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Red Cell Depletion from the Bone Marrow Aspirates for the ABO Incompatible Transplantation by Apheresis Separations.

Kyung Hwan CHOI ; Hyun Ju SUNG ; Woon Hyoung LEE ; Hyun Ok KIM ; Chuhl Joo LYU ; Yoo Hong MIN

Korean Journal of Hematology.2001;36(4):318-323.

BACKGROUND: Allogeneic bone marrow transplantation across ABO incompatibility barriers may result in immune mediated hemolysis. Hemolysis may be avoided by RBC depletion from the graft. In vitro graft manipulations carry the risk of hematopoietic stem cell loss, a factor that may be most important in graft failure. We report 16 major ABO blood group incompatible allogeneic bone marrow transplants using erythrocyte depletion of marrow prior to infusion. METHODS: From March 1997 to July 2001 in Yonsei University College of Medicine, 16 patients underwent ABO blood group incompatible allogeneic BMT: 5 for acute myelocytic leukemia, 5 for severe aplastic anemia, 3 for acute lymphocytic leukemia, 2 for chronic myelocytic leukemia, and 1 for myelodysplastic syndrome. RBC depletions were done with automatic cell separator, COBE Spectra (COBEBCT Inc., Lakewood, USA). RBC removal rates and mononuclear cell recovery rates were calculated. And the evidence of successful engraftment and intravascular hemolysis were also evaluated. RESULTS: The RBC removal rate was 99.1+/-0.0% and a mean of 1% of the original red cell volume was contained in the final infusate. The mononuclear cell recovery rate was 70.0+/-16.3% from the original MNCs. Fourteen patients tolerated the infusion of the marrow concentrates without any adverse effects. Two patients experienced hemoglobinuria, but disappeared within 2 days by continued observation. After transplantation, absolute neutrophil counts exceeded 500/nL by 10.8+/-1.9 days, platelet counts exceeded 50,000/nL by 30.5+/-8.5 days, and reticulocytosis sustained at >1% was by 25.8+/-13.9 days. CONCLUSION: RBC depletion from ABO major mismatched bone marrow aspirates by the automatic cell separator is a safe and effective technique.
Anemia, Aplastic ; Blood Component Removal* ; Bone Marrow Transplantation ; Bone Marrow* ; Cell Size ; Erythrocytes ; Hematopoietic Stem Cells ; Hemoglobinuria ; Hemolysis ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes ; Neutrophils ; Platelet Count ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Reticulocytosis ; Transplants

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Iron Status in Adolescents and University Students in Incheon.

Tae Wan KIM ; Myoung Hyun KIM ; Young Jin HONG ; Byong Kwan SON ; Jong Weon CHOI ; Soo Hwan PAI ; Won Sick CHOE ; Kyung Ja CHANG ; Soon Ki KIM

Korean Journal of Hematology.2001;36(4):311-317.

BACKGROUND: Iron deficiency anemia (IDA) frequently occurs in adolescents because of accelerated physical growth in boys and girls. This was aimed at assessing the prevalence of iron deficiency and IDA in apparently healthy Korean adolescents according to the gender and age. METHODS: Apparently healthy students(M: F=1: 1.2) aged 11 to 24 years were included in this study and blood samples were obtained from April to May, 2000. Hemoglobin, hematocrit, red blood cell indices, serum ferritin, iron and total iron-binding capacity were measured. RESULTS: In males, the prevalence of iron deficiency was 15.7% in the 11~12 years group, 16.1% in the 13~14 years group, 9.9% in the 15~16 years group, and 6.4% in the 17~18 years group. In females, the prevalence of iron deficiency was 26.8% in 11~12 years group, 27.9% in the 13~14 years group, 38.8% in the 15~16 years group, 36.0% in the 17~18 years group, 30.9% in the 19~24 years group. The prevalence of IDA in males was 3.6% in 11~12 years, 2.1% in 13~14 years group, 1.9% in 15~16 years group, and 0.6% in 17~18 years group. The prevalence of IDA in females was 4.2% in 11~12 years, 9.7% 13~14 years, 20.4% in 15~16 years, 16.2% in 17~18 years group, and 12.4% in 19~24 years group. CONCLUSION: As the prevalence of iron deficiency and IDA were substantially greater than expected, studies of iron state in adolescent girls, especially middle to high school age, should be undertaken to assess iron deficiency.
Adolescent* ; Anemia ; Anemia, Iron-Deficiency ; Erythrocytes ; Female ; Ferritins ; Hematocrit ; Humans ; Incheon* ; Iron* ; Male ; Prevalence

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Partial Splenic Embolization Therapy of Chronic Idiopathic Thrombocytopenic Purpura.

Seung Ho BAICK ; Kyu Taek LEE ; Nam Su LEE ; Sung Kyu PARK ; Jong Ho WON ; Dae Sik HONG ; Hee Sook PARK ; Won Soo CHO

Korean Journal of Hematology.2001;36(4):306-310.

BACKGROUND: Initial treatment of chronic idiopathic thrombocytopenic purpura (ITP) is generally done with corticosteroid. In case of refractory to corticosteroid or dependency, splenectomy seems to be the most effective and definitive treatment. Partial splenic embolization is an easier procedure with minimal morbidity. We evaluated the efficacy and complications of partial splenic embolization as treatment of chronic ITP refractory to corticosteroid or corticosteroid dependency. METHODS: Eight patients with chronic ITP and two systemic lupus erythematosus (SLE) patients with immunothrombocytopenia underwent partial splenic embolization. Embolization of 70~80% of the splenic volume was performed with endocoils or gelform particles without anesthesia by selective arterial catheterization and followed up for 4~50 months. The therapeutic effect of partial splenic embolzation was defined on the basis of the platelet count at the last follow-up after partial splenic embolzation : complete response, >100,000/nL,partial response, 100,000~50,000/nL and no response, <50,000/nL without medication. RESULTS: Partial splenic embolization brought a complete response in six of ten patients, a partial response in three, and no response in one. With a follow-up of 4~50 months, these responses were maintained in all except three patients. One patient was treated by splenectomy and one by partial splenic embolization again. Tolerance was good in all patients. Abdominal pain and fever was observed in 8 and 4 patients, respectively. One patient had a left pleural effusion with spontaneous resolution. No serious infection occurred. All patients were discharged within 6 days after partial splenic embolization. CONCLUSION: We conclude that partial splenic embolization may be useful and safe procedure and a good alternative to splenectomy in chronic ITP refractory to medical treatment.
Abdominal Pain ; Anesthesia ; Catheterization ; Catheters ; Fever ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic ; Platelet Count ; Pleural Effusion ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

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Treatment of Refractory and Relapsed Acute Myeloid Leukemia with High-dose Cytarabine and Idarubicin.

Hyo Rak LEE ; Se Hoon PARK ; Seo Young SONG ; Joon Oh PARK ; Soon Il LEE ; Ki Hyun KIM ; Won Seog KIM ; Chul Won JUNG ; Young Hyuck IM ; Won Ki KANG ; Keun Chil PARK ; Gu Ehn PARK ; Sun Hee KIM ; Hong Ghi LEE

Korean Journal of Hematology.2001;36(4):299-305.

BACKGROUND: The therapeutic outcome for refractory or relapsed acute myeloid leukemia (AML) is very poor; it is difficult to expect the long-term disease free survival in these patients. We evaluated the therapeutic outcome of a salvage chemotherapy consisting of high- dose cytarabine and idarubicin. METHODS: From December 1995 to September 2000, 20 patients (12 patients with primary refractory AML and 8 patients with first relapsed AML) were treated with the regimen that included cytarabine 3.0g/m2 (1.5g/m2 for patients >or=50 years of age) over 3 hours every 12 hours for 12 doses (D1-6, total 36g/m2) plus 12mg/m2 idarubicin for 3 days (D2-4) by intravenous infusion. RESULTS: The complete remission (CR) rate was 55.0% (95% confidence interval, 31.2 ~ 78.8%): 58.3% (7 of 12) for refractory AML and 50.0% (4 of 8) for relapsed AML. The causes of remission induction failure were resistant disease (15.0%, 3 of 20) and early death from infection (30.0%, 6 of 20). The median duration of disease free survival of the CR patients was 15 months (range, 1~59 months) and the median duration of overall survival of all patients was 6 months (range, 0~61 months). The median time of neutrophil recovery over 500/nL from the initiation of chemotherapy was 31 days and the median time of platelet recovery over 20X10(3)/nL was 32 days. For a total of 20 patients, grade 3 and 4 toxicity were observed in 20.0% for nausea/vomiting, 20.0% for diarrhea and 5.0% for stomatitis. CONCLUSIONS : We found that a combination chemotherapy of high-dose cytarabine and idarubicin was an effective salvage regimen for patients with refractory or relapsed acute myeloid leukemia. However aggressive supportive care is necessary to minimize the treatment related morbidity and mortality resulting from prolonged myelosuppression.
Blood Platelets ; Cytarabine* ; Diarrhea ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Idarubicin* ; Infusions, Intravenous ; Leukemia, Myeloid, Acute* ; Mortality ; Neutrophils ; Remission Induction ; Stomatitis

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Analysis of BCR-ABL Fusion Transcripts of Chronic Myeloid Leukemia Patients in Korea.

Yoo Li KIM ; Ji Yeon HWANG ; Chun Choo KIM ; Dong Wook KIM

Korean Journal of Hematology.2001;36(4):292-298.

BACKGROUND: The BCR-ABL rearrangement, the molecular hallmark of chronic myeloid leukemia (CML) can be used as a marker to identify residual disease after therapy. So far, very limited data exists in Korea regarding the frequency of BCR-ABL fusion gene in patients with CML. The objective of this study was to identify the type of BCR-ABL fusion variants of CML patients in Korea. METHODS: We performed a two-step reverse transcription-polymerase chain reaction(RT- PCR) to detect BCR-ABL specific mRNA in 154 CML patients who were diagnosed by histologic examination and cytogenetics at our institute between January 1997 and November 2000. We used different primer set to amplify various breakpoints of BCR-ABL fusion gene. RESULTS: All patients showed at least one of BCR-ABL transcripts. One hundred and four of 154 patients (67.5%) represented b3a2 transcript that was most frequent transcript in our CML patients. 44 patients (28.6%) had b2a2 transcript and b3a2+b2a2 splicing variants were identified in 5 cases (3.25%). In addition, c3a2 variant which is very rare transcript was identified in a patient (0.65%). CONCLUSIONS: The RT-PCR assay could identify the presence of the BCR-ABL transcript in all patients with exquisite sensitivity. The frequency of BCR-ABL transcript was different from that of western countries but similar to that of eastern. Long-term follow up of CML patients with different variants are needed to determine the prognostic importance of each gene variant.
Cytogenetics ; Humans ; Korea* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; RNA, Messenger

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Non-Hodgkin's Lymphoma of the Orbit and Ocular Adnexa: Clinical Analysis of 22 Cases.

Jae Lyun LEE ; Kyeong Hee LEE ; Myung Soo HYUN ; Hwa Sun CHUNG ; Sei One SHIN ; Hun Mo RYOO

Korean Journal of Hematology.2001;36(4):286-291.

BACKGROUND: Non-Hodgkin's lymphoma presenting in the eye is a rare disorder. The aim of this study was to evaluate the clinical features, treatment outcome and complications of patients with non-Hodgkin's lymphoma of the eye. METHODS: We designed retrospective, observational case study. The participants included 22 consecutive patients with non-Hodgkin's lymphoma of the orbit and ocular adnexa treated at the Yeungnam University Hospital between 1992 and 2001. RESULTS: There were 16 males (73%) and 6 females (27%). The median age at ocular presentation was 47. The most common presenting complaint was slowly growing mass at the eye. Histopathologic studies revealed extranodal marginal zone B-cell lymphoma, MALT type in 19 cases (86%), B-cell small lymphocytic lymphoma in one case, diffuse large B-cell lymphoma in one case, and lymphoplasmacytoid lymphoma/immunocytoma in one case. The stages of lymphomas were IA(E) in 17 cases (82%), IIA(E) in 2 cases (9%), IIIA(E) in 2 cases (9%). Radiotherapy alone was employed in 17 cases, chemoradiotherapy was done in 3 cases, chemotherapy alone was administered in one case. Nineteen out of 21 cases (90%) achieved a complete remission, and 5 year survival rate was approximately 90%. Subgroup analysis of the patients with lymphomas in stage IA(E) revealed that complete response rate was 100% and 5 year survival rate was 100% CONCLUSION: Radiotherapy alone can produce durable remission in the majority of the patients with localized extranodal marginal zone B-cell lymphoma, MALT type. However, combination chemotherapy or chemoradiotherapy should be considered in the patients with aggressive lymphomas or indolent lymphomas with systemic manifestation.
B-Lymphocytes ; Chemoradiotherapy ; Drug Therapy ; Drug Therapy, Combination ; Female ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin* ; Male ; Orbit* ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

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The Clinical Significance of Ann Arbor and Musshoff's Staging System in Primary Gastrointestinal Non-Hodgkin's Lymphoma-A Retrospective Analysis.

Kwang Woon SEO ; Dong Hwan KIM ; Woo Jin SUNG ; Sung Won PARK ; Jong Gwang KIM ; Jin Tae JUNG ; Tae In PARK ; Se Hwan KIM ; Dong Gun SHIN ; Sang Kyun SOHN ; Kyu Bo LEE

Korean Journal of Hematology.2001;36(4):275-285.

BACKGROUND: Primary Gastrointestinal Non- Hodgkin's Lymphoma (GIL) represents 4 to 20 % of all Non-Hodgkin's Lymphoma(NHL) and gastrointestinal tract(GIT) is the most frequently involved extranodal site in NHL. It is known that the prognosis of GIL is better than that of other NHLs because of it's unique biologic behavior and anatomical location. We reviewed clinical aspects of GIL and analyzed survival data based on Ann-Arbor and Musshoff's staging system. METHODS: Sixty six cases were analyzed by age, sex, clinical manifestation, location, histology, clinical course, and two staging systems (Ann Arbor and Musshoff's modified staging). Histologies were reviewed according to REAL classification. RESULTS: The median age was 51.5 years. The most frequent gross finding was ulcerofungating lesion in upper GIL and mass lesion in lower GIL. Treatment results were as following : 76.9% of response rate, 59.5% of 5-year overall survival rate, and 54.8% of 5-year disease free survival rate. There was a significant difference of overall survival or disease free survival rate between group below stage IIE1 and above IIE2 according to Musshoff's staging system. There were no significant differences in survival between stage I and II, and between stage III and IV based on Ann Arbor staging system. CONCLUSION: There might be the necessity of discriminating localized disease (IIE1) and locally advanced lesion (IIE2) to predict the prognosis of GIL through Musshoff's staging system. Larger study will be needed to confirm the role of Musshoff's staging system.
Classification ; Disease-Free Survival ; Hodgkin Disease ; Prognosis ; Retrospective Studies* ; Survival Rate

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A Case of Natural Killer-Large Granular Lymphocyte (NK-LGL) Leukemia.

Jung Ho LEE ; Soo Jin PARK ; Sang Eun PARK ; Seung Keun KWAK ; Hyun Young SHIN ; Sung Eun KIM ; Jung Chan LEE ; Hwan Jung YUN ; Deog Yeon JO ; Samyong KIM ; So Young SHIN ; Kye Chul KWON ; Jong Woo PARK

Korean Journal of Hematology.2001;36(3):269-273.

Large granular lymphocyte (LGL) leukemia, a rare hematologic malignancy, is classified into two groups, CD3+ T-LGL leukemia and CD3- NK-LGL leukemia based upon immunophenotype of the cells. We describe a patient with NK-LGL leukemia, who showed a rapidly fatal course. A 56-year-old man was presented with a very high count of white blood cells (154,400/mm3) consisting of mostly LGLs. Immunophenotyping using flow cytometric analysis revealed that majority of the cells were positive for HLA-DR and CD56 but negative for all the myeloid and lymphoid markers. Despite of active supportive care, he died of coagulopathy and multi-organ failure on the sixth hospital day.
Hematologic Neoplasms ; HLA-DR Antigens ; Humans ; Immunophenotyping ; Leukemia* ; Leukemia, Large Granular Lymphocytic ; Leukocytes ; Lymphocytes* ; Middle Aged

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Total Plasma Exchange in a Patient with HD-MTX-induced Acute Renal Failure: A Case Report.

Hyong Ju KANG ; Hae Won HAN ; Myoung Cheol KIM ; Jin No PARK ; Dong Chan JIN ; Young Seon HONG ; Seung Koo RHEE ; Chun Choo KIM ; Kyung Shick LEE

Korean Journal of Hematology.2001;36(3):265-268.

A 16-year-old male patient was diagnosed as chondroid osteosarcoma of the left humeral shaft. He showed normal serum creatinine level and no complications following the first course of high-dose methotrexate (HD-MTX) chemotherapy with a total dose of 12g/m2. After the 2nd HD-MTX chemotherapy with the same dosage as in the 1st course, plasma MTX levels soared up to 72micromol/L and serum creatinine level increased to 1.39mg/dL. We failed to lower the plasma MTX levels and to recover the renal function by high-dose leucovorin rescue and plasmapheresis. Plasma MTX level was successfully lowered after three consecutive total plasma exchanges and the withdrawal of aceclofenac which was suspected as an aggravating agent. No rebound in plasma MTX level was observed. We report that total plasma exchanges were effective in a patient with renal failure and delayed MTX excretion which occurred after HD-MTX chemotherapy.
Acute Kidney Injury* ; Adolescent ; Creatinine ; Drug Therapy ; Humans ; Leucovorin ; Male ; Methotrexate ; Osteosarcoma ; Plasma Exchange* ; Plasma* ; Plasmapheresis ; Renal Insufficiency

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Auer rod-like crystal inclusions in plasma cells of multiple myeloma.

Sung hee OH ; Chan Jeoung PARK

Korean Journal of Hematology.2010;45(4):222-222. doi:10.5045/kjh.2010.45.4.222

No abstract available.
Multiple Myeloma ; Plasma ; Plasma Cells

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