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)

One must conclude on the basis of the above analysis that tumor doses in excess of 3,600 or 4,000 rads add only to morbidity, and not to local control. Secondly, the technique of irradiating involved lymph node groups only, leaving other areas to be treated "later," apparently denies the possibility of cure to a significant number of patients with early stage Hodgkin's disease. Recurrence or extension almost uniformly leads to eventual death from disease despite retreatment. No case of second primary cancer has been documented in the patient population included in this report. However, the number at risk is relatively small and chemotherapy was reserved only for generalized recurrence. Since the reported 20 times expected incidence occurred with the combination of total-nodal and multple-agent chemotherapy, one would not expect an increased incidence of second primary lesions in this series.
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PMID:Irradiation of stage I and II Hodgkin's disease. 111 49

A retrospective analysis of 133 patients with localized nodal and extranodal non-Hodgkin's lymphomata whose staging investigations included marrow aspirate and lymphography shows that more than 60% remain alive and disease-free 4 years after initial therapy. Further relapses may occur in this group, particularly in the nodular lymphomata, but so far the majority of relapses and three quarters of the deaths from disease have occurred within 2 years of diagnosis. Of the entire group of patients, only 15% showed an unequivocally nodular pattern and a further 25% a partially nodular, partially diffuse pattern. Thus, 60% of patients had diffuse lymphoma but differences were observed depending upon the site of presentation. In the nodal Stages I and II cases, whereas only 4 of 55 patients with supradiaphragmatic disease showed a nodular pattern, 12 of 24 infradiaphragmatic presentations had nodular lymphoma. This difference was reflected in a lower relapse rate in the latter group. Mediastinal involvement was uncommon but carried a grave prognosis. As far as it was possible to judge, extension to adjacent nodal areas as a cause of relapse was not a common problem and, as observed previously, relapse was much commoner to a wide variety of extranodal sites than is the case with Hodgkin's disease. In this series marrow involvement was documented in only 7 patients but this surprisingly low frequency might be due in part to infrequent marrow sampling after the initial investigations were completed.
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PMID:Survival in localized nodal and extranodal non-Hodgkin's lymphomata. 118 75

A total of 218 non-Hodgkin's malignant lymphomata of the upper digestive and respiratory tract are reported. 72% had Waldeyer's ring involvement and 22% had paranasal sinus involvement. Ilio-lumbar lymphography was performed in 98 cases: 33 lymphograms were abnormal. In 152 Stage I and II patients, loco-regional irradiation gave 129 remissions. Among these patients, 66 suffered a relapse, most of them during the first year after treatment. Primary relapse analysis revealed 18 true recurrences, 10 nodal extensions and 38 extranodal disseminations. The median survival is 14 months for all stages; the survival rate at 5 years is 38% for Stages I and II for patients treated by 60Co alone. No statistical significance in prognosis has been found for age, sex, size of primary tumour, involvement of upper or lower nodes in the neck, histological type nor between Stage I and Stage II. Lymphography and x-ray gastrointestinal examination must be performed routinely before treatment in order to stage patients correctly.
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PMID:Non-Hodgkin's malignant lymphomata of upper digestive and respiratory tract: natural history and results of radiotherapy. 118 76

The hematologic and immunologic status was evaluated after 5 years of continuously disease-free survival for 71 consecutive patients treated for Hodgkin's disease by radiotherapy. There was no evidence of residual hematologic depression, even in those patients treated initially with total nodal irradiation. Similarly, quantitative immunoglobulin levels were within the normal range, and the response to delayed hypersensitivity skin testing was intact in nearly all patients. These immunologic studies were consistent with the observed absence of an unusual incidence of infectious complications in these long-term survivors.
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PMID:Hematologic and immunologic status in Hodgkin's disease 5 years after radical radiotherapy. 119 76

In 88 patients with Hodgkin's disease the clinical value of the general lymphographic picture (lymphodynamic aspects plus nodal patterns) is analysed. The survival times are also reported according to the different pre- and postlymphographic evolution. Histologic types and prelymphographic therapy are correlated with the general lymphographic picture. The predominance of foamy and/or spotty lymphographic patterns of lymph nodes as well as the lymphatic blockages have a severe prognosis (mean intervals between lymphography and exitus 8.3 and respectively 6.2 months). In such cases lymphocytic depletion represents the most frequent histologic type.
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PMID:Clinical evolution, histologic type and general lymphographic picture in Hodgkin's disease. 121 2

The pattern of Hodgkin's disease has changed significantly with the use of radical radiotherapy (total nodal irradiation) and chemotherapy, and with the general adoption of the histological classification of LUKES and the Ann Arbor modification of Rye staging system. Histological classification of non-Hodgkin's lymphoma is far from satisfactory, a fact which renders evaluation of the optimum treatment difficult. Spread is usually hematogenic. Bone marrow and mesenteric nodes are involved in 60% of cases, and therefore total nodal irradiation is ineffective in eradicating the disease. Chemotherapy is the treatment of choice except in some stages IE and IIE when, after careful pretherapy evaluation, local radiotherapy may be sufficient. In generalized lymphomas the role of total body irradiation is still under study.
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PMID:[Do we have to treat non-Hodgkin's lymphomas the same as Hodgkin's disease?]. 121 6

Twenty Stage I and II children with Hodgkin's disease were treated with involved field radiation therapy. Twelve patients were Stage I. The histologic types were:nodular sclerosis(seven cases), mixed cellularity (two) and lymphocyte predominant (three). There were eight Stage II patients (six nodular sclerosis and two of mixed cellularity). One Stage I and 4 Stage II patients had class B disease. Involved field irradiation was used in these children after staging laparotomy showed no disease below the diaphragm. Eight of the 20 patients relapsed, five in lymph nodes adjacent to the primary site, two in areas across the diaphragm; the other had both local and distant extension. The median time to relapse after completion of radiation therapy for Stage I and II were 15 and 5 months, respectively. Two of the eight children with recurrent disease are dead. The other six were retreated and are alive and free of disease for periods ranging from 24 to 68 months after original treatment (median, 36 months). Two of the six survivors in this group received irradiation to the site of the recurrent disease only, one was given total nodal irradiation, and three had chemotherapy. The other 12 patients are in continuous first remission. They have been followed for a median time of 26 months. The actuarial relapse-free survival and survival rates at 3 years are 57 and 89%, respectively.
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PMID:Involved field radiation therapy for early stage Hodgkin's disease in children: preliminary results. 126 Jun 79

All patients below the age of 66 whose Hodgkin's disease was treated at the Massachusetts General Hospital between July 1, 1965 and June 30, 1973 were analyzed. The patients were divided into an early group seen before November 1, 1968 and a later group seen after that date. Survival and survival without recurrence were calculated by the actuarial method of Berkson and Gage, and compared with figures obtained from a historical series seen at this institution between 1948 and 1964. In the most recent period (1969-1973), 87% of patients with all stages of Hodgkin's disease were alive five years after diagnosis, a remarkable improvement over the 65% survival of the 1965-1968 group and the 34% survival of the historical series. The excellent survival of the recent group was a result of improved management of patients with advanced disease (Stages III and IV), most plausibly attributed to better appreciation of the extent of disease by surgical staging and to the shift from total nodal irradiation to combination chemotherapy for initial treatment of these patients. Recurrence after irradiation was extremely uncommon in patients in Stage IA and IIA (lymphangiogram-negative, asymptomatic) subjected to aging laparotomy, while similarly staged and irradiated patients in Stages IB and IIB (lymphangiogram-negative, symptomatic) did much less well. Except for the surgically staged patients in Stages IA and IIA, the continuing high relapse rate indicates that five-year survival, even when relapse-free, is not synonymous with cure, and emphasizes the need for caution in predicting the ultimate cure rate with current therapy.
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PMID:Improved survival in hodgkin's disease. 126 Jul 24

In a multicentre study on the treatment of Hodgkin's disease, 88 out of 297 patients with primary advanced stages IIIB/IV failed to respond to alternating COPP/ABVD chemotherapy +/- radiotherapy. They may be broken down as follows: tumour progression under current therapy (PD) 23/28, partial remission at the end of treatment (PR) 28/88, early nodal recurrence 13/88, late nodal recurrence 15/88, extranodal recurrence 7/88, unclear localisation 1/88. Thirty-six months after noting failure of treatment, 45% of all patients were still alive. The prognosis was poorest in the case of primary PD. Only 1/23 of these patients experience lasting complete remission thanks to salvage treatment (cCR). Eleven patients with an exclusively nodal recurrence experienced a cCR on treatment with radiation alone, and may be considered a low-risk recurrence group. For a high-risk recurrence group (n = 57), indication for high-dose chemotherapy with subsequent autologous bone marrow transplantation (HDC/ABMT) should have been recognized on the basis of the present definition. The survival probability of these patients, who only received conventional salvage treatment, was 38% after 30 months (95% confidence limit, 22 to 54%). These data would not appear to be appreciably poorer than those reported in the literature for comparable patients receiving HDC/ABMT. Only a randomized comparison would be capable of showing whether HDC/ABMT is superior to high-dose conventional chemotherapy with haematopoietic growth factors. It is proposed that such a therapeutic trial should be initiated as soon as possible.
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PMID:[Recurrence of Hodgkin's disease after advanced primary stages. German Hodgkin's Study Group]. 128 5

The outcome of treatment for a first relapse in early stages (IA and IIA) of Hodgkin's disease after primary radiotherapy was analyzed in 86 patients. They received total nodal radiotherapy (TNR) as the primary treatment. Survival was used as the major endpoint. Median follow-up was 13.1 years. Duration of first complete remission was 60% for patients in stage IA and 39% for patients in stage IIA (p < .01). At 10-years, the survival for patients in stage IA was 78% and only 55% for patients in stage IIA (p < .01). A risk factor analysis showed that the presence of stage IIA and bulky disease (adenopathy > 7 cm) were associated with a worse prognosis. We believe that the use of TNR as initial treatment in early stages of Hodgkin's disease should be considered in patients in stage IA and without bulky disease. Patients in stage IIA and risk factors, such as bulky disease, should be treated with more aggressive therapeutic regimens.
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PMID:[The role of radiotherapy in the early stages of Hodgkin's disease]. 128 25


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