溶連菌製剤OK-432が有効と思われた慢性骨髄性白血病の急性転化の1例

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書誌事項

タイトル別名
  • A Case of Blastic Crisis of Chronic Myelogenous Leukemia with Good Response to the Streptococcal Agent OK-432
  • ヨウレンキン セイザイ OK 432 ガ ユウコウ ト オモワレタ マンセイ

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Refractoriness to any form of treatment is a well-known characteristic of blastic crisis of chronic myelogenous leukemia (CML). We presented a case of blastic crisis of CML, which responded well to a combination therapy of betamethasone and the streptoccocal agent OK-432.<br>A 65-year-old male was admitted to our hospital on May, 1973, with a chief complaint of left upper abdominal distension. A diagnosis of CML was made from splenomegaly, positive Philadelphia chromosome (Ph1) and the hematological findings of peripheral blood and bone marrow. He was treated with busulfan (2 mg/day) and complete remission was obtained on January, 1974. On February, 1975, he was diagnosed of blastic crisis of CML by hemorrhagic tendency, anemia, thrombocytopenia, rapid enlargement of the spleen and 29.6% of atypical myeloblasts in bone marrow. He was treated with betamethasone and OK-432, which was administrated with a dose of 0.5 units/day intramuscularly and 0.2 to 0.5 units/twice a week intravenously. On March, 1975, complete remission was obtained. Relapse occured on August, 1975 and reinduction of complete remission was achieved by the same therapy of betamethasone and OK-432 on October, 1975. Despite of the maintenance treatment of betamethasone and OK-432 (intramuscularly), the second relapse occured on March, 1976. Since it seemed that resistance to a combination therapy of betamethasone and OK-432 had developed, he was treated with a combination of DCMP therapy and OK-432 (intramuscularly) and partial remission was obtained. But he was died of bronchopneumonia on May, 21th, 1976. Autopsy findings showed the remission state of CML and suggested that the cause of death would be pneumonia.<br>In this case, the principal effect of OK-432 appeared to be on cytolytic action of leukemia cells and/or on reticuloendothelial function. But cell-mediated action could not be denied.

収録刊行物

  • 臨床血液

    臨床血液 18 (11), 1336-1342, 1977

    一般社団法人 日本血液学会

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