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)

Between 1967 and 1977, 48 patients with Hodgkin's disease under 16-years-old were treated with MOPP chemotherapy alone at the Uganda Cancer Institute because radiotherapy facilities are not available. Thirty-eight percent had early stage disease (stages I-IIIA). Prolonged first remissions were achieved in 74% of 42 complete responders. Of 11 patients who relapsed, 5 had prolonged second remissions induced by MOPP. Three patients were lost to follow-up and 15 of the remaining 45 died: 12 of these from progressive Hodgkin's disease, 2 from unrelated causes and 1 from Burkitt's lymphoma after 4 months remission from Hodgkin's disease. Acturial survival for all patients is 67% (75% for stages I-IIIA and 60% for stages IIIB-IV). Treatment complications included Herpes zoster and gynaecomastia. The latter is probably related to gonadal dysfunction. All stages of childhood Hodgkin's disease can be successfully managed with MOPP chemotherapy alone.
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PMID:Childhood Hodgkin's disease in Uganda: a ten year experience. 68 86

A relatively common viral agent of low virulence and infectivity might be of etiologic importance in Hodgkin's disease. Age at initial exposure is a major determinant of the outcome of infection (immunity versus clinical disease) and the different epidemiologic patterns for this lymphoma observed internationally. Early exposure, particularly when it occurs in persons from high birth ranks, is associated with a relatively durable immunity. In contrast a delay in initial exposure, also mediated by family factors, results in higher clinical disease-to-immunity ratio. The large male excess in childhood Hodgkin's disease might be due to some sex-linked environmental factor operating early in life and the greater frequency of an asymptomatic carrier state in this sex.
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PMID:Immunity in Hodgkin's disease: importance of age at exposure. 69 36

Sex, age and histopathologic pattern of 322 cases of Hodgkin's disease diagnosed at the Laboratory of Pathology of Oporto Medical School between 1930 and 1974 are presented. 35 (10.9%) of the 322 patients were less than 10 years old. The male/female ratio of childhood Hodgkin's disease was 2.9:1 and the histologic observation revealed mixed cellularity in 18 (51.4%) and nodular sclerosis in 10 (28.6%) of the 35 cases. Childhood Hodgkin's disease relative frequency has abruptly decreased in the last five years of the study period. Most of the children belonged to large families living under poor socioeconomic conditions and the majority of them presented in advanced clinical stages. These findings are similar to those previously described in some developing countries of tropical and subtropical regions and reinforce the advanced relationship between under-development and the geographic variations in childhood Hodgkin's disease frequency and pattern.
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PMID:Relative high frequency of childhood Hodgkin's disease in the north of Portugal. 70 41

Fifty-nine children with Hodgkin's disease were seen over a 34-year period. Compared with Hodgkin's disease in adults, there was an increased male incidence, especially in the younger children. This was associated with an increased male incidence of lymphocyte-predominant histology. Forty-six patients underwent lymphography as part of their staging, and 13 had staging laparotomies. The 5-year survival for the entire group was 85%, with a median survival of 10 years. Response to radiotherapy in children with Stages I-IIIA disease was: 12 children treated with involved-field radiotherapy after inadequate clinical staging had a 3-year remission rate of 13%, and a median length of remission of 18 months; 24 children treated with extended-field radiotherapy after adequate clinical staging, including lymphography, had a 3-year remission rate of 72%, and a median duration of remission not yet reached; 3 children treated with elective local radiotherapy for Stage IA disease after intensive clinical staging remain in complete remission for periods of up to 34 months. Eight out of 10 children with Stages IIIB-IV disease, treated with combination chemotherapy, achieved complete remission with a 3-year remission rate of 70%; 7 children treated with combination chemotherapy following relapse after radiotherapy all achieved complete remission with a 3-year complete remission rate of 66%. Thirteen children underwent laparotomy and splenectomy as a staging procedure. Five were found to have intra-abdominal disease, including 4 with splenic involvement. These results show that there is no place for involved-field radiotherapy after inadequate clinical staging, in the management of childhood Hodgkin's disease. Extended-field radiotherapy after adequate staging, and combination chemotherapy, produce results which are as good as those for adults, but the benefits of these treatments and of staging laparotomy must be balanced against the possible complications when they are used in children. These problems are discussed and a scheme of management is proposed.
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PMID:Hodgkin's disease in children. 88 79

From 1970 to 1988, 121 patients younger than 18 years of age who had newly diagnosed Hodgkin's disease were treated at the Children's Hospital of Philadelphia (CHOP) and the Hospital of the University of Pennsylvania (HUP), Philadelphia, Pennsylvania. Fifty-five of 79 children with mediastinal masses (MM) had pretreatment chest radiographs from which a mediastinal mass ratio (MMR) could be calculated. Within a range of MMR values, 0.25 was the best prognosticator for event-free survival (EFS) for all patients. In those treated with radiation therapy (RT) alone, the intrathoracic relapse rate was zero of five patients with small MM (MMR less than 0.25) versus five of eight patients with large MM (P = 0.09). For combined-modality therapy (CMT), there were intrathoracic relapses in zero of four patients with small MM versus 5 of 32 patients with large MM (P = 0.8). For CMT, the intrathoracic relapse rates for those receiving more than 3500 cGy versus less than 2500 cGy were 0 of 4 patients and 5 of 27 patients, respectively (P = 0.8). The intrathoracic relapse rate in children with large MM was significantly lower for CMT than for RT (5 of 32 patients versus 5 of 8 patients) (P = 0.02). The authors concluded that in pediatric Hodgkin's disease, a MM with a MMR greater than or equal to 0.25 may be associated with poor intrathoracic control after RT alone. Despite this, children with large MM treated with RT alone had an excellent overall survival rate.
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PMID:Mediastinal masses in children with Hodgkin's disease. An analysis of the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania experience. 137 89

The results of treatment of 171 children with stage I-II Hodgkin's disease from two institutions with differing approaches to management have been analyzed. At the Stanford University Medical Center/Children's Hospital at Stanford (SUMC/CHaS), pathologic staging followed by extended-field radiation alone or involved-field radiation plus combination chemotherapy have been cardinal to the management policy. At St Bartholomew's Hospital/The Hospital for Sick Children at Great Ormond Street (Barts/GOS), clinical staging only has been used over the last 10 years, and involved/regional-field radiotherapy used as the treatment of choice rather than extended-field radiotherapy. Some children at each institution received combined modality therapy as primary management. Relapse among children with stage I disease was a more frequent occurrence in the Barts/GOS series than in the SUMC/CHaS group. However, the survival rates from the two centers are identical, 91% at 10 years. The following scientific-philosophic question is asked: Should one maximally stage and treat all children to increase the likelihood of a high freedom from relapse (FFR; cure) rate, or is it acceptable to minimize the initial staging and treatment, realizing that a proportion of patients will fail and require salvage/rescue therapy? With the awareness of morbidity from pathologic staging and aggressive treatment, and the favorable survival data reported from specialized centers using differing approaches, treatment strategies should be directed toward the long-term goal of cure of disease with maximal quality of life. A multidisciplinary management philosophy undertaken at a center with extensive experience in pediatric Hodgkin's disease is important to achieving this goal.
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PMID:Stage I-II pediatric Hodgkin's disease: long-term follow-up demonstrates equivalent survival rates following different management schemes. 219 15

In this register study the epidemiologic features of Hodgkin's disease (HD) in Cuba and Sweden during 1964-1981 are compared. HD in the adult (greater than or equal to 15 years of age) is more common in Sweden than in Cuba (age-standardized incidence rate 3.6 X 10(5) vs. 3.1 X 10(5) but for childhood HD the opposite is true (2.1 X 10(5) vs. 3.0 X 10(5). In both countries a male predominance is found. A decrease in the incidence of HD is noted only in the Swedish population after 1973. The study reveals a stable bimodal age incidence pattern in Sweden but a shift from a linear increasing to a bimodal incidence pattern in Cuba, which parallels the Cuban development from an agricultural to an industrialized country.
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PMID:Epidemiological study of Hodgkin's disease in Cuba and Sweden. 234 66

The relationship of iron-binding proteins to prognosis was studied in 50 children at the Children's Hospital of Philadelphia, newly diagnosed with Hodgkin's disease (HD). There were five patients with Stage I, 18 with Stage II, 14 with Stage III, and 13 with Stage IV. Initial serum ferritin, transferrin, iron, hemoglobin (Hb), erythrocyte sedimentation rate (ESR), and A or B symptoms were analyzed for their association with progression-free survival (PFS). There was a linear increase of mean and median ferritin levels and a decrease of mean and median transferrin levels with advancing stages. Also, there was a significant inverse correlation between ferritin and transferrin (P less than 0.001). In univariate analyses, high ferritin (greater than 142 ng/ml) (P = 0.02) and low transferrin (less than or equal to 250 mg/dl) (P = 0.008) were significantly associated with poor PFS. Serum iron, Hb, ESR, and A or B symptoms were not associated with PFS. Stepwise proportional hazards regression analysis of all factors showed that transferrin was the only factor significantly associated with PFS. These preliminary results suggest that serum transferrin can also be used as a prognostic factor in addition to serum ferritin and that it may be helpful to assay both serum ferritin and transferrin as prognostic factors in childhood HD. Further testing of large groups of patients is needed to determine whether they are independent of tumor bulk and other established prognostic factors.
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PMID:Prognostic importance of serum transferrin and ferritin in childhood Hodgkin's disease. 236 13

Since pediatric Hodgkin's disease is a curable malignancy, it is essential to limit treatment sequelae. This study examines post-treatment pulmonary, cardiac, and thyroid function in 34 children, ages 5 to 17 (23 male and 11 female) with Hodgkin's disease. All received combined modality therapy of 6 cycles of alternating ABVD/MOPP chemotherapy and low dose (1500-2500 cGy) involved field radiotherapy. Mean follow-up period is 27.5 months with actuarial freedom from relapse of 94% and survival of 92%. Twenty asymptomatic patients underwent pulmonary function testing following chemotherapy and supradiaphragmatic radiotherapy. Eleven patients had post-treatment carbon monoxide diffusing capacity (DLCO) performed. Six of 11 children (55%) had abnormal values (mean 66%, range 58-80) showing either a reduced DLCO compared to pretreatment or an low absolute value. Eight of the twenty patients (40%) tested post-treatment for FEV1, FVC, TLC and flow volume loop had abnormal results. Six showed restrictive abnormalities and two had obstructive dysfunction. Fourteen patients underwent cardiac nuclear gated angiogram after completion of chemotherapy. Two asymptomatic patients (14%) had abnormal scans showing either a low resting ejection fraction or a decreased response to exercise. Thyroid function was evaluated post-treatment in twenty-one patients by TSH, T4, free T4 or sensitive TSH analysis. Four (21%) had an elevated TSH with a normal T4 after treatment. Although post-treatment thyroid and cardiac effects were minimal, post-treatment pulmonary dysfunction in asymptomatic patients was substantial with more than 50% of tested children demonstrating an abnormal DLCO and 40% showing restrictive or obstructive pulmonary parameters. These abnormalities were observed following a maximum bleomycin dose of 60 units/m2. Bleomycin and pulmonary radiotherapy have adverse effects on diffusing capacity and the long-term pulmonary sequlae of combined ABVD chemotherapy and radiotherapy are unknown. Our analysis suggests that even in asymptomatic children, pulmonary abnormalities are frequent.
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PMID:Pediatric Hodgkin's disease: pulmonary, cardiac, and thyroid function following combined modality therapy. 246 27

Childhood Hodgkin's Disease rarely involves the nasopharynx or the brain. This is a report of a 12-year-old boy who presented with a 3-month history of headache, diplopia, dizziness, and early morning vomiting. Computerized axial tomography (CT) scan revealed a nasopharyngeal mass with intracranial extension through the skull base. Biopsy of the nasopharyngeal mass and an upper cervical lymph node was consistent with Hodgkin's disease of mixed cellularity. This, to the author's knowledge, is the first report of a child having the combination of nasopharyngeal and intracranial involvement in Hodgkin's disease.
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PMID:Nasopharyngeal Hodgkin's disease with intracranial extension in a child. 270 39


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