Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 92 patients with previously untreated intermediate- or high-grade non-Hodgkin's lymphoma attending the University Department of Medicine, Queen Mary Hospital, Hong Kong, were treated with the m-BACOD chemotherapy regimen (methotrexate, bleomycin, doxorubicin, cyclophosphamide, vincristine and dexamethasone). Additional involved-field radiotherapy was given to 32 (35%) patients. Myelosuppression was the major toxicity, and 5 (5%) treatment-related deaths occurred due to pneumonia, bleomycin sensitivity, doxorubicin cardiotoxicity and reactivation of hepatitis B infection. The overall complete response (CR) rate was 65/92 (71%) and the relapse rate was 22/65 (34%). The disease-free survival of the 65 CR patients at 2 years was 52% and the overall survival of all 92 patients at 3 years was 56%. The CR rate of stage I and II patients was significantly better than that of those with stage III and IV disease (87% vs 59%; P = 0.01), and the CR rate of stage III patients was superior to that of those with stage IV disease (86% vs 50%; P = 0.05). The overall survival of stage III and IV patients was significantly worse than that of subjects with stage I and II disease (31% vs 73%; P = 0.02). Multivariate analysis revealed that the independent prognostic variables significantly determining the CR rate and survival included the clinical stage and the serum lactate dehydrogenase level. From this study, the results of treatment with the m-BACOD regimen in patients with advance disease appeared to be similar to those obtained using the conventional CHOP regimen (cyclophosphamide, doxorubicin, vincristine and prednisone).
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PMID:m-BACOD chemotherapy for intermediate- and high-grade non-Hodgkin's lymphoma. 171 34

Pulmonary toxicity may complicate the treatment of non-Hodgkin's lymphoma (NHL). The possible drug-related cause of pulmonary toxicity was investigated retrospectively in 207 NHL patients treated between 1981 and 1988 with three regimens containing cyclophosphamide with and without methotrexate or bleomycin: methotrexate, calcium, leucovorin, bleomycin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-BACOD) (n = 134); methotrexate, calcium, leucovorin, doxorubicin, cyclophosphamide, vincristine, and dexamethasone (m-ACOD) (n = 43); or cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) (n = 30) chemotherapy. These regimens contained the same drugs and were administered in the same schedule; the regimens differed primarily in the addition of bleomycin or methotrexate. Pulmonary toxicity occurred in 24 of 134 (18%) m-BACOD-treated and in six of 43 (14%) m-ACOD-treated patients (P = 0.65). Chest radiography revealed diffuse pulmonary infiltrates in 16 (67%) and six (100%) of the m-BACOD-treated and m-ACOD-treated patients with pulmonary toxicity, respectively. None of the CHOP-treated patients had pulmonary toxicity. The clinical features of pulmonary toxicity and the amount of chemotherapy administered before it occurred did not differ in patients treated with m-BACOD or m-ACOD, although the toxicity tended to be more severe in the m-BACOD group. Open lung or transbronchial biopsies done in six (38%) of the m-BACOD-treated and three (50%) of the m-ACOD-treated patients with pulmonary infiltrates revealed nonspecific pneumonitis compatible with drug-related toxicity. In summary, these results showed that pulmonary toxicity during m-BACOD and m-ACOD therapy occurred with similar frequency and clinicopathologic features. This suggested that bleomycin was not responsible uniquely for the pulmonary toxicity in m-BACOD-treated patients. That pulmonary toxicity was not observed in patients treated with CHOP suggested that methotrexate may play an important role in the pathogenesis of the pulmonary toxicity.
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PMID:Drug-related pulmonary toxicity in non-Hodgkin's lymphoma. Comparative results with three different treatment regimens. 171 21

Two cases of Trichosporon beigelli pneumonia in severely immunocompromised patients are reported. At autopsy, Trichosporon beigelii was detected in all lobes in one patient who had a small cell lung cancer. Polymycotic infection involving Trichosporon beigelii and Aspergillus was proved in the other patient who had a non-Hodgkin's lymphoma. Miconazole therapy was not effective against Trichosporon beigelii infection in both cases. Although diagnosis and management are difficult, Trichosporon beigelii must be considered as a cause of visceral opportunistic fungal infection.
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PMID:[Two cases of Trichosporon beigelii pneumonia in immunocompromised hosts]. 206 58

A gene locus for ataxia-telangiectasia (A-T) is in chromosome region 11q22 to 11q23 and predisposes to cancer. Ataxia-telangiectasia patients appear to have two separate clinical patterns of malignancy. One pattern involves solid tumors, which have not been stressed and which include malignancies in the oral cavity, breast, stomach, pancreas, ovary, and bladder. Detection of a solid tumor in an A-T patient should serve as a warning. It heralds a markedly elevated risk of another malignancy in that patient. The second pattern of neoplasia in A-T is well recognized and consists of lymphocytic leukemia and non-Hodgkin's lymphoma. These malignancies may relate to immunodeficiency in A-T and to chromosome breakage and rearrangement, which are a feature of A-T. These two patterns of malignancy may be truly separate and reflect different mechanisms of malignancy in A-T, or they may not really be separate but instead reflect a single mechanism of malignancy. The situation in A-T is reminiscent of that in the acquired immunodeficiency syndrome (AIDS), in which Kaposi's sarcoma occurs with mild immunodeficiency and pneumocystis carinii pneumonia occurs with more profound immunodeficiency owing to the human immunodeficiency virus. Next to pulmonary disease, cancer is the leading cause of death in A-T.
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PMID:Cancer in ataxia-telangiectasia patients. 218 34

Pneumocystis carinii is a common cause of pneumonia in the immunosuppressed patient. Its radiological findings are usually homogeneous, diffuse and bilateral. We present a 27-year-old woman with non-Hodgkin's lymphoma presenting with unilateral right lung parenchymal infiltrates due to Pneumocystis carinii. In the immunosuppressed host, pneumonia limited to one lung should not preclude the diagnostic possibility of Pneumocystis carinii infection.
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PMID:Atypical presentation of Pneumocystis carinii pneumonia. 224 32

Children presenting with advanced leukaemia and non-Hodgkin's lymphoma may develop life-threatening complications in the early stages of management. Major metabolic disturbances with encephalopathy, septicaemic shock, pneumonitis, massive haemorrhage, or the physical effects of tumour masses may on occasion warrant intensive therapy. Close liaison between paediatric oncologists, oncological surgeons, and anesthesiologists is essential in establishing admission criteria for such cases and in defining therapeutic end points in the event of multisystem failure. This paper discusses the principles of intensive care management of patients with haematological malignancies by considering two cases who developed the tumour lysis syndrome with respiratory and renal failure. A case associated with metabolic encephalopathy is also described.
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PMID:Tumour lysis syndrome and the anaesthesiologist: intensive care aspects of paediatric oncology. 234 46

From July 1981 to July 1985, 20 patients with bulky mediastinal Hodgkin's Disease (maximum mediastinal width divided by the maximum intrathoracic diameter for a mediastinal mass ratio (MMR) greater than 0.33 were treated at Stanford University with definitive radiation therapy alone. The majority of these patients were selected to receive radiation therapy because they had the more favorable characteristics of minimal extralymphatic involvement, mediastinal masses that were superior and central in location, and a MMR less than or equal to 0.50. All 20 patients were laparotomy staged, and 17 received some radiation to the mantle before laparotomy. Seventeen patients had pathologic stage (PS) II disease (13 PS IIA, 4 PS IIB), two had PS IIISA, and one had PS IB. Eleven patients (55%) had extralymphatic involvement. All patients were irradiated to the mantle field using a shrinking field technique (mediastinal dose, 4400 to 5500 cGy, mean 4990 cGy). After completion of the mantle, all patients with good clinical responses received infradiaphragmatic radiation. Treatment complications included two cases of mild radiation pneumonitis, five of hypothyroidism, five of localized Herpes zoster, one of amenorrhea, one of non-Hodgkin's lymphoma, and one of sepsis. Four patients relapsed. All had an intrathoracic component to their failure. All four patients were salvaged with MOP(P) chemotherapy and are currently alive and free of disease. For the entire group, the actuarial freedom from relapse is 80% at 7 years and the survival is 100%. Median follow-up time is 67 months. The authors conclude that radiation therapy alone is effective in the management of selected patients with Hodgkin's disease who have extensive mediastinal involvement, even when the MMR exceeds 1/3.
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PMID:Radiation therapy in the management of bulky mediastinal Hodgkin's disease. 235 12

Twenty-four patients with non-Hodgkin's lymphoma aged 60 years and older were treated with epirubicin-based combination chemotherapy. Complete remission was obtained in nineteen (83%) of 23 patients with measurable disease. Of these complete responders seventeen patients with localized disease attained complete remission. No patients received radiation therapy after chemotherapy. The survival rate was 78% at 50 months in patients with the localized disease. The median follow-up time is 40 months, ranging from 13 to 65 months. All of the localized disease were treated in the out-patient clinic and no patients died of chemotherapy-related infectious complications. No severe infection such as either bacteremia or pneumonia occurred. It was concluded that epirubicin-based combination chemotherapy was highly effective in patients with localized non-Hodgkin's lymphoma.
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PMID:[Epirubicin-based combination chemotherapy in the treatment of non-Hodgkin's lymphoma: with emphasis of elderly patients]. 239 10

Nineteen patients in poor prognostic subgroups of aggressive non-Hodgkin's lymphoma (NHL) were treated with weekly chemotherapy consisting of low dose mitoxantrone and cyclophosphamide alternating with bleomycin and vincristine together with continuous oral prednisolone. Six patients developed pneumonitis which was severe in five patients. This occurred at total bleomycin doses of less than 50 U/m2 and cyclophosphamide less than 1875 mg/m2. The 31 per cent incidence of pneumonitis following low dose bleomycin suggests an increased susceptibility to drug-induced pulmonary damage in non-Hodgkin's lymphoma.
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PMID:Severe lung toxicity with a weekly low dose chemotherapy regimen in patients with non-Hodgkin's lymphoma. 246 Mar 99

The Conference of State and Territorial Epidemiologists (CSTE) approved the following definitions regarding the case definition of acquired immunodeficiency syndrome (AIDS) at its annual meeting in June 1985. 1st, the case definition of AIDS used for national reporting will continue to include only the more severe manifestations of human T-lymphotropic virus type III (HTLV-III) infection. 2nd, Centers for Disease Control (CDC) will develop more inclusive definitions and classifications of HTLV-III infection for diagnosis, treatment, and prevention, as well as for epidemiologic studies and special surveys. 3rd, a number of refinements will be adopted in the case definition of AIDS used for national reporting. In the absense of the opportunistic diseases required by the current case definition, disseminated histoplasmosis, isosporiasis, bronchial or pulmonary candidiasis, non-Hodgkin's lymphoma of high-grade pathologic type, and histologically confirmed Kaposi's sarcoma in patients 60 years or over will be considered indicative of AIDS if the patient has a positive serologic or virologic test for HTLV-III. Also, in the absence of the required opportunistic diseases, a histologically confirmed diagnosis of chronic lymphoid insterstitial pneumonitis in a child under 3 years of age will be considered indicative of AIDS unless HTLV-III antibody tests are negative. Patients who have a lymphoreticular malignancy diagnosed more than 3 months after the diagnosis of an opportunistic disease used as a marker for AIDS will no longer be excluded as AIDS cases. Finally, to increase the specificity of the case definition, patients will be excluded as AIDS cases if they have a negative result on testing for serum antibody to HTLV-III, have no other test for HTLV-III with a positive result, and do not have a low number of T-helper lymphocytes or a low T4:T8 ratio.
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PMID:Revision of the case definition of acquired immunodeficiency syndrome for national reporting--United States. 298 77


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