PubMed Health⌕ Search

Biomedical subjects

F Kodama

Publications and source records attributed to F Kodama.

At least 73 records · Page 4Linked to original sources

The effect of 1-hydroxyvitamin D3 for prolongation of leukemic transformation-free survival in myelodysplastic syndromes.

Leukemic transformation (LT) free survival was studied in 30 patients with myelodysplastic syndromes (MDS). In 15 cases, 4-6 micrograms/day of 1-hydroxyvitamin D3 was administered, for a median duration of 17 months (D-group), other subjects had no therapy (N group). LT free survival of the D group had significant advantage over that of the N group according to the Kaplan-Meier method (P less than 0.001). In addition, 7 cases in the N group developed acute leukemia, in contrast to only one in the D group (P less than 0.05). These results suggest that oral administration of 1-hydroxyvitamin D3 prevents the progression of MDS to overt leukemia under the effect of differentiation capacity from blasts to monocytes.

Acute Disease↗

[Studies on EDTA-dependent pseudoneutropenia].

The phenomenon of EDTA-dependent pseudoleukocytopenia was observed in seven patients during the period from September 1989 to March 1990. The pseudoleukocytopenia was found to have come from aggregation of neutrophils. The aggregations were composed of neutrophils only, and did not include other granulocytes, monocytes and lymphocytes. The aggregations showed their maximum in size from 30 to 180 minutes after venipuncture at room temperature. The aggregated neutrophils were again dispersed by incubating at 37 degrees C for 30 minutes. The degree of aggregation was found to be dependent on the concentration of EDTA. Neutrophil aggregation was not recognized in the blood films when sodium citrate or heparin was used as an anticoagulant. The results of mercaptoethanol agglutination test and immunocytochemical staining suggest that IgM antibody may play an important role in the formation of neutrophil aggregation. Four of the seven patients had suffered from hepatic disorder. However, the mechanism of EDTA-dependent neutrophil aggregation remains uncertain.

Adult↗

[Clinical effects of low-dose Ara-C in acute nonlymphocytic leukemia and myelodysplastic syndromes].

Forty-eight patients with acute nonlymphocytic leukemia (ANLL) and myelodysplastic syndromes (MDS) were treated with low-dose Ara-C regimen (LDAC) (10 mg/m2 or 10 mg/body subcutaneously every 12 hours). Complete remission (CR) was obtained in sixteen patients (33%) and partial remission (PR) in six (16%). Seven of eight patients with hypoplastic leukemia entered CR. However, LDAC was not effective in MDS and ANLL developing from MDS. The rate of CR was 20% in relapsed or refractory ANLL. Relapse was occurred in thirteen patients until now. The median duration of remission was 7 months (range: 3-20 months). Seven of the sixteen patients who achieved CR were received LDAC at the same dose for 10 days every month as a maintenance therapy. The duration of CR of these patients was shown to be longer than that of the patients without any maintenance therapy. Myelosuppression was observed in nearly all of them and the other clinical findings including cytogenetic analysis indicated cytotoxicity rather than differentiation as the mechanism of LDAC. LDAC was effective especially in hypoplastic leukemia and the maintenance therapy was found to prolong the duration of CR.

Adult↗

Donor-HLA-incompatible marrow transplantation with an anti-donor cytotoxic antibody in the serum of the patient.

A 42-year-old female with acute mixed lineage leukemia received a marrow transplantation from an HLA non-identical sibling. The serum of the patient showed a positive crossmatch for anti-donor lymphocytotoxic antibody and exhibited a complement-mediated cytotoxicity to donor hematopoietic progenitor cells. In an attempt to reduce the risk of graft rejection, a large volume plasma exchange was performed, which was followed by an infusion of irradiated donor lymphocytes to eliminate remaining antibodies from her serum. The level of anti-donor antibody fell below the sensitivity of the anti-human immunoglobulin lymphocytotoxicity test after the infusion of donor lymphocytes. The cytotoxic activity against donor progenitor cells also disappeared from the serum. Cyclosporin had been administered for 2 weeks before marrow infusion, and methylprednisolone and prednisolone for 1 week before the initiation of conditioning chemoradiotherapy. Conditioning comprised cytosine arabinoside 5.6 g/m2, cyclophosphamide 4500 mg/m2 and fractionated total body irradiation with 15 Gy followed by an infusion of 4.0 x 10(8) cells/kg of unmodified marrow cells. Engraftment of donor cells was documented by HLA typing of peripheral lymphocytes. A sustained engraftment may be obtained in a donor-incompatible HLA non-identical marrow transplantation with anti-donor antibody by elimination of the antibody and achieving an intensive immunosuppression in the recipient before marrow infusion.

Adult↗

Granulocytosis associated with malignant neoplasms: a clinicopathologic study and demonstration of colony-stimulating activity in tumor extracts.

We studied seven cases of malignant neoplasms, taken from various sites in the body, that were associated with marked granulocytosis. The seven cases were characterized clinically by marked granulocytosis with mature neutrophils, nonspecific inflammatory signs, and a rapid and progressive fatal course of the disease. The elevation of granulocyte count generally paralleled the increase in tumor size. Postmortem examination revealed no evidence of extensive bone marrow metastases or significant suppuration in any case. The bone marrows showed varying degrees of granulocytic hyperplasia with or without a shift to the left in the maturation series. Erythroid cell hyperplasia was observed in some cases, and in one instance there was an increase in immature eosinophils. The spleen showed various degrees of infiltration by neutrophils, from minimal to extremely marked; some spleens had foci of extramedullary hemopoiesis. Colony-stimulating activity was demonstrated in tumor extracts from three of these cases and from the serum in another case. Thus, it is suggested that marked granulocytosis in these patients was caused, at least in part, by colony-stimulating factor produced by the neoplastic cells.

Adult↗

[Clinical evaluation of fluconazole in the case of deep mycosis associated with leukemia].

The clinical efficacy of fluconazole at doses of 100-400 mg daily given intravenously in the treatment of 6 cases of deep mycosis complicated with leukemia was evaluated. Types of leukemia as underlying disease were acute lymphatic leukemia in 4 patients (included post bone marrow transplantation in 2 patients), acute myelocytic leukemia in 1 and acute myelomonocytic leukemia (AMMoL) in 1. Causative fungi were Candida in all patients. Diagnoses established were pulmonary or bronchial candidiasis in 3 patients, candiduria in 2 and suspected candidemia accompanied with stomatitis in 1. A patient with candiduria died from AMMoL thus the evaluation of efficacy was made with 5 patients. Overall clinical efficacies were judged to be good in 3 cases of pulmonary or bronchial candidiasis and in 1 case of suspected candidemia accompanied with stomatitis and excellent in 1 case of candiduria with an efficacy rate of 100%. No side effect, either subjective or objective, was reported with any patient. In clinical laboratory tests, elevations of serum transaminase and Al-P were observed in 2 patients and a rise of S-Cr. in 1, but all these abnormalities were judged to be related to the drugs for leukemia treatment.

Acute Disease↗

[Allogeneic bone marrow transplantation as primary treatment in acute myelofibrosis].

A 20-year-old man with acute myelofibrosis received ablative chemotherapy consisting of busulfan, Ara-C and cyclophosphamide followed by bone marrow transplantation from his histocompatible sister. There was a prompt engraftment with a rising WBC and platelet count and with donor karyotype in specimen of marrow. A bone marrow examination on day 29 showed a prominent decrease in marrow fibrosis. However, fibrosis was again exacerbated with leukemic relapse as overt acute megakaryoblastic leukemia on day 110, The patient died on day 126. Marrow fibrosis was found to be reversible by ablation of malignant cells and repopulation of normal hemopoietic cells after bone marrow transplantation.

Acute Disease↗

Acquired von Willebrand disease due to inhibitor of human myeloma protein specific for von Willebrand factor.

A patient with acquired von Willebrand disease associated with multiple myeloma (IgG-lambda) is described. Mixture of his plasma or IgG fraction with washed control platelets resulted in the inhibition of aggregation with ristocetin, but mixture of control plasma or IgG fraction with washed patient platelets showed no inhibition of ristocetin-induced aggregation. Although his vWF: Ag, RCo, and factor VIII coagulant activity were all normal, inactivation of RCo was induced in normal plasma by incubation with patient plasma. Crossed immunoelectrophoretic analysis showed that vWF:Ag was composed of much more anodic component. A marked increase of Factor VIII and a rapid return of RCo to the baseline after 1-deamino-8-arginine vasopressin (DDAVP) infusion were observed. A transient increase in vWF:Ag after the infusion of DDAVP showed with less anodic forms and in the relative proportion as in normal. Treatment of the underlying disease also led to a correction of the bleeding time, improvement of platelet adhesion and ristocetin-induced aggregation, and normalization of crossed immunoelectrophoresis of vWF:Ag. The present study showed that myeloma-associated IgG interacted specifically with the antigenic sites on the von Willebrand portion of the Factor VIII complex.

Adult↗

Relation of estrogen receptor expression to clonal growth and antiestrogen effects on human breast cancer cells.

Expression of estrogen receptor (ER) was studied in the ER-positive human breast cancer cell line MCF-7 using immunoperoxidase staining with monoclonal antibodies to ER. Using a soft agar colony assay and liquid culture, effects of growth and the antiestrogen tamoxifen were examined. Heterogeneity in expression of ER was observed between different clones in the agar cultures as well as among cells within the same clone. Clonal expression of ER increased progressively with increasing cell number within a clone. At pharmacological doses, tamoxifen significantly reduced clonal growth but also markedly reduced the expression of ER within clones that grew despite the presence of the antiestrogen. These findings are consistent with the hypothesis that ER-positive colonies arise from ER-negative progenitors and that ER expression occurs along with differentiation of cells within clones. Furthermore, the findings are consistent with tamoxifen exerting its antineoplastic action beyond the level of the tumor stem cell. Such therapy would therefore be capable of suppression but not eradication of breast cancer clonal progenitors.

Breast Neoplasms↗

[Clinical studies of cefoxitin in the field of internal medicine].

Ten patients with sepsis and pneumonia complicated by leukemia or lung cancer were treated with cefoxitin (CFX) at daily dose of 6 g. The following results were obtained. 1. Clinical effects of CFX were good in 5 patients, fair in 2 and poor in 3 with effective rate of 50%. 2. Out of 8 patients with sepsis, 5 showed good response to CFX and effective rate was 62.5%. 3. Bacteriological outcomes were eradicated in 1, unchanged in 1, replaced in 2 and unknown in 6 cases. 4. Diarrhea was observed in 1 patient but this was not considered related to CFX therapy. 5. No abnormal laboratory finding due to CFX was observed. 6. It should be considered that 6 g or more of CFX is given in case of severe infections, such as sepsis or pneumonia complicated by serious underlying diseases.

Adult↗

A new system of hemopoietic colony formation for permanent slides and medium changes: use of glass-fiber filters.

A new method for hemopoietic colony formation that allows the preparation of permanent slides and medium changes during the incubation period was developed in vitro. Bone marrow cells from mice were spread over glass-fiber filters, which were placed on agar medium and cultivated for 7 days. Hemopoietic colonies appeared on the glass-fibers filters. The glass-fiber filters with colonies were stained by a peroxidase and nonspecific esterase double-staining method and mounted as permanent slides. Each colony could be clearly identified and easily counted after the staining. The dose-response relationship between the number of seeded cells and the colony counts was a linear one, with the line very nearly passing through the origin on extrapolation. The colonies were classified into three types by the staining results: granuloid type, monocyte-macrophage type, and mixed type, the last containing both granuloid and monocyte-macrophage cells. Medium change during the incubation period was attempted in the experiment for phagocytic activity of the cultured cells and proved to be useful. This system appears to be useful and convenient in the study of hemopoietic colony formation.

Animals↗