We report herein a case of subcutaneous granuloma annulare occured in a 3-year-old girl who had 7 subcutaneous nodules on the scalp, lumbar area, buttock, right tibial area and both ankles. liistopathologically, multiple foci of complete and incomplete collagen degeneration surrounded by histiocytes in a palisading arrangement were seen in the subcutaneous layer. Some vessel walls were thickened and infiltrated with inflammatory cells and many eosinophils were scattered among the inflamrnatory cell infiltrate around the palisaiing granuloma. Five of the lesions disappeared spontaneously and other s decreased in size without specific treatment in 2 months.
Ankle ; Buttocks ; Child, Preschool ; Collagen ; Eosinophils ; Female ; Granuloma Annulare* ; Granuloma* ; Histiocytes ; Humans ; Scalp

Systemic lupus erythematosus(SLE) is a multisystemic autoimmune disease. In rare case, aplastic anemia can develop as a complication of SLE. We report a case of SLE patient with aplastic anemia and nephrotic syndrome. A 33-year-old woman was admitted because of gum bleeding. After laboratory work up including bone marrow biopsy study, she was diagnosed as SLE with aplastic anemia and nephrotic syndrome. The patient was initially treated with high dose steroid pulse therapy. However the patient did not responded to high dose steroid treatment. We treated the patient with plasma filtration and synchronized cyclophosphamide thrapy followed by monthly intravenous cyclophosphamide treatment. Complete clinical remission of hematologic and renal complications was achieved in this patient. We suggest that plasma filtration and synchronized cyclophosphamide therapy might be one of efffectie treatment modality in the management of severe SLE patient.
Adult ; Anemia, Aplastic* ; Autoimmune Diseases ; Biopsy ; Bone Marrow ; Cyclophosphamide* ; Female ; Filtration ; Gingiva ; Hemorrhage ; Humans ; Nephrotic Syndrome ; Plasma

BACKGROUND: This study aimed to survey the clinical spectrum of diffuse large B-cell lymphoma (DLBCL) in terms of epidemiology, pathologic subtypes, stage, and prognostic index as well as treatment outcomes. METHODS: In 2007-2008, 13 university hospitals evenly distributed in the Korean peninsula contributed to the online registry of DLBCL at www.lymphoma.or.kr and filed a total of 1,665 cases of DLBCL recorded since 1990. RESULTS: Our analysis showed a higher prevalence of DLBCL in male than in female individuals (M:F=958:707), and extranodal disease was more common than primary nodular disease (53% vs. 47%). Among the 1,544 patients who had been treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or rituximab-CHOP (R-CHOP) therapy with or without radiation, 993 (63.9%) were alive, with 80% free of disease, 417 were dead (26.8%), with 13% free of disease, and 144 (9.3%) were lost to follow-up, with 23% free of disease. Age below 60 years, stage at diagnosis, international prognostic index (IPI) score regardless of age, and addition of rituximab to CHOP therapy in low- and low-intermediate-risk groups according to IPI scores significantly increased survival duration. CONCLUSION: The epidemiology, clinical spectrum, and biological behavior of DLBCL in Korea are similar to those observed in Western countries, and the advent of rituximab improved survival.
Antibodies, Monoclonal, Murine-Derived ; Antineoplastic Combined Chemotherapy Protocols ; B-Lymphocytes ; Cyclophosphamide ; Doxorubicin ; Female ; Hospitals, University ; Humans ; Korea ; Lost to Follow-Up ; Lymphoma ; Lymphoma, B-Cell ; Male ; Prednisolone ; Prevalence ; Vincristine ; Rituximab

PURPOSE: High dose chemotherapy (HDC) is increasingly being used for ovarian cancer. Although early studies of autotransplantation for advanced ovarian cancer have been encouraging, most reported series were small, and no randomized trials have been reported. HDC and autologous hematopoietic stem cell transplantation were rarely performed in patients with ovarian cancer in Korea, and no results have been reported with the exception of one case report. MATERIALS AND METHODS: We retrospectively analyzed 10 patients with refractory or relapsed ovarian cancer having received HDC and autologous peripheral blood stem cell transplantation (APBSCT), between January 1996 and September 1998, at the Soon Chun Hyang and Ajou University Hospitals. RESULTS: Ten patients were treated with HDC and APBSCT. Six patients achieved complete response (CR) and 1 a partial response (PR), with a response rate of 70%. Three patients did not respond following mobilization chemotherapy, and failed to respond after HDC. The median duration of progression free survival (PFS) and overall survival (OS) were 6 (4~46) and 13 (3~50+) months, respectively. The median duration of OS of the responders following mobilization chemotherapy was 23 (8~50+) compared with 12 (3~18) months of the non- responders. With regard to the treatment related toxicity, 8 patients had neutropenic fevers, and bacteremia was documented in 4. The non-hematological toxicities were never life threatening, and there were no treatment related deaths. CONCLUSION: HDC, followed by APBSCT, is well-tolerated patients with refractory or relapsed ovarian cancer, and following mobilization chemotherapy the responders survived longer than the non-responders.
Autografts ; Bacteremia ; Disease-Free Survival ; Drug Therapy* ; Fever ; Hematopoietic Stem Cell Transplantation ; Hospitals, University ; Humans ; Korea ; Ovarian Neoplasms* ; Peripheral Blood Stem Cell Transplantation* ; Retrospective Studies ; Stem Cell Transplantation

BACKGROUND: To compare the mobilizing effects and toxicities of two different doses of cyclophosphamide (CY) plus lenograstim (glycosylated G-CSF), we performed a prospective randomized study by enrolling patients suffering with either high-risk Non-Hodgkin's lymphoma (NHL) or breast cancer undergoing ablative chemotherapy. METHODS: The NHL patients received 4 cycles of CHOP and the breast cancer patients received 2-3 cycles of FAC (FEC) adjuvant chemotherapy. Then, the patients were randomly allocated to receive CY 4 g/m2 (arm A) or 1.5 g/m2 (arm B) in combination with lenograstim. Large volume leukapheresis was carried out and it was continued daily until the target cell dose of 2x10 (6) CD34+ cell/kg was reached. RESULTS: Twenty-seven patients were enrolled in the study. The median number of leukaphereis sessions actually performed was 2.5 sessions in arm A and 3 sessions in arm B. The target cell dose was obtained with the median number of one leukapheresis session in both arms of the study (p=0.09). The collected number of CD34+ cells in the leukapheresis products was higher in arm A than arm B (22.4 vs. 9.9x10 (6) /kg, respectively, p=0.05). Grade III or IV leukopenia was present in 14/15 patients (94%) in arm A and in 1/12 patients (8%) in arm B (p< 0.0001). Grade III or IV thrombocytopenia was present in 8/15 patients (54%) in arm A, but this was not present in any patients of arm B (p=0.0004). Neutropenic fever occurred in 6/15 patients (40%) in arm A, and in 1/12 patients (8%) in arm B (p=0.09). The hematological recovery of the leukocytes and platelets after transplantation was not statistically different between the two doses. CONCLUSION: Low-dose CY plus lenograstim is a safe and effective mobilizing regimen.
Transplantation Conditioning ; Stem Cells/*drug effects ; Recombinant Proteins/administration & dosage/pharmacology ; Prospective Studies ; Myeloablative Agonists/*administration & dosage/pharmacology ; Middle Aged ; Male ; Lymphoma, Non-Hodgkin/*drug therapy ; Leukapheresis ; Humans ; *Hematopoietic Stem Cell Mobilization ; Granulocyte Colony-Stimulating Factor/*administration & dosage/pharmacology ; Female ; Drug Therapy, Combination ; Cyclophosphamide/*administration & dosage/pharmacology ; Chemotherapy, Adjuvant ; Breast Neoplasms/*drug therapy ; Adult

We conducted a phase II multicenter trial to estimate the response and survival of patients with newly diagnosed multiple myeloma to high dose melphalan therapy followed by autologous peripheral blood stem cell transplantation. Eligible patients who had undergone induction with vincristine, adriamycin and dexamethasone (VAD) should have adequate cardiac, pulmonary and renal function (creatinine <2 mg/dL). Melphalan at 200 mg/m2 was used as a conditioning regimen. Eighty patients were enrolled from 13 centers. The median age of the patients was 53 yr (range; 20 to 68 yr). The initial stage was IA/IIA/IIB/IIIA/IIIB in 3/8/1/54/14 patients, respectively. Beta2-microglobulin, CRP and LDH were increased in 74, 42 and 34% of the patients examined. Cytogenetic data were available in 30 patients, and 6 patients showed numeric or structural abnormalities. Two therapy-related mortalities occurred from infection. Among the 78 evaluable patients, CR/PR/MR/NC/PD were achieved in 48/26/2/1/1patients, respectively. After a median follow-up of 30 months, the median overall and event-free survivals were 66 months (95% CI: 20-112) and 24 months (95% CI: 18-29), respectively. This study verifies the efficacy and feasibility of high dose melphalan therapy with autologous stem cell transplantation in newly diagnosed multiple myeloma.
Adult ; Aged ; Antigens, CD34/biosynthesis ; Antineoplastic Agents, Alkylating/*therapeutic use ; C-Reactive Protein/biosynthesis ; Cell Survival ; Combined Modality Therapy ; Cytogenetics ; Disease-Free Survival ; Female ; Human ; Korea ; L-Lactate Dehydrogenase/biosynthesis ; Male ; Melphalan/*therapeutic use ; Middle Aged ; Multiple Myeloma/*therapy ; Peripheral Blood Stem Cell Transplantation/*methods ; Time Factors ; Transplantation, Autologous/*methods ; beta 2-Microglobulin/blood

BACKGROUND: In combination with standard-dose CHOP (cyclophosphamide, vincristine, adriamycin, and prednisolone), the addition of rituximab produces a better clinical response in the treatment of aggressive B-cell non-Hodgkin's lymphoma (NHL) than CHOP alone. METHODS: Thirty-four patients with previously untreated diffuse large B-cell NHL received at least three or four cycles of rituximab 375 mg/m2 or 500 mg per dose on day 1 of each cycle in combination with CHOP chemotherapy. RESULTS: The median age of patients were 61.5 years (range, 28-83 years). After the end of therapy, twenty-five patients (73.5%) experienced a complete response, four patients (11.8 %) had a partial response, and two patients (5.9%) were classified as having progressive disease. The median follow-up duration was 9.4 months (range, 0.2-19.5 months) and 1-year overall survival and progression free survival was 84.8+/-8.7% and 80.3+/-9.4%, respectively. Two patients (5.9%) experienced fever, myalgia, and skin eruption due to rituximab. Neutropenia of grade 3 or 4 occurred in thirty-one patients (91.2%). CONCLUSION: The benefits of rituximab in combination with CHOP chemotherapy include high response rates and good tolerance. However, further prospective, randomized studies are needed to draw definitive conclusions.
B-Lymphocytes* ; Disease-Free Survival ; Doxorubicin ; Drug Therapy* ; Fever ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell* ; Lymphoma, Non-Hodgkin ; Myalgia ; Neutropenia ; Skin ; Vincristine ; Rituximab