1.Transfusion - Associated Graft - Versus - Host Disease in Patients with Acute Leukemia.
Myung Soo CHA ; Kwang Hoon LEE ; Yoo Hong MIN ; Kwang Gil LEE
Korean Journal of Dermatology 1996;34(2):345-349
Graft-versus-host disease can develop in immunosuppressed individuals who receive blood product transfusions that contain imrnunocompetent lymphocytes. We report a case of transfusion-associated graft-versus-host disease(TA-GVHD) that developed in a patient with acute lymphocytic leukemia who were undergoing therapy. The groups at risk for development of TA-GVHD, the clinical presentation and course, and methods of diagnosis are summarized. Prevention of TA-CVHD is possible by irradiation of blood products given to patients at risk, but problems remain in determining the groups that warrant such measures. We should be aware of the risk of developing TA-GVHD after routine blood transfusion, especially in areas where the population's HLA types are rather homogeneous.
Blood Transfusion
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Diagnosis
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Graft vs Host Disease
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Humans
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Leukemia*
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Lymphocytes
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Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
Transplants*
3.A Multicenter Retrospective Analysis on the Treatment Pattern and Outcome in Relapsed/Refractory Childhood Acute Lymphoblastic Leukemia
Keon Hee YOO ; Nak Gyun CHUNG ; Bin CHO ; Hyoung Jin KANG ; Hee Young SHIN ; Ho Joon IM ; Jong Jin SEO ; Young Tak LIM ; Chuhl Joo LYU ; Soon Ki KIM ; In Sang JEON ; Hoon KOOK ; Hong Hoe KOO
Clinical Pediatric Hematology-Oncology 2017;24(2):101-106
BACKGROUND: Although the overall survival of childhood acute lymphoblastic leukemia (ALL) approaches 85-90%, the prognosis of relapsed or refractory (R/R) ALL is grave. This study aimed to identify the treatment pattern, treatment response, and overall survival of these patients.METHODS: We reviewed data of 64 patients with R/R ALL whose initial diagnosis of ALL had been made between 1 and 21 years of age. Patients who received clofarabine as part of an induction regimen were excluded. Relapsed patients were limited to those who relapsed after ≥2 prior induction regimens. Treatment patterns, response rates, and overall survival were analyzed.RESULTS: Patients' median age was 15.0 years (range, 6.0-25.0) at the diagnosis of R/R ALL. The most frequently used agents other than steroid were vincristine (54.0%), cytarabine (44.6%), and idarubicin (36.5%), while L-asparaginase was used in only one patient. The complete remission (CR) and overall response (OR) rates were 38.1 and 42.9%, respectively. Sixteen patients (25.4%) underwent allogeneic hematopoietic stem cell transplantation (HSCT). The 5-year overall survival was 6.7%. The survival of patients with HSCT was significantly higher compared with those without HSCT (35.2% vs 0%, P=0.0097). Among 14 patients who achieved CR or CR without platelet recovery (CRp) before HSCT, the 3-year survival was 46.9%.CONCLUSION: The survival of Korean patients with R/R childhood ALL was dismal despite a reasonable CR rate, whereas that of those who received HSCT after CR or CRp was excellent. More treatment options are needed to improve the overall outcome of R/R childhood ALL.
Blood Platelets
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Cytarabine
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Diagnosis
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Hematopoietic Stem Cell Transplantation
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Humans
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Idarubicin
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
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Prognosis
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Retrospective Studies
;
Vincristine
4.Differential Blast Counts Obtained by Automated Blood Cell Analyzers.
Seungwon JUNG ; Hyojin CHAE ; Jihyang LIM ; Eun Jee OH ; Yonggoo KIM ; Yeon Joon PARK ; Kyungja HAN
The Korean Journal of Laboratory Medicine 2010;30(6):540-546
BACKGROUND: Automated blood cell analyzers often read leukemic blasts as normal cells. In this study, we evaluated the 5-part differential patterns of blasts using automated analyzers to determine if they can differentiate among blast types. METHODS: Blood samples containing 10% or more blasts were collected from patients with acute leukemia (N=175). The 5-part differential count was conducted using DxH 800 (Beckman Coulter, USA) and XE-2100 analyzers (Sysmex Co., Japan), and the results were compared with manual differential counts, which was used as a reference method. RESULTS: The DxH 800 reported the 5-part white blood cell differential count in 98.9% of the cases. The XE-2100 provided an invalid automated differential count in 72% of the cases. Both analyzers counted most lymphoblasts as lymphocytes and most myeloblasts as monocytes. In 11 cases, the DxH 800 reported a 5-part differential count without a blast flag. CONCLUSIONS: Some automated analyzers are able to recognize and count blasts according to their characteristic cell types. Therefore, complete blood counts obtained automatically can provide valuable data for making provisional decisions regarding the lineage of leukemia cells before further investigation.
Acute Disease
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Automation
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Blood Cell Count/*instrumentation/methods
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Humans
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Leukemia/blood/*diagnosis
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Leukemia, Monocytic, Acute/blood/diagnosis
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Leukemia, Myeloid, Acute/blood/diagnosis
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Leukemia, Promyelocytic, Acute/blood/diagnosis
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Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood/diagnosis
5.ALL-2005 protocol experience in the therapy of children and adolescents over 10 years of age with acute lymphoblastic leukemia.
Qi-dong YE ; Jing-yan TANG ; Ci PAN ; Hui-liang XUE ; Jing CHEN ; Min ZHOU ; Hua JIANG ; Chang-ying LUO ; Jian-min WANG ; Yan-jing TANG ; Long-jun GU
Chinese Journal of Hematology 2011;32(12):840-843
OBJECTIVETo explore the incidence, clinical characteristics and prognosis of children and adolescents over 10 years of age with acute lymphoblastic leukemia (ALL).
METHODSFrom May 1, 2005 to April 30, 2009, 67 newly diagnosed ALL children and adolescents over 10 years of age were enrolled in protocol of ALL-2005. All of the clinical characteristics of the patients were analyzed. The statistics was done by SPSS 13.0.
RESULTSThere were 40 males (59.7%) and 27 females (40.3%). The mean age at diagnosis was 12.3 ± 1.7 (10.0 to 17.8) years with median age of 12.2 years. Of 67 patients, 48 were in medium risk group, and 19 in high risk group. During induction therapy, 83.6% and 86.6% patients had good response to prednisone and bone marrow blasts ≤ 5% at day 19, respectively. The overall hematologic response rate in these 67 patients was 88.1% (59) in complete remission (CR) after induction therapy, 15 patients relapsed with mean continuous CR period of (14.9 ± 9.9) months. The five-year event-free survivals (EFS) and overall survivals (OS) were (64.4 ± 6.3)% and (74.1 ± 6.1)%, respectively. According to univariate analysis, elevated serum ferritin, bcr-abl translocation, poor response to prednisone, high bone marrow blasts at day 19 or after induction therapy, and high minimal residual disease (MRD) after induction therapy increased risk for recurrence. Multivariate analysis indicated that high MRD after induction therapy was associated with recurrence (RR = 2.20, 95%CI 1.26 - 3.84, P < 0.01).
CONCLUSIONSurvival has improved for children and adolescents with ALL by ALL-2005 protocol. Analysis of serum ferritin and bcr-abl translocation at diagnosis, early responses to treatment and MRD detection during therapy are powerful prognostic indicators.
Adolescent ; Child ; Female ; Ferritins ; blood ; Genes, abl ; Humans ; Male ; Neoplasm, Residual ; pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; therapy ; Prognosis
7.Detection of cytokine expression patterns in the peripheral blood of patients with acute leukemia by antibody microarray analysis.
Qing LI ; Mei LI ; Yao-hui WU ; Xiao-jian ZHU ; Chen ZENG ; Ping ZOU ; Zhi-chao CHEN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2014;34(2):176-180
The cytokines of acute leukemia (AL) patients have certain expression patterns, forming a complex network involved in diagnosis, progression, and prognosis. We collected the serum of different AL patients before and after complete remission (CR) for detection of cytokines by using an antibody chip. The expression patterns of cytokines were determined by using bioinformatics computational analysis. The results showed that there were significant differences in the cytokine expression patterns between AL patients and normal controls, as well as between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). In confirmatory test, ELISA revealed the expression of uPAR in AL. Moreover, the bioinformatic analysis showed that the differentially expressed cytokines among the AL groups were involved in different biological behaviors and were closely related with the development of the disease. It was concluded that the cytokine expression pattern of AL patients is significantly different from that of healthy volunteers. Also, differences of cytokine expression patterns exist between AML and ALL, and between before and after CR in the same subtype of AL, which holds important clinical significance for revealing disease progression.
Cytokines
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biosynthesis
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blood
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Diagnosis, Differential
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Gene Expression Regulation, Leukemic
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Humans
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Leukemia, Myeloid, Acute
;
blood
;
Microarray Analysis
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Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
blood
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Prognosis
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RNA, Messenger
;
biosynthesis
;
blood
8.Ultrasound and MR Findings of Aleukemic Leukemia Cutis in a Patient with Complete Remission of Acute Lymphoblastic Leukemia: A Case Report.
Min Sung KIM ; Won Hee JEE ; Sun Ki KIM ; So Yeon LEE ; Gye Yeon LIM ; Gyeongsin PARK ; Seok LEE
Journal of the Korean Society of Medical Ultrasound 2010;29(4):247-252
Aleukemic leukemia cutis is an extremely rare condition characterized by the infiltration of leukemic cells in skin without blasts in the peripheral blood. Leukemia cutis is considered a grave prognostic sign, thus early diagnosis is important. Leukemia cutis usually occurs in patients with myeloid leukemia. To the best of our knowledge, there has been no report regarding the radiological findings of aleukemic leukemia cutis, which is probably due to the presence of the skin changes in most patients. We report the ultrasound and MR findings of aleukemic leukemia cutis, even without the skin manifestation in patients with a history of complete remission of the acute lymphoblastic leukemia following an allogeneic peripheral blood stem cell transplantation.
Early Diagnosis
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Humans
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Leukemia
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Leukemia, Myeloid
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Peripheral Blood Stem Cell Transplantation
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Precursor Cell Lymphoblastic Leukemia-Lymphoma
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Skin
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Skin Manifestations
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Subcutaneous Tissue
9.A successful treatment of hypercalcemia with zoledronic acid in a 15-year-old boy with acute lymphoblastic leukemia.
Hye Jin PARK ; Eun Jin CHOI ; Jin Kyung KIM
Annals of Pediatric Endocrinology & Metabolism 2016;21(2):99-104
Severe hypercalcemia in children is a rare medical emergency. We present a case of a 15-year-old boy with hypercalcemia (total calcium level, 14.2 mg/dL) with a normal complete blood count, no circulating blasts in the peripheral blood film, and no other signs of acute lymphoblastic leukemia (ALL), including no signs of lymphadenopathy or hepatosplenomegaly. The hypercalcemia was successfully treated with zoledronic acid. As hypercalcemia can be the only presenting symptom of ALL in children, the diagnosis is often delayed. In children presenting with hypercalcemia, malignancies must be considered in the differential diagnosis.
Adolescent*
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Blood Cell Count
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Calcium
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Child
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Diagnosis
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Diagnosis, Differential
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Emergencies
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Humans
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Hypercalcemia*
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Leukemia
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Lymphatic Diseases
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Male*
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
10.A successful treatment of hypercalcemia with zoledronic acid in a 15-year-old boy with acute lymphoblastic leukemia.
Hye Jin PARK ; Eun Jin CHOI ; Jin Kyung KIM
Annals of Pediatric Endocrinology & Metabolism 2016;21(2):99-104
Severe hypercalcemia in children is a rare medical emergency. We present a case of a 15-year-old boy with hypercalcemia (total calcium level, 14.2 mg/dL) with a normal complete blood count, no circulating blasts in the peripheral blood film, and no other signs of acute lymphoblastic leukemia (ALL), including no signs of lymphadenopathy or hepatosplenomegaly. The hypercalcemia was successfully treated with zoledronic acid. As hypercalcemia can be the only presenting symptom of ALL in children, the diagnosis is often delayed. In children presenting with hypercalcemia, malignancies must be considered in the differential diagnosis.
Adolescent*
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Blood Cell Count
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Calcium
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Child
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Diagnosis
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Diagnosis, Differential
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Emergencies
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Humans
;
Hypercalcemia*
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Leukemia
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Lymphatic Diseases
;
Male*
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*