A case of peripheral T-cell lymphoma with central nervous system and bilateral pulmonary involvement / 대한내과학회지

Mature T-cell non-Hodgkin's lymphoma (NHL) has more frequent extranodal involvement and is less sensitive to chemotherapy than B-cell lymphoma. Peripheral T-cell lymphoma unspecified (PTCL-U) is rarely combined with pulmonary or CNS involvement. We report a case of PTCL-U with lung and CNS involvement that was treated with high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). A 62-year-old man was admitted with right-side weakness and paresthesias, and was diagnosed with PTCL-U after alung biopsy. Successful complete remission was achieved after threecycles of IMEP (ifosfamide, methotrexate, etoposide, and prednisone) chemotherapywith concurrent intrathecal chemotherapy and subsequent high-dose chemotherapy with ASCT to treat potential advanced stage PTCL-U. The non-anthracycline-containing IMEP regimen can be effective for PTCL-U, especially in cases with CNS involvement.

A Case of Steroid Refractory Acute GVHD Treated with IL-2 & TNF-alpha Blocker in a Myelodysplastic Syndrome Patient who Underwent Unrelated Allogeneic Stem Cell Transplantation

Hematopoietic stem cell transplantation has evolved as a central treatment modality for the management of various hematologic malignancies. Despite adequate posttransplantation immunosuppressive therapy, acute GVHD remains a major cause of morbidity and mortality, even for the patients who have received HLA identical sibling grafts. Once established, acute GVHD is difficult to treat, and the best primary treatments such as corticosteroid have shown responses of approximately 50%. Once GVHD becomes steroid-refractory, the chances of survival are slim at best, and the possibility of long-term complications from chronic GVHD is almost always the rule. Many agents are currently being evaluated to treat this malady, including ATG, monoclonal antibodies, pentostatin, denileukin diftitox, etc. We reported here on a case of steroid refractory acute GVHD that was treated with IL-2 and TNF-alpha blocker in myelodysplastic syndrome patient who underwent unrelated allogeneic stem cell transplantation.

A case of successful allogeneic bone marrow transplantation in a HBV-positive severe aplastic anemia patient with prophylactic lamivudine treatment / 대한내과학회지

Reactivation of hepatitis B virus (HBV) infection has been known to be a serious complication of immunosuppressive or cytotoxic chemotherapy in HBV carriers or chronic hepatitis B patients. We report here a 25-year-old woman who has severe aplastic anemia and chronic hepatitis B underwent successful allogeneic bone marrow transplantation (BMT) with prophylactic lamivudine treatment and showed no evidence of reactivation of hepatitis B, HBV DNA elevation, or liver dysfunction. This result suggests that prophylactic administration of lamivudine to a BMT recipient of chronic hepatitis B might be a safe and promising measure to prevent fatal liver dysfunction.

Eosinophilic fasciitis preceding relapse of peripheral T-cell lymphoma

Although eosinophilic fasciitis (EF) may precede hematologic malignancy or Hodgkin's disease, association with peripheral T-cell lymphoma (PTCL) is extremely rare. Only four cases of EF preceding or concomitant PTCL have been reported in the world literature. We experienced the first Korean case of EF complicated by the later relapse of peripheral T-cell lymphoma. A 63-year-old Korean male has been followed at our outpatient clinic periodically after treatment for stage IV PTCL. He had been in complete remission for seven and a half years when he developed edema of both lower extremities followed by sclerodermatous skin change in both hands with peripheral eosinophilia. Biopsy from the left hand showed fibrous thickening of the fascia with lymphoplasmacytic and eosinophilic infiltrate, consistent with EF. Twenty-five months later, a newly developed lymph node from the left neck showed recurrence of PTCL. EF may occur as a paraneoplastic syndrome associated with the relapse of PTCL. Therefore, in a patient with EF, the possibility of coexisting and/or future occurrence of hematologic neoplasm should be considered.

Study on Growth Suppression Effect of Vetamin D3 Mediated by Transfrorming Growth Factor-B1(TGF-B1) in Acute Myelogenous Leukemic Cell / 대한암학회지

PURPOSE: Vitamin D3 was shown to arrest the growth of acute myelogenous leukemic cells and transforming growth factor- B1 (TGF- B1) was reported to be involved in the mechanism of vitamin D3. We studied the growth inhibitory effect of 1,25(OH)2-vitamin D3(C) and its analogue (EB1089) in leukemic cell lines and the changes in the secretion or the activation of TGF-B1 in the supernatant and the status of TGF-B1 type II receptor. MATERIALS AND METHODS: Growth inhibition by vitamin D3 and TGF-B1 in 5 leukemic cell lines (HEL, HL-60, U937, KG-1, K562) were assessed with clonogenic and [3H]thymidine assay respectively. TGF-B type II receptor status was examined by Southern and Northern blotting. The concentrations of TGF- B1 in the supernatant were quantitated by enzyme immunoassay. RESULTS: The growth of HEL, HL-60, U937 were inhibited in a dose-dependent fashion by both C and EB1089, more markedly by the latter. Anti-TGF-B neutralizing antibody partially reversed the growth inhibition. TGF-B1 markedly inhibited the growth of HEL, U937, KG-1, SNU-16 dose dependently while HL-60 and K562 showed no growth inhibition. HEL secreted latent TGF- 1 and HL-60 activated latent TGF- B1 or secreted active TGF-B1 irrespective of the treatment with vitamin D3. In U937, vitamin D3 increased the concentration of both active and latent TGF-B1. Deletion or abnormal expression of TGF- B type II receptor gene was not found in the 5 cell lines examined. CONCLUSION: Vitamin D3 has various pattern of growth inhibition in acute myelogenous leukemia and inhibits the growth of some cell lines by secretion or activation of TGF-B1. Abnormality of TGF-B type II receptor DNA or mRNA seems to be rare.