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

Lymphomas, which are frequently subdivided into Hodgkin's disease and non-Hodgkin's lymphoma, represent one of the more curable cancers that present as a solid tumor. Unfortunately, most patients cannot be cured with conventional chemotherapy, therefore new techniques have been developed including high-dose chemotherapy and autotransplantation. Non-Hodgkin's lymphoma was one of the first illnesses to be tested using the new methods and initial encouraging results in relapsed lymphoma led to the testing of high-dose chemotherapy with autotransplantation as a primary therapy for patients with lymphomas. Encouraging results have been obtained in several randomized trials. Studies of the treatment of lymphoma have identified several principles related to the application of autotransplantation, which may be relevant to other solid tumors. Autotransplantation is likely to be of benefit only when using active chemotherapeutic agents that can be escalated in dose and when myelosuppression is the dose-limiting toxicity. Chemotherapy-responsive tumors are obvious targets for autotransplantation, whereas chemotherapy-resistant tumors are unlikely to benefit. Other factors that should be taken into account when selecting patients for high-dose chemotherapy regimens include the extent of disease, preceding therapy and the performance status of the patient.
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PMID:High-dose chemotherapy and autologous hematopoietic stem cell transplantation: the lymphoma experience and its potential relevance to solid tumors. 1076 20

CD34+ cell counts in peripheral blood (PB) and corresponding numbers of CD34+ cells and colony-forming units-granulocyte/macrophage (CFU-GM) in 299 leukapheresis products of 209 patients undergoing PB progenitor cell (PBPC) mobilization for autologous transplantation in two different centers were analyzed and compared according to diagnosis: non-Hodgkin lymphoma (NHL, 94 leukaphereses), multiple myeloma (MM, 75), Hodgkin's disease (HD, 37), solid tumors (35), and chronic myeloid leukemia (CML, 32). Without separating disease entities, correlations between PB CD34+ cell counts and leukapheresis content of CD34+ cells (r>0.83, P<0.01) and CFU-GM (r>0.81, P<0.01) were excellent. In both centers, a PB CD34 threshold ensuring a leukapheresis yield > 10(6) CD34/kg was determined. This threshold was higher in center 1 than in center 2, and its predictive accuracy (91.4%, i.e., prediction correct 91.4% of the time) was significantly lower than in center 2 (98.4%, P=0.02). When data were analyzed by pathology, PB CD34+ cell counts and leukapheresis content of CD34+ cells and CFU-GM remained well correlated, and in both centers PB CD34 thresholds predictive of a yield > 10(6) CD34/kg per leukapheresis could be determined for each pathology. For most patients, pathology-specific PB CD34 thresholds could be obtained directly from the equation of the PB CD34/leukapheresis CD34 correlation curve; they varied depending on both pathology and center (range: 7-20 x 10(6) CD34/l). Pathology-specific thresholds predicted a leukapheresis yield > or = 10(6) CD34/kg accurately 100% of the time for MM patients in center 2 and HD and solid tumor patients of both centers, resulting in overall rates of accurate prediction of sufficient graft CD34 content of 96.6% in center 1 and 98.9% in center 2.
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PMID:Use of pathology-specific peripheral blood CD34 thresholds to predict leukapheresis CD34 content with optimal accuracy: a bicentric analysis of 299 leukaphereses. 1175 22

A study is presented of second malignancies detected after treatment for Hodgkin's disease in 942 patients treated at the Institute's Clinic (1973-1993). Solid tumors were diagnosed, generally, during long complete remission, both after chemoradiation or radiotherapy (2.2 and 1.3%, respectively, p > 0.1). Yet, second tumor incidence tended to increase after combination treatment. Intestinal tumors were the most frequent. Tumors did not arise necessarily at sites which had been irradiated. Total doses absorbed by involved organs varied from 4-7 to 24-44 Gy, thus implying that absolute values of such doses did not correlate directly with risk of solid tumor development; the same was true for size of exposure fields. Dose distribution in time is of particular interest: there were no tumors among those treated with accelerated multifractionated irradiation. If radiotherapy procedures are improved and individual schedules of fractionated irradiation are used, the probability of solid tumor incidence, which, after radiotherapy of Hodgkin's disease, is not very high, can be still lowered.
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PMID:[Secondary tumors in Hodgkin's disease patients]. 1178 9

Solid tumor growth consists of an avascular and a subsequent vascular phase. Several studies have now shown that, as in solid tumors, angiogenesis also plays a critical role in the progression of hematological malignancies. Monoclonal gammopathy of undetermined significance (MGUS) and non-active to active multiple myeloma (MM) progress when plasma cells induce angiogenesis and this in turn promotes progression. The increased bone marrow neovascularization, increased angiogenic and proteolytic potential of plasma cells may explain the frequent occurrence of extramedullary localization in MM. As observed in active MM, enhanced bone marrow neovascularization is apparent in acute untreated lymphoblastic leukemia. In B-cell non-Hodgkin's lymphomas, angiogenesis is significantly enhanced in relation to progression. Angiostatic molecules, such as thalidomide, could also be considered for the clinical management of hematological tumors.
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PMID:Angiogenesis, angiogenic factor expression and hematological malignancies. 1190 88

Bone marrow necrosis (BMN) is a relatively uncommon clinicopathologic entity. The etiology is diverse, and malignancy, especially hematopoietic in origin, is the most common underlying disease of BMN. In this retrospective analysis, cases with BMN were re-evaluated for etiology, histopathologic details, and clinical manifestations. In the last 8 years, 23 cases of BMN were detected among the 1,083 bone marrow (BM) biopsies, and the prevalence was found to be 2.2%. Three of these 23 cases with BMN were children, and 20 cases were in adults. Sixteen of these cases (80%) had underlying malignant disease, and four (20%) had nonmalignant disease. Among the malignant cases, three cases had acute myeloblastic leukemia (AML), four had relapsed Hodgkin's disease (R-HD), one had acute lymphoblastic leukemia (ALL), two had chronic myelocytic leukemia (CML), two had non-Hodgkin's lymphoma (NHL), three had disseminated intravascular coagulation (DIC) associated with metastatic solid tumor, and one had myelodysplastic syndrome/myeloproliferative syndrome (MDS/MPS). Among the nonmalignant cases, two had tuberculosis infection, one had anti-phospholipid syndrome (APS), and one had a history of drug ingestion. The most common symptoms were bone pain, fever, fatigue, and jaundice. The most common laboratory findings were variable and associated with underlying disease, but anemia, leukopenia, thrombocytopenia, and high LDH and alkaline phosphatase levels were detected in the majority of the cases, as was also seen in other series. BMN was graded according to the extent of necrosis in the BM biopsy, and necrosis was extensive in 12 cases, moderate in five cases, and mild in three cases. Increased reticulin was found in 16 cases; four cases had severe, eight had moderate, and four had mild fibrosis, and this was found to be an interesting accompanying finding in BMN. In conclusion malignancy is the most common cause of BMN but some nonmalignant conditions such as tuberculosis and APS may be the underlying cause of BMN.
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PMID:Bone marrow necrosis: clinicopathologic analysis of 20 cases and review of the literature. 1221 Aug 11

The current management of early stage Hodgkin's disease (HD) is usually based on clinical staging, combined modality therapy and the use of less toxic chemotherapy regimens. This approach entails high cure rates, while ensures less long term toxicity with avoidance of laparotomy. The aim of this study was to assess the efficacy of a brief course of Adriamycin, Bleomycin, Vinblastine, Dacarbazine (ABVD) chemotherapy followed by limited field radiotherapy (RT) in favorable clinical stage (CS) I and IIA HD. Forty patients, aged 17-68 (median 34) years, with favorable CS I and IIA HD, without bulky mediastinal disease, have been treated with 4-6 (median 4) cycles of ABVD plus limited field RT. Twenty seven (67%) patients received 4 cycles of chemotherapy, while 13 received 5-6 cycles. Thirty five (87%) patients received limited field RT with dose 24-36 Gy and five (13%) received extended field with 36-46 Gy. All patients responded completely to chemotherapy. One patient experienced a relapse two months after the end of therapy. All patients are alive; 39 in continuous complete remission. With a median follow-up period of 44 months (range 18-101) the actuarial overall and progress free survival was 100 and 97% at 5 years. We did not observe any case of secondary leukemia or solid tumor. Pulmonary toxicity was mild in cases of mediastinal irradiation. Considering the short follow-up time and the small number of patients, the combination of a brief course of ABVD plus regional RT is a very efficacious treatment of favorable CS I and IIA HD with mild toxicity. However, long term survival data are needed, which could give confident answers regarding the risk of late therapy related complications, particularly second malignancies.
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PMID:Treatment of early clinically staged Hodgkin's disease with a combination of ABVD chemotherapy plus limited field radiotherapy. 1456 54

Relapse after anthracycline based combination chemotherapy is frequently seen in patients with aggressive non Hodgkin's Lymphomas (NHL), whereas complications such as secondary leukemia or solid tumor rarely occur. We report a patient with diffuse large cell (DLC) NHL and concurrent renal cancer, who developed acute myelofibrosis (AMF) later in the course of her disease. This 60-year-old female patient presented with pancytopenia and a right sided renal mass. Diagnostic work up revealed severe bone marrow infiltration by DLC NHL and renal cancer T1N0M0G2. Cytogenetic and molecular evaluation of bone marow cells showed three distinct clones, (a normal 46XX karyotype, a ringed chromosome 7 and a third clone with an enlarged chromosome 2 as well as several fragments). The patient underwent nephrectomy and eventually received 6 cycles of CHOP 14 chemotherapy. Anemia persisted followed by severe granulocytopenia and thrombocytopenia 6 weeks later. Repeated bone marrow biopsy showed absence of lymphoma and/or cancer metastasis, but massive myelofibrosis with an increased number of atypical megakaryocytes. Considering the short clinical course and the absence of hepatosplenomegaly AMF was diagnosed. The concurrence of three distinctneoplasms within a short period of time as well as the complex cytogenetic aberrations found in her bone marrow cells reflect a strong individual susceptibility to malignant disease in this patient.
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PMID:Acute myelofibrosis in a patient with diffuse large cell non Hodgkin's lymphoma and renal cancer. 1456 65

The most common cause of Pancoast syndrome is bronchogenic carcinoma. Other less common causes are solid tumor metastases, other chest tumors, infections, and hematologic neoplasms. Pancoast syndrome due to lymphoma is very rare, and cases described in the literature are essentially associated with non-Hodgkin lymphomas. In a review of the literature we found a single case of Pancoast syndrome secondary to a Hodgkin lymphoma; however, the syndrome manifested during recurrence of disease in that patient. We report a case of nodular sclerosis Hodgkin lymphoma which first manifested clinically as Pancoast syndrome and which was initially diagnosed by bronchial biopsy.
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PMID:[Pancoast syndrome and endobronchial tumor infiltration as the first manifestation of Hodgkin lymphoma]. 1516 97

This study was performed to determine the degree of osteopenia in children with malignancy before and after completion of treatment. Twenty six subjects (17 male, 9 female) treated for acute lymphoblastic leukemia (n=15), lymphogranulomatosis maligna (n=7) or solid tumor (n=4) at a mean age 9.34 (range 3-17.41 years) before and 15.85 (range 9.66-23) after treatment participated in this longitudinal study. Mean follow up period after discontinuation of therapy was 5.5 years (range 2.6-8.3 years). Interview (estimation of physical activity, other chronic disease, and fractures), anthropometric measurements of body mass and height, body mass index (BMI), bone mineral density total (BMD Total) and spine (BMD Spine) were obtained from every child. Gained findings were compared to the same parameters in the group of 473 healthy children, comparable in age and gender with examined group and showed as SD score. There were no differences in BMI and BMD Total and Spine between patients and controls. No correlation was found between the BMD values and the diagnosis, age at diagnosis, gender and cranial irradiation and duration of follow-up. BMD Spine SD score was significantly increased in a subgroup of patients in pubertal stage at diagnosis as compared to patients in prepubertal stage. Further studies are needed to evaluate the long-term effect on BMD in patients with cancer and how to prevent a decrease of BMD.
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PMID:[Bone mineral density in children before and after completion of cancer treatment]. 1555 8

A 62-year-old woman being treated for stage IIIC rectal adenocarcinoma was diagnosed with primary non-Hodgkin lymphoma of the breast after a 4-year follow-up. This case illustrates the importance of close and long-term follow-up as well as of differential diagnostic procedures for second primary malignancies after the initial diagnosis and treatment of a solid tumor.
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PMID:Primary non-hodgkin lymphoma of breast in a patient with rectal carcinoma and magnetic resonance spectroscopic examination. 1576 90


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