第 152 次聯合學術研討會 

時間 : 民國 101 年 12 月 15 日 ( 星期六 ) 

地點 : 中國醫藥大學附設醫院癌症大樓 1 樓階梯教室 

會長 : 葉士芃主任 

時間 

演講題目 

13:00 起報到 

13:30-13:35 會長葉士芃主任致歡迎詞 

13:35-13:40 中華民國血液病學會田蕙芬理事長致開幕詞 

專題演講主持人 : 

13:40-14:30 講題 :Latest Topics of HSCT for AML – Fine Tuning of Reduced Intensity 

and Reduced Toxicity Conditioning for Allogeneic Stem Cell 

Transplantation in AML 

主講人 :Professor Arnon Nagler, MD, MSc 

會員演講 (I) 主持人 : 

14:30-14:40 〔01〕A Chimeric Receptor with NKG2D Specificity Enhances Natural Killer 

Cell Activation and Killing of Tumor Cells 

張裕享 / 高雄榮民總醫院小兒血液腫瘤科 

14:40-14:50 〔02〕Haploidentical Transplant Is Feasible when Using Combined BM and 

PBSC as Stem Cells Source: A Case Experience at NTUH 

黃威翰 / 台大醫院內科部血液科 

14:50-15:00 〔03〕Monoclonal Gammopathy of Undetermined Significance Related Pyoderma 

Gangrenosum Refractory to Autologous Peripheral Blood Stem Cell 

Transplantation Was Treated with Allogenous Peripheral Blood Cell 

Transplantation 

陳彥谷 / 台中榮民總醫院血液腫瘤科 

15:00-15:20 Coffee Break 

會員演講 (II) 主持人 : 

15:20-15:30 〔04〕Diffuse Large B-cell Lymphoma of Testis in CGMH 

施宣任 / 林口長庚紀念醫院血液腫瘤科 

15:30-15:40 〔05〕FcgRIIIa 158 V/F Polymorphism Correlated with Rituximab-induced Late 

Onset Neutropenia in Newly-diagnosed B-cell Lymphoma but Not 

Correlated with Long-term Survival: A prospective study of Single 

Institute, Ten-year Follow-up 

賴泓誌 / 大林慈濟醫院血液腫瘤科 

15:40-15:50 〔06〕Synchronous Primary Brain Large B-cell Lymphoma and Metastatic Renal 

Cell Carcinoma 

盧介聖 / 三軍總醫院血液腫瘤科

15:50-16:00 〔07〕Small Lymphocytic Lymphoma Complicated with Chylothorax: Case 

Report and Review of the Literature 

許彥寧 / 中山醫學大學附設醫院血液科 

16:00-16:10 〔08〕Chronic Lymphocytic Leukemia Cells in Ascites Detected by Clonality 

Analysis Using Gene Rearrangement Assay 

黃彥閔 / 林口長庚紀念醫院血液腫瘤科 

16:10-16:20 〔09〕Influence of Gender on the Prognosis on Adult Patients with Acute Myeloid 

Leukemia 

連銘渝 / 中國醫藥大學附設醫院血液腫瘤科 

備註 : 

會員演講 (III) 主持人 : 

16:20-16:30 〔10〕Primary Myeloid Sarcoma of Right Neck 

曾瑞如 / 台中榮民總醫院小兒血液腫瘤科 

16:30-16:40 〔11〕Multiple Myeloma with Unusual Clinical Presentation 

蔡明宏 / 中山醫學大學附設醫院血液科 

16:40-16:50 〔12〕Pulmonary Embolism after Vertebroplasty in Patient with Multiple 

Myeloma 

周政緯 / 台中榮民總醫院血液腫瘤科 

16:50-17:00 〔13〕Adherence to Deferasirox Treatment for Low Risk Myelodysplastic 

Syndrome with Hematological Improvement 

賴冠銘 / 彰化基督教醫院血液腫瘤科 

17:00-17:10 〔14〕Hepatitis B Virus Reactivation in a Chronic Myeloid Leukemia Patient 

Receiving Imatinib 

李品萱 / 彰化基督教醫院血液腫瘤科 

17:10-17:20 〔15〕Thrombotic Thrombocytopenic Purpura Presenting with Acute Myocardial 

Infarction: A Case Report 

賴學緯 / 三軍總醫院血液腫瘤科 

17:20-17:25 中華民國血液及骨髓移植學會林凱信理事長致閉幕詞 

18:00- 晚宴 ( 台中僑園大飯店漂亮廳 ) 

專講演講 : 演講 50 分鐘 , 討論 2 分鐘。47 分鐘鈴響一聲 ,48 分鐘鈴響兩聲 , 請結束演講。 

會員演講 : 每題演講 8 分鐘 , 討論 2 分鐘。7 分鐘鈴響一聲 ,8 分鐘鈴響兩聲 , 請結束演講。 

主辦單位 : 中華民國血液病學會、中華民國血液及骨髓移植學會 

協辦單位 : 中國醫藥大學附設醫院 

贊助單位 : 台灣協和醱酵麒麟股份有限公司

CURRICULUM VITAE 

Professor Arnon Nagler, MD, MSc 

Arnon Nagler, MD, MSc, is Director of both the Division of Hematology and the 

Bone Marrow transplantation and Cord Blood Bank at the Chaim Sheba Medical 

Center, Tel Hashomer, Israel and Professor of Medicine at the Tel Aviv University, Tel 

Aviv, Israel. 

Dr Nagler received his medical training at the Hebrew University-Hadassah Medical 

School, Jerusalem, Israel, specializing in hematology at the Rambam Medical Center, 

Haifa, Israel. He carried out a Postdoctoral research fellowship in hematology and 

bone marrow transplantation at "Stanford University Hospital" Palo Alto, CA, in the 

USA, from 1986 to 1990. 

Dr. Nagler has been working in the fields of bone marrow transplantation for 

hematological malignancies, including NHL, and hemato-oncology, for the last 20 

years. His main clinical interests include stem cells, bone marrow transplantation, 

hematological malignancies, cord blood biology, and adoptive cell-mediated 

immunotherapy. Dr Nagler established the first public cord blood bank in Israel and 

performed the first cord blood transplantations from related and unrelated donors in 

genetic and malignant hematological disease in Israel. Dr Nagler is a member of 

multiple national and international societies and committees in the field. He serves on 

the Editorial Board of several journals and is a Section Editor for Leukemia. Dr 

Nagler has written numerous articles, reviews and chapters for peer-review journals, 

and is the principal investigator for a number of clinical studies. In addition, he has 

made numerous, invited, international presentations and has received several awards.

Latest Topics of HSCT for AML – Fine Tuning of Reduced Intensity and Reduced 

Toxicity Conditioning for Allogeneic Stem Cell Transplantation in AML 

Professor Arnon Nagler, MD, MSc 

待補

〔01〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

一個具有 NKG2D 專一性的嵌合受體加強自然殺手細胞之活化和腫瘤毒殺 

A Chimeric Receptor with NKG2D Specificity Enhances Natural Killer Cell 

Activation and Killing of Tumor Cells 

原著 (Original Article) 

Acute Leukemia 

張裕享 

1 , John Connolly 3 , Noriko Shimasaki 2 , Kousaku Mimura 4 , Koji Kono 4 , and 

Dario Campana 2 

Yu-Hsiang Chang 1 , John Connolly 3 , Noriko Shimasaki 2 , Kousaku Mimura 4 , Koji 

Kono 4 , and Dario Campana 2 

1 

高雄榮總兒科 2 新加坡大學兒科 3 新加坡免疫網絡 ,A*STAR 4 新加坡大學外科 

Affiliations 1 Department of Pediatrics, Kaohsiung Veterans General Hospital1 

2 

Department of Pediatrics, National University of Singapore, Singapore 117599; 

3 

Singapore Immunology Network, A*STAR, Singapore 138648 

4 

Department of Surgery, National University of Singapore, Singapore 119228 

Abstract 

關鍵字 

Keyword 

Purpose: 

We expressed this receptor(“NKG2D-DAP10-CD3zeta”) in human activated NK 

cells, and tested whether its supra-physiologic activating signals could augment tumor 

cell killing. 

Materials & Methods: 

After cloning the genes encoding these three molecules and assembling them into a 

single construct (NKG2D-DAP10-CD3zeta), we used a retroviral vector to express 

them in human NK cells. 

Results: 

Retroviral transduction of NKG2D-DAP10-CD3zeta markedly increased NKG2D 

surface expression in NK cells (n=21; P

〔02〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

以合併骨髓及周邊造血幹細胞為半相合移植之幹細胞來源是可行的 - 一位病患之個 

案報告 

Haploidentical Transplant Is Feasible When Using Combined BM and PBSC as Stem 

Cells Source: A Case Experience at NTUH 

病例報告 (Case Report) 

Hematopoietic Stem Cell Transplantation Including Stem Cell Biology 

黃威翰、李啟誠、姚明、柯博升、林建廷、劉家豪、唐季祿 

Wei-Han Huang 1 , Chi-Cheng Li 1,2 , Ming Yao 1 , Bor-Sheng Ko 1 , Chien-Ting Lin 1,2 , Jia- 

Hau Liu 1,2 , Jih-Luh Tang 1,2 

1 

台大醫院內科部血液科 2 台灣大學台成幹細胞治療中心 

Affiliations 1 Division of Hematology, Department of Internal Medicine, National Taiwan 

University Hospital 2 Tai-Cheng Stem Cell Therapy Center, National Taiwan University 

Abstract 

關鍵字 

Keyword 

Introduction: 

Haploidentical transplant 

Case presentation: 

A 55 years old woman underwent haploidentical transplantation with combining BMSC 

and PBSC 

Conclusions: 

Haploidentical transplant with combined BMSC and PBSC as stem cell source is 

feasible 

半相合移植、骨髓幹細胞、周邊造血幹細胞 

Haploidentical Transplant, Bone Marrow Stem Cells, Peripheral Blood Stem Cells 

著作權授權同意書 : 本人不同意將本次投稿主題之會員演講幻燈片掛網。

〔03〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

在未知臨床意義的單株免疫球蛋白增高合併壞疽性膿皮病的病患接受異體幹細胞移植可改善皮膚 

病灶及血液中免疫球蛋白之比例 

Monoclonal Gammopathy of Undetermined Significance Related Pyoderma Gangrenosum Refractory to 

Autologous Peripheral Blood Stem Cell Transplantation Was Treated with Allogenous Peripheral Blood 

Cell Transplantation 


Hematopoietic Stem Cell Transplantation Including Stem Cell Biology 

陳彥谷、滕傑林、黃文豊 

Yeh-Ku Chen, Chieh-Lin Teng, Wen-Li Hwang 

台中榮民總醫院血液腫瘤科 

Affiliations Division of Hematology/Oncology, Department of internal medicine of Taichung Veterans General 

Hospital 

Abstract 

關鍵字 

Keyword 

Introduction: 

Various kinds of skin disorders have been associated with monoclonal gammopathy. Some of these 

dermatologic disorders directly relate to the malignant plasma cells infiltration, but some are associated 

with the M protein. It is uncommon, however, that patients with MGUS manifest severe dermatologic 

diseases, especially pyoderma gangrenosum. Standard treatment to MGUS-related dermatologic 

disorders remains unclear. 


A 33-year-old man suffered from rapidly enlarging pustular papules and plagues that ulcerated the 

necrotic base over his left leg 5 years ago. His serum immuno-electrophoresis revealed IgA-λ 

monoclonal gammopathy (IgA 782 mg/dL, normal 70-400 mg/dL; κ/λ 1.17, normal 1.35-2.69). Bone 

marrow examination disclosed slight plasmacytosis, which was less than 10% of all the nucleated cells. 

Without anemia (Hb: 12.7 mg/dl; normal 12-14 mg/dl), thrombocytosis (platelet count 426 x 10^9 /l; 

normal 150-430 x 10^9 /l), osteolytic lesions, and impaired renal function, he was diagnosed as MGUS, 

IgA-λ, complicated with pyoderma gangrenosum. 

The patient was initially treated with methylprednisolone pulse therapy, but the response duration was 

short. He was then treated as having myeloma, but neither thalidomide nor chemotherapy with 

vincristine, adriamycin, and decadron regimen(VAD) was effective. High-dose cyclophosphamide 

(4g/M^2) was given, and his peripheral blood hematopoietic stem cells were collected. Consequently, he 

received autologous PBSCT with 6.5 x 10^ 6/kg CD34+ cells infusion. Conditioning regimen included 

total body irradiation(6 Gy) and melphalan(140 mg/M^2). After the PBSCT, his skin has been free of 

lesions for 18 months. Serum immuno-electrophoresis could not detect the IgA-λ M-protein either. 

18 months after autologous PBSCT , progressive swelling, erythematous change with pain were noted 

over right lower leg gradually. IgA level elevated, and then he received decadron with thalidomide for 

disease replase of MGUS. The next month, he received four cycles VTD regimen (Velcade and 

Thalidomide and Decadron), and good response for his skin lesion was noted. Then he received 

allogenous peripheral blood stem cell transplantation(PBSCT) (day on 2012/10/23) conditioned by RIC 

from a mis-matched unrelated donor, with engraftment (on 2012/10/31). Then he was followed up at 

hematologic clinic regularly. 

Conclusion: 

Since the pathogenesis of pyoderma gangrenosum basically comes from the plasma cells or secreted M- 

protein, it may be reasonable to treat this scenario as myeloma. Due to disease relapse even after 

autologous PBSCT., allogenous PBSCT might be one of the options for patient with monoclonal 

gammopathy-related dermatologic disorders refractory to steroid and chemotherapy. 

未知臨床意義的單株免疫球蛋白增高、壞疽性膿皮病、幹細胞移植 

Monoclonal Gammopathy of Undetermined Significance, Pyoderma Gangrenosum, Stem Cell 

Transplantation 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於血液病學會網站上 

供該會會員瀏覽下載。

〔04〕 

中文標題 

Title 

性質 

內容 

作者 

林口長庚醫院的睪丸瀰漫性大 B 細胞淋巴瘤 

Diffuse Large B-cell Lymphoma of Testis in CGMH 


Lymphoma, CLL, and Myeloma 

施宣任 

1 、施麗雲 

1,2 、王博南 

1 、張鴻 

1 、吳金和 

1 、郭明宗 

1 、洪玉馨 

1 、鄧波 

Author Hsuan-Jen Shih 1 , Lee-Yung Shih 1,2 , Po-Nan Wang 1 , Hung Chang 1 , Jin-Hou Wu 1 , 

Ming-Chung Kuo 1 , 1 Yu-Shin Hung, Po Dunn 1,2 

單位 

1 

林口長庚紀念醫院血液腫瘤科、 2 長庚大學醫學系 

Affiliations 1 Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung 

Memorial Hospital, Taiwan 

2 Chang Gung University, College of Medicine, Taoyuan, Taiwan 

Abstract 

關鍵字 

Keyword 

We retrospectively reviewed 3,490 patients with non-Hodgkin's lymphoma diagnosed 

between Jan 1995 and Jun 2012 in Chang Gung Memorial Hospital in Linkou. The 

initial presentation was a testicular mass in twenty-two (0.6%) patients, all of whom 

had histologically proven lymphoma. Nineteen patients received orchiectomy while 3 

received biopsy alone. Two patients had Burkitt's lymphoma and one with diffuse 

large B-cell lymphoma (DLBCL) was lost to follow-up after diagnosis. Thus, 19 

patients with DLBCL were available for analysis. The median age was 69 years (range 

38.2 to 89.7 years). Sixteen patients had unilateral testis involvement (eight patients 

on each side). Three patients had bilateral testicular enlargement. The tumor stages 

according to the Ann Arbor system were IEA (10 cases), IIEA (5 cases), IIIEA (1 

case), IVA (2 cases), and IVB (1 case). The three patients in stage IV had extra-nodal 

involvement in skin, spine, and pleural effusion. The median overall survival (OS) and 

progression free survival (PFS) were 36.3 and 28.3 months for the 19 patients, 

respectively. 

Three stage IE patients received orchiectomy with or without scrotum radiotherapy 

(RT), and 16 patients received chemotherapy with or without orchiectomy or scrotum 

RT. Fifteen (78.9%) of the 19 patients achieved complete remission (CR) after initial 

treatment. The patients who achieved CR had a longer median OS and PFS than those 

who did not (60.1 vs. 3.0 months and 47.1 vs. 3.0 months, p < 0.001 and p < 0.001). 

Eight patients (53%) developed a recurrence. Two relapsed in inguinal lymph nodes, 1 

in retroperitoneal lymph node, brain, duodenum, kidney, soft tissue at back and bone 

marrow, and maxillary sinus each. Only 3 patients had achieved a second remission 

after salvage chemotherapy or local RT. None out of the 7 patients received 

prophylactic intrathecal chemotherapy (ITC) developed central nervous system (CNS) 

disease, in contrast, 1 out of the 12 patients who did not receive ITC developed CNS 

disease. Patients in low to low/intermediate International Prognostic Index (IPI) risk 

group had longer median OS and PFS (47.1 vs. 3.4 months, p = 0.04 and 28.3 vs. 3.4 

months, p = 0.04). 

In conclusion, similar to those reported in the literature, the testicular lymphoma is 

rare and affects elderly persons. The prognosis is poor because of the high relapse 

rate. Patients with testicular DLBCL have a better outcome if initial IPI score is low. 

瀰漫性大 B 細胞淋巴瘤、睪丸 

Diffuse Large B-cell Lymphoma, Testis 

著作權授權同意書 : 本人不同意將本次投稿主題之會員演講幻燈片掛網。 

1,2

〔05〕草稿 

中文標題 

Title 

性質 

內容 

作者 

FcgRIIIa 158 V/F 基因變異性與 Rituximab 在新診斷之 B 細胞淋巴癌引起之晚發 

性白血球低下相關 , 但與長期存活情形無相關性 - 單一醫院前瞻性研究 ,10 年追蹤 

報告 

FcgRIIIa 158 V/F Polymorphism Correlated with Rituximab-induced Late Onset 

Neutropenia in Newly-diagnosed B-cell Lymphoma but Not Correlated with Longterm 

Survival: A prospective study of Single Institute, Ten-year Follow-up 



賴泓誌 

1 、李思錦 

1 、余芝嘉 

3 、蘇裕傑 

Author Hung-Chih Lai 1 , Szu-Chin Li 1 , Chi-Chia Yu 3 , Yu-Chieh Su 1,2* 

單位 

1 

大林慈濟醫院血液腫瘤科、 2 慈濟大學醫學院、 3 嘉義大學 

Affiliations 1 Division of Hematology–Oncology, Department of Internal Medicine, Buddhist 

2 School of Medicine, Tzu Chi University, Hualian, Taiwan 

3 Department of Biochemical Science and Technology, National Chiayi University, 

Abstract 

Chiayi, Taiwan 

1,2* 

後補 

關鍵字 

Keyword 

基因多型性 , 莫須瘤 , 晚發性白血球低下症 , 長期存活情形 

polymorphism, Rituximab, late onset neutropenia, long-term survival 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於 

血液病學會網站上供該會會員瀏覽下載。

〔06〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

原發性腦部大型 B 細胞淋巴瘤與轉移性腎細胞癌 

Synchronous Primary Brain Large B-cell Lymphoma and Metastatic Renal Cell 

Carcinoma 



盧介聖、劉智軒、林信仲、戴明燊 

Cheih-Sheng Lu, Jhih-Syuan Liu, Hsin-Chung Lin, Ming-Shen Dai 

三軍總醫院血液腫瘤科 

Affiliations Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service 

General Hospital, National Defense Medical Center, Taipei, Taiwan 

Abstract 

關鍵字 

Keyword 

Introduction: 

Targeting PI3K/AKT/mTOR pathway in B-cell non-Hodgkin lymphomas (B-NHL) is 

important, and various small-molecule rapalogs focus on the prototype rapamycin 

including temsirolimus with less immunosuppression has been reported. This is the first 

report of single-agent activity of temsirolimus in patient with coexistence of renal cell 

carcinoma and central nervous system diffuse large B cell lymphoma. 

Case: 

A 73-year-old male patient presented with right-sided progressive hemiparesis. The 

magnetic resonance imaging (MRI) of brain showed a gadolinium-enhanced tumor in 

the left parietal lobe with significant perifocal edema. Besides, abdominal ultrasound 

indicated a heterogeneous echogenic lesion in right kidney. Emergent craniotomy with 

removal of brain tumor demonstrated a diffuse large B cell lymphoma. The follow-up 

magnetic resonance imaging with contrast of brain indicated a minimal residual tumor. 

Percutaneous biopsy of right renal tumor showed clear cell renal cell carcinoma. 

Coexistence of renal cell carcinoma and central nervous system diffuse large B cell 

lymphoma were diagnosed. His brain lymphoma did not respond to subsequent 

chemotherapy (Rituximab and high-dose methotrexate) and palliative irradiation. His 

renal tumor became larger during the period of chemotherapy. Targeted therapy with 

temsirolimus was initiated and the brain lesion showed apparent interval regression and 

stable disease in RCC. Unfortunately, the patient died of infectious complication 5 

months later. 

Conclusion: 

This is the first report of single-agent activity of temsirolimus in patient with 

coexistence of renal cell carcinoma and central nervous system diffuse large B cell 

lymphoma. Although the patient died secondary to sepsis, temsirolimus did control the 

synchronous double primary malignancies significantly. The obvious activity of 

monotherapy temsirolimus in patients with RC and central nervous system DLBCL is 

encouraging and promising strategy. 

特癌適、腎細胞癌、瀰漫性大型 B 細胞淋巴瘤、mTOR 

Temsirolimus, Renal Cell Carcinoma, Diffuse Large B Cell Lymphoma, mTOR 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於血 

液病學會網站上供該會會員瀏覽下載

〔07〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

小淋巴球性淋巴癌合併乳糜胸 : 病例報告及文獻回顧 

Small Lymphocytic Lymphoma Complicated with Chylothorax: Case Report and 

Review of the Literature 



許彥寧、黃偉修、蕭培靜 

Yen-Ning Hsu, Wei-Shou Hwang, Pei-Ching Hsiao 

中山醫學大學附設醫院內科部血液腫瘤科暨中山醫學大學醫學系 

Affiliations Department of Hematology, Chung Shan Medical University Hospital and Chung 

Shan Medical University 

Abstract 

關鍵字 

Keyword 

Introduction: 

Chylothorax occurs when a disruption in the thoracic duct allows chyle to escape into 

the pleural space. The most commonly reported cause is malignancy, especially 

lymphoma. However, chylothorax caused by small lymphocytic lymphoma (SLL)is 

rarely reported in the literature. 


We describe a 50-year-old lady, suffered from oral ulcer and redness of eye 5 months 

ago, was found shortness of breath in admission. Chythorax was diagnosed by 

thoracocentesis, however, treatment was in vain despite NPO + TPN without lipid. 

History of low grade lymphoma was told later by the patient in 2004, and she was then 

found left perirenal and pararenal mass. Biopsy showed SLL. So chemotherapy with 

COP was tried. After 3 cycle of COP, follow up image showed decreased of the tumor 

size, but she suffered from persistent chythorax. 

Conclusion: 

The pathologenesis, diagnosis, treatment of chylothorax and the relationship between 

lymphoma and chylothorax are reviewed. 

小淋巴球性淋巴癌、乳糜胸 

Small Lymphocytic Lymphoma, Chylothorax 


〔08〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

以基因重組方法診斷腹水中慢性淋巴性白血病細胞 

Chronic Lymphocytic Leukemia Cells in Ascites Detected by Clonality Analysis 

Using Gene Rearrangement Assay 



黃彥閔、洪玉馨、施麗雲 

Yen-Min Huang, Yu-Shin Hung, Lee-Yung Shih 

林口長庚紀念醫院血液科 

Affiliations Division of Hematology, Department of Internal Medicine, Chang Gung Memorial 

Hospital, Linkou, Taiwan 

Abstract 

關鍵字 

Keyword 

Ascites is an uncommon manifestation of chronic lymphocytic leukemia. The 

diagnosis of chronic lymphocytic leukemia (CLL) involvement is mainly based on 

morphologically and immunophenotypically similar to peripheral blood and bone 

marrow cells. However, it is relatively difficult to make a diagnosis of CLL 

involvement due to the pleomorphism of lymphocytes in ascites. Here we present a 

patient with diagnosis of CLL before. Three years after diagnosis, he suffered from 

massive transudative ascites. The etiology including heart, liver, or infection were 

surveyed but were all negative. Predominant T lymphocytes in ascites made it difficult 

to make immunophenotypical diagnosis by flow cytometry. We applied clonality 

analysis of immunoglobulin gene rearrangements on lymphocytes from ascites to 

diagnose the involvement of CLL, which was compatible with the pathological 

findings. 

慢性淋巴性白血病、腹水、基因重組 

Chronic Lymphocytic Leukemia, Ascites, Gene Rearrangements 


〔09〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

Influence of Gender on the Prognosis on Adult Patients with Acute Myeloid Leukemia 

Influence of Gender on the Prognosis on Adult Patients with Acute Myeloid Leukemia 



連銘渝、林柏翰、葉士芃、邱昌芳 

Ming-Yu Lien, Po-Han Lin, Su-Peng Yeh, Chang-Fang Chiu 

中國醫藥大學附設醫院血液腫瘤科 

Affiliations Division of Hematology and Oncology, Department of Internal Medicine 

Abstract 

關鍵字 

Keyword 

Purposes: 

Prior studies suggested that hormone influence the leukemic cell survival, but the 

prognostic value of gender on the survival of adult acute myeloid leukemia (AML) 

was unknown. Therefore, from hypothesizing hormone may affect the prognosis of 

AML patients, we investigated the hypothesis that gender was associated the 

prognosis and the interaction between gender and the survival depends including, age, 

comorbidities, therapy methods, complications and period of diagnosis. 

Patients and Methods: 

We extracted data from the National Health Insurance system of Taiwan between 

2002 and 2010. A total of 6571 AML patients were enrolled into this study. Cox 

proportional hazards regression analysis was used to estimate the hazards ratios of 

overall survival (OS) and corresponding 95% confidence interval (CI) for controlling 

risks, including age, gender, comorbidities, therapy methods, complications and 

period of diagnosis. 

Results: 

Both in univariate and multivariate analysis, female patients had longer OS than male 

patients (univariate: hazard ratio [HR]=1.21, 95% CI, 1.14-1.28; multivariate: 

HR=1.10, 95% CI, 1.04-1.17). This result is compatible well with SEER Cancer 

statistics Review 1975-2009, which showed female patients had a significantly longer 

5-year relative survival than males in the period of 2002-2008 for Whites, Blacks and 

all races (survival rate of all: male vs. female, 21.9% vs. 27.3%, p

〔10〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

右頸部原發性髓細胞肉瘤之病例報告 

Primary Myeloid Sarcoma of Right Neck 



曾瑞如、黃芳亮、張德高 

Jui-Ju Tseng, Fang-Liang Huang, Te-Kau Chang 

台中榮民總醫院小兒血液腫瘤科 

Affiliations Department of Pediatric Oncology/Hematology, Taichung Veterans General Hospital, 

Taichung 

Abstract 

關鍵字 

Keyword 

Introduction: 

Isolated primary myeloid sarcoma without evidence of systemic malignant blasts is rare 

in pediatric oncology. Skin infiltration is the most frequent localization. Other sites are 

also reported which include reproductive organs, lymph nodes, soft tissues, orbits, 

CNS, bone, pericardium, and liver. 


A 13-years-old boy, a case of G6PD deficiency, was admitted to our hospital for 

progressive enlargement of right neck mass. He has history of right neck mass for one 

month, which was accompanied with hoarseness, dysphagia and difficulty in mouth 

opening. He denied weight loss, night sweating, or fever. During admission, a mass 

about 2 cm in size over right neck was revealed by neck CT. Initial blood studies were 

as followed: WBC: 5600/mm3 (neutrophil: 73.3 %, and lymphocyte: 19.5%), 

hemoglobin: 12.1 mg/dl, platelet: 268,000/mm3, sodium: 139 mEq/dl, potassium: 4.3 

mEq/dl, calcium: 9.4 mg/dl, uric acid: 4.4 mg/dl, LDH: 229 IU/L, GPT: 10 U/I and 

creatinine: 0.5 mg/dl. The result of biopsy of neck mass was diffuse infiltration of 

medium immature blast - like cell with immunohistochemical stain of focal positive in 

MPO and positive in LCA and negative in desmin and chromograin. The bone marrow 

biopsy was normal. Negative results of Image study with lung CT and whole body 

bone scan were noted. Isolated myeloid sarcoma over right neck was impressed. 

Chemotherapy with TPOG AML 97A was implanted. He was still having 

chemotherapy. Disease is under the status of complete remission. 

Conclusion: 

According to the experience of previous studies, patients with isolated primary myeloid 

sarcoma may subsequently developed acute myeloid leukemia, and the prognosis is 

poor. Intensive AML- specific chemotherapy is recommended after diagnosis. The role 

of HSCT and radiation therapy in the treatment of isolated primary myeloid sarcoma is 

still under investigated. 

原發性髓細胞肉瘤、急性骨髓性白血病 

Priamry Myeloid Sarcoma, Acute Myeloblastic Leukemia 


〔11〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

罕見的多發性骨髓瘤臨床表現 

Multiple Myeloma with Unusual Clinical Presentation 



蔡明宏、許彥寧、黃偉修、蕭培靜 

Ming-Hung Tsai, Yen-Ning Hsu, Wei-Shou Hwang, Pei-Ching Hsiao 

中山醫學大學附設醫院內科部血液科 

Affiliations Division of Hematology, Department of Internal Medicine, Chung Shan Medical 

University Hospital 

Abstract 

關鍵字 

Keyword 

MM is characterized by the neoplastic proliferation of a single clone of plasma cells 

producing a monoclonal immunoglobulin. This clone of plasma cells proliferates in the 

bone marrow and often results in extensive skeletal destruction with osteolytic lesions, 

osteopenia, and/or pathologic fractures. The diagnosis of MM is often suspected 

because of bone pain with lytic lesions, increased total protein (monoclonal protein in 

the urine or serum), unexplained anemia, hypercalcemia, or acute renal failure.In our 

presentation, we describes three MM patients with unusual clinical presentation, which 

include left lung plasmacytoma combined with massive pleural effusion, rheumatoid 

arthritis-like polyarthritis and multiple intra-abdominal lymphoadenopathy with initial 

diagnosis of hepatocellular carcinoma. Pleural effusion in multiple myeloma occurs in 

about 6% of patients and is due to several etiologies requiring different types of 

therapy. These etiologies are most commonly, heart failure secondary to amyloidosis, 

followed by: pulmonary embolism, chronic renal failure, second neoplasm and pleural 

myelomatous involvement. Pleural effusion secondary to pleural involvement has been 

rarely reported in the literature but this condition as the first manifestation of multiple 

myeloma is exceptional. Rheumatoid arthritis -like polyarthritis is a very rare initial 

clinical manifestation of multiple myeloma, when serological marker of rheumatoid 

arthritis, such as FR and anti-CCP antibody are negative in patients with polyarthritis, 

cancer related arthritis might be a clue for differential diagnosis, such MM, MDS or 

lung cancer, and an intensive early cancer detection should be performed as soon as 

possible. 

多發性骨髓瘤、關節炎、肋膜積水、肝癌 

Multiple Myeloma, Arthritis, Pleural Effusion, Heaptocellular Carcinoma 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於 

血液病學會網站上供該會會員瀏覽下載

〔12〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

多發性骨髓瘤病患於經皮穿刺椎體成形術後發生肺栓塞 

Pulmonary Embolism after Vertebroplasty in Patient with Multiple Myeloma 



周政緯、黃文豊 

Cheng-Wei Chou, Wen-Li Hwang 

台中榮民總醫院血液腫瘤科 

Affiliations Division of Hematology/Oncology. Department of internal medicine, Taichung 

Veterans General Hospital 

Abstract 

關鍵字 

Keyword 

Introduction: 

Percutaneous vertebroplasty for osteoporotic compression fracture or malignant 

osteolytic spinal tumor is a minimal invasive procedure to relieve pain and provide 

stability. Complication included leakage to spinal canal and perivertebral venous 

system. Pulmonary embolism after procedure was rare and most patient were 

asymptomatic. 


We report a 62-year-old woman with multiple myeloma IgG, kappa, Stage III(Durie- 

Salmon), received of vertebroplasty for multiple compression fracture of thoracolumbar 

spine(T12, L2, and L4). After procedure, shortness of breath as the first 

presenting symptoms was noted. Chest radiography shows numerous, radiographically 

dense tubular branching opacities over both lung fields. Chest computed tomography 

confirmed embolus of cement within the right upper and lower lobe segment artery, 

inferior vena cava and the paravertebral veins. Due to progressive dyspnea, she was 

referred to our hospital for evaluation. Respiratory failure with ventilator support was 

noted. Cardiologist and cardiovascular surgeon performed percutaneous intervention for 

pulmonary emboli retrieval with partially retrieval. However, this patient still died 

several days later. 

Conclusion: 

Percutaneous vertbroplasty for malignancy-related compression fracture could be 

relative a safe and minimal invasive procedure. But it could still cause fatal 

complication like pulmonary embolism. Further treatment plan for osteolytic spinal 

lesion should be further investigated. 

肺栓塞、多發性骨髓瘤 , 經皮穿刺椎體成形術 

pulmonary embolism, multiple myeloma, percutaneous vertebroplasty 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於血 

液病學會網站上供該會會員瀏覽下載。

〔13〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

在低風險的骨髓分化不良症候群規律服用易解鐵帶來血液相的改善 

Adherence to Deferasirox Treatment for Low Risk Myelodysplastic Syndrome with 

Hematological Improvement 


Myelodysplastic Syndromes, Myeloproliferative Neoplasms 

賴冠銘、王全正、鐘智淵、林炫聿、林敬業、沈銘鏡、林正純、張正雄 

Guan Min Lai, Ciyuan-Jheng Wang , Chih-Yuan Chung , Shyuann-Yuh Lin, Chin-Ye 

Lin, Ming-Ching Shen, Jen-Tsun Lin, Cheng-Shyong Chang, 

彰化基督教醫院內科部血液腫瘤科 

Affiliations Division of Hemato-Oncology, Department of Internal Medicine, Chunghua Christian 

Hospital, Chunghua, Taiwan, R.O.C 

Abstract 

關鍵字 

Keyword 

Introduction: 

Most patients with myelodysplastic syndrome are transfusion-dependent. Iron overload 

resulted from transfusion may cause cardiac, hepatic, and endocrine dysfunction. In 

recent study, iron chelation therapy may decrease complication of iron overload in 

myelodysplastic syndrome. Interesting, iron chelation therapies also have effect on 

hematopoiesis and decrease frequency of blood transfusion and improve quality of life. 

Deferasirox (DFX) is an orally administered iron chelator which has been highly 

efficient in the treatment of secondary iron overload. Most frequent side effects of DFX 

are gastrointestinal disturbances, which leads in some patients to low adherence to the 

therapy. We will present a case and discuss about the effort and resources in strategies to 

improve adherence, those can result in significant long-term benefits. 

Case report: 

A 69 year-old-male was referred to our department due to thrombocytopenia. Physical 

examination revealed no hepatosplenomegaly. The initial blood counts were as follow: 

WBC: 2400/μL, Seg: 32%, Hb: 5.3 g/dl, and PLT: 6000/μL. Bone marrow aspiration 

revealed hypercellularity with RBC dysplasia, presence micromegakaryocyte, and

〔14〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

慢性骨髓性白血病病人在使用基利克之後引起 B 型肝炎活化 

Hepatitis B Virus Reactivation in a Chronic Myeloid Leukemia Patient Receiving 

Imatinib 


Myelodysplastic Syndromes, Myeloproliferative Neoplasms 

李品萱、王全正、鐘智淵、林炫聿、林敬業、沈銘鏡、張正雄 

Ping-Hsuag Lee,Ciyuan-Jheng Wang,Chih-Yuan Chung,Shyuann-Yuh Lin, Chin-Ye 

Lin, Ming-Ching Shen,Cheng-Shyong Chang, 

彰化基督教醫院內科部血液腫瘤科 

Affiliations Division of Hemato-Oncology, Department of Internal Medicine, Chunghua Christian 

Hospital, Chunghua, Taiwan, R.O.C 

Abstract 

關鍵字 

Keyword 

Introduction: 

Hepatitis B virus (HBV) reactivation is a well-recognized complication in patients 

with chronic HBV infection receiving cytotoxic or immunosuppressive chemotherapy 

for hematologic malignancies. Imatinib mesylate (IM) (Glivec; Novartis, Basel, 

Switzerland), a selective Bcr/Abl tyrosine kinase inhibitor (TKI), is now widely used 

in the treatment of chronic myeloid leukemia (CML) and gastrointestinal stromal 

tumors. We report here one case of HBV reactivation during treatment of CML 

respectively with imatinib mesylate. 

Case report: 

A 43-year-old man was a HBV carrier who received regular follow-ups at our 

hospital. He was diagnosed with chronic myeloid leukemia during follow-ups in 

Division of Hepatology. He started to receive imatinib mesylate 400 mg once daily 

after bone marrow study. Complete cytogenic response was achieved after imatinib 

mesylate treatment. His liver tests after three months of treatment were within normal 

limits. However, he started to feel easy fatigue. The patient denied usage of other 

medications including acetaminophen or herbs. Laboratory investigation revealed an 

increased AST level of 273 U/L and an increased ALT level of 1086 U/L. HBV DNA 

was positive at a concentration of 229,254,031 IU/ml. Results for Hepatitis A IgM 

antibody, hepatitis C antibody, HSV, EBV, and CMV were negative. ANA and 

immunoglobulins were within normal limits. Liver ultrasonography showed mild 

coarse liver parenchyma and normal biliary tract. Because HBV reactivation was 

considered, he started to receive entecavir 0.5mg once daily. After 2-weeks treatment 

with entecavir, his ALT and AST levels fell to 891 and 82 IU/l respectively. Clinical 

symptoms and laboratory abnormalities resolved 6 weeks later. He got major 

molecular response status 8 months later with imatinib mesylate . 

Conclusion: 

This case report highlights the importance that HBV reactivation may occur in 

hematologic patients undergoing TKI therapy. Once HBV reactivation is suspected 

during TKI treatment, early detection of HBV load and utilization of antiviral agent 

are suggested to achieve better clinical outcome. 

B 形肝炎活化、慢性骨髓性白血病、基利克 

Hepatitis B Virus Reactivation, Chronic Myeloid Leukemia, Imatinib 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片檔案 , 經部份修改後轉成 

PDF 檔格式 , 掛於血液病學會網站上供該會會員瀏覽下載。

〔15〕 

中文標題 

Title 

性質 

內容 

作者 

Author 

單位 

血栓性血小板減少紫斑症倂急性心肌梗塞之個案報告 

Thrombotic Thrombocytopenic Purpura Presenting with Acute Myocardial Infarction: A 

Case Report 


Anemia and Other RBC Disorders 

賴學緯、葉人華、劉益昇、黃子權、陳佳宏、吳宜穎、張平穎、戴明燊、何景良、陳 

宇欽、高偉堯 

Shiue-Wei Lai 1 ,Ren-Hua Ye 1 ,Yi-Shen Liu 1 ,Tzu-Chuan Huang 1 ,Jia-Hong Chen 1 , Yi-Ying 

Wu 1 ,Ping-Ying Chang 1 ,Ming-Shen Dai1,Ching-Liang Ho 1 , Yeu-Chin Chen1,Wei-Yau 

Kao1 2 

1 

三軍總醫院血液腫瘤科、 2 新店慈濟醫院血液腫瘤科 

Affiliations 1 Division of Hematology-Oncology, Department of Medicine, Tri-Service General Hospital, 

National Defense Medical Center 2 Division of Hematology-Oncology, Department of 

Medicine, Xindian Tzu Chi General Hospital 

Abstract 

關鍵字 

Keyword 

Introduction: 

Thrombotic thrombocytopenic purpura (TTP) is acute disseminated microvascular 

thrombosis syndromes involving multiple organ systems and causing microangiopathic 

hemolytic anemia and thrombocytopenia. Cardiac involvement of TTP is less commonly 

encountered but carry high risk for mortality and morbidity. 

We report a case of TTP with presenting acute myocardial ischemia which leads to fatal 

consequence. 


A 69-year-old, male patient without systemic illness before, presented with progressively 

intermittent chest tightness for two days. The symptoms lasted for few minutes and relieved 

by rest. Her related manifestations included poor appetite, no fever or body weight loss. His 

electrocardiography (ECG) revealed ST-segment depression in leads V1 to V4. Laboratory 

work-ups on admission revealed white cell count 7.13 x 103/uL, hemoglobin 7.0 g/dL, 

platelet count 8 x 103 /uL, reticulocytosis (2.31%), schistocytes in the peripheral blood 

smear, prothrombin time 11.4 sec., activated partial thromboplastin time 29.3 sec., 

fibrinogen 487.6 mg/dL, lupus anticoagulant less than 1.2, blood urea nitrogen 31.0 mg/dL, 

creatinine 1.3 mg/dL, total bilirubin 3.2 mg/dL, conjugated bilirubin 1.2 mg/dL, lactate 

dehydrogenase 1214 u/L, haptoglobin less than 5.8 g/L, creatinine kinase 544 u/L and 

troponin I 2.13 u/L. The echocardiography showed grade II diastolic function, 40% ejection 

fraction with generalized hypokinesia of of left ventricle and thrombus in apex (0.4x0.3cm). 

TTP complicating with acute non-ST elevation myocardial infarction was diagnosed. The 

cardiac biomarkers were elevated (CK 846 U/L, troponin I 8.44 U/L) despite of 

acetylsalicylic acid, clopidogrel and nitroglycerin treatment. The cardiac catheterization was 

not suggested due to bleeding risks. Urgent plasma exchange was performed and fatal 

cardiogenic shock developed due to deterioration of myocardial infarction. 

Conclusion: 

We present this report to highlight the difficult management for acute myocardial ischemia 

in TTP. In the review literature, early plasma exchange for TTP-related myocardial disease 

may reduce mortality and reverse ischemic cardiomyopathy. 

血栓性血小板減少紫斑症、微小血管內溶血性貧血、冠心症、血漿置換術 

TTP, Microangiopathic Hemolytic Anemia, Coronary Artery Disease, Plasma Exchange 

著作權授權同意書 : 本人同意將本次投稿主題之會員演講幻燈片轉成 PDF 檔格式後 , 掛於血液 

病學會網站上供該會會員瀏覽下載。

中華民國血液病學會 

中華民國血液及骨髓移植學會 

第 152 次聯合學術研討會 

時間 : 民國 101 年 12 月 15 日 ( 星期六 ) 

地點 : 中國醫藥大學附設醫院癌症大樓 1 樓階梯教室 

地址 : 台中市北區育德路 2 號 

交通資訊 : 詳參閱 http://www.cmuh.cmu.edu.tw/web/guest/citymap 

【去程】 

☆ 本會接駁專車發車時間為 12:40, 欲搭接駁車者請到台中烏日高鐵站 1 樓 6 號出口 7 號 

月台集合。(※ 車站大廳位於二樓 , 請各位前往一樓搭車 )。( 聯絡窗口 : 張經理 0932- 

875-201; 柯思綺小姐 0936-433-738; 陳憶芳小姐 0933-157-377。) 

☆ 欲搭乘本會接駁車者 , 請會員搭乘下列高鐵 644 或 645 車次 , 以利接送。未搭乘學會接 

駁專車者 , 請自行前往會場。 

車次台北板橋桃園新竹台中 

645 11:36 11:44 11:57 12:10 12:38 

車次左營台南嘉義台中 

644 11:36 11:49 12:09 12:35 

☆ 自行開車 , 停車優惠 : 請會員將車輛停在癌症中心 / 急重症中心大樓後方停車場 ( 附件黃 

色圓圈標示處 ), 於會場跟工作人員領取停車兌換卷 , 憑停車磁卡跟停車兌換券可享免 

費停車優惠。 

【返程】 

晚宴會場 : 台中僑園大飯店漂亮廳 ( 地址 : 台中市西屯區惠中路一段 111 號 ) 

★ 參加晚宴者 : 備有接駁車送至晚宴會場 , 於季會結束後發車。( 車程約 30 分鐘 )。 

★ 不參加晚宴者 : 備有接駁車送至台中烏日高鐵站 , 於季會結束後發車。( 車程約 30 分鐘 )。 

建議回程搭程車次如下 : 

不參加晚宴 

參加晚宴 

車次台中新竹桃園台北 

226 18:15 - - 19:06 

728 18:35 19:03 19:16 19:36 

車次台中嘉義台南左營 

227 18:22 - - 19:06 

729 18:38 19:02 19:21 19:36 

車次台中新竹桃園台北 

744 20:35 21:03 21:16 21:36 

246 20:39 - - 21:22 

車次台中嘉義台南左營 

745 20:38 21:02 21:21 21:36 

1247 20:46 - - 21:30 

※ 其他高鐵車次請參閱高鐵時刻表 , 謝謝 !

中國醫藥大學附設醫院地圖 ( 資料來源 :http://www.cmuh.cmu.edu.tw/web/guest/citymap )

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?