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)

To determine if a normal antibody response can develop after therapy for Hodgkin's disease, we immunized 53 patients and 10 normal controls with dodecavalent pneumococcal vaccine. Antibody concentrations three weeks after immunization (geometric mean of 11 serotypes) were 1566 ng of protein nitrogen per milliliter in controls, 963 ng per milliliter after subtotal radiation (P less than 0.05 compared to controls), 658 ng per milliliter after chemotherapy (P less than 0.05), 377 ng per milliliter after subtotal radiation plus chemotherapy (P less than 0.01) and 283 ng per milliliter after total nodal radiation plus chemotherapy (P less 0.001). Low levels of antibody before immunization correlated with a poor response (r = +0.73, P less than 0.001). The ability to respond to immunization improved significantly but did not return to normal as long as four years after combined therapy. The antibody response to pneumococcal vaccine is profoundly impaired in patients who have received intensive treatment for Hodgkin's disease: the ability of this vaccine to protect them from overwhelming postsplenectomy infections remains in doubt.
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PMID:Impaired antibody response to pneumococcal vaccine after treatment for Hodgkin's disease. 2 83

117 patients with stage IIIA Hodgkin's disease were randomly allocated for treatment in a multicentre trial comparing the results of total nodal irradiation (T.N.I.) with those of combination chemotherapy. Staging procedures for most patients included laparotomy; a few patients whose staging did not include laparotomy were studied separately. Of the 81 patients staged by laparotomy, 40 out of 42 (95%) achieved complete remission (C.R.) after treatment by T.N.I. and 29 out of 39 (74%) achieved C.R. during treatment with mustine hydrochloride, vincristine ("Oncovin"), procarbazine, and prednisone (MOPP) (P=0.018). An analysis of the disease-free survival up to four years favoured the group of patients treated by T.N.I. (P less than 0.01) but differences in overall survival were not statistically significant. In the 36 patients with presumed IIIA disease whose staging did not include laparotomy no significant differences in the incidence of C.R. or rates of disease-free or overall survival were observed. It is concluded that T.N.I. is the optimum initial treatment for patients with IIIA disease whose staging includes laparotomy.
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PMID:Initial treatment of stage IIIA Hodgkin's disease. Comparison of radiotherapy with combined chemotherapy. British National Lymphoma Investigation. 6 65

The use of Hodgkin's disease as a model for the evaluation and management of the non-Hodgkin's lymphomas may not be appropriate. This latter group of different syndromes and diseases differs significantly in their clinical presentation from each other as well as from Hodgkin's disease. Survival must be separated from relapse-free survival since the latter is a measure of the effectiveness of any individual therapy being applied. Localized nodal lymphoma is uncommon, but important to identify since it is potentially curable by irradiation. Stage I nodular, non-histiocytic lymphomas treated by radiation results in significant, extended, relapse-free survival. All other localized nodal lymphoma is associated with a high proportion of patients relapsing outside the treatment portal. Whole body irradiation is a useful systemic agent causing regression for an extended period of time in stage III or stage IV nodular lymphoma. Chemotherapy seems to have a limited value in nodular lymphomas, with no clear evidence that combination chemotherapy is more effective than single agents. In diffuse lymphomas, aggressive chemotherapy shows more promise, with diffuse histiocytic lymphoma having extended relapse-free survival.
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PMID:The place of radiation therapy in the treatment of non-Hodgkin's lymphomas. 6 8

Three patients with Hodgkin disease, eight with non-Hodgkin lymphoma, and one with chronic lymphocytic leukemia refractory to conventional combination chemotherapy were treated for remission induction with a new kinetically designed four-drug combination consisting of bleomycin, vincristine, adriamycin, and prednisone and given the acronym "BOAP." Eight patients had prior radiotherapy, included two who had total nodal irradiation. Eight patients (all three with Hodgkin disease and five of eight with non-Hodgkin lymphoma) achieved complete remission (73% of the lymphoma patients). An additional two patients with non-Hodgkin lymphoma sustained partial remissions, for an overall response rate of 91%. Toxicity caused the interruption of therapy in three patients and an additional patient might have sustained a drug-related death. This study compares favorably with other studies investigating primary or secondary combination chemotherapy of advanced lymphomas.
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PMID:A kinetically designed chemotherapeutic regimen for advanced refractory lymphoma patients. 7 37

From 1970 to 1976, twenty patients with stage II E or II B to IV B Hodgkin's disease were treated at Children's Hospital of Philadelphia. Initially, four of the stage II or III patients received planned total nodal irradiation (TNI) alone; three patients developed progressive disease during irradiation, and one relapsed after 18 months. These results with TNI led to the use of combined modality therapy. Sixteen patients (4, stage II E or B; 8, stage III; 4, stage IV) were treated with COPP (cyclophosphamide, Oncovin, prednisone, and procarbazine) and radiation therapy. In 14 patients treatment was started with COPP. Patients with disease below L2 received TNI; the rest received involved field (IF) or extended field (EF) irradiation. No patient treated with combination therapy encountered life-threatening toxicity. Relapse-free survival in 12 stage II or III patients is 100% with a median follow-up of 28 months (range, 24 to 91 months). Only one of four stage IV patients is alive. Combined modality therapy is effective, tolerable therapy for children with stage II B--III Hodgkin's disease. No relapses occurred in 10 patients given less that potentially curative radiation. Smaller radiation fields and lower doses are planned for the future.
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PMID:Treatment of advanced Hodgkin's disease in pediatric patients. 10 Feb 4

Seven patients with advanced nodular sclerosing Hodgkin's disease who relapsed after initial intensive combination chemotherapy were selected for individualized pathologic restaging and comprehensive radiotherapy. One patient failed to respond completely to mantle-field irradiation and no further staging or radiotherapy was undertaken. Six other patients underwent staging laparotomy and received total nodal irradiation including prophylactic lung irradiation (5 cases) and hepatic irradiation (3 cases). Irradiation was well tolerated. Complete remission was achieved by 5 patients and 2 continue in remission 29+ and 32+ months after beginning of irradiation. Five of the 7 patients remain alive. This study indicates that comprehensive irradiation is a relatively well tolerated and effective treatment for carefully selected patients with advanced Hodgkin's disease who have relapsed after combination chemotherapy. For selected patients, pathologic restaging and comprehensive radiotherapy can be considered as an alternative to further chemotherapy.
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PMID:Comprehensive radiotherapy for advanced Hodgkin's disease refractory to chemotherapy. 10 36

In a series of 121 unselected, previously untreated patients with Hodgkin's disease staging laparoscopy combined with needle bone marrow biopsy detected the presence of extranodal disease in the liver or marrow or both in 9% of the patients. A spleen biopsy yielded positive findings in 13%. Subsequent laparotomy with open marrow biopsy performed in 110 patients with negative liver and marrow findings from the first combined procedure revealed the presence of extranodal hepatic lymphoma in two additional spleens. Surgical marrow biopsy was always interpretey. Although devoid of major complications, biopsy of the spleen is not recommended as a routine procedure in staging laparoscopy. This prospective sequential study confirms that laparoscopy plus needle marrow biopsy is a useful, rapid, safe, and economic procedure to establish stage IV disease in the large majority of patients with nodal involvement. Considering the recent more extensive use of chemotherapy for intermediate stages of Hodgkin's disease, our findings suggest that laparotomy with splenectomy needs a critical re-evaluation as a routine staging procedure for patients with no overt extranodal lymphoma.
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PMID:Sequential laparoscopy and laparotomy combined with bone marrow biopsy in staging Hodgkin's disease. 13 79

The preferred histopathological classification of Hodgkin's disease (HD) is that suggested by Lukes and Butler as modified at the Rye Symposium; the histologic subtypes are highly reproducible and correlate well with the anatomic sites of involvement, clinical stage, and survival. The accuracy of the bipedal lymphangiogram, 67gallium scan, and ultrasonography in predicting abdominal involvement by HD is 90% , 50%, and 88%, respectively. Staging laparotomy remains the most accurate method of detecting intra-abdominal disease and has added immensely to new concepts in the management of HD. These concepts suggest that patients with nodal disease limited to the celiac axis or upper para-aortic areas (substage III1) or pathologic stage (PS) IIIS+N-A, when treated with extended field radiotherapy alone have survival rates comparable to PS IIA patients. In contrast, patients in PS IIIA with lower abdominal nodal disease (substage III2), regardless of splenic involvement, have a prognosis comparable to PS IV disease. Thus, there may only be two stages of HD, those curable with extended mantle or smaller radiotherapy fields alone, and those requiring chemotherapy with or without supplemental radiotherapy.
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PMID:Hodgkin's disease: problems of staging. 15 Sep 39

The CT appearance of normal retroperitoneal lymph nodes has been described. In many instances the structures are too small to be identified. other retroperitoneal structures, such as collapsed bowel loops, vessels, and other perirenal structures, may simulate the presence of nodes. CT is of great benefit in disease with bulky tumors, such as non-Hodgkin's lymphoma, testicular tumors, etc. Its usefulness is much more limited in disease that may have extensive nodal involvement but no significant enlargement of the nodes. The accuracy of CT scanning in Hodgkin's disease and in many instances of genitourinary tumors is questioned, and we submit that further studies are needed to establish the reliability of this mode of examination.
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PMID:Normal anatomy and limitations in CT interpretation of lymph node disease. 26 16

Blood lymphocytes from nineteen patients with Hodgkin's disease were tested in vitro before and after treatment. The patients were retested in complete and unmaintained remission at least 15 months after termination of radiotherapy. All patients except two had been treated with total nodal irradiation. The lymphocyte-DNA synthesis induced by concanavalin A (Con A) and PPD was poor and the spontaneous DNA synthesis was increased in untreated patients. Most patients had a T lymphocytopenia before treatment. After irradiation the total lymphocyte counts were reduced drastically. The number of T lymphocytes was particularly low, though the number of B lymphocytes decreased as well. However, the lymphocyte response to Con A and PPD remained low and unchanged. The results may suggest a persisting immunodeficiency in Hodgkin's disease as reflected by the lymphocyte response to Con A and PPD.
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PMID:Persisting lymphocyte deficiences during remission in Hodgkin's disease. 30 64


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