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

Optimal treatment in Hodgkin's disease requires the knowledge of the stage the disease has reached. Laboratory tests, x-ray and scintigraphy, usually, are not sufficient, but biopsies of bone marrow and liver are necessary, in special cases supplemented by laparoscopy or explorative laparotomy with splenectomy. As treatment of choice, irradiation is favored for disease restricted to lymph nodes, and cytostatics for disease complicated by severe symptoms or by organ involvement. Diagnosis and therapy should be adapted to the individual patient. New therapeutic approaches must be compared with the sometimes excellent results obtained by several institutions.
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PMID:[Hodgkin's disease. Results in diagnosis and treatment (author's transl)]. 15 14

A total of 220 fine needle aspiration (FNA) specimens from 212 patients with clinically suspected or previously histologically confirmed lymphoma were evaluated by cytology in conjunction with immunophenotyping analysis of the aspirate; the results were compared with the histologic diagnosis made on previous or current accessions of lymph node or extranodal tissue. Smears of the aspirates were stained with the Diff-Quik and Papanicolaou stains while immunoperoxidase staining using antibodies against kappa and lambda immunoglobulin light chains and Leu-4 was routinely performed on Cytospin preparations. Where indicated, additional marker studies (including T-200, Leu-1, Leu-2a, Leu-3a + 3b, Leu-M1, B1, Leu-12, IgM, CALLA and TdT) were performed. For the non-Hodgkin's lymphomas, specimens were classified by the cytologic characteristics of the neoplastic cells according to the International Working Formulation scheme. The combination of cytologic smears and immunoperoxidase studies resulted in a diagnosis of lymphoma in 173 cases (79%). The remaining aspirates were interpreted as suspicious for lymphoma (7%), benign (10%) or inadequate for diagnosis (4%). Of the 15 suspicious aspirates, 5 proved to be Hodgkin's disease and 2 to be T-cell lymphoma by subsequent biopsy. The cause of failure in the nine inadequate aspirates were necrosis (3 cases), sclerosis (2 cases) and faulty technique (4 cases). In the cases that had concurrent tissue biopsies, no false-positive diagnoses were rendered. These results indicate that FNA used in association with immunocytochemistry is a reliable tool for establishing the diagnosis and classification of the majority of cases of lymphoma. Optimal immunoglobulin light-chain ratios for defining monoclonality in FNA specimens of B-cell lymphomas are proposed.
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PMID:Morphologic and immunocytochemical evaluation of 220 fine needle aspirates of malignant lymphoma and lymphoid hyperplasia. 211 24

Immunogold-silver staining was used for the detection of lymphocyte cell surface antigens in cryostat sections of lymphoid tissues. The sections were incubated with monoclonal mouse antibodies and then with colloidal gold-labeled goat anti-mouse antibodies. They were then immersed in a physical developer, counterstained, and mounted. In light microscopy, the tissue architecture was well preserved, and a dark labeling was seen on the positive cells. Optimal labeling conditions were determined. The distribution of the lymphocyte subsets, as defined by a panel of monoclonal antibodies in tonsil and reactive lymph nodes, was similar to that found with a biotin-avidin-horseradish peroxidase method. The monoclonality of the neoplastic cells in lymph nodes of B-cell non-Hodgkin's lymphomas clearly could be demonstrated. The sensitivity of the technic was comparable with that of the biotin-avidin-horseradish peroxidase labeling method. In addition, immunogold-silver labeling was combined with acid phosphatase cytochemistry.
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PMID:Detection of cell surface antigens in cryostat sections with immunogold-silver staining. 242 21

Adoptive immunotherapy involving bolus-dose recombinant interleukin-2 (rIL-2) has been reported to induce tumor regression in some patients with cancer, but has been associated with severe fluid retention and cardiopulmonary stress. In an effort to preserve the efficacy but reduce the toxicity of this treatment, we used escalating doses of rIL-2 as a constant infusion rather than as a bolus dose. Forty-eight patients with advanced cancer received rIL-2 as a 24-hour infusion in five-day cycles separated by five-day periods of rest and leukapheresis. Eight patients were removed from the study before receiving cells activated in vitro. In the 40 who could be evaluated for their response, there were 13 partial responses (32.5 percent) and 2 minor responses. Partial responses were observed in Hodgkin's disease (one of one), non-Hodgkin's lymphoma (one of one), lung cancer (one of five), ovarian cancer (one of one), parotid cancer (one of two), renal cancer (three of six), and melanoma (five of ten). Responses were associated with a good performance status, a base-line lymphocyte count above 1400 per cubic millimeter, and an rIL-2-induced lymphocyte count of at least 6000. Optimal lymphocytosis required a priming dose of rIL-2 of 3 X 10(6) U per square meter of body-surface area per day, and 15 of 28 patients receiving this priming dose responded to treatment. A weight gain of more than 10 percent of total body weight (five patients) and dyspnea at rest (six patients) were unusual events restricted to patients with poorer pretreatment performance. We conclude that the administration of rIL-2 as a constant infusion may preserve the antineoplastic activity of adoptive immunotherapy while increasing the safety and comfort of patients.
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PMID:Constant-infusion recombinant interleukin-2 in adoptive immunotherapy of advanced cancer. 349 33

Patients with advanced lymphoma who relapse from intensive first-line combination chemotherapy generally have a very poor prognosis. The use of investigational drugs which lack cross-resistance to agents commonly used for initial therapy represents an important approach to the management of such patients. Based upon our prior experience, we developed a protocol which employed a combination of three new agents. Mitoguazone (600 mg/m2) was administered on Days 1 and 10; etoposide (100-125 mg/m2) was administered on Days 2, 3, and 4; and gallium nitrate (300 mg/m2/day) was administered as a continuous iv infusion over 24 hours on Days 1-7. Treatment cycles were repeated every 3-4 weeks pending tolerance to toxic reactions. Forty-two patients are evaluable for response (35 with non-Hodgkin's lymphoma and seven with Hodgkin's disease). All patients had received extensive prior treatment (median of two previous chemotherapy regimens). Less than one-half of patients had achieved complete remission (CR) with previous therapy. Twenty-two patients (52%) showed major antitumor responses (five CR, 17 partial). All patients who achieved CR had diffuse large cell lymphoma. Two patients in CR relapsed in the CNS. The median duration of response for patients who achieved partial response was 4 months (range, 1-11+). Major toxic reactions included myelosuppression, optic neuritis, mucositis, and corneal keratitis or conjunctivitis. This combination of experimental agents has major therapeutic activity in patients with advanced, resistant lymphoma. Optimal application of these drugs may be obtained by use as one arm of an intensive program of alternating non-cross-resistant regimens.
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PMID:Salvage chemotherapy of advanced lymphoma with investigational drugs: mitoguazone, gallium nitrate, and etoposide. 379 Dec 68

Optimal conditions were established for evaluating the phytohemagglutinin-induced proliferative responses of purified peripheral blood T lymphocytes. This assay was utilized to determine whether T cells (in the absence of monocytes and serum inhibitory factors) from patients with Hodgkin's disease were defective in their ability to proliferative in response to optimal (50 microgram/ml) and suboptimal (25 and 12.5 microgram/ml) concentrations of phytohemagglutinin. T cells from 6 of 12 untreated patients exhibited 6-day proliferative responses below the range of 15 control subjects using optimal mitogen concentrations, and 9 of 12 patients exhibited subnormal responses using lower concentrations. Kinetic analyses indicated that the abnormal T-cell proliferative responses were characterized by peak proliferation occurring at day 4 or 5, rather than day 6. The observed abnormalities were not related to elevations in the proportions of T cells bearing surface receptors for IgG (T gamma Cells). Our results suggest that intrinsic functional T-cell defects contribute to the impaired immunity associated with Hodgkin's disease.
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PMID:Abnormal phytohemagglutinin-induced T-cell proliferative responses in Hodgkin's disease. 697 56

Lennert's lymphoma is a malignant lymphoproliferative disease first described by K. Lennert in 1966. Morphological manifestation of the disease is the presence of Hodgkin-, Berezovsky-Sternberg cells which are arranged at the background of lymphoid series cells, neutrophils, epithelioid cellular elements in the histological preparation. The clinical presentations of the disease include rapid progression, the presence of general toxic symptoms. Optimal treatment option of these conditions includes, in the authors' judgement, 1-3 courses of polychemotherapy at the start of the treatment, remote gamma-therapy to the area of the lesion foci, with subsequent use of several courses (not fewer than three) of polychemotherapy.
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PMID:[The clinico-morphological aspects and treatment characteristics of patients with Lennert's lymphoma]. 760 95

Recent studies are refining the treatment approaches of radiation therapy and combination chemotherapy in Hodgkin's disease. In early-stage disease, attempts are being made to lessen the toxicity of treatment while maintaining excellent results. Optimal results are achieved in advanced disease with combined radiation therapy and chemotherapy, most often with alternating or hybrid regimens. Several groups have attempted to define a poor-prognosis group of patients with advanced disease who might be candidates for more intensive treatment.
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PMID:Modern treatment approaches for Hodgkin's disease. 821 90

The therapeutic strategy in the treatment of malignant lymphomas changed somewhat in recent years. In Hodgkin's disease except for exceptional cases (mediastinal involvement) either radiotherapy alone is used or more frequently chemotherapy alone. Optimal treatment is a chemotherapeutic combination of four drugs (MOPP or ABVD). In low grade malignancy non-Hodgkin lymphomas so far cytostatic monotherapy is still the standard treatment, the assumed curative effect of an aggressive combined chemotherapy is being tested. As to new cytostatics, attention is drawn to fludarabine phosphate. In high-grade malignancy non-Hodgkin lymphomas chemotherapy may have a curative effect if the correct principles of its administration are respected, in particular adequate dose intensity in the initial cycles. This demand is met by third generation combinations. The author mentions also contemporary therapeutic possibilities of resistant forms and draws attention to problems of treatment of relapses in Hodgkin's disease and in non-Hodgkin lymphomas.
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PMID:[The present status of therapeutic possibilities in malignant lymphomas]. 851 71

The toxicity and feasibility of a high-dose sequential (HDS) chemotherapy programme delivered with growth factor support were evaluated in patients with intermediate and high-grade non-Hodgkin's lymphoma (NHL) or with progressive Hodgkin's disease. The scheme includes the sequential administration of single cytotoxic drugs at very high doses followed by intensified treatment with circulating progenitor autograft. In some instances, the original HDS scheme, initially designed at the Milan Cancer Center, was partially modified and intensified with a preliminary debulking phase. The use of G-CSF (filgrastim) made toxicity in the high-dose phase acceptable and allowed good harvests of peripheral blood progenitor cells (PBPC); the use of PBPC in the final autografting phase resulted in low haematological toxicity. Of 71 patients with NHL treated at our institution with either the original or the intensified HDS version, the overall toxicity-related mortality was 5.6%, thus comparable to lethal toxicity commonly associated with conventional chemotherapy. Adequate PBPC harvests are crucial for good tolerability of the programme. Optimal harvests are generally obtained in patients without neoplastic marrow infiltration while patients with marrow disease often have a poorer mobilisation. However, an optimally time-spaced chemotherapy debulking might also restore sufficient mobilisation in these latter patients. In terms of therapeutic efficacy, HDS had produced promising results since the initial experience in relapsed patients. More recently, HDS was evaluated as first-line treatment in a series of 22 consecutive patients, presenting with advanced-stage, intermediate-grade NHL other than diffuse large cell subtype. A CR rate of 82% was obtained following HDS, with a projected survival of 86% at five years. Thus, delivery of an intensive high-dose chemotherapy programme with haematopoietic growth factor support was found to be feasible and reasonably safe. The high anti-tumour efficacy of such a scheme makes it suitable for wider applicability in all those chemosensitive tumours where a dose increase might enhance the chance of cure.
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PMID:Haematological support of high-dose sequential chemotherapy: clinical evidence for reduction of toxicity and high response rates in poor risk lymphomas. 875 Jan 37


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