Disseminated Intravascular Coagulation



中華民國血液病學會九十四年度年會節目表

高雄醫學大學附設醫院啟川大樓六樓

三月二十六日（星期六）

|時間/講堂 |第一講堂 |第二講堂 |

|8:00 |報到 Registration |

|8:25-8:30 |高雄醫學大學王國照校長開幕致詞 | |

|8:30-9:15 |教育演講（Ⅰ）Disseminated Intravascular Coagulation Update | |

| |蔡偉醫師 臺大醫院內科 | |

|9:15-10:00 |教育演講（Ⅱ）Plasticity of stem cell | |

| |施子弼教授 台北醫學大學細分所 | |

|10:00-10:20 |休息 Coffee Break |醫學倫理演講Physician-Patient Relationship |

| | |高雄醫學大學免疫風濕內科蔡文展主任 |

|10:20-12:00 |會員演講（Ⅰ） |會員演講（Ⅲ） |

|12:00-13:00 |午餐 Lunch Time Satellite Symposium Pfizer Co | |

|13:00-14:00 |外賓演講（Ⅰ） |骨髓移植護理 |

| |Chemotherapy of DLBCL - the DSHNHL perspective | |

| |Dr. Frank Hartmann |專題演講 |

|14:00-14:40 |會員演講（Ⅱ） | |

|14:40-15:00 |Coffee Break | |

|15:00-16:10 |九十三年青年研究發展獎成果報告及 | |

| |九十四年青年研究發展獎、青年優秀論文獎得獎演講與頒獎及青年優秀論文報告獎頒| |

| |獎 | |

|16:10-17:10 |血液病學會會員大會暨理監事選舉 | |

|17:10-18:00 | |血液及骨髓移植學會會員大會 |

|18:30 |晚宴（漢來飯店） |

| | |

|三月二十七日（星期日） | |

|時間 |第一講堂 |第二講堂 |

|8:30-10:00 |會員演講（Ⅳ） |會員演講（Ⅴ） |

|10:00-10:20 |Coffee Break |

|10:20-11:20 |外賓演講（Ⅱ） |

| |Using Busulfan Pharmacokinetics to Improve the Safety and Antitumor Efficacy of Pretransplant Conditioning Therapy for |

| |Myeloid Malignancies |

| |Dr. Borje S. Andersson |

|11:20-12:00 |辯論演講：Low grade lymphoma是否應接受幹細胞移植 |

| |正方：蕭樑材醫師 台北榮總血液腫瘤科 |

| |反方：張義芳醫師 馬偕醫院血液腫瘤科 |

|12:00-12:05 |中華民國血液及骨髓移植學會理事長邱昌芳閉幕致詞 |

|中華民國血液病學會第十二屆第一次會員大會 |

|中華民國血液及骨髓移植學會第七屆第二次會員大會 |

暨聯合學術演講年會

時間：94年3月26日～27日（星期六-日）

地點：高雄醫學大學附設醫院啟川大樓六樓

三月二十六日【星期六】

|8:00起 |報到 Registration |

|【第一講堂】 |

|08:25-08:30 |高雄醫學大學王國照校長致開幕詞 |

|8:30-9:15 |教育演講（Ⅰ） 主持人： 王玉祥 主任 |

| |Disseminated Intravascular Coagulation Update |

| |台大醫院 內科部 蔡偉醫師 |

|9:15-10:00 |教育演講（Ⅱ） 主持人： 陳耀昌 教授 |

| |Plasticity of stem cell |

| |台北醫學大學細分所 施子弼教授 |

|10:00-10:20 | Coffee Break |

| |會員演講（Ⅰ） 主持人：黃偉修 黃文豊 |

|10:20-10:30 |Non-myeloablative Allogeneic Stem Cell Transplantation in Hematologic Malignancy |

| |廖裕民 葉士芃 黃馨慧 林振源 邱昌芳 |

| |中國醫藥大學附設醫院 血液腫瘤科 |

|10:30-10:40 |CD34-positive Selected Autologous Stem Cell Transplantation in High Risk non-Hodgkin's Lymphoma (NHL) Patients |

| |林鵬展1 李明陽1 傅雪美1 鄧豪偉1 施盈逸1 林炯熙2 王緯書1 顏厥全1 趙大中1 蕭樑材1 楊慕華 曾成槐2 陳博明1 邱宗傑1 |

| |台北榮民總醫院內科部 1腫瘤科 2輸血醫學科 |

|10:40-10:50 |Successful treatment of advanced breast cancer with allogeneic nonmyeloablative stem cell transplantation: A case |

| |report |

| |樊 聖 |

| |衛生署豐原醫院內科 |

|10:50-11:00 |Treatment of Corticosteroid-refractory GVHD with Sirolimus: The CMUH Experience |

| |林振源 葉士芃 黃馨慧 廖裕民 邱昌芳 |

| |中國醫藥大學附設醫院血液腫瘤科 |

| |主持人：邱宗傑 唐季祿 陳彩雲 |

|11:00-11:10 |The role of SOCS1 and SOCS3 in patients with GVHD after peripheral blood stem cell transplantation |

| |楊文祺 劉益昌 蕭惠樺 劉大智 陳田柏 林勝豐 |

| |高雄醫學大學附設醫院內科部血液腫瘤科 |

|11:10-11:20 |Successful engraftment and low incidence of acute GvHD in adult patients with high-risk acute leukaemia receiving |

| |allogeneic peripheral blood stem cell transplantation from a parent by fludarabine containing conditioning regimen|

| |吳尚儒 姚明 唐季祿 柯博升 陳耀昌 |

| |台大醫院 內科部 血液腫瘤科 |

|11:20-11:30 |Plasma Level of Interleukin-10 Correlates Well with the Activity of Graft-Versus-Host Disease and the |

| |Responsiveness to Immunosuppressive Treatment |

| |葉士芃1.2 廖裕民1 廖育晴2 羅文吉2 林嬌玲2 張建國2 邱昌芳1 |

| |中國醫藥大學附設醫院內科部 血液腫瘤科1 醫研部幹細胞研究室2 |

|11:30-11:40 |Occult Hepatitis B Virus Infection in Hematopoietic Stem Cell Transplantation Recipients |

| |蕭樑材1 邱宗傑1 劉俊煌1 朱巧君1 王緯書1 顏厥全1趙大中1 楊慕華1 |

| |林玉真1 王世禎2 張泰階3 曾成槐4 陳博明1 |

| |台北榮民總醫院1內科部腫瘤科、 2核子醫學部、3教學研究部、4內科部輸血醫學科 |

|11:40-11:50 |Reactivation of Hepatitis B Virus Infection in Patients Receiving Nonmyeloablative Stem Cell Transplantation |

| |鄧豪偉 蕭樑材 施盈益 傅雪美 林鵬展 李明陽 趙大中 楊慕華 顏厥全 王緯書 邱宗傑 劉俊煌 陳博明 |

| |臺北榮民總醫院內科部腫瘤科 |

|11:50-12:00 |Pulmonary Complications in Stem Cell Transplant Patients－A Single Institute Experience |

| |譚傳德 吳茂青 劉美瑾 陳博文 高國彰 黃達夫 |

| |辜公亮基金會和信治癌中心醫院 血液腫瘤科, 臍帶血幹細胞研究室 |

|12:00-12:10 |The 2-year Results of Hematopoietic Stem Cell Transplantation in Taiwan |

| |邱宗傑 陳博明 何照洪 林炯森 黃文豊 楊吉雄 王玉詳 趙祖怡 黃偉修 |

| |曹朝榮 王博南 施麗雲 邱昌芳 葉士芃 陳彩雲 譚傳德 林勝豐 |

| |中華民國血液病學會 |

|12:10-13:00 |午餐 Lunch Time |

| |Satellite Symposium Pfizer Co：Management of invasive fungal infections: brain or algorithm Dr. B.E. dePauw |

| |外賓演講（Ⅰ） 主持人： 陳博明主任 |

|13:00-14:00 |Chemotherapy of DLBCL - the DSHNHL perspective |

| |Dr. Frank Hartmann |

|會員演講（Ⅱ） 主持人：曾成槐 高偉堯 |

|14:00-14:10 |Proteasome Inhibitor (Bortezomib) in the Treatment of Relapsed and Refractory Multiple Myeloma: NTUH Experience |

| |林世強 黃聖懿 唐季祿 姚明 柯博升 蔡偉 陳耀昌 田蕙芬 |

| |台大醫院 內科部 血液腫瘤科 |

|14:10-14:20 |Mabthera® in Combination of Chemotherapy Improved the Survival Rate of Aggressive B-cell Lymphoma Patients – A |

| |Report From a Single Institute |

| |王威堯1 林哲斌1 張意恆1 鄭企峰1 徐會棋1 朱素娟1 施麗順2 |

| |1臺北市立醫院 仁愛分院 內科部 血液腫瘤科， 2病理科 |

|14:20-14:30 |Prolonged Fever of Unknown Origin and Hemophagocytosis Evolving into Subcutaneous Panniculitis-Like T-Cell |

| |Lymphoma |

| |臺中榮民總醫院 血液腫瘤科 |

| |滕傑林 楊吉雄 楊陽生 黃文豊 林增熙 |

|14:30-14:40 |Delayed Hepatitis B Virus Reactivation after Cessation of Preemptive Lamivudine in Rituximab Plus CHOP-treated |

| |Lymphoma Patients |

| |戴明燊 趙祖怡 高偉堯 徐榮源* 劉譚美** |

| |三軍總醫院 血液腫瘤科 腸胃科* 風濕免疫科** |

|14:40-15:00 |Coffee Break |

|九十三年研究發展獎成果報告及 主持人：林勝豐理事長 |

|九十四年青年研究發展獎、青年優秀論文獎得獎演講與頒獎 |

|及青年優秀論文報告獎頒獎 |

|15:00-15:10 |九十三年度研究發展獎成果報告： |

| |合併使用Superoxide Dimutase抑制劑及Proteasome抑制劑對急性髓性白血病治療之體外及動物研究 |

| |台北市立萬芳醫院血液腫瘤科 劉興璟 醫師 |

|15:10-15:20 |利用細胞株系統建立完整的T及自然殺手細胞白血病及淋巴瘤基因表現藍圖 |

| |台北榮民總醫院腫瘤科 蕭樑材 醫師 |

|15:20-15:25 |九十四年度麒麟研究發展獎： |

| |SOCS1（suppressor of cytokine signaling 1）,SOCS3（suppressor of cytokine signaling 3）的表現在接受過週邊血液細 |

| |胞移植後，發生移植物對抗宿主反應的病人的角色極其機轉的探討 |

| |高雄醫學大學附設醫院血液腫瘤科 楊文祺 醫師 |

| |麒麟藥品股份有限公司總經理頒獎 |

|15:25-15:30 |Notch1訊息傳遞途徑調控轉錄因子PU.1誘導骨髓細胞分化受阻在急性骨髓性白血病生成之重要性 |

| |台北榮民總醫院腫瘤科 楊慕華 醫師 |

| |麒麟藥品股份有限公司總經理頒獎 |

|15:30-15:40 |九十四年度青年優秀論文獎—頭獎 |

| |Nonirradiated NOD/SCID-Human Chimeric Animal Model for Primary Human Multiple Myeloma A Potential in Vivo |

| |Culture System |

| |台大醫院內科部血液科 黃聖懿 醫師 |

| |血液病學會林勝豐理事長頒獎 |

|15:40-15:50 |九十四年度青年優秀論文獎—貳獎 |

| |Evidence of parvovirus B19 infection in patients of preeclampsia or eclampsia with dyserythropietic anaemia |

| |中國醫藥大學附設醫院血液腫瘤科 葉士芃 醫師 |

| |血液病學會林勝豐理事長頒獎 |

|15:50-16:00 |九十四年度青年優秀論文獎—參獎 |

| |Chromosomal abnormalities of 200 Chinese patients with non-Hodgkin’s lymphoma in Taiwan: with special reference |

| |to T-cell lymphoma |

| |台北縣立醫院內科/台大醫院內科部 陳建源 醫師 |

| |血液病學會林勝豐理事長頒獎 |

|16:00-16:10 |九十四年度青年優秀論文報告獎頒獎 |

| |Occult Hepatitis B Virus Infection in Hematopoietic Stem Cell Transplantation Recipients |

| |台北榮民總醫院腫瘤科 蕭樑材 醫師 |

| |Correlation of Endogenous Erythroid Colony Formation in Serum-free Culture System and Expression of PRV-1 |

| |mRNA in Granulocytes from Patients with Chronic Myeloproliferative Disorders |

| |林口長庚醫院血液科 林棟樑 醫師 |

| |Cost Effectiveness of Hematopoietic Stem Cell Transplantation for Transfusion-Dependent Thalassemia in |

| |Comparison With Conventional Therapy |

| |台大醫院兒科 何宛玲 醫師 |

| |Autocrine expression of platelet-derived growth factor in B-cell chronic lymphocytic leukemia |

| |三軍總醫院血液腫瘤科 何景良 醫師 |

| |Delayed Hepatitis B Virus Reactivation after Cessation of Preemptive Lamivudine in Rituximab Plus |

| |CHOP-treated Lymphoma Patients |

| |三軍總醫院血液腫瘤科 戴明燊 醫師 |

|16:10-17:10 |血液病學會會員大會暨理監事選舉 |

|18:30- |晚宴（漢來飯店） |

研究發展獎成果報告每題10分鐘，9分鐘鈴響一聲，10分鐘鈴響兩聲並全面開燈，請結束演講。

研究發展獎得獎報告每題 5分鐘，4分鐘鈴響一聲，5分鐘鈴響兩聲並全面開燈，請結束演講。

優秀論文獎演講時間每題10分鐘，9分鐘鈴響一聲，10分鐘鈴響兩聲並全面開燈，請結束演講。

|【第二講堂】 |

|醫學倫理演講 主持人：林勝豐 理事長 |

|10:00-11:00 |Physician-Patient Relationship |

| |高雄醫學大學免疫風濕內科 蔡文展主任 |

|會員演講（Ⅲ） 主持人：施麗雲 何照洪 |

|11:00-11:10 |Correlation of Endogenous Erythroid Colony Formation in Serum-free Culture System and Expression of PRV-1 mRNA in |

| |Granulocytes from Patients with Chronic Myeloproliferative Disorders |

| |林棟樑 施麗雲 李慶泰 張佳慧 黃千芳 王博南 鄧波 吳金和 |

| |郭明宗 張 鴻 湯崇志 吳鴻誠 |

| |長庚紀念醫院 血液腫瘤科 |

|11:10-11:20 |Global cytokines analysis in chronic myeloproliferative disorder |

| |何景良1 趙祖怡1 Tefferi Ayalew2 |

| |三軍總醫院 1內科部血液腫瘤科 2美國梅約醫學中心血液科 |

|11:20-11:30 |Chronic idiopathic myelofibrosis: The clinical and pathological study of 7 cases at Chi-Mei Medical Center |

| |林正耀 莊世松* 林建良 陳昭勳 陳尚文 林明賢 黃冠誠 黃健泰 |

| |黃偉修 曹朝榮 |

| |奇美醫學中心血液腫瘤科 *解剖病理科 |

|11:30-11:40 |Role of bone marrow examination in patients with isolated leukopenia |

| |何照洪 余垣斌 周永強 高志平 |

| |台北榮民總醫院內科部血液科 |

|11:40-11:50 |Dannzole plus oral prednisolone in the treatment of steroid refractory thrombocytopenia：6 cases report and |

| |literature review |

| |戴承正 |

| |臺北醫學大學附設醫院內科部血液腫瘤科 |

| |主持人：曹朝榮 沈銘鏡 |

|11:50-12:00 |Gly392Cys Missense Mutation in the A2 Domain of Factor V Causing Severe Factor V Deficiency: Molecular |

| |Characterization by Expression of the Recombinant Protein |

| |李妍蒨 林尊媚* 馮盈勳 顏家瑞 黃文聰 蘇五洲 陳彩雲 |

| |成大醫院內科部血液腫瘤科 |

| |成功大學醫學檢生物技術學系* |

|12:00-12:10 |Clinical and Laboratory Studies of 25 Patients with Von Willebrand Disease in Taiwan |

| |歐偉仁1,2 陳宇欽1,2 莊岳泉1,2 萬祥麟1,2 姚乃舜1,2 何景良1,2 謝安臺1,2 高偉堯1,2 錢新南1,3 趙祖怡1,2 |

| |1血友病中心, 2血液腫瘤科, 3小兒部, 三軍總醫院, 國防醫學中心 |

|12:10-12:20 |Chronic Complications of Patients with Hemophilia: The TSGH Experience |

| |陳宇欽1,2 歐偉仁1,2 莊岳泉1,2 萬祥麟1,2 戴明燊,2 姚乃舜2, 何景良2, |

| |謝安臺2, 高偉堯2 陳俊榮1,3 錢新南1,3 趙祖怡1,2 |

| |1血友病中心, 2血液腫瘤科, 3小兒部, 三軍總醫院, 國防醫學中心 |

|12:20-12:30 |Heparin-like anticoagulant in a woman with abnormal bleedings well responded to the treatment of protamin sulfate |

| |and rVIIa, respectively. |

| |謝志崗1王明倫1郭夙峰2林炫聿1鐘智淵1張正雄1林正純1王全正1 |

| |林正修2沈銘鏡1, 2 |

| |1彰化基督教醫院內科部 2彰化基督教醫院檢驗醫學部 |

| |2台大醫院內科部 |

|12:30-13:00 |午餐 Lunch Time |

|骨髓移植護理專題演講 主持人： 方慧芬督導 |

|14:40-15:00 |血液腫瘤病患接受造血幹細胞移植之醫療決策經驗及其移植後生活品質之研究（臺灣大學附設醫院高維菁 護理長） |

|17:10-18:00 |骨髓移植併發症之照護（三軍總醫院黃春戀 護理長） |

|14:40-15:00 |以縱貫性研究探討急性骨髓性白血病化學治療的經驗（臺灣大學附設醫院陳佩瑛 護理師） |

|17:10-18:00 |白血病之症狀照護（中國醫藥大學附設醫院李燕蓉 護理師） |

|17:10-18:00 |Coffee Break |

| |主持人： 黃綉雲督導 |

|14:40-15:00 |莎希米亞孩子的新希望－臍帶血移植之照護經驗（林口長庚紀念醫院方恩真專科護理師） |

|17:10-18:00 |案例分享（成功大學附設醫院蔡靜誼 護理師） |

|14:40-15:00 |骨髓及血液造血幹細胞移植後病人的居家調適（台北榮民總醫院李淑貞 護理長） |

|14:40-15:00 |案例分享（中國醫藥大學附設醫院陳沛綺 護理師） |

|17:10-18:00 |血液及骨髓移植學會會員大會 |

|18:30 |晚宴（漢來飯店） |

|三月二十七日【星期日】 |

|【第一講堂】 |

|會員演講（Ⅳ） 主持人：田蕙芬 張正雄 |

|8:30-8:40 |Role of Imitinib mesylate in Chronic Myeloid Leukemia: NTUH Experience |

| |侯信安 徐思淳 黃聖懿 姚明 柯博升 蔡偉 陳耀昌 沈銘鏡 田蕙芬 |

| |唐季祿 |

| |台大醫院 內科部 血液腫瘤科 |

|8:40-8:50 |Molecular monitoring of BCR-ABL fusion transcript and analysis of ABL kinase mutation in CML patients treated with|

| |imatinib |

| |郭明宗 施麗雲 郭景元 王銘崇 王博南 林棟樑 鄧波 張鴻 |

| |吳鴻誠 吳金和 藍以政 湯崇志 |

| |長庚紀念醫院 血液腫瘤科 |

|8:50-9:00 |Resistance to Imitinib mesylate in Chronic Myeloid Leukemia: NTUH Surveillance |

| |林建廷 徐思淳 黃聖懿 姚明 柯博升 蔡偉 陳耀昌 沈銘鏡 田蕙芬 |

| |唐季祿 |

| |台大醫院 內科部 血液腫瘤科 |

|9:00-9:10 |Expression of Cyclin D1 predicts outcome of accelerated-phase chronic myeloid leukemia |

| |劉俊煌1 施盈逸1 余垣斌2 蕭樑材1 趙大中1 楊慕華1邱宗傑1陳博明1 |

| |台北榮總暨國立陽明大學 腫瘤科1, 血液科2 |

|9:10-9:20 |Analysis of a single nucleotide polymorphism in the MDM2 gene promoter in human CML and its relationship to |

| |accelerate disease progression to blast crisis |

| |劉益昌 蕭惠樺 劉大智 蔡慧珍 曾士賓 楊文祺 陳田柏 林勝豐 |

| |高雄醫學大學 血液腫瘤內科 |

| |主持人：張建國 劉大智 |

|9:20-9:30 |Characterization of CEBPA mutations in acute myeloid leukemia: most |

| |patients with CEBPA mutations have biallelic mutations and show a distinct immunophenotype of the leukemic cells |

| |陳建源1 林亮音23 林東燦3 蔡偉1 唐季祿1 葉又嘉1 沈惠齡1 蘇芳仙1 |

| |姚明1 黃聖懿1 田蕙芬1 |

| |台大醫院內科部1, 台大醫學院醫技所2, 台大醫院檢驗醫學部3 |

|9:30-9:40 |Expression of nucleostemin in acute leukemia patients |

| |蔡慧珍 林柏每 蕭惠樺 劉益昌 曾士賓 劉大智 陳田柏 林勝豐 |

| |高雄醫學大學血液腫瘤內科 |

|9:40-9:50 |Multiplex RT-PCR for the Detection of Leukaemia- Aaaociated Translocations |

| |Manuel Salto-Tellez, MD |

| |Asia Biomedix Sdn Bhd |

|9:50-10:00 |Autocrine expression of platelet-derived growth factor in B-cell chronic lymphocytic leukemia |

| |何景良1 趙祖怡1 李清揚2 |

| |三軍總醫院 1內科部血液腫瘤科 2美國梅約醫學中心血液病理科 |

|10:00-10:10 |Mesenchymal Stem Cells Can Be Easily Isolated from Bone Marrow of Patients With Various Hematological Malignancies|

| |But The Surface Antigens Expression May Be Different From Patient to Patient and Passage to Passage |

| |葉士芃12 吳蜜蘭2 廖育晴2 羅文吉2 林嬌玲2 張建國2 邱昌芳1 |

| |中國醫藥大學附設醫院內科部 血液腫瘤科1 醫研部幹細胞研究室2 |

|10:10-10:20 |Coffee Break |

| |外賓演講（Ⅱ） 主持人：趙祖怡 |

|10:20-11:20 |Using Busulfan Pharmacokinetics to Improve the Safety and Antitumor Efficacy of Pretransplant Conditioning Therapy|

| |for Myeloid Malignancies |

| |Dr. Borje S. Andersson |

|1:20-12:00 |辯論演講 主持人： 邱昌芳 |

| |題目：Low grade lymphoma是否應接受幹細胞移植 |

| |正方：蕭樑材醫師 台北榮總血液腫瘤科 |

| |反方：張義芳醫師 馬偕醫院血液腫瘤科 |

|12:00-12:05 |中華民國血液及骨髓移植學會邱昌芳理事長閉幕致詞 |

|三月二十七日【星期日】 |

|【第二講堂】 |

|會員演講（Ⅴ） 主持人： 林凱信 梁德城 |

|8:30-8:40 |The long-term survivors of acute leukemia in children: Report from one institution |

| |洪悠紀 陳世翔* 楊兆平 江東和 羅福松+ |

| |林口長庚兒童醫院血液腫瘤科 |

|8:40-8:50 |Invasive fungal infection in children with cancer under chemotherapy |

| |葉庭吉 劉希哲 王麟燕 陳淑惠 梁德城 |

| |馬偕醫院小兒血液腫瘤科 |

|8:50-9:00 |Unusual Subtypes of Peripheral T-cell Lymphoma with Fetal Outcome Occurring in Teenagers – Report of Two Cases |

| |楊兆平 王博南1 |

| |林口長庚兒童醫院 血液腫瘤科、林口長庚紀念醫院 血液腫瘤科1 |

|9:00-9:10 |SEN virus infection in transfusion-dependent thalassemia patients in southern Taiwan |

| |林世雄1、邱世欣1、余明隆2、章人欽1、林佩瑾1、張泰琮1 |

| |高雄醫學大學小兒科1、內科2 |

| |主持人： 張泰琮 林東燦 |

|9:10-9:20 |CEBPα mutations in childhood acute myeloid leukemia |

| |梁德城1 施麗雲2,3 黃千芳2 洪悠紀3,4 楊兆平3,4 劉希哲1 江東和4 |

| |王麟燕1 張琬惠5 |

| |1馬偕醫院小兒血液腫瘤科; 2長庚醫院血液腫瘤科; 3長庚大學醫學系; |

| |4林口長庚兒童醫院血液腫瘤科; 5兒童癌症基金會統計中心 |

|9:20-9:30 |Cost Effectiveness of Hematopoietic Stem Cell Transplantation for Transfusion-Dependent Thalassemia in Comparison |

| |With Conventional Therapy |

| |何宛玲1 林凱信1 林東燦1 周獻堂1 盧孟佑1 陳鵬升2 |

| |臺灣大學附設醫院1 署立桃園醫院2 |

|9:30-9:40 |Recombinant factor VIIa in the treatment of bleeding in hemophilia A with high-titer inhibitors – experience in |

| |south Taiwan |

| |章人欽 邱世欣 林佩瑾 張泰琮 |

| |高雄醫學大學附設醫院 小兒血液腫瘤科 |

|9:40-9:50 |Treatment of Severe Aplastic Anemia with Sequential Immunosuppressive Regimens in Children - Report of 18 Cases |

| |江東和1 黃一安1 楊兆平1 洪悠紀1 陳世翔1 孫建峰2 |

| |林口長庚兒童醫院 血液腫瘤科1, 長庚紀念醫院 臨床病理科2 |

|10:00-10:20 |Coffee Break |

※ 附註：

1. 專題演講每題45分鐘（含10分鐘討論）

2. 外賓演講每題60分鐘（含10分鐘討論）

3. 辯論演講每題40分鐘，正反兩方各15分鐘，討論10分鐘。

4. 會員演講每題10分鐘，討論2分鐘，8分鐘鈴響一聲，10分鐘鈴響兩聲，請結束演講。

※繼續教育積分：

中華民國血液病學會：15分（甲類）

中華民國癌症醫學會：3分

台灣家庭醫學醫學會：3/26乙類6點，3/27乙類3點

台灣內科醫學會：15分，醫學倫理：1分

台灣兒科醫學會：5分

致 謝

本次會員大會及聯合學術年會，承蒙高雄醫學大學附設醫院提供會場，更感謝每位會員的共同參與，並承蒙下列廠商的鼎力贊助，使大會圓滿完成，特此致謝。

1. 麒麟藥品股份有限公司

2. 輝瑞大藥廠股份有限公司

3. 羅氏大藥廠股份有限公司

4. 台灣諾華股份有限公司

5. 台灣東洋藥品工業股份有限公司

6. 美商默沙東藥廠股份有限公司台灣分公司

7. 吉發企業股份有限公司

8. 台灣中外製藥股份有限公司

9. 台灣安萬特藥品股份公司

10. 賽諾菲聖德拉堡股份有限公司

11. 台灣惠氏股份有限公司

12. 明達實業股份有限公司

13. 台灣綠十字股份有限公司

14. 台灣先靈股份有限公司

15. 吉帝藥品有限公司

16. 台灣必治妥施貴寶股份有限公司

17. 荷商葛蘭素史克藥廠股份有限公司

18. 訊聯生物科技股份有限公司

19. 瑪里士實業有限公司

20. 台灣諾和諾德藥品股份有限公司

21. 美時化學製藥股份有限公司

22. 台灣拜耳股份有限公司

23. 楊森大藥廠

中華民國血液病學會敬謝

九十四年三月二十六日

Disseminated Intravascular Coagulation Update

台大醫院 內科部 蔡偉醫師

Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread fibrin deposition in the circulation, which results in microvascular thrombi in multiple organs. Consumption and subsequent exhaustion of coagulation proteins and platelets may induce severe bleeding complications. Hence, a patient with acute DIC can present with a simultaneously occurring thrombotic and bleeding problem.

DIC is not a disease entity in itself but a complication of an underlying disorder, such as infection, inflammation, or malignancy. In recent years, the mechanism of DIC became clearer. DIC exemplifies multifaceted interactions between the inflammatory and coagulation pathways. During systemic inflammatory response syndrome, both perturbed endothelial cells and activated mononuclear cells may produce proinflammatory cytokines that mediate coagulation activation. Activation of coagulation is initiated by tissue factor (TF) expression on activated mononuclear cells, endothelial cells, or some malignant cells. Many embryonic tissues and malignant cells including APL (acute promyelocytic leukemia) blasts, also can express the cancer procoagulant (CP), which can directly activate factor X in the absence of factor VII. In addition, downregulation of physiologic anticoagulant mechanisms (such as the antithrombin system and protein C systems) and inhibition of fibrinolysis（mainly by high circulating levels of PAI-1 released from endothelial cells）will further promote intravascular fibrin deposition. Furthermore, the increased availability of anionic phospholipids surfaces, which provided by circulating microparticles and lipoproteins released as part of the stress response, may contribute to sustain thrombin generation.

However, the clinical and laboratory diagnosis of DIC may remain difficult, since routinely available tests do not specifically assess ongoing thrombin generation. A Japanese scoring system for DIC was first proposed in 1987, and was revised in 1995. This scoring system was not widely adopted, because of practical limitations. In 2001, a simple five-step diagnostic algorithm for calculating a DIC score was presented by the subcommittee on DIC of the International Society on Thrombosis and Haemostasis. It needs several common tests, including platelet count, prothrombin time, DIC profile (FDP, D-dimer, and/or fibrin monomer), and fibrinogen, which are available in the most hospital laboratories. A combination of tests was proposed because no single test has an adequate predictive value to establish the diagnosis of DIC. The sensitivity and specificity of this DIC score were very high. Using this scoring system, an accurate diagnosis of DIC can be easily made. Further standardization and modification of this scoring test will make it more convenient to apply.

The cornerstone of the management of DIC is the specific and vigorous treatment of the underlying disorders. The suggestion that administration of blood components might “add fuel to the fire” has never been proved in clinical or experimental studies. Plasma or platelet transfusion therapy is indicated in patients with active bleeding and in those requiring an invasive procedure. A beneficial effect of heparin in patients with DIC has never been shown in controlled clinical trials. Heparin was only recommended to use in some special DIC situations, such as cancers, obstetrical complications (abruptio placentae, amniotic-fluid embolism), that thrombotic manifestations are predominant. All-trans-retinoid acid had also been well documented to control the DIC caused by APL. In addition, supportive treatments aimed at the inhibition of coagulation activation may theoretically be justified and were beneficial in experimental and initial clinical studies. These strategies comprised inhibition of TF-mediated activation of coagulation and restoration of physiological anticoagulant pathways. The recombinant activated protein C (rAPC) has been approved by the FDA in the USA (in November 2001) for adjuvant treatment of sepsis-related purpura fulminans. In addition to acting as an anticoagulant, rAPC also has direct anti-inflammatory and anti-apoptotic properties. But, the clinical trials of recombinant tissue factor pathway inhibitor (rTFPI), antithrombin (AT), and recombinant soluble thrombomodulin (sTM) failed to improve the survival of severe sepsis. Further breakthroughs will need a conceptual shift that emphasizes relations between the various mediators and factors that propagate generation of thrombin, especially with regard to the links between inflammation and coagulation.

Plasticity of Human Tissue Stem/Progenitor Cells

By Daniel Tzu-bi Shih

Grad. Inst. Cell & Mol. Biology,

Taipei Medical University

Biology of Stem Cell Plasticity is a major arm in the current stem cell biology program.

Several surprising observations proved that tissue-specific stem cells are capable, under suitable conditions, of producing a whole spectrum of cell types, regardless, whether these tissues are derived from the same germ layer or not. This ability is frequently called stem cell “plasticity” or “trans-differentiation”. In vivo, mesodermal stem/progenitor cells accumulate in bone marrow (BM) and being a mobile population are released into peripheral blood after tissue injury to regenerate damaged organs also including ectodermal, and endodermal tissues other than hematopoietic tissues, including liver, pancreas, kidney, lung, skin, gastrointestinal tract, heart, skeletal muscles, and neural tissues. In vitro, human BM tissue contains hematopoietic stem cell system, which differentiate into all mature blood cells, and marrow stromal cells (MSCs) that provide the microenvironment for hematopoietic stem/progenitor cells (HS/PCs) along with the capability to differentiate into mature cells of multiple mesodermal mesenchymal tissues including fat, bone, and cartilage. Studies on the plasticity of BM cells have therefore become a focus of interest because they suggest that clinical applications could be at hand using easily obtainable cells in the treatment of tissue damage or degenerative diseases.

Presently, however, definitive evidence explaining the mechanism of the plasticity of human tissue stem cells is controversial. Since better understanding of the plastistic nature of human tissue stem/progenitor cells may benefit for translational medicine with various devastating diseases such as leukemia, diabetes, spinal cord injury, stroke, and neural degenerative disorders, e.g. Parkinson’s and Huntington’s disease. In this communication, the current understanding and controversies in investigation of the plasticity or trans-differentiation potentiality of human and mouse tissue-derived stem cells at cell and molecular aspects will be discussed.

Non-myeloablative Allogeneic Stem Cell Transplantation in Hematologic Malignancy Experience of China Medical University Hospital

廖裕民 葉士芃 黃馨慧 林振源 邱昌芳

中國醫藥大學附設醫院 血液腫瘤科

Allogeneic hematopoietic stem cell transplantation has been increasingly used to treat hematologic malignancy. Those patients with acute and/or chronic graft-versus-host disease have better relapse-free survival. The evidence supports the graft-versus-malignancy effect in chronic myelocytic leukaemia, indolent lymphoma, acute myelocytic leukaemia and myeloma.

From 2000 till October 2004, eight patients received non-myeloblative allogeneic peripheral blood stem cell transplantation in China Medical University Hospital. The diagnosis of primary disease included multiple myeloma in 4 patients, chronic myelocytic leukaemia in 1 patient, Hodgkin’s disease in 1 patient, and acute myelocytic leukaemia in 2 patients. Two of those patients received two transplantations. No transplant-related mortality occurred. Seven of eight patients obtained complete donor chimerism. All of them are disease free. Two died on extensive chronic graft-versus-host disease. Severe post-transplant infection with multiple organ failure occurred in one patient. So, we presented our experience.

CD34-positive Selected Autologous Stem Cell Transplantation in High Risk non-Hodgkin's Lymphoma (NHL) Patients

林鵬展1、李明陽1、 傅雪美1、 鄧豪偉1、 施盈逸1、 林炯熙2、王緯書1、 顏厥全1、 趙大中1、 蕭樑材1、 楊慕華1、曾成槐2、 陳博明1、 邱宗傑1

1Peng-Chan Lin, 1Ming-Yang Lee, 1Say-Bee Poh, 1Hao-Wei Teng, 1Ying-Yih Shih, 2Jeong-Shi Lin, 1Wei-Shu Wang, 1Chueh-Chuan Yen, 1Ta-Chung Chao, 1Liang-Tsai Hsiao, 1Muh-Hwa Yang, 2Cheng-Hwai Tzeng, 1gPo-Min Chen, 1Tzeon-Jye Chiou M.D.

1Section of Medical Oncology and 2Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan

Purpose : The feasibility and efficacy of in vitro autologous positive selection of CD34+ peripheral blood stem cells (PBSCs) with a clinical scale method of magnetic- activated cell sorting system (CliniMACS) was evaluated in high-risk non-Hodgkin's lymphoma (NHL) patients.

Patients and Methods: Ten high-risk NHL patients were evaluated and treated with chemotherapy and autologous enriched CD34+ cell transplantation. Purging tumor cells from PBSCs are used to prevent lymphoma recurrence. PBSCs were mobilized with cyclophosphamide (4g/m2) plus G-CSF 10ug/kg/day, and leukophresis was performed for consecutive 3 days when white blood cell (WBC) > 3000/ul to harvest the PBSCs. After the harvest, patients were treated with high-dose C/T and SCT. The engraftment, post-transplant complications and survival status were closely monitored to evaluate the toxicity and efficacy of CD34+-selected transplantation.

Results: The results showed that a median of 4.4 × 1010 total nucleated cells (TNC) (range, 0.58 - 5.5 × 1010) were colleted with median 99.52% (range, 90% - 99.84%) purity rate and a median recovery rate was 97.9% (range, 45% - 99%). After re-transfusion of CD34-selected cells, the median recovery time of neutrophil and platelet was absolute neutrophil count (ANC) of 500/µL at day +12 (range, 9 - 24) and platelet count of 20,000/µL at day +13(range, 4 - 27), respectively. Two patients developed liver toxicities, one patient with HBV carrier developed grade III-IV liver toxicities post transplantation 3 months later and the other developed grade I-II liver toxicities post transplantation 1 month later. No other complications were noted. One patient, tumor relapsed 5 months after auto-PBSCT. The immunological surveillance and TRM will be reported later.

Conclusions: Our study showed that CliniMACS is an effective, CD34-positive selection method with good recovery and purity rate without compromising the hematopoietic reconstitution capacity of the graft in NHL patients.

Successful treatment of advanced breast cancer with allogeneic nonmyeloablative stem cell transplantation: A case report

衛生署豐原醫院內科 樊 聖

The patient, Miss Chiang, 40-years-old, received lumpectomy for her left breast invasive duct carcinoma in Oct. 2001. The tumor was ER-negative, PR-negative, and axillary lymph nodes-negative. Adjuvant radiotherapy and chemotherapy with cyclophosphamide, methotrexate, and fluorouracil were prescribed after surgical treatment. Unfortunately, recurrence with multiple bony metastasis was found in Feb. 2004. Along with local radiotherapy to right humerus, spine, and pubic bone, salvage chemotherapy with doxorubicin and paclitaxel was given since Mar. 2004. Unfortunately, the response duration was very short and pulmonary metastasis occurred in Jun. 2004. After explanation of the expected dismal outcome of continuous chemotherapy to the patient and her family, they agreed for allogeneic nonmyeloablative stem cell transplantation (NST) as an immunotherapy for rescue in July. The conditioning regimen composed of cyclophosphamide and fludarabine. Cyclosporine was used for GvHD prophylaxis. Peripheral blood stem cells were harvested from the patient’s HLA-completely-matched younger brother. Cell loading was 1.64x106/kg CD34+ cells. On day 7, absolute neutrophil count was above 500/ul and there was no necessity of platelet transfusion ever since. Cyclosporine was tapered from day 21 and discontinued on day 60. Donor DNA in the peripheral blood became 100% after cyclosporine was removed as judged by short tandem repeat analysis. Progressive decrease of tumor marker CA-153 to normal range took place since the beginning of NST. CT scan and bone scan revealed almost complete remission of the pulmonary and bony lesions seven months after NST. Chronic limited GvHD was noted and was easily controlled with prednisolone. The exciting result surely encourages us to do more NST for advanced breast cancer in the future.

Treatment of Corticosteroid-refractory GVHD with Sirolimus: The CMUH Experience

林振源，葉士芃，黃馨慧，廖裕民，邱昌芳

Chen-Yuan Lin, Su-Peng Yeh, Hsin-Hui Huang, Yu-Mine Liao, Chang-Fang Chiu

中國醫藥大學附設醫院血液腫瘤科

Division of Hematology and OncologyChina Medical University Hospital

Graft-versus-host disease (GVHD) remains a major complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the prognosis of corticosteroid- refractory GVHD is dismal. A more effective agent to prevent or control the progress of steroid-refractory GVHD is eagerly needed. Sirolimus has been approved for the prophylaxis or treatment of acute or chronic rejection after solid organ transplantation, specifically in renal transplantation. It is a macrocyclic lactone with a novel mechanism of immunosuppressive action. In the past four years, it had also been applied to prevent or treat GVHD after allo-HSCT and favorable response was found in Phase II studies and many phase III clinical trials are ongoing now. We had treated three patients of steroid-refractory GVHD with sirolimus in this year. Patient No.1 had extensive cGVHD involving liver, GI tract, and lacrimal gland. Patient No.2 had extensive cGVHD with severe ocular involvement. Patient No.3 had aGVHD involving liver, skin, and oral cavity. All of them had been treated with pulse-steroid in combination with other immunosuppressive agents and were ineffective. After the administration of sirolimus, good response was achieved in patients No.2 and 3. More detail information will be presented in the meeting.

The role of SOCS1 (suppressor of cytokine signaling 1) and SOCS3 (suppressor of cytokine signaling 3) in patients with GVHD (graft versus host disease) after peripheral blood stem cell transplantation

楊文祺、劉益昌、蕭惠樺、劉大智、陳田柏、林勝豐

高雄醫學大學內科部血液腫瘤科

Suppressors of cytokine signaling (SOCS) proteins have been identified as inhibitors of cytokine signaling and have been shown to act in a classical feedback loop. The SOCS family proteins contain a central SH2 domain and a conserved C-terminal SOCS box thought to interact with an E3-lagase complex. To date, a number of mechanisms have been suggested through which the SH2 domain can bind to phosphotyrosines on signaling intermediates, particularly receptor chains and Jaks, leading to the inhibition of signal transduction or blocking STAT recruitment to the receptors. There are eight SOCS family members. The SOCS1 and SOCS3 proteins inhibit the signaling of many cytokines including leukemia inhibitory factor (LIF), interferons, interleukin (IL)-2, IL-3, IL-4, IL-6, erythropoietin, thrombopoietin, and other cytokines, by binding to phosphorylated Y1007 within the JAK2 activation loop and regulates JAK activity. One paper has been shown that the myeloablative mice (with lethal irradiation) who was transplanted with SOCS1-/- bone marrow cells appeared the symptoms and signs of graft versus hose disease.

GVHD (graft versus graft disease) occurs when genetically disparate lymphocytes are transferred into an immunologically compromised recipient incapable of rejection the donor graft. The induction and release of cytokines (eg., IL-2, IL-3, TNF( tumor necrosis factor)) might be important in the development and maintenance of GVHD reaction. Acute GVHD is one of the most lethal complications after peripheral blood stem cell transplantation. The risk of severe, life-threatening acute GVHD is approximately 15% following transplantation between HLA-identical siblings.

As the SOCS1 protein has a universal activity in the negative regulation of several cytokine-signaling pathways, the loss of this regulation could play a role in abrupt inflammatory reaction of acute graft-versus-host disease. SOCS3 is another member of the SOCS family. It has similar activity in the regulation of several cytokine-signaling pathways. Aim 1: We want to know the role of SOCS1 and SOCS3 proteins in patients who got GVHD after peripheral blood stem cell transplantation. Aim 2: Then try to find the mechanism and discuss the cause of developing GVHD. Initial results showed that all of SOCS1 and SOCS3 proteins are in cytoplasm and PMN cells by immunocytochemical stain. In one patient with acute GVHD, the expression amount of SOCS1 and SOCS3 proteins were significantly lower than the other 2 patients without acute GVHD post-PBSCT ( ................
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