Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clinical and morphological observation of 56-year-old man with a primary isolated malignant non-Hodgkin's lymphoma of the central nervous system in the hypothalamus, with the formation of metastases in the space of the cerebrospinal fluid and a solitary extraneural metastasis in the epicardium. No generalised lymphoma. The histological classification is discussed. The importance of the cytology of the cerebrospinal fluid to a climical diagnosis is pointed out.
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PMID:[Primary malignant lymphoma of the central nervous system]. 699 20

Although involvement of the heart by malignant lymphoma is relatively common, it is difficult to detect antemortem, and only a small number of studies discuss this subject in the literature. The authors reviewed the 150 patients with malignant lymphoma autopsied at this hospital and studied the 13 (8.7%) who were found to have metastases to the heart or parietal pericardium. Four patients had Hodgkin's disease, and nine non-Hodgkin's lymphoma. Cardiac or pericardial disease apparently resulted from retrograde lymphatic spread, hematogenous spread, and direct extension from other intrathoracic tumor masses. In two cases, lymphomatous involvement of the heart and pericardium was the immediate cause of death; in one of these, myocardial infiltration was detected during life. For the group as a whole, the signs and symptoms of cardiac dysfunction were typically absent or nonspecific, and electrocardiograms and thallium imaging were not effective screening tools for lymphoma metastases. The findings suggest, however, that the most destructive form of cardiac involvement is that associated with direct epicardial spread, and that this form appears with cardiac dysfunction, which should clinically suggest its presence.
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PMID:Involvement of the heart by malignant lymphoma: a clinicopathologic study. 703 54

Thirty-five consecutive, previously untreated patients with intra-abdominal non-Hodgkin's lymphoma (IANHL), seen between January 1971 and June 1978, were entered on the LSA2-L2 protocol. Six patients had Stage II disease, 23 Stage III and six Stage IV. The prevalent histologic types were diffuse lymphocytic poorly differentiated (13 patients) and diffuse undifferentiated (13 patients) followed by diffuse histiocytic (5 patients) and diffuse lymphoblastic (2 patients). All patients received LSA2-L2 protocol chemotherapy. Three of 4 patients with gross residual disease following initial surgery, who were seen prior to 1974, received radiation therapy during induction chemotherapy; there were no survivors among these 3 patients. Our treatment plan was revised in 1974 to include a "second-look" laparotomy during the third week of induction chemotherapy for all patients with gross residual intra-abdominal disease following their initial surgery. The disease-free actuarial survival for the total group of 35 patients is 72%. Fifteen of the 26 surviving patients are off therapy and have shown no evidence of recurrence or metastases (median observation time 26 + months). Fifteen of 26 patients seen after 1973 underwent the second laparotomy and only two were found to have residual disease. The LSA2-L2 protocol has significantly improved the disease-free survival rate of children with IANHL, even with widespread intra-abdominal and extra-abdominal disease at diagnosis. Further, the "second-look" laparotomy in patients with large unresectable disease at presentation has proved a useful method of unequivocal evaluation of response, thus eliminating unnecessary extensive abdominal irradiation in many of these children.
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PMID:Improved prognosis in children with intra-abdominal non-Hodgkin's lymphoma following LSA2L2 protocol chemotherapy. 738 47

The prognostic effect of weight loss prior to chemotherapy was analyzed using data from 3,047 patients enrolled in 12 chemotherapy protocols of the Eastern Cooperative Oncology Group. The frequency of weight loss ranged from 31 percent for favorable non-Hodgkin's lymphoma to 87 percent in gastric cancer. Median survival was significantly shorter in nine protocols for the patients with weight loss compared to the patients with no weight loss. Chemotherapy response rates were lower in the patients with weight loss, but only in patients with breast cancer was this difference significant. Decreasing weight was correlated with decreasing performance status except for patients with pancreatic and gastric cancer. Within performance status categories, weight loss was associated with decreased median survival. The frequency of weight loss increased with increasing number of anatomic sites involved with metastases, but within categories of anatomic involvement, weight loss was associated with decreased median survival. These observations emphasize the prognostic effect of weight loss, especially in patients with a favorable performance status or a limited anatomic involvement with tumor.
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PMID:Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. 742 38

Between 1978 and 1993, 1013 patients 529 with Hodgkin's disease and 484 with non-Hodgkin's lymphomas--were treated in our department. Out of 1013 patients secondary neoplasms developed in 23 cases: 3 acute nonlymphocytic leukemia, 19 solid tumors and 1 secondary non-Hodgkin's lymphoma. The median time from diagnosis of malignant lymphoma was 7 years and their median age was 49 years. 11 patients with secondary tumor were treated with chemotherapy and 12 received combined (radio- and chemo-) therapy. Since alkylating agents increase the risk of leukemia and radiation contributes mainly to other cancer, future treatment protocols should attempt to reduce the most serious consequences of therapy without compromising the survival. Careful lifelong observation is indicated for patients with malignant lymphomas, with special attention given to new clinical signs or symptoms.
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PMID:[Second malignant disease in patients under treatment for malignant lymphoma]. 747 76

We treated 115 patients in a phase I/II dose-escalation study of ifosfamide/carboplatin/etoposide (ICE) followed by autologous stem cell rescue. Patients treated had a variety of diagnoses, including breast cancer (high-risk stage II disease with eight or more positive nodes, stage III disease, and responsive metastatic disease), non-Hodgkin's lymphoma, Hodgkin's disease, acute leukemia in first remission, and various solid tumors that were responsive to induction therapy. Patients received autologous bone marrow stem cells or peripheral blood stem cells primed by one of several methods. The maximum tolerated dose of ICE was determined to be ifosfamide 20,100 mg/m2, carboplatin 1,800 mg/m2, and etoposide 3,000 mg/m2 when administered as a 6-day regimen. The dose-limiting toxicities included acute renal failure, severe central nervous system toxicity, and "leaky capillary syndrome" with hypoalbuminemia, profound fluid overload, and pulmonary insufficiency. Analysis of hematologic recovery based on stem cell source and influence of hematopoietic growth factor administration was undertaken. Hematopoietic growth factor use significantly reduced neutrophil engraftment time for patients receiving bone marrow stem cells, with evidence of earlier recovery times for patients receiving granulocyte colony-stimulating factor compared with granulocyte-macrophage colony-stimulating factor. Neutrophil recovery times varied based on the source of stem cells used, with the earliest engraftment times seen for patients receiving peripheral blood stem cells primed with cyclophosphamide and granulocyte colony-stimulating factor. Platelet recovery times were not statistically different for any of the subsets. In conclusion, the maximum tolerated dose of ICE has been defined, and the source of stem cells and the use of hematopoietic growth factors influence hematopoietic recovery.
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PMID:High-dose ifosfamide/carboplatin/etoposide: maximum tolerable doses, toxicities, and hematopoietic recovery after autologous stem cell reinfusion. 752 92

The management of patients with critical major airways obstruction has been made possible by the recent introduction of expandable metal stents as the sole treatment or as an adjunct to other treatment modalities, to alleviate the distressing symptoms from tracheobronchial obstructions Gianturco self-expanding stents were used successfully in the management of 27 patients. The indications were: stenosis from postoperative strictures and recurrent tumours (n = 6), extrinsic compression from metastatic disease (n = 9), inoperable primary tumours of central airways (n = 9), airway collapse from relapsing polychondritis (n = 1), excessive mediastinal shift following right pneumonectomy (n = 1) and endobronchial non-Hodgkin's lymphoma (n = 1). Twenty three patients had immediate relief of stridor and the remaining two patients were successfully weaned from ventilatory support. There were two postoperative deaths. The stents were inserted under general anaesthesia through a rigid bronchoscope under direct vision. The ease of insertion under radiological control, self-expanding nature of the stents and the lack of major complications on follow-up of up to 47 months are particular advantages. The self-expanding tracheobronchial stents are a useful addition to our armamentarium in maintenance of the airways in patients with major airway stenosis and collapse.
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PMID:Self-expanding tracheobronchial stents in the management of major airway problems. 759 44

Recombinant interleukin-2 (IL-2) products (e.g. aldesleukin, teceleukin) are nonglycosylated, modified forms of the endogenous compound. IL-2 acts as a pleiotropic mediator within the immune system, having a variety of effects via specific cell surface receptors. The interaction of IL-2 with the IL-2 receptor induces proliferation and differentiation of a number of T lymphocyte subsets, and stimulates a cytokine cascade that includes various interleukins, interferons and tumour necrosis factors. Antitumour effects of IL-2 appear to be mediated by its effects on natural killer, lymphokine-activated killer (LAK) and other cytotoxic cells. In vivo and in vitro effects of IL-2 seem to be dependent to a large extent on the environment; many studies have reported conflicting results, perhaps due to diverse populations of effector cells, the availability of other cytokines that have synergistic or inhibitory influences, and the dosage regimens used. The recombinant products appear to be biologically indistinguishable from native IL-2 in vitro and in vivo; the former induce minor antibody formation but this does not appear to alter functional properties. In patients with metastatic renal cell carcinoma, IL-2 therapy achieves average objective response rates of 20% (range 0 to 40%), with a complete response rate of about 5% (range 0 to 19%). Response duration varies considerably but can be durable (lasting for > 12 months), with some patients remaining in complete response for > 60 months. It is unclear at present whether higher dosage regimens improve clinical response, or whether combination therapy with other agents and/or adoptive therapy is beneficial. Survival duration may depend on the risk factors present, with poorer performance status and more than one site of metastases associated with shorter survival times. Patients with metastatic malignant melanoma receiving IL-2 as monotherapy show an average objective response rate of 13% (range 3 to 24%); however, objective response rate averages 30% (range 4 to 59%) when IL-2 is used in combination with other agents. Overall median survival appears to be about 10 months. Preliminary data indicate that IL-2 produces a lower response rate in patients with refractory colorectal carcinoma, ovarian cancer, bladder cancer, acute myeloid leukemia or non-Hodgkin's lymphoma. Adverse effects accompanying high dose, intravenous IL-2 therapy can be severe, with cardiovascular, pulmonary, haematological, hepatic, neurological, endocrine, renal and/or dermatological complications frequently requiring doses to be withheld.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Interleukin-2. A review of its pharmacological properties and therapeutic use in patients with cancer. 769 34

A patient with non-Hodgkin's lymphoma who developed acute hypercalcemia following chemotherapy was evaluated for skeletal metastases with a whole-body bone scan. Although metastatic disease is an unlikely cause of hypercalcemia, considering the acutely rising serum calcium, the bone scan is useful in excluding multiple metastases as a cause. In addition, the study demonstrated metastatic calcification in multiple organs, including the pancreas which is uncommon, and the liver and spleen, which is rare.
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PMID:Metastatic calcification of multiple visceral organs in non-Hodgkin's lymphoma. 773 57

We report our experience with bronchoalveolar lavage (BAL) and its value in the diagnosis of malignant lung infiltrates. A total of 162 patients with biopsy- or autopsy-proven cancer had an analysis of BAL fluid performed. Cytologic examination showed malignant cells in 123 (76%) patients. The diagnostic accuracy varied depending on the neoplastic nature and growth pattern of the disease. BAL disclosed cancer cells in 93% of 44 bronchioloalveolar carcinomas. Carcinomatous lymphangitis due to metastatic cancer was diagnosed in 83% of 69 cases. Hematogenous metastases (with sharply circumscribed nodules on chest radiography) were diagnosed in 45% of 22 such cases. We recognized 67% of 15 non-Hodgkin's lymphomas and 3 of 9 cases of Hodgkin's disease with pulmonary involvement. Immunocytochemistry using monoclonal and/or polyclonal antibodies was of value in the identification and classification of cells in non-Hodgkin's lymphoma.
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PMID:Bronchoalveolar lavage in the diagnosis of disseminated lung tumors. 776 34


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