| [ Summary ] |
The occurrence of HLM in dialysis patients is becoming more frequent. Here in we report the present status of therapeutic outcomes for these diseases, specifically in Japan. Accompaning with recent developments in treatment strategies, the therapeutic outcome for HLM is improving. An etiologic study has shown the incidence of HLM in non-dialysis patients is 3.0-4.6 for acute leukemia, and 4.4-7.5 in lymphomas, per 100.000 population. Compared to the present number of dialysis patients in Japan (200.000), the crude number of dialysis patient with HLM is thought to be quite low. There are several reports suggesting favorable prognoses for dialysis patient with HLM. Since HLM are life-threatening but "curable" diseases, treatment should be cure-oriented, even in dialysis patients. The initiative for treatment strategies is on the side of hematologists, but nephrologists need to offer supportive care, including dose-adjustment of anti-neoplastic reagents, methods of administration, risk management for infection during dialysis, and even mental health. |