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1.
Tohoku J Exp Med ; 227(1): 31-7, 2012 05.
Artigo em Inglês | MEDLINE | ID: mdl-22531159

RESUMO

Severe diarrhea is a serious complication after allogeneic hematopoietic stem cell transplantation (HSCT). Acute graft-versus-host disease (GVHD) has been one of the major causes of diarrhea after HSCT, which is triggered by donor-derived cytotoxic T-lymphocytes. On the other hand, intestinal thrombotic microangiopathy (TMA) sometimes coexists with acute GVHD, and intensified immunosuppression to treat acute GVHD could exacerbate intestinal TMA, presumably through the vascular endothelial cell damage. The differential diagnosis between intestinal TMA and acute GVHD of the gut has mainly relied on the pathological findings, as clinical diagnosis of intestinal TMA has not been established. Therefore, we aimed to assess the feasibility of our clinical diagnosis for the patients with diarrhea after HSCT. We made tentative clinical criteria for intestinal TMA and acute GVHD of the gut, based on the clinical manifestations, laboratory data and colonoscopic findings, and started treatment before pathological diagnosis were made. Subsequently, a pathologist retrospectively assessed the accuracy of clinical diagnosis in a blind manner. In this study, we enrolled 19 patients complicating watery diarrhea after HSCT, and diagnosed as having acute GVHD (n = 10), intestinal TMA (n = 3), or both (n = 6) according to our criteria. We demonstrated that our clinical diagnosis for intestinal TMA and acute GVHD of the gut was overall correct, in terms of the response to the therapy and the pathological diagnosis. The present study may provide a clue on making clinical diagnosis of patients with watery diarrhea after HSCT, which enables us to start a prompt therapy.


Assuntos
Doença Enxerto-Hospedeiro/diagnóstico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Enteropatias/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Microangiopatias Trombóticas/diagnóstico , Doença Aguda , Adolescente , Adulto , Colonoscopia , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/etiologia , Feminino , Doença Enxerto-Hospedeiro/tratamento farmacológico , Doença Enxerto-Hospedeiro/etiologia , Humanos , Enteropatias/tratamento farmacológico , Enteropatias/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Microangiopatias Trombóticas/tratamento farmacológico , Microangiopatias Trombóticas/etiologia , Transplante Homólogo , Adulto Jovem
2.
Leuk Lymphoma ; 51(8): 1509-12, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20496989

RESUMO

The prognosis of advanced extranodal NK/T cell lymphoma (ENKTL) is poor. Allogeneic hematopoietic stem cell transplant (allo-HSCT) has been suggested to be a promising treatment for this disease, but its utility has yet to be established. Here we retrospectively analyzed five cases of ENKTL treated with allo-HSCT in our institute. After induction chemotherapy, disease status at allo-HSCT was second CR in three patients and refractory in two patients. All patients received a myeloablative conditioning regimen, and GVHD prophylaxis consisted of tacrolimus or cyclosporine with short-term methotrexate. Only one patient who received conventional induction chemotherapy developed severe complications, which needed long-term treatment, while others who received chemotherapy containing l-asparaginase did not have severe complications. There were no cases of treatment-related mortality, and all patients survived without disease for a median follow-up period of 1911 days. These results suggested that allo-HSCT following l-asparaginase-containing induction chemotherapy might improve the outcome of advanced ENKTL.


Assuntos
Asparaginase/uso terapêutico , Resistencia a Medicamentos Antineoplásicos , Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas , Linfoma de Células T/terapia , Células T Matadoras Naturais/patologia , Neoplasias Nasais/terapia , Adulto , Antineoplásicos/uso terapêutico , Terapia Combinada , Ciclosporina/uso terapêutico , Feminino , Humanos , Imunossupressores/uso terapêutico , Linfoma de Células T/patologia , Masculino , Metotrexato/uso terapêutico , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Neoplasias Nasais/patologia , Indução de Remissão , Estudos Retrospectivos , Terapia de Salvação , Taxa de Sobrevida , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
3.
Intern Med ; 48(20): 1833-5, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19834277

RESUMO

Plasma cell leukemia (PCL) is a rare variant of multiple myeloma, which is very aggressive and resistant to chemotherapy. We report a case of PCL successfully treated with syngeneic peripheral blood stem cell transplantation followed by low-dose thalidomide. As of March 2009, the patient has maintained CR for 39 months posttransplant. The clinical course of the present case suggests that autologous stem cell transplantation using a graft with reduced contamination of malignant cells followed by low-dose thalidomide maintenance therapy may improve the PCL treatment outcome.


Assuntos
Leucemia Plasmocitária/diagnóstico , Transplante de Células-Tronco , Talidomida/administração & dosagem , Adulto , Terapia Combinada , Humanos , Leucemia Plasmocitária/tratamento farmacológico , Leucemia Plasmocitária/cirurgia , Masculino , Indução de Remissão , Transplante de Células-Tronco/métodos , Transplante Isogênico/métodos
4.
Tohoku J Exp Med ; 204(2): 125-33, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15383693

RESUMO

Stanniocalcin is a glycoprotein hormone that regulates the calcium level in fish. We found that mRNA of human stanniocalcin 1 (STC-1) is detectable in phytohemagglutinin-stimulated T cells and in most human leukemia cell lines, suggesting a role of STC-1 for cell proliferation. This finding prompts us to study the usefulness of STC-1 for monitoring acute leukemia. The levels of STC-1 transcripts increased in patients with acute leukemia at diagnosis and relapse, as judged by quantitative real-time RT-PCR. Levels of transcripts rapidly decreased to within the cut-off levels, when the blast numbers decreased with chemotherapy. Prolonged elevation of STC-1 levels after treatment was associated with a poor prognosis. All of 7 patients relapsed 1 to 4 months after they showed an elevated level of the transcripts in clinical remission. These results indicate that STC-1 is a novel marker for minimal residual disease of acute leukemia, and for an early diagnosis of relapse.


Assuntos
Biomarcadores Tumorais/sangue , Glicoproteínas/sangue , Leucemia/diagnóstico , Neoplasia Residual/diagnóstico , Adulto , Sequência de Bases , Cálcio/classificação , Linhagem Celular Tumoral , Primers do DNA , Feminino , Regulação Neoplásica da Expressão Gênica , Glicoproteínas/genética , Células HL-60 , Humanos , Células K562 , Leucemia/sangue , Leucemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neoplasia Residual/sangue , RNA Mensageiro/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Linfócitos T/fisiologia , Transcrição Gênica
5.
Artigo em Inglês | MEDLINE | ID: mdl-14564097

RESUMO

The majority of all parotid lymphomas are of the non-Hodgkin type and of B-cell origin. Primary natural killer cell lymphomas of the parotid gland are extremely rare. We present a case of natural killer cell lymphoma in a 34-year-old woman. The disease was refractory to chemotherapy, and the patient eventually succumbed due to lymphoma-associated hemophagocytic syndrome.


Assuntos
Células Matadoras Naturais/patologia , Linfoma/diagnóstico , Glândula Parótida/patologia , Neoplasias Parotídeas/diagnóstico , Adulto , Antígenos CD/análise , Antígenos Virais/análise , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Southern Blotting , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Evolução Fatal , Feminino , Citometria de Fluxo , Rearranjo Gênico da Cadeia beta dos Receptores de Antígenos dos Linfócitos T/genética , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/imunologia , Herpesvirus Humano 4/isolamento & purificação , Humanos , Linfoma/tratamento farmacológico , Linfoma/genética , Linfoma/virologia , Imageamento por Ressonância Magnética , Glândula Parótida/imunologia , Glândula Parótida/virologia , Neoplasias Parotídeas/tratamento farmacológico , Neoplasias Parotídeas/genética , Neoplasias Parotídeas/virologia , Prednisona/administração & dosagem , Terapia de Salvação , Tomografia Computadorizada por Raios X , Vincristina/administração & dosagem
6.
Br J Haematol ; 119(4): 940-8, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12472571

RESUMO

The retinoblastoma protein-interacting zinc finger gene (RIZ), a member of the nuclear protein methyltransferase superfamily, is characterized by the presence of the N-terminal PR domain. The RIZ gene encodes for two proteins, RIZ1 and RIZ2. While RIZ1 contains the PR (PRDI-BF1 and RIZ homologous) domain, RIZ2 lacks it. RIZ gene expression is altered in a variety of human cancers and RIZ1 is now considered to be a candidate tumour suppressor. To investigate the role of RIZ in leukaemogenesis, we analysed the differential expression of RIZ1 and RIZ2 by quantitative real-time reverse-transcription polymerase chain reaction assay. Our results showed that the expression of RIZ1 was significantly decreased in leukaemia cell lines (14 out of 17, 82%) and in patients with acute myeloblastic leukaemia (eight out of 14, 57%). In contrast, RIZ2 expression was increased in patients with acute lymphoblastic leukaemia (eight out of 11, 73%), compared with normal bone marrow cells. These findings indicate that suppression of RIZ1 expression or enhancement of RIZ2 expression may have an important role in leukaemogenesis.


Assuntos
Proteínas de Ligação a DNA , Regulação Neoplásica da Expressão Gênica , Leucemia/genética , Proteínas de Neoplasias/genética , Proteínas Nucleares/genética , Fatores de Transcrição , Adolescente , Adulto , Idoso , Transformação Celular Neoplásica/genética , Feminino , Histona-Lisina N-Metiltransferase , Humanos , Cariotipagem , Leucemia/metabolismo , Leucemia Mieloide Aguda/genética , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/biossíntese , Proteínas Nucleares/biossíntese , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , RNA Mensageiro/genética , RNA Neoplásico/genética , Proteína do Retinoblastoma/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Células Tumorais Cultivadas , Dedos de Zinco/genética
7.
Tohoku J Exp Med ; 196(3): 193-201, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12002276

RESUMO

The retinoblastoma protein-interacting zinc finger gene (RIZ) is a zinc-finger type DNA binding protein and is postulated as a member of the nuclear protein-methyltransferase superfamily. RIZ gene encodes for two proteins, RIZ1 and RIZ2. While RIZ1 contains the N-terminal PR (PRDI-BF1 and RIZ homologous)-domain, RIZ2 lacks it. RIZ1 is now considered as a tumor suppressor. We analyzed nucleotide alteration of RIZ gene in human leukemia. The results revealed a single nucleotide polymorphism (SNP), T1704 to A, near the conserved Rb-binding domain, leading to an amino acid change, Asp283 to Glu. Interestingly, 17 of 21 leukemia cell lines are homozygous for the T1704 allele whereas only 2 of 20 normal subjects are homozygous for the allele. In addition, one base pair deletion in the poly (A)9 tract in the coding region near the C-terminal zinc-fingers was identified, resulting in frameshift, in 1 out of 17 leukemia cell lines, but no mutation in samples from 15 patients with acute lymphoblastic leukemia (ALL) and 6 patients with adult T cell leukemia (ATL). In the PR or SH3 (src homology 3) domain of the RIZ gene, no mutation was found. These findings suggest that RIZ may be a possible target of structural alteration leading to leukemia.


Assuntos
Proteínas de Ligação a DNA , Leucemia/genética , Proteínas Nucleares/genética , Proteína do Retinoblastoma/metabolismo , Fatores de Transcrição , Alelos , Histona-Lisina N-Metiltransferase , Humanos , Leucemia/metabolismo , Mutação , Proteínas Nucleares/metabolismo , Polimorfismo Genético , Proteína do Retinoblastoma/genética , Células Tumorais Cultivadas , Dedos de Zinco
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