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1.
Cancer Research and Treatment ; : 907-916, 2020.
Article | WPRIM | ID: wpr-831101

ABSTRACT

Purpose@#The purpose of this study was to compare ramosetron (RAM), aprepitant (APR), and dexamethasone (DEX) [RAD] with palonosetron (PAL), APR, and DEX [PAD] in controlling highly-emetogenic chemotherapy (HEC)–induced nausea and vomiting. @*Materials and Methods@#Patients were randomly assigned (1:1) to receive RAD or PAD:RAM (0.3 mg intravenously) or PAL (0.25 mg intravenously) D1, combined with APR (125 mg orally, D1 and 80 mg orally, D2-3) and DEX (12 mg orally or intravenously, D1 and 8 mg orally, D2-4). Patients were stratified by gender, cisplatin-based chemotherapy, and administration schedule. The primary endpoint was overall complete response (CR), defined as no emesis and no rescue regimen during 5 days of HEC. Secondary endpoints were overall complete protection (CP; CR+nausea score < 25 mm) and total control (TC; CR+nausea score < 5 mm). Quality of life was assessed by Functional Living Index Emesis (FLIE) questionnaire on D0 and D6. @*Results@#A total of 279 patients receiving RAD (n=137) or PAD (n=142) were evaluated. Overall CR rates in RAD and PAD recipients were 81.8% and 79.6% (risk difference [RD], 2.2%; 95% confidence interval [CI], −7.1 to 11.4), respectively. Overall CP and TC rates for RAD and PAD were 56.2% and 58.5% (RD, −2.3%; 95% CI, −13.9 to 9.4) and 47.5% vs. 43.7% (RD, 3.8%; 95% CI, −7.9 to 15.5), respectively. FLIE total score ≥ 108 (no impact on daily life) was comparable between RAD and PAD (73.9% vs. 73.4%, respectively). Adverse events were similar between the two groups. @*Conclusion@#In all aspects of efficacy, safety and QOL, RAD is non-inferior to PAD for the control of CINV in cancer patients receiving HEC.

2.
Korean Journal of Pancreas and Biliary Tract ; : 61-67, 2019.
Article in English | WPRIM | ID: wpr-760166

ABSTRACT

BACKGROUND/AIMS: Pancreatic cancer (PC) patients have poor prognoses because this cancer is typically diagnosed at an advanced stage and the therapeutic options are limited. We examined the potential of metabolic profiling for early diagnosis and identification of potential therapeutic targets. METHODS: Ten patients and 10 healthy volunteer controls older than 20 years of age were enrolled between May and December 2015. The patients were confirmed to have pancreatic ductal adenocarcinoma cytologically or histologically. Blood plasma samples were derivatized and analyzed by gas chromatography mass spectrometry (GC-MS). Untargeted GC-MS data were analyzed using statistical methods, including Wilcoxon rank-sum test and principal component analyses. RESULTS: L-lysine was 1.36-fold higher in patients than in healthy controls (p<0.05). L-leucine was 0.63-fold lower (p<0.01) and palmitic acid was 0.93-fold lower (p<0.5) in patients than in controls. Orthogonal partial least squared-discriminant analysis revealed significant differences between the patients and controls. CONCLUSIONS: This study suggests that the metabolic profiles of patients with PC are distinct from those of the healthy population. Further studies are required to develop methods for early diagnosis and identify therapeutic targets.


Subject(s)
Humans , Adenocarcinoma , Early Diagnosis , Gas Chromatography-Mass Spectrometry , Healthy Volunteers , Korea , Leucine , Lysine , Metabolome , Palmitic Acid , Pancreatic Ducts , Pancreatic Neoplasms , Plasma , Principal Component Analysis , Prognosis
3.
The Korean Journal of Internal Medicine ; : 383-390, 2018.
Article in English | WPRIM | ID: wpr-713534

ABSTRACT

BACKGROUND/AIMS: Because of rarity, role of chemotherapy of bladder adenocarcinoma are still unidentified. Therefore, we performed a retrospective analysis of the clinical features and chemotherapy outcomes of bladder adenocarcinoma. METHODS: Eligible patients for this retrospective analysis were initially diagnosed with bladder adenocarcinoma and presented with a clinically no other primary site of origin. The collected data included age, gender, performance status, stage, hemoglobin, albumin, initial date of diagnosis, treatment modality utilized, response to treatment, presence of relapse, last status of patient, and last date of follow-up. RESULTS: We retrospectively reviewed 29 patients, who were treated with chemotherapy for bladder adenocarcinoma at 10 Korean medical institutions from 2004 to 2014. The median age of patients was 58 years (range, 17 to 78) and 51.7% of the patients were female. Urachal adenocarcinoma was identified in 15 patients. Of 27 symptomatic patients, 22 experienced gross hematuria. Twelve patients were treated with 5-f luorouracil based chemotherapy, five were gemcitabine based, three were taxane and others. Thirteen of them achieved complete response (10.3%) or partial response (34.5%). Median progression-free survival (PFS) and overall survival (OS) for all patients were 10.6 months (95% confidence interval [CI], 9.5 to 11.6) and 24.5 months (95% CI, 1.2 to 47.8), respectively. The cases of urachal adenocarcinoma exhibited worse tendency in PFS and OS (p = 0.024 and p = 0.046, respectively). CONCLUSIONS: Even though bladder adenocarcinoma had been observed moderate effectiveness to chemotherapy, bladder adenocarcinoma is a highly aggressive form of bladder cancer. PFS and OS were short especially in urachal carcinoma.


Subject(s)
Female , Humans , Adenocarcinoma , Diagnosis , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Gynecology , Hematuria , Recurrence , Retrospective Studies , Urinary Bladder Neoplasms , Urinary Bladder
4.
Radiation Oncology Journal ; : 325-331, 2018.
Article in English | WPRIM | ID: wpr-741958

ABSTRACT

PURPOSE: Soft tissue sarcoma (STS) is a rare and heterogeneous cancer with over 50 known subtypes. It is difficult to understand the role of adjuvant treatment in STS. We aimed to determine the benefits of adjuvant treatment for a rare STS subset: non-extremity STS with moderate chemosensitivity. MATERIALS AND METHODS: We reviewed medical records from Pusan National University Hospital and Kosin University Gospel Hospital, which had detailed pathological reports on patients diagnosed between 2006 and 2016. The most important inclusion criterion was resection with curative intent. We grouped STS by chemosensitivity based on reported data and analyzed non-extremity STS with moderate chemosensitivity. RESULTS: We investigated 142 patients with 20 pathological subtypes of STS. Eighty-six patients had extremity STS and 56 had non-extremity STS. Thirty-eight of 56 patients were categorized as having moderate chemosensitivity. Seventeen of 38 patients (44.7%) received adjuvant radiotherapy and 14 (36.8%) received adjuvant chemotherapy. A log-rank test showed longer disease-free survival (DFS) in the adjuvant radiotherapy group than in the group treated without adjuvant radiotherapy (not reached vs. 1.468 years, p = 0.037). Multivariate Cox proportional hazard analysis, with covariates including age, stage, resection margin, adjuvant chemotherapy, and adjuvant radiotherapy, revealed that adjuvant radiotherapy was associated with longer DFS (odds ratio = 0.369, p = 0.045). Overall survival was not correlated with adjuvant radiotherapy. CONCLUSION: Adjuvant radiotherapy may be associated with longer DFS in patients with non-extremity STS with moderate chemosensitivity.


Subject(s)
Humans , Chemotherapy, Adjuvant , Disease-Free Survival , Extremities , Medical Records , Radiotherapy, Adjuvant , Sarcoma
5.
Korean Journal of Pancreas and Biliary Tract ; : 108-115, 2018.
Article in English | WPRIM | ID: wpr-715804

ABSTRACT

BACKGROUND/AIMS: This study aimed to compare the outcomes of patients who received systemic chemotherapy or chemoradiotherapy as adjuvant therapies following pancreatic adenocarcinoma resection. METHODS: We reviewed the medical records of 40 patients with locoregional pancreatic adenocarcinoma who underwent tumor resection at Pusan National University Hospital between 2008 and 2012. RESULTS: Twenty-nine patients were treated with adjuvant therapy comprising either systemic chemotherapy or chemoradiotherapy after curative-intent surgery. Adjuvant therapy (p=0.025) and complete resection (p=0.043) were associated with longer overall survival. There was no significant difference between chemotherapy and chemoradiotherapy in terms of extending overall survival; however, patients who received chemotherapy had significantly higher survival rates than those who received no adjuvant therapy at all (p=0.012). CONCLUSIONS: Adjuvant therapies improve the prognoses of patients with resected pancreatic adenocarcinoma; moreover, chemotherapy produced more favorable outcomes than chemoradiotherapy.


Subject(s)
Humans , Adenocarcinoma , Chemoradiotherapy , Chemotherapy, Adjuvant , Drug Therapy , Medical Records , Pancreatic Neoplasms , Prognosis , Retrospective Studies , Survival Rate
6.
Journal of Rheumatic Diseases ; : 130-135, 2016.
Article in English | WPRIM | ID: wpr-84885

ABSTRACT

Sarcoidosis is a multisystem inflammatory disease of unknown etiology characterized by noncaseating epithelioid granuloma formation. Although the relationship between sarcoidosis and malignancy has been noted in recent decades, there are few case reports describing the concurrent diagnosis of sarcoidosis and malignancy. Herein, we describe a case of biopsy-proven splenic sarcoidosis mimicking metastasis at the time of ovarian adenocarcinoma. Imaging studies including positron-emission tomography-computed tomography were not useful for differentiating sarcoidosis from malignancy. Thus, our case highlights the importance of histopathological examination to rule out nonmalignant conditions before the diagnosis of metastatic disease is made.


Subject(s)
Adenocarcinoma , Diagnosis , Granuloma , Neoplasm Metastasis , Ovarian Neoplasms , Positron-Emission Tomography , Sarcoidosis
7.
Journal of Rheumatic Diseases ; : 326-331, 2016.
Article in English | WPRIM | ID: wpr-81680

ABSTRACT

A 50-year-old woman, who had been treated for rheumatoid arthritis (RA) over a 10-year period, suddenly presented with monocular vision loss while the RA had a stable course over many years. She was diagnosed with central retinal artery occlusion (CRAO) based on ophthalmologic examinations including optical coherence tomography and fluorescein angiography. There was no evidence of atherosclerosis, infection, and malignancy that can cause CRAO. Considering the association between CRAO and other rheumatic diseases, such as systemic vasculitis and systemic lupus erythematous in previous reports, it was presumed that her RA might have contributed to the development of CRAO. Although cases of CRAO in patients with RA are extremely rare, these findings suggest that physicians need to be aware of the possibility of CRAO in patients with RA who experience decreased visual acuity.


Subject(s)
Female , Humans , Middle Aged , Arthritis, Rheumatoid , Atherosclerosis , Fluorescein Angiography , Retinal Artery Occlusion , Retinal Artery , Rheumatic Diseases , Systemic Vasculitis , Tomography, Optical Coherence , Vision, Monocular , Visual Acuity
8.
Blood Research ; : 175-180, 2016.
Article in English | WPRIM | ID: wpr-209256

ABSTRACT

BACKGROUND: It is widely known that the prognosis of acute myeloid leukemia (AML) depends on chromosomal abnormalities. The majority of AML patients relapse and experience a dismal disease course despite initial remission. METHODS: We reviewed the medical records and laboratory findings of 55 AML patients who had relapsed between 2004 and 2013 and who had been treated at the Division of Hematology of the Pusan National University Hospital. RESULTS: The event-free survival (EFS) was related to prognostic karyotype classification at the time of diagnosis and relapse (unfavorable vs. favorable or intermediate karyotypes at diagnosis, 8.2 vs. 11.9 mo, P=0.003; unfavorable vs. favorable or intermediate karyotypes at relapse, 8.2 vs. 11.9 mo, P=0.009). The overall survival (OS) was significantly correlated with karyotype classification only at diagnosis (unfavorable vs. favorable or intermediate vs. karyotypes at diagnosis, 8.5 vs. 21.8 mo, P=0.001; unfavorable vs. favorable or intermediate karyotypes at relapse, 8.5 vs. 21.2 mo, P=0.136). A change in karyotype between diagnosis and relapse, which is regarded as a factor of resistance against treatment, was not a significant prognostic factor for OS, EFS, and post-relapse survival (PRS). A Cox proportional hazards model showed that the combined use of fludarabine, cytosine arabinoside, and granulocyte colony-stimulating factor (FLAG) as a salvage regimen, was a significant prognostic factor for OS (hazard ratio=0.399, P=0.010) and the PRS (hazard ratio=0.447, P=0.031). CONCLUSION: The karyotype classification at diagnosis predicts survival including PRS in relapsed AML patients as well as in treatment-naïve patients. We suggest that presently, administration of salvage FLAG could be a better treatment option.


Subject(s)
Humans , Chromosome Aberrations , Classification , Clonal Evolution , Cytarabine , Diagnosis , Disease-Free Survival , Granulocyte Colony-Stimulating Factor , Hematology , Karyotype , Leukemia, Myeloid, Acute , Medical Records , Prognosis , Proportional Hazards Models , Recurrence
9.
Cancer Research and Treatment ; : 46-54, 2015.
Article in English | WPRIM | ID: wpr-20377

ABSTRACT

PURPOSE: The aim of this study is to identify the prognostic factors of distant metastasis (DM) after induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer (HNC). MATERIALS AND METHODS: A total of 321 patients with HNC who underwent IC followed by CRT treated between January 2005 and December 2010 were analyzed retrospectively. IC consisted of three courses of docetaxel (70 mg/m2) and cisplatin (75 mg/m2) every three weeks, followed by radiotherapy of 66-70 Gy/2 Gy per fraction/5 fractions per week concurrent with weekly cisplatin (40 mg/m2). Tumor/nodal stage, primary site, tumor differentiation, lower neck node involvement (level IV, VB, and supraclavicular regions), number of concurrent chemotherapy cycles, overall duration of radiotherapy, and response to IC were assessed as potential prognostic factors influencing DM and survival outcome. RESULTS: The five-year loco-regional recurrence and DM rates were 23.6% and 18.2%. N stage, overall duration of radiotherapy, lower neck node involvement, and response to IC were significant factors for DM. With a median follow-up period of 52 months (range, 4 to 83 months), the 5-year progression-free, DM-free, and overall survival rates were 41.2%, 50.7%, and 55.1%, respectively. Lower neck node involvement (p=0.008) and poor response to IC (p < 0.001) showed an association with significantly inferior DM-free survival. CONCLUSION: Even with the addition of IC, the DM rate and survival outcome were poor when metastatic lower neck lymph nodes were present or when patients failed to respond after receiving IC.


Subject(s)
Humans , Chemoradiotherapy , Cisplatin , Drug Therapy , Follow-Up Studies , Head and Neck Neoplasms , Induction Chemotherapy , Lymph Nodes , Neck , Neoplasm Metastasis , Prognosis , Radiotherapy , Recurrence , Retrospective Studies , Survival Rate
10.
Cancer Research and Treatment ; : 244-249, 2013.
Article in English | WPRIM | ID: wpr-54655

ABSTRACT

A 37-year-old male presented with a mass measuring 2.5 cm in size in the midbrain and obstructive hydrocephalus, which had manifested as a headache and dizziness. Magnetic resonance (MR) imaging of the brain showed intermediate enhancement on T1-weighted MR imaging and a high intensity of enhancement on T2-weighted MR. Neurosurgeons performed an occipital craniotomy with partial removal of the tumor and the postoperative diagnosis was a pineal parenchymal tumor with intermediate differentiation. He had undergone irradiation with 54 Gy of radiation on 27 fractions for removal of the remaining tumor approximately one month after surgery. However, in follow-up imaging performed four months after radiotherapy, a remnant mass in the superoposterior aspect of the midbrain was found to have extended to the hypothalamus and the third ventricle. He was treated with six cycles of procarbazine, lomustine, vincristine chemotherapy. At five months since the completion of chemotherapy, the brain MR imaging showed no evidence of any remaining tumor and he no longer displayed any of his initial symptoms.


Subject(s)
Adult , Humans , Male , Brain , Craniotomy , Dizziness , Follow-Up Studies , Headache , Hydrocephalus , Hypothalamus , Lomustine , Magnetics , Magnets , Mesencephalon , Pinealoma , Procarbazine , Third Ventricle , Vincristine
11.
Journal of Breast Cancer ; : 140-146, 2011.
Article in English | WPRIM | ID: wpr-179785

ABSTRACT

PURPOSE: The role of first-line trastuzumab-based therapy has been firmly established in patients with human epidermal growth factor receptor-2 (HER2) positive metastatic breast cancer. In this trial, we evaluated the efficacy and safety of a vinorelbine and trastuzumab combination chemotherapy in patients who were pretreated with anthracyclines and taxanes. METHODS: Thirty-three patients with HER2 overexpressing metastatic breast cancer, all of whom had previously been treated with anthracyclines and taxanes, were included in this study. The patients were treated with 25 mg/m2 of vinorelbine (over a 15-minute infusion) on days 1 and 8 every 3 weeks. Additionally, trastuzumab was administered at an initial dose of 4 mg/kg over 90 minutes, and was subsequently administered at weekly doses of 2 mg/kg (over 30 minutes). RESULTS: The median age of the patients was 53 years (range, 39-72 years). The overall response rate was 30.3% (10 patients; 95% confidence interval [CI], 23-57%). The median time to progression was 6.8 months (95% CI, 5.3-8.2 months). The median overall survival was 12.4 months (95% CI, 10.3-14.6 months). In the 194 cycles of treatment, the incidence rates of grade > or =3 neutropenia and anemia were 7.2% and 1.0%, respectively. Neutropenic fever was detected in three cycles (1.5%). The non-hematological toxicities were not severe: grade 1 or 2 nausea or vomiting was detected in 15.2%, and grade 2 neuropathy was noted in 6.1% of patients. None of the patients experienced any serious cardiac toxicity, and no treatment-related deaths occurred. CONCLUSION: These results show that a combination chemotherapy consisting of vinorelbine and trastuzumab is useful in patients with HER2-overexpressing metastatic breast cancer who were pretreated with anthracyclines and taxanes, with a favorable toxicity profile.


Subject(s)
Humans , Anemia , Anthracyclines , Antibodies, Monoclonal, Humanized , Breast , Breast Neoplasms , Drug Therapy, Combination , Epidermal Growth Factor , Fever , Incidence , Nausea , Neoplasm Metastasis , Neutropenia , Taxoids , Vinblastine , Vomiting , Trastuzumab
12.
The Korean Journal of Internal Medicine ; : 76-81, 2011.
Article in English | WPRIM | ID: wpr-75324

ABSTRACT

BACKGROUND/AIMS: Autologous stem cell transplantation (ASCT) has become the treatment of choice for patients with multiple myeloma (MM). Studies have shown that maintenance treatment with interferon-alpha is associated with improved survival rates following ASCT. However, despite these recent advances in regimes, relapses are inevitable; thus, the prediction of relapse following ASCT requires assessment. METHODS: We retrospectively analyzed 39 patients who received ASCT between 2003 and 2008. All patients received chemotherapy with vincristine, adriamycin, and dexamethasone (VAD), and ASCT was performed following high-dose melphalan conditioning therapy. We evaluated the influence of the post-transplant day +14 (D+14) bone marrow plasma cell percent (BMPCp) (> or = 2 vs. or = 50 vs. or = 50% at diagnosis, CR after 3 cycles of VAD therapy, del (13q) by fluorescence in situ hybridization, and BMPCp > or = 2% at post-transplant D+14 were correlated with PFS and OS. A multivariate analysis revealed that a post-transplant D+14 BMPCp > or = 2% (PFS, hazard ratio [HR] = 4.426, p = 0.008; OS, HR = 3.545, p = 0.038) and CR after 3 cycles of VAD therapy (PFS, HR = 0.072, p = 0.014; OS, HR = 0.055, p = 0.015) were independent prognostic parameters. CONCLUSIONS: Post-transplant D+14 BMPCp is a useful parameter for predicting the outcome for patients with MM receiving ASCT.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow/pathology , Combined Modality Therapy , Hematopoietic Stem Cell Transplantation , Multiple Myeloma/mortality , Plasma Cells/pathology , Predictive Value of Tests , Retrospective Studies , Transplantation, Autologous
13.
Korean Journal of Hematology ; : 188-192, 2010.
Article in English | WPRIM | ID: wpr-720393

ABSTRACT

BACKGROUND: Bortezomib has significant activity in treating multiple myeloma (MM). The risk of herpes zoster (HZ) has been reported to increase significantly with bortezomib treatment, but the predisposing factors for HZ are not clear. This study is a retrospective analysis of the relevant risk factors for HZ in Korean MM patients treated with bortezomib. METHODS: Sixty-six patients with refractory or relapsed MM who underwent chemotherapy with bortezomib were included in the study. Prophylactic antiviral drugs were not used for treatment. The following parameters were reviewed: age, gender, stage and type of MM, extent of previous treatment, history of HZ, duration from the time of diagnosis to the time of bortezomib treatment initiation, and absolute lymphocyte counts (ALC) at the time of bortezomib treatment initiation. RESULTS: The incidence of HZ was 16.7%. There were no intergroup differences between the HZ-positive and the HZ-negative groups with regard to a history of HZ, number of previous treatments, and exposure to steroids before bortezomib treatment. The median duration from the time of MM diagnosis to the time of bortezomib treatment initiation in the HZ-positive group was significantly shorter than that in the HZ-negative group. The median ALC at the time of bortezomib initiation in the HZ-positive group was significantly lower than that in the HZ-negative group. CONCLUSION: Bortezomib itself might act as a risk factor for HZ by inhibiting cell-mediated immunity, and patients with low ALC at the time of bortezomib treatment initiation were at greater risk of HZ during bortezomib treatment.


Subject(s)
Humans , Antiviral Agents , Boronic Acids , Herpes Zoster , Immunity, Cellular , Incidence , Lymphocyte Count , Multiple Myeloma , Protease Inhibitors , Pyrazines , Retrospective Studies , Risk Factors , Steroids , Bortezomib
14.
Journal of Korean Medical Science ; : 555-560, 2009.
Article in English | WPRIM | ID: wpr-185542

ABSTRACT

Previous reports have suggested that a high serum cyclosporine A (CsA) level could result in a lower incidence of acute-graft-versus-host disease (aGVHD). An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia. In this study, we retrospectively analyzed the records of 24 patients who received allogeneic SCT from an HLA-matched sibling donor for acute and chronic myelogenous leukemia. Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment). A higher serum level of CsA and lower serum LDH level at the third week after SCT were associated with a lower incidence of aGVHD (P=0.015, 0.030). In multivariate analysis, the serum CsA level (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.022-0.652, P=0.0014) and serum LDH level (HR, 6.59; 95% CI, 1.197-36.316, P=0.030) at the third week after SCT were found to be independent factors that were significantly associated with the development of aGVHD. We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acute Disease , Cyclosporine/blood , Graft vs Host Disease/epidemiology , L-Lactate Dehydrogenase/blood , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Leukemia, Myeloid, Acute/therapy , Multivariate Analysis , Predictive Value of Tests , Retrospective Studies , Risk Factors , Stem Cell Transplantation , Transplantation, Homologous
15.
Korean Journal of Hematology ; : 163-167, 2009.
Article in Korean | WPRIM | ID: wpr-720031

ABSTRACT

Acquired hemophilia is a rare but potentially life-threatening hemorrhagic disorder caused by the development of autoantibodies against coagulation factor VIII. Concentrates of human factor VIII, desmopressin, activated prothrombin complex concentrates, recombinant activated factor VII can all be used to control episodes of acute bleeding. The recent availability of bypassing agents like recombinant activated factor VII has been shown to be clinically safe and effective as treatment for acute bleeding. In this case report, a 67 year-old male patient with Rh negative blood type developed gross hematuria and bleeding after transurethral resection due to prostatic hypertrophy. After vesicocutaneous fistular reduction operation, post-operative bleeding was presented. The acute bleeding was controlled successfully by the combined treatment with recombinant activated factor VII (Novo seven(R)) and prednisone.


Subject(s)
Humans , Male , Autoantibodies , Blood Coagulation Factors , Deamino Arginine Vasopressin , Factor VIIa , Factor VIII , Hematuria , Hemophilia A , Hemorrhage , Hemorrhagic Disorders , Prostatic Hyperplasia , Prothrombin
16.
Korean Journal of Medicine ; : 554-563, 2009.
Article in Korean | WPRIM | ID: wpr-211079

ABSTRACT

BACKGROUND/AIMS: The prevalence of malignancies associated with human immunodeficiency virus (HIV) is rapidly increasing. The aim of the present study was to identify clinical features associated with malignancies in South Korean patients infected with HIV. METHODS: From January 1990 to June 2007, we reviewed an electronic database containing pathological reports obtained from HIV-infected patients and then retrospectively analyzed a total of 27 malignancy cases treated at four different institutions. RESULTS: Among 683 patients infected with HIV, malignant diseases were diagnosed in 27 cases (4.0%). Twenty-five of these patients were male, and the median age was 48 (range; 24-76). At the time of diagnosis, the median CD4+ lymphocyte count was 42/uL (range 3-339). Acquired immune deficiency syndrome (AIDS)-defining malignancies were diagnosed in 13 patients (48%) and non-AIDS-defining malignancies were diagnosed in 14 patients (52%). Two patients each were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the pre-highly active anti-retroviral therapy (HARRT) period. In contrast, 11 patients (48%) and 12 patients (52%) were diagnosed with AIDS-defining and non-AIDS-defining malignancies during the HARRT period, respectively. Among AIDS-defining malignancies, non-Hodgkins lymphoma was the most frequently observed (9/13), followed by Kaposi's sarcoma (4/13). Among the 9 patients with non-Hodgkins lymphoma, diffuse large B-cell lymphoma was most common (5/9), followed by primary CNS lymphoma (3/9) and Burkitt's lymphoma (1/9). Gastrointestinal (GI) malignancies [i.e., gastric cancer (3/14), rectal cancer (3/14), and esophageal cancer (1/14)] and hepatocellular carcinoma (3/14) were the most commonly observed among the non-AIDS-defining malignancies. Other observed non-AIDS-defining malignancies were thyroid cancer (1/14), tonsillar cancer (1/14), angiosarcoma (1/14), and eccrine cancer (1/14). Finally, median CD4+ lymphocyte counts at the time of diagnosis were significantly different (18 vs. 114/uL, p=0.001) between AIDS-defining malignancies and non-AIDS-defining malignancies. CONCLUSIONS: Malignancies were diagnosed in 4.0% of patients infected with HIV. This study showed similar rates of incidence between AIDS-defining and non-AIDS-defining malignancies. Non-Hodgkins lymphoma was the most frequently observed malignancy, whereas GI malignancies and hepatocellular carcinoma were common among non-AIDS-defining malignancies.


Subject(s)
Humans , Male , Acquired Immunodeficiency Syndrome , Burkitt Lymphoma , Carcinoma, Hepatocellular , Electronics , Electrons , Esophageal Neoplasms , Hemangiosarcoma , HIV , Incidence , Lymphocyte Count , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Prevalence , Rectal Neoplasms , Retrospective Studies , Sarcoma, Kaposi , Stomach Neoplasms , Thyroid Neoplasms , Tonsillar Neoplasms
17.
The Korean Journal of Internal Medicine ; : 368-373, 2009.
Article in English | WPRIM | ID: wpr-33198

ABSTRACT

BACKGROUND/AIMS: Serum ferritin is a marker of acute phase reactions and iron storage. In addition, hematologic malignancies are associated with elevated serum ferritin levels. Other studies have suggested that ferritin is a surrogate for advanced disease and has an impact on relapse, because elevated serum ferritin predicts overall survival (OS) and relapse-free survival following autologous stem cell transplantation for lymphomas. METHODS: We studied 89 consecutive patients with newly diagnosed multiple myeloma to determine the value of serum ferritin in comparison with known prognostic factors. RESULTS: The OS in the elevated serum ferritin group (> or =300 ng/mL) was shorter than that in the normal serum ferritin group (<300 ng/mL, p<0.001) after a median follow-up of 25 months. In univariate analysis, elevated ferritin was correlated with poor survival in the patients (relative risk [RR], 2.588; 95% confidence interval [CI], 1.536 to 4.358; p<0.001). Furthermore, multivariate analysis showed that elevated serum ferritin was an independent predictor of mortality in patients with multiple myeloma (RR, 2.594; 95% CI, 1.403 to 4.797; p=0.002). CONCLUSIONS: The serum ferritin can a prognostic parameter of survival as well as disease activity in patients with multiple myeloma.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , C-Reactive Protein/analysis , Ferritins/blood , Multiple Myeloma/blood , Prognosis , Proportional Hazards Models , beta 2-Microglobulin/blood
18.
Korean Journal of Hematology ; : 83-88, 2008.
Article in Korean | WPRIM | ID: wpr-720807

ABSTRACT

BACKGROUND: Although the platelet count may not always correlate with the risk of thrombosis, there is evidence that a strict control of the platelet count decreases the incidence of thrombotic and hemorrhagic complications. However, it is difficult to select an appropriate platelet-lowering agent. This retrospective study was performed to assess the efficacy and adverse effect of the use of hydroxyurea and anagrelide for patients with essential thrombocythemia. METHODS: Sixty patients with essential thrombocythemia received either hydroxyurea (n=30) or anagrelide (n=30). Early responses and adverse effects of hydroxyurea and anagrelide in the patients were retrospectively analyzed. RESULTS: Treatment with anagrelide or hydroxyurea resulted in a rapid decrease of the platelet count within two weeks. The response rates after treatment with hydroxyurea and anagrelide were 83% and 77%, respectively. As compared with patients treated with hydroxyurea, patients treated with anagrelide presented with adverse effects such as headache palpitation was also frequently noticed (P=0.001). However, serious hemorrhage (n=2) and transformation to leukemia (n=1) occurred in patients treated with hydroxyurea. CONCLUSION: Both anagrelide and hydroxyurea were effective and well-tolerated agents for the reduction of the platelet count. Long-term efficacy and adverse effects of the drugs remain to be determined.


Subject(s)
Humans , Headache , Hemorrhage , Hydroxyurea , Incidence , Leukemia , Platelet Count , Quinazolines , Retrospective Studies , Thrombocythemia, Essential , Thrombosis
19.
Korean Journal of Hematology ; : 122-125, 2008.
Article in Korean | WPRIM | ID: wpr-720521

ABSTRACT

A 52-yr-old male with multiple myeloma underwent autologous stem cell transplantation in June 2002. In August 2004, the multiple myeloma had recurred. The patient received allogenic stem cell transplantation in September 2005. Before undergoing transplantation, the presence of HBsAb and the absence of HBsAg were noted. The patient underwent allogenic peripheral blood stem cell transplantation (PBSCT) from a sibling donor who was hepatitis surface antibody (HBsAb) positive and hepatitis surface antigen (HBsAg) negative. Nineteen months after the PBSCT, the liver function tests showed elevation of the aminotransferases. The patient was HBsAg positive and HBsAb negative. The liver biopsy specimen revealed hepatitis. The reactivation of a hepatitis B virus infection, in a hepatitisB immune patient, referred to as reverse seroconversion, is a rare complication of hematopoietic stem cell transplantation.


Subject(s)
Humans , Male , Antigens, Surface , Biopsy , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Hepatitis , Hepatitis B , Hepatitis B Surface Antigens , Hepatitis B virus , Liver , Liver Function Tests , Multiple Myeloma , Peripheral Blood Stem Cell Transplantation , Siblings , Stem Cell Transplantation , Tissue Donors , Transaminases , Transplants
20.
Korean Journal of Hematology ; : 272-275, 2008.
Article in Korean | WPRIM | ID: wpr-720438

ABSTRACT

Granulocytic sarcoma is a localized tumor that's composed of immature granulocytic cells and this is more common in patient with 8;21 translocation. We present here a case in a 64-year-old man who was diagnosed with acute myelogenous leukemia (erythroleukemia) that had a complex hyperdiploid karyotype. While he underwent chemotherapy, he developed nausea, vomiting, headache and dysarthria. After several diagnostic work-ups, granulocytic sarcoma in the cerebellum and leptomeningeal metastasis of his leukemia were found on the magnetic resonance imaging and the cerebrospinal fluid cytology.


Subject(s)
Humans , Middle Aged , Brain , Cerebellum , Dysarthria , Headache , Karyotype , Leukemia , Leukemia, Erythroblastic, Acute , Leukemia, Myeloid, Acute , Magnetic Resonance Imaging , Nausea , Neoplasm Metastasis , Sarcoma , Sarcoma, Myeloid , Vomiting
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