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)

Among a total of 2147 patients admitted to our hospital for acute myocardial infarction between 1978 and 1987, three young patients aged 24, 29, and 39 years had previously been treated for Hodgkin's disease. Staging laparotomy, including splenectomy, had been performed in all three patients. Two patients had both mediastinal irradiation (21 and 27 months before infarction) and chemotherapy. In the first patient, postmortem histologic examination of the coronary arteries revealed fibrotic changes, which were probably induced by radiotherapy. In our second patient, myocardial infarction developed 5 days after vinblastine treatment; early angiography showed thrombotic occlusion of the proximal right coronary artery, which was recanalized using the diagnostic Sones catheter. Subsequent angiography revealed normal coronary arteries. This is, to our knowledge, the first case of documented coronary artery thrombosis after treatment with vinca-alkaloids. In our third patient, neither mediastinal irradiation nor chemotherapy had been performed prior to myocardial infarction. However, a marked increase in platelet counts following splenectomy was observed in this patient. The role of radiotherapy, chemotherapy, and splenectomy with consecutive thrombocytosis as a third possible pathogenic factor for subsequent development of myocardial infarction is discussed.
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PMID:Myocardial infarction in young patients with Hodgkin's disease--potential pathogenic role of radiotherapy, chemotherapy, and splenectomy. 768 Sep 26

Cisplatinum is highly effective in numerous solid tumors and was evaluated in Hodgkin's disease clinical stages (CS) I/II. Sixty-five patients (43 male, 22 female; median age 25, with 12 patients under 16: CS IA-IIA 41, IB 5, IIB 19) were randomly assigned to one of the following arms (PAF87 protocol): 3 ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine with methylprednisolone) cycles (ABVD arm) or 3 ABVD plus cisplatinum cycles (ABVD-Plt arm) followed by radiotherapy (RT); extended field (40 Gy) RT with a short paraaortic field including the spleen (30 Gy) was then administered in the ABVD arm; extended field (30 Gy) without lombosplenic port prophylaxis. RT was administered in ABVD-Plt arm when patients were in complete remission (CR) after chemotherapy (CT). Median follow-up was 35 months (6-62 months). During CT, 1 patient (ABVD-Plt) died from viral meningo-encephalitis; five patients (1 ABVD, 4 ABVD-Plt) stopped treatment because of emesis, of whom three receiving only 1.5-2.5 (ABVD-Plt) cycles, are still in CR after 13-60 months. Fifty-five patients (27 ABVD-Plt) were in CR after CT. Among the 27 ABVD-Plt patients, all in CR after RT, two died (one from myocardial infarction and one from immunoblastic lymphoma); one patient from the ABVD arm died from gastro-intestinal hemorrhage in 1st CR. No ABVD-Plt patient relapsed; 1 ABVD patient relapsed in non-irradiated area. At five years, actuarial survival/relapse-free survival was 96.1/90% and 88.2/100% for ABVD and ABVD-Plt patients, respectively.
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PMID:[Hodgkin disease, clinical stages IA-IIB: evaluation of the value of cisplatin. Preliminary results]. 820 18

From a group of 366 patients with complete data complete remission was achieved by 290. Fifty-five patients relapsed, 39 men and 16 women, mostly with an initial finding of advanced disease (KS III + IV 64%), with affection of the mediastinum (73%) aged under 40 years. 42% of the relapses were detected within one year after termination of primary treatment and 33% during the subsequent 2 years, the longest interval before a relapse being 20 years. During primary treatment in 63% of the patients chemotherapy was reduced to 75-25% of the total dose of cytostatics with protraction of the interval between cycles in 58% and radiotherapy in another 34% of the patients. 76% of the patients with a first relapse achieved a second complete remission and 29 of them survive without signs of the disease, 12 died from generalized lymphoma. Sixteen patients developed repeated relapses (nine two relapses, four three relapses, another two four relapses and one patient five relapses). After treatment of the relapse a total of 22 patients died, incl. 19 who died from Hodgkin's disease, two from secondary carcinoma and one from myocardial infarction. The longest survival period after treatment of a relapse was 26 years.
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PMID:[Relapse in Hodgkin's disease. Incidence of relapse in a group of 374 patients from 1 June 1968 to 31 March 1995]. 860 Jun 52

A 48-year-old woman with no cardiovascular risk factors was admitted to the hospital because of acute dyspnea. At 27-year-old, she developed Hodgkin's disease, that was successfully treated with splenectomy, combined chemotherapy (nitrogen mustard, vincristine, procarbazine, prednisone-MOPP regimen) and radiotherapy (4500 rads). At 43-year-old the lymphoma relapsed and she had further chemotherapy with doxorubicin, bleomycin, vinblastina and dacarbazine. After this treatment, she had an episode of pulmonary edema, attributed to doxorubicin acute cardiotoxicity. She responded to digitalis and diuretics and was discharged with an electrocardiogram (ECG) showing left bundle branch block and a normal echocardiogram. The patient enjoyed good health for several years and 4 months before the present admission the ECG and echocardiogram were unchanged. On this admission there were signs of left ventricular failure with acute pulmonary edema, and a new soft apical murmur (3-4 Levine). The patient required endotracheal intubation and high doses of diuretics, digitalis and vasodilators. The cardiac enzymes were negative, the serial ECGs confirmed left bundle branch block, while the echocardiogram showed moderate to severe mitral regurgitation, akinesia of the interventricular septum and inferior wall with dilation of the left ventricle. A previous silent myocardial infarction was suspected. After recovery, she underwent cardiac catheterization confirming akinesia of the interventricular septum and inferior wall with moderate mitral regurgitation, while coronary angiography showed a critical ostial stenosis of the right coronary artery. In view of a dipyridamole-thallium scan negative for myocardial viability, reperfusion was not attempted. With changes in radiotherapeutic techniques, the incidence of radiation-induced heart disease (pericarditis, myocarditis, conduction abnormalities and, rarely, occlusive coronary artery disease) is declining. Nevertheless, after irradiation of the chest and mediastinum a longterm cardiological follow-up is useful in selecting patients at higher risk of radiation-induced coronary artery disease, who will eventually require coronary angiography and reperfusion intervention.
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PMID:[Silent myocardial infarction in a patient treated with radiation therapy and polychemotherapy for Hodgkin's lymphoma]. 928 80

The aim of this article is to describe guidelines for rational use of lactate dehydrogenase and its isoenzymes, in the diagnostic processes and during follow-up, based on a systematic review of relevant literature. Sources of data for this study were English-language scientific publications, obtained from the database of the National Library of Medicine (Medline), concerning the clinical application (diagnosis, monitoring or treatment of disease) of lactate dehydrogenase and lactate dehydrogenase isoenzyme measurements in serum in the following main clinical fields: cardiology, hepatology, haematology and oncology. For acceptance in the present review, studies had to include: a proper definition of the tested patient population, diagnostic criteria, sampling time, sampling frequency, and test characteristics. Estimation of the relation between lactate dehydrogenase or lactate dehydrogenase isoenzymes and specific diseases expressed as sensitivity, specificity, survival or remission rate were extracted. The application of serum lactate dehydrogenase is relevant in the diagnosis of myocardial infarction (late detection), haemolytic anaemia, ovarian dysgerminoma and testicular germ cell tumor. For monitoring the progress of a disease lactate dehydrogenase is relevant in establishing the survival duration and rate in Hodgkin's disease and non-Hodgkin's lymphoma, and in the follow-up of ovarian dysgerminoma. Rational use of lactate dehydrogenase can be achieved when requests for its determination are limited to the above mentioned conditions. No rationale could be found for measuring lactate dehydrogenase isoenzymes.
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PMID:The clinical value of lactate dehydrogenase in serum: a quantitative review. 947 26

In Hodgkin's disease stage I or II, excellent survival rates have been reached by radiotherapy alone as well as by the combination of radiotherapy and chemotherapy. Unfortunately, patients surviving for longer than 10 to 15 years are at risk for late complications due to the irradiation, such as myocardial infarction and lung and breast cancer. The current treatment strategy is aimed at minimising these late effects without jeopardizing the good survival rates. Randomized trials, such as the Hodgkin trials of the European Organization for Research and Treatment of Cancer (EORTC), are the only way to ultimately determine the relative values of radiotherapy and chemotherapy. Every Hodgkin patient deserves being included in such a trial, because the survival results are optimal. In future clinical trials, radiotherapy alone will probably be replaced by chemotherapy combined with radiotherapy as the principal treatment modality.
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PMID:[Stage I or II Hodgkin's disease: more chemotherapy and less irradiation]. 954 50

A comprehensive survey of late effects (physical, social and reproductive) following treatment at a single institution for early stage Hodgkin's disease (HD) was performed. A total of 611 patients with stage I and II HD treated between 1973 and 1984 were reviewed; 460 were alive and were mailed a self-reported questionnaire. A total of 363 (79%) replies were received. Twenty patients died of second malignancy, 14 of heart disease and nine from respiratory disease. There were 37 cases of second malignancy [relative risk (RR) 2.2, absolute excess risk (AR) 35.8]. The 15-year incidence of heart disease was 11% and there were nine myocardial infarction deaths (RR 1.55, AR 5.4). Twenty-eight (8%) respondents stated that their career had been greatly interfered with, 53 (14.5%) perceived financial loss. Sexual activity was disrupted in 25.8%. In total, 56 men had fathered 112 pregnancies. Of 171 women, 40.3% became pregnant, resulting in 92 live births. A total of 43 men and 16 women had sought medical advice with regard to infertility.
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PMID:Late effects of treatment for early-stage Hodgkin's disease. 957 37

A 76 year old man, who had undergone tonsillectomy for non Hodgkin's malignant lymphoma, died suddenly in rapidly evolving cardiogenic shock with electrocardiographic signs of acute lateral myocardial infarction. Post mortem examination showed three cardiac lesions, two in the left ventricle and one in the right atrium, corresponding to the "crista terminalis". Histologic examination of autopsy samples confirmed the presence of lymphoma in the heart, partially affecting the sino atrial node (NSA) but excluding other sites. There was no evidence of acute myocardial infarction in spite of the clinical signs and symptoms. An infarction-type electrocardiographic pattern associated with conduction disturbances in patients with lymphoma should suggest the possibility of cardiac localization of the disease.
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PMID:Cardiac malignant lymphoma: a case report. 961 4

While radiation therapy has been known to cause myocardial and pericardial damage, its role in accentuating coronary artery disease in the absence of traditional cardiovascular risk factors has been controversial. As younger patients with treatable cancers are being treated with mediastinal radiation, coronary artery disease as a cause for severe chest pain should be entertained as a possible diagnosis. We describe a 25-year-old male who presented with an inferior wall myocardial infarction 6 years after receiving mediastinal radiation and chemotherapy for Hodgkin's disease. He was subsequently treated by directional atherectomy to a 95% lesion in the right coronary artery. Histological examination of the atherectomy specimen revealed evidence of radiation-induced endothelial damage that had resulted in plaque formation and subsequent ischemia. Possible mechanisms for radiation-induced coronary artery disease and treatment options are discussed.
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PMID:Directional coronary atherectomy for the diagnosis and treatment of radiation-induced coronary artery stenosis. 1017 46

A total of 221 consecutive early stage Hodgkin's disease (HD) patients were given mantle field irradiation only or in combination with chemotherapy in 1971-1991. In 1994 these patients responded to a mailed self-report questionnaire covering items on late medical symptoms. Of 200 patients (91%) who reported that their thyroid function had been tested, 110 patients (55% of those tested) had thyroid hypofunction at follow-up in 1994. Ninety-five patients (86% of patients with biochemical hypothyreosis) had started hormonal substitution. In 1993 and 1994, 101 of these patients who had received mantle field irradiation in 1980-1988 were called in for interview, clinical examination and thyroid function tests. Eighteen patients (18%) had started hormonal substitution treatment earlier, but 58 (70%) of the other 83 patients were found to have biochemical hypothyreosis. Of the 221 patients who completed the questionnaire, 66 patients (30%) reported dyspnoea on exertion for more than 3 years after treatment, 8 patients (4%) reported a history of myocardial infarction, 6 patients (3%) reported pericardial disease and 25 patients (11%) heart valve disease. Increased expenses incurred for dental care were reported by 106 patients (48%), increasing to 55% when Waldeyer's ring had been irradiated. The consequences of late sequelae after mantle field irradiation for future treatment are discussed.
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PMID:Late medical sequelae after therapy for supradiaphragmatic Hodgkin's disease. 1041 20


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