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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 considered the prognostic factors in high-grade non-Hodgkin's lymphomas (HG-NHL) over the past two decades. In an effort to clarify the relationship between prognostic factors and therapy, we pooled the literature reports concerning 3,480 patients into four different periods according to the mean years of the clinical trials. The most important prognostic factors discovered in period A (mean year prior to 1970) were histology, symptoms and stage. In period B (1970 through 1975), in addition to the former indicators, two new factors were pointed out: bone marrow involvement and serum lactic dehydrogenase. In period C (1976 through 1980) the significance of stage was reduced, while bulk and measures of lymph nodal and extranodal involvement (LSI, ESI) were found to be better prognostic factors. In studies related to this period the prognostic role of albumin, hemoglobin and erythrocyte sedimentation rate were also emphasized. Period D (1980 through 1985) was characterized by a decrease in the importance of the Kiel and Working Formulation (WF) classifications by virtue of the better outcome, in different reports, of HG-NHL with respect to low-grade NHL. The conclusion of our analysis is that symptoms, ESI, bulk, LDH, albumin and hemoglobin should be the most important factors used today in planning the therapy and management of patients with HG-NHL. In addition, an update of the WF is necessary.
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PMID:Relationship between prognostic factors and therapy in high-grade non-Hodgkin's lymphomas over two decades. 251 Nov 24

Bone marrow involvement was seen in 11 percent of patients with Hodgkin's Disease which was determined from pre-treatment biopsy specimens using established histopathologic criteria. Analysis of 32 evaluable patients with marrow involvement showed male preponderance with a peak in fourth decade of life. Twenty four cases (75%) had B-symptoms and 15 (46%) presented within six months of onset of symptoms. On categorizing for clinical staging, 21 (65%) belonged to stage III and IV. Hepatomegaly (greater than or equal to 2 cms) was present in seven cases (21%) and splenomegaly in 13 cases (40%). Mixed cellularity and lymphocytic depletion histopathologic subtypes showed the highest frequency of involvement (21 cases; 65%). Out of 28 cases ESR was raised in 27 cases (96%). Eighteen cases (56%) showed elevated serum alkaline phosphatase levels. Serum copper levels were determined in 14 cases, out of which 12 (85%) showed elevated levels. These parameters along with anemia (hemoglobin of 12 g/dl or less) in 26 cases (81%), correlated well with the disease activity. Only four cases had leukopenia at presentation pointing to no hindrance for aggressive chemotherapy. All cases received minimum of six courses of standard combination chemotherapy with or without local radiotherapy. Sixteen cases (50%) relapsed subsequently and were managed accordingly. A five year follow-up revealed a minimal 31 percent overall survival, and 18 percent of patients were disease free and well since the time of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hodgkin's disease with bone marrow involvement. 259 99

Paraffin-embedded lymph node biopsies from 107 patients with newly diagnosed non-Hodgkin's lymphomas were examined for cell DNA content and proliferative activity (as percentage of S-phase cells) by means of flow cytometry. Patients were diagnosed between 1975 and 1985 and were homogeneously treated according to the grade of histologic malignancy. Cytofluorimetric data were studied with regard to their correlation with histology (classified and reviewed according to both Kiel and Working Formulation criteria), clinical stage, presence of constitutional symptoms, presence of bulky disease, sex, age, and the following laboratory data measured at diagnosis: erythrocyte sedimentation rate, hemoglobin, serum lactic dehydrogenase and serum albumin concentration. Aneuploidy was more frequent in the high grade malignant subtypes and in the miscellaneous group but showed no correlations with the other clinical parameters studied. Proliferative activity demonstrated a wide variation of data but a trend was evident toward higher proliferative values in the more severe histologic subtypes. The survival discrimination allowed by high- and low-grade malignant histology is exactly reproduced when highly and slowly proliferating lymphomas are considered (greater than or less than or equal to 12% of S-phase cells). These results, analyzed with those in the literature, suggest that measurements of ploidy and proliferative activity add little independent information to what is already provided by current histologic classifications, mainly as far as clinical evaluation and prognosis are concerned. Cytokinetic-aided therapeutic choices can be usefully proposed in a restricted number of cases. Improvement of the available lymphoma classifications through a better integration of ploidy and cytokinetic data with immunologic, genetic and histologic findings is still an object to be pursued in cytometric studies.
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PMID:Ploidy and proliferative activity measurement by flow cytometry in non-Hodgkin's lymphomas. Do speculative aspects prevail over clinical ones? 263 57

Results of bone marrow biopsy were retrospectively evaluated in 120 previously untreated patients with Hodgkin's disease. The incidence of bone marrow involvement was 13%. All patients with marrow invasion had B symptoms and/or clinically advanced disease. When patients with bone marrow involvement were compared to those without there were significant differences in the incidence of B symptoms, the clinical stage, hemoglobin levels, leukocyte counts, platelet counts, and serum levels of lactate dehydrogenase and alkaline phosphatase. None of 59 patients with clinical stage IA and IIA had evidence of marrow invasion. This study demonstrates that trephine bone marrow biopsy is of value in detecting marrow involvement in specific subgroups of untreated patients with Hodgkin's disease, i.e., those patients with constitutional symptoms and/or clinical stage III or IV. However, bone marrow biopsy adds little to the initial staging of patients with clinical stage IA and IIA. Routine use of this procedure in such patients may be unnecessary.
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PMID:Bone marrow biopsy in the initial staging of Hodgkin's disease. 291 70

61 cases of Hodgkin's disease (HD) with age over sixty years were diagnosed in a series of 387 patients. Mixed cellularity (57.4%) and nodular sclerosis (14.7%) were the most common histologic subtypes. Clinical presentation was characterized by superficial lymphadenopathy (92%) and/or general symptoms (57.4%). Mediastinal involvement was observed in 24.6% of cases, and 24.6% of patients had a primitive infradiaphragmatic presentation. Stage II was the most frequent (47.5%). At the onset of the disease, normal values of hemoglobin and white cells were observed while the platelet count was more variable. Only 3 patients (5%) were given radiotherapy (RT), 3 received chemotherapy (CH) plus RT, and 55 (90%) CH. Severe hematologic toxicity was observed in only 11.1% of cases. Complete remission (CR) was obtained in 37 patients (61%), 10 of whom relapsed. Elderly patients had a 5-year survival rate of 54.9%, while in younger ones it was 76.4% (p less than 0.001). Survival was strongly influenced by the achievement of CR (p less than 0.001), whereas stage, histopathology, systemic symptoms and therapeutic modalities did not correlate significantly.
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PMID:Hodgkin's disease in the elderly: a retrospective clinicopathologic study of 61 patients aged over 60 years. 312 41

The value of serum deoxythymidine kinase (TK) for the staging and evaluation of disease activity of non-Hodgkin lymphoma (NHL) as compared with serum beta 2-microglobulin, serum lactate dehydrogenase, blood sedimentation rate, blood hemoglobin, white blood cell count, lymphocyte count and platelet count was investigated in 101 patients. In addition, the performance status was determined by the Karnofsky index. Patients with chronic lymphocytic leukemia (CLL; n = 43) and immunocytoma (IC; n = 19) were staged according to the Binet classification, and the other low (n = 28) and high grade NHL (n = 8) according to the Ann Arbor classification. The analysis of all CLL and IC patients revealed that TK values correlated better with Binet stages (p = 0.01; n = 58) than blood sedimentation rate (p = 0.05, n = 12), lactate dehydrogenase (p = 0.08; n = 50), beta 2-microglobulin (p = 0.29; n = 28), lymphocyte count (p = 0.70; n = 57), white blood cell count (p = 0.69, n = 59) and the Karnofsky index (p = 0.16, n = 50). Mean TK levels of these patients were for Binet stage A 6.2 +/- 0.8 U/l (mean +/- S.E.M., range 2.3-18.0), stage B 13.3 +/- 6.5 U/l (3.8-38.8) and stage C 19.6 +/- 4.4 U/l (1.9-79.0), and for 22 healthy controls 3.8 +/- 0.2 U/l (2.2-6.0). Patients with multiple courses of chemotherapy (n = 32) previous to the study had significantly (p = 0.01) higher TK levels (16.4 +/- 3.7 U/l; 2.3-79.0) than those with only up to one course (n = 66; TK: 8.6 +/- 1.4 U/l; 1.5-66.3). The follow-up of 16 patients with low grade NHL showed that serum TK levels paralleled well the clinical response. The results indicate that TK might be a worthful parameter to estimate progression and response to therapy of NHL.
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PMID:Activity of serum thymidine kinase in non-Hodgkin lymphoma: relationship to other prognostic factors. 317 80

Hematologic malignancy has rarely been reported in adults with sickle cell disease. We describe four sickle cell patients (two with hemoglobin SC, two with hemoglobin SS) who developed hematologic malignancy (acute myeloblastic leukemia, multiple myeloma, malignant histiocytosis, and Hodgkin's disease). Three of the cases represent the first adult association between SC or SS hemoglobinopathy and the particular malignancy involved. Sickle hemoglobin does not appear to exert a protective effect against childhood hematologic malignancies, suggesting that better survival in sickle cell disease may be accompanied by an increased incidence of hematologic neoplasms in adulthood. Karyotypic analysis revealed alterations of chromosome 5 in two sickle cell patients with leukemia, raising the possibility of a chromosomal link between the two diseases. Further epidemiologic and cytogenetic studies are needed to define the relationship between hematologic malignancy and sickle cell disease.
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PMID:Hematologic malignancy in sickle cell disease: report of four cases and review of the literature. 345 91

Stainable iron was absent or decreased in 36 of 45 bone marrow biopsy specimens (80 percent) among 33 patients with chronic-stage chronic granulocytic leukemia. Decreased iron did not correlate with sex, treatment status, duration of disease, marrow cellularity, or hemoglobin level. In contrast, marrow iron was absent or decreased in 34 percent of biopsy specimens at diagnosis of acute nonlymphocytic leukemia (p less than 0.0001) and 31 percent of biopsy specimens from patients with Hodgkin's disease (p less than 0.0001). The serum ferritin level was determined in eight patients with chronic granulocytic leukemia and absent marrow iron, and it was normal in all. Fifteen of 17 patients, followed with chronic-stage disease for one to four years after the finding of absent marrow iron, demonstrated increases in their hemoglobin levels during antileukemic therapy or maintained normal values. Thus, absent or decreased stainable marrow iron is a common finding in chronic granulocytic leukemia and usually does not indicate iron deficiency.
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PMID:Decreased stainable marrow iron in chronic granulocytic leukemia. 346 10

Forty-seven patients with Hodgkin's disease in relapse were treated with MIME combination chemotherapy (methyl-GAG, ifosfamide, methotrexate, etoposide). All patients had previously received nitrogen mustard, vincristine, prednisone, procarbazine (MOPP) or similar regimens and doxorubicin-containing combinations, and many had received extensive irradiation. Complete remission (CR) occurred in 23%, and was influenced by presence of extranodal disease, hemoglobin, lactic dehydrogenase (LDH), and number of prior relapses. Median survival for all patients was 50 weeks, and was affected adversely by the presence of extranodal disease and the number of prior relapses. Toxicity was significant, including infections (23%), neutropenic fever (34%), and hemorrhagic cystitis (23%), but was related in part to the extent of prior therapy. These results with this novel chemotherapy program in heavily pretreated patients suggest that MIME should be studied in less extensively treated patients and considered as a part of treatment programs for patients with Hodgkin's disease in first relapse.
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PMID:MIME chemotherapy (methyl-GAG, ifosfamide, methotrexate, etoposide) as treatment for recurrent Hodgkin's disease. 355 49

Food intake and nutritional status were estimated in 34 cancer patients (14 patients with non-Hodgkin lymphoma and 20 patients with relapse of different cancers) and 25 healthy subjects (control group). A two-month dietary history based on Burke's method was used to estimate food intake. Nutritional status was expressed by weight, anthropometric parameters and hematologic parameters. The patients' intake of cheese, eggs, rye bread, and poultry was reduced compared to controls. The difference in food preferences resulted in a higher energy supply from carbohydrate and a lower intake of indigestible carbohydrate, vitamin B12, iron and iodine in patients than in controls. The groups did not differ in anthropometric parameters, but a decreased total serum protein, albumin and hemoglobin was observed in patients, whereas their alpha-globulin levels were increased. Thus, food preferences in cancer patients seem to be associated with insufficient intake of nutrients.
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PMID:Food preferences, nutrient intake and nutritional status in cancer patients. 368 83


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