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Lee, Ji Hyun,Kwon, Kyung A,Lee, Suee,Oh, Sung Yong,Kim, Sung-Hyun,Kwon, Hyuk-Chan,Han, Jin-Yeong,Song, Moo-Kon,Chung, Joo-Seop,Lee, Ho Sup,Kim, Yang Soo,Lee, Sang-Min,Joo, Young-Don,Kim, Hyo-Jin Korean Society of Hematology; Korean Society of Bl 2010 Blood Research Vol.45 No.4
<P><B>Background</B></P><P>Cytogenetic abnormalities (CAs) have been reported frequently in patients with otherwise typical aplastic anemia (AA), but their implications in the prognosis and in the evolution to hematologic malignancies are controversial.</P><P><B>Methods</B></P><P>We retrospectively analyzed 127 adult AA patients who had successful cytogenetic analysis at initial diagnosis.</P><P><B>Results</B></P><P>The patients were classified into 3 groups according to the initial and follow-up results of cytogenetic profiles. Group 1 included patients who had persistent AA with normal cytogenetic profiles (N=117); Group 2, those who had a normal cytogenetic profile at initial diagnosis but later acquired CA (N=4, 3.1%); and Group 3, those who had CA at the initial diagnosis, regardless of follow-up cytogenetic status (N=6,4.7%). In Group 2, 2 patients later developed CA without progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS); the other 2 patients later progressed to AML. None of the patients in Group 3 progressed to AML or MDS. There was no significant difference in overall survival between Groups 1 and 3.</P><P><B>Conclusion</B></P><P>AA patients with CA at initial diagnosis or follow-up may not be at greater risk for evolution to AML or MDS, or show shorter survival periods. Prospective studies and a larger patient samples are needed to establish the clinical relevance of CA.</P>
( Ho Jin Lee ),( Dong Hyun Kim ),( Seul Lee ),( Myeong Seok Koh ),( So Yeon Kim ),( Ji Hyun Lee ),( Suee Lee ),( Sung Yong Oh ),( Jin Yeong Han ),( Hyo Jin Kim ),( Sung Hyun Kim ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6
Background/Aims: This study investigated whether patients with acute promyelocytic leukemia (APL) truly fulfill the diagnostic criteria of overt disseminated intravascular coagulation (DIC), as proposed by the International Society on Thrombosis and Haemostasis (ISTH) and the Korean Society on Thrombosis and Hemostasis (KSTH), and analyzed which component of the criteria most contributes to bleeding diathesis. Methods: A single-center retrospective analysis was conducted on newly diagnosed APL patients between January 1995 and May 2012. Results: A total of 46 newly diagnosed APL patients were analyzed. Of these, 27 patients (58.7%) showed initial bleeding. The median number of points per patient fulfilling the diagnostic criteria of overt DIC by the ISTH and the KSTH was 5 (range, 1 to 7) and 3 (range, 1 to 4), respectively. At diagnosis of APL, 22 patients (47.8%) fulfilled the overt DIC diagnostic criteria by either the ISTH or KSTH. In multivariate analysis of the ISTH or KSTH diagnostic criteria for overt DIC, the initial fibrinogen level was the only statistically significant factor associated with initial bleeding (p = 0.035), but it was not associated with overall survival (OS). Conclusions: Initial fibrinogen level is associated with initial presentation of bleeding of APL patients, but does not affect OS.
Third-line docetaxel chemotherapy for recurrent and metastatic gastric cancer
( Ji Hyun Lee ),( Sung Hyun Kim ),( Sung Yong Oh ),( Suee Lee ),( Ho Jin Lee ),( Hye Jung Lee ),( Hyo Jin Kim ) 대한내과학회 2013 The Korean Journal of Internal Medicine Vol.28 No.3
Background/Aims: To determine the effi cacy and toxicity of docetaxel as a thirdline therapy for patients with relapsed gastric cancer who have undergone modi- fied oxaliplatin-fluorouracil (m-FOLFOX)-4 and modified irinotecan-fluorouracil (m-FOLFIRI) regimens. Methods: We analyzed 33 patients who had been histologically diagnosed with adenocarcinoma of the stomach and who had progressed after m-FOLFOX-4 and m-FOLFIRI regimens. Patients were treated with cycles of 75 mg/m2 docetaxel on day 1 every 3 weeks. Results: The median age of the patients was 56.0 years (range, 31.0 to 74.0), and 73% of the patients (24/33) had an Eastern Cooperative Oncology Group performance status of 0 or 1. All patients were evaluated in terms of tumor response: five (15%), nine (27%), and 19 (58%) patients experienced a partial response, stable disease, and progressive disease, respectively. The median time to progression was 2.1 months (95% confidence interval [CI], 1.63 to 2.58), and overall survival was 4.7 months (95% CI, 3.20 to 6.20), from the start of the docetaxel regimen. Assessing patients` toxicity profiles, the median number of cycles was 2.0 (range, 1.0 to 12.0). The major hematologic toxicities included grade 3 to 4 neutropenia (19/33, 58%), grade 3 to 4 thrombocytopenia (2/33, 6%), and grade 3 to 4 anemia (5/33, 15%). Neutropenic fever developed in three patients (3/33, 9%). The nonhematological toxicities were nausea and vomiting (10/33, 30%), abdominal pain (4/33, 12%), skin rash (1/33, 3%), and fluid retention (3/33, 9%). Conclusions: Docetaxel is a feasible third-line therapy regimen for patients with advanced gastric cancer after m-FOLFIRI and m-FOLFOX-4 regimens.
Clinical significance of coagulation factors in operable colorectal cancer
Lee, Suee,Huh, Seok Jae,Oh, Sung Yong,Koh, Myeong Seok,Kim, Sung-Hyun,Lee, Ji Hyun,Han, Jin Young,Choi, Hong Jo,Kim, Su Jin,Kim, Hyo-Jin D.A. Spandidos 2017 Oncology letters Vol.13 No.6
<P>Abnormal hemostasis in cancer patients has prev iously been studied. The primary objective of the present study was to evaluate the association between preoperative hemostasis markers and clinicopathological parameters, and to identify a hemostasis marker affecting survival in patients following curative resection for colorectal cancer. A total of 170 patients who underwent curative surgery for colorectal carcinoma were evaluated. Preoperative coagulation tests included platelet, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer and fibrinogen degradation product (FDP). The clinicopathological variables, including age, gender, tumor location (rectum/colon), tumor size (≥5 cm vs. <5 cm), depth of tumor invasion, lymph node metastasis, stage, lymphovascular invasion, margin involvement and histological differentiation were analyzed. The median age of analyzed patients was 63 years (range, 28–84). The male to female ratio was 62:38. Increased levels of plasma fibrinogen, PT and platelet count (PLT) were associated with larger tumor size (P<0.001, P=0.015 and P=0.002, respectively). Increased plasma fibrinogen levels were significantly associated with depth of tumor invasion and stage (P=0.014 and P=0.048, respectively). Increased plasma D-dimer and FDP levels were significantly associated with tumor node metastasis stage (P=0.031 and P=0.002, respectively). Prolonged PT level (≥11.7 sec), hyper-fibrinogenemia (≥327 mg/dl), high D-dimer level (≥1.3 µg/ml) and increased FDP level (≥2.7 µg/ml) were the prognostic factors associated with shorter survival. Preoperative plasma fibrinogen level was significantly associated with tumor size and depth of tumor invasion. Preoperative plasma prolonged PT level, hyperfibrinogenemia, high D-dimer level and increased FDP level may function as hemostasis markers that predict overall survival in operable patients with colorectal cancer.</P>
Lee, Ji Hyun,Choi, Jimin,Kwon, Kyung A,Lee, Suee,Oh, Sung Yong,Kwon, Hyuk-Chan,Kim, Hyo-Jin,Han, Jin Yeong,Kim, Sung-Hyun Korean Society of Hematology; Korean Society of Bl 2010 Blood Research Vol.45 No.2
<P><B>Background</B></P><P>A combination of busulfan (Bu) and cyclophosphamide (Cy) has been used as a standard myeloablative regimen for allogeneic hematopoietic stem cell transplantation (HSCT). Recent studies postulate that fludarabine (Flu) is a less toxic substitute for Cy.</P><P><B>Methods</B></P><P>Forty-two patients who were diagnosed with acute leukemia or myelodysplastic syndrome and received BuFlu (n=17) or BuCy (n=25) from August, 1999 to July, 2009 at Dong-A University Medical Center were retrospectively analyzed.</P><P><B>Results</B></P><P>The median follow-up duration was 39.75 months. The BuFlu group showed a lower incidence of mucositis (<I>P</I>=0.005), but there was no significant intergroup difference in the time of engraftment, nausea/vomiting, acute/chronic graft-versus-host disease, hepatic veno-occlusive disease, or hemorrhagic cystitis. Moreover, the 2 groups showed no significant difference in the cumulative risk of relapse, event-free survival, or overall survival.</P><P><B>Conclusion</B></P><P>BuFlu administration can be employed as a preparative regimen for allogeneic HSCT and shows efficacy and transplant-adverse effects comparable to those of BuCy. However, randomized prospective studies in more patients are warranted.</P>
( Seul Lee ),( Dong Hyun Kim ),( Sung Yong Oh ),( So Yeon Kim ),( Myeong Seok Koh ),( Ji Hyun Lee ),( Suee Lee ),( Sung-hyun Kim ),( Jong-young Kwak ),( Min Gyoung Pak ),( Mi Ha Ju ),( Hyo-jin Kim ),( 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.2
Background/Aims: CD11c is a dendritic cell marker in humans, which potentially induces a cytotoxic effect on lymphoma cells. Forkhead boxP<sub>3</sub> (FOXP<sub>3</sub>) is a regulator of T lymphocyte in the microenvironment of the lymphoma. The principal objective of this study was to determine whether the tumors` microenvironment expressions of CD11c and FOXP<sub>3</sub> are predictive of clinical outcomes in diffuse large B-cell lymphoma (DLBCL) patients receiving treatment with rituximab, cyclophosphamide, anthracycline, vincristine, and prednisone (R-CHOP) combination chemotherapy. Methods: The study population consisted of 100 patients with DLBCL. The CD11c and FOXP<sub>3</sub> expression in primary tumors` microenvironment were evaluated using an immunohistochemistry (IHC). Results: CD11c and FOXP<sub>3</sub> expression positivity in microenvironment were 25% and 35%, respectively. Each one counted for 1 point. In CD11c and FOXP<sub>3</sub> stain, positive was counted as 0 and negative was 1. The points were separated into low risk (0 to 1) and high risk (2) groups. Only the extranodal DLBCL patient group analysis conveyed significant differences of progression-free survival (p = 0.019) and overall survival (p = 0.039) between the two groups. Conclusions: We can achieve possible clinical significance of lymphoma tumor microenvironments through CD11c and FOXP<sub>3</sub> IHC stains in extranodal DLBCL patients receiving R-CHOP therapy.