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

We treated 20 young men, after giving informed consent, with buserelin during their tumor treatment period. 11 of them suffered from Hodgkins disease, 2 had a non-Hodgkin lymphoma, 6 had a seminoma and 1 patient had an embryonic carcinoma of the testis. 7 of these patients received cytostatic treatment with MOPP and/or ABVD, 9 patients had a radiation treatment, 3 received both treatments. One patient remained free of further treatment. Buserelin treatment was recommended to start at least 7 days prior to the tumor treatment, the interval ranged between 7 and 43 days. It ended on the same day as the tumor treatment or some days later, but this recommendation was followed only in 12 patients. 4 patients cessated buserelin treatment before end of the tumor therapy, and 4 other dropped out of the study. Testosterone plasma levels were measured before, during and after treatment with buserelin. 7 days after starting they were increased in most patients, while they were lower after 14 days and at the end of treatment period. Semen analysis showed sperm counts of 1 to 44 millions/ml with motility rates from 9 to 81%. In only ten patients we analysed a semen sample up to 6 months after cessation of treatment. In all but one we found azoospermia. Thus this treatment at now cannot be recommended in young men undergoing cytotoxic treatment to preserve fertility.
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PMID:Treatment with the gonadotropin-releasinghormone agonist buserelin to protect spermatogenesis against cytotoxic treatment in young men. 247 46

Mediastinal large cell lymphoma with sclerosis (MLCLS) is a recently described entity characterized by its locoregional extension, within the anterior mediastinum, and its B cell origin, although the proliferation arises from the thymus. It has been, in the past, often mistaken for other tumors of the anterior mediastinum: invasive thymoma, Hodgkin's disease, poorly differentiated clear cell carcinoma and seminoma, thus leading to inappropriate therapeutic approaches. We diagnosed 6 cases of MLCLS in 1986 and 1987, in 4 males and 2 females, aged 16 to 44 (mean 27). Five of the 6 patients presented with a compressive anterior mediastinal mass, dyspnea, dysphonia, superior vena cava syndrome and parietal protrusion (3 cases). The CT scan confirmed the invasive and compressive characters of the tumor. Two patients initially had disseminated disease. Microscopically, the proliferation was composed of large clear cells, and segmented by bands of sclerosis. Immunologic studies demonstrated the B origin of the tumor cells. All 6 patients received combination therapy with an intensive CHOP protocol (L N H 84 Lyon). The first patient was initially operated, after a false frozen section diagnostic of thymoma. Resistance to chemotherapy (and rapid death within 2 months) was seen in 2 cases. On patient had a partial remission and 3 entered complete remission, of 5+, 10+ and 11 months duration, respectively, with central nervous system relapse in the latter case. Excavation of the tumor on CT scan imaging seemed to be a poor prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Large B cell lymphoma of the mediastinum. 6 cases]. 265 64

A case of seminoma is described in a patient with HIV infection. The tumor presented atypically with no lymphocytic infiltrates within the stroma. HIV infection has been reported to be associated with an increased incidence of Kaposi's sarcoma, non-Hodgkin's lymphomas, oropharyngeal carcinoma and pancreatic carcinoma.
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PMID:Unusual presentation: testicular seminoma. 272 75

Mutant clonogenic cells, resistant to individual chemotherapeutic agents, are known to play a central role in clinical chemotherapy failure. The possibility that mutant cells, resistant to conventionally fractionated megavoltage photon radiotherapy, exist in human tumors is considered. Applying the mutation theory of Luria and Delbruck to describe the appearance of resistant cells, several conclusions follow: (a) the mean number of resistant cells in a tumor will be determined by the tumor size and the mutation rate; (b) a wide variation in radiosensitivity in tumors of the same histology is expected, because of a large variation in the number of resistant cells that they contain; (c) the presence of a resistant clone will not reduce the tumor-control probability until the tumor becomes sufficiently large; (d) initial response will not be a reliable predictor of long-term control; (e) clonogenic assays may not accurately predict treatment outcomes; (f) the mutation rate may be the most accurate predictor of tumor aggressiveness and resistance to various treatment modalities; (g) tumors with a low mutation rate, which may include seminoma, Hodgkin's disease and many pediatric tumors would be curable by either chemotherapy or radiation; (h) pleomorphic tumors with a high mutation rate, which may include glioblastoma multiforme, would be difficult to cure by any means. Clinical and experimental evidence is reviewed for the existence of radioresistant cell lines in human and animal tumors, and further experiments are proposed to test this hypothesis. Treatment strategies for targeting radioresistant clones are discussed.
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PMID:Tumor heterogeneity, tumor size, and radioresistance. 280 62

Glycoproteins isolated from human milk fat globule membranes, designated epithelial membrane antigen (EMA), have been detected immunohistochemically in most nonneoplastic epithelia and are potentially a highly effective marker for establishing the epithelial nature of neoplastic cells. With commercially available monoclonal antibodies and an indirect immunoperoxidase technique, EMA localization was evaluated in paraffin-embedded tissues from a wide variety of neoplasms (320 specimens). Adenocarcinomas from various primary sites (breast, lung, colon, stomach, pancreas, gallbladder, prostate, endocrine glands, ovary, kidney, thyroid) were immunoreactive for EMA in 88 of 97 cases (91 per cent). Cytoplasmic and apical luminal membrane staining were the most common patterns of immunoreactivity, with peripheral membrane staining or other patterns also seen in some neoplasms. Squamous cell (13 of 13 cases) and transitional cell (12 of 12 cases) carcinomas, small cell anaplastic carcinomas (12 of 12 cases), and mesotheliomas (six of six cases) were also uniformly EMA-positive. Malignant lymphomas of the Hodgkin's (15 cases) and non-Hodgkin's types (74 cases), except for the true histiocytic lymphomas and occasional T-cell lymphomas, were nonreactive for EMA. Neoplastic and nonneoplastic plasma cells showed variable EMA positivity. Endocrine neoplasms (17 cases), including carcinoid tumors, medullary carcinoma of thyroid, adrenocortical carcinomas and pheochromocytomas, and germ cell tumors (eight cases, embryonal carcinoma and seminoma), and a wide variety of soft tissue tumors (27 cases) generally lacked immunoreactivity for EMA; the exceptions to this finding were synovial sarcomas and an epithelioid sarcoma. Malignant melanomas (eight cases) were typically nonreactive. Based on the observations in this large series of neoplasms, EMA is an excellent marker of epithelial differentiation, appears to be highly reliable for discriminating between poorly differentiated carcinomas and malignant lymphomas, and is especially helpful in characterizing small cell anaplastic carcinomas. Epithelial membrane antigen immunoreactivity is well preserved in paraffin sections of routinely processed tissues, facilitating application of this technique in diagnostic surgical pathology.
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PMID:Epithelial membrane antigen--a diagnostic discriminant in surgical pathology: immunohistochemical profile in epithelial, mesenchymal, and hematopoietic neoplasms using paraffin sections and monoclonal antibodies. 299 53

Twenty-eight patients with malignant tumors of the thymus were surgically treated during the 15-year period from 1969 to 1984. Twenty-six patients had far advanced disease when treatment was began. Of fifteen patients with malignant thymoma, the tumors were successfully removed in five patients by using the technique of combined resection of SVC. Of two patients with carcinoid, one is alive and another died two years after extended operation. Of two patients with malignant lymphoma, one with non Hodgkin's disease died three years after operation, and the other with Hodgkin's disease is alive with tumor bearing. It is important to distinguish malignant lymphoma from other types of thymic tumors, because chemo-radiotherapy is superior to surgical therapy. Of nine patients with germ cell tumor, two patients with seminoma have been well for 11 and 5 years. CDDP and radiotherapy were effective on their long survival. Three patients with embryonal carcinoma responded well to combined surgical and chemo-radiotherapy. But only one of them is alive with tumor free one year after operation. Prosthetic grafts were employed in 7 cases for replacement of the innominate and superior caval vein. Angiogram taken one month after operation disclosed the overall patency rate with 92% and the longest patent period confirmed was 4 years. Extended operation by using the prosthetic graft should be performed in the advanced cases to achieve a complete removal and to aim better prognosis for this kind of disease. In conclusion, aggressive surgical removal followed by radio-chemotherapy offers best cure of the malignant thymic tumor.
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PMID:[Management of malignant tumors of the thymus]. 299 45

Fifty-seven patients with advanced malignant tumours were treated with ifosfamide (Holoxan) and mesna (Uromitexan) in our department from November 1979 to December 1984. This series comprised eight cases of soft tissue sarcoma, nine cases of ovarian carcinoma, five cases of non-seminomatous testicular tumour, 11 cases of bronchogenic carcinoma, three cases of renal carcinoma, seven cases of non-Hodgkin's lymphoma, two cases of skeletal fibrosarcoma, two cases of breast carcinoma, one case each of Ewing's tumour, prostatic carcinoma, seminoma, plasma cell tumour, multiple myeloma, malignant teratoma, nasopharyngeal carcinoma, Wilms's tumour, neuroblastoma and mycosis fungoides. Out of these 57 cases, 53 were evaluable. There were five complete remissions and 20 partial remissions, corresponding to a total response rate of 47%. The overall median survival time (MST) of the 53 evaluable patients was 7.5 months. The responders had a longer survival time (MST 10 months) than the non-responders (MST 4.75 months) (p greater than 0.05). Analysis of the results according to sex, age, dosage of ifosfamide and degree of histological differentiation of the tumour cells failed to show any influence of these factors on the therapeutic results. The response rate to ifosfamide found in this study might be related to the histological origin of the tumours and to whether the primary tumours had been resected. The non-seminomatous testicular tumours, non-Hodgkin's lymphomas and ovarian carcinomas showed a high response rate. The response rate was higher in the group in which the primary tumour had been resected (61%) than in the non-resected group (12%) (except the non-Hodgkin's lymphoma). The side-effects of this regimen were moderate. Dyspepsia, nausea, vomiting, myelodepression, dizziness, and alopecia were common. Cystitis could be prevented nearly completely by concomitant administration of mesna, when given correctly, for preventing side-effects of ifosfamide on the urinary system (haemorrhagic cystitis, etc.).
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PMID:Treatment of advanced malignancies with ifosfamide under protection with mesna. 313 Mar 16

There are only infrequent complications from intermediate dose infradiaphragmatic radiation to the para-aortics or para-aortic and iliac nodal regions as given in Hodgkin's disease or seminoma. Nonetheless, such complications can cause significant debility and may be lifelong. Treatment related factors associated with such complications should be identified and where possible, avoided. We have analyzed the records of 1,026 patients treated nationwide in the Patterns of Care Outcome. Studies including the Hodgkin's national practice survey (387 patients), Hodgkin's large facility survey (253 patients), and Seminoma national practice survey (386 patients). There were 883 patients who received infradiaphragmatic radiation to the para-aortics or para-aortic and iliac regions. Complications which occurred in these patients included gastrointestinal injury, hepatitis, nephritis, gonadal injury, hematopoietic injury, second malignancy, and miscellaneous others. There were 139 complications of any severity and 35 major complications requiring hospitalization for management. The 3-year actuarial complication rates were 14% and 4% for any and major complications, respectively. There was a statistically significant increase in both any complications and major complications with dose (p less than .01). The most frequent complications were those related to gastrointestinal injury such as peptic ulceration, hemorrhage, chronic diarrhea, and intestinal obstruction. Major bowel complications comprised 60% (21/35) of major complications and increased with dose from 1% for doses less than 3,500 cGy to 3% for doses greater than or equal to 3,500 cGy (p = .03). This study indicates that total dose is an important factor in determining complications, particularly gastrointestinal injury, in patients receiving infradiaphragmatic radiation in Hodgkin's disease and seminoma and that prior G.I. disease is associated with an increased risk of radiation related bowel complication. The radiotherapist should seek to optimize the therapeutic ratio in these diseases where gross disease can be controlled with 3500 cGy or less with few exceptions.
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PMID:Complications from large field intermediate dose infradiaphragmatic radiation: an analysis of the patterns of care outcome studies for Hodgkin's disease and seminoma. 339 25

Human cancers are either refractory to chemotherapy, or acquire resistance to it. Although acquired resistance to chemotherapy is generally ascribed to the drug itself, it may be linked with the nature of neoplasia, since normal tissues e.g. gastrointestinal mucosa or bone marrow, do not seem to acquire resistance and their perpetuating sensitivity even undermines effective treatment. According to the theory presented herewith, chemotherapy ultimately fails since it is based on wrong premises. Cancer is regarded here as a metabolic deficiency, originating in stem cell destruction. Besides serving as tissue progenitors, stem cells are postulated to secrete a vital substance 'A' necessary for proper tissue function. Carcinogens interfere with 'A' production mainly by destroying stem cells, which the organism is incapable of fully replenishing, so that less 'A' is produced. This irreversible 'A' deficiency may be replenished solely by a substitute, or substance 'B', produced by a specialized organ, the neoplasm. Since carcinogens continue depleting additional stem cells, the deficiency worsens. In order to keep up with increasing demand the neoplasm has to proliferate more and more until it reaches a stage of decompensation when the harm inflicted by it outweighs its benefit. Stem cell depletion is regarded here as the common final pathway of carcinogens. The theory predicts that following a supply of 'A' producing stem cells or inactivated 'B' producing neoplastic stem cells, the tumor will regress. Tumor regression is achievable also by diminishing the demand for the missing metabolites, which may be accomplished by chemotherapy. 'A' and 'B' are consumed mainly by transitional cells. Upon their elimination the demand for 'A' declines and the tumor may wane. This is regarded here as the main role of chemotherapy in cancer, while its tumoricidal potency is indicated solely for repairing tumor induced function loss. It is proposed here that the good response to chemotherapy by Hodgkin's disease and seminoma is linked with their being partially infective. Both start as genuine smouldering infections turning later into neoplasms. While chemotherapy is adequate only during the infective phase, it is met with mounting resistance when applied during the neoplastic phase.
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PMID:Resistance to cancer chemotherapy. 363 6

Although most thymic seminomas have a histologic appearance similar to those arising in the testis, some seminomas undergo pronounced secondary changes that may obscure the diagnosis. We found three cases that showed a combination of reactive follicular hyperplasia (three cases), large cysts (three cases), epithelioid granulomas (two cases), and fibrosis (two cases), to such a degree that the seminoma component was indistinct. Immunoperoxidase staining for keratin in one case highlighted the intimate association of the positively staining thymic epithelial cells with the nonstaining seminoma cells. The seminoma cells in this case were reactive with placental alkaline phosphatase. No other group of thymic or mediastinal tumors, including those of Hodgkin's disease, exhibited this combination of secondary reactive changes to a similar degree. Because of the favorable prognosis of thymic seminomas, these variants should not be confused with other mediastinal tumors.
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PMID:Unusual thymic seminomas. 375 28


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