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Biomedical subjects

U Sawada

Publications and source records attributed to U Sawada.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Primary nasopharyngeal lymphoma with CD3- and CD56+ phenotype].

A 73-year-old man was admitted to our hospital with nasal hemorrhage and high grade fever on Aug, 1992. Physical examination revealed a tumor in the nasopharyngeal cavity, generalized skin eruptions and three tumors on different subcutaneous lesions, splenomegaly 2 cm below the costal margin, and the enlargement of the right cervical and axillary lymph nodes. Biopsy of the nasopharyngeal and cutaneous tumor disclosed non-Hodgkin's lymphoma (WF: Diffuse small cleaved). Peripheral blood examination showed a WBC of 4,800/microliters with 10% blastoid cells. Bone marrow examination showed 60% blastoid cells which frequently appeared a hand mirror configuration had no azurophilic granules in the cytoplasm. Flow cytometic analysis of these cells in the bone marrow showed that they expressed CD56 (NKH-1) and Ia but not expressed T-cell antigens as well as B-cell antigens and myeloid cell antigens. Phenotype of subcutaneous tumor biopsy cells was similar to that of blastoid cells in the bone marrow. T-cell receptor gene (TCR beta and gamma) rearrangements in blastoid cells were not found. The patient was treated with local radiotherapy to nasopharyngeal and skin tumors, followed by chemotherapy. The patient died of complication with pulmonary bleeding due to DIC. These results suggested that this nasopharyngeal lymphoma derived from NK cell.

Aged↗
PubMed1995

[Long term remission following relapsed CNS lymphoma].

A case of NHL which has been in long-term remission following vigorous treatment for CNS relapse with intrathecal administration of Ara-C and focal irradiation to the brain is presented. The patient was a 61-year-old man, who was successfully treated with CHOP followed by MACOP-B for diffuse large cell NHL in 1988. Five months later he was admitted to our hospital because of loss of visual acquity and numbness in the right upper and lower extremities. The presence of lymphoma cells in CSF, abnormal shadow in the left frontal lobe on a cranial CT scan and MRI scan, and positive Ga scintigraphy yielded a diagnosis of CNS relapse of NHL. Twenty one whole brain and additional 1.0Gy to the left frontal lobe of irradiation were performed. Eight days later the left tumor disappeared. Neurological remission was obtained and has continued until now.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Daily oral low-dose etoposide therapy for aged patients with relapsed aggressive lymphoma].

Two patients with relapsed Non-Hodgkin's lymphoma (NHL) were treated with oral administration of etoposide. In these patients, long-term hematological remission was obtained. One patient was a 76-year-old man, who was successfully treated with CHOP for diffuse large cell NHL stage III B. One year after obtaining CR, he was admitted to our hospital for enlargement of lymph node. Rebiopsy of lymph node made a diagnosis of relapse from NHL. A new regimen of oral administration of etoposide treatment was employed. Hematological remission was obtained and continued for 3 years. Without interfering with his quality of life. The other patient was a 74-year-old man, who was treated with 6 cycles of CHOP for diffuse large cell NHL stage IV B. The patient attained complete remission following an additional 2 cycles of COMLA therapy. Eight years later, he was admitted for enlargement of lymph node. Rebiopsy of lymph node provided the basis for a diagnosis of relapse from NHL. Oral administration of etoposide treatment was started. Hematological remission was obtained and has been continued until now. These results show that oral administration of etoposide treatment is effective for some patients with recurrent NHL.

Aged↗
PubMed1995

[Natural interferon alpha for chronic myelogenous leukemia in the chronic phase: hematologic, cytogenetic and molecular response].

Twenty one patients with Philadelphia chromosome positive CML were treated with natural interferon alpha. All patients were in the chronic phase, 5 were untreated and 16 had been previously treated with busulfan or hydroxyurea. Eight patients in complete remission (CR) were given IFN subcutaneously at a dose of 5 x 10(6) unit per day as maintenance therapy, whereas 13 non-CR patients were given 2. 5 approximately 10 x 10(6) units for remission induction. Doses and intervals of IFN were adjusted to maintain the WBC count below 5 x 10(9)/l, but additional drugs were given when the WBC count could not be controlled with IFN alone. Six out of 10 evaluable non-CR patients attained CR with IFN only and 4 others achieved with additional drug. Cytogenetic responses were evaluated in 15 patients. CCR, PCR and MCR were attained in 5, 2 and 1 patients respectively. Southern blotting method showed that the BCR gene rearrangement disappeared in 5 out of 13 patients. Cytogenetic response rate was not different between untreated and previously treated patients, however it differed between patients with or without additional drug. The time to first cytogenetic effect was within 12 months in almost all effective cases. Fever and general fatigue were seen in almost all patients. IFN administration was discontinued only patients with severe skin eruption (3 patients) and bone marrow aplasia (1 patient).

Adult↗
PubMed1994

[Massive skeletal invasion in Hodgkin's disease observed by MRI].

A 35-year-old female developed cervical adenopathy and mediastinal tumor in 1988. A lymph node biopsy specimen showed nodular sclerosing Hodgkin's disease. She received combination chemotherapy with cyclophosphamide, vincristine, adriamycin and prednisolone, and radiotherapy for mediastinal tumor. She had a complete remission (CR). In September 1990, she developed swelling of the left hip and felt pain in the left hip and thigh. She also noticed swelling of the left inguinal lymph nodes. MRI T2-weighted images showed enlargement and destruction of the fascia and hyperintense signal of the left iliac and gluteus muscle. A biopsy specimen of the inguinal lymph node showed recurrence of Hodgkin's disease of mixed cellularity. She received salvage therapy with ifosfamide, methotrexate, etoposide and procarbazine, and achieved a second CR. The clinical appearance of the skeletal muscle involvement by lymphoma is uncommon, especially in Hodgkin's disease.

Adult↗
PubMed1993

[Treatment of high risk non-Hodgkin's lymphoma].

Among malignant disease, the non-Hodgkin's lymphomas (NHL) are a diverse group of lymphoid neoplasms that display a wide spectrum of clinical, morphologic, immunologic, and molecular features. Currently the NHL are divided into three groups based on their clinical behavior: 1) indolent, 2) aggressive, and 3) highly aggressive. Among the groups, many patients with aggressive NHL is curable with current combination chemotherapy, however fractions of patients will relapse, and resistant disease remains a problem. It would be valuable to identify those patients with a particularly poor prognosis when treated with a standard regimen so that alternative therapies could be tested. A number of risk factors distinguish patients with a distinct natural history and probability of response to therapy. Recently, international index identifies subsets of patients who are likely to do well or unlikely to benefit from standard regimens and younger high-risk patients are candidates for more intensive experimental therapy. A major idea that is guiding the development of new treatment programs is augmenting the dose intensity of the treatment. The development of colony-stimulating factors allow us to increase intensity of chemotherapy. However, it must be confirmed that such therapy really improve the survival of the patients with high risk NHL. Formerly a universally fatal disease, relapsed aggressive lymphoma now appears to be responsive to combinations of non-cross resistant antineoplastic drugs or to high-dose chemotherapy with or without rediation therapy followed by autologous or allogeneic bone marrow or peripheral blood stem cell transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

A comparative study of CHOP versus MEVP (mitoxantrone, etoposide, vindesine, prednisolone) therapy for intermediate-grade and high-grade non-Hodgkin's lymphoma: a prospective randomized study.

To evaluate a new combination chemotherapy with mitoxantrone (MXT), etoposide (VP-16), vindesine (VDS), and prednisolone (MEVP therapy) as a front-line chemotherapy for non-Hodgkin's lymphoma (NHL), a prospective randomized study comparing this therapy (28 patients) with CHOP therapy (29 patients) was conducted in 57 patients with intermediate-grade or high-grade NHL with stages II-IV. The MEVP therapy consisted of 10 mg/m2 of MXT intravenously on day 1, 2 mg/m2 of VDS intravenously on day 1, 200 mg/m2 of VP-16 orally on days 1-3, and 40 mg/m2 of prednisolone orally on days 1-5. This regimen was repeated every 3 weeks for up to 10 courses. Complete responses (CR) were achieved in 17 (63.0%) of the 27 evaluable patients treated with MEVP therapy, and in 20 (71.4%) of the 28 evaluable patients treated with CHOP therapy. Relapse-free survival rates and overall survival rates at 3 years were 58.8% and 46.4%, respectively, for the MEVP group and 70.0% and 54.0%, respectively, for the CHOP group. Granulocytopenia was more severer and associated infection episodes were more frequent in the MEVP group. MEVP therapy was effective as a front-line chemotherapy for intermediate- and high-grade NHL, although it was not superior to CHOP therapy in treatment effect and was not less toxic than CHOP.

Adolescent↗
PubMed1992

[Complete remission with MEC regimen of acute myeloid leukemia (M4) secondary to 5-year treatment of non-Hodgkin lymphoma].

A 32-year-old woman was admitted to our hospital with pyrexia and general lymphadenopathy in July 1984. She was diagnosed as having malignant lymphoma (follicular, small cleaved cell), stage IV based on the histological findings of lymph nodes in the neck and bone marrow specimen. She was treated with melphalan orally for 3 years, followed by MACOP-B. She attained partial remission with MACOP-B. Thereafter, she received melphalan or Endoxan orally as maintenance therapy. She developed fever and swelling in the gingivae in October 1989. Peripheral blood showed WBC 80,200/microliters with 7.5% myeloblasts and 85.5% monocytes. Bone marrow aspirate revealed hypercellularity with 47.9% myeloblasts, 46.5% monoblasts and monocytes, which were positive for peroxidase and NSE stains. The karyotype of bone marrow cells showed a 46,XX,t(9;11). The lysozyme in serum was elevated. She was diagnosed having AML (M4). DCMP regimen was initiated but failed to achieve CR. Consequently she received MEC regimen and obtained complete remission, lasting for 6 months. Patients with second leukemia have a low probability of achieving complete remission using conventional chemotherapy. The MEC regimen is thought to be one of the most promising treatments for secondary leukemia.

Adult↗
PubMed1992

Treatment of diffuse non-Hodgkin's lymphoma with combined chemotherapy using methotrexate, adriamycin, cyclophosphamide, vincristine, prednisolone and bleomycin (MACOP-B).

Forty-nine previously untreated adult patients with diffuse non-Hodgkin's lymphoma were treated with MACOP-B (methotrexate, adriamycin, cyclophosphamide, vincristine, prednisolone and bleomycin) between December 1986 and December 1990. Forty patients (82%) achieved a complete response (CR), three (6%) a partial response (PR), while four (8%) had either no response or progression of disease, one (2%) patient ceased MACOP-B therapy and received other chemotherapy because of sustained neutropenia, and one patient (2%) died of sepsis during therapy. The factors that adversely affected the CR rate were by stage IV, the presence of B symptoms, the presence of a large mass (greater than 5 cm), and low serum total protein level. The 4-year survival for all 49 patients was 70% and the 4-year disease-free survival (DFS) for the 40 CR patients was 77%. Relapses were higher in patients whose initial serum lactic dehydrogenase (LDH) level was higher than 660 IU/1 (DSF 89% vs. 49%). Toxicity was substantial but acceptable, with neutropenia and mucositis proving to be the most frequent severe side-effects. These preliminary results confirmed the effectiveness of MACOP-B therapy for diffuse non-Hodgkin's lymphoma.

Adolescent↗
PubMed1992

[Three familial patients with chronic acquired pure red cell aplasia].

It has not been reported that chronic acquired pure red cell aplasia (PRCA) occurs among family members. The authors report his at familial patients with chronic acquired PRCA, a 23-year-old male, a 54-old uncle and a 20-year-old male cousin. They had no complication sor thymoma, and hematological findings were compatible with typical chronic acquired PRCA. In the 23-year-old male, the autologous BFU-E number was suppressed by the addition of pretreatment serum, and in the his uncle, the autologous CFU-E number was suppressed by the addition of IgG fraction of plasma. In these cases, the development of PRCA was considered to be based on the autoimmune mechanism due to by the presence of serum antibodies. This suggests the possibility that genetically inherited susceptibility may also be an important factor causing chronic acquired PRCA.

Adult↗
PubMed1991

Expression of a multidrug-resistance gene in human malignant lymphoma and related disorders.

The expression of mdr1 gene was measured to determine whether it plays a role in clinical resistance to chemotherapy of human malignant lymphomas. mdr1 expression was found in 4 of 9 cases resistant to chemotherapy. Expression of mdr1 was not detectable in any of 7 chemotherapy-sensitive tumors. The 2 cases of reactive lymphadenitis and the 3 samples of normal mononuclear cells did not show any expression of mdr1 gene, either. These results indicate that expression of the mdr1 gene is not always detectable in cases of malignant lymphoma resistant to chemotherapy, but the detectable expression of mdr1 gene may predict clinical resistance to chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[An autopsy case of adult T-cell leukemia complicated with metastatic calcification of the lung].

46-year-old male patient was born in Niigata Prefecture and thereafter lived in Tokyo. In late January 1985, he noticed swelling of the bilateral inguinal lymph-nodes followed by fever and lumbago. In February, he consulted a local doctor and hepatosplenomegaly, marked leukocytosis and renal dysfunction were pointed out and he was referred to our hospital on February 22nd. The clinical laboratory data on admission were as follows; WBC 23,200/microliter, serum-Ca 18.4 mg/dl, BUN 85.3 mg/dl, creatinine 5.4 mg/dl, antibody to ATLV x160. ATL was diagnosed by biopsy of lymph nodes and examinations of peripheral blood and bone marrow hemogram. Remission was achieved in March by the treatment with adriacin. Renal failure and hypercalcemia also improved. However his respiratory dysfunction gradually worsened. The chest radiographies++ showed pulmonary edema, although there was no clinical evidence of heart failure. When his condition became stable, TBLB was performed and revealed extensive deposition of calcium along alveolar septae, suggesting that pulmonary edema was induced by the metastatic calcification of the lung. After the second treatment for ATL, he died of pneumonia. The autopsy showed calcium deposition not only in the lung but in pyramids of the kidney and in sub-serous layer of the small intestine. There was no tumor cell invasion into the bone or parathyroid gland. High urinary c-AMP together with normal levels of PTH suggested that the hypercalcemia in this case was induced by PTH-related protein. It was concluded that careful treatment for hypercalcemia is important as regards the occurrence of pulmonary edema.

Calcinosis↗
PubMed1990

[A double-blind, cross-over clinical trial of recombinant human G-CSF on neutropenia induced by chemotherapy for non-Hodgkin's lymphoma].

A double-blind, placebo-controlled, cross-over clinical trial of recombinant human granulocyte colony-stimulating factor (rG-CSF), produced by Chinese hamster ovary cells, was conducted in 46 patients receiving intensive chemotherapy for non-Hodgkin's lymphoma. Each patient received 2 cycles of CHOP therapy. rG-CSF (2 micrograms/kg/day) or its placebo was given subcutaneously to each patient for 14 days from 2 days after initiation of the chemotherapy, in a cross-over fashion. rG-CSF significantly increased the absolute neutrophil counts (ANC) at nadir, and reduced the number of days with ANC less than 1,000/mm3 and also the number of days for recovery to ANC greater than or equal to 2,000/mm3. Bone marrow examination showed a significant increase in the number of myeloid cells after rG-CSF treatment. 12 infective episodes were observed during placebo cycles, while 6 infective episodes were observed during rG-CSF cycles. No serious side effects were observed. We concluded that rG-CSF was effective in neutropenia induced by intensive chemotherapy for non-Hodgkin's lymphoma.

Adult↗
PubMed1989

[Chemotherapy of stage III-IV Hodgkin's disease. A retrospective analysis of the 53 cases collected from 9 institutions in Japan].

The clinical data of 53 patients with Stage III-IV Hodgkin's disease collected from 9 institutions in Japan were analyzed for the efficacy of chemotherapy. CR rate (78%) and five-year relapse-free survival (RFS) rate (61%) were higher in the patients treated with VEPA/CHOP regimen than those in patients with VEMP/BONP or MOPP/C-MOPP regimen, although the difference was not statistically significant because of the small number of the patients. As to 14 patients treated with CHOP regimen, CR rate was 87% and RFS curve trend toward plateau at 67% after 2 years and 3 months from the initiation of chemotherapy. Salvage therapy with adriamycin-based combination chemotherapy achieved CRs in 9 of 14 (64%) patients who had been treated with VEMP, BONP, modified MOPP or C-MOPP regimen. The CHOP regimen was effective in the treatment of III-IV Hodgkin's disease but an alternative multidrug chemotherapy with ADM, CPM, VCR, BLM, etoposide and procarbazine is recommended for achieving a higher CR rate and a better RFS. Prospective study is needed to establish the standard chemotherapy for Hodgkin's disease in Japan.

Adolescent↗
PubMed1989

[Follicular lymphoma in Japan: retrospective study on natural history and therapeutic results in 50 cases collected from 4 institutions].

Clinical data of the 50 patients with nodal follicular lymphoma were collected from 4 institutions in Japan and were analysed retrospectively. A frequency of follicular lymphoma was 9.3% in the 364 patients with nodal lymphoma registered between 1981-1986. Twenty-one patients (42%) were classified as follicular medium-sized cell type (F-medium; identical with follicular small cleaved cell type by Working Formulation criteria), 12 (24%) as follicular mixed (F-mixed), and 17 (34%) as follicular large (F-large). There were 31 (62%) patients with Stage III-IV disease involving bone marrow in 6 patients, liver in 2, bone marrow and liver in 2, stomach in 1. Overall five- and ten-year survival rates were 65% and 32%, respectively, in the 49 patients whose median follow-up period was 3 years, ranging from 2 to 11 years. Adriamycin-based combination chemotherapy [ADM(+) therapy] produced 10 (100%) complete response (CR) of 10 patients with F-large lymphoma and 8 (80%) of them were free from relapse. But, in the patients with F-medium lymphoma, ADM(+) therapy produced one (17%) CR of 6 patients and their survivals were not superior to those treated with ADM(-) therapy, single agents or radiotherapy alone. There was no difference in the natural history or therapeutic results between the patients in Japan and United States, although the frequency of follicular lymphoma was extremely lower in Japan. ADM(+) therapy can be accepted as the first-line chemotherapy for the patients with F-large lymphoma, but the best modality of treatment should be investigated for the patients with F-medium lymphoma.

Adult↗