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Biomedical subjects

C Shimazaki

Publications and source records attributed to C Shimazaki.

At least 127 records · Page 7Linked to original sources
PubMed1993

[Chronic myelomonocytic leukemia and esophageal cancer developed in a renal allograft recipient].

A 46-year-old man treated with azathioprine (100-150 mg/day) and prednisolone (10mg/day) for 14 years after allogeneic renal transplantation, was admitted to our hospital in December, 1988 for the evaluation of leukocytosis. His leukocyte count was 32,700/microliters with 38% monocytes and 2% blasts. Chromosomal analysis of the bone marrow revealed 45, XY, -7. He was diagnosed as chronic myelomonocytic leukemia (CMML), and treated with low-dose Ara-C. Two months later, he progressed to overt acute leukemia, and he complained of difficulty in swallowing. Endoscopic examination revealed esophageal cancer. The patient died of respiratory failure on April 18, 1989. This case suggests that immunosuppressive agents might play an important role on the pathogenesis of CMML and esophageal cancer.

Azathioprine↗
PubMed1992

Immunophenotype and DNA content of myeloma cells in primary plasma cell leukemia.

To clarify the biological characteristics of the myeloma cells in primary plasma cell leukemia (PCL), we studied the immunological phenotype and DNA content of cells from five patients with primary PCL as compared to those from the patients with typical multiple myeloma (MM). In two of five patients with PCL myeloma cells had B-cell-associated antigens (B1, J5) and surface immunoglobulin in addition to plasma cell associated antigens, suggesting that these cells are immunologically immature as compared to mature plasma cells. Concerning the DNA content of myeloma cells, two of four patients had hypodiploid while two had diploid myeloma cells. In contrast, 24 of the 37 (65%) patients with typical MM had hyperdiploid and 1 had hypodiploid myeloma cells. These observations suggest that the myeloma cells in PCL are immunologically heterogeneous. The increased incidence of hypodiploidy in PCL may explain its relatively poor prognosis as previously shown in those with typical MM and hypodiploid DNA content.

Adult↗
PubMed1992

Novel type of clonally involved cytoplasmic immunoglobulin-negative cells in multiple myeloma: flow cytometric study.

In order to identify myeloma cells and their precursor cells, we studied bone marrow samples from 39 patients with multiple myeloma, including 2 with plasma cell leukemia, using dual parameter cytometry of both DNA and cytoplasmic immunoglobulin (Cyt-Ig). Myeloma cells from 25 patients (64.1%) were aneuploid and those from the remaining 14 patients were diploid. In 25 patients with aneuploid myeloma, we found a small component of cells which had aneuploid DNA content without Cyt-Ig in addition to myeloma cells showing aneuploidy with Cyt-Ig. These aneuploid Cyt-Ig-negative cells were considered to be clonally involved because they were aneuploid, and detected predominantly in patients with stage III myeloma. This suggests that these cells may contribute to disease progression. The characteristics of these cells are described and the relationship between these cells and myeloma precursor cells is discussed.

Aneuploidy↗
PubMed1992

Effects of interleukin-3 and interleukin-6 on peripheral blood cells from multiple myeloma patients and their clinical significance.

The effects of interleukin-3 (IL-3) and interleukin-6 (IL-6) on nonadherent mononuclear cells (NMC) from the peripheral blood of 28 patients with multiple myeloma (MM), 3 patients with monoclonal gammopathy of undetermined significance (MGUS), and 3 normal controls were investigated. In 15 of 27 evaluable patients with MM, monoclonal-cytoplasmic-immunoglobulin (cIg)-positive plasma cells appeared from the T-cell-depleted NMC after 10 days of culture in the presence of IL-3 and IL-6. These changes were not observed in the T cell fraction of myeloma blood or in the T-cell-depleted NMC obtained from cases of MGUS or from normal controls. The percentage of cIg-positive plasmacytoid cells after 10 days of culture was significantly higher in the presence of both IL-3 and IL-6 than with each interleukin alone or the control medium. Furthermore, these changes were often observed in untreated patients. These findings suggest that myeloma precursor cells exist in the peripheral blood of MM patients, especially at diagnosis, and differentiate into cIg-positive cells in the presence of IL-3 and IL-6. This assay may be useful in discriminating the early stage of myeloma from MGUS.

Antigens, CD↗
PubMed1992

[A successfully treated case of acute renal failure due to acute immune hemolytic anemia and nontraumatic rhabdomyolysis induced by streptomycin reinjection].

A case of acute immune hemolytic anemia associated with non-traumatic rhabdomyolysis (NTR) induced by streptomycin (SM) reinjection, which developed acute renal failure, has been reported. A 70-year-old female was admitted to our hospital because of sudden macroscopic hematuria after reinjection of 1g. SM. Laboratory findings on admission were as follows; hemoglobin and myoglobin were positive in urine. RBC 129 x 10(4)/microliters, Hb 4.9g/dl, Ht 11.1%, reticulocytes 52/1000, serum indirect billirubin 3.8g/dl, LDH 9, 230 WU, BUN 149mg/dl, Cr 7.9mg/dl, myoglobin 1, 400ng/ml and haptoglobin 10.6mg/dl. The drug lymphocyte stimulating test of SM was positive (215%). A direct antiglobulin test was also positive. An indirect antiglobulin test was negative, but became positive after incubation with SM. These observations made the diagnosis of SM-induced hemolytic anemia associated with NTR. On the second hospital day she developed anuria, and was put on hemodialysis treatment. Two months after the acute hemolytic episode and acute renal failure she recovered and is presently in good health without recurrence.

Acute Disease↗
PubMed1992

[Auer rods-positive neutrophils observed at diagnosis increased after remission induction in patient with acute promyelocytic leukemia].

50-year-old male was admitted to our hospital because of gingival bleeding and fever in August 1987. The leukocyte count was 13,300/microliters with 80.5% leukemic promyelocytes and bone marrow was hypercellular with 86.4% leukemic promyelocytes. A small number of mature neutrophils containing Auer rods were seen in bone marrow. On a diagnosis of acute promyelocytic leukemia and treated with induction chemotherapy consisting of behenoyl-arabinofuranosyl cytosine (BHAC), daunorubicin, 6-mercaptopurine (6-MP) and prednisolone (PSL) was reformed. After cytoreduction, leukemic cells reappeared in the peripheral blood, concomitant with mature neutrophils having Auer rods. Vitamin D3 was not effective as a differentiation inducing agent. Complete remission was obtained in November 1987 by the reinduction chemotherapy consisting of BHAC, aclarubicin, 6-MP and PSL. In this case, neutrophils with Auer rods might have been derived from the leukemic clone and differentiation of leukemic promyelocytes by intensive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Collection of peripheral blood stem cells mobilized by high-dose Ara-C plus VP-16 or aclarubicin followed by recombinant human granulocyte-colony stimulating factor.

We developed an effective method for harvesting large numbers of peripheral blood stem cells (PBSC) for use in autotransplantation. Twenty patients with hematological malignancies were treated with high doses of Ara-C (12 g/m2) and VP-16/aclarubicin followed by administration of rhG-CSF (50 micrograms/m2). The optimal time for starting PBSC collection was determined by monitoring the CD34-positive stem cells in blood using immunomagnetic beads. PBSC were collected with a CS-3000 blood cell separator. A total blood volume between 7000 and 9000 ml was processed in each apheresis. Under these conditions, a total of 64 apheresis procedures was performed in the 20 patients. The mean numbers of mononuclear cells and of CFU-GM harvested per apheresis were 4.1 x 10(8)/kg and 110 x 10(4)/kg, respectively. A number of CFU-GM sufficient for engraftment (> 30 x 10(4)/kg) could be harvested by a single apheresis in 15 of the 20 patients. So far, 11 patients have been transplanted with PBSC and obtained rapid hematopoietic recovery. The median time to recover neutrophils more than 0.5 x 10(9)/l was 10 days, and that for platelets 50 x 10(9)/l was 11 days. This method for harvesting large numbers of PBSC allows safer autotransplantation in patients with chemoradiosensitive tumors, and is applicable to older patients.

Aclarubicin↗
PubMed1991

Detection of minimal residual myeloma cells by dual parameter analysis of DNA and cytoplasmic immunoglobulin.

We demonstrated the utility of dual parameter analysis of DNA and cytoplasmic immunoglobulin for the detection of minimal residual myeloma cells in bone marrow and peripheral blood. This method is sensitive: even 0.1% of contaminating myeloma cells could be detected in peripheral blood of myeloma patients and in the model experiments using cell lines. This method is useful for the selection of patients undergoing high-dose chemotherapy and autologous blood stem cell transplantation.

Bone Marrow↗
PubMed1991

[Chronic lymphocytic leukemia with bilateral exophthalmos and visual disturbance].

A 61-year-old male was admitted to our hospital because of progressive bilateral exophthalmos and visual disturbance. He was diagnosed as chronic lymphocytic leukemia (CLL) with stage I of Rai system. Ophthalmologic examinations suggested that CLL cells might have invaded diffusely to bilateral orbits. Radiation to orbital lesions might result in other ophthalmologic complications such as cataract, therefore we tried to treat him with chemotherapy alone. As a result, combination chemotherapy consisting of vincristine, cyclophosphamide, prednisolone and doxorubicin (VEPA) and additional daily oral administration of cyclophosphamide were effective enough for his ophthalmologic recovery.

Exophthalmos↗
PubMed1991

[Studies on 13 cases of double gammopathy].

By a combined use of immunoelectrophoresis and immunofixation, we detected 13 cases of double gammopathy among 269 cases of monoclonal gammopathy investigated between 1986 and 1990. The incidence of double gammopathy (4.8%) was greater than that in previous studies. Double gammopathy was classified into 5 groups: (1) identical pairs of both heavy (H)- and light (L)-chains (1 case); (2) identical H-chains and different L-chains (2 cases); (3) different H-chains and identical L-chains (3 cases); (4) different pairs of both H- and L-chains (5 cases); and (5) monoclonal immunoglobulin and Bence Jones protein of different type (2 cases). An additional M-component was detected during the course of illness in 2 of the 13 cases. As to H-chain combinations, a pair of IgG and IgA (46%) was most frequently encountered. Seven patients had myeloma, three benign double gammopathy and two macroglobulinemia. One case of benign double gammopathy developed IgA (lambda) myeloma three years after the diagnosis. Serum and urine immunofixation is a useful method to detect a trace amount of M-component and to follow up the clinical course of monoclonal gammopathy.

Adult↗
PubMed1991

Philadelphia chromosome positive precursor B-cell acute lymphoblastic leukemia with a translocation t(2;14)(p13;q32).

A female patient with precursor B-cell acute lymphoblastic leukemia (precursor B-ALL) was analyzed cytogenetically. Karyotyping of the leukemic cells showed a Philadelphia chromosome (Ph1), and also showed a translocation between 2p13 and 14q32, which is thought to be specific for children with B-cell chronic lymphocytic leukemia. DNA analysis with both conventional and pulsed-field gel electrophoresis revealed the rearrangement of the c-abl gene, the BCR gene outside the 5.8 kb breakpoint cluster region (bcr or M-BCR), and the comigration of an abnormal Not I pHabl 5' and 3'-bcr fragment, indicating the presence of BCR/c-abl recombination. The JH gene was rearranged, but the JK gene showed a germline configuration, as with previously reported cases with a t(2;14). This case is the first report of a patient with Ph1-positive precursor B-ALL, in whom a specific translocation t(2;14)(p13;q32) is found simultaneously.

Adult↗
PubMed1991

[Successful pregnancy after 6 years complete remission in patient with acute myeloblastic leukemia].

A 25-year-old woman was diagnosed as acute myeloblastic leukemia (M1 in FAB classification) in May 1983, and treated with DCMP regimen, which led to the complete remission. Intensification therapies and maintenance therapy with OK-432 were continued until August 1988, and 10 months later she conceived. She delivered a healthy 2,680 g male baby at 36th week of pregnancy by Cesarean section because of abruptio placentae. This case suggests that normal pregnancy is possible in patients with acute leukemia who received anti-cancer drugs.

Adult↗
PubMed1990

Translocation between chromosomes 8q24 and 14q11 in T-cell acute lymphoblastic leukemia.

Cytogenetic study was performed on a patient with T-cell acute lymphoblastic leukemia (T-ALL). It revealed a chromosomal translocation between chromosome bands 8q24 and 14q11. 8q24 is known to encode the oncogene c-myc, while 14q11 encodes the genes for T-cell receptor-alpha (TCR-alpha) and T-cell receptor-delta (TCR-delta). Therefore, this chromosomal translocation t(8;14) (q24;q11) seemed to be unique and specific to T-cell malignancy.

Adult↗
PubMed1990

Chromosomal abnormalities define clonal proliferation in CD3- large granular lymphocyte leukemia.

Six patients with lymphoproliferative disorder of large granular lymphocytes (LDGL) were studied for chromosomal abnormalities. When the patients were divided into two groups depending on the expression of a mature antigen of T cell lineage, CD3, two with CD3+ phenotype had a stable disease, whereas three of the four patients with CD3- phenotype had marked hepatosplenomegaly and a highly aggressive disease. Chromosomal abnormalities were detected in four of six patients, indicating a clonal proliferation of large granular lymphocytes in individual patients. In particular, chromosomal abnormalities were found in three of the four patients with CD3- LDGL, all of which had a germ-line configuration of the T cell receptor beta-chain gene. Thus, the chromosomal abnormalities provide definitive evidence for the clonal origin of the expanded cells in the CD3- LDGL.

Adult↗
PubMed1990

Giant neutrophils derived from tetraploid leukemic clone in an acute myeloblastic leukemia: cytofluorometric study.

Near-tetraploid chromosomes were observed in a patient with acute myeloblastic leukemia with maturation (M2 in FAB classification). Large and morphologically bizarre leukemic cells and giant neutrophils in each maturation stage were observed in both peripheral blood and bone marrow. Cytogenetic studies revealed that the main stem line was 93; XXYY, +9, and DNA cytofluorometry showed that these large leukemic cells and giant neutrophils had 4C DNA content. These findings strongly suggested that these giant neutrophils were derived from leukemic clone with tetraploidy.

Aged↗