Journal Detail Information

1

Cite

Share

Megakaryocytic Differentiation of Human Card Blood CD34+ Cells during ex vivo Expansion.

Moon Hee CHOI ; Joo Young SEOH ; Wha Soon CHUNG

Korean Journal of Hematology.1999;34(4):596-607.

No abstract available.
Humans*

2

Cite

Share

Apoptosis and Overexpression of p53 in Patients with Myelodysplastic Syndrome and Acute Myelogenous Leukemia.

Hye Reoun KIM ; Hyoun Tae KIM ; Seok Lae CHAE ; Young Joo CHA

Korean Journal of Hematology.1999;34(4):584-595.

BACKGROUND: The expression of mutant p53 seems to induce malignant transformation by blocking the progression of cell differentiation or apoptotic process. The purpose of this study was to investigate the role of apoptosis and, possibly, a mutant p53 in ineffective hematopoiesis in myelodysplastic syndrome(MDS). The role of the mutant p53 in the leukemic transformation was also studied. METHODS: The bone marrow sections were prepared from 41 patients with MDS, 20 patients with acute myelogenous leukemia(AML) and 10 normal controls. The degree of apoptosis and the overexpression of p53 were evaluated using in situ end-labelling (ISEL) and immunohistochemical staining, respectively. RESULTS: Apoptosis was significantly increased in MDS(P<0.01 vs controls), while AML showed decreased apoptosis (P<0.01 vs controls). Overexpression of p53 protein was observed in 7 (17.1%) of 41 MDS and 3 (15.0%) of 20 AML patients, while it was not increased in normal controls. There were no p53 overexpression in all patients with normal karyotype. However, p53 overexpression was found in 5 out of 10 patients with abnormal karyotype. Three of 5 patients with p53 overexpression showed weak positive staining, and 2 with strong positive staining had complete or partial loss of 17p. CONCLUSION: These findings suggest that apoptosis has a role in ineffective hematopoiesis in MDS. The apoptosis is remarkably decreased in patients with AML. Mutation of p53 may contribute to transformation. Further systemic studies using more cases would be needed to obtain objective assessment data that immunohistochemical examination for p53 overexpression is considered to be useful in predicting the evolution to overt leukemia from MDS in the future.
Abnormal Karyotype ; Apoptosis* ; Bone Marrow ; Cell Differentiation ; Hematopoiesis ; Humans ; Karyotype ; Leukemia ; Leukemia, Myeloid, Acute* ; Myelodysplastic Syndromes*

3

Cite

Share

Allogeneic Bone Marrow Transplantation for Acute Myelogenous Leukemia: Retrospective Analysis in a Single Institution.

Inho KIM ; Joo Young JUNG ; Soo Mee BANG ; Jae Ho BYUN ; Heung Moon CHANG ; Moon Hee LEE ; Young Jin YOO ; Jin Seok AHN ; Jong Tae LEE ; Seok Ah IM ; Chul Won JUNG ; Sung Hyun YANG ; Myung Don OH ; Kang Won CHOE ; Kyou Sup HAN ; Myoung Hee PARK ; Sung Whan HA ; Charn Il PARK ; Kyung Hae JUNG ; Seonyang PARK ; Byoung Kook KIM

Korean Journal of Hematology.1999;34(4):573-583.

BACKGROUND: Acute myelogenous leukemia (AML) is the most common cause of leukemia in adults. Allogeneic bone marrow transplantation (BMT) for the treatment of AML is done worldwide now. METHODS: Between November 1987 and June 1998, we performed allogeneic BMT for 27 patients with AML from HLA-identical sibling donors. We reviewed medical records of these patients. RESULTS: The median age of patients was 31 (range, 15~43) and male to female ratio was 18 : 9. Conditioning regimens were BU/CY (busulfan, cyclophosphamide) for 22 patients, TBI/CY (total body irradiation, cyclophosphamide) for 3 patients, and TBI/VP/CY (TBI, VP-16, cyclophosphamide) for 2 patients. Cyclosporine and methotrexate were used in 18 patients for prophylaxis of graft-versus-host disease (GVHD), and cyclosporine and methyl-prednisolone were used in 9 patients. The median nucleated cell dose given to patients was 4.1x108 /kg. All evaluable patients achieved absolute neutrophil count of 500 /microliter after median 15 days after BMT (range, 11~45 days). Twenty-five percent of patients developed acute GVHD (> or = grade II) and there was no patient with grade IV acute GVHD. Twenty-nine percent developed chronic GVHD. Hepatic venoocclusive disease (VOD) occurred in 7 patients (26%). At the time of BMT, 16 patients were in the first remission status and 11 patients were in the advanced disease status. After a median follow-up of 27 months (range 7~127 months), the actuarial disease-free survival at 5 years was significantly higher in the first remission group than the others (44% vs. 9%; P=0.05). The difference of 5 year overall survival between these two groups approached statistical significance (50%for the first remission group and 12% for the others; P=0.13). There were 17 deaths. The causes of death were relapse (8 patients, 47%), VOD (3 patients, 18%), sepsis (2 patients, 12%), interstitial pneumonia (2 patients, 12%), chronic GVHD (1 patient, 6%), and drug-toxicity (1 patient, 6%). Eary deaths (<100 days) occurred in 6 patients (22%). CONCLUSION: Allogeneic BMT for patients with AML was most successful when done during the first remission. Clinical features of patients with AML treated with allogeneic BMT were similar to those from Western countries, but the incidence and severity of acute GVHD seem to be lower.
Adult ; Bone Marrow Transplantation* ; Bone Marrow* ; Cause of Death ; Cyclosporine ; Disease-Free Survival ; Etoposide ; Female ; Follow-Up Studies ; Graft vs Host Disease ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute* ; Lung Diseases, Interstitial ; Male ; Medical Records ; Methotrexate ; Neutrophils ; Recurrence ; Retrospective Studies* ; Sepsis ; Siblings ; Tissue Donors

4

Cite

Share

Nuclear Hyperploidy of Megakaryocytes and Platelet Aggregation Test in Essential Thrombocythemia.

Young Rok SHIN ; Cheolwon SUH ; Byung Min JUN ; Jeong Hee HAN ; Suk Sue LEE ; Hyun Young KIM ; Tae Won KIM ; Je Hwan LEE ; Sung Bae KIM ; Sang We KIM ; Kyoo Hyung LEE ; Jung Shin LEE ; Woo Kun KIM ; Sang Hee KIM ; Chan Jeoung PARK ; Hyun Sook CHI

Korean Journal of Hematology.1999;34(4):568-572.

BACKGROUND: Essential thrombocythemia (ET) is a rare chronic myeloproliferative disorder characterized by an extremely high platelet count in the circulating blood and abnormal proliferation of the megakaryocytes in bone marrow, resulting in splenomegaly, thromboembolic or hemorrhagic complications. We studied the presence of nuclear hyperploidy of the megakaryocytes in bone marrow, the presence of abnormal response to the individual reagent on platelet aggregation test, and its clinical implication. METHODS: We analyzed the 43 cases of ET at the Asan Medical Center between January, 1989 and March, 1999. The Polycythemia Vera Study Group criteria were used to diagnose ET. RESULTS: Nuclear hyperploidy was observed at 43 cases (100%). Platelet aggregation test was done at 32 (74.4%) cases, of which 27 (84.4%) cases showed abnormal response to more than one reagent, 16 (50%) cases to more than two reagents. Abnormal response to epinephrine and collagen was most common, but 5 cases showed normal response. By individual reagent, 1 (3%) cases to adenosine diphosphate, 1 (3%) case to ristocetin, 22 (69%) cases to epinephrine, 19 (59%) cases to collagen showed abnormal response. CONCLUSION: We observe that nuclear hyperploidy of the megakaryocyts and abnormal response on platelet aggregation test are frequent in ET in this study.
Adenosine Diphosphate ; Blood Platelets* ; Bone Marrow ; Chungcheongnam-do ; Collagen ; Epinephrine ; Indicators and Reagents ; Megakaryocytes* ; Myeloproliferative Disorders ; Platelet Aggregation* ; Platelet Count ; Polycythemia Vera ; Ristocetin ; Splenomegaly ; Thrombocythemia, Essential*

5

Cite

Share

SDS-PAGE Analysis of Red Cell Membrane Proteins in Hereditary Hemolytic Anemia.

Young Kyung LEE ; Han Ik CHO ; Sung Sup PARK ; Eunkyung RA ; Yoon Hwan CHANG ; Mina HUR ; Young Joon LEE ; Hee Young SHIN ; Hyo Seop AHN

Korean Journal of Hematology.1999;34(4):559-567.

BACKGROUND: Red cell membrane is a lipid bilayer laminated by the membrane cytoskeleton at the surface of inner monolayer. A class of hemolytic anemia, such as hereditary spherocytosis (HS) or hereditary elliptocytosis (HE) is mainly caused by the abnormalities of the protein components in the cytoskeleton, which is useful to diagnosis each disorder. We investigated red cell membrane protein defects in HS and HE using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). METHODS: We studied 10 normal healthy volunteers, 27 HS cases and 5 HE cases. Erythrocyte membrane proteins were prepared by hypotonic lysis, and fractionated by SDS-PAGE using both the Fairbanks system (3.5~17% exponential gradient gel), and the Laemmli system (4~17% linear gradient gel). Fractionated proteins were stained with Coomassie brilliant blue and scanned to quantitate each protein using a densitometer. RESULTS: We detected nine peaks in Fairbanks' gel and eight peaks in Laemmli's. We identified red cell membrane abnormalities in 18 of 27 HS patients (66.7%) : Spectrin deficiency alone was in 7.4% of HS cases (2/27), ankyrin deficiency alone in 29.6% (8/27), combined spectrin and ankyrin deficiency in 3.7% (1/27), band 3 deficiency in 11.1% (3/27) and protein 4.2 deficiency in 14.8% (4/27). In HE, three of five cases showed protein 4.1 deficiency. RBC membrane protein deficiencies were not observed in nine HS cases and two HE case. CONCLUSION: In HS, Ankyrin deficiency is the most common RBC membrane protein abnor mality, and protein 4.2 deficiency is more frequently found in Korean HS patients than in Caucasians. In HE patients, protein 4.1 deficiencies is the main red cell membrane protein defect, which is rarely reported in Caucasians.
Anemia, Hemolytic ; Anemia, Hemolytic, Congenital* ; Ankyrins ; Cell Membrane* ; Cytoskeleton ; Diagnosis ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel* ; Elliptocytosis, Hereditary ; Erythrocyte Membrane ; Healthy Volunteers ; Humans ; Lipid Bilayers ; Membrane Proteins* ; Membranes ; Sodium ; Spectrin

6

Cite

Share

Retrospective Analysis of Treatment Outcome and Prognostic Factors in Hodgkin's Disease.

Sang Won LEE ; Baek Yeol RYOO ; Bong Seog KIM ; Yeon Hee PARK ; Tae You KIM ; Young Hyuck IM ; Young Woo LEE ; Hyun Ju HONG ; Jin Young KWAG ; Yoon Koo KANG

Korean Journal of Hematology.1999;34(4):549-558.

BACKGROUND: The prognostic outlook for Hodgkin's disease has markedly improved in recent decades and 70 to 80% of patients can be cured with the modern combination chemotherapy. However, there is no standard treatment strategy according to each stage of the disease. In the present work we analysed retrospectively the therapeutic outcomes of 66 newly diagnosed patients with Hodgkin's disease treated with the strategy of Korea Cancer Center Hospital (KCCH) between 1989 and 1998. Also we studied to identify prognostic factors influencing the therapeutic outcome of the disease. METHODS: The treatment strategy of our institute was as follows; Patients in clinical stage IA with cervical, inguinal or mediastinal involvement and favorable histology (lymphocyte predominant) received radiotherapy without staging laparotomy. However, other patients of IA and the patients in IB, IIA, IIB, IIIA1 were recommended staging laparotomy to determine pathologic stage. The patients who were contraindicated to or refused staging laparotomy, or who were in clinical stage IIIA2, IIIB, IVA, IVB received chemotherapy. The patients in pathologic stage I or II received radiotherapy, and who in IIIA, IIIB, IIB, IV were treated with chemotherapy. The patients who have had massive tumor in any stage received additional radiotherapy following chemotherapy and who had residual lymph node after chemotherapy received additional radiotherapy to involved area. RESULTS: Of all 66 patients, 13 patients received radiotherapy alone and 53 patients were treated with chemotherapy +/- radiotherapy. Staging laparotomy was performed in 6 patients and pathologic stage tended to be upstaged after laparotomy. A complete response (CR) rate following treatments was reached to 81.8% (54/66, 95% C.I.=72.3~91.3%). Five-year progression free survival and overall survival rate were 59.1% and 74.3%, respectively. In prognostic factors analysis, age (P=0.0323) and performance status (P=0.0183) were the independent prognostic factors influencing overall survival. CONCLUSION: The outcome of Hodgkin's disease treated with our strategy was as good as that in other institutes. However, the prognosis of the patients who did not reach complete remission was poor. The prognostic factors analysis showed that age and performance status, which were not considered in establishment of treatment strategy, were the independent factors influencing the outcome of Hodgkin's disease. Further studies to develop treatment strategy considering all important prognostic factors including age and performance status and to increase complete response rate and ultimately overall outcome were warranted.
Academies and Institutes ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Hodgkin Disease* ; Humans ; Korea ; Laparotomy ; Lymph Nodes ; Prognosis ; Radiotherapy ; Retrospective Studies* ; Survival Rate ; Treatment Outcome*

7

Cite

Share

The Effect of Recombinant Fibronectin Fragment (Retronectin) and Cytokines during deltaLNGFR Retroviral Transduction of CD34+ Cells.

Seok LEE ; Yoo Hong MIN ; Yun Woong KO

Korean Journal of Hematology.1999;34(4):534-548.

BACKGROUND: Hematopoietic stem cells (HSC) remain one of the most promising target cells for gene therapeutic approaches, but is currently limited by a number of issues, including the low gene transfer efficiency. METHODS: We evaluated the effect of recombinant fibronectin fragment (retronectin) and cytokines during retroviral transduction of CD34+ cells and analyzed the characteristics of transduced cells. To rapidly characterize and isolate transduced cells, we used a retroviral vector coding for the truncated form of the low-affinity nerve growth factor receptor (delta LNGFR). RESULTS: The total number of CD34+ cells (1.5~6.3-fold) and the amount of cycling (S+G2/M) cell fractions (2~6-fold) were increased after cytokine prestimulation, especially using thrombopoietin (TPO)-based cytokines. The immunophenotype of CD34+ cells showed no significant differences according to the cytokines. However, CD34+AC133+ cells were more effectively maintained in the presence of TPO. The transduction efficiency of CD34+ cells was significantly increased in the presence of retronectin (6.7+/-2.3% vs 23.1+/-4.4%). Immunomagnetic selection of the transduced cells allowed us to enrich these effectively (6.7+/-2.3% --> 86.3+/-6.5%). Compared with control, delta LNGFR transduction did not influence on the immunophenotype and cloning efficiency of CD34+ cells. Among the delta LNGFR+/-derived colonies, 85.0% were shown to contain an integrated delta LNGFR gene. CONCLUSION: These data show that retronectin and TPO-based cytokines can be used to facilitate retroviral transduction of CD34+ cells. Also, delta LNGFR transduced cells could be rapidly characterized by FACS analysis and effectively enriched by immunomagnetic selection method. Further improvement of transduction conditions for stimulation of HSC proliferation without differentiation and development of new vectors that obviate the requirement for cell division are likely to enhance transduction of primitive HSC.
Cell Division ; Clinical Coding ; Clone Cells ; Cloning, Organism ; Cytokines* ; Fibronectins* ; Hematopoietic Stem Cells ; Nerve Growth Factor ; Thrombopoietin ; Zidovudine*

8

Cite

Share

Effects of Increased Lymphocytes and B Cell Clonality of Marrow Aspirates on Marrow Involvement and Prognosis in Children with Neuroblastoma.

Yoon Hee KANG ; Chan Jeoung PARK ; Mee Jung KIM ; Eul Ju SEO ; Sung Ryul KIM ; Hyun Sook CHI ; Yong Hee SHIM ; Joo Ryung HUR ; Jong Jin SEO ; Hyung Nam MOON ; Thad T GHIM

Korean Journal of Hematology.1999;34(4):521-533.

BACKGROUND: The lymphocytes including morphologically immature lymphoid cells are frequently increased in the marrow aspirates of children with neuroblastoma. We studied about the clonality of these lymphoid cells and its effects on the marrow involvement and prognosis of disease. METHODS: We evaluated 30 marrow aspirates of 23 children with neuroblastoma from 1990 to 1998. We tested the immunoglobulin heavy chain gene rearrangement PCR for B cell clonality and T cell receptor gamma gene rearrangement PCR for T cell clonality with bone marrow specimens. RESULTS: Younger children showed negative bone marrow involvement more than older children. In this group, the proportions of immature lymphoid cells and total lymphocytes were higher (3.4+/-3.2% vs. 0.8+/-1.9%, 31.3+/-17.0% vs. 14.7+/-12.0%). Immunoglobulin heavy chain gene rearrangements were present in 19/30 (64%) specimens and more frequently observed in negative marrow involvement cases. Seven cases with the proportions of total lymphocytes more than 30% showed significantly high long-term survival probability (P=0.05). Ten cases with B cell monoclonality showed the tendency of high long-term survival probability (P=0.13). CONCLUSION: The increase of lymphocytes including morphologically immature lymphoid cells in the marrow aspirates of children with neuroblastoma were frequently observed in the children without marrow involvement of malignancy and closely related to B cell clonality. The increase of total lymphocytes and related B cell monoclonality may be one of possible explanations of goodprognosis of children with neuroblastoma.
Bone Marrow* ; Child* ; Gene Rearrangement ; Humans ; Immunoglobulin Heavy Chains ; Lymphocytes* ; Neuroblastoma* ; Polymerase Chain Reaction ; Prognosis* ; Receptors, Antigen, T-Cell

9

Cite

Share

Effect of Splenectomy in Adult Patients with Idiopathic Thrombocytopenic Purpura (ITP).

Chul Won CHOI ; So Young YOON ; Chang Won PAEK ; In Keun CHOI ; Jae Hong SEO ; Byung Soo KIM ; Sang Won SHIN ; Yeul Hong KIM ; Jun Suk KIM

Korean Journal of Hematology.1999;34(4):513-520.

No abstract available.
Adult* ; Humans ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

10

Cite

Share

A Case of Non-Immune Mediated Marrow Suppression Associated with Phenytoin Therapy.

Hyuck Joon CHUNG ; Sung Gyun AHN ; Cheol Gweon JEONG ; Joon Seung PARK ; Do Yeun CHO ; Hyun Soo KIM ; Jin Hyuk CHOI ; Dong Ki NAM ; Ho Yeong LIM ; Hugh Chul KIM

Korean Journal of Hematology.1999;34(3):507-511.

Diphenylhydantoin (DPH) is one of the most widely used anticonvulsants for treatment and prevention of seizures. However it is frequently associated with drug-induced leukopenia. Hypersensitivity reactions to phenytoin are well recognized and can be severe. Phenytoin is associated with serious hematologic side effects such as agranulocytosis, thrombocytopenia, red cell aplasia and hemolytic anemia, either through humoral or cell-mediated immunemechanism. We describe a 57-year-old male patient who developed a severe granulocytopenia while taking phenytoin for 66 days in the total amount of 21.6 gram. Bone marrow examination showed isolated depletion of myeloid elements. After 10 days of phenytoin withdrawal and G-CSF treatment, the patient recovered from granulocytic suppression. Using in vitro culture, marrow suppression associated with phenytoin therapy was felt to be non-immune mediated marrow suppression.
Agranulocytosis ; Anemia, Hemolytic ; Anticonvulsants ; Bone Marrow Examination ; Bone Marrow* ; Granulocyte Colony-Stimulating Factor ; Humans ; Hypersensitivity ; Leukopenia ; Male ; Middle Aged ; Phenytoin* ; Seizures ; Thrombocytopenia

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share