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)

Recent progress in the chemotherapy for malignant lymphoma is reviewed. From the viewpoint of treatment, malignant lymphoma is classified into five major categories; aggressive lymphoma, indolent B-lymphoma, Hodgkin's disease, T-lymphoblastic lymphoma and adult T-cell leukemia-lymphoma (ATL). Based on the results of the clinical chemotherapy trials conducted by the cooperative oncology groups in Western countries and the Lymphoma Study Group (LSG) in Japan, the state of the art of chemotherapy for malignant lymphoma is described. In aggressive lymphoma of advanced stages, after establishment of CHOP therapy (first generation), better results were reported in the United States for single institute single-arm studies of non-cross resistant alternating multiagent chemotherapy (second generation) and high relative dose intensity chemotherapy (third generation). However, recent multicenter phase III studies, comparing CHOP with third generation regimens, revealed that CHOP remains the best available treatment, because of similar failure-free and overall survival with lower cost and lower severe toxicity. More recently, the results of the International Non-Hodgkin's Lymphoma Prognostic Factors Project were reported. Based on the number of the five unfavorable factors present, such as age, stage, LDH, performance status and the number of extranodal disease sites, a new predictive model "international index" for aggressive lymphoma was developed. Such predictive models based on prognostic factor analyses would be very useful in the design of future clinical trials in patients with aggressive lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
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PMID:[Recent progress in the treatment of malignant lymphoma]. 803 Nov 55

Prognosis of non-Hodgkin's aggressive lymphoma in relapse is very poor. Because of lymphoma high sensitivity to chemotherapy, intensive treatment followed by hematopoietic stem cells transplantation (SCT) could be an appropriate choice. Although randomized studies results are not yet available, evidence of favourable impact of intensive chemotherapy plus SCT was produced by retrospective studies. Our study on relapsing patients after LNH84 regimen showed a longer survival for transplanted patients in comparison with conventional chemotherapy treated patients. In follicular lymphomas after progression, a prolonged event free survival could be achieved at least when an effective marrow purging procedure was obtained. Despite mortality related to complications, allogenic bone marrow transplantation was followed by a low relapse rate suggesting a graft versus lymphoma effect. However, the majority of patients were treated by intensive chemotherapy with autologous stem cells rescue and a great challenge remains to decrease documented high relapse rate.
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PMID:Intensive chemotherapy plus hematopoietic stem cells transplantation for relapsing non-Hodgkin's lymphoma: the GELA experience. 809 32

Nationwide epidemiological studies have disclosed that lymphoid malignancies in Japan are markedly different from those in Western countries; they are less frequent in indolent B-lymphoma and Hodgkin's disease and more frequent in T-cell lymphoma, particularly adult T-cell leukemia-lymphoma (ATL). In 1978, the Lymphoma Study Group (LSG) of Japan started multicenter clinical trials for malignant lymphoma. Since then various kinds of phase II and III studies for aggressive lymphoma, Hodgkin's disease, ATL, T-lymphoblastic lymphoma, acute lymphoblastic leukemia and multiple myeloma have been conducted by the LSG. Based on the results of clinical trials conducted in Western countries and the LSG, the state of the art of chemotherapy for malignant lymphoma is described. In aggressive lymphoma of advanced stages, after establishment of CHOP therapy (1st generation), better results were reported in Western countries for single institute phase II studies of non-cross resistant alternating multiagent chemotherapy (2nd generation) and high relative dose intensity chemotherapy (3rd generation). However, recent multicenter phase III studies, comparing CHOP with 3rd generation regimens, revealed that CHOP remains the best available treatment, because of similar failure-free and overall survival with lower cost and lower severe toxicity.
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PMID:[Chemotherapy for malignant lymphoma in Western countries and Japan]. 827 44

In order to analyze systemic immune surveillance in patients with B cell non-Hodgkin's lymphomas (B-NHL), we investigated circulating lymphocytes using two-color flow cytometry. The proportions of CD3-CD56+ natural killer (NK) cells and CD8++(bright) S6F1++ killer-effector T cells corresponding to activated cytotoxic T lymphocytes (aCTL) were studied in the peripheral blood of 26 patients with indolent lymphoma (IL) and 24 with aggressive lymphoma (AL). The AL patients with both limited disease and advanced disease had an increased proportion of NK cells. However, this feature was not evident in IL patients with either limited or advanced disease. In contrast, an increased proportion of aCTL was observed only in IL patients with advanced disease. These findings indicate that IL may differ from AL in terms of immune surveillance against neoplastic B cells.
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PMID:Cytotoxic lymphocytes in the peripheral blood of patients with B cell lymphomas. 860 27

A feasibility study was carried out on the treatment for refractory and relapsed non-Hodgkin's lymphomas with a combination of two oral topoisomerase II inhibitors, MST-16 and VP-16. On the basis of the synergistic activity in preclinical studies and the schedule dependency in these drugs, low-dose and long-term administration was planned. For the anticipated myelosuppression, two different regimens were designed as an open label trial in this study. In Regimen I, 400 mg of MST-16 combined with 25 mg of VP-16 was administered daily. With this regimen, the response rate (RR)/median time to tumor progression (TTP) in all evaluable patients was 50% (2/4)8.5 months in low grade (indolent) lymphoma and 60% (6/10)/5.2 months in intermediate/high grade (aggressive) lymphomas. In Regimen II, 400 mg of MST-16 combined with 25 mg of VP-16 was administered intermittently (3 days a week or every other day). With this regimen, there was an RR/median TTP of 60% (3/5)/7.0 months in indolent lymphoma and 33.3% (4/12)/1.1 months in aggressive lymphoma. A major side effect in both of these regimens was myelosuppression, with the incidence of grades 3 and 4 toxicity being higher in Regimen I than in Regimen II. The other side effects were uncommon and not severe. These findings indicated that two regimens were tolerated well and were promising for refractory and relapsed aggressive non-Hodgkin's lymphomas. To define the anti-tumor activity and safety of these regimens precisely, large-scale prospective randomized trials are necessary.
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PMID:Feasibility of salvage chemotherapy for refractory or relapsed non-Hodgkin's lymphoma with two topoisomerase II inhibitors, MST-16 and VP-16. MST-16 Study Group. 892 84

Several clinical trials have demonstrated that high-dose chemotherapy (HDC) with autologous hematopoietic stem-cell transplantation is more effective than conventional-dose chemotherapy in some subsets of patients with malignant lymphoma, such as relapsed aggressive lymphoma patients showing a response to salvage chemotherapy and those with Hodgkin's disease who fail primary initial chemotherapy. This paper summarizes recent findings and the following issues remaining to be resolved: (1) whether HDC is superior to conventional-dose chemotherapy as initial therapy for aggressive lymphoma in unfavorable risk groups, (2) whether single HDC or multiple semi-HDC is better, (3) whether HDC has curative potential in indolent lymphoma or mantle-cell lymphoma, and (4) the HDC regimen that is most useful. To clarify these controversial issues, well-designed clinical trials are needed. To evaluate whether the concept "the more chemotherapy, the better in malignant lymphoma" is valid, the Lymphoma Study Group of the Japan Clinical Oncology Group is conducting two kinds of clinical trials in high- and high-intermediate-risk aggressive lymphoma patients, focusing on the dose intensity of key agents. One is a randomized phase II trial of dose-escalated cyclophosphamide, doxorubicin, vincristine, and prednisolone (high CHOP) versus shortened CHOP (biweekly CHOP) with prophylactic use of granulocyte colony-stimulating factor. The other is a phase II trial of HDC with peripheral blood stem-cell transplantation as a part of the initial therapy. If promising results are obtained from these trials a randomized phase III trial will be considered to compare the best dose-intensive regimen with standard CHOP.
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PMID:Chemotherapy: the more, the better in malignant lymphoma? 927 45

Autologous peripheral blood stem cell transplantation (PBSCT) for patients with malignant lymphoma has been extensively performed in Japan for several years. Some of the disease states of lymphoma are considered to be a good candidate for auto-PBSCT application. Sensitive relapsers in non Hodgkin's lymphoma should be treated with a combination of salvage therapy and high dose chemo(radio)-therapy with stem cell support, and up-front PBSCT is recommended for poor risk aggressive lymphoma. The clinical results and indications for auto-PBSCT including other types of lymphoma such as lymphoblastic lymphoma, mantle cell lymphoma, low-grade lymphoma and Hodgkin's disease will be reviewed in this paper.
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PMID:[Autologous peripheral blood stem cell transplantation for malignant lymphoma]. 988 Oct 78

Mutation of the p53 gene has been associated with treatment failure and poor outcome in various malignancies. It has been suggested that immunohistochemical analysis of p53 and p21Waf1, a downstream target, can be used to screen for p53 gene mutations. We determined the value of immunohistochemical screening for p53 gene mutations as a prognostic marker in a population-based group of B- and T-cell non-Hodgkin's lymphomas (NHLs). On the basis of p53 gene mutation status and immunohistochemically detected p53 and p21Waf1 expression in 34 lymphomas, we established an immunophenotype (delta p53) correlating with p53 gene mutation. The immunohistochemical analysis was extended to encompass 199 lymphomas from a population-based registry and was correlated with clinical parameters. Delta p53 showed 100% concordance with p53 gene mutation and was detected in 42 cases (21%). Multivariate analysis of advanced stage lymphomas showed that delta p53 was independently associated with treatment failure (relative risk, 3.8; P = 0.001). Delta p53 predicted poor survival when analyzing all patients (P = 0.0001), as well as B-cell (P = 0.04) and T-cell NHL (P = 0.000002). In multivariate analysis, delta p53 (relative risk, 2.2; P = 0.001) maintained prognostic significance. The impact on prognosis of delta p53 was highly significant in the low-intermediate-risk group (P = 0.00002). Comparing survival of the aggressive lymphoma patients in this group showed that the 8 delta p53 patients died within 1 year, whereas the median survival of the 28 non-delta p53 patients was 36 months. These results suggest that immunohistochemically assessed p53 status may predict treatment response and outcome in B- and T-cell NHL patients.
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PMID:Disrupted p53 function as predictor of treatment failure and poor prognosis in B- and T-cell non-Hodgkin's lymphoma. 1035 42

We have studied clinical and pathological features of a series of 21 patients followed at the hospital Saint-Louis for a nodal nodular lymphocytic predominant Hodgkin's disease or paragranuloma of Poppema-Lennert. Histopathologically, all these lymph nodes were involved by a nodular proliferation of atypical cells, called pop corn cells with a B cell phenotype, admixed with small lymphocytes. Clinically, most patients were young males. The disease was localized except in one case and the prognosis good (only one death). However, one patient relapsed and another developped an aggressive lymphoma. These results were in keeping with different studies in the literature and confirmed that the paragranuloma is a clinicopathological entity, distinct from the classical Hodgkin's disease. Nowadays, it's strongly suggested that the pop corn cell is of centroblastic origin. Treatment remains controversial, however, according to most of the authors, patients with localized disease could be followed without treatment after surgical excision.
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PMID:[Hodgkin disease with nodular lymphocytic predominance or type I (paragranuloma of Poppema-Lennert): a clinico-pathological entity. Study of 21 cases and review of the literature]. 1064 84

High-dose chemotherapy with autologous bone marrow or peripheral blood stem cell transplantation has gained widespread acceptance for the treatment of certain malignancies. Since the introduction of this therapy in 1988 we have treated 272 patients. Indications for high-dose chemotherapy were high-risk large cell lymphoma and lymphoblastic or Burkitt lymphoma in first remission (73 patients), non-Hodgkin's lymphoma in chemosensitive relapse (65 patients), Hodgkin's lymphoma in relapse (52 patients), germ cell tumours with inadequate response to chemotherapy (34 patients), multiple myeloma (29 patients), and other malignancies (19 patients). Treatment mortality was 1.8%. The 3-year event-free survival and overall survival for all patients were 48 and 61% respectively. High-dose chemotherapy with autologous stem cell transplantation has become a safe procedure and is considered the treatment of choice for relapsed large cell lymphoma, relapsed Hodgkin's disease, stage II or III multiple myeloma, and germ cell tumours with inadequate response to cisplatin-based chemotherapy. In other situations, including aggressive lymphoma with risk factors, acute leucaemia or breast cancer, the superiority of high-dose over conventional chemotherapy remains to be proven. Patients with such diseases should not receive high-dose chemotherapy outside a controlled clinical study.
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PMID:[High-dose chemotherapy with autologous bone marrow transplantation: 11 years' experience in Zurich]. 1068 81


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