1/17. Endoscopic injection sclerotherapy control of intractable hematuria following radiation-induced hemorrhagic cystitis. A novel approach.OBJECTIVE: To establish the utility of endoscopic sclerotherapy using 1% ethoxysclerol for the control of intractable hematuria following post-irradiation telangiectatic cystitis (PTC). methods: Our experience of treating 4 patients (one female and three male) with massive exsanguinating hematuria resulting from PTC, using a combined intralesional and perilesional injection of 1% ethoxysclerol, is presented. observation on the distribution, grading of telangiectasis and pattern of bleeding are made. RESULTS: A dramatic and lasting cessation of the hematuria in all the 4 patients was achieved during the follow-up period varying from 1 month to 4 years. CONCLUSION: Endoscopic injection sclerotherapy is a simple, highly effective, less invasive new technique in the management of massive and intractable hematuria due to radiation-induced telangiectasia of the urinary bladder.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/17. Cidofovir treatment of human polyomavirus-associated acute haemorrhagic cystitis.We report the case of an 18-year-old patient who received an allogeneic bone marrow transplant from an HLA-identical unrelated donor for a Ph acute lymphoblastic leukemia, in his third complete remission. cyclophosphamide and busulfan were used as conditioning treatment. Acute graft-versus-host disease developed on day 9, and the response to adequate treatment (steroids) was favourable. On day 45 the patient developed an acute severe haemorhragic cystitis, and BK polyomavirus was demonstrated in urine samples using electron microscopy and polymerase chain reaction. Urinary symptoms did not improve in spite of palliative treatment, but a response was evident after 2 weeks of cidofovir treatment.- - - - - - - - - - ranking = 0.00064697359379731keywords = leukemia (Clic here for more details about this article) |
3/17. Lethal adenovirus infection in a patient who had undergone nonmyeloablative stem cell transplantation.We present a case of adenovirus (ADV) infection in a patient who had undergone nonmyeloablative stem cell transplantation (NST). A 50-year-old man with chronic myelogenous leukemia in the second chronic phase underwent NST from an HLA 2-loci-mismatched sibling. ADV hemorrhagic cystitis developed and progressed to lethal pneumonia. ADV was isolated from urine, bronchoalveolar lavage fluid, and postmortem specimens of kidney and liver. Because there are few reports of lethal pneumonia associated with ADV in japan, we present the case and discuss the cause of and therapy for the infection.- - - - - - - - - - ranking = 0.00064697359379731keywords = leukemia (Clic here for more details about this article) |
4/17. Chemotherapy for leukaemia following previous pelvic radiotherapy is associated with severe enteritis and haemorrhagic cystitis.We describe two patients who developed extensive ulceration, haemorrhage and necrosis of bladder or bowel following treatment with intensive chemotherapy for acute leukaemia. Major surgical intervention was required in both cases. Both patients had previously undergone pelvic radiotherapy for gynaecologic malignancy and had suffered symptoms of chronic radiation-induced cystitis and enteritis. Bowel and bladder histology showed evidence of chronic radiation cystitis or enteritis. We postulate that combined mucosal toxicity secondary to cytotoxic therapy and chronic radiation-induced damage to bowel or bladder mucosa resulted in critical ischaemia, ulceration and necrosis of bowel and bladder. Caution must be exercised in the treatment of patients receiving intensive chemotherapy if there is a history of chronic radiation enteritis or cystitis, and dosage reductions may be justified.- - - - - - - - - - ranking = 0.4keywords = radiation-induced (Clic here for more details about this article) |
5/17. Donor cell-derived acute myeloid leukemia developing 14 months after matched unrelated bone marrow transplantation for chronic myeloid leukemia.We report a patient with Ph-positive CML who developed a Ph-negative AML in donor cells 14 months after BMT from an HLA-identical male unrelated donor. The Ph translocation could not be detected by either conventional cytogenetics, FISH or RT-PCR analysis excluding relapse of CML in myeloid blast crisis. chimerism studies were performed by variable number of tandem repeats (VNTR) analysis. These revealed donor-type hematopoiesis in both unseparated mononuclear cells and CD34 selected blasts proving the leukemia to be of donor origin. The patient received three cycles of polychemotherapy with mitoxantrone, topotecan and ara-c resulting in CR after the first treatment cycle and reconstitution with donor hematopoiesis. A second transplant from a female alternative matched unrelated donor was performed after conditioning with fludarabine and 200 cGy TBI and was well tolerated. Nine months after the second transplant the patient is at home and in CR. T cell chimerism was studied by sex chromosome analysis and revealed complete female donor chimerism.- - - - - - - - - - ranking = 0.0058227623441758keywords = leukemia (Clic here for more details about this article) |
6/17. Acute myeloid leukemia complicated with staghorn calculus.An 11-year-old girl who presented with hyperleukocytosis accompanied by significant increases in serum uric acid and lactate dehydrogenase levels was discovered to be suffering from acute myeloid leukemia (AML). Subsequently a staghorn calculus was identified 22 months after the start of chemotherapy. The diagnosis of staghorn calculi was suggested by plain abdominal X-ray and ultrasonography. This paper describes the course of an adolescent patient with AML and focuses specifically upon her urological complications. To the best of our knowledge, this is the first reported pediatric case of AML complicated with staghorn calculi, which developed following repeated episodes of septicemia.- - - - - - - - - - ranking = 0.0032348679689866keywords = leukemia (Clic here for more details about this article) |
7/17. Intravesical ozone therapy for progressive radiation-induced hematuria.BACKGROUND: Progressive radiation-induced cystitis can become a serious clinical problem the therapeutic solution of which is limited and almost invariably aggressive. ozone therapy is a nonconventional therapy that has been reported to offer benefits in late-onset wound healing and ischemic disorders. This report describes a patient with progressive radiation-induced hematuria from standard conservative treatment that was further treated with ozone therapy. METHOD: ozone therapy was achieved by intravesical instillation of ozonized bi-distilled water over a period of 30 minutes, three sessions per week during the first weeks. Later, ozone therapy sessions were decreased and involved ozonized water or direct intravesicular instillation of ozone at 20-25 microg/mL. RESULTS: hematuria was successfully controlled by intravesical application of ozone therapy. CONCLUSIONS: The successes achieved with this technique suggest that intravesicular instillation of ozonized bi-distilled water or ozone merits further investigation with a view to its application to counter this radiation-induced side-effect.- - - - - - - - - - ranking = 1.4keywords = radiation-induced (Clic here for more details about this article) |
8/17. Epstein-Barr virus (EBV) genome carrying monoclonal B-cell lymphoma in a patient with adult T-cell leukemia-lymphoma.A Japanese patient with adult T-cell leukemia-lymphoma (ATL) showed a disease progression from the smoldering type to the chronic type and finally to the acute type. The patient was variously treated, including 2'-deoxycoformycin, with some beneficial effects. During the chronic type he developed a composite lymphoma consisting of T-cell lymphoma (ATL) of medium-sized cells and B-cell lymphoma of diffuse large cell type. At that time, he also suffered from miliary tuberculosis and adenovirus type 11-induced hemorrhagic cystitis, indicating that he was in a marked immunodeficient state. Southern-blot analysis revealed that the two malignancies have distinct clonal origin on the basis of the following results: (1) clonally rearranged T-cell receptor beta-chain gene (TcR-beta gene) and germline configuration of immunoglobulin heavy chain gene (IgH gene) in ATL leukemic cells, (2) clonal rearrangement of IgH gene in lymphoma cells, indicating a monoclonal B-cell lymphoma, (3) monoclonal integration of HTLV-I provirus in ATL leukemic cells, (4) definite presence and monoclonal origin of EBV genome in lymphoma cells. This is the first report of secondary EBV genome carrying monoclonal B-cell lymphoma in an ATL patient. It is suggested that the immunodeficient state in the patient with ATL allows the emergence of EBV-related B-cell lymphoma.- - - - - - - - - - ranking = 0.0032348679689866keywords = leukemia (Clic here for more details about this article) |
9/17. Intravenous ribavirin therapy for adenovirus cystitis after allogeneic bone marrow transplantation.Acute hemorrhagic cystitis due to adenovirus infections may be more severe or protracted in immunocompromised patients. This patient with chronic graft-versus-host disease following allogeneic marrow transplantation for acute myelogenous leukemia developed painful hematuria due to adenovirus infection that failed to respond to diuresis and narcotic analgesics. Intravenous ribavirin, administered for a total of 9 days, produced rapid resolution of symptoms while urine cultures became negative for adenovirus. No adverse drug reactions were observed. We conclude that controlled clinical trials of intravenous ribavirin therapy for serious adenovirus infections following bone marrow transplantation are warranted.- - - - - - - - - - ranking = 0.00064697359379731keywords = leukemia (Clic here for more details about this article) |
10/17. Spontaneous remission from acute exacerbation of chronic adult T-cell leukemia.Spontaneous remission without any anti-cancer therapy in a 57-year-old woman with adult T-cell leukemia (ATL) is reported. The patient was referred to our department because of persistent cough and appearance of abnormal lymphocytes in the peripheral blood, and she was diagnosed as having chronic ATL. Eight months later, she was re-admitted because of cystitis, watery diarrhea and worsening of respiratory symptoms with an increase of ATL cells (WBC 31 x 10(9)/l with 56% ATL cells). Acute exacerbation of ATL was diagnosed. Interestingly, antibiotic therapy for the pulmonary and urinary tract infections brought about spontaneous reduction of the ATL cell count. Spontaneous remission of ATL continued for one year without chemotherapy. The role of infection as a trigger of acute exacerbation and spontaneous remission of ATL is discussed.- - - - - - - - - - ranking = 0.0032348679689866keywords = leukemia (Clic here for more details about this article) |
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