Given these findings, we recommend that HCVab is measured upon diagnosis of chronic ITP, and that splenectomy is planned in patients with HCVab in the event that prednisolone treatment is ineffective.

We report a case of haemophagocytic syndrome (HPS) occurring after allogeneic bone marrow transplantation (BMT) for acute promyelocytic leukaemia (APL) in a patient in fourth complete remission (CR). Anti-cytomegalovirus (CMV) antibody (Ab) was negative in this patient before BMT. BMT was performed from an HLA-identical unrelated donor who was positive for CMV Ab. After bone marrow engraftment and haematological recovery, severe acute graft-versus-host disease (GVHD) developed. This patient was treated with methylprednisolone in addition to cyclosporin A (CsA). Acute GVHD showed partial improvement, but CMV antigenaemia was observed. Despite administration of gancyclovir and immunoglobulin, CMV antigenaemia showed no improvement and HPS developed. As no other infections or malignancies were observed, we suspect that CMV infection was the trigger for development of HPS.

We report a case of gammadelta T-cell-type large granular lymphocyte (LGL) leukemia (CD3 +,CD8 +, CD57 +,TCR gammadelta+), which was accompanied by pure red cell aplasia, neutropenia and thrombocytosis. Southern blotting analysis of the T-cell receptor beta gene showed the germline configuration, but clonal TCR J gamma rearrangements were identified. These granular lymphocytes demonstrated non-major histocompatibility complex-restricted cytotoxicitity. The serum-soluble FasL (sFasL) concentration of this patient was very high, whereas the serum levels of tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma), interleukin-1 beta (IL-1beta), interleukin-2 (IL-2) and thrombopoietin were normal. After treatment with cyclosporin A, anemia and thrombocytosis were improved, and LGL and the elevated sFasL concentration decreased. These observations suggested that FasL may have played a role in the establishment of the clinical symptoms of this patient and could be useful as an indicator of disease activity.

We investigated the effect of ubenimex, which has been demonstrated to have immunomodulating activities, on the proliferation of human leukaemic cell lines (HL 60 and K 562, myelogenic lines, Jurkat, a T-cell line and RPMI 8226, a multiple myeloma cell line) and on human bone marrow mononuclear cells from haematopoietic malignancy patients with acute myeloblastic leukaemia, chronic lymphocytic leukaemia or multiple myeloma. The growth of the myeloid cell lines and of a multiple myeloma cell line, but not the T-cell line, was significantly inhibited by cocultivation with ubenimex in a dose-dependent manner. The results of the experiment with haematopoietic malignancy cells showed inhibitory effects on tumour cells from patients with acute myeloblastic leukaemia and multiple myeloma, but not on those from patients with chronic lymphocytic leukaemia. These findings suggest the usefulness of ubenimex for the treatment of multiple myeloma.

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