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)

A teenage boy with mixed-cellularity Hodgkin disease presented with severe anemia secondary to pure red cell aplasia of marrow without evidence of lymphomatous infiltration or hemolysis. In vitro studies of the patient's serum demonstrated an inhibitor of erythropoietin activity which appeared to be an IgG but which did not directly bind erythropoietin. The patient's anemia resolved and the inhibitor disappeared following chemotherapy for Hodgkin disease. Presumably, the inhibitor was directed at a very early stage of red blood cell production. This phenomenon may be related to other autoimmune manifestations occasionally seen in patients with lymphomas. The case is presented to bring attention to the unusual occurrence of red cell aplasia in Hodgkin disease. Several hypotheses concerning significance and etiology of the anemia are detailed.
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PMID:Hodgkin disease and red cell aplasia. 74 84

As an introduction to a Satellite Symposium on the utilization of recombinant human erythropoietin (rHu-EPO) in hematology (Leukemia & Lymphoma 1992; 7 (Suppl.2): 94-100) a contribution to its mechanism of action was presented, and is published here. In three patients with advanced Hodgkin's disease treated with combination chemotherapy (MOPP) incorporating vincristine, and receiving at the same time a fixed daily dose of 8000 U of rHu-EPO subcutaneously for 10 to 15 days because of myelosuppressive anemia, myeloaspirates were performed one week before and 24 hours after the administration of vincristine. A dramatic accumulation of arrested metaphases in all stages of erythroblasts was found, while there was no augmentation of granulocytic metaphases. This is a further confirmation, following a previous contribution (Marmont AM: Haematol 1991; 76, 251-255), of the demonstration in man of the combined effects of erythropoietin as an erythroid mitogen and vincristine as a mitotic blocker.
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PMID:Selective metaphasic arrest of erythroblasts by vincristine in patients receiving high doses of recombinant human erythropoietin for myelosuppressive anemia. 143 24

Anemia is a common complication of lymphoproliferative syndromes. The exact pathogenic mechanism of this anemia is unclear. Many patients require progressive and persistent blood transfusions. We treated 10 patients (8 with multiple myeloma, 1 with non Hodgkin Lymphoma, 1 with chronic lymphocytic leukemia) by administering low doses of recombinant human erythropoietin (60 U/kg 3 times a week s.c.). All patients presented anemia with hemoglobin levels less than 10 gr/dl; renal function was not impaired (serum creatinine levels less than 1.2 mg/dl or creatinine clearance greater than 60 ml/min). A response was defined as an increase of hemoglobin level of at least 2 gr/dl or stop of red-cell transfusion within the first 3 months of treatment. Nine patients (90%) responded to treatment with a significant increase in the hemoglobin concentration. Two patients presented a cerebral stroke not correlated with erythropoietin administration.
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PMID:[Efficacy of erythropoietin in anemia of patients with immuno-lymphoproliferative disease]. 152 59

In the course of a phase I-II clinical study exploring the therapeutic potential of recombinant human erythropoietin in malignancy-associated anemias, a significant morphologic aspect was found in the marrow aspirates in two cases. The first was a patient with Hodgkin's disease, and the other a patient with acute T lymphoblastic leukemia. Bone marrow aspirates were performed while the patients were receiving recombinant human erythropoietin (rHu-EPO), 24 hours after the administration of vincristine, which was part of the therapeutic regimens. In all myeloaspirates over 90% of the numerous erythroblasts were in metaphasic arrest or displayed all the other aspects of so-called C mitoses, including star and ball metaphases, scattered chromosomes and multinuclear cells expressing so-called reconstructive polyproidism. All these alterations are caused by vincristine, a vinca dimer alkaloid, binding mechanistically to tubulin and thus blocking the polymerizing process that forms the mitotic spindle. The target cells for erythropoietin are specifically responsive cells, including microscopically identifiable erythroblasts. This is the first morphological demonstration in man of the combined effects of erythropoietin as a mitogen and vincristine as a mitotic blocker.
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PMID:Selective metaphasic blockade of erythroblasts in the bone marrow of patients treated sequentially with recombinant human erythropoietin and vincristine. 174 98

The influence of splenectomy on erythroid burst colony formation by peripheral blood mononuclear cells from 10 patients (four with hereditary spherocytosis, two with beta-thalassaemia major, two with Hodgkin's disease and two with idiopathic thrombocytopenic purpura) was studied. In every instance splenectomy was followed by a lowering of blood BFU-E. The post-splenectomy levels ranged from 0 to 30% of the preoperative levels. Mononuclear cells from the spleens of eight patients were cultured and found to contain numerous BFU-E. The total quantity of BFU-E in the whole blood and in the spleen of the patients was generally of the same order of magnitude. The number of splenic BFU-E did not correlate with spleen size. Splenic BFU-E differed from peripheral blood BFU-E in that they were more sensitive to erythropoietin (Ep) and in that they failed to respond to burst promoting activity (BPA) produced by preincubating the spleen mononuclear cells with phytohaemagglutinin M (PHA). In contrast, media conditioned by PHA-treated spleen cells contained BPA active on peripheral blood BFU-E from normal individuals. These data suggest that the spleen may have an influence on the numbers and functional properties of BFU-E.
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PMID:The relationship between human spleen and blood erythroid burstforming units (BFU-E). 668 75

When human marrow cells were cultured in a medium containing alpha-medium, methylcellulose, fetal calf serum, bovine serum albumin, erythropoietin, and leucocyte-conditioned medium, mixed colonies composed of erythrocytic cells and granulocytes were formed. The clonal nature of the mixed colonies was confirmed by the linear relationship between the numbers of cells plated and the number of colonies, and the absence or presence of Y-chromatin in the mixed colonies in a co-culture experiment with male and female cells. Using the methylcellulose cell culture techniques, the pluripotent hemopoietic precursors (CFUMIX) in marrow cells from 15 patients with aplastic anemia were assayed. In the control subjects of patients with iron-deficiency anemia, lymphoadenitis, reactive leucocytosis or Hodgkin's disease, 8 X 10(5) marrow cells in 4 dishes produced 12.7 +/- 6.9 (mean +/- SD) mixed colonies. On the other hand, 8 X 10(5) marrow cells from patients with aplastic anemia formed only 2.1 +/- 5.5 (mean +/- SD) mixed colonies. Furthermore, the marrow cells from 5 patients who were repeatedly receiving transfusions contained no CFUMIX which give rise to mixed colonies. The present results provided the first direct evidence that pancytopenia in most patients with aplastic anemia results from a reduced influx into the compartment of maturing hemopoietic cells from the compartment of pluripotent hemopoietic precursors.
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PMID:Pluripotent hemopoietic precursors in vitro (CFUMIX) in aplastic anemia. 722 71

We studied a patient who developed pure red cell aplasia (PRCA) following peripheral stem cell transplantation for non-Hodgkin lymphoma. Serum erythropoietin was appropriate for the degree of anemia. Corticosteroid treatment was ineffective. Four months after transplantation rHuEpo was administered subcutaneously at a dose of 150 U/Kg per day, five days a week for 8 weeks. Treatment induced an erythropoietic response and corrected anemia. Response was maintained following discontinuation of rHuEpo. This study and previous reports indicate that high doses of rHuEpo given over a short time can resolve PRCA following autologous or allogeneic stem cell transplantation.
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PMID:Pure red cell aplasia following peripheral stem cell transplantation: complete response to a short course of high-dose recombinant human erythropoietin. 784 33

Acquired pure red cell aplasia (PRCA) has been associated with various lymphoproliferative conditions but its occurrence with Hodgkin's disease is rare. We report a case of PRCA occurring immediately following the completion of induction chemotherapy in a patient with Stage IIIB nodular sclerosing Hodgkin's disease. In vitro erythroid colony studies documented evidence for T cell mediated suppression of erythropoiesis and lack of a serum inhibitor. Addition of cyclosporin to the in vitro cultures stimulated erythroid colony growth. Following in vivo treatment with cyclosporin peripheral blood CD4/CD8 ratios returned to normal. However, serum erythropoietin levels were inappropriately low. Subsequent treatment with erythropoietin induced a reticulocytosis and transfusion independence. Since discontinuing the erythropoietin, the patient has been able to maintain a hemoglobin of 100 g/L. This case illustrates that red cell aplasia occurring in the setting of Hodgkin's disease may be due to T cell mediated suppression of erythropoiesis. A response to cyclosporin may be masked by inappropriately low erythropoietin levels.
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PMID:Pure red cell aplasia after chemotherapy for Hodgkin's lymphoma: in vitro evidence for T cell mediated suppression of erythropoiesis and response to sequential cyclosporin and erythropoietin. 818 75

Patients with cancer can now benefit from intensive drug dosage. Intensive drug dosage has become more effective because of the availability of better anti-emetics, hematopoietic growth factors such as granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte CSF (G-CSF), erythropoietin, etc. and improvements in hematopoietic stem cell transplantation. We have evaluated the clinical and cost effectiveness of GM-CSF in patients undergoing autologous bone marrow transplantation (AuBMT) for Hodgkin's disease. Administration of GM-CSF after AuBMT enhances myeloid and platelet recovery and is cost effective in the treatment of patients with relapsed Hodgkin's disease who received intensive chemotherapy and AuBMT. We also describe the use of various new therapeutic approaches with emphasis on clinical and cost benefit. Further work is needed to improve the route and duration of growth factor(s) infusion and the timing of the various treatments.
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PMID:GM-CSF as an adjunct to autologous bone marrow transplantation. 845 76

Erythropoietin can be successfully used in the treatment of anaemia induced by chemotherapy and radiotherapy as well as for the treatment of anaemia induced by malignant disease without previous chemotherapy of radiotherapy. Erythropoietin administered during chemotherapy is effective in 50-70% patients, it has a more marked effect as a supplement to chemotherapy with cisplatinum and carboplatinum than non-platinum regimens. Erythropoietin reduces the consumption of red cell concentrates during chemotherapy on average by one half. Long-term administration of erythropoietin in anaemia caused by malignant disease alone proves most effective in multiple myeloma and in chronic lymphatic leukaemia or in non-Hodgkin lymphomas with a low malignity. The therapeutic responses defined as independence on transfusions and a rise of the haemoglobin level by at least 20 g/l, as compared with the pretreatment value, can be achieved in 60 to 80% of the patients. Erythropoietin is much less effective (10-20% therapeutic responses) in myelodysplastic syndrome, in myeloproliferative diseases or in aplastic anaemia. The authors give an account on the effectiveness of erythropoietin in different indications.
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PMID:[Erythropoietin in oncology. II. Evaluation of the effectiveness of erythropoietin in hematologic and oncologic diseases]. 876 96


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