A Case Report of Recurrent Subacute Stent Thrombosis After Repetitive Percutaneous Coronary Interventions

Stent thrombosis (ST) is one of the major complications that occur in percutaneous coronary interventions (PCIs) with stents. Various factors have been attributed to the development of ST, and several strategies have been recommended for its management. We report the case of a patient suffering from recurrent subacute STs after recurrent PCIs. The patient was treated by coronary artery bypass graft (CABG).

Novel PML-RARA Fusion Gene on Chromosome 17 in Acute Promyelocytic Leukemia with Normal Chromosome 15 and 17 / 대한혈액학회지

We describe a patient with acute promyelocytic leukemia (APL) with no detectable cytogenetic abnormality of either chromosomes 15 or 17 who nevertheless had juxtaposition of promyelocytic leukemia (PML) and retinoic acid receptor-alpha (RARA) and expressed a chimeric transcript. Conventional cytogenetics showed the 46, XX. The metaphase fluorescence in situ hybridization (FISH) with a 5' PML and 3' RARA probe showed a juxtaposed PML-RARA fusion signal on one chromosome 17 homologue, an RARA signals on the other chromosome 17 homologue, and one PML signal on each chromosome 15 homologue. Our patient is presently in remission and doing well after chemotherapy with idarubicin and all trans retinoic acid (ATRA) treatment. Our results show that APL patients with cytogenetically normal chromosome 15 and 17 may, nevertheless, have involvement of both PML and RARA genes and as the prognostic outcome in APL is associated with the presence of a PML-RARA fusion, it is necessary to perform RT-PCR or FISH to aid diagnosis.

Influential Factors for Engraftment in Autologous Peripheral Hematopoietic Stem Cell Transplantation (APBSCT) / 대한혈액학회지

BACKGROUND: Autologous peripheral hematopoietic stem cell transplantation (APBSCT) has been widely used to treat various types of hematological disorders, metabolic diseases and congenital immunodeficiency. Hematopoietic recovery is important because prolonged duration of neutropenia and thrombocytopenia is associated with a higher risk of infection, bleeding and treatment related mortality. Many investigators have studied the factors that affect hematopoietic recovery after stem cell transplantation. METHODS: We retrospectively investigated the factors influencing hematopoietic engraftment in 112 patients with hematological malignancies and solid tumors who received APBSCT. We evaluated the gender, age, CD34+ cell number, conditioning regimens, and the type of tumor and their association with neutrophil and platelet engraftment. RESULTS: Post-transplant neutrophil engraftment (>500/microL) required a median of 11 days (range 6~50) and platelet engraftment 12 (range 1~78) days (>20,000/microL). The univariate analysis showed that the factors that positively affected hematopoietic recovery were: the type of conditioning regimens such as BEAM (BCNU, etoposide, cytosine arabinoside, melphalan) and BEAC (BCNU, etoposide, cytosine arabinoside, cyclophosphamide) versus BC (busulfan, cyclophosphamide), the CD34+ cell number and the disease diagnosis such as multiple myeloma versus acute myelogenous leukemia. The multivariate analysis showed only the CD34+ cell number (5~10 x 10(6)/kg) to be significantly associated with early neutrophil and platelet engraftment (P<.001). CONCLUSION: These findings suggest that measurement of the CD34+ cell count may be sufficient to predict the time to engraftment after APBSCT.

Phase II Study of Docetaxel and Cisplatin as First-line Chemotherapy in Patients with Recurrent or Metastatic Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Palliative chemotherapy for patients with recurrent or metastatic gastric cancer has been shown to have a survival benefit. Docetaxel monotherapy has achieved appreciable results for treating gastric cancer. We investigated the clinical efficacy and feasibility of a docetaxel and cisplatin combination regimen for patients suffering with recurrent or metastatic gastric cancer. MATERIALS AND METHODS: Patients with histologically proven, bidimensionally measurable lesions of recurrent or metastatic gastric cancer, and they had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 and no prior palliative chemotherapy were eligible for this study. The combination chemotherapy regimen consisted of docetaxel 75 mg/m2 plus cisplatin 75 mg/m2 on day 1, and this was repeated every 3 weeks until disease progression. RESULTS: 32 patients were enrolled from 2002 to 2005. The objective response rate was 31.3% (95% confidenceinterval (CI): 14.2~48.2%) with no CR. The disease control rate was 59.4%. At a median follow up of 38.9 months, the median overall survival was 7.4 months (95% CI: 6.3~8.5). The median time to progression was 4.7 months (95% CI: 3.1~6.3). During a total of 106 cycles, grade 3 or 4 hematological toxicities were observed as follows: neutropenia (39 of 106 cycles) and anemia (3 of 106 cycles). The grade 3 or 4 non-hematological toxicities included anorexia (18.9%) and nausea/vomiting (21.7%). CONCLUSION: Docetaxel and cisplatin combination chemotherapy showed promising anti-tumor activity and this was well tolerated as a first-line treatment for patients with recurrent or metastatic gastric cancer. Further large, randomized phase III studies are warranted.