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

Seventeen patients with advanced stage Hodgkin's disease who relapsed or failed to respond to multiple regimens of combination chemotherapy (mostly Mechlorethamine, Vincristine, Procarbarzine, Prednisone and Adriamycin, Bleomycin, Vinblastine, Dacarbazine) were treated with accelerated hyperfractionated total lymphoid irradiation (TLI) and high-dose chemotherapy followed by autologous bone marrow transplantation (AuBMT). Candidates for the protocol did not have prior radiation therapy and had no evidence of bone marrow involvement. Their bone marrow was initially harvested and cryopreserved. The treatment protocol consisted of reinduction with conventional doses of combination chemotherapy followed by boost local field irradiation to areas of residual disease (1500 cGy within 5 days) and total lymphoid irradiation (2004 cGy given in 12 fractions of 167 cGy each t.i.d. delivered within 4 days). The patients were treated with Etoposide (250 mg/m2/day I.V. X 3 days) and high-dose Cyclophosphamide (60 mg/kg/day I.V. X 2 days). Cryopreserved (unpurged) autologous bone marrow was infused 48 hr after completion of chemotherapy. Of the 17 patients treated, four were in relapse and 13 refractory to multiple regimens of combination chemotherapy. Four patients died during the immediate peritransplant period (2--septicemia, 2--pulmonary complications). Of the 13 surviving patients, 12 entered a complete remission and one had a partial remission and died of disease 6 months later. One patient relapsed 5 months after treatment and is currently alive with disease. Eleven patients (65%) are alive with no evidence of disease 4-35 months (median 20 months) following completion of therapy. Treatment with this protocol results in a high rate of complete remission and a potential for long-term disease-free survival in previously unirradiated patients with advanced stage refractory or relapsed Hodgkin's disease who have exhausted conventional modes of chemotherapy.
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PMID:Total lymphoid irradiation, high-dose chemotherapy and autologous bone marrow transplantation for chemotherapy-resistant Hodgkin's disease. 247 11

A patient with bilateral renal metastases from non Hodgkin's malignant lymphoma originating in the aortocaval abdominal lymph nodes was treated with chemotherapy. Initially, methotrexate (20 mg/m2), vincristine (0.6 mg/m2), cyclophosphamide (500 mg/m2), adriamycin (20 mg/m2), and bleomycin (30 mg/m2) were given on day 1, cisplatinum (50 mg/m2) was given on day 2, and prednisolone (20 mg/body) was given from day 1 to 3 (MVP-CAB regimen). Since the patient was 74 years old and had slight renal dysfunction, for the first and second courses of this therapy, methotrexate and cisplatinum were administered at 60% of the usual dose and the other 4 anticancer agents at 70% of the usual dose. Only prednisolone was given at the full dose. From the third course the 6 anticancer agents were used at 70% of the normal dose. Administration was performed every 4 weeks until the third course, and every 8 weeks after the fourth course (total number of cycles of MVP-CAB: 8 cycles). A marked improvement of the general state and a reduction of the tumor size were noted following treatment. Since regrowth of the residual tumor occurred, as second line chemotherapy cytosine arabinoside (100 mg/m2) on day 1, ifosfamide (1 g/m2) on day 1 to 2, etoposide (100 mg/m2) plus prednisolone (20 mg/body) on day 1 to 3 were administered (AraC-VIP regimen). The timing of administration was similar to that of the MVP-CAB regimen. More than 50% tumor reduction was obtained with this regimen. The total survival time since the beginning of chemotherapy is 2 years to date.
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PMID:[A case of bilateral renal metastases from non Hodgkin's malignant lymphoma]. 261 83

Modern multidisciplinary treatment of childhood cancer has made extent of disease evaluation important for proper treatment planning. Accurate staging is essential to cooperative group studies and for comparing treatment modalities at different centers. Operative staging plays an important role where clinical or imaging methods are limited, as in abdominal Hodgkin's disease or regional nodal metastasis. Operative staging is carried out either as a special diagnostic procedure, as in lymphoma, or as part of a planned surgical resection of a solid tumor. For lymphomas: Operative staging of abdominal Hodgkin's disease is required where protocols include involved field irradiation and sparing of normal growing tissue in the child. In non-Hodgkin's lymphoma, bulky abdominal tumor may be surgically evaluated after intensive chemotherapy either in delayed primary surgery or in second look procedures. Residual tumor may be excised or tagged with clips for localized irradiation to the tumor sparing normal abdominal organs. For solid tumors: During surgical resection of neuroblastoma, Wilms' tumor and rhabdomyosarcoma, the correct procedure involves regional staging either by formal node dissections or by multiple biopsies to determine extent of spread. Regional node dissections are often part of a correct cancer operation for cure, but also give staging information unobtainable by other methods. The surgeon must plan every procedure carefully with the aim of curing the patient and also deriving maximum information from the operation to enable correct planning of further treatment.
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PMID:The objectives and importance of operative staging of children with cancer. 301 92

Thanks to computed tomography the diagnostics of Hodgkin's disease has improved for both the nodal and the extranodal affection. CT is of special importance to determine an extension along the thoracic wall and to assess a pericardial and vascular invasion. All lymph node groups are visualized by computed tomography, but the structure of the lymph nodes cannot be assessed. In a series of 68 patients suffering from Hodgkin's and non Hodgkin's lymphomas, a retroperitoneal lesion was found by CT in 77% and by lymphography in 90% of cases. Sonography is considered as a complementary method. CT is not very sensitive in case of a spleen and liver lesion. Percutaneous biopsy is recommended for the diagnosis of recurrences and for the assessment of residual tumor tissue.
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PMID:[Lymphogranulomatosis: diagnosis by conventional roentgen studies and computed tomography]. 389 Feb 74

The autopsies of seven patients with disseminated varicella were reviewed. Six patients had acute lymphoblastic leukemia (ALL) and the seventh had Hodgkin's disease. All the patients were on chemotherapy at the time of commencement of their varicella rash, and at autopsy only the patient with Hodgkin's disease had residual tumor. The typical anatomic lesion of varicella was one of focal necrosis (often hemorrhagic) with eosinophilic intranuclear (Cowdry type-A) inclusions. In fatal disseminated varicella the complications most commonly encountered at autopsy were interstitial pneumonitis, hepatitis, necrotizing splenitis and lymphadenitis, esophagitis, enteritis, colitis, and pancreatitis. The most significant of these complications appears to be the interstitial pneumonitis, as the major cause of death is respiratory failure.
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PMID:Disseminated varicella at autopsy in children with cancer. 632 Oct 8

We examined and surgically restaged (using posttreatment laparotomy) 26 patients with stage III and IV Hodgkin's disease treated with combination chemotherapy and in apparent remission to determine the status of their clinical remission. Eleven patients had normal clinical restaging and surgical restaging. Fifteen patients had abnormal clinical restaging, mainly consisting of abnormal lymphangiograms or abdominal CT scans. Ten lymphangiograms were abnormal and could not exclude persistent lymphoma. Two of the 15 patients proved to have Hodgkin's disease involving the para-aortic nodes and the spleen. With a median follow-up of 24 months, two patients had relapses in supradiaphragmatic sites and no patient with a negative laparotomy had a recurrence abdominal sites. Restaging laparotomy in selected patients with Hodgkin's disease with abnormal lymphangiograms or CT scans may identify additional patients with residual lymphoma who require further therapy and, more importantly, may identify those patients who have no residual disease and, therefore, may be spared additional therapy. Mortality and morbidity were nil.
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PMID:Posttreatment laparotomy for Hodgkin's disease. 663 38

Cervical lymph nodes are frequently involved in malignant lymphomas, especially in Hodgkin's disease. The surgeon who performs a lymph node biopsy should be aware of the technical problems concerning fixation, conservation, and transport of the surgical specimen in order to allow special immunologic and histochemical techniques, if there is a high degree of suspicion of malignant lymphoma. Staging laparotomy should be considered only if non invasive diagnostic methods have been non contributory and if the potential change in staging involves a change in treatment. Radiotherapy is the main part of the therapeutic strategy in stage I/II whereas chemotherapy is primarily considered for stage III/IV. Stage I/II, with B symptoms, with massive mediastinal involvement, and/or with a large number of nodal sites, may benefit from the combination of chemotherapy and radiotherapy. On the other hand, irradiation of residual disease after chemotherapy should be considered in disseminated disease.
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PMID:[Cervical adenopathies of malignant lymphomas and especially Hodgkin's disease]. 685 33

Twenty-six patients with Hodgkin's disease were restaged both clinically and surgically within 2 months of completing their planned chemotherapy. Six patients (23%) had surgically proven persisting disease. Patients were divided into three groups: group I--eight patients had normal findings at clinical restaging and all were free of disease at surgery; group 2--13 patients had abnormal findings at clinical restaging, but only two (15%) were surgically documented to have persistent disease; and group 3--five patients had incomplete clinical restaging but, because of initial bulky disease, underwent surgical restaging, which showed that four patients had residual disease. The spleen was the site of persisting disease in all six patients with residual disease; four also had para-aortic nodal involvement. All 20 patients in pathologically documented complete remission remain relapse-free, with a mean followup of 26 months. This is significantly better (P less than 0.001) than the 21% relapse rate for 224 comparable patients in complete remission established by clinical but not surgical restaging. It appears that surgical restaging provides useful prognostic and therapeutic information in selected patients with Hodgkin's disease.
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PMID:Surgical restaging of Hodgkin's disease. 707 45

The intensity of treatment and the extent of restaging necessary to document the level of response to therapy in patients with non-Hodgkin lymphoma (NHL) remains controversial. One hundred patients with advanced non-Hodgkin lymphoma were randomized to treatment with cyclophosphamide, vincristine, plus prednisone or cyclophosphamide, doxorubicin, vincristine, plus prednisone combination chemotherapy. After induction therapy sequential noninvasive restaging including lymphangiogram and 67gallium scan yielded 33 patients in clinical complete remission and 38 patients in partial remission. Twenty of these 38 patients in partial remission had complete normalization of all clinical and chemical tests ("apparent" clinical partial remission); however, lymphangiogram, gallium scan, abdominal sonogram, or abdominal CAT scan remained abnormal. In these 20 patients in "apparent" clinical partial remission, exploratory laparotomy was performed to further assess disease status. Laparotomy revealed evidence of residual disease in only four patients (20%). When correlated with the laparotomies the accuracy of repeat lymphangiograms and gallium scans was 17% and 50% respectively. Thus, restaging lymphangiogram and gallium scan in NHL patients in "apparent" clinical partial remission are inaccurate, and "second look" operations are recommended for accurate appraisal of response to therapy. The assessment of true complete remission should help define the role of aggressive treatment.
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PMID:Restaging laparotomy in the management of the non-Hodgkin lymphomas. 714 95

The value of aspiration cytology in the management of Hodgkin's disease is shown in this study of 228 patients and 403 aspirations; 385 from lymph nodes and 18 from extranodal masses. In all patients the initial diagnosis was established on surgical biopsy. Aspirates were helpful in staging, defining extension of unusual radiation fields, and in recognizing residual disease and relapses after therapy. Adequate material was obtained in 80% of aspirations. The diagnosis of Hodgkin's disease could not be established in the adequate cytologic sample in 9.9% of cases. In 5.5%, the diagnosis was that of benign reactive hyperplasia and in 4.4%, non-Hodgkin's lymphoma. Unsatisfactory material was usually obtained from nodes less than 1 cm in diameter or from residual lesions following radiation or chemotherapy. Only 14 of 93 such lesions proved to have active disease during follow up. There were no significant complications. Characteristics of the varied aspects of aspirated tumor cells found in Hodgkin's disease are described.
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PMID:Appraisal of aspiration cytology in management of Hodgkin's disease. 737 Sep 23


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