[Multiple liver abscesses in four cases of acute leukemia].
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Biomedical subjects
Publications and source records attributed to M Omine.
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A marked prolongation of QTc (corrected QT interval for heart rate) in ECG developed in two patients with acute leukemia during induction chemotherapy with aclarubicin, one of the anthracycline antibiotics. This ECG change was followed by ventricular fibrillation. No signs or symptoms of congestive heart failure were noted. The outcome in one case was fatal; in the other case, the ECG change was reversible. These observations suggest that QTc prolongation, which has been considered to be a sign of acute cardiotoxicity of anthracycline derivatives, may signal a clinical risk of ventricular fibrillation.
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A 7-year-old boy with juvenile erythroleukemia is described, whose red cells demonstrated a high content of Hb F with fetal structure and yet contained carbonic anhydrase at adult red cell level. The findings seem to exemplify the occurrence of uncoordinated expression of fetal markers and consequently the incomplete reversion to fetal-type erythropoiesis in a hematologic malignancy.
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Abnormal hemoglobin, which was latter identified as hemoglobin Zürich, was discovered in a 45-year-old female with severe valvular heart disease, congestive heart failure and moderate anemia and hyperbilirubinemia. Same abnormal hemoglobin was demonstrated in her two apparently healthy sons. This is the first reported family of hemoglobin Zürich in Japan.
Clinical investigation of cefotiam and aminoglycosides combination use against infections complicated by acute leukemia was performed, and the results obtained were as follows. 1) Sixteen patients were treated with cefotiam in doses 4--6 grams per day parenterally. The clinical effectiveness were excellent 47.6%, good 14.3%, fair 9.5% and poor 28.6%. No significant differences in therapeutic efficacy was observed between the patients given CTM 4 g/day and CTM 6 g/day. 2) It was considered that the clinical effectiveness of CTM has not been influenced by the difference of a number of maturation granulocyte. CTM has showed a certain, though not distinctive, efficacy compared with CFX. 3) As side effects with CTM, eruption appeared in 1 case, and no remarkable laboratory findings was observed. Cefotiam is thus considered to be a useful drug for the treatment of infections complicated by acute leukemia.
To elucidate the biochemical basis of megaloblastic hematopoiesis, the cellular content and metabolism of deoxyribonucleoside triphosphates (dNTPs) were investigated using the bone marrow cells from nine patients with untreated vitamin B12 deficiency and one with folic acid deficiency. The marked imbalance among four dNTPs was noted in all patients. dTTP was invariably elevated rather than depressed. The most striking abnormality, however, was the excessive accumulation of dCTP, which represented the consistent feature exclusive for megaloblastic anemia. Purine nucleotides were also involved to a lesser extent. The apparent turnover pattern of the dTTP pool of megaloblastic anemia marrow cells, in the presence or absence of hydroxyurea, did not differ significantly from that of normoblastic hematopoiesis. The megaloblastic cells assimilated exogenous thymidine into dTTP pool in vitro with enhanced efficiency. It was suggested that the excessive accumulation of dCTP may be related more closely to the pathogenesis of megaloblastic hematopoiesis than to the presumed but not proved deficiency of dTTP.
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