Hematology
Introduction
The Hematology Division is a part of the Division of Oncology and Hematology. Accordingly, all seven staff physicians and two residents are involved in the clinical and research activities of chemotherapy for patients with both hematological and non-hematological tumors in this division. The same physicians also perform high-dose chemotherapy with stem cell transplantation. The number of patients with hematological malignancies has been increasing annually. About 60 patients with malignant lymphoma are seen in this division each year.
Routine Activities
We manage
various kinds of hematological malignancies, including non-Hodgkin’s lymphoma,
Hodgkin's disease, multiple myeloma, acute leukemia, chronic myeloid leukemia,
and myelo-dysplastic syndrome. We also manage most patients treated with aggressive
chemotherapy in the 8F ward in which we have 8 laminar air flow rooms. High-dose
chemotherapy with autologous hematopoietic stem cell transplantation is now
considered the standard treatment for relapsed non-Hodgkin's lymphoma; therefore,
the incidence of peripheral blood stem cell harvest and transplantation is
increasing. Our clinical practice consists of not only the treatment of patients
but also consultation concerning hematological abnormalities.
There is a weekly case conference every Tuesday afternoon in the Division of Oncology/Hematology and a monthly joint conference on malignant lymphoma with pathologists. Morning journal clubs meet on Monday, Thursday, and Friday in the Division of Oncology/Hematology.
Research Activities
The following clinical trials were conducted in 1999.
1. Phase I trial
Weekly docetaxel for solid tumors
2. Phase I/II trials
1)Phase I/II study of CPT-11 and CDDP for relapsed non-Hodgkin's lymphoma
2)Feasibility study of 75% CHOP for elderly patients with aggressive non-Hodgkin's lymphoma
3. Phase II trials
1)Combination of IDEC-C2B8 (monoclonal anti-body against CD20) and CHOP for untreated low-grade non-Hodgkin's lymphoma
2)IDEC-C2B8 alone for relapsed aggressive non-Hodgkin’s lymphoma
3)JCOG-LSG 16 for lymphoblastic lymphoma or acute lymphoblastic leukemia
4)JCOG-LSG 22 for Hodgkin's disease
5)JCOG-9801 for adult T-cell leukemia and lymphoma
4. Phase III trials
1)JCOG-9809, randomized study of standard CHOP and biweekly CHOP, for non-Hodgkin's lymphoma
2)JALSG (Japan Adult Leukemia Study Group) AML 97 for acute myeloid leukemia
3)JALSG APL 97 for acute promyelocytic leukemia
New Developments
We were part of a multicenter study evaluating the mobilization kinetics of circulating CD34+ cells in a randomized comparison of biweekly CHOP and dose-escalated CHOP in patients with aggressive non-Hodgkin's lymphoma with a high risk. Dose-escalated CHOP yielded a significantly higher number of circulating CD34+ cells in the first cycle compared with biweekly CHOP (p=0.05). the peak number of circulating CD34+ cells with biweekly CHOP did not significantly change cycle by cycle; however, in dose-escalated CHOP, the peak number of circulating CD34+ cells mobilized after the fifth and sixth cycle was lower than the number mobilized after the first cycle (p=0.07 and 0.009, respectively). accordingly, the mobilization kinetics of circulating progenitor cells in patients with aggressive non-Hodgkin's lymphoma is dependent on the dosage and schedule of CHOP.
|
Number
of Patients Enrolled in Clinical Trials |
||||
|
Protocol |
No. of pts |
|||
|
Hodgkin's
disease |
LSG
22 |
8 |
||
|
Non-Hodgkin's
lymphoma |
IDEC-C2B8
plus CHOP |
5 |
||
|
IDEC-C2B8
alone |
3 |
|||
|
LSG
16 |
1 |
|||
|
JCOG
9801 (ATL98) |
1 |
|||
|
JCOG
9809 (NHL-RCT98) |
14 |
|||
|
Acute
myeloid leukemia |
JALSG
AML 97 |
4 |
||
|
Acute
promyelocytic leukemia |
JALSG
APL 97 |
2 |
||
(K. ITO)
