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Takashi Ashida,
Ami Kawano,
Erika Yamada,
Daisuke Ide,
Chiemi Sugano,
Yuko Kato,
Yuko Tsubakimoto,
Shiho Ito,
Yoshiko Mine,
Michiko Fujita,
Yasushi Kanemitsu,
Yoshiyuki Morishima,
Yasuyoshi Morita,
Hirokazu Tanaka,
Takahiro Shimada,
Kazunobu Kawanishi,
Junichi Miyatake,
Yoichi Tatsumi,
Itaru Matsumura
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ABSTRACT: We retrospectively investigated the status of transfusional iron overload at Kinki University Hospital. One hundred and sixty three patients received more than 10 red blood cell (RBC) units per year in 2009 and 2010. Myelodysplastic syndrome (37.4%) and aplastic anemia (11.0%) accounted for about 50% of the underlying diseases. At the time of receiving a total of 20 RBC units, 90.8% and 66.2% of the 65 patients evaluated had more than 500 and 1,000 ng/ml of serum ferritin, respectively. The frequency of organ dysfunction associated with iron overload was 56.9% of all the patients assessed, 37.8% of patients with serum ferritin levels of 500∼999 ng/ml, and 67.4% of patients with serum ferritin levels >1,000 ng/ml. Although the Japanese guidelines propose 40 units of RBC transfusion and/or a serum ferritin level of 1,000 ng/ml as a good point to start iron chelation therapy, our results suggest that iron overload and consequent organ dysfunction may occur earlier than this. Therefore, it may be necessary to start iron chelation therapy earlier than that suggested by the Japanese guidelines.
[Rinshō ketsueki] The Japanese journal of clinical hematology 04/2013; 54(4):365-9.
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ABSTRACT: A 32-year-old woman was referred to our hospital due to systemic lymphadenopathy. The patient's peripheral blood showed expansion of CD5(+)CD20(+)CD38(+)CD23(-) mature lymphocytes. However, the axillary lymph nodes were infiltrated by both CD23(+) large lymphocytes and CD23(-) small lymphocytes. Because the pattern of the rearranged immunoglobulin heavy chain gene was different between the peripheral blood and lymph node samples in a Southern blot analysis, the patient was diagnosed with Richter syndrome, in which diffuse large B-cell lymphoma develops from a clone distinct from B-cell chronic lymphocytic leukemia. After undergoing rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) therapy, the patient was successfully treated with allogeneic hematopoietic transplantation, and no relapse was observed for three years.
Internal Medicine 01/2013; 52(2):273-6. · 0.94 Impact Factor
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ABSTRACT: KL-6, a mucinous high—molecular weight glycoprotein expressed on type 2 pneumocytes, has been shown to be elevated in the
serum and bronchoalveolar lavage fluid of patients with interstitial pneumonitis (IP). We measured the serum levels of KL-6
in patients after they had undergone allogeneic bone marrow transplantation (BMT) to determine whether KL-6 could be a clinically
useful indicator for the development of IP. The serum concentrations of KL-6 were determined by a sandwichtype enzyme-linked
immunosorbent assay using an anti—KL-6 monoclonal antibody. A total of 1028 samples were tested from 76 patients (78 transplantations)
who received BMTs. The KL-6 values were markedly elevated in patients with pulmonary complications, but not in those with
acute and chronic graft-versus-host disease, hemorrhagic cystitis, herpes encephalitis, sepsis, and veno-occlusive disease.The
serum levels of KL-6 from patients with pulmonary complications were significantly higher than from those without pulmonary
complications (P < .001) and those with other complications (P < .001). Of the 12 patients with pulmonary complications, 6 had idiopathic IP (IIP). The levels were not high at the onset
of IIP. Four of 6 IIP patients showed marked elevations of KL-6 levels in parallel with the severity of IP and died of respiratory
failure without response to treatment.Assessment of serum KL-6 levels might not be useful for the early diagnosis of IP, but
may be a useful indicator for monitoring the severity of IP after BMT.
International Journal of Hematology 04/2012; 74(4):464-468. · 1.27 Impact Factor
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ABSTRACT: Here we report the first case of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), who initially presented with peripheral neuropathy. Nerve conduction, cerebral spinal fluid studies and his clinical course were compatible with sub-acute demyelinating polyradiculoneuropathy. In addition, left cervical lymph node swelling was observed on admission. Diagnosis of PTCL-NOS was made by the histological, immunohistochemical, and Southern blot analyses on the biopsy specimen from the enlarged lymph node. Combination chemotherapy composed of cyclophosphamide, vincristine, doxorubicin and prednisolone (CHOP) was effective for polyneuropathy as well as for lymphoma. Several antibodies relating to paraneoplastic syndrome such as Ma1, Ma2, Amphiphysin, CV2, Ri, Yo and Hu were all negative. Because sural nerve biopsy performed prior to CHOP therapy revealed no infiltration of lymphoma cells, immune dysfunction mediated by some cytokine or unidentified autoantibody related to PTCL-NOS was thought to be involved in the polyradiculoneuropathy.
Internal Medicine 01/2012; 51(15):2015-20. · 0.94 Impact Factor
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Yasuyoshi Morita,
Takahiro Shimada,
Terufumi Yamaguchi,
Shinya Rai,
Chikara Hirase,
Masakatsu Emoto,
Kentaro Serizawa,
Yasuhiro Taniguchi,
Mayuko Ojima,
Yoichi Tatsumi, Takashi Ashida,
Itaru Matsumura
International journal of hematology 11/2011; 94(6):583-4. · 1.17 Impact Factor
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ABSTRACT: We report a rare case of chronic myelomonocytic leukemia (CMML) with pericardial effusion. After receving the diagnosis of CMML, she had been successfully treated with hydroxycarbamide (HU). However, she was admitted to our hospital due to pericardial effusion. The majority of the cells in the pericardial fluid were monocytes. We made the diagnosis of pericardial involvement with CMML cells and intravenously administered etoposide (100 mg/body daily for 5 days). Although CMML cells disappeared from the peripheral blood, the pericardial effusion still persisted. This case indicates that pericardial effusion is a possible and life-threatening complication in CMML patients despite stably controlled leukocytes.
Internal Medicine 01/2011; 50(16):1737-40. · 0.94 Impact Factor
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Yasuyoshi Morita,
Mitsuhiro Matsuda,
Terufumi Yamaguchi,
Mika Sakaguchi,
Shinya Rai,
Yoshitaka Kanai,
Chikara Hirase,
Kazunobu Kawanishi,
Junichi Miyatake,
Takahiro Shimada,
Yoichi Tatsumi, Takashi Ashida,
Yasuhiro Maeda,
Akihisa Kanamaru
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ABSTRACT: We report a case of primary cardiac lymphoma (PCL) occurring in a 76-year-old man during maintenance hemodialysis. Chest computed tomography (CT) revealed a tumor with pericardial effusion in the left ventricular posterior wall. Cytological examination of the pericardial fluid revealed monotonous lymphoid cells positive for B-cell markers, and clonal immunoglobulin heavy chain gene rearrangement was detected, indicating B-cell lymphoma. Rituximab monotherapy was administered biweekly at the therapeutic level on hemodialysis. The follow-up chest CT showed tumor disappearance with pericardial fluid after two courses of therapy. Rituximab monotherapy was effective for an elderly hemodialysis patient with PCL.
Internal Medicine 01/2010; 49(19):2163-6. · 0.94 Impact Factor
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ABSTRACT: A 53-year-old male with myelodysplastic syndrome developed Sweet's syndrome extensively over his left iliac and inguinal regions that was refractory to standard treatment with corticosteroids and chemotherapy, received a stem cell transplant from an HLA-matched unrelated donor, conditioned by reduced-intensity regimen. The patient achieved complete hematological remission, and the cutaneous lesions improved gradually and then disappeared completely despite the patient receiving granulocyte colony-stimulating factor after transplantation and developing acute graft-versus-host disease.
Hematology (Amsterdam, Netherlands) 07/2006; 11(3):179-81. · 1.33 Impact Factor
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ABSTRACT: Eosinophilic colitis is a rare inflammatory disease characterized by eosinophilic infiltration of the colon and peripheral blood eosinophilia. We report on a case of eosinophilic colitis in a 29-year-old woman with acute myeloid leukemia following allogeneic bone marrow transplantation from her HLA-identical sister. To our knowledge, eosinophilic colitis has rarely been reported in association with allogeneic bone marrow transplantation.
International Journal of Hematology 08/2003; 78(1):76-8. · 1.27 Impact Factor
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Takashi Ashida,
Yasuhiro Maeda,
Akihisa Kanamaru,
Tatsuo Ichinohe,
Takahisa Yamane,
Kazuo Hatanaka,
Hiroyasu Ogawa,
Yutaka Kobayashi,
Hiroshi Hara,
Tetsuya Inoue,
Tateo Sugiyama,
Kenichi Nagai
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ABSTRACT: The status of reduced-intensity stem cell transplantation (RIST) in the Kinki area was investigated by questionnaires. We sent out questionnaires to 72 institutions and received 51 replies (72.2%). RIST was performed in 16 institutions (31.4%). A total of 91 cases were included of whom approximately 70% were non-remission or advanced hematological malignancies. Various conditioning regimens were used for RIST, most often consisting of fludarabine, busulfan and antithymocte globulin. Acute GVHD developed in 57% of all patients. Relapse or disease progression developed in 42.7% of evaluable patients. The overall survival rate was 54.6%, and 80% of low risk patients were alive at the time of analysis.
[Rinshō ketsueki] The Japanese journal of clinical hematology 07/2003; 44(6):407-13.
