We report a 58-year-old man who developed synchronous gastric non-Hodgkin`s lymphoma (NHL) and renal cell carcinoma. He presented with epigastric discomfort for 2 months. Endoscopic finding of the stomach disclosed a large inegular ulceration with nodular margin on the upper body. Constrast enhanced CT scan of the abdomen showed an ulceration and focal wall thickening in the greater curvature side of stomach, and an enhanced bulging mass in the left kidney incidentally. The tissue obtained by radical proximal gastrectomy and nephrectomy showed diffuse large B-cell lymphoma on stomach and chromophobic type of renal cell carcinoma on kidney. To our knowledge, this is the first report of synchronous gastric NHL and renal cell carcinoma in Korea.
Abdomen ; Carcinoma, Renal Cell* ; Gastrectomy ; Hodgkin Disease* ; Humans ; Kidney ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Middle Aged ; Nephrectomy ; Stomach ; Tomography, X-Ray Computed ; Ulcer

BACKGROUND: A number of clinical and biological factors in acute myeloid leukemia (AML) have been used to predict the response to induction treatment or the likelihood of relapse. This study investigated CD34 expression in AML patients to evaluate its clinical and prognostic significance. METHODS: This study included 165 patients with de novo AML who underwent flow cytometry for CD34 at diagnosis between July 1994 and February 2001. To analyze the response to or outcome of therapy, we evaluated 81 patients who received induction chemotherapy with idarubicin and either cytarabine or N4-behenoyl-1-D-arabinofuranosylcytosine. RESULTS: CD34 was expressed in 38.1+/-2.7% of mononuclear cells that isolated from AML patients, and 56.4% of the patients with AML were CD34+. There were no significant differences in the clinical and hematological parameters between the CD34+ and CD34- groups. The patients with CD34+ frequently encountered in M2 subtype (49.5%), and cytogenetic abnormality of t (8;21) and karyotypes with poor risk were CD34+ in 66.7% and 92.9% of the cases, respectively. When we compared the CD34+ group with CD34- group, no significant differences were found in CR rate (70.9% vs 76.9%, P=0.61), in median duration of overall survival (16.4+/-2.4 months vs 25.1+/-3.9 months, P=0.45), or in disease free survival (P=0.42). CONCLUSION: This study did not show the definitive clinical and prognostic implications of CD34 expression. Further studies with a large number of patients are needed to elucidate the association of CD34 expression with specific subtypes of AML, such as t (8;21) or t (15;17) karyotypes.
Biological Factors ; Chromosome Aberrations ; Cytarabine ; Diagnosis ; Disease-Free Survival ; Flow Cytometry ; Humans ; Idarubicin ; Induction Chemotherapy ; Karyotype ; Leukemia, Myeloid, Acute* ; Prognosis ; Recurrence

BACKGROUND: After a zealous advocates of granulocyte transfusion therapy (GTX) in the 1970s and early 1980s, the use of GTX has diminished strikingly because of the several problems of GTX and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. Recently, GTX offers renewed interest because several investigators reported the transfusion efficacy of granulocytes collected by stimulating normal donors with recombinant human granulocyte-colony stimulating factor (G-CSF). METHODS: To evaluate the safety and efficacy of GTX, thirteen patients with neutropenia- related infections at Chonnam University Hospital from March 1997 to February 1998 were treated with dexamethasone- or G-CSF-stimulated granulocyte transfusions apheresed from normal donor. RESULTS: Patients received a mean number of 2.4 transfusions (range, 1-7) and a mean dose of 5.5x1010 granulocytes (range, 0.2-19.6). Six patients (46.2%) had favorable responses. Favorable responses occurred among patients with more fungal infection than bacterial infection (71.4 vs 28.6%, P<0.05) and more increment of absolute neutrophil count at 1 hour after transfusion (P<0.05). Adverse reactions of GTX were pulmonary edema in 2 patient (15.4%) and transient hypoxia in 1 patient (7.7%). One patient (7.7%) with pulmonary edema died of severe pulmonary reaction. Two of 20 donors received by G-CSF complained of mild myalgia and bone pain. CONCLUSION: G-CSF- or dexamethasone-stimulated GTXs were well tolerated and may be clinically beneficial for neutropenia-related infection, particularly in fungal infection, that is refractory to antimicrobial therapy.
Anoxia ; Anti-Infective Agents ; Bacterial Infections ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Humans ; Intercellular Signaling Peptides and Proteins ; Jeollanam-do ; Myalgia ; Neutropenia ; Neutrophils ; Pulmonary Edema ; Research Personnel ; Tissue Donors

The myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis associated with multilineage cytopenias leading to serious morbidity or mortality, and the additional risk of leukemic transformation. The management of patients with MDS can be very complex and varies according to both the clinical manifestations in individual patients as well as the presence of complicating medical conditions. However, therapeutic dilemmas still exist for MDS due to the multifactorial pathogenetic features of the disease, its heterogeneous stages, and the elderly patient population. For these reasons, proper guidelines for management are necessary. This review describes the proper diagnosis for MDS, decision-making approaches for optimal therapeutic options that are based on a consideration of patient clinical factors and risk-based prognostic categories, and the use of recently available biospecific drugs such as hypomethylating agents that are potentially capable of abrogating the abnormalities associated with MDS. Proper indications and methods for transplantation, response criteria, management for iron overload for highly transfused patients and specific considerations for MDS in childhood are also described. All of these topics were discussed at the third symposium of AML/MDS working party on 3 March, 2007.
Aged ; Diagnosis ; Hematopoiesis ; Humans ; Iron Overload ; Mortality ; Myelodysplastic Syndromes* ; Transplantation

BACKGROUND: This study was designed to examine the prevalence of aberrant promoter methylation in a selected panel of genes potentially involved in lymphoid tumors. METHODS: The promoter hypermethylation status of MGMT, DAPK1, hMLH1, CDH1, SHP1, and HIC1 was measured by methylation-specific PCR for 82 cases of B-cell lymphoma. Immunohistochemical staining using MGMT and SHP1 antibodies was conducted on 43 out of 82 cases. RESULTS: The number of MGMT aberrant methylations was lower in diffuse large B-cell lymphoma (DLBCL) than in other malignant lymphomas. The methylation of DAPK1 was frequently detected in follicular lymphoma (FL), marginal zone B-cell lymphoma (MZL) and DLBCL. With one exception, methylation of hMLH1 was not observed in B-cell lymphomas. The methylation frequency of CDH1, and HIC1 was similar in B-cell lymphomas. However, the methylation of SHP1 gene was more frequently observed in cases of FL, DLBCL, and MZL than in chronic lymphocytic lymphoma. MGMT and SHP1 promoter methylation were inversely correlated with the protein expression observed upon immunohistochemical staining. CONCLUSIONS: Aberrant promoter methylation of multiple genes occurs with variable frequency throughout the B-cell lymphomas, and methylation of hMLH1 is rarely observed in B-cell lymphomas.
Antibodies ; B-Lymphocytes ; DNA ; DNA Methylation ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Follicular ; Methylation ; Polymerase Chain Reaction ; Prevalence

BACKGROUND/AIMS: This study evaluated the role of hypomethylating agents (HMA) compared to best supportive care (BSC) for patients with high or very-high (H/VH) risk myelodysplastic syndrome (MDS) according to the Revised International Prognostic Scoring System. METHODS: A total of 279 H/VH risk MDS patients registered in the Korean MDS Working Party database were retrospectively analyzed. RESULTS: HMA therapy was administered to 205 patients (73.5%), including 31 patients (11.1%) who then received allogeneic hematopoietic cell transplantation (allo-HCT), while 74 patients (26.5%) received BSC or allo-HCT without HMA. The 3-year overall survival (OS) rates were 53.1% ± 10.7% for allo-HCT with HMA, 75% ± 21.7% for allo-HCT without HMA, 17.3% ± 3.6% for HMA, and 20.8% ± 6.9% for BSC groups (p < 0.001). In the multivariate analysis, only allo-HCT was related with favorable OS (hazard ratio [HR], 0.356; p = 0.002), while very poor cytogenetic risk (HR, 5.696; p = 0.042), age ≥ 65 years (HR, 1.578; p = 0.022), Eastern Cooperative Oncology Group performance status (ECOG PS) 2 to 4 (HR, 2.837; p < 0.001), and transformation to acute myeloid leukemia (AML) (HR, 1.901; p = 0.001) all had an adverse effect on OS. CONCLUSIONS: For the H/VH risk group, very poor cytogenetic risk, age ≥ 65 years, ECOG PS 2 to 4, and AML transformation were poor prognostic factors. HMA showed no benefit in terms of OS when compared to BSC. Allo-HCT was the only factor predicting a favorable long-term outcome. The use of HMA therapy did not seem to have an adverse effect on the transplantation outcomes. However, the conclusion of this study should be carefully interpreted and proven by large scale research in the future.
Cell Transplantation ; Cytogenetics ; Humans ; Leukemia, Myeloid, Acute ; Multivariate Analysis ; Myelodysplastic Syndromes* ; Retrospective Studies ; Transplants

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization