Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Mitoxantrone and Epirubicin are active agents in non-Hodgkin's lymphomas (NHL). These drugs have reduced cardiotoxicity and therefore are indicated in treatment of elderly patients. Cyclophosphamide, mitoxantrone, vincristine and methylprednisone (CNOP) and cyclophosphamide, epirubicin, vincristine and methylprednisone (CEOP) are combination chemotherapy and contain Mitoxantrone and Epirubicin that have been shown to be effective in treatment of NHL of intermediate and highgrade of malignancy in the elderly. Since Mitoxantrone and Epirubicin are partially non-cross resistant their combined use may diminish emergence of resistant neoplastic clones and may be associated with enhanced anti-neoplastic activity. In this study, a polychemotherapy schedule alternating 3 cycles of CEOP and 3 cycles of CNOP, was used in a single center between December 1988 and April 1995 to treat 41 previously untreated patients, over 60 years of age affected by intermediate or high grade non-Hodgkin's lymphoma according to the Working Formulation. In treated patients, 57.5% achieved complete response, 35% partial response and 7.5% were non-responders. Overall survival was 52.4 % at 4 years, Disease free survival (DFS) for complete responders was 48.9%. Only one case of severe extrahematological toxicity (grade 3-4 WHO) was observed. Severe mucositis (grade 3-4 WHO) was absent, and delayed administration of chemotherapy was required in only 7/230 cycles. No treatment related deaths were registered. This regimen achieved results comparable to that of other anthracycline or mitoxantrone based chemotherapy, but determined lower toxicity. Alternating CEOP and CNOP may improve overall toxicity.
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PMID:Alternation of epirubicin and mitoxantrone in CHOP-like regimens retains efficacy and reduces overall toxicity in elderly patients with high and intermediate grade non-Hodgkin lymphomas. 1261 18

Mantle cell lymphoma (MCL) accounts for approximately 6% of non-Hodgkin's lymphomas. Patients usually present with advanced disease, with a tendency for extranodal involvement. MCL is an aggressive lymphoma with moderate chemosensitivity, but it remains one of the most difficult therapeutic challenges. Complete response rates to chemotherapy range from 20% to 40%, with median survivals of 2 1/2 to 3 years. Anthracycline-containing regimens do not prolong survival compared with nonanthracycline regimens. Single-agent rituximab (Rituxan) has produced response rates of about 30%, and when combined with an anthracycline-containing regimen, response rates increase to above 90%; however, an impact on survival has not yet been demonstrated. More intensive regimens such as hyperCVAD (hyperfractionated cyclophosphamide [Cytoxan, Neosar], vincristine, doxorubicin [Adriamycin], dexamethasone, methotrexate, cytarabine) with either stem cell transplant or rituximab have been associated with promising results.
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PMID:Mantle cell lymphoma: clinicopathologic features and treatments. 1284 28

Primary adrenal lymphoma (PAL) with adrenal insufficiency is a rare entity that has a unique presentation and prognosis when compared to other high-grade B-cell Non-Hodgkin's Lymphomas (NHL). Radiologic characteristics and image-guided biopsy are helpful in diagnosis. Current chemotherapy of choice is CHOP [Cyclophosphamide, Hydroxydaunomycin (doxorubicin), Oncovin (vincristine sulfate) and Prednisone]. More cases need to be documented to formulate an effective approach to PAL.
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PMID:Primary adrenal lymphoma presenting as adrenal insufficiency. A case report and review of literature. 1475 12

Bcl-2 functions as a key survival factor for lymphocytes and is highly expressed in a majority of non-Hodgkin's lymphomas. The ability of oblimersen sodium (Genasense, previously known as G3139) to target bcl-2 messenger RNA and decrease Bcl-2 protein levels has the potential to enhance the activity of cytotoxic chemotherapy. Pretreatment with oblimersen followed by cyclophosphamide (Cytoxan, Neosar) markedly improved survival relative to single-agent cyclophosphamide in a murine xenograft model. Oblimersen has also enhanced the cytotoxicity of a variety of other agents against non-Hodgkin's lymphoma, including etoposide, rituximab (Rituxan), and alemtuzumab (Campath). An initial phase I study of oblimersen in non-Hodgkin's lymphoma demonstrated modest single-agent activity. Recent reports suggest that oblimersen may add to the activity of R-CHOP (rituximab-cyclophosphamide/doxorubicin/vincristine/prednisone) in previously untreated mantle cell lymphoma and to rituximab alone in a variety of subtypes of relapsed non-Hodgkin's lymphoma. Additional studies in both treatment-naive and relapsed patients will define the role of oblimersen in the treatment of non-Hodgkin's lymphoma.
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PMID:Targeting the proapoptotic factor Bcl-2 in non-Hodgkin's lymphoma. 1565 Nov 74

Transitional cell carcinoma (TCC) of the bladder in children is a rare occurrence. Cyclophosphamide is a known risk factor for the development of TCC. Other alkylating agents, such as nitrogen mustard, have not been implicated in the development of secondary adult or pediatric TCC. The role of radiotherapy in the development of secondary malignancies of the bladder remains controversial. We report a case of childhood TCC in a patient in remission from Hodgkin's lymphoma previously treated with non-cyclophosphamide chemotherapy and low-dose nodal radiotherapy.
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PMID:Secondary transitional cell carcinoma and nitrogen mustard treatment. 1592 37

Cyclophosphamide (CPA) is widely used in chemotherapy. The CPA is a prodrug that requires metabolic transformation to generate the active metabolite, 4-hydroxy-CPA (4-OH-CPA). Ciprofloxacin (CF) is a fluoroquinolone antibiotic with a broad spectrum that is commonly used in treatment of a variety of infections. It has been reported that prophylactic administration of CF during CPA conditioning was a high-risk factor for relapse in patients undergoing allogeneic bone marrow transplantation. In the present study we investigated the pharmacokinetics of CPA and 4-OH-CPA in eight non-Hodgkin lymphoma (NHL) patients treated with CPA together with or without CF. Clearance and distribution volumes of CPA were significantly (P < 0.01) lower (4.7 L/h and 42.3 L, respectively) when patients were treated with CF prior to CPA compared to that observed when the patients did not receive CF (5.9 L/h and 48.1 L, respectively). No change in the elimination half-life was observed. The CF administration prior to CPA has resulted in significantly (P < 0.01) lower exposure to 4-OH-CPA as expressed as area under the plasma concentration curve (AUC). The metabolic ratio AUC(4-OH-CPA)/AUC(CPA) was lower in all patients treated with CF prior to CPA compared to that observed when patients received CPA only (P = 0.008). Our study showed that CF administration alters CPA kinetics in patients with NHL. Other antibiotics than these contain fluoroquinolones should be used during CPA therapy.
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PMID:The effect of ciprofloxacin on cyclophosphamide pharmacokinetics in patients with non-Hodgkin lymphoma. 1610 76

Primary lymphoma of the lacrimal drainage system (LDS) is an extremely rare condition. All of those previously reported have been of B-cell origin, with the exception of 1 case report of a natural killer/T-cell lymphoma in a Japanese woman. We report a 41-year-old Chinese woman who had a primary diffuse large B-cell non-Hodgkin lymphoma of left LDS. After 8 cycles of CHOP (cyclophosphamide [Cytoxan], doxorubicin hydrochloride [Adriamycin], vincristine, and prednisone) therapy and further 14 months' follow-up, the patient's conditions were stable without evidence of recurrence. After reviewing associated articles, an interesting finding which, to the best of our knowledge, has never been described before is that all the expired or recurrent cases of primary lymphoma of lacrimal drainage system are of women, including the only 1 case of natural killer/T-cell lymphoma. In our opinion, sex should be considered 1 of the prognostic factors in primary lymphoma of LDS. The relationship between this tumor and hormone response is to be determined.
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PMID:Primary lymphoma of nasolacrimal drainage system: a case report and literature review. 1613 39

This is a rare case report of Hashimoto's thyroiditis in a patient with MALT thyroid lymphomas. The patient presented with an enlarged neck mass over the past 10 years and had rapidly enlarged neck mass with compressive symptoms for about 2 months. Examination by an endocrinologist found that the size of the thyroid gland was 120 gm with firm consistency and with no tenderness. She had clinical hypothyroidism and no abnormality of neither lymphadenopathy nor any masses. She was diagnosed with Hashimoto's thyroiditis because her thyroids function lest showed primary hypothyroidism [(FT4 = 0.76 ng/dl (0.93-1.71), FT3 = 1.76 pg/ml (1.8-4.6), TSH = 8.24 mIU/L (0.27-4.21)] with antimicrosomal antibody positive titers (> 1:409,600): Diagnosis of primary thyroid lymphoma was diagnosed by FNA and total thyroidectomy was performed. About 1 day after total thyroidectomy, she developed clinical hypocalcemia and the laboratory showed that calcium was = 6.2 ng/dl (8.5-10.1), phosphorus = 6.4 mg/dl (2.5-4.9). After 10% calcium gluconate replacement, her hypocalcemic symptoms didn't appear and she received oral replacement of calcium carbonate and vitamin D before discharge. During OPD follow up, her pathological report from Maha Chakri Sirinthorn Medical Center was a diagnosis of Non Hodgkin's lymphoma, low grade and the latter 1 week immunohistochemically staining of tumor markers indicated B-cell type (CD20) with MALT (AE1/AE3) lymphoma. Staging of the disease was stage IE and she received one course of CHOP (Cyclophosphamide, doxorubicin, vincristin and prednisolone). After one course of CHOP regimen, she was healthy and the hematologist ordered two courses of CHOP and external radiation.
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PMID:Hashimoto's thyroiditis in a patient with non-Hodgkin's thyroid lymphoma of B cell type and originated from mucosa-associated lymphoid tissue (MALT): A case report. 1685 37

Diffuse large B-cell lymphoma (DLBCL) is one of the most common subtypes of non-Hodgkin lymphoma. It is a heterogeneous disease, and a distinctive subgroup of patients with different treatment outcome can be identified based on clinical and molecular prognostic factors. Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy has been the standard systemic therapy for this disease with a cure rate of 40% to 50%, although, more recently, the addition of rituximab has been shown in phase III trials to confer a significant survival benefit in both older and younger patients. To further improve on the treatment outcome of this disease, dose-dense, and/or dose-intense regimens have been developed and tested against CHOP. However, these regimens are not yet accepted as standard therapy because of the increased toxicity as well as the uncertain benefit over CHOP with rituximab. In patients with localized DLBCL, available randomized trials suggest that radiation therapy improves local control and disease-free survival and that the addition of radiation therapy cannot replace inadequate chemotherapy.
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PMID:Diffuse large B-cell lymphoma. 1759 63

There are reports of patients with sickle cell disease who developed hematological malignancies but the relationship between these malignancies and sickle cell disease (SCD) is not yet defined. The co-existence of a hematological malignancy with SCD poses certain challenges for the management of each condition. We describe a 7-year-old boy with sickle cell anemia who developed Hodgkin's lymphoma and the challenges of management. He presented with a 4-year history of bilateral neck swelling and a 2-month history of weight loss and high-grade fever. Histology of a lymph node biopsy was consistent with mixed cellularity Hodgkin's lymphoma. He was treated with five cycles of Cyclophosphamide, Vincristine, Procarbazine and Prednisolone (COPP) and had complete clinical response. Chemotherapy was associated with an increase in frequency of painful crises and complicated by septicaemia. Blood transfusion needs were minimal; apart from the transfusion preceding the first cycle of chemotherapy, there was no need for further transfusion. Myelosuppression was not a problem in the patient; he responded well to antibiotics during the two episodes of septicemia without the use of hemopoetic growth factor. Patients with sickle cell anaemia who develop Hodgkin's lymphoma can be successfully treated with chemotherapy along with supportive management for crises and infections.
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PMID:Hodgkin lymphoma in a child with sickle cell anemia. 1778 89


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