Biomedical subjects

Kazuyoshi Ishii

Publications and source records attributed to Kazuyoshi Ishii.

7 recordsLinked to original sources

PubMed2006

Burkitt lymphoma of the uterus in a human T lymphotropic virus type-1 carrier.

A 71-year-old Japanese woman who was seropositive for T-lymphotropic virus type-1 (HTLV-1) developed primary Burkitt lymphoma of the uterus. CT showed marked enlargement of the uterine body. Chromosomal abnormalities were detected in biopsied cells, and most showed the t (8; 14) (q24; q32) translocation. Fluorescence in situ hybridization (FISH) with a dual-color stain for IgH/C-MYC fusion showed 99% positively. Biopsies from abdominal operation were diagnosed as Burkitt lymphoma. Treatment was started with intensive chemotherapy according to a protocol for Burkitt lymphoma and mature-B cell leukemia. Two regimens were done with four courses with rituximab. Treatment response was fast, with a documented and lasting first complete remission on CT and laboratory markers after the 4 cycle treatment.

Aged↗

PubMed2006

Role of platelet-derived chemokines (RANTES and ENA-78) after stem cell transplantation.

Stem cell transplantation (SCT) is being used for hematopoietic reconstitution following high-dose chemotherapy for malignancy. Some patients seem to have an imbalance of the immune response after SCT and cytokines are known to regulate this response. Recently, platelets have been shown to contain members of the chemokine family, suggesting a role of platelets as inflammatory cells. We measured and compared levels of platelet activation markers, chemokines, and soluble factors in patients undergoing SCT. IL-8 and GROalpha exhibited a significant elevation in the early phase (1 or 2 weeks) after SCT; this trend was marked after autologous SCT. Furthermore, these levels significantly and positively correlated with the change in G-CSF. In contrast, ENA-78 exhibited a significant elevation in the later phase (3 or 4 weeks) after SCT. In addition, its level negatively correlated with the change in G-CSF. Soluble CD40 ligand and platelet-derived microparticles significantly increased after both auto- and allo-SCT. In addition, ENA-78 positively correlated with the level of platelet-derived microparticles. The increase of RANTES seems to be related to platelet activation, since RANTES was in the dynamic phase similar to soluble CD40 ligand and platelet-derived microparticles. RANTES exhibited changes similar to IL-6, TNFalpha, and soluble IL-2 receptors, which are GVHD markers. Thus, the platelet-derived chemokines ENA-78 and RANTES exhibited particular changes after SCT. Our results suggest that ENA-78 play a role in hematopoietic conditions in which G-CSF is not involved, and RANTES generation after allo-SCT relates to GVHD.

Blood Platelets↗

PubMed2006

Unusual gamma heavy chain disease protein in a patient with splenic marginal-zone lymphoma.

We conducted an electrophoretic analysis of monoclonal gamma-globulin found in the serum of a patient with splenic marginal-zone lymphoma. This monoclonal protein showed electrophoretic mobility to the gamma region and reacted with anti-immunoglobulin (IgG) antiserum but not with anti-kappa or anti-lambda light chain antisera. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting of the monoclonal protein-rich gamma-globulin fraction extracted from the sliced gel revealed the presence of two types of abnormal IgG molecule, low- and high-molecular-weight IgG, neither of which reacted with anti-kappa or anti-lambda light chain antisera. Additionally, an abnormal high-molecular-weight gamma heavy chain was identified by reducing SDS-PAGE. These findings suggest that this monoclonal protein is composed only of gamma heavy chains of normal and larger size. The presence of abnormal serum immunoglobulin composed of only gamma heavy chain has been known as a fundamental feature of gamma heavy chain disease (HCD). However, the unique composition of monoclonal gamma-globulin makes our case distinct from typical gammaHCD, which is characterized by an abnormal truncated low-molecular-weight gamma heavy chain. Thus, the unusual monoclonal protein may have been produced by a somatic mutation of IgH gene associated with splenic marginal-zone lymphoma.

Female↗

PubMed2005

[VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, predonisolone, bleomycin) therapy in elderly patients with aggressive non-Hodgkin lymphoma--a study of efficacy and safety, final report].

We experienced the VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, predonisolone, bleomycin) combination regimen for the treatment of elderly patients with aggressive non-Hodgkin lymphoma (NHL) in a multicenter study by 6 collaborative institutions. Patients were previously untreated > or = 60 years of age and received prophylactic G-CSF. Twenty patients entered this trial, and all of them were evaluated for feasibility, toxicity, and efficacy. The complete remission rate was 75.0%, with a 100% overall response rate; overall survival (OS) rate at 3 years was 79.1% (median follow up 761.5 days), with a 60.7% progression-free 3-year survival (PFS) rate (median follow-up 600.0 days). Our trial was promising and well-tolerated. According to IPI, high/high-intermediate risk was associated with significantly worse OS and PFS than low/low-intermediate risk (2-year OS: 51.8% versus 100.0%, p=0.0118; 2-year PFS: 33.3% versus 80.0%, p=0.0125). Grade 3/4 infections occurred in 3 patients, but no patients experienced it with predonisolone reduced.

Aged↗

PubMed2005

[CD30-negative diffuse large B-cell lymphoma expressing ALK].

A 33-years-old man was diagnosed as having undifferentiated carcinoma presenting with right neck lymphadenopathy in December 2000. He obtained complete remission (CR) following chemotherapy, radiation and lymphadenectomy on the right neck. He had multiple para-aorta lymphadenopathy and splenomegaly in December 2001. An open-abdominal lymph node biopsy was performed from which a diagnosis of anaplastic large cell lymphoma was made. CR was achieved with biweekly CHOP, however, the patient suffered from a relapse twice. He underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from his HLA-matched sister while in non-CR in November 2002. Engraftment was achieved on day 14, and at the same time, complete chimerism was confirmed. Acute grade III graft-versus-host disease (GVHD) developed and was controlled with cyclosporine A and prednisolone. Extensive chronic GVHD was subsequently observed and required systemic immunosuppression. His condition returned to CR after the PBSCT and he sustained complete chimerism. He suddenly died of fulminant thrombotic microangiopathy seven months after the PBSCT. The tumor cells were ALK-positive, CD30-negative and JH rearrangement was detected, and were therefore classified as diffuse large B-cell lymphoma with expression of ALK according to the WHO classification, though they differed from this subtype in some points. Although this case was refractory for chemotherapy with a complex karyotype, the graft-versus-lymphoma effect might have contributed to the sustained CR following the PBSCT.

Adult↗

PubMed2004

[Clonal Ph-negative hematopoiesis with trisomy 8 in chronic myeloid leukemia during imatinib therapy].

We report a case of chronic myeloid leukemia (CML) with clonal Philadelphia negative hematopoiesis arising after treatment with imatinib. A 45-year-old man was diagnosed as having Ph-positive CML. Therapy with MCNU and hydroxyurea was carried out for 12 days, and was then replaced by imatinib. A major cytogenetic response was obtained after 13 months of therapy with imatinib, but at the same time a new Ph-negative clone with trisomy 8 appeared in the bone marrow. Blood cell counts were still within normal limits. This observation indicates that patients on imatinib should be followed with bone marrow morphologic finding and routine cytogenetic testing, even after induction of a good response.

Antineoplastic Agents↗

PubMed2004

[Adult T-cell leukemia/lymphoma of bone with multiple pathological fractures].

We report a 49-year-old woman who had adult T-cell leukemia/lymphoma (ATL) of the bone with multiple osteolytic lesions and pathological fractures of her extremities. The WBC count was 15,810/microliter with 0-1% of abnormal lymphocytes, but CT scan revealed no lymphadenopathy. Antibodies to HTLV-I were positive, and a right tibial bone biopsy showed infiltration of ATL cells. Monoclonal integration of HTLV-1 proviral DNA was demonstrated in bone tumor cells. Seven weeks later, she died of DIC due to severe infection during extensive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗