Current therapeutic strategy (Hemostatic and thrombotic diseases)—
Clinical Study
  • Usefulness of measuring serum procalcitonin levels by immunochro-matographic assay in febrile neutropenia
    Shigekatsu HATANAKA, Hiroyoshi ICHIHARA, Yasutaka AOYAMA, Shiroh KOH, ...
    2013 Volume 55 Issue 1 Pages 105-109
    Published: 2013
    Released on J-STAGE: February 04, 2014
    DOIhttps://doi.org/10.11406/rinketsu.55.105
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    In order to clarify the usefulness of measuring procalcitonin (PCT) values under the extreme condition called febrile neutropenia (FN), PCT was measured with immunochromatographic assay (ICA) and electro-chemi-luminescence immunoassay (ECLIA) at two time points: upon FN occurrence and 12 to 24 hours after FN occurrence, and correlations and associations between the two methods were reviewed. A strong correlation between the ICA and ECLIA results was observed when Spearman's rank correlation coefficient was 0.878, and the association was also demonstrated by Fisher's direct test since P=4.68×10-10. Special equipment is not required, the operations are simple, and the ICA method currently adopted by many facilities can be used as the standard method even for the clinical condition known as FN.
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  • A single institution experience of HLA-haploidentical hematopoietic stem cell transplantation for children: current problems and perspective
    Keiko OKADA, Yoshiko NAKANO, Kai YAMASAKI, Chika TANAKA, Hiroyuki FUJI ...
    2014 Volume 55 Issue 1 Pages 110-119
    Published: 2014
    Released on J-STAGE: February 04, 2014
    DOIhttps://doi.org/10.11406/rinketsu.55.110
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    HLA-haploidentical 2 or 3-loci mismatched families are alternative donors for high-risk patients without HLA-matched donors. We retrospectively reviewed our case series of HLA-halpoidentical hematopoietic stem cell transplantations (haplo-HSCTs). Between Jul 2005 and Dec 2012, 25 patients (median age, 8 y; 13 ALL, 8 AML, 4 others) received haplo-HSCTs because of a worsening prognosis (i.e. induction failure, non-CR, or relapse after prior HSCT). Disease status was CR in 8 and non-CR in 17 patients. The 17 patients received myeloablative conditioning, while the 8 were given reduced-intensity conditioning because of their conditions (e.g. early relapse after prior HSCT). ATG was not administered in all but 3 patients. Tacrolimus and sMTX were used for prophylaxis GVHD and steroids were immediately given to prevent the onset of aGVHD. The 3-year OS and EFS were 35.6±10.0% and 31.3±10.1%, respectively (median follow-up, 49 mo); 14 patients died of their primary disease. Grade 3-4 aGVHD occurred in 7 patients, 2 of whom died of grade 4 aGVHD. Eleven patients had extensive cGVHD. While 4 of the 8 CR patients remained in CR, only 4 of the 17 non-CR patients achieved long-term CR (survival time, 6-89 mo). Haplo-HSCT was tolerable with strict control of infections and GVHD. However, further strategies for non-CR patients appear to be required.
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Case Reports
  • Successful treatment with high-dose methotrexate/cytarabine regimen in a patient in SMILE regimen-resistant extranodal natural killer/T-cell lymphoma
    Masuho SABURI, Kazuhito ITANI, Kentarou NAGAMATSU, Yasuhiko MIYAZAKI, ...
    2014 Volume 55 Issue 1 Pages 120-124
    Published: 2014
    Released on J-STAGE: February 04, 2014
    DOIhttps://doi.org/10.11406/rinketsu.55.120
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    A 28-year-old man complained of pain in the oral mucosa and pharynx in March 2011, and then developed fever and generalized swelling of the cheek. In March 2012, a gum biopsy led to a diagnosis of extranodal natural killer/T-cell lymphoma (ENKL). 18F-FDG-PET revealed significant uptake in the mouth, tonsils, jawbone, shoulder blade, humerus, ilium, femur, and spleen. After two courses of the SMILE (dexamethasone, methotrexate (MTX), ifosfamide, L-asparaginase, etoposide) regimen, the response was stable disease. However, a high-dose MTX/cytarabine (MA) regimen was effective. After three courses of the MA regimen, a partial response was achieved. Then, allogeneic bone marrow transplantation from an unrelated donor was performed. At 10 months after transplantation, there was no sign of recurrence. Although the optimal treatment for ENKL refractory to the SMILE regimen has yet to be established, our case suggests the MA regimen to be a potentially effective treatment option.
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  • Hydroxyurea (hydroxycarbamide)-induced hepatic dysfunction confirmed by drug-induced lymphocyte stimulation test
    Takayuki SHIMIZU, Takehiko MORI, Daiki KARIGANE, Taku KIKUCHI, Yuya KO ...
    2014 Volume 55 Issue 1 Pages 125-129
    Published: 2014
    Released on J-STAGE: February 04, 2014
    DOIhttps://doi.org/10.11406/rinketsu.55.125
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    A 62-year-old man with refractory leukemia transformed from myelodysplastic syndrome was placed on hydroxyurea (hydroxycarbamide) at a daily dose of 500 mg. Because of insufficient cytoreductive efficacy, the dose was increased to 1,500 mg five days later. Eight days after the initiation of hydroxyurea, the patient started complaining of chills, fever, and vomiting. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were markedly elevated to 5,098 and 3,880 IU/l from 44 and 59 IU/l in one day, respectively. Tests for hepatitis viruses were all negative. With the discontinuation of hydroxyurea, AST and ALT returned to their former levels within two weeks. A drug-induced lymphocyte stimulation test for hydroxyurea was positive with a stimulating index of 2.0. Hepatic dysfunction has been recognized as one of the side effects of hydroxyurea. However, there have been only a limited number of reports demonstrating drug allergy to have a role in hepatic dysfunction accompanied by fever and gastrointestinal symptoms. The findings of our case strongly suggest that all presentations could be explained by drug allergy. Physicians should be mindful of the potential for acute and severe hepatic dysfunction due to allergic reaction against hydroxyurea.
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Short Report
  • Intestinal bleeding in patients with chronic myelogenous leukemia treated with tyrosine kinase inhibitors
    Makoto SAITO, Koh IZUMIYAMA, Akio MORI, Tatsuro IRIE, Masanori TANAKA, ...
    2014 Volume 55 Issue 1 Pages 130-132
    Published: 2014
    Released on J-STAGE: February 04, 2014
    DOIhttps://doi.org/10.11406/rinketsu.55.130
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    Tyrosine kinase inhibitors (TKIs) are highly effective in the treatment of chronic myelogenous leukemia (CML), but there have been a few adverse event reports describing gastrointestinal bleeding. We clinically analyzed two patients who developed intestinal bleeding during the administration of TKIs for CML. Platelet counts of both patients were normal. The patients showed endoscopic findings characterized by mildly hemorrhagic mucosa. The imatinib patient was diagnosed by capsule endoscopy of the small intestine, and required frequent blood transfusions. The dasatinib patient showed occult bleeding due to CD8-positive colitis. We should adequately recognize that gastrointestinal bleeding may occur during the administration of TKIs.
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