Including selleck kinase inhibitor our study, most of DC-based immunotherapies have been studied in patients with advanced stage disease, resulting in poor clinical responses. Future trials in less advanced disease may accompany better clinical responses. DC-based tumor immunotherapy will be a good indication as an adjuvant setting to radical therapy, such as surgical resection or RFA, to prevent tumor recurrences in patients with HCC. Acknowledgments We thank Ms. Sawa Yamamoto and Ms. Sakiko Sugawasa for their excellent technical assistance. This work was supported in part by the Japanese Ministry of Education, Culture, Sports, Science and Technology (JSPS KAKENHI 21790669) to M.A and Korean Ministry of Health and Welfare Bio New Drug Grants (A110054).
A 48-year-old woman was admitted for the evaluation of acute abdominal pain and hematochezia.
The patient had been treated with combination therapy of pegylated IFN-�� 2a (180 ��g/wk) (Pegasys; Roche, Basel, Switzerland) and ribavirin (1000 mg/d) (LG Ribavirin; LG Life Sciences, Seoul, Korea) for CHC, genotype Ib. A qualitative HCV test was initially obtained using reverse transcription-polymerase chain reaction (RT-PCR) (Abbott Laboratories, Abbott Park, IL, United States), and the serum HCV viral load was 1.67 �� 106 viral copies/mL. The serum HCV RNA level decreased to undetectable levels after 12 wk of treatment. The treatment process was uneventful until 16 wk of therapy. At week 16, the patient complained of mild epigastric discomfort and nausea, which resolved spontaneously a few days later.
Three weeks later, at week 19 of therapy, the patient complained of severe abdominal pain with hematochezia, but she remained afebrile. Small amounts of bloody stool were passed 2-3 times per day. The patient denied recent travel or additional medications such as antibiotics or non-steroidal anti-inflammatory drugs. The patient had no history of diabetes mellitus, hypertension, inflammatory bowel disease, atrial fibrillation, valvular heart disease, coronary artery disease, or hypercoagulable conditions. She was a non-smoker, and her family history was unremarkable. Physical examination revealed direct tenderness on the left lower quadrant of the abdomen. Blood pressure was 114/76 mmHg, pulse 80 beats/min, respiration rate 20/min, and body temperature 37.9 ��C. Complete blood count revealed a hematocrit of 26.9%, hemoglobin 8.
7 gm/dL, platelets 115 000/��L, and white blood cell count 4700/��L with differential counts within the normal range. C-reactive protein was slightly elevated at 0.7 mg/dL (normal < 0.4 mg/dL). Serum electrolytes, liver profile, renal function tests, amylase, and lipase were within normal limits. The coagulation profile was within the normal range, with a prothrombin time of 11.2 s and an activated partial thromboplastin time of 23.9 s. Upper endoscopy was performed 6 mo prior to admission, which documented a healing stage small gastric ulceration Drug_discovery at the antrum.