without detectable blast infiltration. At diagnosis of MDS, interface cytogenetic and RT-PCR analyses, respectively, showed trisomy 8 and absence of AF9-MLL rearrangement in Introduction the bone marrow (BM). On readmission with florid leukemia, his peripheral white blood cell count was 13 200/mm 3 , with A subtle, reciprocal translocation exchanging the terminal 56% leukemic blasts. His hemoglobin concentration was short and long arm segments of chromosomes 9 and 11, 15.0 g/dl, and his platelet count was 22 000/mm 3 . The bone respectively t(9;11)(p21-22;q23), is associated with acute marrow aspiration showed 92% leukemic blasts, and the mormyeloid leukemia (AML)-M5, 1 particularly the M5a subtype. 2 phological diagnosis was made as AML-M5a. Cytogenetic Ascertainment may be difficult in suboptimal preparations analysis was interpreted as: 47, XY, +8, t(9;11)(p22;q23). and, despite being regarded as the 'standard' cytogenetic Immunophenotyping analysis of fresh leukemia blasts change in acute monoblastic leukemia, its overall incidence revealed no significant expression of CD antigens associated and pattern of associations remain uncertain. 2 A recent study with the myelo-monocytic lineage. CD34 was 30% positive comparing AML-M1 and -M5 patients, analyzed simuland non-lineage-associated HLA-DR was found to be positive taneously by reverse transcriptase-polymerase chain reaction at 70%; whereas those indicative of lymphoid lineage includ-(RT-PCR), Southern blotting and fluorescence in situ hybridizing CD3, CD4, CD8, CD10, CD19 were absent or weakly ation (FISH) with an MLL-specific yeast artificial chromosome expressed. Myeloperoxidase activity was weakly detected on (YAC) probe, suggests the overall incidence of MLL rearrangethe fresh leukemic blasts. Despite receiving chemotherapy, he ment in AML-M5 may be as high as 60%. 3 It was apparent in succumbed to rapidly progressive leukemia on 15 August that study that approximately half the cases with MLL 1995. rearrangement went undetected by cytogenetic methods, including a cryptic t(6;11)(q27;q23) resulting from a cytogenetically invisible insertion juxtaposing AF6 and MLL.Materials and methods A case of AML-M5a with de novo MLL-AF9 fusion evolving from MDS with trisomy 8 present at all phases has recently Cell culture been described. 4 We describe a pair of cell lines, MOLM-13 During relapse, after chemotherapy, a heparinized peripheral blood specimen, obtained with informed consent, was proCorrespondence: Y Matsuo,

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ICAM-1 plays an important role in cell-cell and cell-extracellular matrix interactions, especially tumor invasion and cytotoxicity of lymphocytes. In the present study, the relationship between metastasis of gastric cancer and ICAM-1 expression by cancer cells or the serum level of s-ICAM-1 was (s-ICAM-1) was examined. ICAM-1 was detected by immunohistochemic staining in 49.0% of 108 patients with gastric cancer. The ICAM-1 expression rate was higher at a more advanced stage, based on lymph node metastasis, being 46.9% in node-negative and 56.1% in node-positive cases. In patients with liver metastasis, the rate was 90.9%, while it was 43.3% in patients without liver metastasis (p < 0.05). The serum s-ICAM-1 level was 262.1 ng/ml (median 205.5, range 176.0-271.0) in healthy subjects and 391.5 ng/ml (median 317.5, range 148.7-1,768.0) in gastric cancer patients (p < 0.001). The serum s-ICAM-1 level was significantly higher in patients with liver metastasis than in patients without liver metastasis (p < 0.0001). In addition, positive ICAM-1 expression cases had significantly higher s-ICAM-1 levels than negative ones, 408.9 ؎ 188.4 and 308. Cell adhesion molecules have been examined as substances involved in cell-cell adhesion, adhesion between cells and the extracellular matrix and cellular interactions such as the immune response; and their structure and function have been gradually clarified. ICAM-1 1,2 and ICAM-2 3 are cell adhesion molecules identified as ligands of LFA-1, 4 which is expressed by lymphocytes; they are expressed by various cells such as vascular endothelial cells, fibroblasts and epithelial cells. 5 ICAM-1 is a glycoprotein with an extracellular region that has an immunoglobulinlike structure and it belongs to the immunoglobulin superfamily. 6,7 Its expression is enhanced by cytokines such as IL-1 and IFN-␥. 5 ICAM-1 has at least 2 integrin receptors 7 as ligands, LFA-1 (CD11a/CD18) and MAC-1 (CD11b/CD18). 8,9 Migration of granulocytes from blood vessels is mediated by adhesion between ICAM-1 and LFA-1 8,10 and ICAM-1 is also involved in adhesion to target cells before destruction by killer cells (NK cells, LAK cells and CTLs); 11,12 thus, it is important for the local immune response. The activity of LAK and NK cells is suppressed by administration of anti-ICAM-1 antibody. 13-15 s-ICAM-1 has been reported in serum 16 -18 and quantified by ELISA. Like the membrane-bound form of ICAM-1, s-ICAM-1 also has 5 domains, suppresses the adhesion of T cells by binding to LFA-1 16 and inhibits NK and LAK cell activity. 14,18 There are several distinct steps in the process of tumor cell metastasis, including detachment of cancer cells from the primary lesion, penetration through the tissue basement membrane, invasion of blood vessels and migration to the target organ. 19 Cancer cells with a high metastatic potential have properties that facilitate each step of metastasis. Concerning the detachment of cancer cells, an increase in metastatic potential has been reported 20,21 along with reduction of cadheri...

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IL-18 is a new type of inflammatory cytokine similar to but distinct from IL-12 and IL-1β. One intriguing property of IL-18 is synergism with IL-12 in many respects. In this study we examined the in vivo synergistic effects of IL-18/IL-12 in mice and found lethal toxicity accompanying an elevated IFN-γ level in the serum. Since treatment with IL-18 alone did not have any apparent toxicity, and treatment with IL-12 alone showed only limited toxicity in our system, the synergy between the two cytokines was all the more remarkable. The major symptoms of the toxicity were weight loss, diarrhea, hemorrhagic colitis, splenomegaly, fatty liver, and atrophic thymus, most of which are similarly found in endotoxin-induced septic shock. However, in contrast to septic shock, TNF-α was not induced. The involvement of IFN-γ in the toxicity was further studied in detail. Treatment of athymic nude mice with anti-asialo-GM1 did not reduce the toxicity, whereas anti-IFN-γ treatment of wild-type mice alleviated it. When IFN-γ-deficient mice were treated with IL-18/IL-12, the majority of them showed mortality and toxicity with severe pulmonary edema. These results indicate that IL-18/IL-12 treatment induces severe adverse effects through not only IFN-γ-dependent mechanisms but also IFN-γ-independent processes.