Myelodysplastic syndrome (MDS) is a clonal stem cell disorder characterized by ineffective hematopoiesis, multilineage dysplasia, peripheral cytopenias with normocellular or hypercellular marrow, and susceptibility to leukemic transformation. MDS represents a heterogenous group of disorders with a wide spectrum of clinical, morphological, biologic, and genetic characteristics. MDS is classified according to the World Health Organization criteria and the International Prognostic Scoring System. Risk-adapted treatment strategies have been developed in consideration of the advanced age of patients and to improve the clinical course of the disease. The pathophysiology, cytogenetic/molecular profiles, clinical characteristics and treatment modalities according to the prognostic groups will be described. In the future, a combination of treatment modalities to increase gene reactivation and to take advantage of increased expression of target genes may be critical to improve clinical outcomes. Multiple pathways may be involved in the MDS phenotype, and combination therapies, including novel agents, may be required to make further progresses in the treatment of this disease.
Bone Marrow ; Classification ; Diagnosis ; Hematopoiesis ; Humans ; Myelodysplastic Syndromes* ; Phenotype ; Stem Cells ; World Health Organization

No abstract available.
Stomach Neoplasms* ; Stomach* ; Water*

Acute myeloid leukemia (AML) is a representative blood cancer, accounting for most adult leukemia cases in Korea. Until recently, intensive chemotherapy and hematopoietic stem cell transplantation were the only curative treatment options for AML. However, the recent introduction of new drugs is bringing about changes in the strategic paradigm for the treatment of AML.Current Concepts: Along with the clinical eligibility for receiving intensive treatment and hematopoietic stem cell transplantation, the most critical determinants in treating AML are precise classification and risk stratification based on cytogenetic and molecular information. The recently revised World Health Organization classification, newly proposed International Consensus Classification, and the latest version of the European LeukemiaNet risk stratification reflect the importance of cytogenetic and molecular information. Although there have been no significant changes for a long time in the landscape of AML, especially in the field of treatment, the treatment paradigm has started to evolve with the introduction of new drugs. This evolution is led by FLT3 inhibitors, Bcl-2 inhibitors, isocitrate dehydrogenase inhibitors, target agents against CD33 antigens, and liposomal formulations of chemotherapeutics.Discussion and Conclusion: Successful initial treatment to induce complete remission followed by post-remission treatment to remove residual disease can lead to the achievement of long-term survival and cure goals in AML. We hope that new drugs will markedly improve the treatment outcomes for patients with AML.

BACKGROUND: Cerebrospinal fluid (CSF) examination can be used to verify the presence of primary malignancies as well as cases of central nervous system (CNS) metastasis. Because of its importance, there have been several studies concerning the sensitivity of CSF cytology. To determine the practical use and reproducibility of diagnoses based on CSF cytology, we evaluated this test by analyzing cytology results from consecutive CSF samples. METHODS: Between July 2010 and June 2013, 385 CSF cytology samples from 42 patients were collected. The samples were gathered using a ventricular catheter and reservoir. CSF cytology of all patients was examined more than two times with immunocytochemistry for cytokeratin. RESULTS: Primary neoplastic sites and histologic types of patients' metastatic cancer were diverse. The overall sensitivity for detecting malignancy was 41.3%. Even within short-term intervals, diagnoses frequently changed. CONCLUSIONS: Our results were inconsistent, with low sensitivity, when compared to the results of previous studies. However, CSF evaluation can still provide valuable diagnostic and prognostic information because adjuvant treatments are now routinely performed in patients with CNS metastasis. Negative CSF cytology results should not be ignored, and continuous CSF follow-up is essential for following the clinical course of patients with metastatic cancer involving the CNS.
Catheters ; Central Nervous System ; Cerebrospinal Fluid* ; Diagnosis ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratins ; Neoplasm Metastasis

Autologous stem cell transplantation (ASCT) is commonly used in relapsed or refractory non-Hodgkin's lymphoma (NHL). Several trials report the role of ASCT for high risk patients. We evaluated the results and the prognostic factors influencing the therapeutic effects on the patients who were treated with high dose chemotherapy (HDC) and autologous peripheral stem cell transplantation. We analyzed the data of 40 cases with NHL who underwent ASCT after HDC. Twenty- four patients had high-risk disease, 12 cases sensitive relapse, and two cases resistant relapse or primary refractory each. The median age of patients was 34 years (range, 14-58 years). The median follow-up duration from transplantation was 16 months (range, 0.6-94 months). Estimated overall survival and progression-free survival at 5 years were 40% and 30%, respectively. Poor prognostic factors for survival included older age (> or = 45 years), poor performance status in all patient analysis, and a longer interval between first complete remission and transplantation in high risk patients. In high risk NHL patients, transplantation should be done early after first complete remission to overcome chemo-resistance.
Transplantation, Autologous ; Survival Rate ; Risk Factors ; Retrospective Studies ; Prognosis ; Platelet Count ; *Peripheral Blood Stem Cell Transplantation ; Middle Aged ; Male ; Lymphoma, Non-Hodgkin/diagnosis/drug therapy/*therapy ; Leukocyte Count ; Humans ; Female ; Combined Modality Therapy ; Adult ; Adolescent

Advanced Hodgkin's disease is usually treated with six or more cycles of combination chemotherapy. Spontaneous regression of the cancer is very rarely reported in patients with Hodgkin's disease. We present an unusual case of a patient with Hodgkin's disease who experienced complete remission with a single cycle of chemotherapy, followed by pneumonia. The case was a 36-year-old man diagnosed with stage IVB mixed cellularity Hodgkin's disease in November 2000. After treatment with one cycle of COPP-ABV (cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine) chemotherapy without bleomycin, the patient developed interstitial pneumonia and was cared in the intensive care unit (ICU) for two months. Follow-up chest computerized tomography (CT), performed during the course of ICU care, revealed markedly improved mediastinal lymphomatous lesions. Furthermore, follow-up whole body CT and 18-fluorodeoxyglucose positron emission tomography showed complete disappearance of the lymphomatous lesions. Four years later, the patient is well and without relapse. This report is followed by a short review of the literature on spontaneous regression of Hodgkin's disease. To the best of our knowledge, this is the first case report of spontaneous remission of Hodgkin's disease in Korea.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Bleomycin/*administration & dosage ; Cyclophosphamide/*administration & dosage ; Doxorubicin/*administration & dosage ; Hodgkin Disease/*complications/*drug therapy ; Humans ; Male ; Pneumonia/*complications ; Prednisone/*administration & dosage ; Procarbazine/*administration & dosage ; Remission, Spontaneous ; Vinblastine/*administration & dosage ; Vincristine/*administration & dosage

No abstract available.
Base Sequence ; Bone Marrow/pathology ; Fusion Proteins, bcr-abl/*genetics ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/*genetics ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction

PURPOSE: Follicular lymphoma (FL) is an indolent non-Hodgkin's lymphoma that is highly sensitive to radiotherapy (RT). However, the effectiveness of RT has not been well established. We reviewed our experiences to assess the role of RT for FL and analyze treatment results. MATERIALS AND METHODS: Retrospective analysis was done on 29 patients who received first RT between January 2003 and August 2013. Of 23 early stage (stage I, II) patients, 16 received RT alone, four received chemotherapy followed by RT, two received RT postoperatively, and one received salvage RT for relapse after resection. Six advanced-stage (stage III, IV) patients received RT after chemotherapy: two received consolidation RT, three received salvage RT for residual lesions, and one received RT for progressive sites. Median RT dose was 30.6 Gy (range, 21.6 to 48.6 Gy). Median follow-up duration was 62 months (range, 6 to 141 months). RESULTS: All patients showed complete response in the radiation field. Eight outfield relapses were reported. Seven patients received salvage treatment (three chemotherapy, four RT). Four patients showed excellent responses, especially to RT. Estimated 5-year and 10-year relapse-free survivals were 72% and 60%. In the RT-alone group, 5-year relapse-free survival was 74.5%. All advanced-stage patients were disease-free with 100% 5-year overall survival. Disease-specific death was noted in only one patient; four others died of other unrelated causes. No significant toxicity was reported. CONCLUSION: RT resulted in excellent treatment outcomes for all FL stages when used as a primary treatment modality for early stage or salvage-treatment modality for advanced-stage disease.
Drug Therapy ; Follow-Up Studies ; Humans ; Lymphoma, Follicular* ; Lymphoma, Non-Hodgkin ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Treatment Outcome

BACKGROUND: In patients who had serum autoantibody that reacted with all screening red blood cells (panagglutination), waiting for compatible blood is likely to delay a needed transfusion. In some cases of severely diminished hemoglobin counts, the least incompatible blood may be transfused. However, the least incompatible transfusion therapy is challenged by the presence of unexpected antibody in patient's serum, which may cause a transfusion reaction. The aim of this study was to evaluate the effect of the least incompatible transfusion on clinical outcomes in patients with panagglutination. METHODS: We conducted a retrospective study of 49 patients with panagglutination on an unexpected antibody screening test between January 2006 and July 2010. In 36 patients having the least incompatible blood transfusion, changes in hemoglobin and lactate dehydrogenase (LD) values before and after transfusion were analyzed. One year mortality after initial need for transfusion was documented. RESULTS: In all 36 patients who underwent transfusion, hemoglobin values showed an increase of 1.2 (0.0~3.0) g/dL per unit without occurrence of acute transfusion reactions indicated by an increase in the LD level. The least incompatible transfusion did not show an association with increased all-cause mortality. CONCLUSION: As an alternative to the time consuming process of alloantibody detection, patients with severe anemia can be effectively transfused with "least incompatible units" in an emergency clinical setting without experiencing acute transfusion reactions.
Anemia ; Blood Group Incompatibility ; Blood Transfusion ; Emergencies ; Erythrocytes ; Hemoglobins ; Humans ; L-Lactate Dehydrogenase ; Mass Screening ; Retrospective Studies

Curschmann's spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June, 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann's spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly coiled mature ones, admixed with thick mucinous back- ground, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.
Cervix Uteri ; Diabetes Insipidus* ; Electrocoagulation ; Female ; Humans ; Infertility ; Leiomyoma ; Mucins ; Mucus ; Parturition ; Pedigree* ; Pilomatrixoma ; Prevalence ; Receptors, Vasopressin* ; Sputum ; Vasopressins*