The Efficacy and Safety of Padexol(R) (Paclitaxel) and Cisplatin for Treating Advanced Non-small Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The authors conducted a multicenter study to evaluate the efficacy and safety of combination chemotherapy with Padexol(R) and cisplatin for treating patients with advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: From November 2003 to April 2005, 42 chemo-naive patients with advanced NSCLC were enrolled into this study from 4 hospitals. The treatment consisted of Padexol(R) 175 mg/m2 as a 3-hr infusion, and this was followed by cisplatin 75 mg/m2 administered as an intravenous infusion with standard premedication. The treatment was repeated every 3 weeks. RESULTS: Among the 42 patients (pts), 33 pts were evaluable for response. On the per protocol analysis, 1 patient (pt) (3.0%) achieved complete response (CR), 17 pts (51.5%) achieved partial response (PR), 6 pts (18.2%) achieved stable disease (SD), and 9 pts (27.3%) progressed; therefore, the overall response rate was 54.6% (95% CI: 37.6~71.5%). On the intention-to-treat analysis, 1 pt (2.4%) achieved CR, 18 pts (42.9%) achieved PR, 11 pts (26.2%) achieved SD, and 9 pts (21.4%) progressed; therefore, the overall response rate was 45.2% (95% CI: 30.2~60.3%). The response, as evaluated by the investigators, was independently reviewed by 2 external radiologists and it was as follows; 13 PR (43.3%), 14 SD (46.7%) and 3 progressive disease (10%). The median duration of response was 5.9 months. The median follow-up duration was 10.3 months (range: 1.3 to 22.1 months). The median time to progression was 5.8 months (95% CI: 4.7 to 7.4 months). The median survival time on the intention-to-treat analysis was 10.5 months (95% CI: 8.1 to 18.8 months). The most common grade 3 or 4 hematologic toxicities were neutropenia (26/180 cycles, 14.4%), anemia (7/180 cycles, 3.9%) and febrile neutropenia (2/180 cycles, 1.1%). The most frequent grade 3 or 4 non-hematologic toxicities were nausea (14/42 patients, 14.3%), anorexia (3/42 patients, 7.1%) and myalgia (3/42 patients, 7.1%). CONCLUSION: The authors observed that Padexol(R) was as good as the other paclitaxel (Taxol(R) or Genexol(R)) formulations when combined with cisplatin for treating patients with advanced NSCLC.

Squamous Cell Carcinoma of Oral Cavity and Metachronously Developed Hepatocellular Carcinoma Arising from Fanconi's Anemia

Fanconi's anemia (FA) is a rare familiar form of aplastic anemia (AA) that is associated with increased chromosomal instability and defective DNA repair, and it characterized by progressive pancytopenia, skeletal abnormalities, hyperpigmentation, and an increased risk of leukemia, hepatocellular carcinoma (HCC) and squamous cell carcinoma (SCC), including head and neck SCC. We reported a 31-year-old man who had AA for 17 years and who developed SCC of oral cavity and then metachronously developed HCC. For treatment of his AA, he was given cyclosporin, steroid and androgen in addition to frequent blood transfusion. At the age of 27, he presented with SCC of the maxilla and the right maxillectomy was performed. Four years later in 2003, hepatic resection of the left medial segment of the liver was performed due to hepatocellular carcinoma. Confirmation of FA was done by cytogenetic analysis. The patient died in 2005 of subdural hemorrhage and pneumonia without involvement of the SCC and HCC.

Sarcomatoid Cholangiocarcinoma of the Liver; a case study / 한국간담췌외과학회지

A 71 year-old man with persistent fever, right pleuritic pain and discomfort for 2 months was referred to hospital. An imaging study using ultrasonography, computed tomography and magnetic resonance imaging showed a huge hepatic mass, which was revealed to be a sarcoma-like mass of the right lobe of the liver. On laparotomy, 5, 6 and 7 segmentectomies were performed. The tumor was 18x16x15 cm in size. On cross section the tumor was a yellowish- fanning, diffusely soft, friable and clearly demarcated mass. Microscopically, the tumor cells were contained in the sarcomatous component (63%), tumor necrosis (36%) and adenocarcinoma component (0.6%) on histological mapping. Histologically, the tumor was composed of malignant osteoid tumor cells. Immunohistochemical staining for cytokeratin was positive in the sarcomatous components. These findings favored the possible epithelial origin of the sarcomatous cells. Thus, the diagnosis confirmed a sarcomatoid cholangiocarcinoma, with 2 osteosarcomatous components. After surgery, the pyrexia subsided, but early peritoneal and intrahepatic recurrence occurred 2 months postoperatively. He received systemic chemotherapy 6 times over 8 months, and partially responded. From our experienced the characteristics of this tumor have been found to be very aggressiveness, with poor prognosis.

The Effect of Photodynamic Therapy on Colon Cancer Cell Line

PURPOSE: Photodynamic therapy (PDT) is a relatively new technology for an alternative modality in the treatment of colorectal cancers. This study was conducted to identify the appropriate dosage and energy level for the photosensitizer as well as effect of PDT on colon cancer cells. METHODS: Colon cancer cell line, COLO 205 (American Type Culture Collection, ATCC) was obtained from Korea Cell Line Bank (KCLB, Seoul, Korea). Cells were cultured on RPMI 1640 medium with 10% fetal calf serum, penicillin, and gentamicin. Cells were incubated at 37 C in a 5% CO2 air environment. Photosense (sulphonated aluminum phthalocyanine, AlPcS4, NIOPIK, State Research Center, Moscow, Russia) was used for the photosensitizer and Fireplace video-3 (Biospec, General Physics Institute, Moscow, Russia, 500 mW/cm2, 670 nm) was used for the light source. 1 104 cells were incubated in 96 well plates with different concentrations of aluminum phthalocyanine: 0.1, 0.3, 0.5 and 1micrometer for 24 hours then photoirradiation was performed at either 24 or 48 J/cm2. The time variations of the viabilities of cells of the four study groups and were measured by using MTT assay according to time were compared to those of the three control groups: control (no treatment), control (AlPcS4, no light), control (light, no AlPcS4), and the study groups (PDT) at one hour, 24 hours, 48 hours and 72 hours after PDT. RESULTS: At, one hour after PDT, the viability of the cells was not changed in the control groups. Viabilities of 117, 40, 35, and 23% in the 24 J group and 76, 31, 52, and 48% in 48 J group were observed, respectively in order of increasing concentration with the value of 87~103% for the control group. 24 hours later, viability of control groups were not changed, By 24 hour after PDT, the viabilities of the control groups had not changed, but those of the 24 J/cm2 and 48 J/cm2 PDT study groups had decreased significantly to 62, 17, 16, and 18% and 24, 15, 13, and 13%, respectively (P=0.00). By 48 hours viability of the 24 J/cm2 and 48 J/cm2 PDT study groups were also significantly decreased being 103, 26, 13, and 13% and 50, 8, 8, and 9%, respectively (P=0.00). By 72 hours, viabilities were 84, 21, 21, and 30 % and 33, 20, 33, and 15%, respectively (P=0.00). CONCLUSIONS: The PDT groups showed a marked cytotoxic effect compared to the control groups, and the effect appeared just after PDT and peaked in 48 hours. The minimum required concentration of the photosensitizer for effective cytotoxicity was at 0.3 micrometer either 24 or 48 J/cm2.

Four Cases of Myelodysplastic Syndrome with Systemic Lupus Erythematosus / 대한진단검사의학회지

Systemic lupus erythematosus (SLE) has been a well-known systemic autoimmune disease with hematologic abnormalities such as anemia, leukopenia, and thrombocytopenia. Myelodysplastic syndrome (MDS) is defined as a clonal expansion of BM derived pluripotent stem cells. Although SLE and MDS are independent disease entities, there have been several reports regarding rheumatic manifestations of MDS, which suggest that there might be a relationship between these two diseases in the pathogenetic sequence. We reviewed our cases of MDS and SLE and encountered four patients with both MDS and SLE, both of which developed concurrently. They were all women from 15 to 50 years old. They had anemia or pancytopenia. Bone marrow findings were disclosed as MDS, RA or hypoplastic MDS, RA. They had positive ANA at a titer above 1:160 of homogeneous, speckled, or dense cytoplasmic pattern. Double-stranded DNA levels increased in all cases, whereas serum complement and immunoglobulin levels were decreased except in case 1.

The Clinical Significance of Ann Arbor and Musshoff's Staging System in Primary Gastrointestinal Non-Hodgkin's Lymphoma-A Retrospective Analysis / 대한혈액학회지

BACKGROUND: Primary Gastrointestinal Non- Hodgkin's Lymphoma (GIL) represents 4 to 20 % of all Non-Hodgkin's Lymphoma(NHL) and gastrointestinal tract(GIT) is the most frequently involved extranodal site in NHL. It is known that the prognosis of GIL is better than that of other NHLs because of it's unique biologic behavior and anatomical location. We reviewed clinical aspects of GIL and analyzed survival data based on Ann-Arbor and Musshoff's staging system. METHODS: Sixty six cases were analyzed by age, sex, clinical manifestation, location, histology, clinical course, and two staging systems (Ann Arbor and Musshoff's modified staging). Histologies were reviewed according to REAL classification. RESULTS: The median age was 51.5 years. The most frequent gross finding was ulcerofungating lesion in upper GIL and mass lesion in lower GIL. Treatment results were as following : 76.9% of response rate, 59.5% of 5-year overall survival rate, and 54.8% of 5-year disease free survival rate. There was a significant difference of overall survival or disease free survival rate between group below stage IIE1 and above IIE2 according to Musshoff's staging system. There were no significant differences in survival between stage I and II, and between stage III and IV based on Ann Arbor staging system. CONCLUSION: There might be the necessity of discriminating localized disease (IIE1) and locally advanced lesion (IIE2) to predict the prognosis of GIL through Musshoff's staging system. Larger study will be needed to confirm the role of Musshoff's staging system.

Long-term Observation of 87 Cases with Chronic Idiopathic Thrombocytopenic Purpura in Adult / 대한혈액학회지

BACKGROUND: Information about the natural history of chronic idiopathic thrombocytopenic purpura (ITP) is still vague and far from complete due to a lack of studies. The purpose of the present study is to define ultimate outcome of adults with chronic ITP by long-term observation of patients. Method : We retrospectively analyzed eighyty-seven ITP patients diagnosed at the Department of Internal Medicine, Kyungpook National University Hospital and Taegu-Hyosung Catholic University Hospital and Taegu-Fatima Hospital between March 1986 and March 1998. RESULTS: Median age was 36 years (range 15 to 74) at the time of diagnosis and median follow-up duration was 46 months (7 to 133). Female to male ratio was 4 : 1. Twenty-four patients who were asymptomatic with stable disease or a platelet count over 50,000/microliter were managed on a wait and see basis. A total of 63 patients received an initial treatment with prednisone (1 mg/kg/day for 1 month). Refractory or relapsed cases underwent splenectomy and/or other therapeutic modalities. An initial complete or partial response to prednisone was observed in 79%. A sustained complete remis- sion (CR) lasting more than 6 months was attained in 11%. Thirty-two refractory or relapsed patients underwent splenectomy. Twenty-two patients (69%) had a CR, with twenty-one (66%) achieving a sustained CR. 5 other cases obtained a partial remission (PR). Long-lasting responses were observed in 3 other case (12 %) following alternative treatment. Five deaths were recorded, but only one was due to thrombocytopenia and the remaining four deaths were unrelated to ITP. Two patients had laboratory features and a clinical history consistent with an autoimmune disease. CONCLUSION: The majority of patients who undergo splenectomy can have a CR for many years. The therapeutic modalities tried as supplements or alternatives to splenectomy all produced some transient remissions but few prolonged recoveries. But the long-term prognosis of chronic ITP is benign even in refractory cases and the development of overt autoimmune diseases is relatively uncommon.

A case of Waldenstr's Macroglobulinemia with Pleural Involvement / 대한임상병리학회지

Waldenstr's macroglobulinemia is a slowly progressing disease characterized by proliferation of small lymphocytes, plasmacytoid lymphocytes and plasma cells in the bone marrow with increased serum monoclonal IgM. Since 1944, only a few cases of Waldenstr's macroglobulinemia with pulmonary involvement have been described. We experienced a case of Waldenstr's macroglobulinemia with pulmonary involvement. The patient was 66-year-old male complaining dyspnea. His cytological finding of pleural fluid aspirates revealed many plasmacytoid lymphocytes. Serum electrophoresis showed the sharp M-peak in the gamma globulin region, which was identified as a IgM, kappa type by immunofixation. Bone marrow findings showed small lymphocytic and plasmacytoid lymphocytic infiltration.

Essential Thrombocythemia: Vascular Complications and Cardiovascular Risk Factors / 대한혈액학회지

BACKGROUND: Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by absolute thrombocytosis and increased incidence of thrombosis and hemorrhage. But the risk of thrombosis or hemorrhage cannot be accurately predicted and the indications for therapy remain unclear. The purpose of this study was to determine the influence of cardiovascular risk factors, e.g. smoking, hypertension, hyperlipidemia and diabetes mellitus, upon complications of ET. METHODS: We have retrospectively analyzed the influence of cardiovascular risk factors upon vascular complications for 37 cases of ET diagnosed at Taegu between January 1987 to December 1996. The PVSG criteria was used to diagnose ET. RESULTS: The mean age of all patients was 55 years(male patients, 58 years; female patients, 53 years). The average platelet count at diagnosis was 1,308x109/L. Eighteen patients (49%) presented with thrombotic complications, and seven (19%) with hemorrhages. Disturbances of microcirculation (30%) were the most frequent thrombotic symptoms. Age and the degree of thrombocytosis did not influence the rate of vascular complications, but patients with cardiovascular risk factors had higher rate of vascular complications. Arterial complications, such as femoropopliteal and coronary artery thrombotic disease, were exclusively seen in patients with cardiovascular risk factors, especially cigarette smoking. CONCLUSION: A group of patients with cardiovascular risk factors, especially smoking have high risk for arterial thrombotic complications of ET, for whom aggressive preventive therapy of cardiovascular disease should be considered.

A Case of Multiple Myeloma with Multiple Intrahepatic Extramedullary Plasmacytomas / 대한혈액학회지

Plasma cell neoplasms of the liver include primary extramedullary plasmacytoma and a local manifestation of multiple myeloma. Extramedullary plasmacytoma of the liver in multiple myeloma is extremely rare although extramedullary involvement frequently occur in extramedullary sites such as lymph nodes, lung, pleura, gastrointestinal tracts, nervous system and spleen. We experienced a case of multiple myeloma with multiple intrahepatic extramedullary plasmacytomas which initially presented as metastatic cancer of the liver. Intrahepatic extramedullary plasmacytoma confirmed by ultrasono-guided liver biopsy, which disclosed numerous neoplastic plasma cell infiltration.

In Vitro Analysis of Apoptotic Cell Death Using Proton Nuclear Magnetic Resonance Spectroscopy / 대한암학회지

PURPOSES: Cells undergoing apoptosis display profound morphologic and biochemical changes in the nucleus and cytoplasm, loss of membrane phospholipid asymmetry, resulting in the exposure of phosphatidylserine (PS) at the surface of the cell, membrane blebbing, and decreased membrane microviscosity. Proton nuclear magnetic resonance spectroscopy ('H NMR spectroscopy) is able to detect the mobile fraction of lipids contained in the cell, and thus is sensitive to membrane fluidity modifications related to lipid composition changes. We have used 'H NMR spectroscopy in HL-60 cell line to detect and characterize the changes in plasma membrane lipid associated with apoptotic cell death. MATERIALS AND METHODS: We performed annexin-FITC and propidium iodide dual fluorescence flow cytometry, DNA gel electrophoresis, and obtained 200 MHz 'H NMR spectra of the HL-60 cell cultures before and at 6, 12, 18, 24, 36 and 48 hours after the addition of doxorubicin (100 ng/mL). RESULTS: The onset of apoptosis is accompanied by a greater than four fold increase in signal intensity ratio of the membrane lipid methylene (-CH2) resonance (at 1.2 ppm) to the methyl (-CH3) resonance (at 0.9 ppm). The quantitative relationship between apoptosis and the H NMR signal intensity was determined by fluorescein-annexin V flow cytometry, and showed that increases in the CH2/CH3 resonance signal intensity ratio paralleled the surface expression of PS as an early marker of apoptosis ( y =0.80, N 18 samples). The gradual decrease in the ratio of choline resonance (at 3.2 ppm) to CH3 signal intensity after 12 hours in the time course' experiment is directly proportional to the percentage of apoptotic cells ( y =0.96, N=18 samples). CONCLUSIONS: Monitoring of the CH2 and choline resonance signal intensity may therefore be useful in detecting apoptosis. Further studies using various stimuli to induce apoptotic cell death will be necessary to better determine the capabilities of 'H NMR spectroscopy for the detection and estimation of apoptosis in vitro.

A Case of Cyclic Thrombocytopenia: A Case Report / 대한임상병리학회지

Cyclic thrombocytopenia is a rare disorder with cyclic change of the platelet counts. Although the pathogenesis of the disorder has not been clarified, recent reports suggest that periodic destruction and/or ineffective production of platelets may be important causes of the disease. We report a 24-year-old female with the episodes of severe thrombocytopenia (minimum platelet count 2x109/L) followed by normal or higher platelet counts (maximum platelet count 877x109/L). The period of platelet count fluctuation was about 20-40 days. Morphological examination of bone marrow showed the cyclic disappearance of mature and immature megakaryocytes. These findings indicate that the cause of platelet fluctuation is periodic failure of megakaryocytopoiesis.

Leukemic Red Marrow Changes Assessed by Proton Magnetic Resonance Spectroscopy Before and Following Chemotherapy / 대한암학회지

PURPOSE: The purpose of this study was to investigate the possibilities for serial in vivo localized proton magnetic resonance spectroscopy (MRS) examination of bone marrow in patients with acute le,ukemia. MATERIALS AND METHODS: Selective measurements of the relaxation times Tl and T2 for the water and fat resonance in the bone marrow spectra were performed (1.5 Tesla whole body magnetic resonance scanner). Six patients with acute leukemia were examined at diagnosis. Follow-up examinations of four patients with acute leukemia in complete remission were also examined. Six normal control subjects were examined with identical methods for comparison. RESULTS: Significant differences could be detected in the spectral patterns from lumbar spine in patients with leukemia at diagnosis compared to healthy normal controls. The relative water content was increased in leukemic patients compared to normal subjects, which indicate an increase in the amount of hemopoietic tissue and a corresponding decrease in marrow fat content. A significant correlation was found between cellularity assessments derived from conventional bone marrow core biopsies and relative water content of proton MRS data. The Tl relaxation time of the water resonance in leukemic patients were significantly prolonged at diagnosis compared to normal controls. After chemotherapeutic induction of remission, the spectra from the bone marrow of lumbar spine resembled normal subjects. CONCLUSIONS: This method provide the possibility for serial measurements of bone marrow in patients with leukemia, and may provide information from regions inaccessible to bone marrow biopsy. This therefore appears to be a promising application of proton MRS that can be performed on a routine basis in a clinical setting.

Measurement of inferior vena cava diameter, alpha-human-atrial natriuretic peptide and cyclic guanosine 3':5'-monophosphate for estimation of dry weight and intravascular volume change in hemodialysis patients / 대한내과학회지

BACKGROUND: A correct estimation of volume status and dry weight in dialysis patients remains a difficult clinical problem. Clinical status and chest X-ray are not sensitive enough, while invasively measured central venous pressures are not routinely available. Recently, the ultrasonographic determination of the diameter and collapse index of the inferior vena cava has been proposed as a noninvasive method for estimating intravascular volume. We tried to evaluate the clinical relevance of this method in dialysis patients by comparing it with alphahuman-atrial natriuretic peptide (alpha-h-ANP) and cyclic guanosine 3:5-monophosphate (cGMP) levels. METHODS: Using echocardiography, the diameter of the inferior vena cava (VCD) and its decrease on deep inspiration (collapse index : CI) were evaluated in 27 hemodialysis patients. Echocardiography of the inferior vena cava (IVC) was performed in the supine position after 10 minutes rest. The transducer was placed in the subxiphoid region and long and short axis views of the IVC were obtained just below the diaphragm in the hepatic segment. VCD was measured before the P-wave on the electrocardiogram to avoid interference with A-wave and V-wave on the venous pressure curve, and corrected for body surface area. Preand post-hemodialysis levels of the plasma alpha-h-ANP and cGMP were measured by radioimmunoassay. The relationship between VCD, CI determined by echocardiography, and alpha-h-ANP and cGMP concentrations were studied. RESULTS: The levels of alpha-h-ANP and cGMP were markedly elevated before hemodialysis and significantly lower values were found after hemodialysis (alpha-hANP : 162.7 102.6 pg/ml vs 90.6 61.0 pg/ml , cGMP : 35.3 8.8 pmol/ml vs 21.3 6.2 pmol/ml). A significant correlation was found between VCD and alpha-h-ANP before (r=0.81, p 0.05) and also no relation was observed between the decrease of cGMP during hemodialysis and VCD before hemodialysis (r=0.12, p > 0.05). A significant correlation between the percent change in body weight and the percent change in VCD during hemodialysis (r=0.91, p<0.05) and also significant relation was observed between the pecent change in body weight and the percent change in alpha-h-ANP levels (r=0.40, p , 0.05). CONCLUSION: Echocardiography of the inferior vena cava allow an estimation of changes of intravascular volume in ESRDpatients without cardiac filling impairment as shown by the correlation to other indices of intravascular volume, such as alpha-h-ANP. In this study, CI and cGMP levels were less informative. Inferior vena cava echocardiography is noninvasive and easily available and serial measurements of VCD and alphah-ANP levels allow an estimation of chages of intravascular volume in ESRD patients on maintenance hemodialysis.

Acquired Idiopathic Sideroblastic Anemia: A clinical study of 15 patients / 대한혈액학회지

BACKGROUND: Acquired idiopathic sideroblastic anemia (AISA) is a heterogeneous condition. Most instances, involving only the erythroid line, are benign disease with a longer survival and a low propensity for evolution into acute leukemia. A subset of patients have severe clinical course and evidence of other cell line involvement at presentation, may develop the emergence of blast cells and evolution into acute leukemia. In an attempt to identify the natural history and the risk factors for the development of acute leukemia, the clinical, hematological and outcome data were studied in the patients with AISA. METHODS: We reviewed retrospectively the medical records of 15 patients of AISA treated at the Catholic University of Taegu-Hyosung and Kyungpook National University Hospital from March 1989 to December 1995. RESULTS: The median age at diagnosis was 41 years and the male to female ratio was 8 : 7. On bone marrow examination, erythroid abnormalities were prominent in all cases, 5 patients also showed involvement of the granulocytic and/or megakaryocytic cell lines (AISA with myelodysplastic features, AISA-M). The median follow-up duration was 32 months. Transfusion dependence occurred in 11 of 16 cases. Progression towards refractory anemia with excess of blasts or acute leukemia (M2) was observed in two patients with AISA-M after follow-up period of 16 months and 24 months, respectively. Infections and hemorrhages were causes of death in 3 patients with AISA-M but not in patients with dyserythropoiesis only (AISA-erythroid, AISA-E). CONCLUSIONS: Most patients with AISA have a relatively benign course with prolonged survival after the onset of anemia. Patients with features of dysgranulopoiesis and/or dysmegakaryopoiesis in addition to dyserythropoiesis at presentation were increased risk of transformation to refractory anemia with excess of blasts or acute leukemia and shorter surtival. But further study of larger numbers of patients and longer follow-up may be warranted.

A Clinical Study on Patients with Chronic Lymphocytic Leukemia / 대한암학회지

PURPOSE: Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in western countries but it has been reported rarely in Korea. The purpose of this study was to evaluate the clinical characteristics, treatment responses and prognosis of the patients with CLL. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 17 patients with CLL diagnosed at the Catholic University of Taegu-Hyosung & Kyungpook National University Hospital from Jan. 1986 to Mar. 1996. RESULTS: There were 9 males and 8 females and the mean age was 55 years. The majority of patients had systemic symptoms (77%) and advanced clinical stage (Binet stage C, 70%) at the time of diagnosis. The bone marrow histology was reviewed in 13 cases and patients were subdivided into those with a diffuse (9cases) and nondiffuse (4cases) pattern of bone marrow histology. In patients with advanced clinical stage, diffuse pattern was predominated and showed poor survival. 14 patients were treated with chlorambucil/steroid or combination chemotherapy. Among the 13 evaluable patients, 1 (8%) achieved a complete response and 7 (54%) achieved partial responses, and median survival duration was 18months. 11 patients died after 2~18 months of follow-up and infection was the main cause of death. CONCLUSION: Poor prognostic factors, such as high blood lymphocyte counts, diffuse bone marrow involvement pattern & advanced clinical stage, are common in our patients at presentation & showed poor survival.

Plasma Cell Leukemia Having Pseudopods: A Case Report / 대한임상병리학회지

Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.