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Background: Helicobacter pylori (H pylori) has been implicated in the pathogenesis of some autoimmune diseases including idiopathic thrombocytopenic purpura (ITP). Several studies recently showed a high prevalence of H pylori infection in patients with ITP and reported a platelet recovery after bacterial eradication therapy. The prevalence of H pylori infection and effect of its eradication in Korea patients with chronic ITP were investigated. Methods: The study included among 35 patients with chronic ITP from eight hospitals. H pylori infection was assessed by urea breath test, rapid urease test or microbial culture. H pylori eradication was performed with amoxicillin, clarithromycin and omeprazol regimen for 7 days or bismuth, metronidazol and tetracycline regimen for 10 days. Eradication was assessed by urea breath test 4 weeks after treatment. Platelet counts were monitored serially after the end of treatment. Results: Thirty five patients with chronic ITP were evaluated, including 12 males and 23 females. Median age was 57 years (range 30–79). The median platelet count before eradication was 23,000/uL (range 4,000–66,000/uL). Sixteen patients were performed the splenectomy previously. H pylori infection was found in 23 (65%) of 35 patients. In 21 patients performed the eradication, 6 patients (28.5%) had a significant increase in platelet count after 2 weeks and 2 months. The response duration was 1–27 (median 7.6) months. Conclusions: This study confirmed the efficacy of H pylori eradication in increasing platelet in adult chronic ITP patients. We must consider the investigation and eradication of H pylori infection in ITP patients as a simple, inexpensive tool in management of the chronic disease.

The result of cytogenetics is one of the most important prognostic factors on the prognosis of AML. HDAC, auto PBPCT and allogeneic BMT after 1 or 2 times of post remission therapy based on 4 prognostic groups(APL: Acute promyelocytic leukemia, GPG: Good prognosis group, IPG: Intermediate prognosis group, PPG: Poor prognosis group by MRC definition) were underwent based on cytogenetics data. We studied CR, relapse, toxic death, DFS and OS. Inclusion criteria were age Three plus seven(Idarubicin 12mg/m2(D1–D3), Ara-C 100mg/m2(D1–D7)) were given to de novo AML, secondary AML and RAEB-T. Intermediate dose(8gm/m2) of Ara-C was given followed by HDAC or auto PBPCT to the patients with GPG(t(8:21) & inv(16)). Three times of post remission therapy including HDAC, or auto PBPCT were given to the patients with IPG or PPG(−5, −7, del 5q, complex). If HLA-identical sibling was available, then allo BMT was underwent after 1st post-remission therapy. In cases of APL, three times of post-remission therapy with idarubicin alone were given. ATRA was given to APL group during remission induction therapy and after post-remission maintenance period for 2 years. Up to Mar., 2005, 422 patients(18 centers) were enrolled. Median follow-up was 48months. Among them, 92.3% was de novo AML, and APL, GPG, IPG and PPG were 10.0%, 21.6%, 51.4%, and 14.7% respectively. Overall CR after 1st induction(3+7) were 69.9%(APL: 87.2%, GPG: 84.7%, IPG: 63.8%, PPG: 55.66%, P In conclusions, this trial seems to be tolerable in terms of toxicities after induction and during post remission therapies. Among GPG, there were no significant statistical differences on OS and LFS in all the therapy modalities(ie, HDAC, Auto, Allo). In IPG, auto arm had a tendency of superior OS and LFS comparing to HDA & allo arm. In PPG, there was significant surperior LFS in allo arm. There were no statistical differences on OS in all the therapy modalities in PPG. This intention to treattrial, which had started in Jan, 2000, has been going on until now. Through this risk based trial using cytogenetics, we might be able to find optimal post-remission therapies for different risk groups with less toxicities.

Background: Inpatient consultation to hematologist increased in incidence and the role of hematologist as consultant continues to expand. But the resons for, frequency, and the result of inpatient hematologic consultation are largely unstudied. The aim of this study was investigation for the profiles of inpatients and their hematologic problems evaluated and managed by the hematology consultation of tertiary hospital. Methods: In this report, we evaluatded 354 consecutive patients with abnormal hematologic manifestation consulted for hematology department from March 2003 to Februery 2005. We prospectively recorded the demographics of the patients for whom consultation was requested, the reason of consultation, provisional diagnosis of the referring service, the final diagnosis and outcome of the patients in each case. Results: The consulted patients were 354 among 55,704 inpatients (0.6%). Approximately half the patients were female (54%). The median age was 55 years (range: 16–85) and the most frequent age group was the 6th decade. The median length of hospitalization was 26 days (range: 4–188) and the median interval from admission to initial consultation was 6 days (range: 1–76). In a third cases of consultations, the hematologic abnormalities were found newly after admission. The departments requesting consultation frequently were neurosurgery (24%), general surgery (11%), divisions of internal medicine (11%), orthopedic surgery (9%), and neurology (9%). The common causes of consultation were as follows: anemia (29%), thrombocytopenia (21%), pancytopenia/bicytopenia (16%), coagulation abnormality (15%) and thrombocytosis (7%). While anemia was the most common reason of consultations from medical services (internal medicine, neurology, psychology, rehabilitation medicine, etc), thrombocytopenia and coagulopathy were the frequent reasons of consultations from surgical services (general surgery, orthopedic surgery, plastic surgery, neurosurgery, etc.). The best part of anemia were IDA (43%) and anemia of chronic disease (33%). Drugs made up 38% of the cause of thrombocytopenia and the suspected drugs were anticonvulsants and antibiotics. A half of pan/bicytopenia were caused by drug-related or vitB12/folate deficiency. 40% of coagulopathy resulted from nonspecific or undefined cause. Bone marrow examination was required in 30 cases (8%). Careful evaluation of patients with hematologic problem sometimes revealed occult bleeding, liver disease or hematologic disease such as myelodysplastic syndrome, immune thrombocytopenic purpura or chronic myeloproliperative disorder. Almost physicians avoided making presumptive diagnoses and requested consultation for abnormal laboratory findings, leaving it to the hematologist to determine the cause. Conclusion: Although It provides a small cross-sectional findings of the types of patients and problems seen by hematologist during inpatient consultation, these informations may be helpful to provide optimal inpatients care for hematologist and to improve the quality of the consultation process by the referring service.

4072 Background: The objectives of the present study were to evaluate the efficacy and safety of a combination regimen of biweekly irinotecan plus cisplatin in pretreated patients with advanced gas...

The current phase II study was conducted to evaluate the response rate and safety of a combination regimen of biweekly irinotecan plus cisplatin in pretreated patients with advanced gastric cancer. Patients with previously treated metastatic or recur- rent gastric cancer received intravenous irinotecan 70 mg/m 2 and cisplatin 30 mg/m 2 on day 1 and 15 every 4-week cycle. Thirty-two patients were enrolled in the current study. Of these, 31 patients were assessable for efficacy and all for toxicity. No complete response and 5 partial responses were confirmed, giving an overall response rate of 15.6% (95% CI; 2.3-28.9%). The median time to progression and median overall survival for all patients was 113 days and 184 days, respectively. Grade 3/4 neutropenia occurred in 6 patients (18.8%), yet no febrile neutropenia was observed. In addition, grade 3 anorexia was observed in 4 patients (12.5%) and grade 3 diarrhea occurred in 2 patients (6.2%). The combination chemotherapy of biweekly irinotecan and cisplatin was found to be moderately effective and well tolerated in pretreated patients with advanced gastric cancer. Accordingly, this regi- men can be regarded as an important second-line treatment option for advanced gastric cancer.

The Clinical Efficacy of Helicobacter pylori Eradication in Patients with Helicobacter pylori-positive Chronic Thrombocytopenic Purpura Bong-Seog Kim, M.D., Seung-Hyun Nam, M.D., Soo-Mee Bang, M.D., Jae Hoon Lee, M.D., Young Rok Do, M.D. , Ki Young Kwon, M.D., Hong Suk Song, M.D., Hun Mo Ryoo, M.D., Sung Hwa Bae, M.D., Min Kyoung Kim, M.D. , Kyung Hee Lee, M.D., Myung Soo Hyun, M.D., Young Jin Yuh, M.D., Eunkyung Park, M.D., Sang-Jae Lee, M.D., Sung-Soo Yoon, M.D., Seonyang Park, M.D. and Byoung Kook Kim, M.D.

Diffuse large B-cell lymphoma (DLBCL) is characterized by a marked degree of morphologic and clinical heterogeneity. Recently, Rosenwalt et al. (N Engl J Med 2002) reported that four gene expression “signature”, 17 genes were identified as correlated with patient outcome by DNA microarray in DLBCL. In this study, we aim to establish predictor of outcome could help to identify patients who may benefit from risk-adjusted therapies in advance. To do it, we evaluate the prognostic relevance of 17 gene expressions in 72 patients with DLBCL who received a conventional chemotherapy. Seventeen genes were studied using RT-PCR assay from paraffin-embedded sections at the time of diagnosis. The median age of the patients was 58 years (range: 21–80 years). When we initially exam an appropriative patient’s selection for survival analysis, overall survival (OS) at 2 years in patients with the international prognostic index (IPI) < 2 and IPI ≥ 2 were 95.2±4.6% and 50.6±11.8%, respectively (p = 0.009), and progression free survival (PFS) at 2 years in patients with the IPI < 2 and IPI ≥ 2 were 75.0±9.7% and 46.7±12.9%, respectively (p = 0.049). Of the 17 genes, patients with uPA expression showed a shorter OS compared with those without the gene expression. Additionally, patients with the expression of NPM3, uPA, fibronectin, or IMAGE814622 showed a shorter PFS compared with those without the gene expressions. In conclusion, these findings suggest that the gene expression profiling with simple RT-PCR assay is useful for analysis of the prognostic implications in patients with DLBCL.

3774 Background: This phase II study evaluated the efficacy and safety of a combination of oxaliplatin and UFT/oral leucovorin in Korean Patients with advanced colorectal cancer (ACC) previously treated with a fluorouracil-based regimen. Methods: From December 1998 to December 2001, 28 patients [male : female 12:16, median age 61 (range 37–71)] with measurable disease and Easter Cooperative Oncolgy Group performance status of 0–2 were treated with a combination of oxaliplatin (130 mg/m2 i.v. for 2 hours) on day 1, UFT (300 mg/m2 p.o.) and 5-FU (20mg/m2 p.o.) on day 1–21, every 3 weeks. Results: 10 out of 28 evaluable patients achieved complete (n=3) or partial (n=7) response, leading to an overall response rate of 35.7%. The estimated median time to progression and survival were 5.5 months and 8.5 months respectively. From the 129 cycles analyzed, sensory neuropathy was the most common toxicity (73%), grade 3,4 hematologic toxicities included neutropenia 1.5%, and thrombocytopenia 1.5%, other toxicities w...

The involvement of central nervous system is rare in acute promyelocytic leukemia (APL). We report a APL patient of a 41 yr-old Korean male who presented with fever and petechia. Complete molecular remission was achieved with all-trans retinoic acid (ATRA), idarubicin, and cytarabine. Ten months later, he complained of a mild headache. The results of the physical examination and the complete blood counts were normal. The examination of cerebrospinal fluid showed the presence of promyelocyte. Bone marrow studies showed cytogenetic remission but with molecular relapse. He was treated with intrathecal and systemic chemotherapy.

Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p to , p, to , p to , p

We retrospectively compared the outcomes of 225 patients with adult acquired aplastic anemia (AA) who underwent allogeneic hematopoietic stem cell transplantation (alloHSCT) from matched related donors (MRDs), and those treated by alloHSCT from alternative donors (ADs). Univariate and multivariate analyses of factors associated with survival were performed. Multivariate analysis showed that age at alloHSCT of ≤ 31 years, MRD, successful engraftment, absence of acute graft-versus-host disease (aGVHD), and platelet engraftment at ≤ 21 days, were independent predictors of longer survival. In addition, time to aGVHD and cumulative nonrelapse mortality (NRM) were better in MRD than in AD recipients. Using propensity score matching (PSM), we performed a case-control study comparing 25 patients in each group who underwent alloHSCT from MRDs and ADs. Pretransplantation clinical factors were well balanced in either group. Median survival time was similar, and no statistically significant difference in transplantation outcomes was apparent when MRD and AD recipients were compared. In conclusion, our results suggest that alloHSCT from an AD should be considered earlier in adult patients with AA who do not have an MRD.