Summary:We report an unusual case of AML, in which the patient showed extramedullary relapse in the pleural fluid and the skin without bone marrow recurrence even 3 years after allogeneic BMT. On examination of the pleural effusion and the skin, which relapsed 31 months and 40 months, respectively, after BMT, we found that most of cells were as the XY-type recipient by quantitative X/Y FISH (fluorescence in situ hybridization). However, 100% of the bone marrow cells remained XX-type donor cells. In the present case, we believe that the graft-versus-leukemia (GVL) response in the extramedullary site was not so effective as that in the bone marrow, where it remains effective. Bone Marrow Transplantation (2002) 30, 57-59. doi: 10.1038/sj.bmt.1703572 Keywords: extramedullary relapse; allogeneic BMT; quantitative X/Y FISH Extramedullary relapse is a recurrence of leukemia in sites other than the bone marrow. It is known to recur 'isolated' without recurrence in the bone marrow. Since the introduction of bone marrow transplantation (BMT) for the treatment of leukemia, extramedullary relapse is often reported after allogeneic BMT in patients with acute myeloid leukemia (AML). The frequent sites of recurrence are the central nervous system (CNS) and the skin (in the form of leukemia cutis), although it rarely occurs in other sites. However, isolated extramedullary relapse is especially rare without recurrence in bone marrow. 1 We report an unusual case of extramedullary relapse in the pleura and the skin, with no evidence of bone marrow recurrence at death, some 40 months after allogeneic BMT. Case reportThe patient was a 41-year-old man having no special past medical history. At the time of hospitalization, the patient appeared chronically ill with a blood pressure of 110/80 mmHg, a pulse rate of 120/min, a respiration rate of 22/min and a body temperature of 37.5°C. He had slightly pale conjunctivae and palpable liver and spleen (each 4 cm). A blood cell count revealed a hemoglobin level of 10.8 g/dl, the white blood cell count was 58.2 ϫ 10 9 /l and the number of platelets was 30 ϫ 10 9 /l. Large myeloblasts with relatively large N/C (nuclear/cytoplasmic) ratio were present at up to 61% in the differential count of peripheral blood cells. Bone marrow sections showed a cellularity of nearly 100% and a diffuse infiltration of myeloblasts. The blasts accounted for up to 46% of the bone marrow nucleated cells and were positive for CD33, CD13, HLA-DR, CD7 and CD34 by flow cytometry (FACScan; Becton Dickinson, San Jose, CA, USA). BCR/ABL and PML/RARA rearrangement by RT-PCR were negative. Conventional cytogenetics revealed a normal karyotype of 46,XY [20]. A diagnosis of FAB classification, M2 was made (Table 1).After induction chemotherapy, the patient showed complete remission and underwent bone marrow transplantation from his HLA-identical sister. The conditioning regimen used was busulfan and cyclophosphamide. The patient was treated with prednisolone and cyclosporin due to chronic graft-versus-host disease (GVHD) acc...

No abstract

Random telegraph noise (RTN) having two discrete current levels was characterised in reverse current of GaN based light-emitting diodes. Through compared magnitude of the hysteresis with RTN amplitude in reverse current, it is confirmed that RTN causes the currentvoltage (I-V ) hysteresis. The mechanism of RTN was analysed by using a tunnelling equation. In addition, activation energy of the trap leading to RTN was characterised by analysis of the time constants with voltage and temperature.

e20630 Background: Although various prognostic factors have been proposed to predict survival in terminally ill cancer patients, accurate prognostication is still a challenging task for oncologists. The objective of this study was to evaluate whether the time interval between diagnosis of advanced cancer and cessation of active anti-cancer treatment (ATP; active treatment period) can predict survival in terminally ill cancer patients. Methods: We prospectively evaluated 79 patients with advanced (recurrent or metastatic) cancer who were determined as terminal stage, namely cessation of active anti-cancer treatment and transition to palliative care, by attending oncologists. ATP and other known prognostic factors including clinical symptoms and signs, performance status, laboratory tests, and clinical prediction of survival (CPS) were analyzed. Results: Of the 79 patients, 46 were male (58%) and 33 were female (42%) with a median age of 60 years (range, 21–82). Median overall survival after being diagnosed with advanced cancer was 11.6 months (95% confidence interval (CI), 8.02–15.18), and survival after being determined as terminal stage was 1.9 months (95% CI, 1.38–2.42). According to 3 ATP categories (< 3months, 3–12 months, and >12 months), terminal stage survival were 1.0 month, 1.8 months, and 3.6 months, respectively (p=0.002). On multivariate analysis, short ATP, non-colorectal cancer, fatigue, and Karnofsky performance status less than 50 were significantly associated with a poor prognosis. Conclusions: Our study suggests that ATP is an independent prognostic factor for survival in terminally ill cancer patients who cannot receive active anti-cancer treatment anymore. Future prognostic models should include ATP as a prognostic variable. No significant financial relationships to disclose.

No abstract