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)

We report on our experience in the use of transdermal fentanyl in management of acute pain due to mucositis WHO-grade IV during high-dose chemotherapy (HDC) and autologous stem cell support (APBSCT). Between 8/96 and 12/98 74 patients received HDC and PBSCT for progressive disease or relapse of non-Hodgkin's lymphoma (n=32), multiple myeloma (n=37), Hodgkin's lymphoma (n=5). All patients suffered from mucositis WHO-grade IV with a need for continuous pain management. Instead of pethidine i.v. fentanyl TTS was used. Sufficient analgesia was achieved mostly with a dose of 50 microg/h. There was no need of supplementary analgesia. Relevant fentanyl-associated side effects were not seen. Patient compliance and acceptance were excellent. The results suggest that transdermal fentanyl is reliable in pain management of chemotherapy-associated mucositis grade IV.
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PMID:Transdermal fentanyl during high-dose chemotherapy and autologous stem cell support. 1076 86

Many articles pertaining to quality of life (QOL) following stem cell transplantation have been published in the US and western Europe. However, since the actions of health insurance systems and overall cultural aspects are strongly associated with QOL, investigations into QOL should be carried out within all countries. Therefore, we have investigated the QOL of adult patients following stem cell transplantation at 31 hospitals in Japan. The survivors, who were surveyed by mail questionnaire, were 20 years or older at the time of this study. The underlying diseases were acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, non-Hodgkin's lymphoma, Hodgkin's disease, myelodysplastic syndrome, and multiple myeloma. Median age at the time of the study was 36 years, and median interval after transplantation was 35.3 months. Of 383 patients surveyed, 282 (73.6%) responded to the questionnaire. One hundred and ninety-two patients were treated with an allogeneic-related transplantation, 52 with allogeneic-unrelated, and 38 with an autologous transplantation. Our data revealed that the length of time since transplantation and the diagnosis of chronic GVHD were associated with QOL. When unrelated and related transplantation recipients were compared, ratings on relief from pain, stability in weight, and confidence in dealing with daily life were lower among unrelated transplantation patients.
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PMID:Quality of life in adult patients after stem cell transplantation. 1084 37

The aim of this retrospective study was to evaluate the role of routinely performed bone scintigraphy in the clinical assessment of patients with previously untreated Hodgkin's disease (HD). One-hundred and eighty-three patients with a median age of 31 yrs (range 16-85) with newly diagnosed HD underwent bone scintigraphy between 1972 and 1995. Bone scintigraphies and skeletal X-ray examinations of patients with any pathological scintigraphic finding were reassessed. Initially HD bone involvement could be excluded in 173 (95%) of the patients. Among the remaining ten patients, two had diffuse increased tracer uptake but X-rays were normal. One of these patients was classified as normal with regard to HD bone involvement. A bone marrow scintigraphy examination and regression of changes following therapy supported primary osseous involvement in the other patient. Five patients had focal scintigraphic abnormalities but skeletal X-rays remained negative; three of these five patients reported pain in the scintigraphically affected areas, and therefore the suspicion of bone involvement was strong. The remaining three patients had focal findings both on bone scintigraphy and skeletal X-ray examination and were considered as having osseous HD involvement. All seven patients judged to have HD bone involvement were planned to receive combination chemotherapy up-front, irrespective of the scintigraphic findings. In this series of 183 patients bone involvement was detected in seven patients based on bone scintigraphy/symptoms (n=3), bone marrow scintigraphy/symptoms (n=1), and bone scintigraphy/X-ray examination (n=3). The decision to give multiagent chemotherapy to all patients was not influenced by scintigraphic findings. Therefore, routine bone scintigraphy seems to be of limited value in the clinical assessment of untreated patients with HD.
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PMID:Routine bone scintigraphy is of limited value in the clinical assessment of untreated patients with Hodgkin's disease. 1096 26

We describe a patient with a clinical disorder that resembled vasculitic neuropathy in which peripheral nerves were successively affected over several months, but without systemic involvement. An initial muscle biopsy near the involved nerves showed signs of nonspecific inflammation around the muscle and nerve fibers. Immunosuppressive treatment resulted in a dramatic reduction in pain, but relapses of the disease eventually occurred, and the patient died 22 months after onset of the first symptoms. Pathologically, a malignant non-Hodgkin's B-cell lymphoma, restricted to the intra- and extradural peripheral nervous system, was found. The demonstration by Southern blotting of immunoglobulin heavy chain gene rearrangement confirmed the monoclonal nature of the lymphomatous cells. In situ hybridization tests for Epstein-Barr and herpes virus subtypes were negative. Our case underlines i) how difficult diagnosis can be despite extensive investigations, ii) the usefulness of immunosuppressive treatment in the early stage of the disease, iii) the importance of immunostaining and genome analysis for distinguishing between different types of human neurolymphomatosis, and iv) the fact that the initial inflammatory process in the muscle biopsy may be interpreted either as a paraneoplastic effect of the lymphoma or as a viral inflammatory neuromyopathy that triggers the development of the malignant lymphoma.
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PMID:Clinicopathological and molecular biological studies in a patient with neurolymphomatosis. 1100

Radiation therapy is an uncommon cause of stenosis and occlusions of the cervical internal carotid artery (ICA). We describe two cases of cerebral ischemia due to ICA stenosis in patients irradiated for malignant tumors (lymphoma and breast cancer). The first patient, a 32-year-old man, presented with an episode of cerebral ischemia. Six years previously he had received irradiation therapy for a left laterocervical mass histologically diagnosed at biopsy as a Hodgkin's lymphoma. Cerebral angiography on entry revealed bilateral occlusion of the cervical ICA, with a 2-cm stump at the origin of the left ICA. Despite anti-platelet aggregation therapy the ischemic attacks persisted, necessitating a stumpectomy. After vascular-repair surgery the patient had no further ischemic symptoms. The second patient, a 42-year-old woman, began to experience the sudden onset of pain in the right arm and left hemiparesis five years after surgery plus irradiation (4500 rad) for breast cancer, and three years after excision of a single cerebral metastasis. Cerebral angiography obtained on admission showed occlusion of the right ICA and right subclavian arteries, both lesions necessitating thrombectomy. After surgery the right radial pulse immediately re-appeared and the hemiparesis regressed. In both patients, 2-year follow-up assessment by Doppler ultrasonography and magnetic resonance angiography (MRA) confirmed that the operated arteries remained patent. These two unusual cases underline the potential risk of irradiation-induced ischemic cerebrovascular symptoms, suggesting that patients who have received radiation therapy to the neck and mediastinum who survive for more than 5 years should undergo regular non-invasive imaging of neck vessels (Doppler ultrasonography and MRA).
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PMID:Radiation injury involving the internal carotid artery. Report of two cases. 1112 53

Many pruritic conditions do not originate in the skin, but are the result of systemic abnormality. Among the diseases that can cause pruritus are renal insufficiency, cholestasis, Hodgkin's lymphoma, polycythemia vera, solid tumors, and many others. Other pruritic conditions appear to be iatrogenic; opioid-induced pruritus may be the most important in palliative medicine. Successful treatment of the underlying condition usually relieves itch. But, with time, many diseases progress and treatment of the cause will be impossible. Topical treatments may be of limited value. Strategies involving systemic treatments include use of antidepressants, oral opioid antagonists, or cholestyramine. There is no one cure for all pruritic symptoms. Better understanding of mechanisms of pruritus may help develop better treatments.
J Pain Symptom Manage 2001 Feb
PMID:Understanding pruritus in systemic disease. 1122 66

During ten years 580 patients have been treated for gastric tumour in our department, 510 of them were operated on. Resection could be performed in 296 cases. 17 resections, 5.7 per cent of all were performed because of primary non-Hodgkin gastric lymphoma. No gastric lymphoma was found among the non-resected patients. The preoperative histological diagnosis was correct only in 8 cases. MALT origin could be proved in 5 patients. Synchronous adenocarcinoma and lymphoma was diagnosed in 2 patients. Staging was decided according to Lugano classification. There were six stage I, four stage II, and seven stage IV patients. 8 subtotal and 9 total gastrectomy was performed, 5 were extended and 2 were combined. R0 resection could be carried out in five stage I, two stage II and in one stage IV patient. We lost 2 patients in the postoperative period. Patients were treated with adjuvant chemotherapy (VEP, CHOP) except for 2 patients with low grade MALT lymphoma. The likelihood of one-year survival is 73 per cent, average two-year survival is 63 per cent. When the tumour is operable by total gastrectomy we suggest to perform splenectomy as well, despite of the fact that some postoperative complications can be related to it. We think it is reasonable to perform palliative resection in cases of locally extended stage IV tumours, which affect the patient's quality of life: to cease the pain, passage troubles, bleeding and to improve the conditions for adjuvant treatment.
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PMID:[Role of surgery, its results and complications, in the combined treatment of primary gastric non-Hodgkin lymphoma]. 1129 90

We present a patient with acute retrosternal pain and dyspnoea. Clinical examination revealed a woman in shock with a loud holosystolic murmur and congested jugular veins. Echocardiography showed severe mitral insufficiency. At transoesophageal echocardiography a large mass was seen in the right atrium. The differential diagnosis was a thrombus or an intracardiac tumour. Subsequent histology revealed a non-Hodgkin lymphoma in the right atrium, the wall of the left atrium extending to the mitral valve and further location in the pelvis and duodenum. The discussion incorporates a brief overview of the literature.
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PMID:An unusual case of biventricular cardiac failure. 1135 25

With the aim of developing an effective therapy for heavily pretreated refractory MM outpatients, we evaluated the OPPEBVCAD regimen, a Hodgkin's disease-derived protocol that includes many drugs effective in MM administered in a sequential schedule. Twenty-two pts aged 42-72 years, with symptomatic highly-pretreated refractory (18 cases), or primary resistant MM (four cases. including two pts with plasma cell leukemia-PCL) received this therapy every 28 days (2-4 cycles, followed by a maintenance program). Therapeutic response (Chronic Leukemia-Myeloma Task Force criteria) and performance status (PS) and pain (W.H.O.) were evaluated. All of the pts were evaluable for response. There were 9 (40%) objective responses (OR: stabilization of blood counts and bone lesions, serum calcium normalization, 50% or more reduction in the concentration of serum monoclonal component (MC), 90% reduction in Bence-Jones proteinuria), 8 (36%) partial responses (PR: 25-50% reduction in serum MC), 1 no response or stable disease (NR), and 4 (18%) cases of progressive disease (PD). OR plus PR were 77%. Of the 4 primary resistant tumors (2 PCL and 2 MM), 2 achieved PR, 1 OR (a PCL case) and 1 progressed. Median survival was 15 months for responding pts (OR plus PR) and 4.5 months for non-responders (NR plus PD). PS and pain improved in 15 pts and did not change in 9. The most frequent side effects were cytopenias, with one drug related infective death. The OPPEBVCAD regimen proved to be an effective therapy for refractory relapsing or primary resistant MM: in responders (two-thirds of the pts), survival was prolonged by about 10 months. Its efficacy in anthracycline-treated pts, as well as the feasibility of using it on an outpatient basis without any continuous drug infusions, make this regimen a promising third line salvage therapy.
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PMID:OPP-EBV-CAD regimen as salvage treatment in advanced refractory or resistant multiple myeloma. 1142 32

Cancer is an increasing cause of disease-related death in childhood within developing countries, where the great majority of the world's children reside. The improving prospects for survival in such children, and the corresponding challenge of undertaking economic evaluations of related health interventions, provide a stimulus to study the health-status and health-related quality of life in survivors of cancer in childhood in Latin America. Spanish language versions of questionnaires for proxy assessors, based on the Health Utilities Index (HUI), were used to elicit responses from parents and physicians. The HUI is a family of multi-attribute, generic, preference-linked measures of health status and health-related quality of life that are reliable, responsive and valid, and have been used previously in pediatric oncology. Valid responses were received from 178 parents and 144 physicians in 6 centres in 4 countries (Cuba, Honduras, Colombia and Uruguay). For children with acute lymphoblastic leukemia the major morbidity burdens were in the attributes of emotion, cognition and pain. The overall burden of morbidity was greater in children with non-Hodgkin's lymphoma. In survivors of Hodgkin's disease and Wilms' tumor the attributes most affected were emotion and pain. In general, there was considerable agreement between the assessments provided independently by parents and physicians. This study demonstrates the feasibility of conducting such measurements in developing countries, and reveals similarities in health status and health-related quality of life to comparable populations in more privileged societies.
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PMID:Health status and health-related quality of life in survivors of cancer in childhood in Latin America: a MISPHO feasibility study. 1144 61


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