| Item type |
[ELS]学術雑誌論文 / Journal Article(1) |
| 公開日 |
2017-01-23 |
| タイトル |
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タイトル |
骨髄移植の実際と問題点 : 自験例を中心に |
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言語 |
ja |
| タイトル |
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タイトル |
Experience of Bone Marrow Transplantation in Two Cases with Hematological Malignancies : Present Status and Its Limitation |
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言語 |
en |
| 言語 |
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言語 |
jpn |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
| 著者 |
大槻, 剛巳
八幡, 義人
幸道, 秀樹
浅野, 茂隆
三輪, 史朗
Otsuki, Takemi
Yawata, Yoshihito
Kodo, Hideki
Asano, Shigetaka
Miwa, Shiro
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| 著者所属(日) |
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ja |
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川崎医科大学血液内科 |
| 著者所属(日) |
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ja |
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川崎医科大学血液内科 |
| 著者所属(日) |
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ja |
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東京大学医科学研究所内科 |
| 著者所属(日) |
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ja |
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東京大学医科学研究所内科 |
| 著者所属(日) |
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ja |
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東京大学医科学研究所内科 |
| 著者所属(英) |
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en |
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Division of Hematology, Department of Medicine, Kawasaki Medical School |
| 著者所属(英) |
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en |
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Division of Hematology, Department of Medicine, Kawasaki Medical School |
| 著者所属(英) |
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en |
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Department of Medicine, Institute of Medical Science, University of Tokyo |
| 著者所属(英) |
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en |
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Department of Medicine, Institute of Medical Science, University of Tokyo |
| 著者所属(英) |
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en |
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Department of Medicine, Institute of Medical Science, University of Tokyo |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
Bone marrow transplantation |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
Acute monocytic leukemia |
| キーワード |
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言語 |
en |
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主題Scheme |
Other |
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主題 |
Chronic myelogenous leukemia |
| 記事種別(日) |
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内容記述タイプ |
Other |
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内容記述 |
原著 |
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言語 |
ja |
| 抄録(日) |
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ja |
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同種骨髄移植は,造血器悪性腫瘍,再生不良性貧血などの疾患に対する根治療法として,最近10余年にわたり著しくその成績を向上させてきた.しかし,いま解決されねばならない問題点も多く,ここに白血病の2症例を提示し,その実際と問題点について述べる.症例1は急性単球性白血病の12歳の女性.分割放射線全身照射とhigh-dose Ara-Cにて前処置を行い,HLAの一致した姉より骨髄移植を施行した.移植後の回復は順調であり,合併症もほぼ認められなかった.症例2は慢性骨髄性白血病急性転化の25歳の女性.high-dose busulfanとcyclophosphamideにて前処置を行い,HLAの一致した弟より,移植を施行した,移植後,血液学的回復は良好であった.GVHDは軽度でIPは認められなかったが,day 30以降に重度の肝内胆汁うっ滞型肝細胞障害を呈した.その後全身状態は改善していったが,day 90の骨髄染色体検査にて再発を認めた.前処置の選択,GVHD,IP,種々の感染症の予防等の問題点は,基礎的,臨床的な研究の成果により,かなり改善が認められてきている.しかし,急性白血病再発例や,慢性骨髄性白血病急性転化例に対する対策や再発予防といった点が,今後の課題となる. |
| 抄録(英) |
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en |
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Allogeneic bone marrow transplantation (BMT) for hematological malignancies has remarkably improved during the last decade. In spite of recent progress, however, many problems remain unsolved in the clinical treatise and in basic research. In this paper, BMT are described practically in two patients with hematological malignancies, and their problems at the present time are also discussed. The first patient (12-year-old female) with acute monocytic leukemia was pretreated by fractionated total body irradiation and high-dose cytosine arabinoside in her first remission. BMT was performed utilizing the marrow cells from a HLA-identical sibling. After severe marrow suppression, granulocytes and platelets reached 500/μl at day 32 and 20,000/μl at day 20, respectively. On day 90, no serious complications had been observed. The second patient (25-year-old female) with a second blastic crisis in Ph1-positive chronic myelogenous leukemia was pretreated with high-dose busulfan and cyclophosphamide and received BMT from her HLA-identical brother. After severe marrow suppression, granulocytes and platelets recovered at day 23 and at day 70, respectively. Graft-versus-host disease (GVHD) was minimal (grade I) and no interstitial pneumonitis (IP) was observed in this patient. Severe intrahepatic cholestasis, however, appeared after day 30. Although her general condition improved slowly around in day 90, metaphasic Ph1-positive blasts were found in the patient's bone marrow, indicating a relapse of leukemia. The following problems are left to be solved in the BMT for acute or chronic leukemia. First is the selection of the best conditioning regimen for pretreatment of BMT, for which no appropriate standard has been available. Second, complications should be prevented, such as bacterial and fungal infections, GVHD, IP, and so on. For these purposes, new prophylaxes for viral infection and for GVHD will be required. Third, the contributions of basic and clinical research should be introduced into BMT extensively. More this to just after research such as work on suppression of the residual leukemic clone, on prolongation of the disease-free survival state, and on the appropriate therapeutical regimen for relapsed cases with acute leukemia or with blastic crisis of chronic myelogenous leukemia. |
| 書誌情報 |
ja : 川崎医学会誌
en : Kawasaki medical journal
巻 13,
号 2,
p. 117-127,
発行日 1987
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| URL |
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識別子 |
http://igakkai.kms-igakkai.com/wp/wp-content/uploads/1987/KMJ13(2)117-127.1987.pdf |
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識別子タイプ |
URI |
| DOI |
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識別子タイプ |
DOI |
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関連識別子 |
https://doi.org/10.11482/KMJ-J13(2)117 |
| ISSN |
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収録物識別子タイプ |
PISSN |
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収録物識別子 |
0386-5924 |
| ISSN |
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収録物識別子タイプ |
EISSN |
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収録物識別子 |
2758-089X |
| 雑誌書誌ID |
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収録物識別子タイプ |
NCID |
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収録物識別子 |
AN00045593 |
| 雑誌書誌ID |
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収録物識別子タイプ |
NCID |
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収録物識別子 |
AN12940574 |
| 著者版フラグ |
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出版タイプ |
VoR |
KJ00009816459.pdf (1.3 MB)
