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

This article reviews the clinical manifestations, diagnostic criteria, and treatment strategies for the acute leukemias, the myelodysplastic syndrome, Hodgkin's disease, and the non-Hodgkin's lymphomas in the elderly. These are relatively common diseases in the elderly, and age is traditionally thought to be a bad prognostic sign. The treatment of these diseases is more difficult in the elderly, but careful attention to concomitant underlying illness and general physical condition and the natural history of the diseases can result in very successful management of otherwise lethal disorders.
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PMID:Acute leukemias, myelodysplasia, and lymphomas. 391 20

Marrow transplantation is effective treatment for a number of hematological diseases in patients under the age of 50 who have an HLA-identical sibling donor. It is successful in the treatment of aplastic anemia with 70-85% long-term survival. It offers 10-30% apparent cures for patients with acute leukemia who have relapsed at least once, and for those with chronic myelocytic leukemia in blast crisis. Although still somewhat controversial, it appears to be the treatment of choice for patients with acute nonlymphoblastic leukemia in first chemotherapy induced remission, and for those with chronic myelogenous leukemia in the chronic phase since approximately 50-60% of these patients experience long-term, disease-free survival. Patients with acute lymphoblastic leukemia grafted in second or subsequent remission may expect a 30% "cure" of their disease. Marrow grafting is the only effective treatment for many patients with inherited immunologic deficiencies and certain genetic storage diseases. Cures of congenital Fanconi's anemia, Blackfan-Diamond anemia, osteopetrosis, paroxysmal nocturnal hemoglobinuria and thalassemia major have been achieved. Marrow transplantation is being explored for the therapy of patients with lymphoma, Hodgkin's disease, preleukemia, multiple myeloma, hairy cell leukemia, small cell lung cancer, testicular cancer, ovarian cancer and neuroblastoma. Marrow transplantation has been limited by the fact that many patients do not have HLA-identical siblings and very few have monozygotic twins. More recently, marrow transplants from HLA-nonidentical family members and even from unrelated donors have been successfully explored.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Marrow transplantation: the Seattle experience. 391 47

A t(1;3)(p36;q21) translocation was found in bone marrow samples of two patients with hematologic disorders. One patient had a myelodysplastic syndrome evolving into acute nonlymphocytic leukemia (ANLL) M1 and the second patient had ANLL-M6 secondary to treatment for Hodgkin's disease. Because myelodysplastic syndromes and secondary leukemia are stem cell disorders, the t(1;3)(p36;q21) appears to be a chromosome abnormality in malignant myeloid stem cells.
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PMID:Translocation t(1;3)(p36;q21) in malignant myeloid stem cell disorders. 395 32

Of 602 patients treated for non-Hodgkin's lymphomas, 9 developed overt acute nonlymphocytic leukemia or preleukemia with refractory cytopenia and cytogenetic abnormalities of the bone marrow. A Kaplan-Meier estimate of the cumulative probability of leukemic complications was 6.3 +/- 2.6% (mean +/- SE) 7 years after start of treatment. All 9 patients with leukemic complications belong to a major subgroup of 498 patients treated with alkylating agents, predominantly cyclophosphamide. The risk of leukemic complications in this subgroup was compared with the risk in 312 patients treated with other alkylating agents for Hodgkin's disease, and with the risk in 553 patients treated with dihydroxybusulfan for ovarian carcinoma. Cumulative 9-year risks were 8.0 +/- 3.3%, 12.8 +/- 3.5%, and 7.1 +/- 1.9%, respectively. The general risk of secondary leukemia after long-term treatment with alkylating agents ranges from 1% to 1.5% per year from 2 to at least 9 years after start of treatment.
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PMID:Risk of acute nonlymphocytic leukemia and preleukemia in patients treated with cyclophosphamide for non-Hodgkin's lymphomas. Comparison with results obtained in patients treated for Hodgkin's disease and ovarian carcinoma with other alkylating agents. 401 1

Therapy-related leukemias are generally preceded by a preleukemic phase of several months duration, characterized by pancytopenia, abnormal bone marrow findings, and nonrandom chromosomal abnormalities in almost all cases. No specific therapeutic guidelines are recommended in this preleukemic phase or any other type of preleukemia; aggressive combination chemotherapy is usually withheld until the full expression of leukemia. A 22-yr-old man with therapy-related preleukemia following treatment of Hodgkin's disease received as primary treatment ablative chemotherapy followed by marrow transplantation from his histocompatible sister. At day 316, the patient is still in complete bone marrow recovery with a normal donor karyotype. In the light of the very poor results obtained with conventional chemotherapy regimens once the leukemic phase is established, we suggest that bone marrow transplantation, if undertaken before leukemic conversion, may be the treatment of choice in young adults with therapy-related preleukemia.
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PMID:Restoration of normal hematopoiesis by bone marrow ablation and allogeneic marrow transplantation in a case of Hodgkin's disease therapy-related preleukemia. 634 Jul 58

Erythrocyte mean corpuscular volume (MCV) evolution was studied during cytotoxic therapy in 12 patients with Hodgkin's disease who developed secondary acute leukemia and in 83 patients with Hodgkin's disease without secondary leukemia as control group. Significant differences were observed in the maximum MCV and in the MCV maximum increase during therapy between the two groups of patients. These differences remained significant between the patients treated with chemotherapy alone and those treated with chemotherapy and radiotherapy. MCV maximum increase greater than 23.9 fl was observed in all patients with secondary leukemia and in only 20% of those without secondary leukemia; it was reached 46.3 months before the first sign of preleukemia. Its value in predicting the leukemic risk in Hodgkin's disease is discussed.
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PMID:Study of erythrocyte mean corpuscular volume during cytotoxic therapy as a predictive parameter of the risk of secondary leukemia in Hodgkin's disease. 650 52

Bone marrow biopsies are now widely used in the investigation and follow-up of many diseases. Semi-thin sections of 8216 undecalcified biopsies of patients with haematological disorders were studied. Observations were made on the cytopenias and the myelodysplastic syndromes, the acute leukaemias the myeloproliferative disorders, Hodgkin's disease and the malignant lymphomas including multiple myeloma, hairy cell leukaemia and angioimmunoblastic lymphadenopathy. Bone marrow biopsies are essential for the differential diagnosis of most cytopenias and for the early recognition of fibrosis which most frequently occurred as a consequence of megakaryocytic proliferation in the myeloproliferative disorders. Different patterns of bone marrow involvement were found in the lymphoproliferative disorders and both their type and extent constituted factors of prognostic significance. A survey of the literature is given and the conclusion is drawn that bone marrow biopsies provide indispensible information for the diagnostic evaluation and the follow-up of patients with haematological disorders.
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PMID:Bone biopsy in haematological disorders. 704 Apr 89

During the period from 1970 to 1981, 391 nonselected patients with Hodgkin's disease were staged and treated with chemotherapy or radiotherapy or both at the Finsen Institute, Copenhagen. Secondary acute nonlymphocytic leukemia or its earlier stages--preleukemia or an acute myeloproliferative syndrome with cytopenia and specific cytogenetic abnormalities of the bone marrow--were observed in 17 patients. A Kaplan-Meier estimate of the cumulative probability of leukemic complications was 3.9 +/- 1.3 per cent (mean +/- S.E.M.) five years after the start of treatment, and 9.9 +/- 2.9 per cent at nine years. All 17 cases of leukemic complications occurred among the 312 patients treated with chemotherapy or combined-modality therapy, whereas no case was observed among 79 patients treated exclusively with radiotherapy (P = 0.003). A significantly increased risk of leukemic complications was observed in chemotherapy-treated patients 40 years old or older (P = 0.001). Despite the observed relatively high risk of secondary leukemia, the rate of death from progressive Hodgkin's disease, nonleukemic complications, and unrelated causes still far exceeds the rate of leukemia-related deaths in these patients.
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PMID:Incidence of acute nonlymphocytic leukemia, preleukemia, and acute myeloproliferative syndrome up to 10 years after treatment of Hodgkin's disease. 711 Feb 99

Myelodysplasia and acute nonlymphocytic leukemia following therapy for Hodgkin's disease are observed rather frequently. Herein, we describe a patient with this syndrome treated with prolonged chemotherapy (alone), having a monosomy 7 karyotype. Cytogenetic studies were performed serially during the myelodysplasia preceding overt leukemia. Review of the literature and relevance of these findings are discussed.
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PMID:Association of monosomy 7 with myelodysplasia following chemotherapy for Hodgkin's disease: serial observations. 727 93

Analysis of most hematologic neoplasms indicates the involvement of one or more cell lineages in the bone marrow and/or the blood but rules out the involvement of all lineages in any one neoplasm. It is important to detect lineage involvement in order to clarify which stem cells are involved in leukemia, to predict prognosis, and to select appropriate treatment. Our aim was to study the cell lineage involvement of some of the recurrent chromosomal abnormalities seen in hematological neoplasms. The direct morphology-antibody-chromosomes (MAC) method was used. The deletion 20q in myeloproliferative diseases (MPD), the deletion of 5q and t(1;7) in myelodysplastic syndromes (MDS), and t(3;3) in acute myeloid leukemia subtype M7 (AML-M7) were seen in all or at least in two myeloid lineages. These were interpreted as stem cell abnormalities. Deletion 13q in MPD, t(8;21) in AML-M2 and t(15;17) in AML-M3 were seen in granulocytic lineages only; t(14;18) in non-Hodgkin's lymphoma and trisomy 12 as the sole abnormality in chronic lymphocytic leukemia (B-CLL) were seen only in immunoglobulin light chain clonal B cells; inversion 14 in T-CLL was seen only in T cells, whereas t(15;14) in acute lymphocytic leukemia with eosinophilia (ALL-EO) was seen in lymphoid stem cells but not in mature granulocytes or lymphocytes. Additional abnormalities (in addition to the Philadelphia chromosome) in chronic myeloid leukemia (CML) were seen in all myeloid cell lineages and also in mature granulocytes, B cells, and large granular lymphocytes. Abnormalities in Hodgkin's disease were restricted to CD30-positive Reed-Sternberg cells. Trisomy 8 and monosomy 7 are abnormalities that may be present in either stem cells or any of the single cell lineages.
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PMID:Cell lineage involvement of recurrent chromosomal abnormalities in hematologic neoplasms. 752 Feb 72


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