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1.
EFORT Open Rev ; 7(12): 817-826, 2022 Dec 21.
Article in English | MEDLINE | ID: mdl-36541537

ABSTRACT

Low-intensity pulsed ultrasound (LIPUS) treatment of fractures has been available to the orthopaedic community for nearly three decades; however, it is still considered an experimental treatment by some clinicians, even though there is a wealth of clinical data. Based on the evaluation of clinical trial data, we have established key criteria which can lead to LIPUS success and avoid failure. These are fracture gap size and stability, accurate transducer placement and minimum treatment number. However, from a clinician's view, the correct attitude to treatment must be observed, and this has also been discussed. It is hoped, armed with this new evaluation of the clinical data, that clinicians can treat patients with LIPUS more effectively, resulting in fewer failures of treatment.

2.
Asia Pac Allergy ; 11(3): e34, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34386410

ABSTRACT

BACKGROUND: Interleukin (IL)-35 has been recently identified as an anti-inflammatory cytokine in allergic inflammation. However, its biological role in the pathogenesis of allergic rhinitis has not been fully elucidated. OBJECTIVE: The purpose of this study was to investigate the anti-inflammatory activity of IL-35 in the pathogenesis of allergic rhinitis in patients with Japanese cedar pollinosis (JCP). METHODS: Peripheral blood mononuclear cells were collected from healthy controls and JCP patients during the off-season for pollen. Peripheral blood mononuclear cells were incubated with Cry j 1, a major allergen of Japanese cedar pollen and production of IL-5, IL-13, and IL-35 were measured by enzyme-linked immunosorbent assay. Th2 (CD4+ST2+) cells and group 2 innate lymphoid cells were isolated from peripheral blood mononuclear cells of JCP patients, and the inhibitory effects of IL-35 on cell differentiation, proliferation and mRNA expression of IL-5, IL-13, and GATA3 were examined. B cells were also isolated and the effects of IL-35 on total IgE production were examined. RESULTS: Cry j 1-induced production of IL-5 and IL-13 was significantly increased in peripheral blood mononuclear cells from JCP patients, whereas Cry j 1-induced IL-35 production was significantly decreased compared with healthy controls. IL-35 significantly inhibited Th2 cell differentiation, group 2 innate lymphoid cell proliferation, and mRNA expression of IL-5, IL-13, and GATA3 in Th2 cells and group 2 innate lymphoid cells. IL-35 also inhibited IgE production from B cells. CONCLUSION: IL-35 is an important anti-inflammatory cytokine in JCP, and its biological roles include the downregulation of Th2 cells and group 2 innate lymphoid cells, and the inhibition of IgE production from B cells. These findings demonstrate that IL-35 may have the potential to exert anti-allergic effects for the treatment of allergic rhinitis.

3.
Int J Hematol ; 109(4): 418-425, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30725360

ABSTRACT

Given the poor prognosis of patients with relapsed/refractory acute myeloid leukemia (AML), better therapy is needed. Fludarabine enhances the efficacy of Ara-C (cytarabine) by increasing intracellular Ara-C-triphosphate. The FLAG (fludarabine, high-dose Ara-C, supported with granulocyte colony-stimulating factor) regimen has been tested for use in AML patients by other investigators. In the phase II study reported here, we evaluated the efficacy and toxicity of FLAGM therapy (FLAG with mitoxantrone), further intensified by adding mitoxantrone, based on the results of a phase I study by our group. The major endpoints were complete remission (CR) rate and early death. From June 2004 to February 2008, 41 patients (median age 52 years; range 18-64 years) were enrolled. Thirty (73% 95% CI 58-84%) patients achieved CR, which met the primary endpoint; there was a single case of early death from pneumonia. Two-year overall survival was 39.4% (95% CI 25.2-55.6%). Of those who achieved CR, 27 underwent allogeneic stem cell transplantation (SCT), and 12 SCT recipients showed long-term survival. Grade 3/4 non-hematological adverse events included infection (59%), nausea/vomiting (15%), diarrhea (7%), and elevated liver enzymes (7%). In conclusion, FLAGM is an effective and safe salvage therapy for patients with relapsed/refractory AML, and facilitated SCT for a large proportion of patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/mortality , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cytarabine/administration & dosage , Cytarabine/adverse effects , Disease-Free Survival , Female , Granulocyte Colony-Stimulating Factor/administration & dosage , Granulocyte Colony-Stimulating Factor/adverse effects , Humans , Male , Middle Aged , Mitoxantrone/administration & dosage , Mitoxantrone/adverse effects , Recurrence , Survival Rate , Vidarabine/administration & dosage , Vidarabine/adverse effects , Vidarabine/analogs & derivatives
4.
J Orthop Sci ; 18(5): 803-10, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23775464

ABSTRACT

BACKGROUND: If some predictable factors that affect the treatment results of low-intensity pulsed ultrasound (LIPUS) for delayed union or nonunion could be determined, these might provide us with suggestions for whether LIPUS should be used as an alternative treatment for surgery or an adjuvant therapy after surgery. Therefore, the objective of the present study was to determine what factors affected failure of fracture healing after LIPUS for delayed unions and nonunions. METHODS: A one-year observational retrospective cohort study was conducted with a consecutive cohort of 101 delayed unions and 50 nonunions after long bone fractures that were treated with LIPUS between May 1998 and April 2007. The main outcome measure was radiographic determination of osseous bone union status within one year after start of LIPUS therapy. Statistical evaluation was used to recognize predictable factors that affect treatment results of LIPUS for delayed union and nonunion. RESULTS: Delayed union group (n = 101): Seventy-five delayed unions (74.3%) united without an additional major surgical intervention. Failure of LIPUS therapy was associated with types of nonunion (atrophic/oligotrophic vs. hypertrophic, relative risk 23.72 [95% CI 1.20-11.5], p < 0.01), instability at fracture site (unstable vs. stable, relative risk 3.03 [95% CI 1.67-5.49], p < 0.001), and maximum fracture gap size not less than 9 mm (relative risk 3.30 [95% CI 1.68-6.45]). Nonunion group (n = 50): Thirty-four nonunions (68.0%) united without an additional major surgical intervention. Failure of LIPUS therapy was associated with method of fixation (intramedullary nail vs. others, relative risk 4.50 [95% CI 1.69-12.00], p < 0.001), instability at fracture site (unstable vs. stable, relative risk 4.56 [95% CI 2.20-9.43], p < 0.0001), and maximum fracture gap size not less than 8 mm (relative risk 5.09 [95 % CI 1.65-15.67]). CONCLUSIONS: LIPUS should be applied as an adjuvant therapy in combination with surgical intervention for an established atrophic nonunion with instability and/or with larger fracture gap.


Subject(s)
Fractures, Ununited/therapy , Ultrasonic Therapy/methods , Adult , Aged , Aged, 80 and over , Cohort Studies , Female , Fractures, Bone/therapy , Fractures, Ununited/pathology , Humans , Male , Middle Aged , Retrospective Studies , Time Factors , Treatment Outcome , Young Adult
5.
Ann Hematol ; 91(10): 1533-9, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22576311

ABSTRACT

The prognosis of acute myelogenous leukemia (AML) in the elderly patients is extremely poor. Although several previous studies have suggested that intensive chemotherapy is associated with a better prognosis, there may have been a selection bias. Therefore, we retrospectively evaluated the impact of intensive chemotherapy for AML in the elderly by stratifying patients according to a propensity score. Eighty-one AML patients aged 70 years or more were included in this study. Patients with acute promyelocytic leukemia were not included. A propensity score for the use of intensive chemotherapy was calculated from four factors at diagnosis. Forty-five patients received intensive chemotherapy, whereas 36 received low-dose or no chemotherapy. We stratified the patients into quartiles based on the propensity score. The numbers of patients in the first, second, third, and forth quartiles who received intensive chemotherapy were 5 of 21, 10 of 20, 12 of 20, and 18 of 20, respectively. A stratified log-rank test showed significantly better overall survival in the intensive chemotherapy group (P = 0.0088). Especially, in the combined second and third quartiles, which showed an equal tendency for intensive and non-intensive strategies; overall survival at 3 years was 37.5 % for the intensive chemotherapy group and 13.0 % for the non-intensive chemotherapy group (P = 0.0022). A conventional multivariate analysis confirmed that intensive chemotherapy was beneficial (hazard ratio 0.50, 95 % confidence interval 0.27-0.93, P = 0.028). In conclusion, intensive chemotherapy may prolong overall survival in elderly AML patients who are considered to be able to tolerate such treatment based on factors at diagnosis.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Leukemia, Myeloid, Acute/drug therapy , Leukemia, Myeloid, Acute/epidemiology , Propensity Score , Aged , Aged, 80 and over , Female , Humans , Japan/epidemiology , Leukemia, Myeloid, Acute/mortality , Male , Retrospective Studies , Survival Rate/trends
6.
Rinsho Ketsueki ; 50(2): 97-101, 2009 Feb.
Article in Japanese | MEDLINE | ID: mdl-19265302

ABSTRACT

Malignant lymphoma (ML) is frequently associated with several forms of collagen diseases such as Sjören syndrome, systemic lupus erythematodes, and rheumatoid arthritis. However, the occurrence of ML in systemic sclerosis (SSc) patients has rarely been reported. Here we report an SSc patient who developed mediastinal (thymic) large B-cell lymphoma (MLBCL). A 31-year-old woman was diagnosed as having SSc in August 2007. The patient was treated with low-dose prednisolone (10 mg/day) without any effect. One year after the diagnosis, chest computed tomography-scan demonstrated thymic tumor in the anterior mediastinum. Thymectomy was performed, and a pathohistological diagnosis of MLBCL was established. Immunohistochemical analysis demonstrated that the tumor cells were positive for CD45 and CD20, but negative for CD30 and EBV-encoded RNA. The patient was treated with 6 courses of CHOP regimen, resulting in complete remission of lymphoma. This report describes the first SSc patient associated with MLBCL. SSc patients occasionally develop ML after a relatively short interval. Our case suggests that intensive monitoring for the development of ML is needed in newly diagnosed SSc patients.


Subject(s)
Lymphoma, Large B-Cell, Diffuse/etiology , Scleroderma, Systemic/complications , Thymus Neoplasms/etiology , Adult , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Female , Humans , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/pathology , Lymphoma, Large B-Cell, Diffuse/therapy , Positron-Emission Tomography , Prednisolone/administration & dosage , Remission Induction , Thymectomy , Thymus Neoplasms/diagnosis , Thymus Neoplasms/pathology , Thymus Neoplasms/therapy , Tomography, X-Ray Computed , Vincristine/administration & dosage
7.
Int J Hematol ; 86(4): 343-7, 2007 Nov.
Article in English | MEDLINE | ID: mdl-18055342

ABSTRACT

This study was designed to determine the optimal high dose for cytosine arabinoside (ara-C) in combination with fludarabine, granulocyte colony-stimulating factor, and mitoxantrone (FLAGM) in adult patients with relapsed or refractory acute myeloid leukemia. Nine patients were enrolled at increasing dosage levels of ara-C (8, 12, and 16 g/m2 per dose level). Ara-C and fludarabine were administered once a day at level 1, once or twice a day at level 2, and twice a day at level 3. All patients had grade 4 hematologic toxicity. The most common adverse events were of grade 2 or less, with nausea and vomiting being the most common (6 events), followed by diarrhea (5 events), and rash (5 events). Of the 13 grade 3 nonhematologic toxicities reported, the 2 most common were febrile neutropenia (6 events) and disseminated intravascular coagulation (3 events). No early deaths were observed. FLAGM with high-dose ara-C was considered safe for patients, and the recommended dosage of ara-C in this study was 2 g/m2 every 12 hours for a total dose of 16 g/m2.


Subject(s)
Cytarabine/therapeutic use , Granulocyte Colony-Stimulating Factor/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Mitoxantrone/therapeutic use , Vidarabine/analogs & derivatives , Adult , Cytarabine/adverse effects , Dose-Response Relationship, Drug , Drug Therapy, Combination , Drug-Related Side Effects and Adverse Reactions , Granulocyte Colony-Stimulating Factor/adverse effects , Humans , Japan , Leukemia, Myeloid, Acute/pathology , Middle Aged , Mitoxantrone/adverse effects , Recurrence , Vidarabine/adverse effects , Vidarabine/therapeutic use
8.
Rinsho Ketsueki ; 48(1): 61-3, 2007 Jan.
Article in Japanese | MEDLINE | ID: mdl-17313078

ABSTRACT

A 63-year-old male presented with fever and general malaise in June 2004. On admission hepatosplenomegaly was apparent, but without lymphadenopathy. The laboratory examination revealed pancytopenia and increased levels of lactate dehydrogenase, direct bilirubin and soluble interleukin-2 receptor. Histological analysis of the bone marrow biopsy specimen demonstrated proliferation of atypical lymphoid cells positive for CD20 in the small capillaries, leading to the diagnosis of the Asian variant of intravascular large B-cell lymphoma (AIVL). The presence of rearrangement of the immunoglobulin gene confirmed the diagnosis. The patient responded well to CHOP therapy followed by seven courses of rituximab-combined CHOP therapy and has remained in complete remission up to the present. This case implies that bone marrow biopsy could be a useful examination for diagnosing AIVL and that rituximab-combinedchemotherapy could improve survival in patients with the disease.


Subject(s)
Bone Marrow/pathology , Lymphoma, B-Cell/diagnosis , Lymphoma, Large B-Cell, Diffuse/diagnosis , Vascular Neoplasms/diagnosis , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Murine-Derived , Antigens, CD20/analysis , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Asian People , Biopsy , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Drug Administration Schedule , Humans , Lymphoma, B-Cell/classification , Lymphoma, B-Cell/drug therapy , Lymphoma, B-Cell/immunology , Lymphoma, Large B-Cell, Diffuse/classification , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/immunology , Male , Middle Aged , Prednisone/administration & dosage , Rituximab , Vascular Neoplasms/drug therapy , Vascular Neoplasms/immunology , Vincristine/administration & dosage
9.
Rinsho Ketsueki ; 47(2): 111-4, 2006 Feb.
Article in Japanese | MEDLINE | ID: mdl-16529013

ABSTRACT

A 63-year-old female was diagnosed as having Philadelphia chromosome-positive acute myelomonocytic leukemia in June 2002. The patient received monotherapy with imatinib mesylate or combination therapy with DCM and idarubicin/cytarabine, both of which failed in attaining disease remission. However, the second imatinib administration plus CAG therapy resulted in disappearance of the Philadelphia chromosome-positive clone and increase of Philadelphia chromosome-negative cells. During a therapy-withholding period due to fungal infection, the Philadelphia chromosome-positive clone expanded and the patient died of cerebral hemorrhage in February 2003. The transient suppression of the Philadelphia chromosome-positive clone may have brought about amplification of the Philadelphia chromosome-negative cells after the secondary imatinib treatment.


Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative , Leukemia, Myelomonocytic, Acute/drug therapy , Piperazines/therapeutic use , Pyrimidines/therapeutic use , Benzamides , Clone Cells , Female , Humans , Imatinib Mesylate , Middle Aged
10.
Cancer Genomics Proteomics ; 3(3-4): 169-181, 2006.
Article in English | MEDLINE | ID: mdl-31394695

ABSTRACT

BACKGROUND: The current classification of acute myeloid leukemia (AML) is based predominantly on the cytogenetic abnormalities and morphology of the malignant blasts and is not always helpful for optimization of the treatment strategy. Gene expression profiles of AML blasts were obtained and a gene expression-based means of predicting the outcome of AML patients was developed. MATERIALS AND METHODS: CD133-positive hematopoietic stem cell-like fractions were purified from the bone marrow of 99 individuals with AML-related disorders and the expression profiles of ~33,000 human transcripts in these cells were characterized with the use of DNA microarray analysis. RESULTS: The comparison of the expression data between individuals with short- or long-term survival by application of Cox's proportional hazard model led to the identification of four genes, whose expression patterns discriminated between the two groups. The gene expression-based stratification (GES) system, based on a combination of the karyotype approach and the risk index calculated from the expression levels of the four outcome predictor genes, was developed to separate the patients into subgroups with distinct prognoses. CONCLUSION: DNA microarray analysis of purified fractions provides novel stratification schemes for AML based on the expression profiles of a handful of genes.

12.
Rinsho Ketsueki ; 45(10): 1135-7, 2004 Oct.
Article in Japanese | MEDLINE | ID: mdl-15553051

ABSTRACT

A 55-year-old man with advanced myelodysplastic syndrome was hospitalized prior to undergoing an allogeneic bone marrow transplantation. Immediately before hospitalization, he had suffered from phlegmon in both lower extremities and right forearm as well as genital and oral ulcers. After admission, he developed an esophageal ulcer and was thus diagnosed as having intestinal tract-type Behçet disease. HLA-B51 was not present. Within a month, he died of pulmonary hemorrhage associated with pneumonia, possibly because of a low platelet count, and vasculoendothelial damage related to Behçet disease. This is a rare case of myelodysplastic syndrome that developed Behçet disease with a severe esophageal ulcer.


Subject(s)
Behcet Syndrome/etiology , Esophageal Diseases/etiology , Myelodysplastic Syndromes/complications , Ulcer/etiology , Disseminated Intravascular Coagulation/complications , Fatal Outcome , Hemorrhage/etiology , Humans , Lung Diseases/etiology , Male , Middle Aged , Thrombocytopenia/etiology
13.
Rinsho Ketsueki ; 45(4): 316-8, 2004 Apr.
Article in Japanese | MEDLINE | ID: mdl-15168449

ABSTRACT

A 17-year-old female was admitted to our hospital because of pyrexia and thrombocytopenia in May 2002. Laboratory examination showed a platelet count of 50,000/microliter with an increased level of fibrinogen degradation product, leading to a diagnosis of disseminated intravascular coagulation (DIC). Gabexate mesilate was intravenously administrated without any effects. Several days later, erythema, joint pain and neck lymphadenopathy developed sequentially. The patient was diagnosed as having adult-onset Still disease (AOSD) complicated with DIC. Moreover, serum inflammatory cytokine levels had increased and activated macrophages were observed in the bone marrow, suggesting the presence of macrophage activation syndrome. After additional treatments with dalteparin and aspirin, the clinical symptoms and laboratory findings associated with AOSD and DIC disappeared. Although this was a severe case of AOSD associated with preceding DIC, the AOSD symptoms resolved in this patient with the treatment of the DIC and with aspirin only without any relapse.


Subject(s)
Disseminated Intravascular Coagulation/etiology , Still's Disease, Adult-Onset/complications , Adolescent , Female , Humans
14.
Am J Hematol ; 75(4): 213-6, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15054812

ABSTRACT

Central diabetes insipidus (DI) is a rare but recognized complication of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) that is caused by leukemic infiltration to the hypothalamo-neurohypophyseal system. In rare patients in whom a wide region of the hypothalamus is involved, central DI results in hypodipsic hypernatremia and dehydration. Typical DI symptoms such as polydipsia, polyuria, and marked thirst are concealed in these cases, because the hypothalamic "thirst center" cannot send thirst stimuli to the cerebral cortex. Herein we describe a patient with MDS developing into AML, who presented with hypodipsic hypernatremia and dehydration. A diagnosis of central DI was made on the ground of a low level of serum anti-diuretic hormone (ADH) despite high serum osmolality. A magnetic resonance imaging study revealed attenuation of a physiological "bright spot" of the neurohypophysis. An induction course chemotherapy including regular-dose cytarabine and daunorubicin produced a rapid improvement of hypernatremia. The bone marrow aspirate after two courses of chemotherapy showed complete remission. At that point, ADH release and the "bright spot" were recovered. In order to correctly diagnose central DI in association with hematological malignancies, we should not overlook this atypical type of DI.


Subject(s)
Dehydration/etiology , Diabetes Insipidus, Neurogenic/etiology , Hypernatremia/etiology , Myelodysplastic Syndromes/complications , Dehydration/blood , Dehydration/urine , Diabetes Insipidus, Neurogenic/blood , Diabetes Insipidus, Neurogenic/pathology , Diabetes Insipidus, Neurogenic/urine , Female , Humans , Hypernatremia/blood , Hypernatremia/urine , Magnetic Resonance Imaging , Middle Aged , Myelodysplastic Syndromes/blood , Myelodysplastic Syndromes/drug therapy , Myelodysplastic Syndromes/urine , Osmolar Concentration , Pituitary Gland, Posterior/diagnostic imaging , Radionuclide Imaging
15.
Rinsho Ketsueki ; 44(11): 1110-2, 2003 Nov.
Article in Japanese | MEDLINE | ID: mdl-14689877

ABSTRACT

21-year-old male was diagnosed as having acute lymphoblastic leukemia (ALL) in March 2001. Standard G-banding analysis revealed normal karyotype. He achieved complete remission after the first course of induction therapy and underwent allogeneic PBSCT in August 2001. However, leukemic cells appeared in the peripheral blood demonstrating complex chromosomal abnormalities with Philadelphia chromosome (Ph1) and expressing minor BCR/ABL transcripts. We thus retrospectively examined the bone marrow sample at presentation with both interphase FISH and RT-PCR methods. Surprisingly, almost all leukemic blasts at presentation turned out to possess the minor type of BCR/ABL fusion gene. In spite of the second allogeneic PBSCT, the patient died of pneumonia and graft-versus-host disease in the liver in September 2002. This case is rare in that cytogenetic analysis failed to detect Ph1 due to leukemic cells dormancy. The application of both FISH and RT-PCR studies would appear to be essential to avoid overlooking Ph1-positive ALL.


Subject(s)
Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Adult , Humans , Karyotyping , Male
16.
Rinsho Ketsueki ; 44(11): 1117-9, 2003 Nov.
Article in Japanese | MEDLINE | ID: mdl-14689879

ABSTRACT

A 26-year-old woman was diagnosed as having autoimmune hemolytic anemia in September 2002. Her eosinophil count was already high (2,190/microliter) at that time. She received prednisolone therapy with a good response and was released from the treatment in April 2003. Eosinophil numbers were within the normal range under the prednisolone administration. However, they began to increase after its completion. No underlying causes for the eosinophilia were evident. When the eosinophil count reached 5,474/microliter, the patient developed massive pleural effusion as well as palpebral swelling and myalgia, leading to a diagnosis of hypereosinophilic syndrome. Re-administration of prednisolone resulted in the disappearance of these symptoms and eosinophilia. Her eosinophils seemed to have reactivated after cessation of the prednisolone therapy and infiltrated into her organs.


Subject(s)
Anemia, Hemolytic, Autoimmune/drug therapy , Hypereosinophilic Syndrome/etiology , Prednisolone/therapeutic use , Substance Withdrawal Syndrome , Adult , Female , Humans
17.
Rinsho Ketsueki ; 44(10): 1032-5, 2003 Oct.
Article in Japanese | MEDLINE | ID: mdl-14639951

ABSTRACT

A 62-year-old female was diagnosed as having acute lymphocytic leukemia in October 2001. She achieved complete remission after induction therapy with L-asparaginase, doxorubicin, vincristine and prednisolone. However, an invasive fungal infection developed in the lung, followed by a sudden complete atrioventricular block. Her heart rate was brought back to normal by the administration of isoproterenol. In spite of anti-fungal therapies, the patient finally succumbed to pneumonia in January 2002. Autopsy revealed an invasion of fungi into the lung, mitral valves and atrioventricular node. We need to pay attention to such a cardiac complication when an immunocompromised host suffers from an invasive fungal infection.


Subject(s)
Heart Block/etiology , Lung Diseases, Fungal/etiology , Mycoses/etiology , Myocarditis/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Female , Heart Valve Diseases/etiology , Humans , Middle Aged , Mitral Valve , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
18.
Am J Hematol ; 72(2): 138-42, 2003 Feb.
Article in English | MEDLINE | ID: mdl-12555219

ABSTRACT

The t(10;11)(p12-14;q14-21) is a non-random translocation that results in the fusion of CALM gene on chromosome 11 with AF10 gene on chromosome 10. This translocation is observed in acute myeloid leukemia, acute lymphoblastic leukemia, and lymphoblastic lymphoma. Here we report a patient with t(10;11) who was diagnosed with AML-M4. Reverse transcriptase-polymerase chain reaction (RT-PCR) assay revealed one type of CALM/AF10 and three types of AF10/CALM fusion transcripts. Sequencing analysis for these RT-PCR products determined the breakpoint in CALM at nucleotide (nt) 1926-1927 and in AF10 at nt 423-424. The latter breakpoint was the same as that identified in three monocytic cell lines carrying t(10;11). After achieving complete remission, the patient developed mediastinal emphysema during the course of consolidation therapy, possibly due to the necrosis of his mediastinal mass. Monocytic leukemias with CALM/AF10 fusion are frequently associated with mediastinal invasion. We need to pay special attention to such a complication, even if the chest X-ray is normal at presentation.


Subject(s)
Leukemia, Monocytic, Acute/genetics , Leukemia, Monocytic, Acute/pathology , Mediastinal Emphysema/etiology , Oncogene Proteins, Fusion/genetics , Adolescent , Base Sequence , Gene Rearrangement , Humans , Male , RNA, Messenger/analysis , RNA, Messenger/genetics , Remission Induction , Translocation, Genetic
19.
Rinsho Ketsueki ; 43(10): 960-2, 2002 Oct.
Article in Japanese | MEDLINE | ID: mdl-12462034

ABSTRACT

Ten patients with acute myelogenous leukemia or high risk myelodysplastic syndrome who had achieved complete remission following treatment with the CAG regimen were monitored for peripheral blood WT1 expression mRNA levels. Induction therapy with the CAG regimen did not seem to be enough to lower WT1 expression levels to the normal range. In comparison with patients who received intensive chemotherapy for post-remission therapy, those who received only CAG therapy showed higher levels of WT1 expression and more easily relapsed. These data suggest that CAG therapy alone might not be sufficient to maintain complete remission and WT1 monitoring could be useful in the choice of appropriate post-remission therapy after achieving remission with the CAG regimen.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Leukemia, Myeloid, Acute/metabolism , Myelodysplastic Syndromes/metabolism , WT1 Proteins/genetics , Aclarubicin/administration & dosage , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cytarabine/administration & dosage , Drug Administration Schedule , Female , Granulocyte Colony-Stimulating Factor/administration & dosage , Humans , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Myelodysplastic Syndromes/drug therapy , Remission Induction
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