Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 30-year-old woman with Stage IIIA diffuse non-Hodgkins lymphoma was treated with doxorubicin, cyclophosphamide, vincristine, and prednisone (CHOP) every 3 weeks. When the cumulative doxorubicin dosage after nine courses of chemotherapy was 515 mg/m2 (average, 57 mg/m2/course and 19 mg/m2/week), the doxorubicin was discontinued. She relapsed 4.5 months later while receiving vincristine, prednisone, and an escalated dosage of cyclophosphamide (CVP) every 3 weeks. Single-agent chemotherapy consisting of weekly doxorubicin was administered for 15 courses (average dose 29 mg/m2/week) and resulted in a complete remission after nine courses. The cumulative dosage of doxorubicin was 955 mg/m2 at the end of the 15 courses. Mild cardiomyopathy was noted on left ventricular gated scan and electrocardiogram (ECG) at the cessation of therapy. Mild congestive heart failure occurred shortly after the discontinuation of the doxorubicin. It responded to treatment with digoxin and diuretics. At present, she has no dyspnea on exertion and no evidence of cardiomegaly on chest x-ray films; she continues to use digoxin alone. She remains in complete remission 29 months after discontinuation of intensive, weekly, single-agent doxorubicin administration (compared to a remission of only 4.5 months from the end of less intensive administration of doxorubicin every 3 weeks as part of combination chemotherapy). This case illustrates that intensive doxorubicin administration may be superior to conventional doxorubicin administration for the treatment of lymphomas, and raises the possibility that weekly administration could be superior to administration of doxorubicin every 3 weeks. Further studies investigating the efficacy of weekly versus conventional scheduling of doxorubicin are warranted in non-Hodgkin's lymphoma, particularly in light of published evidence that weekly doxorubicin administration is also less cardiotoxic than treatment given every 3 weeks.
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PMID:The importance of dose intensity of doxorubicin administration in non-Hodgkin's lymphoma. A case report. 375 69

The case histories of 1200 patients admitted to our hospital over a 20 month period were reviewed to determine the degree, frequency and cause of dissociated cholestasis as a biological syndrome. Patients were divided into two groups: group I with 80 cases, included all patients whose gamma-GT levels were more than 30 mU/ml and serum-bilirubin less than 1.2 mg/ml, with alkaline phosphatase levels between 90-180 mU/ml. Group II included those with alkaline phosphatase levels higher than 180 mU/ml (57 cases). All over incidence of dissociated cholestasis was 13.82%. Main causes in group I were infectious diseases, mainly pneumonias and urinary infections and congestive cardiac failure. In group II, neoplasias such as Hodgkin's disease and epithelial metastases and obstructions of the biliary tract such as vesicular or choledocal litiasis were the main causes. Transaminase levels underwent variable increases according to the different entities, without there being any difference between the two groups. The physiopathology as well as the anatomopathological aspects which could originate the syndrome are discussed.
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PMID:[Clinical significance of dissociated cholestasis as a biological syndrome (author's transl)]. 611 5

Forty-six previously untreated patients with advanced Hodgkin's disease (3 cases) and non-Hodgkin's lymphoma (Intermediate grade of the Working Formulation) were treated with Adriamycin-based combination chemotherapy at Saitama Cancer Center between January 1977 and December 1982. The median age was 55 years (range, 18-74 years), with 10 patients (22%) 66 years of age or older. The overall complete response rate was 23 of 46 or 50%. The complete response rate of stage III (62.5%) was superior to that (36.4%) of stage IV, but there was no statistical difference between stage III and IV. The complete response in patients with extranodal lymphoma including Waldeyer's ring primary was 9 of 16 (56.2%), while 11 of 27 patients (40.7%) with nodal lymphoma had complete responses. The median survival for all patients was 26 months. The survival curve of complete responders became flat at 41 months and was well sustained with an actuarial survival of 79%. The survival at 5 years was 60% in patients who had stage III and 26% in patients who had stage IV (p greater than 0.05). Congestive heart failure resulting in death occurred in one case given 315mg /m2 of adriamycin and then 90 mg/m2 of mitoxantrone.
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PMID:[Adriamycin-based combination chemotherapy in the treatment of advanced malignant lymphoma. A progress report]. 620 45

Mitoxantrone is an anthracenedione, showing structural similarities to doxorubicin. This drug has been proved active against several tumor systems, including some tumors resistant to doxorubicin, and also against human breast xenografts. It is also less cardiotoxic than doxorubicin. Mitoxantrone has been given to 335 patients in an i.v. perfusion of 12 mg/m2 or 14 mg/m2 every 3 weeks. Two hundred and sixty-three patients with advanced disease were evaluable for response: breast (94 patients), head and neck (40), kidney (20), bronchial (19), lymphomas (13) and various sites (77). Most of the patients had been previously treated with radiotherapy and chemotherapy, including/not including doxorubicin. In breast cancer three complete remissions (CR) and 16 partial remissions (PR) have been achieved (20%). The therapeutic activity was higher in patients who had not received any prior chemotherapy: 35 vs 15% (P = 0.06). The response rate observed at 14 mg/m2 (32%) was superior to the response rate observed at 12 mg/m2 (15%). However, no response has been reported in lung metastases (0/22). The median duration of response is 8 months. Mitoxantrone shows borderline activity in head and neck tumors (one CR and two PR out of 40 patients) but no activity in squamous cells of the lung (0/19). One CR and three PR have been seen out of 13 malignant lymphomas (four Hodgkin's disease and nine non-Hodgkin's lymphomas). The duration of response ranges from 10 to 24+ months. Myelosuppression was moderate and no severe leukopenia has been reported. Nausea and vomiting were seen in 50% of the patients. Four patients presented cardiac events associated with mitoxantrone, such as reversible congestive heart failure or a significant decrease in the ventricular ejection fraction. Alopecia was observed in 17 and 48% of the patients treated with 12 and 14 mg/m2 respectively. Due to its anti-tumoral activity, mainly in breast cancer, and its low hematological and cardiac toxicity, mitoxantrone must be considered as a major antimitotic.
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PMID:An EORTC phase II study of mitoxantrone in solid tumors and lymphomas. 654 6

Changes in the transverse heart diameter and cardiothoracic ratio were determined by comparing the pretreatment and last follow-up posteroanterior chest x-rays of 96 patients with stage I-III Hodgkin's disease who had received radiation therapy (RT) to the mediastinum, with the same parameters observed in 20 similar patients whose mediastinum was not irradiated. A significantly higher proportion of patients who had received RT to the mediastinum had a decrease in transverse heart diameter and cardiothoracic ratio. Among patients presenting with a large mediastinal mass, these changes were more pronounced as compared to the other groups; however, this difference was not of statistical significance. First-pass left ventricular ejection fraction (LVEF) performed with 99mTc pertechnetate (obtained in 55 of these patients 30-120 months after RT to the mediastinum) was compared with the LVEF of 20 normal controls. The control group had a significantly higher LVEF than the group of patients who had received RT to the mediastinum. No correlation was observed between changes in these parameters and the use of adjuvant, salvage, or no chemotherapy after mediastinal RT. None of these patients presented congestive heart failure or constrictive pericarditis, but our findings indicate a subclinical cardiomyopathy in more than one-half of the patients who received RT to the mediastinum, suggesting that the incidence of heart damage after mediastinal RT might be higher than expected. Prospective studies are necessary to elucidate the incidence and implications of this potentially serious complication.
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PMID:Heart size and function after radiation therapy to the mediastinum in patients with Hodgkin's disease. 665 27

Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Congestive heart failure occurred in 2 patients. Six patients had pericardiectomy for constrictive pericarditis and 3 patients had coronary artery bypass surgery for coronary artery disease. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable.
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PMID:Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients. 685 75

Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluation was performed in 108 patients, mean age 46 +/- 6.2 years, with Hodgkin's disease at 175 +/- 43 months after irradiation. The study protocol included clinical examination, graded treadmill exercise test and echocardiography. Some patients with angina pectoris, previous myocardial infarction and an abnormal ECG were studied by thallium-201 scintigraphy, cardiac catheterization and coronary angiography. Cardiac disease was found in 12 patients (11%). Three patients had angina pectoris, one patient had myocardial infarction, two complained of dyspnea on effort and two had congestive heart failure. At catheterization, constrictive pericarditis was diagnosed in four patients; in two additional patients an occult constrictive pericarditis was found. One patient had both mitral and tricuspidal regurgitation and one had mitral regurgitation alone. Eight patients (7.4%) had severe coronary artery disease; four of these had associated constrictive pericarditis. Four patients had a pericardiectomy and another four had undergone coronary artery by-pass graft. Two patients died after operation from persistent pericardial constriction. It is concluded that the incidence of delayed cardiac disease after radiotherapy is relatively high; chronic pericardial disorders and coronary artery disease are the most frequent manifestations of this disease. Standard surgical treatment may be beneficial because of the relative youth of these patients.
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PMID:Cardiac disease after chest irradiation for Hodgkin's disease: incidence in 108 patients with long follow-up. 760 65

A 71 years old man, ex-smoker, moderate drinker, with a history of diabetes mellitus (type II), moderate arterial hypertension, mild aortic stenosis and moderate uniform left ventricular hypertrophy echographically documented, developed a non Hodgkin low malignancy cavum lymphoma. He has underwent chemotherapy for two years (adriamycin and other chemotherapy drugs) at moderate dosages. A complete remission of the lymphoma followed the treatment, but an initial deterioration of left ventricular function, with heart dilatation and congestive heart failure, was found. The patient improved by medical treatment, returning to the previously stable clinical condition. However a ventricular dilatation reoccurred and a paroxysmal complete atrio-ventricular block developed, necessitating the implantation of a pace maker. The patient died suddenly, during sleep, at home. This is a unique case, because of the numerous cardiac factors associated (chemotherapy and clinical findings). More probably the combination of these multiple factors and their interrelationship could explain the unique non-linear evolution of the left ventricular hypertrophy. In conclusion in these patients a very strict clinical and pharmacological follow up with serial echocardiographical examinations is fundamental and highly recommended.
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PMID:[Normalization of left ventricular function and subsequent recurrence of dilatation and pump failure in a patient with hypertensive heart disease in dilated phase after treatment with anthracycline]. 792 84

A case of malignant lymphoma in the heart is presented. A 75-year-old man was admitted to hospital for dyspnea. Echocardiography revealed a right atrial tumour and enlargement of the right ventricular wall. Myxoma was suspected clinically. The patient died from rapidly progressing congestive heart failure. Autopsy revealed massive infiltration of the myocardium in the right atrium, right ventricle and the tricuspid valves by a high grade malignant non-Hodgkin lymphoma of B-cell type. Malignant lymphoma was found at no other sites except for a five mm tumour in the thyroid gland and a larger six by five by four cm mediastinal tumour.
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PMID:[Malignant lymphoma of the heart]. 806 29

A case of 32-year old male with congestive heart failure and pleural effusion was described. When he was seven years old, he suffered from Hodgkin's disease and radiotherapy of the mediastinum and the neck was instituted. Twenty years later he developed acute myocardial infarction and then two episodes of circulatory arrest. The examinations revealed extensive, calcified stenoses of the coronary and cervical arteries. Risk factors of atheromatosis were absent. Moreover, the diagnosis of pleural mesothelioma which could also be caused by irradiation, was established.
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PMID:[Heart failure, recurrent ventricular fibrillations and pleural mesothelioma in a young man who was treated in childhood with radiotherapy for Hodgkin's disease]. 812 95


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