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)

The aggressive non-Hodgkin's lymphomas include some of the malignancies most frequently cured with chemotherapy. However, not all patients are cured, and the best treatment approach remains uncertain. The most common aggressive non-Hodgkin's lymphomas are diffuse large-cell lymphoma and immunoblastic lymphoma. Most recent studies suggest no useful difference between these two groups. When these lymphomas are localized at presentation they are highly curable. Earlier studies showed that radiotherapy alone had a high relapse rate. Chemotherapy alone has been found to have an excellent cure rate, but when followed by radiotherapy, the amount of chemotherapy can be reduced with the same good result. A number of chemotherapy regimens have been shown to cure approximately 50% of patients with disseminated large-cell lymphoma. It appears that a number of regimens including m-BACOD, MACOP-B, LNH-84, ProMACE-CytaBOM, CAP-BOP, COP-BLAM, F-MACHOP, and perhaps full-dose CHOP achieve similar results when prognostic factors are taken into account. Currently the most important area for therapeutic research (unless new drugs are found) is in identifying those patients likely to be cured with our present treatments and those patients for whom alternative therapies such as bone marrow transplantation need to be considered as part of the primary treatment. This is true not only for large-cell lymphoma but also for the less common aggressive non-Hodgkin's lymphomas such as lymphoblastic lymphoma, small noncleaved-cell lymphoma, and peripheral T-cell lymphoma.
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PMID:The present status of therapy for patients with aggressive non-Hodgkin's lymphoma. 204 15

Sixty-four patients with stages I and II non-Hodgkin's lymphomas (NHL) involving Waldeyer's ring treated between 1970 and 1987 were reviewed. Patients with stage II NHL were subdivided into stage II 1 (limited type) and stage II2 (advanced type) from the state of neck nodes. Stage II1 was defined as involvement of unilateral cervical nodes less than 4 cm in diameter as well as Waldeyer's ring involvement. Other stage II cases were classified as stage II2. All 17 patients with stage I NHL were treated with radiation therapy alone. Their diseases were well controlled, and none of them died of causes related to the lymphoma. Among 14 patients with stage II1 NHL, the 5-year survival rate for the 9 patients treated with radiation therapy alone was 87.5%. Until 1982, 19 of 21 patients with stage II2 NHL treated with radiation therapy alone or radiation therapy and adjuvant chemotherapy (VEMP or COPP) died within 5 years mainly of disseminated diseases. Since 1983, CHOP has been used as the main treatment as well as radiotherapy for the 12 stage II2 NHL patients. So far, only 3 of them relapsed and 2 of them died of causes related to the lymphoma. Only 1 of these 12 patients was T-cell lymphoma compared to 7 of 9 stage II2 patients before 1982. This suggests that patients with stage I and those with limited stage II can be safely treated with radiotherapy. Also aggressive chemotherapy as well as radiotherapy should be used for patients with advanced stage II NHL involving Waldeyer's ring.
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PMID:[Radiotherapy and chemotherapy in stages I and II non-Hodgkin's lymphomas of Waldeyer's ring]. 221 35

Because of growing evidence that there are differences in the natural history of HIV infection in intravenous drug users (IVDU) and homosexual men, the clinicopathological features and response to treatment of AIDS-related non-Hodgkin's lymphomas (NHL) were analyzed in 150 cases (96 IVDU and 31 homosexual men) by the Italian Cooperative Group on AIDS-related tumors. Twenty-three patients fell within other risk groups. The median age was 26 years for the IVDU and 38 for the homosexual men. Forty percent of patients in both of the risk groups manifested full-blown AIDS prior to development of the lymphoma. In both groups, most of the NHL were of high or intermediate type (IVDU 96%, homosexual men 86%). In high-grade NHL, Burkitt's type lymphoma was present in 40% of the homosexual men and in 29% of the IVDU (a non-significant difference), while an immunoblastic lymphoma was diagnosed in 46% of IVDU and 27% of homosexual men (non-significant). No oral localizations were observed, and one homosexual presented with a rectal lymphoma. Almost half of the patients (47%) received no antineoplastic treatment because of rapid disease progression or of diagnosis only at post-mortem. Intensive combination regimens administered in one-third of both IVDU and homosexual men (compared to CHOP or CHOP-like combinations) provided more CR (3/13 vs 3/24 in IVDU and 2/3 vs 1/7 in homosexuals), although the overall survivals with both the intensive and less intensive chemotherapy protocols remained similar. Overall, the median survival was 3.7 months for IVDU and 3.6 months for homosexual men. The most reliable predictors for survival were opportunistic infections at onset in IVDU.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:AIDS-associated non-Hodgkin's lymphoma in Italy: intravenous drug users versus homosexual men. The Italian Cooperative Group on AIDS-Related Tumors (GICAT). 226 66

A 29-year-old Japanese male was diagnosed as having autoimmune hemolytic anemia (AIHA) in 1985, and systemic lupus erythematosus (SLE) in 1988. In 1989 a large mass was found of the right posterior area in the liver by computed tomography and ultrasonography. The liver biopsy specimen showed non-Hodgkin lymphoma, diffuse large cell type. No adenopathies or other extranodal involvements were detected. He was treated with five courses of CHOP, followed by involved field irradiation 24 Gy. On completion of chemoradiotherapy, the mass was smaller in size with a sign of partial necrosis. Gallium scan was negative suggesting the achievement of a complete remission. Primary hepatic lymphoma is extremely rare, and its occurrence in patients with AIHA and SLE has not been reported previously. We also review the previously reported cases of primary hepatic lymphoma with respect to its clinical management and abscess the therapeutic strategy of this unusual extranodal lymphoma.
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PMID:[Primary hepatic lymphoma in a patient with autoimmune hemolytic anemia and SLE]. 228 76

The course of disease in 61 consecutive patients with non-Hodgkin lymphoma of high grade malignancy, treated between 1979 and 1985 with either CHOP or COP-BLAM regimen, was analysed retrospectively. Both groups showed a highly similar distribution of prognostic variables. COP-BLAM treatment resulted in significantly more complete remissions (23 of 27) than CHOP (11 of 29, P = 0.001). Life expectancy was, therefore, considerably higher in the COP-BLAM treated group. The mean observation period, however, was longer for CHOP-treated patients (37 vs. 30 months. The higher remission rate of the COP-BLAM regimen was not compromised by a substantial increase in toxicity; no therapy-related death was observed. Thus, the COP-BLAM regimen appears to be superior in inducing complete remissions in aggressive non-Hodgkin lymphoma. Actual survival curves suggest that this corresponds to an increased proportion of cured patients, but longer follow-ups are needed.
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PMID:[Comparison of CHOP and COP-BLAM chemotherapy in highly malignant non-Hodgkin's lymphoma]. 242 72

Adriamycin is the most successful anthracycline in malignant lymphomas. Epirubicine is too new to be fully appreciated. Others anthracyclines have no real efficacy in nonleukemic lymphoid malignancies. The prognosis of malignant lymphomas has been transformed since the introduction of this drug in the chemotherapeutic protocols: the level of complete remission increased from 25% with CVP protocols to 50% with CHOP-types protocols, and to more than 70% with intensive chemotherapy protocols (m-BACOD, LNH-80). The number of live patients at 2 years grew in the same proportions. The efficacy of adriamycin in follicular lymphomas is of less value. In Hodgkin's disease the efficacy of adriamycin pull it to first line protocols (ABVD) with identical results to those obtained with MOPP chemotherapy. This drug has its place in the treatment of myeloma patients and in chronic lymphocytic leukemia patients with stage C.
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PMID:[Contribution of anthracyclines in treatment of lymphoproliferative disorders]. 243 32

Previous studies have established CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) as the standard of comparison for treatment programs for patients with advanced stages of aggressive non-Hodgkin's lymphomas. Three sequential CHOP studies conducted by the Southwest Oncology Group (SWOG) showed a complete remission (CR) rate of 53% for 418 patients. This rate did not vary among the three studies. Median age was over 55 years. Relapse-free survival of CRs plateaued at 4 to 5 years. Approximately 21% of all patients in the first study and 33% of all patients in the following two studies are long-term survivors and presumed cured. Survival was clearly a function of patient age. Approximately 45% of all patients under age 55 at the time of treatment are cured by CHOP chemotherapy. To determine the toxicity, CR rate, and patient survival of m-BACOD (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine, dexamethasone), ProMACE-CytaBOM (prednisone, methotrexate, doxorubicin, cyclophosphamide, etoposide, cytarabine, bleomycin, vincristine, methotrexate), and MACOP-B (methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin), SWOG initiated a series of phase II studies. Of 118 eligible patients in the m-BACOD study, the median age of 85 patients treated with the full-dose regimen was 54 years, while the median age of 33 patients who started therapy at reduced doses was 67 years. Fatal toxicity was observed in 6% of patients receiving full doses and 13% of those receiving reduced doses. Life-threatening toxicity occurred in 31% of patients on the full-dose regimen and 34% on the reduced-dose regimen. CR was 65% for full-dose treatment, but 27% for reduced doses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Southwest oncology group clinical trials for intermediate- and high-grade non-Hodgkin's lymphomas. 243 78

Between 1975 and 1982 in 2 centres in Glasgow, 53 previously untreated patients with aggressive non-Hodgkin's lymphomas received chemotherapy consisting of one of the following regimens-CVP, MOPP, CHOP or BACOP. Twenty nine patients (55%) entered complete remission (CR), 20 (38%) had partial remission (PR) and 4 (7%) had progressive disease (PD). Of the 29 patients in CR, 9 have relapsed and died, 5 died of infection, 4 died of non-malignant causes, and 11 (21%) remain alive and disease free. The median survival for the CR group is 40 months. All of the patients in the PR and PD group are dead, median survival 11 months. These chemotherapy regimens will cure only the minority of patients with aggressive lymphomas and the use of more intensive regimens is indicated.
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PMID:Failure of conventional chemotherapy in aggressive lymphomas. 244 60

Between 1979 and 1985 61 consecutive patients with non-Hodgkin's lymphomas of unfavourable histology (mostly diffuse large cell lymphomas subclassified according to Kiel nomenclature) were treated in our departments by either the CHOP- (n = 34) or the COPBLAM-regimen (n = 27). A retrospective analysis revealed that prognostic variables, excluding primary central nervous system (CNS)-involvement (n = 5), were equally distributed between both groups. Remission rates were significantly higher in the COPBLAM treated patients as compared with the CHOP treated group (85 per cent versus 38 per cent CR, P = 0.001) even when cases with primary CNS-disease were excluded. The survival curve did not reach a plateau in CHOP treated cases, whereas 85 per cent of the COPBLAM treated group reached a plateau by 15 months. The mean observation time, however, was shorter in the COPBLAM treated group (37 versus 30 months, respectively). It is concluded that the COPBLAM regimen is superior to the CHOP-protocol in inducing complete responses in aggressive non-Hodgkin's lymphomas. Longer follow-ups are needed to definitely show if this corresponds to an increased proportion of 'cures'.
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PMID:CHOP and COPBLAM chemotherapy for diffuse large cell non-Hodgkin's lymphomas: a retrospective comparison. 244 84

In malignant lymphomas, ifosfamide-containing regimens were at first used mainly in second-line therapy and response-adapted protocols. Currently, in combination with other drugs, ifosfamide is being used in several phase-III trials. As salvage therapy in non-Hodgkin's lymphoma (NHL), IMV-Bleo (ifosfamide, methotrexate, etoposide, bleomycin) produced a complete remission (CR) rate of 41% and seemed to be particularly effective in patients with suboptimal response to first-line treatment. IBEP (ifosfamide, bleomycin, etoposide, procarbazine), in combination with procarbazine and bleomycin was an effective non-cross-resistant alternative in CHOP (cyclophosphamide, hydroxydauomycin/doxorubicin, vincristine, prednisone)-refractory NHL. In a trial of response-oriented therapy in high-grade malignant lymphoma patients, the investigators concluded that consolidation therapy was necessary even in patients with rapid response to CHOP. Patients with NHL resistant to or relapsing from conventional chemotherapy or with MOPP-ABVD (mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine, decarbazine)-resistant Hodgkin's disease (HD) were treated with BMV-VIP [bleomycin, plus high-dose methylprednisolone plus ifosfamide, etoposide, plus methylprednisolone]. In high-grade malignant NHL, patients received three cycles of COP-BLAM (cyclophosphamide, vincristine, procarbazine, prednisone, bleomycin, doxorubicin). Those who achieved CR received two more cycles of COP-BLAM and IMV (ifosfamide, methotrexate, etoposide) as consolidation therapy. Patients in partial remission (PR) or with less of a response to COP-BLAM were switched to IMV. After reaching CR, patients received two additional cycles as consolidation therapy. After the second restaging, patients were randomized to observation v additional radiotherapy. Of 191 patients, 148 have passed first restaging with 51% in CR; 85 went through the second restaging with 61% in CR. Of 32 patients who only reached PR after the first restaging, 15 (47%) achieved CR with IMV. For primary treatment of HD, the German Hodgkin Study Group added a third non-cross-resistant regimen, IMEP (ifosfamide, methotrexate, etoposide, prednisone), to supplement COPP (cyclophosphamide, vincristine, procarbazine, prednisone) and ABV in the primary treatment of HD. In a pilot study, 87% of 63 evaluable patients reached CR. The current phase-III protocol is comparing COPP/ABVD with fast alternating cycles of COPP/ABV/IMEP.
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PMID:European experience with ifosfamide in lymphomas. 246 84


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