[Show abstract][Hide abstract] ABSTRACT: We report on a case of malignant pleural effusion as initial metastatic presentation of occult gastric cardia cancer in a young woman. To the best of our knowledge, this is the first report of gastric adenocarcinoma metastasized to pleura as an initial presentation. Location of cardia and signet ring cell histology may contribute to the manifestation. Utilization of PET/CT was helpful for proper diagnosis. For patients with such distinct clinical presentations, it would be appropriate to consider gastric cancer as one of the possible primary sites.
Cancer Research and Treatment 07/2014; 46(4). DOI:10.4143/crt.2013.068 · 3.32 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present study sought to elucidate the role of induction and consolidation therapy in elderly patients. We retrospectively collected data of 477 patients who were aged over 60 years at the time of acute myeloid leukemia (AML) diagnosis. The median overall survival (OS) was 339 days in the induction group (n = 266) and 86 days in the best supportive care group (n = 211) (P < 0.001). In the induction group, the complete remission (CR) rate was 58.3 %, and treatment-related death was 15.4 %. Successful induction was related to good performance [Eastern Cooperative Oncology Group (ECOG <2)] [hazard ratio (HR) 3.215; P = 0.002]. Mortality correlated with failure to achieve CR (HR 4.059; P < 0.001) and poor performance status (ECOG >2) (HR 2.731; P = 0.035). In CR patients, poor karyotype and absence of consolidation (HR 2.313; P = 0.003) correlated with mortality. More than one cycle of consolidation was associated with better OS (P < 0.001). Lack of salvage therapy was associated with mortality in patients who did not achieve CR (HR 3.223; P = 0.005). Intensive induction in patients with good performance and >1 cycle of consolidation after CR may be the best strategy for improving OS in elderly AML patients.
International Journal of Hematology 07/2014; 100(2). DOI:10.1007/s12185-014-1617-8 · 1.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Waldenström's macroglobulinemia (WM) is a B-cell proliferative malignancy characterized by immunoglobulin M monoclonal gammopathy and bone marrow infiltration by lymphoplasmacytic cells. Clinical features and cytogenetics of WM in Asia including Republic of Korea remain unclear. Moreover, no study has reported treatment outcomes in patients with WM treated with novel agent combined with conventional chemotherapy. This study investigated clinical features and assessed treatment outcomes with novel agent and conventional chemotherapy in Republic of Korea. Data from all (n = 71) patients with newly diagnosed WM at 17 hospitals who received chemotherapy between January 2005 and December 2012 were collected retrospectively. The median age of patients was 66 years (range: 37-92 years) and male to female ratio was 5 : 1. Patients treated with novel agent combined chemotherapy displayed higher overall response rate (ORR) compared to conventional chemotherapy alone (92.9% versus 52.6%, P = 0.006). The 5-year overall survival rate was 62.6% (95% confidence interval: 34.73-111.07). Use of novel agents produced higher ORR but survival benefit was not apparent due to the small number of patients and short follow-up duration. Further studies are needed to confirm the efficacy of novel agents in patients with WM.
BioMed Research International 06/2014; 2014:253243. DOI:10.1155/2014/253243 · 1.58 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Systemic chemotherapy followed by whole brain radiotherapy (WBRT) is a widely used treatment strategy for patients with primary central nervous system lymphoma (PCNSL). However, the outcome of this treatment strategy in elderly patients, particularly with a poor prognostic score, was disappointing compared with younger patients, and the deterioration of cognitive function after WBRT is more problematic in these patients. To avoid this debilitating complication of WBRT and increase treatment efficacy in elderly patients, we designed systemic chemotherapy that incorporated interim gamma-knife surgery (GKS) treatment for elderly PCNSL patients (age ≥65 years), omitting WBRT in this pilot trial. A total of four elderly patients with a poor prognostic score based on an International Extranodal Lymphoma Study Group were enrolled in this pilot clinical trial. All study patients acquired complete response and showed stable or improved neuropsychological function during the disease-free state. The median progression-free survival was 9.5 months (range 8.6-22.5 months), and the median overall survival was 15.8 months (range 13.3-25.1 months), which were likely to be similar to those of the chemotherapy followed by WBRT for those patients. This pilot study demonstrated that GKS-incorporated systemic chemotherapy can obtain complete response with high probability and considerably long survival, which suggests that this treatment strategy is efficient and neuropsychologically safe for elderly PCNSL patients with a poor prognostic score.
Medical Oncology 03/2014; 31(3):863. DOI:10.1007/s12032-014-0863-1 · 2.63 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There have been rare comparative studies of hematopoietic stem cell transplantation from matched sibling donors (MSDs) and unrelated donors (URDs) with regard to peripheral blood stem cell transplantation (PBSCT). We performed a retrospective study of 104 consecutive acute myeloid leukemia (AML) patients who had received an allogeneic PBSCT from an MSD or a URD in order to compare transplant outcomes and posttransplant complications between the 2 groups of patients. The cumulative incidence of grade 2-4 acute graft-versus-host disease (aGVHD) at 100 days (22.6% with MSD vs. 35.3% with URD; p = 0.107) and that of chronic GVHD (cGVHD) at 2 years (72.9% with MSD vs. 56.1% with URD; p = 0.153) was not significantly different between the 2 groups. Multivariate analysis also indicated that a URD was not an independent predictor of grade 2-4 aGVHD or cGVHD. No statistically significant differences were observed in terms of relapse incidence (p = 0.371), nonrelapse mortality (p = 0.473), disease-free survival (p = 0.925) or overall survival (p = 0.534) at 2 years. URDs are comparable with MSDs as a donor type for PBSCT in AML patients if risk-stratified GVHD prophylaxis is adopted.
[Show abstract][Hide abstract] ABSTRACT: We conducted a retrospective study to find out the optimum values of serum ferritin and other hematologic indices in adult anemic patients who should be referred for thorough gastrointestinal (GI) endoscopic evaluation for GI neoplasms. 544 adult anemic patients were stratified into three groups according to the results of GI endoscopy: benign versus premalignant versus malignant. As compared to non-malignant groups, malignant group demonstrated statistically significant differences in terms of median values of ferritin and total iron-binding capacity (TIBC) saturation. By receiver operating characteristics curve analyses to find out optimum cut-off points of the serum ferritin and TIBC saturation which distinguish between non-malignant diseases and malignant diseases, the cut-off ferritin value of 44.33 ng/mL in male had 72.73 % sensitivity and 70.95 % specificity. The cut-off TIBC saturation value of 9.13 % in male had 73.33 % sensitivity and 70.92 % specificity. The cut-off TIBC saturation value of 6.16 % in female had 69.57 % sensitivity and 65.13 % specificity. It is recommended that adult male patients with anemia undergo thorough endoscopic evaluation to detect GI neoplasms when their serum ferritin levels are ≤44 ng/mL or TIBC saturation values are ≤9 %. For adult female, only TIBC saturation values less than 6 % may contribute to determining whether they undergo GI endoscopic evaluation.
International journal of hematology 06/2012; 96(2):214-21. DOI:10.1007/s12185-012-1129-3 · 1.92 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Therapy-related acute leukemia showing mixed phenotype is extremely rare. We report a 49-year-old woman who presented with palpable masses in her neck and back. She had received systemic chemotherapy (adriamycin and cisplatin) and radiotherapy for endometrial adenocarcinoma 7 years before. Her peripheral blood and bone marrow showed increased blasts, which coexpressed myeloid (CD13, CD33, and myeloperoxidase) and B-lymphoid antigens (CD19 and CD79a). Cytogenetic analysis showed a karyotype of 46,XX,dup(1)(q21q32),add(5)(q33),t(9;22)(q34;q11.2)/47,idem,+der(22)t(9;22), and BCR/ABL1 rearrangement was detected. Leukemic infiltration was also confirmed in her back mass. After induction chemotherapy with idarubicin, cytarabine, and imatinib, she achieved complete remission. Only 2 cases of therapy-related acute leukemia with mixed phenotype have been reported so far: one with hyperploidy and the other with t(1;21)(p36;q22). To the best of our knowledge, this is the first case of therapy-related acute leukemia with mixed phenotype and t(9;22) as well as extramedullary leukemic infiltrations.
Human pathology 10/2011; 43(4):605-9. DOI:10.1016/j.humpath.2011.07.010 · 2.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: CD4+CD25+ regulatory T-cells (Tregs) play a critical role in immune responses. We explored the status of Tregs in neoplastic and autoimmune hematologic diseases. We also evaluated the technical aspects of Treg measurement in terms of sample type and detection markers.
A total of 68 subjects were enrolled: 11 with AML, 8 with MDS, 10 with autoimmune diseases, and 39 controls. Tregs were analyzed in peripheral blood (PB) and bone marrow (BM) samples from each subject. Flow cytometry and the Human Regulatory T cell Staining Kit (eBioscience, USA) for CD4, CD25, and FoxP3 (forkhead box P3) were used.
The CD4+CD25(high)/CD4 and CD4+CD25(high)FoxP3+/CD4 populations were significantly correlated (P<0.0001). The AML and high-risk MDS groups had significantly larger CD4+CD25(high)/CD4 and CD4+CD25(high)FoxP3+/CD4 populations in PB than the autoimmune (P=0.007 and 0.012, respectively) and control groups (P=0.004 and 0.006, respectively). Comparable findings were observed in BM. The CD4+CD25(high)FoxP3+/CD4 population was significantly larger in PB than in BM (P=0.0003).
This study provides comparison data for Tregs in AML, MDS, and autoimmune hematologic diseases, and would be helpful for understanding the different immunologic bases of various hematologic diseases. Treg measurement using CD4, CD25, and/or FoxP3 in PB rather than in BM seems to be practical for routine hematologic purposes. Large-scale analysis of the diagnostic role of Treg measurement is needed.
The Korean Journal of Laboratory Medicine 10/2011; 31(4):231-7. DOI:10.3343/kjlm.2011.31.4.231 · 1.31 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Variant Burkitt-type translocation, t(8;22)(q24;q11), is very rare in plasma cell myeloma. We report a 51-year-old male patient with plasma cell myeloma, who showed t(8;22) (q24;q11). He suffered from pelvic pain for two months, and showed IgG, lambda type of monoclonal gammopathy (5.14 g/dL; 49.9% of protein). His bone marrow examination showed increased plasma cells (66.9% of all nucleated cells). Plasma cells (74.9% of all nucleated cells) and monoclonal spike (3.38 g/dL; 42.2%) persisted after three cycles of thalidomide and dexamethasone. Cytogenetic analysis showed complex chromosomal abnormalities: 44,XY,-1,t(2;5)(q33;q13),add(8)(q24.1),t(8;22)(q24.1;q11.2),add(10) (p15), der(11)t(1;11)(q21;p11.2),del(12)(p11.2p13),-13,-14,add(14)(q32),der(15)t(1;15)(p2 2;p11.2),-16,add(17)(q11.2),+21,+1-3mar[cp6]/46,XY. To the best of our knowledge, this is the first report on plasma cell myeloma with a variant Burkitt-type t(8;22)(q24;q11) in the Korean patient. A review of 11 such cases in the literature, including the present case, implicated that plasma cell myeloma with t(8;22)(q24;q11) might be related to advanced stage and poor prognosis.
The Korean journal of hematology 06/2011; 46(2):135-8. DOI:10.5045/kjh.2011.46.2.135
[Show abstract][Hide abstract] ABSTRACT: Variants of t(8;21)(q22;q22) account for approximately 3% of all t(8;21) in acute myeloid leukemia (AML). We report a 63-year-old female patient with AML, who showed a 3-way novel variant of t(8;21), t(1;21;8)(q21;q22;q22). She presented with gastric discomfort and splenomegaly, and her complete blood count was: white blood cell count 7.96 × 10(9)/l, with 7% blasts; hemoglobin 8.3 g/dl, and platelets 66 × 10(9)/l. Her bone marrow showed increased blasts (32.5%) with a basophilic cytoplasm, salmon-pink granules and Auer rods. Cytogenetic analysis revealed a karyotype of 46,XX,t(1;21;8)(q21;q22;q22), and fluorescence in situ hybridization confirmed a RUNX1-RUNX1T1 fusion signal on the derivative chromosome 8. After induction chemotherapy, the patient achieved complete remission and has been stable for 6 months. To the best of our knowledge, this is the first report on the novel variant of t(8;21) involving the breakpoint 1q21 and the third case with a translocation among chromosomes 1, 21 and 8. Although the clinical relevance of variant t(8;21) is still unclear, a review of 24 such cases in the literature does not imply a poorer prognosis of variant t(8;21) than of the classic t(8;21).
[Show abstract][Hide abstract] ABSTRACT: We characterized the cytogenetic changes and prognostic characteristics of 133 Korean patients with myelodysplastic syndrome (MDS), focusing on 5q- syndrome and MDS with chromosome abnormalities involving 5q deletion according to World Health Organization 2008 classification. In all patients, G banding and fluorescence in situ hybridization for 5q were performed, and in MDS patients with 5q deletion, the deleted region on chromosome 5 was mapped with fluorescence in situ hybridization for EGR1, CSF1R, and PDGFRB. The frequency of isolated del(5q) syndrome and 5q deletion was 2.2% (3 of 137 patients) and 15.3% (21 of 137 patients), respectively. International Prognostic Scoring System (IPSS) groups were low risk (5.8%), intermediate 1 (51.1%), intermediate 2 (27.8%), and high risk (15.3%). The patients with del(5q) were significantly older (62 years) and showed an unfavorable survival compared to patients without del(5q). Half (53%) of the patients with del(5q) also had complex chromosome abnormalities, including chromosome 7 abnormalities. Of the patients with del(5q), 93.3% were deleted for all three regions on 5q, compared to 66.7% of patients with isolated del(5q). Marker chromosomes proved to be chromosome 5 with interstitial deletion of q arm by fluorescence in situ hybridization in three patients. The biological characteristics of MDS in Korea seem to be markedly different from those of Caucasians, with Koreans having a younger age, lower frequencies of 5q- syndrome, higher frequencies of complex cytogenetic abnormalities including del(5q), and poorer prognosis. We infer that additional chromosome abnormalities contribute to the adverse prognostic impact in patients with del(5q).
Cancer genetics and cytogenetics 12/2010; 203(2):193-202. DOI:10.1016/j.cancergencyto.2010.08.007 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Helicobacter pylori (H. pylori) infection appears to subvert the human iron regulatory mechanism and thus upregulates hepcidin, resulting in unexplained iron-deficiency anemia (IDA). We evaluated serum prohepcidin levels before and after eradication of H. pylori in IDA patients to assess whether it plays a role in IDA related to H. pylori infection.
Subjects diagnosed with unexplained IDA underwent upper gastrointestinal endoscopy and colonoscopy to confirm H. pylori infection and to exclude gastrointestinal bleeding. Blood was sampled before treatment to eradicate H. pylori and again 1 month later. Serum prohepcidin levels were measured using a commercial enzyme-linked immunosorbent assay kit.
Serum prohepcidin levels decreased significantly after oral iron replacement combined with H. pylori eradication (p = 0.011). The reduction ratio of serum prohepcidin levels after the treatment did not differ among the combined oral iron replacement and H. pylori eradication groups, the H. pylori eradication only group, and the iron replacement only group (p = 0.894).
Serum prohepcidin levels decrease after both H. pylori eradication and oral iron administration, with improvement in IDA. Serum concentration of prohepcidin is related to the anemia status, rather than to the current status of H. pylori infection, in IDA patients.
The Korean Journal of Internal Medicine 06/2010; 25(2):195-200. DOI:10.3904/kjim.2010.25.2.195 · 1.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: SUMMARY: We experienced a 16-year-old patient with T-cell acute lymphoblastic leukemia, who had multiple unrelated chromosomal abnormalities in host cells after chemotherapy and cord blood transplantation (CBT). In 7 consecutive cytogenetic studies after CBT, he showed various chromosomal abnormalities including t(1;11)(p32;q23), t(8;21)(q22.2;q22.2), t(6;10)(p21.3;q26), and del(7) (q22q34). His chromosomal abnormalities were unstable and different in each cytogenetic study except del(7)(q22q34). He had neither anemia nor leukopenia, and his thrombocytopenia continuously improved after CBT. He was clinically stable for 2.5 years despite his complex chromosomal abnormalities. The clinical relevance of genetic instabilities in host cells after CBT is unclear, and long-term monitoring with additional cases is needed.
[Show abstract][Hide abstract] ABSTRACT: We evaluated the role of FDG-PET/CT in patients with metastatic gastric adenocarcinoma before palliative chemotherapy to predict prognosis and chemotherapeutic response.
The study included 35 consecutive newly diagnosed patients with metastatic gastric adenocarcinoma who underwent FDG-PET/CT before palliative chemotherapy. Maximum standardized uptake value (SUVmax) of the primary tumor was assessed to evaluate survival and chemotherapeutic response. Survival analysis was performed for time to progression and overall survival using the Kaplan-Meier method. Cox proportional hazard models were used to determine independent prognostic factors.
All primary tumors were visualized using FDG-PET/CT (mean SUVmax = 8.1 ± 4.5, range 2.5-22.1). Sensitivity, specificity, and accuracy of FDG-PET/CT in detection of solid organ metastasis were 95.2% (20/21), 100% (14/14), and 97.1% (34/35), respectively. No significant difference of primary tumor SUVmax was found among the chemotherapeutic response groups. Univariate survival analysis demonstrated ECOG performance status (≥2), presence of solid organ metastasis, number of organs involved in distant metastasis (≥2), and SUVmax of the primary tumor (>8) as significant predictors for poor overall survival. Multivariate survival analysis showed SUVmax of the primary tumor (P = 0.048), presence of solid organ metastasis (P = 0.015), and ECOG performance status (P = 0.002) as significant independent prognostic predictors for overall survival.
High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.
Journal of Cancer Research and Clinical Oncology 03/2010; 136(12):1929-35. DOI:10.1007/s00432-010-0852-5 · 3.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Intravenous (IV) busulfan has been developed to overcome variable absorption of oral busulfan and tested in several trials. We tested its pharmacological properties and tolerability in 16 Korean stem cell transplantation (SCT) patients. IV busulfan was administered at 0.8 mg/kg every six h for a total of 16 doses (days -7 to -4), which was followed by cyclophosphamide administration at 60 mg/kg every 24 h for two d (days -3 and -2). The median AUC(inf) values (at the first dose) and AUC(ss) (at the steady state) were 1060.4 microM.min (range: 511.1-1812.7) and 1092.5 microM.min (range: 539.7-1560.8) respectively. All patients had an AUC(inf) of <1500 microM.min at the first dose, and 13 of the 16 (81.3%) maintained AUC(ss) levels between 800 and 1500 microM.min. Thirteen of 16 patients showed successful engraftments but four patients (25%) developed hepatic VOD (two of which were fatal), three of whom had advanced disease at the time of SCT. Overall, pharmacokinetics of IV busulfan in our SCT patients appeared comparable with those observed in other study. However, hepatic VOD was a major morbidity in patients with advanced disease.
[Show abstract][Hide abstract] ABSTRACT: This retrospective study compared the results of reduced-intensity conditioning stem cell transplantation (RIST) and a conventional myeloablative regimen (CST) followed by allogeneic peripheral blood stem cell transplantation. In this respect, 63 RISTs and 41 CSTs were performed at 5 transplantation centers in Korea between April 1998 and December 2002. The RIST group had more adverse pretransplant characteristics. More aggressive diseases, like acute myeloid or lymphoblastic leukemia, were included in the CST group, while the RIST group included more indolent diseases, like chronic myeloid leukemia or myeloma (p < 0.001). The incidence of acute graft-versus-host disease (GVHD) grades 2-4 was 29.1 and 57.9% for the RIST and CST groups, respectively (p = 0.010), yet the incidence of chronic GVHD was similar in the two groups (57.4 vs. 71.9%). With a median follow-up of 13 months (0.5-61 months, 17 months in 52 survivors), the 3-year overall (OS) and disease-free survival (DFS) was similar in the RIST and CST groups (p = 0.965 for OS, p = 0.545 for DFS). In a multivariate analysis, RIST (p = 0.010), good performance status (p = 0.006) and a higher CD34+ cell dose (p = 0.008) were all identified as independent favorable prognostic factors for OS. Accordingly, in the current study, RIST produced equivalent or acceptable results compared with CST in terms of OS. Therefore, a prospective randomized trial of RIST and CST is warranted.
[Show abstract][Hide abstract] ABSTRACT: LEARNING OBJECTIVES
To describe the MR imaging with the clinicopathologic correlation of marrow changes after treatment in the leukemic patients. To provide differential diagnostic points on MR imaging from other bone marrow disorders.
Magnetic resonance imaging (MRI) are useful for noninvasive monitoring of hematopoietic changes after the treatment even though chemotherapy or bone marrow transplantation (BMT).The pattern of these marrow changes with the clinical manifestation allows the post-therapy interpretations including 1) the diagnosis of complication during treatment such as infection etc. and 2) objective measures of marrow response to therapy, In this pictorial essay, the authors describe the MR imaging findings of various form of marrow changes after treatment with clinicopathologic correlation, providing differential diagnostic points from other post-treatment hematopoietic disorder.
Radiological Society of North America 2004 Scientific Assembly and Annual Meeting; 11/2004
[Show abstract][Hide abstract] ABSTRACT: Cyclin-dependent kinase inhibitor p27Kip1 functions at the nuclear level by binding to cyclin E/cyclin-dependent kinase-2. It was shown that Akt or protein kinase B (Akt/PKB)-dependent phosphorylation of p27Kip1 led to the cytoplasmic mislocalization of p27Kip1, suggesting the potential abrogation of its activity. Here, we evaluated the localization of p27Kip1 protein in leukemic blasts in relation to Akt/PKB phosphorylation and clinical outcomes in acute myelogenous leukemia (AML). Western blot analysis of the nuclear and cytoplasmic fractions revealed a heterogenous localization pattern of p27Kip1 in AML. Cytoplasmic mislocalization of p27Kip1 was significantly associated with the constitutive serine(473) Akt/PKB phosphorylation in AML cells (P < 0.05). Transfection of U937 cells with an expression construct encoding the constitutively active form of Akt/PKB resulted in a remarkable increase in the levels of cytoplasmic p27Kip1. Whereas the transfection of U937 cells with a construct encoding dominant-negative Akt/PKB resulted in a recovery of nuclear localization of p27Kip1. Both the disease-free survival and overall survival are significantly shorter in AML cases with high cytoplasmic to nuclear ratio of p27Kip1 localization compared with the cases with low cytoplasmic to nuclear ratio (P = 0.0353, P = 0.0023, respectively). Multivariate analysis indicated that the cytoplasmic to nuclear ratio of p27Kip1 localization was an independent prognostic variable for both disease-free survival and overall survival (P = 0.043, P = 0.008, respectively). These findings additionally extend our understanding of the role of p27Kip1 in AML, and buttress the case of p27Kip1 mislocalization as a prognostic indicator and Akt/PKB/p27Kip1 pathway as a ready target for antileukemia therapy.
Cancer Research 09/2004; 64(15):5225-31. DOI:10.1158/0008-5472.CAN-04-0174 · 9.33 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The F-box protein S-phase kinase-associated protein 2 (Skp2) positively regulates the G(1)-S phase transition by controlling the stability of several G(1) regulators, such as p27Kip1. However, the clinical significance of Skp2 in patients with acute myelogenous leukemia (AML) remains unknown.
We examined the clinical and biological significance of Skp2 expression in AML and evaluated the relationship between Skp2 and p27Kip1 expression and phosphatase and tensin homologue (PTEN) phosphorylation.
Western blot analysis showed that high Skp2 expression was observed in 57 (57.6%) cases and significantly correlated with unfavorable cytogenetics (P = 0.035) but not with age, white blood cell count, serum lactic dehydrogenase level, and the French-American-British subtype. An inverse correlation was not observed between Skp2 and p27Kip1 expression. However, p27Kip1 protein was preferentially localized to cytoplasm in the high-Skp2-expression group. The cytoplasmic to nuclear ratio of p27Kip1 expression was significantly correlated with the levels of Skp2 expression (P < 0.001). The frequency of PTEN phosphorylation was significantly higher in the high-Skp2-expression group compared with the low- Skp2-expression group (P = 0.035). The Skp2 overexpression was significantly associated with shorter disease-free survival and overall survival (P = 0.0386 and P = 0.0369, respectively). Multivariate analysis showed that Skp2 expression was an independent prognostic factor both in the disease-free survival and overall survival.
These findings suggest that Skp2 expression is an independent marker for a poor prognosis in AML. The presence of a positive correlation between Skp2 and phosphorylated PTEN suggests that an aberration in the PTEN/Skp2 signaling pathway might be operating in AML.
Clinical Cancer Research 08/2004; 10(15):5123-30. DOI:10.1158/1078-0432.CCR-04-0136 · 8.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Major ABO incompatibility may be potentially associated with immediate or delayed hemolysis and delayed onset of erythropoiesis in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). To determine if hemolysis can be prevented by the inhibition of graft erythropoiesis, we performed hypertransfusion and assessed red cell transfusion requirement and independence. Between October 1995 and December 2001, 28 consecutive patients receiving major ABO incompatible HSCT at Samsung Medical Center were hypertransfused to maintain their hemoglobin levels at 15 g/dL or more. We retrospectively compared the outcomes of these patients with those of 47 patients at Asan Medical Center whose target hemoglobin levels were 10 g/dL. Reticulocyte engraftment was significantly delayed in hypertransfused group (51 days vs. 23 days; p=.001). There was no significant difference in the total amount of red cells transfused within 90 days post-HSCT (25 units vs. 26 units; p=.631). No significant difference in the time to red cell transfusion independence was observed between the two groups (63 days vs. 56 days; p=.165). In conclusion, we failed to improve red cell transfusion requirement and independence in major ABO incompatible HSCT with hypertransfusion.
Journal of Korean Medical Science 03/2004; 19(1):79-82. DOI:10.3346/jkms.2004.19.1.79 · 1.27 Impact Factor