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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1970 and 1980, 66 children or adolescents with Hodgkin's disease were treated at the Children's Hospital of Philadelphia. Since 1977, prepubertal patients and postpubertal patients with Stage IIA massive mediastinal disease or Stage IIB-IVB disease were clinically staged and treated with six courses of chemotherapy and 2000 rad involved-field irradiation. Postpubertal patients with Stage IA or IIA disease were staged pathologically and treated with 3600-4400 rad extended-field irradiation. At four years, actuarial survival in 27 patients with Stage IA or IIA disease is 100%; relapse-free survival is 86% in 16 patients treated with combined modality and 70% in 11 patients treated with irradiation. Among 39 patients with Stage IIB-IVB disease, 34 received combined modality; at five years, survival is 86% and relapse-free survival is 60%. In the majority of cases relapses in patients treated with combined modality could be better explained by chemotherapy failure rather than by insufficient radiation. Clinical staging and combined modality therapy may offer advantages for prepubertal patients and those postpubertal patients at high risk of relapse when treated with irradiation alone. The complications of laparotomy and splenectomy are avoided; however, with 2000 rad and limited-field irradiation, hypothyroidism does occur and growth disturbances may appear.
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PMID:Management of Hodgkin's disease in children and adolescents. 640 88

Thyroid function and serum thyroglobulin levels were studied in 66 subjects whose Hodgkin's disease had been previously treated by cervical, mediastinal and axillary lymph node (mantle) irradiation. Three patients were already undergoing treatment for thyroid disorders (one for primary hypothyroidism, two for Graves' disease) and a fourth was found to have euthyroid Graves' disease. 36 (Group I) of the remaining 62 patients had normal free thyroxine indices, normal basal thyrotrophin (TSH) levels and normal TSH response to thyrotrophin releasing factor (TRH). In 20 patients (Group II) free thyroxine indices were normal but either basal TSH levels were raised or normal basal TSH levels were associated with an exaggerated response to TRH. In 6 patients (Group III) free thyroxine indices were subnormal. Although results of thyroid function tests in group I lay within the normal range, the mean free thyroxine index was significantly lower and mean basal and peak TSH levels were significantly higher than those of a group of 35 normal subjects, indicating mild thyroid hypofunction. Elevated thyroglobulin levels were demonstrated in 11 irradiated subjects (18%). Mean thyroglobulin levels were significantly raised in each of the three groups of irradiated subjects. Significant positive correlations were found between log serum thyroglobulin and log basal TSH (r = 0.453, P less than 0.001) and log peak TSH (r = 0.515, P less than 0.001) levels. Mild thyroid hypofunction is common after mantle irradiation for Hodgkin's disease and raised serum thyroglobulin levels are a sensitive indicator of TSH stimulation of the damaged thyroid gland.
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PMID:Serum thyroglobulin after mantle irradiation for Hodgkin's disease. 641 92

From January 1965 to December 1975, 122 patients diagnosed with Hodgkin's disease, Stage I-A, II-A, and III-A were treated at the Department of Radiation Therapy at Hahnemann Medical College and Hospital. Twenty-five patients with Stage I-A, 54 patients with Stage II-A, and 43 patients with Stage III-A were accepted for treatment. Retrospective analysis was made to define the impact of the cell type, clinical and pathologic stage, and tumor bulk on prognosis. Of the 25 patients with Stage I-A Hodgkin's disease, 13 were clinically staged and 12 pathologically staged. Nine patients received extended-field radiation therapy with the overall relapse-free survival of 100% at 5 and 9 years; 16 patients received mantle radiation only, with overall survival of 84% and relapse-free survival of 68% at 5 and 10 years. Of 54 patients with Stage II-A Hodgkin's disease (32 clinically staged and 22 pathologically staged), six patients received involved field radiation therapy with overall survival of 68 and 49% at 5 and 10 years, and relapse-free survival of 33 and 17% at 5 and 10 years. Nineteen patients received limited-field radiation therapy (mantle or inverted Y) with overall survival of 49% at 5 and 10 years, and relapse-free survival of 42 and 31% at 5 and 10 years, and 29 patients received extended-field radiation therapy (mantle and para-aortic or TNI) with overall survival of 88% at 5 and 10 years, and relapse-free survival of 82 and 73% at 5 and 10 years. The overall and relapse-free survival at 5 and 10 years in 22 patients pathologically staged II-A (treated by different techniques) are 95 and 75%. Forty-three patients with Stage III-A Hodgkin's disease (treated with different techniques) reveal an overall survival of 79 and 64% at 5 and 10 years, and relapse-free survival of 58 and 45% at 5 and 10 years. Complications consisted of six patients with overt symptoms of hypothyroidism, two patients with peripheral neuropathy, one patient with radiation myelitis, and two patients with symptoms of leukoencephalopathy. Two patients developed second malignancies.
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PMID:Hodgkin's disease. Results from a program in radiation therapy. 642 36

Thyroid function was measured in 119 children, 16 years of age or less, after radiotherapy (XRT) for Hodgkin's disease. Thyroid abnormalities developed in 4 of 24 children (17%) who received 2600 rad or less, and in 74 of 95 children (78%) who received greater than 2600 rad to the cervical area, including the thyroid. The abnormality in all but three (one with hyperthyroidism and two with thyroid nodules) included the development of elevated levels of thyroid stimulating hormone (TSH). Age, sex, and administration of chemotherapy were not significant factors in the development of thyroid dysfunction. All children had lymphangiograms (LAG) and no time relationship was noted between thyroid dysfunction and LAG-XRT interval. The mean interval from radiotherapy to documented thyroid dysfunction was 18 months in the low-dose group and 31 months in the high-dose group, with most patients becoming abnormal within 3 to 5 years. Of interest was a spontaneous return of TSH to within normal limits in 20 children and substantial improvement in another 7. This study confirms the occurrence of dose-related occult hypothyroidism in children following external irradiation of the neck.
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PMID:Thyroid dysfunction after radiotherapy in children with Hodgkin's disease. 669 89

When ichthyosis occurs in adulthood, it may signify internal disease, including sarcoidosis and malignancy,--especially Hodgkin's lymphoma. Other systemic diseases associated with acquired ichthyosis are leprosy, hypothyroidism, chronic renal failure and nutritional deficiencies.
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PMID:Acquired ichthyosis: a marker for internal disease. 670 26

Thyroid function was measured serially in 28 children with Hodgkin disease diagnosed from 1971 to 1978. The patients' ages ranged from 4 to 16 years at diagnosis, and treatment consisted of chemotherapy only (four patients), radiation alone (15), or radiation plus chemotherapy (nine). None of the four children given chemotherapy only developed thyroid hypofunction, in contrast to 21 (88%) of the 24 children given high doses of radiation (P less than 0.001). Thyroid function in three patients with compensated hypothyroidism and in one child with primary hypothyroidism reverted to normal without thyroid replacement. One child given chemotherapy only and one child given radiation only became transiently hyperthyroid. These results indicate that patients given combined modality therapy for Hodgkin disease are at high risk for thyroid abnormalities. The results of long-term follow-up of thyroid function demonstrate, however, that all such thyroid abnormalities may not necessarily be permanent.
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PMID:Serial thyroid function measurements in children with Hodgkin disease. 674 54

The effects on the thyroid of radiation therapy to the neck and/or chemotherapy were investigated in 54 Hodgkin's and 72 non-Hodgkin's lymphoma patients. These patients had received radiation therapy with doses ranging from 2000 to 4000 rad (median 3600 rad) to the cervical or mantle fields and/or multiple-agent chemotherapy following usual staging procedures. Palpable abnormalities of the thyroid were found in 15 patients. The patients with irradiation to the neck had a higher incidence of hypothyroidism than those patients treated with chemotherapy alone (31/74 vs. 8/52, P less than 0.001 for TSH and 10/74 vs. 1/52, P less than 0.025 for T4). A higher frequency of elevated serum TSH levels and antithyroid antibodies were also observed in patients receiving radiation therapy alone to the neck than in those receiving both radiation therapy and chemotherapy (19/33 vs. 12/41, P less than 0.025 for TSH and 16/33 vs. 7/41, p less than 0.01 for antibodies), suggesting that chemotherapy agents may reduce the thyroid dysfunction induced by irradiation. There was no difference in prevalence of elevated TSH levels following irradiation to the neck between patients in whom lymphangiogram was or was not performed (21/51 vs. 10/23).
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PMID:Thyroid abnormalities associated with treatment of malignant lymphoma. 726 Aug 63

Fifty-four children and adolescents with Hodgkin's disease Stages I--IV were treated with chemotherapy plus radiotherapy from 1967 to 1972. Thirty-eight patients (70%) remain in continuous complete remission. Nine patients have died, four of progressive disease, three of pneumonitis, one with probable pneumococcal sepsis, and one of acute myelocytic leukemia. Significant retardation of height and crown-rump length occurred, particularly in boys who received at least mantle or abdominal radiotherapy when younger than age 16 years. Five women have amenorrhea and no patient has clinical evidence of hypothyroidism. The major long-term effects of therapy in this group of patients has been growth retardation. Future studies to minimize long-term effects of therapy are necessary but must be carefully designed so that present cure rates are not jeopardized.
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PMID:Long-term results of treatment of children and adolescents with Hodgkin's disease. 742 56

A patient with bilateral chylous effusions and chylous ascites resulting from mediastinal and periaortic radiation for Hodgkin's lymphoma is described. The chylothoraces were resistant to medical treatment as well as to surgical pleurectomy. The patient's medical condition worsened due to progression of the chylous effusions and an episode of catheter-related bacteremia complicated by respiratory failure requiring mechanical ventilation. While receiving mechanical ventilation, the patient was found to have hypothyroidism and was subsequently begun on thyroid hormone replacement therapy. Within 1 week, the chylous drainage from the pleural spaces dramatically decreased and eventually resolved. Eighteen months after beginning thyroid hormone replacement therapy, the patient continues to do well without recurrence of the chylous effusions.
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PMID:Recalcitrant chylothorax and chylous ascites associated with hypothyroidism. 843 44

Generalized or localized itch without primary skin manifestations may be the presenting symptom of serious internal diseases. Five characteristic cases of pruritus are discussed: Hodgkin's disease, primary sclerosing cholangitis, polycythemia vera, iron deficiency (with pica), and uremia. Other important causes must be considered; all forms of cholestasis, including primary biliary cirrhosis, drug-induced, pregnancy-related, and extrahepatic cholestasis; other hematologic and malignant disorders such as non-Hodgkin's lymphoma, leukemia, multiple myeloma, solid tumors, and myelodysplastic syndromes; metabolic and endocrine diseases, most notably diabetes mellitus, hyperthyroidism, hypothyroidism, and carcinoid syndrome; focal neurologic diseases such as brain tumors, cerebral infarctions and multiple sclerosis; adverse drug reactions without rash; infectious diseases, especially parasitic and HIV infections. A diagnostic laboratory screening for pruritus of undetermined origin is suggested.
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PMID:[Pruritus--also a challenge in internal medicine]. 852 44


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