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)

To define the contribution of aggressive lymphoma treatment to the risk of post-splenectomy septicemia, we investigated the humoral immunity of 44 patients with Hodgkin's disease. Specific antibody against Haemophilus influenzae Type b was significantly reduced (mean, 147 ng per milliliter, P less than 0.01) in patients receiving combined treatment (radiotherapy and chemotherapy), whereas single treatment reduced titers marginally (chemotherapy) or not at all (radiotherapy). Untreated patients had normal values (396 ng per milliliter), and splenectomy was without effect. In some patients who received combined treatment, titers were reduced to levels seen in infants. IgM levels were likewise normal in untreated patients. Chemotherapy, however, significantly reduced IgM levels (P less than 0.025), an effect potentiated by prior splenectomy. IgG, IgA, alternate-pathway activity, C3, C4 and CH50 were all normal or elevated. Aggressive treatment with chemotherapy and radiation impairs humoral defense against encapsulated micro-organisms, and thus magnifies the risk of post-splenectomy septicemia in patients with Hodgkin's disease.
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PMID:Impaired humoral immunity in treated Hodgkin's disease. 30 8

Seventy-five peripheral T-cell lymphomas (PTLs) were classified according to the recently proposed "Updated Kiel Classification of Non-Hodgkin's Lymphomas" (mycosis fungoides and Sezary's syndrome excluded). Thirty-seven PTLs belonged to the low-grade category (T-cell chronic lymphocytic leukemia [T-CLL], 3; lymphoepithelioid, 4; angioimmunoblastic, 22; T-zone, 6; pleomorphic small cell, 2) and 38 belonged to the high-grade category (pleomorphic medium and large cell, 24; immunoblastic, 1; large-cell anaplastic Ki-1-positive, 13). Loss of pan-T antigens occurred exclusively in high-grade PTLs; on paraffin sections UCHL 1 was slightly more sensitive than MT 1. Sixty patients presented with lymphadenopathy and 15 patients (20%) presented with extranodal disease most frequently affecting the skin and upper aerodigestive tract. B-cell lymphoma symptoms were found in 43 cases (57%) and bone marrow involvement (T-CLL excluded) was found in 12 cases (17%). Staging (T-CLL excluded) revealed stage I in 13%, stage II in 15%, and stages III and IV in 72% of the cases. Among the intensively treated patients, 37% achieved complete remission and 15 are still in complete remission after 4 to 79 months (median: 24 months). The overall median survival (MS) rate was 23 months. Peripheral T-cell lymphoma of pleomorphic medium and large-cell type was the most aggressive lymphoma (MS: 8 months). B-cell lymphoma symptoms, bone marrow involvement, and Ki-67 positivity 60% or greater significantly shortened survival times, whereas age (under 60 versus over 60 years), stage (I and II versus III and IV), and grade had no significant influence. Ki-67 reactivity was found to be a prognostic factor which allows prediction of probable poor outcome, especially in cases with limited stage of disease.
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PMID:Peripheral T-cell lymphomas: a clinicopathologic study of 75 cases. 222 19

5,6-Dihydro-5-azacytidine (DHAC; NSC 264880) is an analogue of 5-azacytidine that does not possess the hydrolytically unstable 5,6-imino bond of the parent compound. Thus, unlike 5-azacytidine, DHAC is stable in aqueous solution and may be administered by prolonged i.v. infusion, potentially avoiding acute toxicities associated with bolus administration of 5-azacytidine. In this study, patients with advanced cancer were treated with DHAC administered as a 24-h constant i.v. infusion every 28 days. Treatment began at a dose of 1 g/sq m and was escalated to the maximum-tolerated dose of 7 g/sq m, where the limiting toxicity was pleuritic chest pain. Other toxicities included nausea and vomiting, which were not limiting. There was no evidence for myelosuppression, nephrotoxicity, or hepatotoxicity. DHAC was measured in plasma, urine, and ascites by a sensitive and specific reverse-phase high-performance liquid chromatography assay capable of detecting 50 ng of drug per ml. Steady-state plasma levels were achieved with 8 h and ranged from 10.0 to 20.5 micrograms of DHAC per ml at the maximum-tolerated dose. Total-body clearance of 311 +/- 76 ml/min/sq m and postinfusion half-lives between 1 and 2 h were observed. Between 8 and 20% of the administered dose was excreted unchanged in urine. While ascites DHAC levels in a patient with ovarian cancer were comparable to plasma levels, postinfusion elimination was slower from this compartment than from plasma. No correlation was observed between DHAC plasma levels and duration or intensity of dose-limiting pleuritic chest pain. One patient with progressive Hodgkin's lymphoma demonstrated stabilization of disease for seven treatment cycles, and two patients with aggressive lymphoma demonstrated dramatic, although transient, disease responses. A dose of 7 g/sq m is recommended for Phase II trials of DHAC using this schedule.
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PMID:A phase I and pharmacokinetic study of dihydro-5-azacytidine (NSC 264880). 240 49

Thirty-one patients underwent autologous bone marrow transplantation (ABMT) after intensive radio and/or chemotherapy. On 18 occasions, bone marrows were treated in vitro with either Asta-Z 7557, Asta-Z 7654 or the rat monoclonal antibody Campath-1M and complement. Sixteen patients were transplanted for acute leukemia: 6 patients were in first complete remission (CR), 5 in CR greater than 1 and 5 in relapse. Twelve out of fourteen evaluable patients have relapsed. Two patients transplanted in CR 2 and CR 1 remain in CR after 9.5 and 12 months respectively. Nine patients were transplanted for aggressive lymphoma: four patients were in CR 1, 2 in CR greater than 1, 1 in first relapse and 2 refractory to best available second line chemotherapy. All 3 achieved CR after ABMT. Nine patients are evaluable: 4 relapsed and 5 remain in CR at 5, 6.5, 21, 25 and 39 months, this last patient transplanted in a refractory state, the others in CR 1. Four patients were transplanted for refractory Hodgkin's disease: 3 patients are evaluable. One patient achieved complete remission which lasted 9 months. Two patients were transplanted for relapsed solid tumors and achieved a partial response. In conclusion, the response rate is encouraging for patients transplanted during active and sometimes refractory phases of the diseases (8/13 evaluable patients achieved CR). However, for the whole group of patients, including those transplanted for acute leukemia in CR 1, the relapse rate was high. Durable remissions were achieved for patients with aggressive lymphoma who were transplanted early in the disease.
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PMID:[Super intensive treatment followed by bone marrow autograft in cases of hematologic neoplasms and solid tumors]. 245 79

Malignant lymphoma is classified roughly into Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) according to the biological characteristics. Malignant lymphoma in Japan has such characteristics as low incidence of HD, which is usually favorable in prognosis, and high incidence of NHLs, which have further distinctive features of less incidence of favorable follicular B cell lymphoma and of higher incidence of unfavorable diffuse T cell lymphoma including adult T cell leukemia/lymphoma (ATLL) in comparison with those in western countries. As a recent trend of progress in lymphoma study, the introduction of molecular diagnosis by means of gene rearrangement analysis of immunoglobulin and T cell antigen receptor has contributed diagnostically to a definitive determination of T and B cell lineage and cellular monoclonality in malignant lymphoma. On the other hand, remarkable progress has been made in the treatment of malignant lymphoma in recent years. After all, in HD even far advanced cases have been expected to be curable by the combination chemotherapy, for example, MOPP regimen in USA at the present time. Furthermore, in NHL even advanced cases with such aggressive lymphoma as diffuse large cell lymphoma of B cell type have also been able to survive for more than 10 years and may be curable with the frequency of more than 30% in several institutions. Nowadays, the treatment for malignant lymphoma has focussed on multidisciplinary cure-oriented therapy including chemotherapy and radiotherapy in a collaboration of surgical procedure and immunotherapeutic maneuvers. The recent chemotherapy regimen has been called "third generation" ones characterized by alternating non-cross resistant combination and frequent administration of intense drug dose. Furthermore, various biologics such as monoclonal antibodies, several BRMs including IFNs, IL-2 and TNF, and recombinant G-CSF and GM-CSF have been applied in lymphoma treatment to improve the efficacy of combination chemotherapy in new designs of clinical trials.
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PMID:[Malignant lymphoma]. 273 35

The role of high dose chemotherapy followed by hematopoietic stem cell transplantation in malignant lymphoma is discussed in comparison with the present state-of-the-art chemotherapy. Very recently, Parma randomized study revealed the apparent survival advantage of high dose chemotherapy in relapsed aggressive lymphoma patients who showed chemosensitivity to DHAP salvage therapy. Another randomized study conducted in UK showed the efficacy of high dose chemotherapy in relapsed or recurrent Hodgkin's disease. Therefore, it is generally accepted that patients with aggressive lymphoma or Hodgkin's disease who are chemosensitive to salvage chemotherapy at relapse are appropriate candidates for high dose chemotherapy. Although it is unclear that those with high-risk aggressive lymphoma will benefit from high dose chemotherapy in an up front setting, this strategy is expected to be the most promising one at the present time to improve the poor prognosis of such patients. To determine the exact role of high dose chemotherapy in malignant lymphoma and address the various questions, consecutive well-designed clinical trials should be conducted.
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PMID:[High dose chemotherapy followed by hematopoietic stem cell transplantation for malignant lymphoma]. 757 2

Among malignant disease, the non-Hodgkin's lymphomas (NHL) are a diverse group of lymphoid neoplasms that display a wide spectrum of clinical, morphologic, immunologic, and molecular features. Currently the NHL are divided into three groups based on their clinical behavior: 1) indolent, 2) aggressive, and 3) highly aggressive. Among the groups, many patients with aggressive NHL is curable with current combination chemotherapy, however fractions of patients will relapse, and resistant disease remains a problem. It would be valuable to identify those patients with a particularly poor prognosis when treated with a standard regimen so that alternative therapies could be tested. A number of risk factors distinguish patients with a distinct natural history and probability of response to therapy. Recently, international index identifies subsets of patients who are likely to do well or unlikely to benefit from standard regimens and younger high-risk patients are candidates for more intensive experimental therapy. A major idea that is guiding the development of new treatment programs is augmenting the dose intensity of the treatment. The development of colony-stimulating factors allow us to increase intensity of chemotherapy. However, it must be confirmed that such therapy really improve the survival of the patients with high risk NHL. Formerly a universally fatal disease, relapsed aggressive lymphoma now appears to be responsive to combinations of non-cross resistant antineoplastic drugs or to high-dose chemotherapy with or without rediation therapy followed by autologous or allogeneic bone marrow or peripheral blood stem cell transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of high risk non-Hodgkin's lymphoma]. 768 31

We studied 23 consecutive patients, median age 34 years, with relapsed or resistant aggressive lymphoma who underwent allogeneic BMT at the UCLA Medical Center Bone Marrow Transplantation Unit from 1 November 1984 to 30 March 1993. All patients were < 50 years of age and had sibling donors who were matched at the HLA-A, B and DR loci. Nine patients had Hodgkin's disease (HD) and 14 had non-Hodgkin's lymphoma (NHL); three of these had low grade histology and 11 had intermediate or high grade lymphoma histology. After a median follow-up of 34 months, eight patients are alive, seven without recurrent lymphoma. Five patients had early deaths. The disease-free survival for the entire group is 26% with an overall survival of 29%. There was no difference in survival rate on the basis of disease or histology. Comparing preparative regimens containing TBI to those without there was no difference in survival rate (P = 0.35). Neither age nor sex was a significant determinant of outcome (P = 0.63 and 0.36, respectively). Disease status at the time of transplantation proved to be the important determinant of outcome. Patients transplanted with chemotherapy sensitive disease (n = 9), defined as a partial or complete response to salvage chemotherapy, had a survival rate of 42%, which was significantly better than those who had refractory disease at transplantation (n = 14), who had a survival rate of 21% (P = 0.006). However, this small, but significant fraction of patients with refractory disease was curable. Thus, our data demonstrate that allogeneic bone marrow transplantation is an effective means of treatment for relapsed or aggressive Hodgkin's and non-Hodgkin's lymphoma.
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PMID:Allogeneic bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma. 777 22

Low-grade lymphomas are rare in Japan, comprising about 10% of non-Hodgkin's lymphomas. They are indolent in natural history with median survival of 7-10 years. Despite a good initial response to radiotherapy or chemotherapy, most patients (Pts), being incurable, ultimately die of their disease. Pts with clinical stage (CS) I/II disease are generally treated with locoreginal radiotherapy. Long-term survival of 60% to 70% and disease-free survival (DFS) of 50% to 55% have been reported. The more precise the staging procedures, the better the results. Chemotherapy used as a primary therapy or as an adjuvant to radiotherapy may improve DFS of pts with CS II with many sites of lymph node involvement or bulky disease. For CS III/IV disease there is no accepted standard therapy. There is no survival advantage for any of the different first-line treatment methods ranging from initial deferral of treatment albeit in highly selected pts, an alkylating agent +/- steroid hormone, to combination chemotherapy (C-MOPP, CHOP, ProMace-MOPP etc) +/- irradiation. The international index for prognostication of aggressive lymphoma has also been shown to be applicable to stratification of low-grade lymphomas. In future studies effectiveness of treatment strategies should be investigated with long-term DFS and improved quality of life being set as primary endpoints.
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PMID:[Hematological neoplasm--how to treat low-grade lymphomas]. 778 52

Recent progress in the chemotherapy of malignant lymphoma is described from the viewpoint of survival advantage. Malignant lymphoma is classified into the following five major categories: aggressive lymphoma, indolent B-lymphoma, Hodgkin's disease, T-lymphoblastic lymphoma and adult T-cell leukemia-lymphoma (ATL). In aggressive lymphoma of advanced stages, recent multicenter phase III studies revealed that first-generation CHOP therapy remains the best available treatment. By multivariate analysis on prognostic factors of non-ATL lymphoma patients who were treated by the second generation LSG 4 protocol, CRP and total number of involved lesions were found to be significantly unfavorable factors. In non-ATL lymphoma, mainly B-lymphoma, three risk groups (low, intermediate and high) were identified. Similarly, the International Non-Hodgkin's Lymphoma Prognostic Factors Project proposed a new predictive model for survival of aggressive lymphoma patients. Such predictive models would be very useful in the design of future chemotherapy trials for aggressive lymphoma. In advanced-stage Hodgkin's disease, about two-thirds of patients are expected to be long-term survivors, thanks to state-of-the-art chemotherapy. A recent phase III study conducted by CALGB disclosed that MOPP/ABVD and ABVD are superior to MOPP. In ATL and indolent B-lymphoma, no state-of-the-art chemotherapy has been established. In order to improve the prognosis of both diseases, innovative treatment strategies should be pursued.
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PMID:[Recent progress in the chemotherapy of malignant lymphoma]. 788 35


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