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3 Sideroblastogram MMC: mitomycin C, CPA: cyclophosphamide, NCS: neocarzinostatin VCR: vincristine, IFA: ifosfamide FOBEM: 5-fluorouracil VCR bleomycin CPA MMC, BVCP: bleomycin VCR CPA. prednisolone
4 Sideroblastogram MFC: MMC 5-fluorouracil cytosine arabinoside, FQI: 5-fluorouracil carboquone IFA, AVIP: adriamycin VCR IFA prednisolone
5 Sideroblastogram IFA: ifosfamide, MMC: mitomycin C, NCS: neocarzinostatin FOBEM: 5-fluorouracil vincristine bleomycin cyclophosphamide MMC, BVCP: bleomycin vincristine cyclophosphamide prednisolone
6 Side roblastogram AVIP: adriamycin vincristine IFA prednisolone, COMP: cyclophoshamide vincristine methotrexate procarbazine
7
8 not significant
9
10 CLINICAL COURSE M. U t. 52y. Hodgkin's disease
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13 9) Kitajima, K., Kamimura, O. and Hiraki, K.: Neocarzinostatin: A new chemotherapeutic ap proach to acute leukemia. Acta Haem. Jap., 37: , ) Shen, S. C. and Homburger, F.: The anemia of cancer patients and its relation to meats tases to the bone marrow. J. Lab. Clin. Med., 37: , ) Banerjee, R. N. and Narang, R. M.: Haematological changes in malignancy. Brit. J. Haemat., 13: , ) Yamada, H.: Clinical studies on iron kinetics. U. Iron kinetics studies in patients with ma lignant neoplasms. Nagoya J. med. Sci., 30: , ) Totterman, L. E. : Intravenous iron tolerance tests in malignant neoplasmas. Their value for
14 diagnosis and for antianemic treatment with iron, Vitamin C and Penicillin. Acta Med. Sca nd., 140: , ) Sandberg, M., Gross, H. and Holly, O. M.: Changes in retention of copper and iron in liver and spleen in chronic diseases accompanied by secondary anemia. Arch. Path., 33: , ) Price, V. E. and Greenfield, R. E.: Anemia in cancer. Adv. Cancer Res., 5: , ) Hyman, G. A. and Harvey, J. E.: The pathogenesis of anemia in patients with carcinoma. Am. J. Med., 19: , ) Miller, A., Chodos, R. B., Emerson, C. P. and Ross, J. F.: Studies of the anemia and iron metabolism in cancer. J. Clin. Invest., 35: , ) Crosby, W. H. and Akeroyd, J. H.: The limit of hemoglobin synthesis in hereditary hemolytic anemia. Am. J. Med., 13: , ) Hyman, G. A.: Studies on anemia of disseminated malignant neoplastic disease. I. The hemo lytic factor. Blood, 9: , ) Sohier, W. D., Juranies, E. and Aub, J. C.: Hemolytic anemia, a host response to malignancy. Cancer Res., 17: , ) Ultmann, J. E.: The role of the spleen in hemolytic anemia of cancer patients. Cancer Res., 18: , ) Haurani, F. I., Young, K. and Tocantins, L. M.: Reutilization of iron in anemia complicating malignant neoplasms. Blood, 22: 73-81, ) Bertinchamps, A., Kenis, Y. and Tagnon, H. J.: The effect of the administration of HN 2 on the utilization of plasma iron. Cancer, 11: , ) Lane, M., Berlin, N. I. and Mengel, C. E: The effect of nitrogen mustard on the distribution of radioiron in man. Cancer, 17: , ) Alfrey, C. P., Lane, M. and Karjala, R. J.: Modification of ferrokinetics in man by cancer chemotherapeutic agents. Cancer, 19: , ) Host, H.: Effect of intermittent hypoxia on regeneration of haematopoiesis in rats treated with cyclophosphamide on total body irradiation. Scand. J. Haemat., 3: , ) Stalzer, R. C., Kiely, J. M., Pease, G. L. and Brown, A. L. Effect of 5-fluorouracil on human hematopoiesis. Cancer, 18: , ) Nesbit, M. E. and Lowman, J. T.: Hematpoiesis and serum iron changes following vincristine sulfate. Blood, 34: , ) Lane, M., Karjala, R. J., Liebelt, R. A. and Smith, F. E.: Effects of nitrogen mustard on
15 iron distridution and localization in the dog. Cancer, 18: , 1965.
16 Studies on sideroblasts Part 2. Changes of sideroblasts by cancer chemotherapy Motoharu SUGIYAMA Department of Medicine, Okayama University Medical School (Director: Prof. I. Kimura) The appearance of sideroblasts was investigated before and after cancer chemotherapies which were carried out 65 times in 53 patients with malignant neoplasms. After treatment, 34 cases showed marked sideroblastosis with a shift to the right in their sideroblastograms ( gshifted group"). The other 31 cases showed no sideroblastosis without a shift in their sidero blastograms ( gnon-shifted group"). The hematological data from these two groups were then studied. After chemotherapy, the shifted group showed significant decreases in erythrocyte counts, hemoglobin concentration, leukocyte counts and nucleated cell counts and a significant increase in erythroid/myeloid ratio, whereas the non-shifted group showed no significant changes. Furthermore, the incidences of serious anemia, leukopenia, decrease in nucleated cell counts and remarkable elevation in serum iron level were significantly higher in the shifted group than in the non-shifted group. These findings suggest that marked sideroblastosis is a useful indicator in the evaluation of impaired hematopoiesis due to cancer chemotherapy.
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