Adjuvant chemotherapy by S-1 following gastrectomy is considered standard treatment in Japan.Analysis of follow-up data have proved the effi cacy of S-1 admin-istration,and that hematological adverse events were relat...Adjuvant chemotherapy by S-1 following gastrectomy is considered standard treatment in Japan.Analysis of follow-up data have proved the effi cacy of S-1 admin-istration,and that hematological adverse events were relatively rare.Pyrimidine anti-metabolites,including S-1,have shown relatively lower risks for secondary hematological malignancies in comparison to alkylat-ing agents and topoisomerase-Ⅱ inhibitors.We here report a case of therapy-related leukemia after S-1 administration.A patient who had received S-1as the sole adjuvant chemotherapy was diagnosed with acute erythroid leukemia.To the best of our knowledge,our patient represents the fi rst report of S-1 induced acute leukemia.展开更多
AIM: To elucidate risk factors for survival of elderly acute myeloid leukemia(AML) patients in a real-world practice by observational study. METHODS: We conducted a population-based study in 213 adult and elderly AML ...AIM: To elucidate risk factors for survival of elderly acute myeloid leukemia(AML) patients in a real-world practice by observational study. METHODS: We conducted a population-based study in 213 adult and elderly AML patients(127 males and 86 females) in Kagawa Prefecture, Japan. To construct this cohort, we gathered all data for patients diagnosed with AML at 7 hospitals in Kagawa between 2006 and 2010. The primary end point was overall survival(OS) after AML diagnosis. Unadjusted Kaplan-Meier survival plots were used to determine OS in the overall cohort. Multivariate analysis was used to determine the independent adverse prognostic factors for OS, with the covariates of interest including age, gender, race/ethnicity, CCI, education, median income, metropolitan statistical area size and history of myelodysplastic syndrome.RESULTS: The average population of Kagawa during the study period was 992489, and the incidence of AML was 4.26 per 100000 person-years. A total of 197 patients with non-acute promyelocytic leukemia(non-APL)(119 males and 78 females) were also included. The median age of non-APL patients was 70 years(average 67, range 24-95). The 5-year OS rate was 21.1%. Subsequent analysis by age group showed that the survival rate declined with age; the 5-year OS rates of non-APL patients younger than 64 years, 65-74 years, and older than 75 years were 41.5%, 14.1%, and 8.9%, respectively. Multivariate analysis revealed that unfavorable risk karyotype, older age, poor performance status(PS)(3-4), lack of induction chemotherapy, and antecedent haematological disease were independent prognostic predictors. In the subgroup analysis, we also found that older patients with non-APL had lower complete remission rates and higher early death rates than younger patients, irrespective of PS. However, intensive chemotherapy was a significant predictor for longer survival not only in the patients < 75 years of age, but also in those over 75 with PS 0-2. CONCLUSION: Age would contribute considerable life expectancy to indicate induction chemotherapy with eligible dose of cytotoxic drugs for a favorable case even in advanced elderly.展开更多
An 82-year-old Japanese man visited our emergency unit complaining of dyspnea. Laboratory data showed 15% atypical lymphocytes in peripheral blood which expressed the T-cell phenotype. Chest/abdominal computed tomogra...An 82-year-old Japanese man visited our emergency unit complaining of dyspnea. Laboratory data showed 15% atypical lymphocytes in peripheral blood which expressed the T-cell phenotype. Chest/abdominal computed tomography depicted hepatosplenomegaly and swelling of systemic lymph nodes. The patient died of advanced respiratory failure 5 d after the first occurrence of his dyspnea. At autopsy, the pathological features revealed a diffuse infiltration of large atypical lymphocytes to systemic organs including the spleen and lung. In immunohistochemical staining, these cells expressed CD30, TIA-1, anaplastic lymphoma kinase(ALK), CD5 and CD3. An advanced surface molecule analysis revealed a lack of CD54(intercellular cell adhesion molecule-1) and CD56(neural cell adhesion molecule). We observed the proliferation and infiltration of these lymphoma cells specifically at the intravascular lesions similar to intravascular lymphoma(IVL). T-cell IVL is not established as an independent clinical entity in the World Health Organization classification, and our patient's ALK-positive T-IVL in lung appears to be the first reported case.展开更多
文摘Adjuvant chemotherapy by S-1 following gastrectomy is considered standard treatment in Japan.Analysis of follow-up data have proved the effi cacy of S-1 admin-istration,and that hematological adverse events were relatively rare.Pyrimidine anti-metabolites,including S-1,have shown relatively lower risks for secondary hematological malignancies in comparison to alkylat-ing agents and topoisomerase-Ⅱ inhibitors.We here report a case of therapy-related leukemia after S-1 administration.A patient who had received S-1as the sole adjuvant chemotherapy was diagnosed with acute erythroid leukemia.To the best of our knowledge,our patient represents the fi rst report of S-1 induced acute leukemia.
文摘AIM: To elucidate risk factors for survival of elderly acute myeloid leukemia(AML) patients in a real-world practice by observational study. METHODS: We conducted a population-based study in 213 adult and elderly AML patients(127 males and 86 females) in Kagawa Prefecture, Japan. To construct this cohort, we gathered all data for patients diagnosed with AML at 7 hospitals in Kagawa between 2006 and 2010. The primary end point was overall survival(OS) after AML diagnosis. Unadjusted Kaplan-Meier survival plots were used to determine OS in the overall cohort. Multivariate analysis was used to determine the independent adverse prognostic factors for OS, with the covariates of interest including age, gender, race/ethnicity, CCI, education, median income, metropolitan statistical area size and history of myelodysplastic syndrome.RESULTS: The average population of Kagawa during the study period was 992489, and the incidence of AML was 4.26 per 100000 person-years. A total of 197 patients with non-acute promyelocytic leukemia(non-APL)(119 males and 78 females) were also included. The median age of non-APL patients was 70 years(average 67, range 24-95). The 5-year OS rate was 21.1%. Subsequent analysis by age group showed that the survival rate declined with age; the 5-year OS rates of non-APL patients younger than 64 years, 65-74 years, and older than 75 years were 41.5%, 14.1%, and 8.9%, respectively. Multivariate analysis revealed that unfavorable risk karyotype, older age, poor performance status(PS)(3-4), lack of induction chemotherapy, and antecedent haematological disease were independent prognostic predictors. In the subgroup analysis, we also found that older patients with non-APL had lower complete remission rates and higher early death rates than younger patients, irrespective of PS. However, intensive chemotherapy was a significant predictor for longer survival not only in the patients < 75 years of age, but also in those over 75 with PS 0-2. CONCLUSION: Age would contribute considerable life expectancy to indicate induction chemotherapy with eligible dose of cytotoxic drugs for a favorable case even in advanced elderly.
文摘An 82-year-old Japanese man visited our emergency unit complaining of dyspnea. Laboratory data showed 15% atypical lymphocytes in peripheral blood which expressed the T-cell phenotype. Chest/abdominal computed tomography depicted hepatosplenomegaly and swelling of systemic lymph nodes. The patient died of advanced respiratory failure 5 d after the first occurrence of his dyspnea. At autopsy, the pathological features revealed a diffuse infiltration of large atypical lymphocytes to systemic organs including the spleen and lung. In immunohistochemical staining, these cells expressed CD30, TIA-1, anaplastic lymphoma kinase(ALK), CD5 and CD3. An advanced surface molecule analysis revealed a lack of CD54(intercellular cell adhesion molecule-1) and CD56(neural cell adhesion molecule). We observed the proliferation and infiltration of these lymphoma cells specifically at the intravascular lesions similar to intravascular lymphoma(IVL). T-cell IVL is not established as an independent clinical entity in the World Health Organization classification, and our patient's ALK-positive T-IVL in lung appears to be the first reported case.
