1.Two Cases of Leukemia Cutis.
Jae Wang KIM ; Kwang Joong KIM ; Chong Min KIM
Korean Journal of Dermatology 1998;36(1):133-138
We report herein two cases of leukemia cutis. One case is a 54-year-old woman who came to our department with complaints of a solitary ulcerating nodule on her left leg that had been present for 2 months since prior to her visit. Through histopathological studies, the diagnosis of myelocytic leukemia cutis was made before the final diagnosis of acute myelocytic leukemia was made by hematological studies. When combined chemotherapy was finished, she was in a partial remission state and the nodule disappeared after 1 month of chemotherapy. The other case is a 77-year-old man having multiple infiltrative nodules on the right forearm and right thigh for 1 month prior his visit. He was diagnosed as having leukemia cutis for his skin lesions histopathologically. This was redefined as chronic myelomonocytic leukemia of the myelodysplastic syndrome with blastic transfor- mation by hematological examination. He developed septicemia and died 3 weeks after the dermato- logical diagnosis.
Aged
;
Diagnosis
;
Drug Therapy
;
Female
;
Forearm
;
Humans
;
Leg
;
Leukemia*
;
Leukemia, Myeloid
;
Leukemia, Myeloid, Acute
;
Leukemia, Myelomonocytic, Chronic
;
Logic
;
Middle Aged
;
Myelodysplastic Syndromes
;
Sepsis
;
Skin
;
Thigh
;
Ulcer
3.Comparative study of molecular response of first-line and second-line nilotinib in patients with chronic-phase chronic myelogenous leukemia.
Hui XU ; Ping WANG ; Rong Jun MA ; Jian Min GUO ; Ping Chong LEI ; Yu Zhu ZANG ; Tong Bao WANG ; Zhong Wen LIU ; Jing YANG ; Yin ZHANG ; Zun Min ZHU
Chinese Journal of Hematology 2019;40(6):522-525
4.Tuberculous Lymphadenitis in Patients with Myelogenous Leukemia.
Chang Seop LEE ; Jin Su SONG ; Pyoeng Gyun CHOE ; Jae Hyun CHO ; Ji Whan BANG ; Kyung Hwa PARK ; Wan Beom PARK ; Hong Bin KIM ; Nam Joong KIM ; Sung Soo YOON ; Seonyang PARK ; Byoung Kook KIM ; Myoung Don OH ; Kang Won CHOE
Infection and Chemotherapy 2006;38(5):266-270
During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult
;
Diagnosis
;
Diagnosis, Differential
;
Drug Therapy
;
Humans
;
Induction Chemotherapy
;
Leukemia
;
Leukemia, Biphenotypic, Acute
;
Leukemia, Lymphoid
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
;
Leukemia, Myeloid*
;
Leukemia, Myeloid, Acute
;
Lymph Nodes
;
Lymphatic Diseases
;
Mycobacterium tuberculosis
;
Tuberculosis
;
Tuberculosis, Lymph Node*
5.Tuberculous Lymphadenitis in Patients with Myelogenous Leukemia.
Chang Seop LEE ; Jin Su SONG ; Pyoeng Gyun CHOE ; Jae Hyun CHO ; Ji Whan BANG ; Kyung Hwa PARK ; Wan Beom PARK ; Hong Bin KIM ; Nam Joong KIM ; Sung Soo YOON ; Seonyang PARK ; Byoung Kook KIM ; Myoung Don OH ; Kang Won CHOE
Infection and Chemotherapy 2006;38(5):266-270
During the neutropenic phase, leukemia patients receiving chemotherapy are prone to bacterial and, fungal infections; occasionally mycobacterial, viral and protozoal organisms may also cause infections. Mycobacterium tuberculosis infection was reported very rarely in these patients. This report describes four patients with M. tuberculosis infection identified from 185 adult patients who were diagnosed myelogenous leukemia between January 2003, and December 2004. There was no patient with M. tuberculosis infection from 44 lymphoid leukemia and 11 acute biphenotypic leukemia patients. Sites of infection were all lymph nodes. Three among four patients were presented with lymphadenopathy at initial diagnosis of leukemia, and the other one presented with lymphadenopathy after induction chemotherapy. There was no patient presented with lymphadenopathy during the neutropenic phase. Tuberculous lymphadenitis was presented in a patient with three acute myelogenous leukemia (FAB class 2 M4, 1 M2) and a chronic myelogenous leukemia, accelerated phase. An acute myelogenous leukemia patient had a leukemic cell and tubercle bacilli in the same lymph node. Tuberculosis should also be included as a differential diagnosis in myelogenous leukemia patient with lymphadenopathy, especially in the countries in which the disease is endemic.
Adult
;
Diagnosis
;
Diagnosis, Differential
;
Drug Therapy
;
Humans
;
Induction Chemotherapy
;
Leukemia
;
Leukemia, Biphenotypic, Acute
;
Leukemia, Lymphoid
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
;
Leukemia, Myeloid*
;
Leukemia, Myeloid, Acute
;
Lymph Nodes
;
Lymphatic Diseases
;
Mycobacterium tuberculosis
;
Tuberculosis
;
Tuberculosis, Lymph Node*
6.Prognostic significance of early molecular response after second-line treatment with dasatinib of chronic myeloid leukemia patients.
Yi Lin CHEN ; Li MENG ; Guo Lin YUAN ; Zhuang Zhi YANG ; Zhi Ping HUANG ; You Shan ZHANG ; Zhe ZHAO ; Chu Cheng WANG ; Ying BAO ; Hang XIANG ; Hua YIN ; Li Feng CHEN ; Ying Yuan XIONG ; Long WANG ; Wei Ming LI
Chinese Journal of Hematology 2019;40(7):608-611
7.Extradural Granulocytic Sarcoma in the Cervical Spine.
Kyoung Hoon YANG ; Young Soo KIM ; Il Seong CHOI ; Kwoang Hum BAK ; Jae Min KIM ; Choong Hyun KIM ; Yong KO ; Seong Hoon OH ; Suck Jun OH ; Kwang Myung KIM ; Nam Kyu KIM
Journal of Korean Neurosurgical Society 1998;27(12):1746-1750
Granulocytic sarcoma is an uncommon tumor composed of immature cells of the granulocytic series, occurring in patients with acute myelogenous leukemia and blast crisis of chronic myelogenous leukemia. It may be rarely preceded by an acute myelogenous leukemia and follows an unformly fatal course. We report a case of granulocytic sarcoma of extradural space presenting as the spinal cord compression without any evidence of leukemia in the peripheral blood. The tumor was located extraduraly in the C6-C7 area compressing the dural sac and spinal cord. After left hemilaminectomy of C6 and C7, this mass was removed completely. Postoperatively, symptoms and signs were improved. At the postoperative 10th day, the patient lost consciousness and peripheral blood study showed the findings of acute myelogenous leukemia. Thereafter, the patient received chemotherapy with Ara-C and Daunorubicin, but hematologic remission was not obtained completely. After 4 months, he revisited our hospital owing to fever, and the septic shock was encountered. The patient died of sepsis.
Blast Crisis
;
Consciousness
;
Cytarabine
;
Daunorubicin
;
Drug Therapy
;
Fever
;
Humans
;
Leukemia
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
;
Leukemia, Myeloid, Acute
;
Sarcoma, Myeloid*
;
Sepsis
;
Shock, Septic
;
Spinal Cord
;
Spinal Cord Compression
;
Spine*
8.Therapeutic effects of imatinib on chronic myeloid leukemia in different phases and the factors affecting the effects.
Wai-yi ZOU ; Duo-rong XU ; Chang SU ; Juan LI ; Shao-kai LUO
Journal of Southern Medical University 2008;28(9):1660-1662
OBJECTIVETo evaluate the therapeutic effect of imatinib on chronic myeloid leukemia (CML) in different phases and analyze the factors that may affect the effects.
METHODSEighty-five patients with CML in chronic phase, 24 in accelerated phase and 19 in blastic phase patients were treated with imitinib. The hematologic response, cytogenetic response, molecular response, overall survival (OS), progression-free survival (PFS) and adverse events were analyzed in these groups.
RESULTSThe rates of complete hematologic response (CHR), complete cytogenetic response (CCyR) and complete molecular response (CMoR) of the patients in chronic phase were 100%, 82.4% and 21.2%, respectively, and the 5-year OS and PFS of these patients were 92.1% and 84.7%. All these rates were significantly higher than those in patients in accelerated and blastic phases (P<0.0001). The CCyR, CMoR, 5-year OS and PFS in the 42 newly diagnosed patients in chronic phase were 92.9%, 26.3%, 100% and 95.2%, respectively, all significantly higher than those in patients with interferon therapy failure (P<0.001). Severe leukocytopenia and thrombocytopenia occurred at greater frequencey in AP and BP patients than in chronic phase patients (P<0.0001). Non-hematologic toxicity was rarer and milder in patients in chronic phase. Multivariate analysis showed that interferon therapy prior to imitinib treatment and prolonged drug cessation were the independent factors that affected the achievement of cytogenetic response and PFS.
CONCLUSIONEarly imitinib therapy can be effective and safe, and should be used as the first line drug for CML.
Antineoplastic Agents ; therapeutic use ; Benzamides ; Female ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Leukemia, Myeloid, Chronic-Phase ; drug therapy ; Male ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; Treatment Outcome
9.Factors influencing severe cytopenia in chronic phase chronic myeloid leukemia patients receiving initial second generation tyrosine kinase inhibitors and its impact on treatment responses and outcomes.
Zi Yu LI ; Ya Zhen QIN ; Yue Yun LAI ; Hong Xia SHI ; Yue HOU ; Xiao Shuai ZHANG ; Qian JIANG
Chinese Journal of Hematology 2023;44(4):295-301
Objective: To explore the influencing covariates of severe neutrophils and/or thrombocytopenia and their effect on treatment response and outcome in patients with chronic-phase chronic myeloid leukemia (CP-CML) receiving initial second-generation tyrosine kinase inhibitors (2G-TKI) . Methods: Data from consecutive patients aged ≥18 years with newly diagnosed CP-CML who received initial 2G-TKI at Peking University People's Hospital from September 2008 to November 2021 were interrogated. Binary logistic regression models and Fine-Gray and Cox regression models were applied. Results: Data from 267 patients who received initial 2G-TKI, including nilotinib (n=239, 89.5% ) and dasatinib (n=28, 10.5% ) , were interrogated. The median age was 36 (range, 18-73) years, and 156 (58.4% ) patients were male. At a median treatment period of 1.0 (0.1-3.0) month, 43 (16.1% ) patients developed grade ≥3 neutrophils and/or thrombocytopenia and recovered within 1.0 (0.1-24.6) month. Male (OR=2.9, 95% CI 1.2-6.8; P=0.018) , age of ≥36 years (OR=3.2, 95% CI 1.4-7.2, P=0.005) , a spleen below a costal margin of ≥7 cm (OR=2.8, 95% CI 1.2-6.6, P=0.020) , and a hemoglobin (HGB) level of <100 g/L (OR=2.9, 95% CI 1.3-6.8, P=0.012) at diagnosis were significantly associated with grade ≥ 3 neutrophils and/or thrombocytopenia. Based on their regression coefficients, male, age of ≥36 years, a spleen below a costal margin of ≥7 cm, and an HGB level of <100 g/L were given 1 point to form a predictive system. All patients were divided into three risk subgroups, and the incidence of severe cytopenia significantly differed among the three groups (P < 0.001) . Grade ≥3 neutrophils and/or thrombocytopenia for >2 weeks was significantly associated with lower cumulative incidences of complete cytogenetic response (CCyR, HR=0.5, 95% CI 0.3-0.7, P<0.001) and major molecular response (MMR, HR=0.4, 95% CI 0.3-0.8, P=0.004) and was not significantly associated with failure, progression, and survival. Conclusion: Male, advanced age, a large spleen, and a low HGB level were significantly associated with severe cytopenia. The four covariates were used to establish a prediction model, in which the incidence of severe cytopenia among different risk groups was significantly different. Severe cytopenia for >2 weeks was a negative factor for responses but not for outcomes.
Humans
;
Male
;
Adolescent
;
Adult
;
Female
;
Protein Kinase Inhibitors/therapeutic use*
;
Tyrosine Protein Kinase Inhibitors
;
Treatment Outcome
;
Retrospective Studies
;
Dasatinib/therapeutic use*
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy*
;
Leukemia, Myeloid, Chronic-Phase/drug therapy*
;
Thrombocytopenia
10.Effects of arsenic trioxide administration styles on leukocytosis.
Jin ZHOU ; Ran MENG ; Xin-Hua SUI ; Lu MENG ; Bao-Feng YANG
Chinese Medical Sciences Journal 2006;21(2):111-114
OBJECTIVETo study the effects of constantly slow intravenous arsenic trioxide (As2O3) infusion regimen on decreasing leukocytosis in vivo and in vitro.
METHODSThree kinds of leukemia cells, NB4, K562, and acute promyelocytic leukemia (APL) cells, were cultured in the media with constant concentration and varying concentrations of As2O3 respectively for 24 hours. Seventy-five patients were enrolled in two groups randomly. In trial group, 37 patients received continuously slow intravenous As2O3 infusion regimen for 24 hours with an infusion rate of 8 drips per minute and total infusion duration of about 18-21 hours daily. In control group, 38 patients received routine regimen with an infusion rate of 45-55 drips per minute and total infusion duration of about 2-3 hours daily for 24 hours. The daily As2O3 dosage was 0. 16 mg/kg. The intracellular arsenic concentration was measured by atomic fluorescence assay. The apoptosis rate of cells, CD33- CD11b+ cells, and CD33+ CD11b- cells were monitored by flow cytometry.
RESULTSThe apoptosis rates of NB4, K562, and APL leukemia cells in the media with constant As2O3 concentration were 56.6% +/- 2.4%, 27.6% +/- 3.1%, and 52.2% +/- 2.8%, respectively, which were significantly higher than those with changing As2O3 concentration (23.2% +/- 2.1%, 11.0% +/- 2.5%, and 21.0% +/- 2.5%, respectively, P < 0.01). The apoptosis rates of APL, M2 type acute myeloid leukemia (AML-M2), and chronic myeloid leukemia (CML) patients in the trial group (28.5% +/- 1.9%, 9.5% +/- 0.6%, and 12.5% +/- 1.8%) were also significantly higher than those in control group (8.5% +/- 2.2%, 2. 9% +/- 0.8%, and 4.5% +/- 1.2%; P < 0.05). The ratios of CD33 CD11b- and CD33- CD11b+ cells in control group were significantly higher than those in trial group.
CONCLUSIONThe continuously slow intravenous As2O3 infusion regimen can obtain high efficiency of apoptosis and low differentiation proportion, relieve leukocytosis, and gain maximal therapeutic benefit.
Antineoplastic Agents ; administration & dosage ; Apoptosis ; drug effects ; Arsenicals ; administration & dosage ; Cell Differentiation ; drug effects ; Cell Line, Tumor ; Humans ; Infusions, Intravenous ; K562 Cells ; Leukemia ; blood ; drug therapy ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; drug therapy ; Leukemia, Myeloid, Acute ; blood ; drug therapy ; Leukemia, Promyelocytic, Acute ; blood ; drug therapy ; Leukocytosis ; blood ; drug therapy ; Oxides ; administration & dosage