No abstract available.
Humans

No abstract available.
Drug Therapy, Combination* ; Head and Neck Neoplasms* ; Head* ; Humans

No abstract available.
Anemia, Refractory* ; Cyclosporine*

We have treated adult acute leukemia 64 patients between January 1990 and October 1991 at the Chungnam National University Hospital. They were examined for the impact of presenting WBC count on the initial course and from them we have chosen twenty patients whose leukocyte count is over one hundred thousands per cubic milimeter. We divided the twenty patients into 4 groups on the base of treatment modalities: conservative therapy only, chemotherapy only, cranial irradiation only, and chemotherapy with cranial irradiation. Early sudden death rate is lower in cranial irradiation with/without chemotherapy groups than the conservative only or chemotherapy only patients. Also the remission rate is high in cranial irradiation with chemotherapy patients. Therefore we suggest that the rapid intervention of cranial irradiation in adult acute leukemia could be helpful in reducing the early sudden death rate and perhaps in increasing the remission rate.
Adult* ; Chungcheongnam-do ; Cranial Irradiation* ; Death, Sudden ; Drug Therapy ; Emergencies* ; Humans ; Leukemia* ; Leukocyte Count ; Leukocytosis*

Lymphomatoid granulomatosis (LG) is a potentially malignant lymphoproliferative disorder. The lung is the most common involved site, followed by the skin and nervous system. However, LG of the central nervous system presenting with Parkinsonism is very rare. We report a patient with LG who presented with parkinsonian features such as bilateral rigidity, bradykinesia, and agitation. Brain magnetic resonance imaging showed multifocal punctuate enhanced lesions in both supra- and infratentorial areas. Steroid pulse therapy resulted in a dramatical improvement in the symptoms and MRI abnormalities.
Brain ; Central Nervous System* ; Dihydroergotamine ; Humans ; Hypokinesia ; Lung ; Lymphomatoid Granulomatosis* ; Lymphoproliferative Disorders ; Magnetic Resonance Imaging ; Nervous System ; Parkinsonian Disorders* ; Skin

No abstract available.
Humans* ; Leukemia*

PURPOSE: The purpose of this study was to evaluate the efficacy and the toxicities of recently developed second generation platinum, carboplatin in combination with 5-fluorouracil and leucovorin in head and neck cancer patients. PATIENTS AND METHODS: Between March 1993 and Apirl 1996, 22 patients with locally advanced/metastatic head and neck cancer were treated with FCL combination chemotherapy. Of these 20 patients were evaluable. RESULTS: Median age was 58 years. The number of patients with stage III and IV patients was 4 and 18 respectively. Among the 20 evaluable patients, 1 (7.2%) achieved a complete response and 8 (40%) achieved partial responses. The median duration of the response was 24 weeks and the median survival duration was 12 months. Out of 77 chemotherapy cycles, 1 patient (1.3%) had anemia of WHO grade 2, 7 patients (9.1%) experienced leukopenia (WHO grade > or =2) and 7 (9.1%) experienced thrombocytopenia (WHO grade > or =2). Non-hematologic toxicities were mild; nausea and voming of WHO grade > or =2 was 12 (15.6%), stomatitis (WHO grade > or =2) was 6 (7.8%). CONCLUSION: FCL chemotherapy was effective in locally advanced head and neck cancer. Toxocities were minimal compaired to cisplatin based combination chemotherapy.Further studies on increased dose of FCL chemotherapy in head and neck cancer patients is warranted.
Anemia ; Carboplatin* ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Leucovorin ; Leukopenia ; Nausea ; Platinum ; Stomatitis ; Thrombocytopenia

BACKGROUND: Stem cell factor (SCF), which is produced from stromal cells of bone marrow, is a growth factor acting in early stages of hematopoiesis. Bone marrow failure in aplastic anemia seems to be mainly due to hematopoietic stem cell defect. However, there has been some evidence that microenvironmental defects contribute to the pathophysiology of this disorder. METHODS: We measured serum SCF levels in 29 patients with aplastic anemia at diagnosis using ELISA to define the status of soluble SCF in this disorder. We also examined the effect of serum from 15 patients with aplastic anemia on the colony growth (CFU-GM and BFU-E) of normal bone marrow cells and the ability of recombinant human SCF to stimulate in vitro colony growth of bone marrow cells from 10 patients with aplastic anemia. RESULTS: Levels of serum SCF in patients with aplastic anemia were not different from those in 25 healthy controls (1,493+/-392pg/mL vs. 1,563+/-322pg/mL) or those in patients with idiopathic thrombocytopenic purpura, acute myeloid leukemia, and myelodysplastic syndrome. No correlation was found between serum SCF levels and hematologic parameters at diagnosis such as neutrophil count, hemoglobin, and platelet count. No difference was noted in the serum SCF levels according to severity of the disease. The effect of serum from patients with aplastic anemia on the colony growth of normal bone marrow cells were variable and were not correlated with serum SCF levels. rhSCF increased the colony numbers of bone marrow cells from patients with aplastic anemia. CONCLUSION: These results indicate that soluble SCF is not deficient in aplastic anemia, but SCF can stimulate the proliferation of bone marrow cells from aplastic anemia.
Anemia, Aplastic* ; Bone Marrow ; Bone Marrow Cells ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Hematopoiesis ; Hematopoietic Stem Cells ; Humans* ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes ; Neutrophils ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; Stem Cell Factor* ; Stem Cells* ; Stromal Cells

BACKGROUND: Fas is a member of the tumor necrosis factor (TNF)/nerve growth factor (NGF) receptor family. Triggering of the Fas receptor pathway by its ligand results in apoptosis. Soluble Fas consists of the extracellular region of Fas receptor and it binds to Fas ligand to inhibit the Fas and Fas ligand induced apoptosis. Recently some evidence indicates that the Fas/Fas ligand system represents an important pathway responsible for the induction of apoptosis in bone marrow CD34+ cells of patients with aplastic anemia. METHODS: We measured serum soluble Fas levels in 27 patients with aplastic anemia at diagnosis using ELISA to define the status of soluble Fas in this disorder. RESULTS: Levels of serum soluble Fas in patients with aplastic anemia were lower com-pared with that of normal healthy controls. No difference was noted in the serum soluble Fas levels according to severity of disease. No correlation was found between serum soluble Fas levels and hematologic parameters at diagnosis such as neutrophil count, lymphocyte count, platelet count and corrected reticulocyte count. CONCLUSION: These results indicate that serum soluble Fas levels are decreased in patients with aplastic anemia. Further studies recruiting more patients and measuring Fas receptor on peripheral blood lymphocyte subsets and bone marrow CD34+ cells concomitantly may be helpful to determine pathophysiology of bone marrow failure.
Anemia, Aplastic* ; Antigens, CD95 ; Apoptosis ; Bone Marrow ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Fas Ligand Protein ; Humans ; Lymphocyte Count ; Lymphocyte Subsets ; Neutrophils ; Platelet Count ; Reticulocyte Count ; Tumor Necrosis Factor-alpha

BACKGROUND: Cord blood (CB), which has no HLA restriction, is an alternative to bone marrow for hematopoietic stem cell transplantation. The use of cord blood, however, is limited by the number of progenitor/stem cells necessary to reconstitute the older child or adult. Therefore, ex vivo expansion of CB could have tremendous impact on diverse clinical settings. We studied the ex vivo expansion of isolated population of CD34+ cells from cryopreserved CB cells. METHODS: CD34+ cells were isolated from cryopreserved CB mononuclear cells. Purified cells were cultured with various combinations of hematopoietic growth factors including erythropoietin (EPO), stem cell factor (SCF), granulocyte-colony-stimulating factor (G-CSF), granulocyte, macrophage-colony-stimulating factor (GM-CSF), interleukin-1beta (IL-1beta), IL-3, and IL-6. After 7, 10 or 14 days of culture, the fold increases of colony-forming unit- granulocyte, macrophage (CFU-GM), burst-forming unit-erythroid (BFU-E), colony-forming unit-mix (CFU-Mix), and high proliferative potential colony-forming cell (HPP-CFC) were evaluated. RESULTS: Ten-day culture with the combination of EPO, SCF, G-CSF, IL-1beta, and IL-3 resulted in a median of 60-fold increase of CFU-GM, which was greater than those with the combinations of less than 5 growth factors. The addition of IL-6 or GM-CSF to this combination did not enhance CFU-GM expansion. Ten-day culture was significantly superior to 7-day culture for CFU-GM expansion. Prolongation of culture to 14 days, however, revealed decreased expansion of CFU-GM compared to 10 days. BFU-E and CFU-Mix were expanded to 2~5 folds in 7-day culture with the combination of EPO, SCF, and G-CSF. Further expansion was not achieved in 10-day culture and colonies disappeared in 14-day culture. HPP-CFC was expanded to a median of 7.5 folds in 7-day culture with the combination of EPO, SCF, G-CSF, IL-1beta, IL-3, and IL-6. Neither 10-day or 14 day-culture enhanced expansion of HPP-CFU. CONCLUSION: Cryopreserved cord blood cells maintain ex vivo expansion potential. In our system, 10-day culture with the combination consisting of EPO, SCF, G-CSF, IL-1beta, and IL-3 seems to be adequate for hematopoietic progenitor/stem cell expansion from cryopreserved cord blood cells.
Adult ; Bone Marrow ; Child ; Erythroid Precursor Cells ; Erythropoietin ; Fetal Blood* ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocyte-Macrophage Progenitor Cells ; Granulocytes ; Hematopoietic Stem Cell Transplantation ; Humans ; Intercellular Signaling Peptides and Proteins ; Interleukin-1beta ; Interleukin-3 ; Interleukin-6 ; Macrophages ; Stem Cell Factor