[Rinshō ketsueki] The Japanese journal of clinical hematology
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Case Reports
[Efficacy and pharmacokinetics of imatinib mesylate in a child with chronic myeloid leukemia].
A 6-year-old girl with chronic myeloid leukemia (CML) was treated with imatinib 230 mg/m2/day and its pharmacokinetics were investigated. The patient had a complete hematologic response on day 21, but had a minor cytogenetic response and the CML progressed to a blast crisis on day 133. ⋯ The pharmacokinetics revealed that the maximum concentration (1.4 micrograms/ml); time to maximum concentration (5.1 h); half-life (11.0 h); trough concentration (0.4 microgram/ml); and, area under the concentration-time curve (28.1 micrograms.h/ml) were inferior to those for adult patients in the 400 mg/day group. This observation suggests that a suboptimal plasma concentration might be related to resistance to imatinib and/or blast crisis.
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Case Reports
[Successful treatment with imatinib mesylate for Philadelphia chromosome-positive refractory acute myeloid leukemia].
A 51-year-old man was diagnosed as having Philadelpha (Ph) chromosome-positive acute myeloid leukemia (AML) with major-BCR/ABL mRNA. He achieved complete remission after induction chemotherapy. Five months later, he was again positive for the Ph chromosome despite additional chemotherapy. ⋯ However, the treatment was interrupted because of thrombocytopenia, skin eruption and face edema. After the patient recovered from these side effects, imatinib was readministered at a dose of 400 mg/day and a complete cytogenetic response was achieved. Imatinib is expected to be an effective drug for Ph chromosome-positive AML.
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A 60-year-old female visited our hospital in May 2001 because of systemic lymphadenopathy. Her white blood cell count was 25,510/microliters with 93% of lymphocytes. Bone marrow aspiration revealed that 86% of nucleated cells were lymphocytes. ⋯ We could not exactly determine how frequently CD 20 expression becomes negative in B-cell lymphomas after treatment with rituximab. We found only two reported cases that suggested rituximab down-regulated CD 20 expression in MCL. We herein describe a case of MCL with very notable clinical features.