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Ogawa, Hiroyuki ; Yanagisawa, Kunio ; Nakamura, Akihiro ; Kobayashi, Mizue ; Ishizaki, Yoshimi ; Kodama, Tomoko ; Hoshikawa, Koumei ; Tago, Akihiro ; Gohda, Fumito ; Hayashi, Toshimasa ; Sawamura, Morio ; Uchiumi, Hideki ; Nojima, Yoshihisa ; Handa, Hiroshi ; 小川, 孔幸 ; 柳澤, 邦雄 ; 中村, 聡洋 ; 小林, 瑞枝 ; 石﨑, 芳美 ; 兒玉, 知子 ; 干川, 孔明 ; 田子, 明弘 ; 合田, 史 ; 林, 俊誠 ; 澤村, 守夫 ; 内海, 英貴 ; 野島, 美久 ; 半田, 寛
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Miyazawa, Yuri ; Irisawa, Hiroyuki ; Matsushima, Takafumi ; Mitsui, Takeki ; Uchiumi, Hideki ; Saitoh, Takayuki ; Handa, Hiroshi ; Karasawa, Masamitsu ; Murakami, Hirokazu ; Tsukamoto, Norifumi ; Nojima, Yoshihisa
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Journal Article<br />We describe a patient with biphenotypic acute leukemia (BAL) with T-lymphoid lineage and\nmyeloid l
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ineage differentiation［BAL (T/M)］. Cytogenetic analysis revealed complex chromosomal\nabnormalities, including der(2)t(2;11)(p21;q23). Neither leukemia cells nor T-cell receptor gene\nrearrangements were detected in the bone marrow samples after four courses of high dose cytosine\narabinoside regimen. However, der(2)t(2;11)(p21;q23) anomaly persisted in most of metaphases.\nFluorescence in situ hybridization (FISH)analysis with a probe for MLL did not detect the split signal.\nForty-five cases of hematological disorder with t(2;11)(p21;q23) abnormality have been previously\nreported. The majority of such cases have been classified as myelodysplastic syndrome(MDS) or acute\nmyeloid leukemia (AML). This is the first case BAL (T/M) associated with a t(2;11)(p21;q23)\nanomaly.
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Toyama, Kohtaro ; Mitsui, Takeki ; Yokohama, Akihiko ; Saitoh, Takayuki ; Uchiumi, Hideki ; Handa, Hiroshi ; Sakuraya, Masataka ; Murakami, Hirokazu ; Nojima, Yoshihisa ; Tsukamoto, Norifumi
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Journal Article<br />A 64-year-old woman,with more than a 20 year history of polycythemia vera(PV),developed portal\nhypertension,myelofibrosis and extramedullary hematopoiesis accompanied by massive ascites.
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Portal\nhypertension resulted not only from infiltration of the liver sinusoids by hematopoietic cells but also from\nnodular regenerative hyperplasia of the liver. Wright-stained smears of ascites samples consisted of\nmesothelial cells and macrophages. However,cultures of mononuclear cells from the ascites showed the\npresence of hematopoietic progenitor cells including megakaryocyte colony formation and burst forming\nunits. The JAK2-V617F mutation was positive in granulocytes. Contrary to other reports, radiation\ntherapy was not effective and severe myelosuppression continued for more than one month. We present\nthe unusual clinical course for this case of PV and discuss the pathophysiology of refractory ascites.
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Uchiumi, Hideki ; Ogawa, Yoshiyuki ; Yanagisawa, Kunio ; Gohda, Fumito ; Ogura, Hidemi ; Mawatari, Momoko ; Sawamura, Morio ; Nojima, Yoshihisa ; 内海, 英貴 ; 小川, 孔幸 ; 柳沢, 邦雄 ; 合田, 史 ; 小倉, 秀充 ; 馬渡, 桃子 ; 澤村, 守夫 ; 野島, 美久
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application/pdf<br />Journal Article<br />[背景・目的]抗レトロウイルス療法を継続中のHIV(human iumnunodeficiency virus)感染者の一部では\n血液中のウイルス量が十分
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抑制されているにもかかわらず,CD4陽性T細胞の回復が十分でない症例が認\nめられるため,この要因にっいて検討をした.[対象と方法]群馬大学医学部附属病院及び関連施設におい\nて,抗HIV療法下で5年以上の長期間にわたってウイルス血症が検出限界以下と艮好にコントロールされて\nいるHIV感染者46名におけるCD4陽性T細胞数の回復と,治療開殆時の年齢, CD4陽性T細胞数,治療レ\nジメン,性別との関係について相関をみた.[結 果]CD4陽性T細胞数の回復が不十分なグループ(CD4\n数く350/Ul)は艮好なグループ(CD4数≧350/Ul)と比較して,治療開殆時のCD4陽性T細胞数が統計学的\n有意に少ない傾向にあった(28.1vs 124.9/Ul p=O.006)が,治療開殆時の年齢には差を認めなかった(50.7歳\nvs 442歳p=O.120).また,性別や治療薬による差もCD4陽性T細胞回復に影響しなかった.[結 語]高\n度に免疫低下が進行したHIV感染者においては有効な抗レトロウイルス療法がなされたとしても治療開殆\n前のCD4陽性T細胞数の低い症例ではその後の免疫再構築が不十分なことがあり,早期発見,早期治療の重\n要性が示唆された.
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Matsumoto, Kumiko ; Yokohama, Akihiko ; Yuzuriha, Akinori ; Toyama, Kohtarou ; Mitsui, Tateki ; Hashimoto, Yoko ; Koiso, Hitomi ; Saitoh, Takayuki ; Uchiumi, Hideki ; Handa, Hiroshi ; Karasawa, Masamitsu ; Murakami, Hirokazu ; Matsui, Hiroshi ; Suzuki, Kazuhiro ; Tsukamoto, Norifumi ; Nojima, Yoshihisa
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Iriuchishima, Hirono ; Handa, Hiroshi ; Takizawa, Makiko ; Yokohama, Akihiko ; Uchiumi, Hideki ; Matsushima, Takafumi ; Tsukamoto, Norifumi ; Karasawa, Masamitsu ; Murakami, Hirokazu ; Nojima, Yoshihisa
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application/pdf<br />Journal Article<br />An 18 year-old male was admitted to our hospital suffering from a large tumor which was located\nat the right frontal bone. He was diagnosed to have acute myeloid leukemia (AML) with
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granulocytic\nsarcoma (GS). A chromosomal analysis showed t(8; 21), and a flow cytometric analysis demonstrated\nthe leukemic cells to be positive for CD56.\nSystemic chemotherapy and radiation therapy to the GS, but the patient experienced a relapse in the\nlumbar vertebrae. He underwent an umbilical-cord blood stem cell transplantation, however, he died 7\nmonths thereafter. GS is a localized tumor consisting of leukemic myelolasts, which is generally\nobserved as a complication of either AML, myelodysplastic syndrome, or myelobproliferative disorders.\nWe herein report this case due to its rarity, even though various sites of GS have been reported.
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