A 58-year-old male visited the Kochi Municipal Central Hospital on May 17, 1984. A barium meal study and endoscopy revealed a huge crater surrounded by a thick embankment on the posterior wall of the stomach body. Biopsy specimens taken from the lesion revealed tubular adenocarcinoma, UFT (600 mg/day) and anti-tuberculous drugs were administered due to the complication of pulmonary tuberculosis. Endoscopic examination on August 6, 1984, revealed a remarkable improvement, showing a shallow irregular depression with converging folds. The patient underwent surgery on August 7, 1984, because from the endoscopic appearance, residual cancer was highly suspect, and also tuberculosis had improved. The histology of the surgically resected specimen showed a chronic peptic ulcer, the base of which was covered with regenerating mucosa. No cancer nests were demonstrated even by serial tissue sections.
Intensive induction chemotherapy was applied to 25 patients with acute myelogenous leukemia by continuing drugs (daunorubicin, behenoyl-cytosine arabinoside, 6-mercaptopurine and prednisolone) until the achievement of severe bone marrow aplasia (leukemic cells less than 1,000/microliters). Complete remission (CR) was achieved in 18 (72%). Numbers of partial remission and an early death were 5 (20%) and 2 (8%), respectively. Although median nadirs of white blood cells (WBC) and platelet counts (Pl) (205/microliters and 8,200/microliters, respectively) were remarkably low, recovery of WBC (over 1,000/microliters) and Pl (over 50,000/microliters) were achieved in 23.8 and 24.5 days, after an initiation of the chemotherapy. Sepsis was a most frequently observed complication during induction stage and a duration of fever was 2-48 days (median 15). Median duration of CR was 22.9 months. Unexpectedly, 11 of 17 CR (except one with bone marrow transplanted) relapsed after 4.2-41.4 months (median; 9.4), but 6 (35.3%) still remain in first CR for 30.5-72.9 months (median; 51.4). A long-term survival might be obtained by intensifying induction chemotherapy in about one fourth of patients, but the intensification or application of non-cross resistant anti-leukemic agents in post-remission therapy may be required to avoid relapses even if induction is intensified.
A 22-year-old female with a thymic carcinoma is reported. The tumor was refractory to both chemotherapy and irradiation. The patient died with an aggressive clinical course. Cytogenetic study showed that the tumor cells had a chromosome translocation, t(15;19)(q15;p13), which was not identified previously in human cancer.
