Prevalent factor XII deficiency in cancer patients with isolated aPTT prolongation

No abstract available.

A Case of Scleroderma-like Cutaneous Lesions Induced by Docetaxel in a Patient with Breast Cancer

Docetaxel, an anti-microtubule agent, has been reported to show cytotoxic effects in solid tumors. Its toxicities also include neutropenia, alopecia, skin reaction, and fluid retention. In this study, we report on a case of a 57-year-old Korean female who presented with rapidly progressive scleroderma-like cutaneous changes in the upper and lower extremities after administration of docetaxel. Results of the following tests were normal or negative: full blood count, serum urea, creatinine, electrolytes, liver function test, thyroid function test, rheumatoid factor, anti-nuclear antibody, and anti-topoisomerase antibody. No structural abnormalities were noted on esophagogastroduodenoscopy, chest computed tomography, and Doppler ultrasonography. A biopsy of skin from the left calf showed dermal sclerosis. There was no other explanation for the lesion, except a scleroderma-like cutaneous change induced by docetaxel in this Korean female undergoing treatment for breast cancer.

Clinical characteristics and outcomes of primary bone lymphoma in Korea

BACKGROUND: This study evaluates the effectiveness of immunochemotherapy and radiation therapy in the treatment of patients with primary bone lymphoma (PBL). METHODS: We retrospectively reviewed the medical records of 33 patients with PBL who were treated at 6 medical centers in Korea from 1992 to 2010. Clinicopathological features and treatment outcomes were analyzed. RESULTS: The median age of the patients participating in our study was 40 years. The most common sites of involvement were the pelvis (12.36%) and femur (11.33%). CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) or CHOP-like regimens were administered to 20 patients (61%), and R-CHOP (rituximab plus CHOP) was administered to the remaining 13 patients (39%). The overall response rate was 89% (complete response, 76%; partial response, 12%). The overall survival (OS) of patients with solitary bone lesions was longer than that of patients with multiple bone lesions (median OS: not reached vs. 166 months, respectively; P=0.089). Addition of rituximab to CHOP did not significantly affect either OS or progression-free survival (P=0.53 and P=0.23, respectively). Combining radiation therapy with chemotherapy also did not improve the OS or progression-free survival of patients with solitary bone lesions. CONCLUSION: Conventional cytotoxic chemotherapy remains an effective treatment option for patients with PBL. Additional benefits of supplementing chemotherapy with either rituximab or radiation therapy were not observed in this study. Further investigation is needed to characterize the role of immunochemotherapy in treating patients with PBL.

A Case of Hantavirus Pulmonary Syndrome Mimicking Apalastic Anemia with Invasive Aspergillosis

Hantavirus is known to a causative agent of hemorrhagic fever with renal syndrome and it can cause hantavirus pulmonary syndrome, a rare disease in Korea. Hantavirus pulmonary syndrome is usually associated with pulmonary hemorrhage and fever. The common hematologic features of this syndrome are elevated hematocrit level, leukocytosis and thrombocytopenia. We report a case of hantavirus pulmonary syndrome with pancytopenia. This patient with severe neutropenia with pulmonary infiltration mimicked aplastic anemia with invasive aspergillosis.

A Phase II Trial of Paclitaxel, 5-fluorouracil (5-FU) and Cisplatin in Patients with Metastatic or Recurrent Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We wanted to assess the effectiveness and safety of combination chemotherapy with paclitaxel, 5-fluorouracil (5-FU) and cisplatin for treating advanced gastric cancer. MATERIALS AND METHODS: Patients with metastatic or recurrent gastric cancer were entered into this study. Paclitaxel at a dose of 135 mg/m2 on day 1, 5-FU 1 g/m2/ day in a 24 hour continuous infusion from day 1 to day 4 and cisplatin 60 mg/m2 on day 1 were administered. This regimen was repeated every 3 weeks. RESULTS: A total of 34 patients were enrolled in this study. Among them, 33 patients were finally evaluable for their response. 17 (51.5%) patients had a partial response (95% CI: 26.0~77.0%). The median duration of overall survival was 13.2 months. Grade 3 or 4 neutropenia and thrombocytopenia were observed in 15.2% and 1.1% of all the cycles, respectively. Grade 3 stomatitis and neurotoxicity were observed in 20.6% and 1.1% of all patients, respectively. Grade 4 non-hematologic toxicity was not observed. CONCLUSIONS: The regimen of paclitaxel, 5-FU and cisplatin demonstrated activity and accepatable toxicity for treating metastatic gastric cancer.

Gemcitabine and Carboplatin Combination Chemotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer: A Feasibility Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Although platinum based chemotherapy is known to improve the survival duration for the patients with non-small cell lung cancer, the role of platinum for elderly patient is not yet clear. We administered gemcitabine and carboplatin combination therapy to elderly patients with NSCLC. The aim of this study was to evaluate the efficacy and toxicities of this regimen for elderly patients. MATERIALS AND METHODS: The eligibility criteria were as follows: pathologically confirmed NSCLC, an age > or = 65 years, advanced disease with stage IIIB or IV and the patients were chemotherapy-naive. The treatment regimen was as follows; gemcitabine 1,000 mg/m2 was administered on days 1 and 8 and carboplatin AUC=5 was administered on day 1. This regimen was repeated every 3 weeks. The efficacy was evaluated in terms of the response rate, the time to progression and the overall survival duration. RESULTS: From Dec 2001 to Feb 2005, a total of 20 pa-tients were entered into this study. The median patient age was 68 years (range: 65~75). 19 patients were evaluable for their treatment response. A partial response was obtained in 8 patients (response rate: 42.1%, 95% CI: 19.4~64.8%). The median time to progression and the survival duration were 136 days and 453 days, respectively. Among a total of 65 cycles of treatment, grade 3 or 4 leukopenia and thrombocytopenia were observed in 7.7% and 13.9% of the cycles, respectively. Grade 3 or 4 vomiting was observed in 7.7% of the cycles. Grade 3 skin rash developed in 1.5% of the cycles. 1 patient died of septic shock after chemotherapy. CONCLUSIONS: Gemcitabine and carboplatin combination chemotherapy was relatively safe and effective for treating elderly patients with NSCLC.

Docetaxel and cisplatin combination chemotherapy for advanced gastric cancer failed to 5-fluorouracil-based chemotherapy / 대한내과학회지

BACKGROUND: There is no effective treatment in patients with advanced gastric cancer failed to first-line chemotherapy. Taxane is one of new drugs identified as having substantial activity in gastric cancer. We performed a phase II trial to evaluate the efficacy and toxicity of docetaxel plus cisplatin regimen as a salvage chemotherapy for advanced gastric cancer failed to 5-fluorouracil (5-FU)-based chemotherapy. METHODS: Metastatic or recurrent gastric cancer patients failed to 5-FU-based regimen with an Eastern Cooperative Oncology Group (ECOG) performance score < or = 2 were eligible in this trial. Docetaxel (60 mg/m2) was infused over 1 hour, before cisplatin (60 mg/m2) infused over 2 hours on day 1, once every 3 weeks until disease progression or unacceptable toxicity was detected. Response to treatment was assessed every two or three cycles. RESULTS: From October 1999 to December 2000, forty-one patients were enrolled in this study. Twenty-eight of forty-one patients were assessable for response. Partial response was observed in seven patients and stable disease in four patients. The response rate was 25.0% (95% confidence interval: 20.4~29.6%) and median duration of response was 22 weeks (range: 11~53 weeks). The median survival of all enrolled patients was 24 weeks (range: 7~65 weeks). For a total of 112 cycles of chemotherapy, grade 3 and 4 toxicity was 8.9% for neutropenia, 4.5% for nausea/vomiting and 1.8% for mucositis. CONCLUSION: Salvage chemotherapy with docetaxel plus cisplatin regimen in gastric cancer was active with acceptable toxicities.

A Case of Multiple Endocrine Neoplasia Type I Presenting with a Watery Diarrhea / 대한내분비학회지

MEN1 is characterized by the combined occurrence of tumors of the parathyroids, pancreatic islet cells and the anterior pituitary. Pancreatic islet cell tumors occur in 40% of MEN1 patients. Pancreatic polypeptidomas occur most commonly but they are asymptomatic. Gastrinomas are the second most common type. VIPomas are rare and there has been no report of a case in Korea so far. We encountered a case of pancreatic VIPoma in MEN Type I. A 49 year old man was referred from his local hospital presenting with a sudden onset of an explosive watery diarrhea of 3 months duration. Abnormal findings in his blood chemistry were hypercalcemia and hypokalemia. The 99mTc-sestamibi sintigraphy showed an increased uptake in right lower parathyroid gland. Abdominal CT demonstrated a mass of 6x4 cm in tail of the pancreas and multiple lesions in both hepatic lobes. Serum levels of VIP hormones were elevated. Subtotal parathyroidectomy and subtotal pancreatectomy were done. Postoperatively his symptoms were improved transiently, however the patient showed repetitive attacks of watery diarrhea. So in order to palliate his symptoms, an RF ablation of the metastatic liver masses was performed. After that therapy his clinical symptoms were reduced dramatically. Unfortunately, the patients condition worsened again. Despite of continuous octreotide therapy, interferon and two courses of combination chemotherapy, the hepatic metastases failed to regress and the patient died 10 months after the diagnosis of a metastatic VIPoma. This is the first report of pancreatic VIPoma in MEN type I in Korea.

Treatment of Refractory and Relapsed Acute Myeloid Leukemia with High-dose Cytarabine and Idarubicin / 대한혈액학회지

BACKGROUND: The therapeutic outcome for refractory or relapsed acute myeloid leukemia (AML) is very poor; it is difficult to expect the long-term disease free survival in these patients. We evaluated the therapeutic outcome of a salvage chemotherapy consisting of high- dose cytarabine and idarubicin. METHODS: From December 1995 to September 2000, 20 patients (12 patients with primary refractory AML and 8 patients with first relapsed AML) were treated with the regimen that included cytarabine 3.0g/m2 (1.5g/m2 for patients >or=50 years of age) over 3 hours every 12 hours for 12 doses (D1-6, total 36g/m2) plus 12mg/m2 idarubicin for 3 days (D2-4) by intravenous infusion. RESULTS: The complete remission (CR) rate was 55.0% (95% confidence interval, 31.2 ~ 78.8%): 58.3% (7 of 12) for refractory AML and 50.0% (4 of 8) for relapsed AML. The causes of remission induction failure were resistant disease (15.0%, 3 of 20) and early death from infection (30.0%, 6 of 20). The median duration of disease free survival of the CR patients was 15 months (range, 1~59 months) and the median duration of overall survival of all patients was 6 months (range, 0~61 months). The median time of neutrophil recovery over 500/nL from the initiation of chemotherapy was 31 days and the median time of platelet recovery over 20X10(3)/nL was 32 days. For a total of 20 patients, grade 3 and 4 toxicity were observed in 20.0% for nausea/vomiting, 20.0% for diarrhea and 5.0% for stomatitis. CONCLUSIONS : We found that a combination chemotherapy of high-dose cytarabine and idarubicin was an effective salvage regimen for patients with refractory or relapsed acute myeloid leukemia. However aggressive supportive care is necessary to minimize the treatment related morbidity and mortality resulting from prolonged myelosuppression.

The Influence of Mycophenolate(MMF) and Azathioprine(AZA) in the Same Cadaveric Renal Transplantation / 대한신장학회잡지

OBJECTIVE: In order to evaluate how immunosuppressive agents such as MMF and AZA would influence on the outcome of the graft kidney, we analyzed the incidence of acute rejection episodes and one year graft survival rate after minimizing influences of donor factors by grafting the same cadaveric donor kidney. METHODS: From April, 1998 to January, 2000, sixty eight patients grafted by 34 cadaver donors were enrolled in our study. From the same donor, one was randomly assigned to the MMF group(n=34) who were treated with cyclosporine, MMF, prednisolone while the other kidney was assigned to the AZA group(n=34) with cyclosporine, AZA, prednisolone. We analyzed the incidence of acute rejection episodes and CMV infection within the first 6 months of renal transplantation and one year graft survival rate was studied prospectively. RESULTS: There were no significant differences in sex, HLA mismatch, cold ischemic time, and patients' weight between two group. Acute rejection or treatment failure occurred in 35.3% in the MMF group by 6 months after transplant, compared with 32.4% in the AZA group without statistic significance(12/34 vs. 11/34, p>0.05). One year graft survival rate was 91.2% and 97.1%, respectively, and CMV infection was documented in 4 patients(1/34 vs. 3/34, p>0.05). CONCLUSION: There were no significant differences in the incidence of acute rejection episodes and one year graft survival rate between two groups. In contrast, previous studies showed that MMF could have lowered the incidence of acute rejection episodes and improved graft survival rate. This discrepancy in results might be explained that donor factors were important to cadaveric renal transplantation. Thus, we suggest that the influences of donor factors should be considered in further clinical study of cadaveric renal trans-plantation.