Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

Ophthalmopathy associated with autoimmune thyroid disease (Graves' ophthalmopathy) may occur years after irradiation of the neck for nonthyroid malignant disease. Two patients developed this complication 2 and 18 years after irradiation treatment of Hodgkin's disease: one with hypothyroidism associated with Hashimoto's thyroiditis and the other with hyperthyroidism. Careful long-term observation of thyroid function following neck irradiation is recommended in view of this unusual complication and the frequent occurrence of hypothyroidism.
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PMID:Ophthalmopathy after neck irradiation therapy for Hodgkin's disease. 58 77

One hundred twenty-seven patients with Hodgkin's disease, Stages III-IV, received total nodal irradiation. Of these, 101 patients were managed primarily by radiation therapy employing the split course sequential segmental radiation technique called the "3 & 2". A dose of 3800-4000 rad is delivered in 2 phases in an overall period of 12 to 13 weeks (TDF 61-64; 1094-1148 rets). For various reasons, the remaining 26 patients received their mantle irradiation to full doses 3800-4000 rad in 4 weeks (TDF 63-66; 1112-1184 rets) without rest periods and a few were irradiated after failing chemotherapy. Of the 101 patients treated between 1969-1974 using the "3 & 2" technique, 2 developed pericarditis (2.0%), none manifested symptomatic pneumonitis (0%), and 3 hypothyroidism )3.0%). The low incidence of severe complications is primarily the result of the technique employed to give total nodal irradiation. The overall incidence of Herpes Zoster was 42% (53/127), and there was a slightly higher incidence when TNI was given following splenectomy.
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PMID:Complications of total nodal irradiation of Hodgkin's disease stages III and IV. 67 47

Three patients who developed hypothyroidism after x irradiation to the neck are presented. The first two cases demonstrate that patients can develop clinical and chemical hypothyroidism after a very short interval following radiotherapy. Hypothyroidism developed in the first patient in the absence of surgical manipulation of the neck, or a large iodine load 4 months after receiving 6800 rad of x-ray therapy to his neck for carcinoma of the larynx. The second patient developed hypothyroidism approximately 6 months after his radiotherapy for carcinoma of the esophagus. Both of these patients demonstrated high titers of serum antithyroid antibodies. A third patient with Hodgkin's disease did not manifest clinical symptoms and signs of hypothyroidism until 6 years after radiation therapy. These cases demonstrate the variability of onset of hypothyroidism after radiotherapy and emphasize the need for careful evaluation of thyroid function before and after neck irradiation.
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PMID:Hypothyroidism after x irradiation to the neck: three case reports and a brief review of the literature. 94 Feb 51

The authors report a case of hypothyroid hypertrophic myopathy consecutive to mantle irradiation for Hodgkin's disease. A rise in TSH level is frequent after mantle irradiation and it justifies prolonged monitoring of these patients' thyroid function, in view of the risk of patent hypothyroidism and perhaps cancer. The patient's age, the pre-irradiation lymphography and the chemotherapy associated with radiotherapy are all factors that influence the incidence of thyroid dysfunction, but there is no agreement concerning their relative importance. Hypertrophic myopathies due to hypothyroidism are rare, and their dramatic clinical presentation contrasts with an almost normal muscle histology. Alterations of energy metabolism and changes in the properties of myosin induced by hormonal deficiency account for the muscular weakness of these patients. On the other hand, the mechanism of muscle hypertrophy remains controverted, the most probable theory being and increase in the number of myotubes. Following irradiation, notably for Hodgkin's disease, the frequency of hypothyroidism requires a regular and systematic laboratory follow-up. Replacement therapy must be instituted if the basal TSH level increases, even if the T4 level is normal.
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PMID:[Hypothyroid hypertrophic myopathy following mantle irradiation for Hodgkin's disease. A case]. 189 13

Thirty five patients with Hodgkin's disease who had received mantle radiotherapy to the neck were investigated for thyroid dysfunction serially over many years post radiation. No incidence of clinical hypothyroidism was noted; however, biochemical hypothyroidism (raised TSH, normal T3 and T4) was seen at some time during follow up in 22 patients. Thirteen had high TSH values at the first post radiation examination: in 6 they remained high during follow up and in seven they fell to normal or near normal without thyroxine substitution at any time. TSH abnormalities were seen by 2-3 years post radiotherapy and the return to normal, when it occurred, was seen by 4-6 years. It is advisable to follow up patients with abnormal TSH values following mantle radiation for a further 2-3 years and begin thyroxine substitution only if TSH abnormalities persist.
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PMID:Follow up of alterations in thyroid hormones and thyrotropin in patients of Hodgkin's disease given mantle radiation. 226 75

To decrease the incidence of hypothyroidism related to mantle irradiation for Hodgkin's disease, we initiated a study designed to protect the thyroid gland using a phantom. A thyroid phantom was filled with technetium-99m. The thyroid phantom was placed inside of its corresponding anterior neck position in a whole body phantom. An anterior scintiscan of the head and neck region demonstrated the radioactivity in the simulated thyroid. A mantle port included a focused block that would shield the thyroid from the anterior port. The phantom was exposed (4 MeV) to 180 cGy (AP-PA) at midplane with lithium fluoride dosimeters in the position of the thyroid. The thyroid received an average of 12 cGy from the anterior field and 48 cGy from the posterior field for a total of 60 cGy per treatment or 30% of the prescribed dose. A complete mantle field course of radiation of 4000 cGy would lead to a thyroid dose of 1200 cGy at a daily fractional dose of 60 cGy. We elected not to block the thyroid from the posterior field to prevent shielding and potential underdosage of involved nodal sites. The present study suggests a method of safe and effective thyroid shielding which needs to be tested clinically to determine whether it would reduce the incidence of chemical and clinical hypothyroidism or simply extend the period until occurrence.
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PMID:Prevention of hypothyroidism related to mantle irradiation for Hodgkin's disease: preparative phantom study. 231 94

From July 1981 to July 1985, 20 patients with bulky mediastinal Hodgkin's Disease (maximum mediastinal width divided by the maximum intrathoracic diameter for a mediastinal mass ratio (MMR) greater than 0.33 were treated at Stanford University with definitive radiation therapy alone. The majority of these patients were selected to receive radiation therapy because they had the more favorable characteristics of minimal extralymphatic involvement, mediastinal masses that were superior and central in location, and a MMR less than or equal to 0.50. All 20 patients were laparotomy staged, and 17 received some radiation to the mantle before laparotomy. Seventeen patients had pathologic stage (PS) II disease (13 PS IIA, 4 PS IIB), two had PS IIISA, and one had PS IB. Eleven patients (55%) had extralymphatic involvement. All patients were irradiated to the mantle field using a shrinking field technique (mediastinal dose, 4400 to 5500 cGy, mean 4990 cGy). After completion of the mantle, all patients with good clinical responses received infradiaphragmatic radiation. Treatment complications included two cases of mild radiation pneumonitis, five of hypothyroidism, five of localized Herpes zoster, one of amenorrhea, one of non-Hodgkin's lymphoma, and one of sepsis. Four patients relapsed. All had an intrathoracic component to their failure. All four patients were salvaged with MOP(P) chemotherapy and are currently alive and free of disease. For the entire group, the actuarial freedom from relapse is 80% at 7 years and the survival is 100%. Median follow-up time is 67 months. The authors conclude that radiation therapy alone is effective in the management of selected patients with Hodgkin's disease who have extensive mediastinal involvement, even when the MMR exceeds 1/3.
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PMID:Radiation therapy in the management of bulky mediastinal Hodgkin's disease. 235 12

Patients successfully treated for Hodgkin's disease provide the oncologist with an opportunity and a responsibility to evaluate long-term adverse effects of staging procedures and treatment regimens. This is necessary both to better understand the often unique clinical problems that develop long after completion of treatment for Hodgkin's disease and to more critically evaluate new treatment programs by comparison with existing effective but toxic regimens. Long-term survivors of Hodgkin's disease have various, often subclinical, cardiac abnormalities that result from both radiation and chemotherapy. Pneumonitis and subsequent fibrosis often follow irradiation. A variety of immunologic disturbances exists before and after treatment and predisposes to significant viral and bacterial infections. Finally, hypothyroidism and premature gonadal failure may follow therapy and require long-term hormone replacement. Further therapeutic advances for Hodgkin's disease will continue to alter this spectrum of complications, which, if unrecognized, may produce significant ongoing morbidity for long-term survivors.
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PMID:Nonmalignant complications of therapy for Hodgkin's disease. 266 31

The biodistribution, toxicity, and therapeutic potential of anti-CD37 monoclonal antibody (MoAb) MB-1 labeled with iodine 131 (131I) was evaluated in ten patients with advanced-, low- or intermediate-grade non-Hodgkin's lymphomas who failed conventional treatment. Sequential dosimetric studies were performed with escalating amounts of antibody MB-1 (0.5, 2.5, 10 mg/kg) trace-labeled with 5 to 10 mCi 131I. Serial tumor biopsies and gamma camera imaging showed that the 10 mg/kg MoAb dose yielded the best MoAb biodistribution in the ten patients studied. Biodistribution studies in the five patients with splenomegaly and tumor burdens greater than 1 kg indicated that not all tumor sites would receive more radiation than normal organs, and these patients were therefore not treated with high-dose radioimmunotherapy. The other five patients did not have splenomegaly and had tumor burdens less than 0.5 kg; all five patients in this group showed preferential localization and retention of MoAb at tumor sites. Four of these patients have been treated with 131I (232 to 608 mCi) conjugated to anti-CD37 MoAb MB-1, delivering 850 to 4,260 Gy to tumor sites. Each of these four patients attained a complete tumor remission (lasting 4, 6, 11+, and 8+ months). A fifth patient, whose tumor did not express the CD37 antigen, was treated with 131I-labeled anti-CD20 MoAb 1F5 and achieved a partial response. Myelosuppression occurred 3 to 5 weeks after treatment in all cases, but there were no other significant acute toxicities. Normal B cells were transiently depleted from the bloodstream, but immunoglobulin (Ig) levels were not affected, and no serious infections occurred. Two patients required reinfusion of previously stored autologous, purged bone marrow. Two patients developed asymptomatic hypothyroidism 1 year after therapy. The tolerable toxicity and encouraging efficacy warrant further dose escalation in this phase I trial.
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PMID:Treatment of refractory non-Hodgkin's lymphoma with radiolabeled MB-1 (anti-CD37) antibody. 266 88

An apparently normal 13-year-old girl developed multiple severe complications over several years after radiation therapy for Stage IIB Hodgkin's disease, including hypothyroidism, esophageal stenosis, restrictive lung and pericardial disease, extrahepatic biliary fibrosis, and sudden death presumed secondary to a myocardial infarction. Cultured skin fibroblast cells from the patient exhibited marked sensitivity to gamma radiation in vitro. The D0 of the radiation survival curve (the inverse of the straight line portion of the curve and that dose of radiation which theoretically leads to one lethal hit per cell) was 89 cGy, compared to a mean D0 for nine normal individuals of 155 cGy, and 85 cGy for two patients with the radiation sensitive disease ataxia-telangiectasia (AT). Profound clinical heterogeneity in response to cancer therapeutic agents may exist, with some individuals who show no signs or symptoms of DNA repair deficiency (for example, as is manifested by individuals with AT) exhibiting marked in vivo and in vitro sensitivity to certain DNA-damaging agents.
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PMID:Sensitivity of cultured cells to gamma radiation in a patient exhibiting marked in vivo radiation sensitivity. 317 49


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