Teiji Fujie

A PILOT STUDY OF A RESPONSE ORIENTED CHEMOTHERAPEUTIC REGIMEN COMBINED WITH AUTOLOGOUS PERIPHERAL BLOOD PROGENITOR CELL TRANSPLANTATION IN AGGRESSIVE NON-HODGKIN'S LYMPHOMA

Fourteen consecutive patients with poor-risk aggressive NHL who at presentation had any one of four risk factors underwent response oriented induction chemotherapy and successive high-dose chemotherapy followed by autologous PBPC transplantation. After treatment with three cycles of conventional CHOP with G-CSF support (CHOP-G), the response was evaluated. For patients who achieved a complete remission (CR), an additional three cycles of CHOP-G were administered, while for partial response patients, another induction regimen including some non-cross-resistant agents was given; three cycles of VIPDexa-G (etoposide, ifosfamide, cisplatinum and dexamethasone) +/- two cycles of ENAP-G (mitoxantrone, etoposide, cytosine arabinoside and prednisone), were given. The scheduled induction chemotherapy, was followed by treatment with a high-dose cytoreductive regimen followed by autologous PBPC transplantation. After three cycles of CHOP-G, four patients (29%) achieved a CR, and 10 (71%) achieved a partial response (PR). When all scheduled induction therapy was completed, 10 patients (71%) had a CR. All 14 patients received high-dose therapy and obtained a complete hematologic recovery, except for one with a bone marrow relapse two months after transplantation. Evaluation of response after high-dose therapy showed 12 CRs (86%) which included three additional CRs, one PR, and one toxicity-related death. With a median follow-up of 12 months (range, 4 to 40), 12 are alive, with 11 in continuous first CR, and one relapse. The 2-year overall survival (OS) rate and event-free survival (EFS) rate are 77% and 79%, respectively, while the disease-free survival (DFS) rate is 92%. In conclusion, this pilot study suggests that response oriented induction chemotherapy and successive high-dose chemotherapy followed by autologous PBPC transplantation is commendable and can be associated with a high rate of remission and DFS for poor risk subjects with aggressive NHL.

Hepatoma associated with erythrocytosis report of two cases

本邦の原発性肝癌には比較的まれとされている,赤血球増多症を伴った2症例を経験したので報告する.症例1は,47歳男性,肝両葉の原発性肝癌(血中AFP:348, 722ng/ml)に赤血球増多症(赤血球数778万,ヘマトクリット65.4%)が随伴し,尿中erythropoietin濃度(150m.i.U/ml)の上昇を認めた.症例2は,66歳男性,肝右葉の原発性肝癌(血中AFP:99, 026ng/ml)に赤血球増多症(赤血球数682万,ヘマトクリット57.7%)が伴い,本症例では,循環赤血球量(80ml/kg)の増加,血中(100m.i.U/ml)および尿中(150m.i.U/ml)erythropoietin濃度の上昇を認めた.以上の所見より,いずれの赤血球増多症も原発性肝癌に随伴した二次性疾患と診断した.