Intensified First Cycle of Rituximab Plus Eight Cycles of Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone with Rituximab Chemotherapy for Advanced-Stage or Bulky Diffuse Large B-Cell Lymphoma: A Multicenter Phase II Consortium for Improving Survival of Lymphoma (CISL) Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This phase II, open-label, multicenter study aimed to investigate the efficacy and safety of a rituximab intensification for the 1st cycle with every 21-day of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP-21) among patients with previously untreated advanced-stage or bulky diffuse large B-cell lymphoma (DLBCL). @*Materials and Methods@#Ninety-two patients with stage III/IV or bulky DLBCL from 21 institutions were administered 8 cycles of R-CHOP-21 with an additional one dose of rituximab intensification on day 0 of the 1st cycle (RR-CHOP). The primary endpoint was a complete response (CR) rate after 3 cycles of chemotherapy. @*Results@#Among the 92 DLBCL patients assessed herein, the response rate after 3 cycles of chemotherapy was 88.0% (38.0% CR+50.0% partial response [PR]). After the completion of 8 cycles of chemotherapy, the overall response rate was observed for 68.4% (58.7% CR+9.8% PR). The 3-year progression-free survival rate was 64.0%, and the 3-year overall survival rate was 70.4%. Febrile neutropenia was one of the most frequent grade 3 adverse events (40.0%) and 5 treatment-related deaths occurred. Compared with the clinical outcomes of patients who received R-CHOP chemotherapy as a historical control, the interim CR rate was higher in male patients with RR-CHOP (20.5% vs. 48.8%, p=0.016). @*Conclusion@#Rituximab intensification on days 0 to the 1st cycle of the standard 8 cycles R-CHOP-21 for advanced DLBCL yielded favorable response rates after the 3 cycles of chemotherapy and acceptable toxicities, especially for male patients. ClinicalTrials.gov ID: NCT01054781.

Safety and efficacy of nilotinib in adult patients with chronic myeloid leukemia: a post-marketing surveillance study in Korea

Background@#Nilotinib is a tyrosine kinase inhibitor approved by the Ministry of Food and Drug Safety for frontline and 2nd line treatment of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML). This study aimed to confirm the safety and efficacy of nilotinib in routine clinical practice within South Korea. @*Methods@#An open-label, multicenter, single-arm, 12-week observational post-marketing surveillance (PMS) study was conducted on 669 Korean adult patients with Ph + CML from December 24, 2010, to December 23, 2016. The patients received nilotinib treatment in routine clinical practice settings. Safety was evaluated by all types of adverse events (AEs) during the study period, and efficacy was evaluated by the complete hematological response (CHR) and cytogenetic response. @*Results@#During the study period, AEs occurred in 61.3% (410 patients, 973 events), adverse drug reactions (ADRs) in 40.5% (271/669 patients, 559 events), serious AEs in 4.5% (30 patients, 37 events), and serious ADRs in 0.7% (5 patients, 8 events). Furthermore, unexpected AEs occurred at a rate of 6.9% (46 patients, 55 events) and unexpected ADRs at 1.2% (8 patients, 8 events). As for the efficacy results, CHR was achieved in 89.5% (442/494 patients), and minor cytogenetic response or major cytogenetic response was achieved in 85.8% (139/162 patients). @*Conclusion@#This PMS study shows consistent results in terms of safety and efficacy compared with previous studies. Nilotinib was well tolerated and efficacious in adult Korean patients with Ph + CML in routine clinical practice settings.

Introduction of Multidisciplinary Team Approach for Head and Neck Cancer: Patient Satisfaction / 대한이비인후과학회지

Background and Objectives@#The head and neck multidisciplinary team (MDT) approach plays a crucial role in bringing together the ideas of various medical professionals. This study aimed to evaluate the early characteristics of the MDT approach for head and neck cancer and analyzed patients’ satisfaction.Subjects and Method We analyzed 450 head and neck cancer patients who received MDT care from August 2014 to June 2022. Patient satisfaction with MDT care was evaluated by selfadministered questionnaires consisting of 9 questions. @*Results@#Of 450, 298 (66.2%) were male and 152 (33.8%) were female. The mean age was 60.8±14.7 year. The most common primary site was the larynx (17.3%), followed by the oral cavity and oropharynx. A total of 726 cases of the MDT approach were performed in 266 MDT sessions, and the mean number of patients per MDT session was 2.74. The number of medical professionals participating in MDT ranged from a minimum of 3 to a maximum of 9, with a mean of 5.11. The mean running time of MDT meetings per case was 19.51 minutes. The time of the 2nd MDT was significantly shorter than that of the 1st or 3rd MDT. The mean score was close to very satisfactory in each of the 9 patient satisfaction questions. @*Conclusion@#We believe that the MDT approach is feasible and recommend its introduction for the treatment of head and neck cancer as most patients have shown very high satisfaction. Further studies on the role and efficacy of MDT care for head and neck cancer are necessary.

Characteristics of Advanced Gastric Cancer Undetected on Gastroscopy / 대한소화기학회지

BACKGROUND/AIMS: Stomach cancer can be easily diagnosed via endoscopy, but also possible to be missed. The aim of this study was to investigate the clinical and endoscopic characteristics of advanced gastric cancers that were not diagnosed based on endoscopic examination. METHODS: We evaluated patients who had newly diagnosed advanced gastric cancer that was undetected via endoscopy within the last six months. RESULTS: Sixteen patients were included in this study. The locations of the cancers were the cardia in six cases, the greater curvature side of the body in eight cases and the antrum in two cases. The histological findings were tubular type adenocarcinoma in 11 cases, with ten cases of moderately to poorly differentiated adenocarcinoma and five cases of signet ring cell type adenocarcinoma. CONCLUSIONS: Even advanced gastric cancer lesions may not be detected during endoscopy. If a patient continues to complain of upper gastrointestinal symptoms, even though endoscopy does not find abnormal findings, repeated endoscopy and/or additional diagnostic studies should be considered.

Pure Red Cell Aplasia Caused by Acute Hepatitis A / 전남의대학술지

Pure red cell aplasia is characterized as a normocytic anemia associated with reticulocytopenia and the absence of erythroblasts in the bone marrow. Pure red cell aplasia can be induced by various causes such as thymoma, connective tissue disease, viral infection, lymphoma, and adverse drug reactions. There have been only a few reports of pure red cell aplasia associated with acute viral hepatitis A. In Korea, no case of pure red cell aplasia caused by acute hepatitis A has yet been reported. We recently experienced a case of acute viral hepatitis A complicated by pure red cell aplasia. The patient was successfully treated with corticosteroids. Here we report this case and review the literature.

Health insurance system for hematologic diseases: what should we do?

No abstract available.

Pure Red Cell Aplasia Caused by Acute Hepatitis A / 전남의대학술지

Pure red cell aplasia is characterized as a normocytic anemia associated with reticulocytopenia and the absence of erythroblasts in the bone marrow. Pure red cell aplasia can be induced by various causes such as thymoma, connective tissue disease, viral infection, lymphoma, and adverse drug reactions. There have been only a few reports of pure red cell aplasia associated with acute viral hepatitis A. In Korea, no case of pure red cell aplasia caused by acute hepatitis A has yet been reported. We recently experienced a case of acute viral hepatitis A complicated by pure red cell aplasia. The patient was successfully treated with corticosteroids. Here we report this case and review the literature.

The Clinical Usefulness of Focally Enhanced Gastritis in Korean Patients with Crohn's Disease / 대한소화기학회지

BACKGROUND/AIMS: Focally enhanced gastritis (FEG) has been suggested as a specific diagnostic marker for patients with Crohn's disease (CD). However, the usefulness of FEG for distinguishing CD from ulcerative colitis (UC) is uncertain and the incidence or prevalence of FEG for inflammatory bowel disease (IBD) patients in Korea has not been defined yet. In this study, we investigated the frequency of FEG and other gastric histological abnormalities in Korean patients with CD and UC. METHODS: We evaluated 37 patients with known CD, 43 patients with UC and 41 non-IBD control group; all underwent upper gastrointestinal endoscopy followed by biopsy from the antrum and the body. The pathology of the gastric biopsy specimens and the presence of Helicobacter pylori (H. pylori) were evaluated. FEG was characterized by a focal perifoveolar or periglandular inflammatory cell infiltrates. RESULTS: H. pylori positive gastritis was found in 10 of 37 (27.0%) of CD patients, in 16 of 43 (37.2%) of UC patients, and in 22 of 41 (53.7%) of non-IBD control group (p=0.054). In H. pylori-negative patients, FEG was found in 8 of 27 patients (29.6%) of CD patients, 6 of 27 (22.2%) patients with UC, and 2 of 9 (10.5%) of non-IBD control group (p=0.324). CONCLUSIONS: In H. pylori-negative patients, there was no statistically significant difference in the occurrence of FEG among CD, UC and control groups in Korea.

Comparison of Helicobacter pylori Eradication Rate in Patients with Non-ulcer Dyspepsia and Peptic Ulcer Diseases according to Proton Pump Inhibitors / 대한소화기학회지

BACKGROUND/AIMS: Conflicting results have been reported whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H. pylori) eradication treatment compared with patients with peptic ulcer diseases (PUD). The aim of this study was to evaluate any difference in H. pylori eradication rates between patients with NUD and PUD according to each proton pump inhibitor (PPI). METHODS: From September, 2004 to April, 2007, we retrospectively reviewed 2,297 patients with NUD (1,050 patients) or PUD (1,247 patients) infected with H. pylori. All patients received a standard 1 week triple therapy comprising of one of the five PPIs (pantoprazole, esomeprazole, omeprazole, lansoprazole, rabeprazole), clarithromycin and amoxicillin. The follow-up H. pylori test was performed 4 weeks after the completion of therapy. RESULTS: There was no significant difference in the eradication rates between the two groups. In comparison of eradication rates according to PPI, omeprazole- based triple therapy group showed higher eradication rate than other groups in patients with NUD, but not in patients with PUD. CONCLUSIONS: This study failed to show any difference in H. pylori eradication rate between patients with NUD and PUD. There is no convincing evidence that the eradication rate may be affected by different PPI.

Effectiveness of 10 Day-sequential Therapy for Helicobacter pylori Eradication in Korea / 대한소화기학회지

BACKGROUND/AIMS: Antibiotic resistance and poor compliance are the main causes of Helicobacter pylori (H. pylori) eradication failure. Proton pump inhibitor (PPI)-based triple therapy is the most preferred regimen in clinical practice. However, a critical fall in the H. pylori eradication rate has been observed in the recent years. A novel 10 day-sequential therapy consists of five days of dual therapy followed by five days of triple therapy regimen has recently been described. We aimed to evaluate whether 10 day-sequential therapy eradicated H. pylori infection better than the PPI-based triple therapy in Korea. METHODS: 158 patients with proven H. pylori infection were randomized to receive either 10 day-sequential therapy (20 mg of omeprazole, 1.0 g of amoxicillin, each administered twice daily for the first 5 days, followed by 20 mg of omeprazole, 500 mg of clarithromycin, 500 mg of metronidazole, each administered twice daily for the remaining 5 days) or PPI-based triple therapy (20 mg of omeprazole, 1.0 g of amoxicillin, 500 mg of clarithromycin, each administered twice daily for 1 week). Outcome of eradication therapy was assessed 8 weeks after the cessation of treatment. RESULTS: Eradication rates of 10 day-sequential therapy and PPI-based triple therapy were 77.9% (60/77) and 71.6% (58/81) by intention to treat analysis, respectively (p=0.361). By per protocol analysis, eradication rates of 10 day-sequential therapy and triple therapy were 85.7% (60/70) and 76.6% (58/76), respectively (p=0.150). There were no significant differences in adverse event rates and treatment compliance between two groups. CONCLUSIONS: The 10 day-sequential therapy regimen failed to achieve significantly higher eradication rates than PPI-based triple therapy.

Assessment of nutritional status and prognosis in advanced metastatic cancer / 대한내과학회지

BACKGROUND: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The PINI (prognostic inflammatory nutritional index) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill patients. The aim of this study was designed to investigate the relationship between nutritional status after the palliative chemotherapy and prognosis in advanced metastatic cancer. METHODS: This study included 130 patients with ECOG PS (Eastern Cooperative Oncology Group performance status) 1~3 in advanced metastatic cancer following the palliative chemotherapy. ECOG PS, body mass index, alpha 1-acid glycoprotein, C-reactive protein, albumin, prealbumin, transferrin, protein, lactate dehydrogenase, PINI ratio, and survival time were evaluated. RESULTS: In 130 patients, the median age was 57 years. The ECOG PS was 1 68 patients, 2 43, 3 19. The mean value of PINI was PS 1 16.0+/-47.8, PS 2 55.6+/-106.9, PS 3 106.3+/-141.6. The mean survival was PS 1 144.0+/-71.8, PS 2 68.9+/-41.2, PS 3 32.0+/-6.9 days. In the PS 3 group, the mean values of alpha 1-acid glycoprotein, C-reactive protein, and lactate dehydrogenase were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of albumin, prealbumin, and transferrin were significantly lower than in the PS 1 group. The survival time was correlated with the ECOG PS (r=-0.602, p<0.001,), PINI (r=-0.318, p<0.001,), alpha 1-acid glycoprotein (r=-0.265, p=0.002), C-reactive protein (r=-0.345, p<0.001), albumin (r=0.324, p<0.001), prealbumin (r=0.260, p=0.003) and transferrin (r=0.277, p=0.001). CONCLUSIONS: The PINI may be a useful scoring system for the assessment of nutritional status and prognosis in advanced metastatic cancer following palliative chemotherapy, but the ECOG PS is most strong correlation with the survival time.

Ovarian Granulosa Cell Tumor presenting as Meigs' Syndrome with elevated CA125

Herein, a rare case of ovarian granulosa cell tumor, presenting as Meigs' syndrome, with elevated carbohydrate antigen 125 (CA125), is reported. A 69-year-old woman was admitted for the investigation of abdominal fullness and dyspnea. A preoperative examination revealed a huge pelvic tumor and an abdominopelvic magnetic resonance image (MRI) assumed ovarian cancer. A chest computed tomography (CT) scan revealed pleural effusion. A laparotomy confirmed the huge mass to be an ovarian tumor. A total abdominal hysterectomy (TAH), with a bilateral salpingo-oophorectomy (BSO) and partial omentectomy, was performed. Although short-term intrathoracic drainage was required, the hydrothorax and ascites rapidly resolved in the postoperative period.

A case of small bowel Burkitt's lymphoma in AIDS patient / 대한내과학회지

HIV-infected individuals have a high risk of developing non-Hodgkin lymphoma (NHL). NHL is the second most common malignant disorder associated with HIV infection, the first being Koposi's sarcoma. In the late 1990s, however, NHL became more common than Kaposi's sarcoma in some areas. Historically, AIDS-definding lymphomas have included systemic B-cell NHL (ie, immunoblastic and Burkitt's lymphoma) and primary brain lymphoma. We report a case of small bowel NHL in AIDS patient. A 58-year-old man presented with chronic fatigue and progressive abdominal pain. Gastroduodenal endoscopy shows multiple polypoid lesion on duodenum and diagnosed as Burkitt's lymphoma by histologic finding, immunohistochemical study associated with HIV positive. This is the first report of small bowel NHL from AIDS patients in Korea.

The Risk of Cytomegalovirus Infection in Non-myeloablative Peripheral Stem Cell Transplantation Compared with Conventional Bone Marrow Transplantation

Non-myeloablative allogeneic peripheral stem cell transplantation (NST) is a novel therapeutic strategy for patients with hematologic malignancies. Whether non-myeloablative transplants are associated with increased risk of cytomegalovirus (CMV) infections is unknown. To clarify this issue, we compared the outcome of CMV infection following 24 allogeneic non-myeloablative peripheral blood stem cell transplants and 40 conventional bone marrow transplants (CBT). The NST regimen consisted of busulfan (4mg/kg/day), fludarabine (30mg/m2) and anti-thymocyte globulin (10mg/kg). Twelve patients (50%) in the NST group and 17 (43%) in the CBT group developed positive antigenemia before day 100 (p=0.60). The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40), and two groups showed similar initial and maximal antigenemia values (p=0.56 and p=0.68, respectively). Only one case of CMV colitis developed in the CBT group whereas CMV disease did not develop in the NST group. Although statistically insignificant, the treatment response against CMV antigenemia using ganciclovir was in favor of NST group. In conclusion, there was no difference in the risk of CMV infection between NST group and CBT group. Further prospective and controlled study is needed to clarify the impact of non-myeloablative procedure on the outcome of CMV infection.

Clinical Significance of HER-2/neu Expression in Colon Cancer / 대한소화기학회지

BACKGROUND/AIMS: The HER-2/neu protein is involved in normal cell proliferation and tissue growth because it is extensively homologous and related to epidermal growth factor receptor. As a prognostic marker, HER-2/neu is used to forecast the clinical course and poor outcome in breast cancer. As a predictive marker, HER-2/neu is used to predict the therapeutic response to adjuvant chemotherapy and endocrine therapy in breast cancer. In this study, we investigated the relationships between clinical and pathologic characteristics of tumor and prognosis according to the HER-2/neu expression in colon cancer. This study was conducted for the future introduction of Herceptin(r) therapy for colon cancer patients. METHODS: Overexpression of HER-2/neu was examined by semiquantitative standardized immunohistochemical staining kit in 88 patients with colon cancer. The patients underwent curative surgery at the Kangbuk Samsung Hospital. RESULTS: Overexpression of HER-2/neu was detected in 11 (12.5%) of 88 patients. Tumors with positive HER-2/neu staining showed a tendency for higher rates of nodal metastasis and poor mean survival (1,646 +/- 269 vs 2,631 +/- 141 days) and 5-year survival (65.5% vs 78.9%). CONCLUSIONS: Tumors with positive HER-2/neu staining showed a tendency for higher rates for nodal metastasis and poor clinical survival rate.

Significance of Endoscopy in the Investigation of Iron Deficiency Anemia / 대한소화기내시경학회지

BACKGROUND/AIMS: There is no consensus for the role of endoscopy in the etiologic investigation of iron deficiency anemia (IDA) in Korea. We carried out a retrospective study to evaluate the role of esophagogastroduodenoscopy (EGD) and colonoscopy for their etiologic diagnosis in IDA. METHODS: Between January 1998 and September 2003, 129 patients (male:female=19:110, mean age=43.6) had been grew EGD and colonoscopy for exam for the investigation of IDA at Kangbuk Samsung Hospital and Samsung Medical Center Medical records were retrospectively reviewed: RESULTS: Significant findings were found in 8.5% (11 cases: grade B reflux esophagitis by L.A. classification (1), angiodysplasia (1), severe erosive gastritis (2), and gastric ulcer (2) and duodenal ulcer (5), while 70% (89 cases) showed some abnormality in EGD examination. Significant findings were seen in 11% (14 cases: polyps >1 cm (2), angiodysplasia (1), bleeding hemorrhoids (5), inflammatory bowel disease (4) and colon cancer (2)), among 36% (46 cases) of patients with some abnormality in colonoscopy. CONCLUSIONS: Gastrointestinal lesions were frequently found in patients with IDA and significant proportion of them could be the source of blood loss. Therefore, EGD and colonoscopy should be included in the evaluation of IDA in Korea.

Optimal midazolam dose, factors affecting midazolam dose and proper timing of flumazenil injection during esophagogastroduodenoscopy / 대한내과학회지

BACKGROUND: Intravenous administration of midazolam is widely used as a premedication for esophagogastroduonenoscopy. However, there are individual differences in midazolam doses for premedication and controversies for starting point of esophagogastroduonenoscopy after midazolam injection. There are also controversies for flumazenil injection time after esophagogastroduonenoscopy. The aims of this study were to determine the proper doses of midazolam for esophagogastroduonenoscopy and factors which affect midazolam doses. Also we evaluated the proper timing of flumazenil injection to increase patient's satisfaction according to sedation status. METHODS: 126 patients who were supposed to be taken diagnostic esophagogastroduonenoscopic exam were enrolled in this study. We evaluated the difference of patient's age, sex, alcohol consumption, sedation score, cooperation score, and satisfaction score according to midazolam doses. The relation between midazolam doses and agitation score, insomnia score, and somatic preoccupation score were checked. We evaluated the relation between midazolam doses and age, sex, alcohol consumption, amnesia, sedation, cooperation and satisfaction. RESULTS: There were no relationship between age, sex and midazolam doses. Alcoholics needed larger amount of midazolam than non-alcoholics. No differences in satisfaction were observed according to sedation status. There were significant relationship between midazolam doses and sedation score but not with satisfaction, cooperation, amnesia, agitation, insomnia and somatic preoccupation score. Patients who were injected flumazenil 20 minutes after esophagogastroduonenoscopy were more satisfied than patients who were injected flumazenil immediately after esophagogastroduonenoscopy. CONCLUSION: Minimal doses of midazolam that could induce mild sedation was enough and safe. Flumazenil injection 20 minutes after esophagogastroduonenoscopy was more efficacious than immediate injection.

Relationship between excretion of 51Cr-EDTA and mucositis in patients with 5-FU based chemotherapy / 대한내과학회지

BACKGROUND: Administration of anticancer drugs may damage gastrointestinal epithelium, thereby increasing the permeability of the gastrointestinal mucosa. It is known that intestinal permeability test using 51Cr-EDTA is a useful test to assess the damage of intestine. The aim of this study was to evaluate intestinal permeability in patients who were treated with 5-fluorouracil (5-FU) based chemotherapy and to evaluate the relationship between the excretion of 51Cr-EDTA and the grading of mucositis. METHODS: Twenty eight patients who were treated with 5-FU based chemotherapy were chosen as study cases while 18 healthy volunteers as controls. Intestinal permeability was assessed by measurement of the urinary excretion of 51Cr-EDTA after oral challenge, and the National Cancer Institute common toxicity criteria were used for assessing oral mucositis. RESULTS: All except 3 patients in the chemotherapy group experienced grade 1~3 stomatitis. The median value of intestinal permeability test was significantly higher in the chemotherapy group than in control group (7.61%, range 2.10-22.92 vs 2.17%, range 1.16-2.76, respectively, p<0.001). The grading of oral mucositis did correlate with the urinary excretion of 51Cr-EDTA (p<0.001, r=0.867). CONCLUSIONS: The measurement of 51Cr-EDTA excretion after oral challenge may be a useful test for evaluating the intestinal permeability by chemotherapy induced intestinal mucosal damage. Testing of intestinal permeability using 51Cr-EDTA may be applicable to evaluate the effect of therapeutic trials in patients with chemotherapy induced mucositis.

Preliminary Results of Paclitaxel, Cisplatin and Concurrent High-Dose Radiation Therapy for Locally Advanced Non-Small-Cell Lung Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To investigate the feasibility, toxicity and response rate, of concurrent chemoradiation therapy with paclitaxel/cisplatin in stage III locally advanced non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between May 1999 and December 2000, 80 patients with stage III NSCLC were enrolled in a prospective protocol. Radiotherapy was given to a total dose of 70.2 Gy (daily fraction of 1.8 Gy for 5 days), over an 8 week period, on the gross tumor volume, combined with chemotherapy. The concurrent chemotherapy consisted of paclitaxel (40 mg/m2) and 20 mg/m2 cisplatin per week for 8 consecutive weeks. All patients received 3-D conformal radiotherapy using CT-simulated planning. Acute toxicities were evaluated by the RTOG scale. The median follow-up period was 16 months, ranging from 3 to 29 months. RESULTS: Of the 80 patients, 71 received treatment per protocol, with minor variation of protocol delivery. The median age of the patients was 60 years. Karnofsky Performance status were 100 and 90 in 62 patients, and 80 and 70 in 9, respectively. Weight loss of less than 5% for 6 months was observed in 22 patients. The response to treatment was evaluated from the radiological findings. Complete and partial responses were observed in 8 and 51 patients, respectively. Ultimately, 82% of patients (included complete responses: 8 cases) obtained more than a partial response. Although, radiation induced esophagitis was the most common treatment related toxicity, occurring in 44 patients (69%), severe radiation esophagitis like, grade 3, was observed in only 3 patients, and the most acute toxicities had completely recovered 1 month following treatment. The overall 2-year actuarial and progression free survivals were 56 and 45%, respectively. CONCLUSION: This combined modality has activity with manageable toxicity and 23 months in mean survival time in patients with stage III NSCLC. A longer follow up will be required to realise the expected higher survival of these results.

A Case of Acute Promyelocytic Leukemia with 46, XX, del(5)(q23)/47, XX, del(5)(q23), +8 but Without (15;17) Translocation / 대한혈액학회지

Acute promyelocytic leukemia (APL/AML- M3) is a distinct subtype of acute myelogenous leukemia, which is characterized by unique morphologic, cytogenetic, molecular, and clinical features. In almost all APL patients, a characteristic t(15;17)(q22;q21) is found, resulting from the fusion of the PML gene and retinoic acid receptor alpha (RAR ) gene. This chromosomal translocation in APL may present variant translocations, and may be associated with secondary chromosomal abnormalities. The most frequent accompanying karyotypic aberration is trisomy 8 in APL. We are reporting a case of a 17-year-old woman who was diagnosed with APL. Cytogenetic study revealed that 46, XX, del(5)(q23)/47, XX, del(5)(q23), +8 chromosomal abnormality but without t(15;17). However, the presence of PML/RAR chimera was found with reverse transcriptase PCR. It is well known that the association of trisomy 8 on top of t(15;17) in APL cases. However, in our review, the mosaicism of del(5)(q23) with trisomy 8 in APL might be the first case. Whether this patient will behave the typical APL cases having good prognosis or not will be interesting to see.