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Abramson Cancer CenterNCI CANCERLIT® Search: Hodgkin's Disease - October 2001
National Cancer Institute®
Last Modified: November 21, 2001
Table of Contents
1
UI - 21240456
AU - Aviles A; Neri N; Cuadra I; Alvarado I; Cleto S
TI -
Second lethal events associated with treatment for Hodgkin's disease: a
review of 2980 patients treated in a single Mexican institute.
SO - Leuk Lymphoma 2000 Oct;39(3-4):311-9
AD - Oncology Disease Research Unit, Oncology Hospital, National Medical
Center, IMSS, Mexico, D.F. Mexico. a.aviles@infosel.net.mx
Presence of second neoplasms and cardiac toxicity has been recognized as
potential late lethal second events in patients treated for Hodgkin's
disease. However, most reports analyze these association independently.
We reviewed 2980 cases of patients treated during 1970-1995 with
long-term follow-up (> 4 years) in an attempt to identify all late
events in Hodgkin's disease secondary to the treatment or those which
are unrelated. Three hundred and ten patients died, and of these 156
were secondary to relapse and tumor progression. Death associated second
tumors and cardiac events were increased 37 fold and 29 fold
respectively compared to the general population. The risk factors for
this complications did not differ to previous reports and included
alkylating agents and/or radiotherapy for second neoplasms and
anthracycline therapy and radiotherapy for cardiac toxicity. Moreover,
61 patients died secondary to non-related events. Nevertheless, at
20-years overall survival was 90 % (95 % confidence interval (CI): 78 %
to 97 %) and event free survival was 88 % (95 % CI: 76 % to 96 %) for
these patients. Thus, second events, fatal in most cases, should be
considered as an expected risk to the treatment in patients with
Hodgkin's disease; the proposed modifications of therapy may indeed be
useful to avoid or diminish these complications in the future.
2
UI - 21240462
AU - Maia DM; Sciarrotta J; Abendroth K; Blatt J
TI -
Sex steroid receptors in Hodgkin's disease.
SO - Leuk Lymphoma 2000 Oct;39(3-4):365-71
AD - Department of Pathology and Laboratory Medicine and the Lineberger
Comprehensive Cancer Center; University of North Carolina School of
Medicine, Chapel Hill, NC.
A case report of a dramatic therapeutic response of Hodgkin's disease
(HD) to diethylstilbestrol (DES) in a man who was being treated for
concurrent prostate cancer suggested that there also may be a role for
sex steroids in the pathogenesis of HD (1). High levels of estrogen
receptors (ER) comparable to those seen in breast carcinoma cells were
detected in that patient's Hodgkin's biopsy specimen. In order to
determine whether this patient was unique or whether sex steroid
receptors commonly are present in HD specimens, we examined expression
of ER and progesterone receptors (PR) in diagnostic tissue from
pediatric (n = 14) and adult (n = 41) patients with HD using
immunohistochemistry. None of the 55 samples expressed PR. 16/55 (29%)
demonstrated weak nuclear ER positivity, which was confined to germinal
center and occasional mantle zone lymphocytes and was comparable to that
seen in non-malignant control lymph nodes. (4/5)5 (7.3%) samples
exhibited moderate positivity in Reed Sternberg cells, which in one case
was nuclear. ER commonly are expressed weakly in some HD tumors
unrelated to clinical stage or patient sex but are generally limited to
germinal center and mantle zone lymphocytes. A rare patient displays
moderate cytoplasmic or nuclear ER in Reed-Sternberg cells.
3
UI - 21240469
AU - Saif MW; Hamilton JM; Allegra CJ
TI -
Varicella zoster meningitis preceeded by thrombophlebitis in a patient
with Hodgkin's disease.
SO - Leuk Lymphoma 2000 Oct;39(3-4):421-6
AD - Medicine Branch, National Cancer Institute, National Naval Medical
Center, Bethesda, MD 20889, USA. saifw@mail.nih.gov
Varicella zoster (V-Z) infections are common among patients with
hematological malignancies, particularly Hodgkin's disease (HD). The
common denominator in both HD and V-Z infections is immunosuppression.
Most of V-Z infections occur in patients with HD during the remission
period, who have mixed cellularity sub-type, with stage III disease and
who have received combined chemo-radiation therapy. Involvement of the
central nervous system usually manifests as post-herpetic neuralgia or
encephalitis. Angiitis has also been found in association with V-Z
infections. The authors describe a case of HD who developed V-Z
meningitis preceeded by superficial thrombophlebitis of upper
extremities during the period of active chemotherapy.
4
UI - 21240484
AU - Montalban C; Abraira V; Morente M; Acevedo A; Aguilera B; Bellas C;
TI -
Fraga M; Del Moral RG; Menarguez J; Oliva H; Sanchez-Beato M; Piris MA
Epstein-Barr virus-latent membrane protein 1 expression has a favorable
influence in the outcome of patients with Hodgkin's Disease treated with
chemotherapy.
SO - Leuk Lymphoma 2000 Nov;39(5-6):563-72
AD - Department of Internal Medicine, Hospital Ramon y Cajal, Universidad de
Alcala, Madrid, Spain. cmontalban@hrc.insalud.es
The effect of molecular factors in the outcome of Hodgkin's Disease (HD)
is being currently studied. In a previous series of HD, including
patients treated only with radiotherapy and patients treated with
chemotherapy (with or without radiotherapy), we found that a high
proliferation index had an adverse influence in overall survival (OS)
and in the achievement of a complete remission (CR). Loss of Rb
expression also had an adverse prognostic influence in achievement of
CR. On the other hand LMP1-EBV expression had a favorable influence for
OS. The expression of other molecular factors, p53, bcl2 and CD15 did
not show prognostic influence. In the present paper we have studied the
effect of these molecular variables in 110 patients, of the previous
series who had been treated with chemotherapy. A retrospective study was
performed in these 110 patients with HD treated with chemotherapy (ABVD
or variants, 62%, or regimes not containing adriamycin, 38%) with or
without adjutant radiotherapy, collected at the 11 centers belonging to
the Spanish Collaborative Group for the Study of Hodgkin's Disease. The
prognostic value of clinical variables and the expression of p53, bcl2,
CD15, Rb, LMP 1-EBV and proliferative fraction demonstrated with
sensitive immunohistochemical methods were studied. Cox's multivariate
analysis was performed to assess their influence in failure-free
survival (FFS) and OS. A multivariate logistic regression analysis was
performed for studying the effect of the variables in the achievement of
a CR. Of the clinical variables, only advanced stage (III/IV) had a
significant independent adverse influence in FFS, in OS and in the
achievement of CR and advanced age in OS. Of the molecular variables,
LMP1-EBV had an independent and strong favorable influence in FFS, in OS
and in the achievement of CR. Rb expression had a modest favorable
influence in CR. The rest of the molecular variables had no independent
influence on the outcome of the disease. In conclusion these results
confirm the favorable prognostic value of LMP1-EBV expression in the
subset of patients with HD treated with chemotherapy.
5
UI - 21215929
AU - Biasotti S; Garaventa A; Gambini C; Stella G; De Bernardi B
TI -
A 7-year-old girl with hip pain and leg weakness.
SO - Eur J Pediatr 2001 Apr;160(4):255-7
AD - Department of Pediatric Hematology/Oncology, Giannina Gaslini Children's
Hospital, Largo G. Gaslini 5, 16148 Genova, Quarto, Italy.
6
UI - 21366220
AU - Tacyildiz N; Cavdar AO; Yavuz G; Gozdasoglu S; Unal E; Ertem U; Duru F;
TI -
Ikinciogullari A; Babacan E; Kuzu I; Cin S
Serum levels and differential expression of CD44 in childhood leukemia
and malignant lymphoma: correlation with prognostic criteria and
survival.
SO - Pediatr Int 2001 Aug;43(4):354-60
AD - Department of Pediatric Oncology, Ankara University Medical School,
Turkey. nurdan@hitit.ato.org.tr
BACKGROUND: The CD44, a cell surface proteoglycan, participates in a
variety of function including tumor dissemination and metastasis.
However, there are no available data on the prognostic significance of
CD44 expression of tumor tissue correlated with serum sCD44 level in
childhood leukemias and lymphomas. METHODS: Serum levels and leukemic
cell tumor tissue expression of CD44 were detected in 54 children with
acute leukemia and malignant lymphoma. Serum samples were obtained from
all patients before treatment and during remission. Twelve age-matched
healthy children were included as a control group. RESULTS: The serum
CD44 levels were significantly higher in patients with Hodgkin's disease
(HD), non-Hodgkin's lymphoma (NHL), Burkitt's lymphoma (BL) and acute
lymphoblastic leukemia (ALL) than those in the control group. The median
values were 1627.0, 1336.0, 1318.5, 1730.4, 902.7 ng/mL, respectively,
and P<0.001, P<0.01, P<0.01, P<0.05 in comparisons, respectively.
However, there was no significant difference between acute myeloid
leukemia (AML) and the control group (median values: 900.3 and 902.7
ng/mL, respectively, P>0.05). Serum sCD44 levels significantly declined
in HD, NHL and ALL patients who were in complete remission (median
values: 684.0, 573.8 and 1101.1 ng/mL, respectively, P<0.05 in each
comparison). Patients with HD had higher levels of serum sCD44 and
correlated well with higher erythrocyte sedimentation rate (ESR),
B-symptoms and advanced-stage disease (P<0.05, P<0.05 and P<0.01,
respectively). Expression of CD44 was significantly high in patients
with HD and NHL who were in advanced stages of disease. High serum CD44
level was also associated with high tumor tissue expression of CD44 in
patients with HD and BL. In addition, patients with higher levels of
serum sCD44, had a poorer outcome and survival than those with lower
sCD44 levels in HD and NHL groups. CONCLUSIONS: A high serum sCD44 level
and/or tumor tissue expression at diagnosis is associated with poor
prognostic criteria and/or unfavorable outcome in childhood leukemias
and lymphomas.
7
UI - 21397996
AU - Suga K; Ariga M; Motoyama K; Hara A; Kume N; Matsunaga N
TI -
Ga-67-avid massive cellulitis within a chronic lymphedematous limb in a
survivor of Hodgkin's disease.
SO - Clin Nucl Med 2001 Sep;26(9):791-2
AD - Department of Radiology, Yamaguchi University School of Medicine, 1-1-1
Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
8
UI - 21413351
AU - Vilchez RA; Kozinetz CA; Butel JS
TI -
The changing incidence of four AIDS-related malignancies in a large
urban center.
SO - AIDS Patient Care STDS 2001 Aug;15(8):405-6
9
UI - 21317104
AU - Thakur V; Sander G; Rab ST
TI -
Hodgkin's disease and lactic acidosis.
SO - Nephron 2001 Jul;88(3):276-7
10
UI - 21370325
AU - Cherubini C; Barbera G; Di Giulio SD; Muda AO; Faraggiana T
TI -
Lymphomas and IgA nephropathy.
SO - Nephrol Dial Transplant 2001 Aug;16(8):1722-3
11
UI - 21418708
AU - Kondo H; Oyamada T; Mori A; Sumi H; Kurosu K; Kajii E; Mikata A
TI -
Direct-antiglobulin-test-negative immune haemolytic anaemia and
thrombocytopenia in a patient with Hodgkin's disease.
SO - Acta Haematol 2001;105(4):233-6
AD - Division of Haematology and Oncology, Department of Medicine, Shimizu
Kohsei Hospital, 578-1 Ihara-cho, Shimuzu-city, Shizuoka 424-0114,
Japan. hakondo@minuet.plala.or.jp
A case of direct-antiglobulin-test (DAT)-negative auto-immune haemolytic
anaemia (AIHA) and immune thrombocytopenia (ITP) associated with
Hodgkin's disease (HD) is reported. A 52-year-old male was admitted with
anaemia, thrombocytopenia, and lymphadenopathy. The patient was DAT
negative, although he exhibited the clinical features of warm-type AIHA
and elevated levels of red-blood-cell-associated IgG (RBC-IgG). The
serum level of platelet-associated IgG (PA-IgG) was markedly increased.
A biopsy specimen of the inguinal lymph nodes showed HD of mixed
cellularity. Marked improvement of subjective symptoms, normalization of
haematological values and a decrease in the level of both RBC- and
PA-IgG were observed after the start of combination chemotherapy for HD.
Although the association of HD, ITP, and/or AIHA has been infrequently
reported, the measurement of RBC-IgG is recommended in cases of HD with
anaemia even though DAT is negative, since HD is known to be associated
with various protean immunological abnormalities. Copyright 2001 S.
Karger AG, Basel
12
UI - 21437217
AU - Lush RJ; Jones SG; Haynes AP
TI -
Advanced-stage, chemorefractory lymphocyte-predominant Hodgkin's
disease: long-term follow-up of allografting and monoclonal antibody
therapy.
SO - Br J Haematol 2001 Sep;114(3):734-5
13
UI - 21453612
AU - Urquhart A; Berg R
TI -
Hodgkin's and non-Hodgkin's lymphoma of the head and neck.
SO - Laryngoscope 2001 Sep;111(9):1565-9
AD - Department of Otolaryngology-Head and Neck Surgery, Marshfield Clinic,
Marshfield, Wisconsin 54449, USA. urquhara@mfdclin.edu
OBJECTIVES/HYPOTHESIS: Lymphomas are a frequent cause of malignant
lymphadenopathy in the head and neck. This study was performed to
evaluate the head and neck manifestations of lymphomas and to emphasize
the different presentations of Hodgkin's disease (HD) and non-Hodgkin's
lymphoma (NHL). STUDY DESIGN: Retrospective review. METHODS: A
retrospective review was made of all cases of lymphomas involving the
head and neck at Marshfield Clinic (Marshfield, WI) between 1988 and
1996. Specifically, the clinical presentations, staging, and prognosis
for HD and NHL with head and neck involvement were sought. RESULTS:
Three hundred eleven patients were included in the study, 76 with HD and
235 with NHL. The median age at diagnosis for patients with HD was 27.7
years, and for patients with NHL, 67.2 years. This difference was highly
significant (P <.001). No significant difference in gender was noted,
with male patients occurring in 59% with HD and 49% with NHL (P=.135).
Extranodal involvement including the oral cavity, oropharynx,
nasopharynx, paranasal sinuses, and larynx occurred with HD in 3
patients (4%) and with NHL in 54 patients (23% P <.001). Cervical
adenopathy consisted of a single node in 24% of patients with HD and 33%
of those with NHL (no significant difference, P=.236). The difference in
mediastinal nodal involvement was highly significant, occurring in 65%
of patients with HD and 38% of patients with NHL(P <.001). Abdominal
nodes occurred in 20% of cases of HD and 45% of cases of NHL (P<.001). A
significant difference in constitutional symptoms was noted with 41% of
cases in HD and 27% of cases in NHL (P=.020). For the percentage of
patients with stage IV disease, there was a highly significant
difference by diagnosis with 10% in HD and 36% in NHL (P <.001). The
median follow-up time was 51 months, and 12% of patients with HD and 41%
of patients with NHL died of their disease. Both the overall survival
and survival from death attributable to disease were significantly
better for HD(P<.001). CONCLUSIONS: Hodgkin's disease presents at a
younger age and is less common than NHL. Cervical lymphadenopathy is the
most common head and neck presentation for both diseases. Associated
mediastinal adenopathy was more common with HD, and abdominal adenopathy
with NHL. Constitutional symptoms were more common with HD. More
advanced disease with a decreased overall survival was seen with NHL.
14
UI - 21464087
AU - Ogura M
TI -
[Recent progress in the treatment of malignant lymphoma]
SO - Gan To Kagaku Ryoho 2001 Sep;28(9):1213-35
AD - Department of Hematology and Chemotherapy, Aichi Cancer Center Hospital,
1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
The present state of the art and developments in the treatment for
Hodgkin's disease (HD), follicular lymphoma (FL), MALT lymphoma, and
aggressive non-Hodgkin's lymphoma are reviewed. Four courses of ABVD
therapy (ABVd therapy in Japan) followed by involved-field irradiation
(IFRT), and 6 to 8 courses of ABVD (ABVd in Japan) are the current state
art of the therapy for early stage HD and advanced stage HD,
respectively. High-dose chemotherapy with autologous hematopoietic stem
cell transplantation (auto-HSCT) is also the state of the art for
refractory or relapsed HD within 1 year after complete remission (CR)
produced by polychemotherapy. The prognosis of the patients with 3 or
more International Prognostic Scores (IPS) is poor. New intensified
polychemotherapy or auto-HSCT as up-front setting is under randomized
phase III clinical trial in Europe and the USA. There is no state of the
art therapy for indolent lymphoma including FL, or MALT. Promising
results were reported from clinical studies using new anti-lymphoma
drugs such as rituximab, iibritumomab, or purine analogs (cladribine and
fludarabine), and auto-HSCT with effectively purged stem cells or
allogeneic HSCT. These therapeutic strategies hold a possibility of cure
for indolent lymphomas. Antibiotic treatment for Helicobacter
pylori-positive localized gastric MALT lymphoma is the state of the art
therapy. However, there is no standard therapy for advanced stage MALT
lymphoma. Risk adapted therapy using the International Prognostic Index
is essential for the treatment of aggressive NHL. Three courses of CHOP
followed by IFRT for localized aggressive NHL and 8 courses of CHOP for
the low-risk group of advanced stage aggressive NHL are the state of the
art therapies, respectively. High-dose chemotherapy with auto-HSCT is
also the state of the art for sensitive relapse patients with aggressive
NHL. Although some clinical studies suggested that high-dose
chemotherapy with auto-HSCT as up-front setting for high-intermediate or
high-risk group aggressive NHL is more effective than conventional
chemotherapy, the efficacy remains to be determined. The development of
new therapeutic strategies with combined use of molecular targeting
drugs such as rituximab, or new anti-lymphoma drugs such as purine
analogs, and HSCT is desired for more effective therapy for refractory
lymphomas.
15
UI - 21299416
AU - Sarmanova J; Benesova K; Gut I; Nedelcheva-Kristensen V; Tynkova L;
TI -
Soucek P
Genetic polymorphisms of biotransformation enzymes in patients with
Hodgkin's and non-Hodgkin's lymphomas.
SO - Hum Mol Genet 2001 Jun 1;10(12):1265-73
AD - Biotransformations Group, Center of Occupational Diseases, National
Institute of Public Health, Srobarova 48, Praha 10, 100 42, Czech
Republic,.
Considering the role in the metabolism of chemicals played by
biotransformation enzymes, we aimed at determining whether any
association exists between genetic polymorphisms in CYP1A1, CYP2E1,
epoxide hydrolase (EPHX), glutathione S-transferases (GSTM1/P1/T1) and
individual susceptibility to lymphomas. PCR-RFLP-based genotyping assays
were used to determine the frequency of polymorphisms in CYP1A1
(3'-flanking region), CYP2E1 (5'-flanking region and intron 6), EPHX
(exons 3 and 4), GSTM1 (deletion), GSTP1 (exon 5) and GSTT1 (deletion)
in a case-control study comprised of 219 patients with morbus Hodgkin
(MH) and non-Hodgkin's lymphomas (NHL) and 455 age- and sex-matched
healthy individuals. The distribution of genotypes in CYP2E1-intron 6
was significantly different between the control group and all lymphomas
(P = 0.03), patients with NHL (P = 0.024), and especially aggressive
diffuse NHL (P = 0.007). Grading of NHL seemed to be associated with
this polymorphism as well (P = 0.041). The EPHX-exon 3 genotype
distribution was significantly different between control males and males
with all lymphomas (P = 0.01) or with NHL (P = 0.019). The Val/Val
genotype of GSTP1-exon 5 was prevalent in all MH [odds ratio (OR) =
2.08, 95% confidence interval (CI) = 1.05-4.14] and this difference was
particularly evident in females (OR = 2.97, 95% CI = 1.16-7.61). A
significant difference in the distribution of GSTP1-exon 5 genotypes was
found between NHL tumors >5 cm and those <5 cm (P = 0.03). The results
suggest that genetic polymorphisms of biotransformation enzymes may play
a significant role in the development of lymphoid malignancies.
16
UI - 21443192
AU - Shimizu K; Iida M; Takahashi S
TI -
Hodgkin's disease producing granulocyte colony stimulating factor.
SO - Am J Hematol 2001 Oct;68(2):134
17
UI - 21469701
AU - Oshima Y; Puri RK
TI -
Suppression of an IL-13 autocrine growth loop in a human
Hodgkin/Reed-Sternberg tumor cell line by a novel IL-13 antagonist.
SO - Cell Immunol 2001 Jul 10;211(1):37-42
AD - The Laboratory of Molecular Tumor Biology, Division of Cellular and Gene
Therapies, Center for Biologics Evaluation and Research, Food and Drug
Administration, 29 Lincoln Drive, NIH Building 29B, Room 2NN10,
Bethesda, Maryland 20892, USA.
IL-13 has been proposed to be an autocrine growth factor for
Hodgkin/Reed-Sternberg tumor cells (H/RS cells). Since we have recently
identified and produced a novel IL-13 antagonist (IL-13E13K) that can
suppress the biological activity of IL-13, here we examined whether
IL-13E13K can inhibit growth of Hodgkin lymphoma (HL)-derived cell
lines. IL-13E13K not only inhibited the growth of an unstimulated H/RS
cell line (L1236) but also cells that were stimulated by exogenous IL-13
in a dose-dependent manner. Several HL-derived cell lines expressed
IL-13 message and protein and message for various chains of IL-13R. H/RS
cell lines expressed mRNA for the IL-13R alpha 1, IL-4R alpha, and IL-2R
gamma chains. However, none of these cell lines expressed the IL-13R
alpha 2 chain. An H/RS cell line (L1236) internalized the
ligand-receptor complex after binding to a fusion protein composed of
IL-13 and a mutated form of Pseudomonas exotoxin A (IL-13-PE38QQR, or
IL-13 cytotoxin), as IL-13 cytotoxin was specifically cytotoxic to H/RS
cells in vitro. These results indicate that IL-13E13K and IL-13
cytotoxin can effectively suppress growth of a L1236 H/RS cell line.
Therefore, additional studies should be performed to determine the
expression of IL-13 and IL-13R in primary clinical samples of Hodgkin's
lymphoma and both agents should be further tested in vitro and in vivo
as possible therapeutic agents for HL.
18
UI - 21349586
AU - Macak J; Rihakova P
TI -
[Morphometric parameters of nuclei in EBV-positive and EBV-negative
Hodgkin's lymphoma]
SO - Cesk Patol 2001 Apr;37(2):57-60
AD - Ustav patologie Lekarske fakulty Univerzity Palackeho, Olomouc.
Five morphometric parameters of nuclei of EBV-positive and EBV-negative
Hodgkin's lymphoma cells were assessed for length, width, area,
circumference, and circularity. For the measurement of the nuclei of the
tumor cells (Hodgkin, Reed-Sternberg cells) the system of image analysis
"Lucie" was used. In comparison with EBV-positive Reed-Sternberg cells,
the nuclei of the EBV-negative Reed-Sternberg cells had significantly
larger circumference, area and width. The nuclei of the Hodgkin cells in
EBV-negative Hodgkin's lymphomas had significantly larger width and
circularity. The authors assume that the altered morphometric parameters
are related to a latent EBV infection.
19
UI - 20251790
AU - Stefano G; Filippo R; Giuseppe A; Tullio P; Benita C; Luca M; Valfredo
TI -
D; Gianfranco A; Roland AK
Stop-flow in mediastinum and thorax for resistant lymphoma.
SO - Hepatogastroenterology 2000 Mar-Apr;47(32):378-82
AD - Department of Surgery, University of L'Aquila, Italy. guadagni@rdn.it
BACKGROUND/AIMS: Management of patients with heavily pretreated
malignant lymphoma failing frontline treatment and salvage high-dose
chemotherapy and autologous peripheral stem cell rescue, is problematic.
A pilot study was conducted to evaluate isolated thoracic perfusion of
drugs by means of stopflow technique. METHODOLOGY: Six patients were
enrolled in the study; diagnoses included 4 advanced Hodgkin's disease,
1 primary mediastinal B-cell lymphoma, and 1 anaplastic large cell
lymphoma. Patients were aged 18-37 years; 4 presented with bulky
mediastinum. They had never achieved a complete response since all had
progressed from front-line treatment, and 3 had even failed salvage
high-dose chemotherapy with autologous peripheral stem cell rescue.
Cisplatin (100 mg/m2) and melphalan (35 mg/m2) were used. Carmustine
(100 mg/m2) were added to these 2 drugs and cytarabine (2000 mg/m2) in
patients not previously treated by carmustine, etoposide, cytarabine,
and melphalan. Epidoxorubicin (70 mg/m2) was added in patients who
previously received a suboptimal dosage of antracycline. Drugs were
delivered monthly via aortic perfusion performed by means of Aigner's
stop-flow technique. RESULTS: Overall 13 cycles of perfusional
chemotherapy were administered with a median number of 2 cycles. During
the procedures there were no technical, hemodynamic, or vascular
complications, and no deaths occurred during surgery. After 1 month, 6
(100%) objective responses after isolated thoracic perfusion were
recorded, 3 (50%) of which were complete. Tolerance to therapy was
excellent. Hematological toxicity was mild and transfusional support was
needed only in one course. At the last follow-up, 2 patients are alive
(1 complete response and 1 very good partial response, maintained).
CONCLUSIONS: This new therapeutical approach seems very active in
recurrent/refractory malignant lymphoma and may play an important role
in this setting.
20
UI - 21341683
AU - Fisher RI
TI -
Treating Hodgkin's disease with bispecific antibodies: Both patients and
antibody are limiting.
SO - Clin Cancer Res 2001 Jul;7(7):1835-6
21
UI - 21341691
AU - Hartmann F; Renner C; Jung W; da Costa L; Tembrink S; Held G; Sek A;
TI -
Konig J; Bauer S; Kloft M; Pfreundschuh M
Anti-CD16/CD30 bispecific antibody treatment for Hodgkin's disease: role
of infusion schedule and costimulation with cytokines.
SO - Clin Cancer Res 2001 Jul;7(7):1873-81
AD - Department of Medicine, Saarland University Medical School D-66421
Homburg, Germany.
The natural killer cell-activating anti-CD16/CD30 bispecific monoclonal
antibody (BiMAb) had shown efficacy in a Phase I/II trial of refractory
Hodgkin's disease (HD). To gain additional information on clinical
efficacy and to investigate the effects of different application
schedules and the concomitant application of cytokines, we performed a
second randomized pilot trial using this BiMAb in patients with
refractory HD. Patients received 4 x 25 mg HRS-3/A9 either as a
continuous infusion for 4 days or as a 1-h infusion every other day. In
case of an objective response, retreatment was attempted after 4 weeks;
in case of stable disease (SD), a second course was given after
prestimulation with interleukin 2 and followed by granulocyte macrophage
colony-stimulating factor s.c. A total of 16 heavily pretreated patients
received one to four BiMAb courses. Overall, we observed one complete
remission and three partial remissions lasting 5-9 months (three of four
of these responses occurred after continuous BiMAb infusion) and four
cases of SD for 3 to >6 months. Interleukin 2 pretreatment before the
second BiMAb course resulted in a significant increase of circulating
natural killer cells in all five patients treated. This coincided with
the conversion of two cases of SD into one complete remission and one
partial remission. HRS-3/A9-related side effects consisted of mild fever
in only six patients. In summary, this second trial confirmed the
antitumor efficacy of this BiMAb against HD and the minor toxicity of
this BiMAb. Coadministration of cytokines might contribute to an
augmented antitumor activity, and additional clinical trials are
warranted to optimize this novel treatment modality.
22
UI - 21463641
AU - Zambudio AR; Lanzas JT; Calvo MJ; Paricio PP
TI -
Mediastinal cystic teratoma associated with a Hodgkin's lymphoma.
SO - Eur J Cardiothorac Surg 2001 Sep;20(3):650-1
23
UI - 21439157
AU - Clarke CA; Glaser SL
TI -
Epidemiologic trends in HIV-associated lymphomas.
SO - Curr Opin Oncol 2001 Sep;13(5):354-9
AD - Northern California Cancer Center, Union City, California 94587, USA.
tclarke@nccc.org
Infection with HIV increases the risk of developing non-Hodgkin lymphoma
and, to a lesser extent, Hodgkin disease. The introduction of highly
active antiretroviral therapy (HAART) in 1996 changed the natural
history of HIV disease, but the HIV-infected population also has changed
in composition. Accordingly, the epidemiology of HIV-associated
lymphomas now differs from that observed in the first 15 years of the
HIV epidemic. In populations with access to HAART, reductions in
lymphoma risk have been reported for NHL and suggested for Hodgkin
disease, but long-term risks are as yet unknown. Lymphomas are
increasingly common cancers in persons with HIV and are fatal in most
patients, warranting continued attention to their incidence and
etiology.
24
UI - 21487558
AU - Ohno T; Huang JZ; Wu G; Park KH; Weisenburger DD; Chan WC
TI -
The tumor cells in nodular lymphocyte-predominant Hodgkin disease are
clonally related to the large cell lymphoma occurring in the same
individual. Direct demonstration by single cell analysis.
SO - Am J Clin Pathol 2001 Oct;116(4):506-11
AD - Department of Pathology and Microbiology, University of Nebraska Medical
Center, Omaha, NE 68198-3135, USA.
Large cell lymphoma (LCL) sometimes occurs concurrently or subsequently
in patients with nodular lymphocyte-predominant Hodgkin disease (NLPHD).
Although there is evidence of a clonal relationship between LCL and
NLPHD, there has been no direct demonstration that the lymphocytic and
histiocytic (L&H) cells in NLPHD are related to the tumor cells in LCL.
We identified 2 cases of NLPHD with an associated LCL. Single L&H cells,
the Reed-Sternberg cell variants in NLPHD, were isolated from
immunostained tissue sections by micromanipulation, and the
immunoglobulin heavy chain gene (IgH) complementarity determining region
(CDR) III of the cells was amplified by the polymerase chain reaction
(PCR). The products were compared with those obtained from
microdissected LCL cells using polyacrylamide gel electrophoresis and
nucleotide sequencing. The IgH CDRIII sequences from the L&H cells were
related to each other, but also showed nucleotide substitutions,
consistent with a germinal center origin. The sequences from the L&H
cells also were related to those from the corresponding LCL cells. We
have provided direct evidence through sequence analysis of the IgH
CDRIII that the L&H cells are clonally related to the corresponding LCL
arising in 2 cases of NLPHD.
25
UI - 83304063
AU - Meleis AI; Jonsen AR
TI -
Ethical crises and cultural differences.
SO - West J Med 1983 Jun;138(6):889-93
26
UI - 81056549
AU - Becker EB
TI -
In re Hofbauer: may parents choose unorthodox medical care for their
child?
SO - Spec Law Dig Health Care (Mon) 1981 Jan;2(11):5-35
27
UI - 93257754
AU - Freer JP
TI -
Decision making in an incapacitated patient.
SO - J Clin Ethics 1993 Spring;4(1):55-8
AD - Department of Medicine, State University of New York, Buffalo.
28
UI - 93257756
AU - Elliott C
TI -
Meaning what you say.
SO - J Clin Ethics 1993 Spring;4(1):61-2
AD - Department of Medical Humanities, East Carolina University School of
Medicine, Greenville, North Carolina.
29
UI - 95038089
AU - Turner SL; Maher EJ
TI -
Information and choice in decisions about cancer treatment.
SO - BMJ 1994 Oct 8;309(6959):955
30
UI - 95262534
AU - Watne K; Donner TA
TI -
Distinguishing between life-saving and life-sustaining treatments: when
the physician and spouse disagree.
SO - Dimens Crit Care Nurs 1995 Jan-Feb;14(1):42-7
There is a fine distinction between life-saving measures and
life-sustaining ones. In the case presented below the husband of a wife
with cancer did not understand the continuation of life-sustaining
treatment after the decision to reject life-saving measures was made.
This resulted in a conflict between the husband and physician that
placed the nurse, as family advocate, in the middle. The case is
followed by an analysis with recommendations on how to handle this type
of situation.
31
UI - 95369310
AU - Dimitrakopoulou-Strauss A; Strauss LG; Goldschmidt H; Lorenz WJ;
TI -
Maier-Borst W; van Kaick G
Evaluation of tumour metabolism and multidrug resistance in patients
with treated malignant lymphomas.
SO - Eur J Nucl Med 1995 May;22(5):434-42
AD - Department of Oncologic Diagnosis and Therapy, German Cancer Research
Center, Heidelberg.
The management of patients with treated malignant lymphomas requires
functional methods to differentiate a residual soft tissue mass.
Patients with treated Hodgkin's lymphoma (HL, n = 20, 68 malignant
lesions, three benign lesions) or non-Hodgkin's lymphoma (NHL, n = 26,
46 malignant lesions, one benign lesion) were studied with positron
emission tomography (PET) and fluorine-18 deoxyglucose (FDG). Oxygen-15
labelled water was used (n = 14, 25 lesions) in addition to FDG in order
to obtain information on the tissue perfusion. Long-term follow-up
studies with PET and FDG were performed in nine patients up to 511 days
after the initiation of second-line therapy. Fourteen patients underwent
single-photon emission tomography (SPET) with technetium-99m sestamibi
immediately prior to the first PET examination. PET with FDG displays a
high sensitivity for the detection of viable tumour tissue, all the
malignant lesions being correctly classified in this study. The possible
limitations are inflammatory processes, which may obscure tumour
detection due to increased FDG uptake, and malignant lesions with low
FDG uptake due to reduced perfusion. Difficulties exist in the prognosis
of long-term response, since the change in FDG uptake may be variable.
Long-term therapy outcome was correlated with the slope values obtained
from the standardized integral uptake (SIU) data, which provides a new
approach for the evaluation of PET follow-up studies. 99mTc-sestamibi,
which should reflect the multidrug resistance, was evaluated with
respect to therapy outcome. A high uptake of 99mTc-sestamibi was
observed in patients with stable disease or better. The data support the
hypothesis that sestamibi may reflect multidrug resistance.(ABSTRACT
TRUNCATED AT 250 WORDS)
32
UI - 21291610
AU - Pfreundschuh M; Hasenclever D; Loeffler M; Ehninger G; Schmitz N;
TI -
Kirchner H; Koch P; Lathan B; Rueffer U; Sextro M; Franklin J; Tesch H;
Diehl V; German Hodgkin's Lymphoma Study Group
Dose escalation of cytotoxic drugs using haematopoietic growth factors:
a randomized trial to determine the magnitude of increase provided by
GM-CSF.
SO - Ann Oncol 2001 Apr;12(4):471-7
AD - Department of Medicine, Saarland University Medical School, Germany.
BACKGROUND: The magnitude of chemotherapy dose escalation made possible
by the use of recombinant haematopoietic growth factors has not been
quantified in a randomized trial. PATIENTS AND METHODS: Patients with
refractory or relapsing Hodgkin's disease were randomized to receive the
Dexa-BEAM regimen with escalating etoposide doses supported by placebo
or granulocyte-macrophage colony-stimulating factor (GM-CSF). Using an
adaptive sampling method independently in both arms, the etoposide dose
was escalated until the maximal tolerated dose for the first cycle was
reached. RESULTS: Thirty patients were randomized to GM-CSF and thirty
to placebo. The etoposide dose could be escalated considerably in both
treatment arms. Maximal etoposide dose for the first cycle was 1920
mg/m2 for patients receiving GM-CSF and 1160 mg/m2 for patients
receiving placebo (P = 0.045 one-sided), corresponding to a 65% higher
etoposide dose and a 13% higher dose intensity with GM-CSF.
Dose-limiting events were similar in both arms, consisting mainly of
prolonged neutropenia and consecutive infections. Treatment efficacy was
not different in the two treatment groups. CONCLUSIONS: While GM-CSF
permits a somewhat higher dose escalation than placebo, the increase in
dose intensity provided by GM-CSF is small. The use of CSF for interval
reduction rather than dose escalation is the more effective strategy for
dose intensification.
33
UI - 21323234
AU - Bar-Shalom R; Mor M; Yefremov N; Goldsmith SJ
TI -
The value of Ga-67 scintigraphy and F-18 fluorodeoxyglucose positron
emission tomography in staging and monitoring the response of lymphoma
to treatment.
SO - Semin Nucl Med 2001 Jul;31(3):177-90
AD - Department of Nuclear Medicine, Rambam Medical Center, Haifa, Israel.
Gallium-67 scintigraphy (GS) has the ability to provide important
diagnostic and prognostic information for the evaluation of patients
with lymphoma. GS is superior to morphologic imaging techniques because
of its affinity to viable lymphoma cells. The value of GS lies not in
the initial diagnosis but primarily in assessing the results of
treatment and in the follow-up of patients with lymphoma. Nevertheless,
GS has not gained the expected wide acceptance, possibly because of the
meticulous technique required and the expertise needed for optimal
interpretation. The introduction of positron emission tomography (PET)
with F-18 fluorodeoxyglucose (FDG) as a tumor-seeking agent, which
provides images of superior quality, may have an impact on the current
role of GS in the management of patients with lymphoma. FDG-PET seems to
share with GS the advantages of a tumor viability agent. It appears to
be more sensitive for detecting nodal and extranodal sites of disease
than GS and may have predictive value during and after therapy for
lymphoma. These potential clinical and economic advantages of FDG-PET
need to be confirmed in systematic, large-scale prospective studies.
34
UI - 21323240
AU - Sopov V; Gorenberg M; Groshar D
TI -
Cold vertebrae on Ga-67 scintigraphy.
SO - Semin Nucl Med 2001 Jul;31(3):251-2
AD - Department of Nuclear Medicine, Bnai-Zion Medical Center, Haifa, Israel.
35
UI - 21407448
AU - el Omri H; Sriha B; Kraiem I; Youssef YB; Skouri H; Korbi S; Ennabli S
TI -
[Gastric adenocarcinoma secondary to Hodgkin's disease treatment]
SO - Tunis Med 2001 Apr;79(4):253-6
AD - Service d'Hematologie Clinique, CHU Farhat Hached de Sousse.
Second malignant neoplasms are a major cause of late morbidity and
mortality following treatment for Hodgkin's disease. Gastric carcinoma
belong to the rare secondary malignancies induced by radiation-therapy
and it is associated with a poor prognosis. We report a patient treated
for Hodgkin's disease by 6 ABVD and total lymphoid radiation therapy,
who developed a gastric carcinoma 9 years after completing treatment.
Our case fits the criteria for radiation induced malignancies reported
from the literature: In conclusion: recommendations are presented for
both prevention and early detection of the tumours we recommend a strict
follow-up for patients treated for HD to detect second cancers.
36
UI - 21523824
AU - Maggio EM; Stekelenburg E; Van den Berg A; Poppema S
TI -
TP53 gene mutations in Hodgkin lymphoma are infrequent and not
associated with absence of Epstein-Barr virus.
SO - Int J Cancer 2001 Oct 1;94(1):60-6
AD - Department of Pathology and Laboratory Medicine, University Hospital
Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands.
Reed-Sternberg (RS) cells, the neoplastic cells of Hodgkin lymphoma (HL)
have clonal immunoglobulin gene rearrangements. The presence of somatic
mutations suggests a germinal center origin, whereas the presence of
crippling mutations suggests rescue of RS precursors from apoptosis by a
transforming event. Epstein-Barr virus (EBV), which can be detected in
30-50% of HL cases, probably plays a role in this transforming event.
The frequent presence of p53 protein expression in RS cells also
suggests a role of the TP53 gene in this escape from apoptosis. Although
mutations of the TP53 gene occur infrequently in RS cells, it has been
suggested that in EBV-negative cases this gene mutation may be
fundamental for the inhibition of apoptosis. In this study, we tested
the hypothesis that there is an inverse correlation between the presence
of TP53 gene mutations and the presence of EBV. In 21 of 67 cases EBV
encoded small RNA (EBER)1-2 mRNAs were detected. Immunostaining for p53
protein revealed positivity in all 67 cases with variable percentages of
positive cells and staining intensity. Screening for mutations in exons
5, 6, 7 and 8 of the TP53 gene in single RS cells obtained by laser
microdissection from 26 HL specimens and 4 HL-derived cell lines
revealed mutations in 2 of 15 EBV-positive cases and in 1 of 11
EBV-negative cases. Our results confirm the presence of infrequent
(11.5%) TP53 gene mutations in HL and suggest that mutations of the TP53
gene are not correlated to the absence of EBV. Copyright 2001
Wiley-Liss, Inc.
37
UI - 21469843
AU - Win PK; Popescu I; Nicoloff R
TI -
Unusual case presentation of lichen simplex chronicus, Hodgkin's
lymphoma, and nonpuerperal hyperprolactinemia-galactorrhea.
SO - Endocr Pract 2001 Sep-Oct;7(5):388-91
AD - Department of Endocrinology, Los Angeles County/University of Southern
California Medical Center, 1200 North State Street, GNH 8250, Los
Angeles, CA 99033.
OBJECTIVE: To report the association of nonpuerperal galactorrhea and
severe pruritus with clinical stage IIB Hodgkin's lymphoma. METHODS: We
present a detailed history, findings on physical examination, laboratory
data, and results of diagnostic imaging in a 25-year-old woman. A review
of the related literature and speculations about possible etiologic
factors for this association are provided. RESULTS: Dermatologic
evaluation of the patient revealed lichen simplex chronicus with
multiple excoriations on the anterior chest area and lower extremities.
High serum prolactin concentrations and easily expressible galactorrhea
were present. Magnetic resonance imaging of the sella with 1-mm cuts,
however, revealed a normal pituitary gland. Computed tomography showed
multiple enlarged mediastinal lymph nodes, and a left supraclavicular
lymph node biopsy revealed the presence of Reed-Sternberg cells and
lymphocyte alterations consistent with the diagnosis of Hodgkin's
lymphoma. After one cycle of chemotherapy for management of the
lymphoma, parallel reductions in serum prolactin concentrations and
galactorrhea were noted. CONCLUSION: Possible causes for this syndrome
include afferent mammary nerve stimulation resulting from scratching of
pruritic skin and cytokine-induced hypersecretion of prolactin
attributable to the lymphoma. Although uncommon, this syndrome may serve
as an important harbinger of developing Hodgkin's lymphoma, and its
disappearance may signify a therapeutic response.
38
UI - 21460451
AU - Magrath I
TI -
Editorial comment on detection of Epstein-Barr virus DNA in peripheral
blood of paediatric patients with Hodgkin's disease by real-time
polymerase chain reaction by Wagner and colleagues.
SO - Eur J Cancer 2001 Oct;37(15):1812-5
39
UI - 21460458
AU - Wagner HJ; Schlager F; Claviez A; Bucsky P
TI -
Detection of Epstein-Barr virus DNA in peripheral blood of paediatric
patients with Hodgkin's disease by real-time polymerase chain reaction.
SO - Eur J Cancer 2001 Oct;37(15):1853-7
AD - Department of Pediatrics, Medical University of Lubeck, Germany.
hjwagner@usa.net
Hodgkin's disease (HD) is commonly associated with latent Epstein-Barr
virus (EBV) infection. The aim of our study was a detailed molecular
analysis of the EBV status in the peripheral blood of paediatric
patients with HD. Blood samples from HD patients were examined before
(n=28) and after treatment (n=12). The control group consisted of 20
healthy children and 10 immunosuppressed children with primary EBV
infection. EBV load in plasma and peripheral blood mononuclear cells
(PBMC) were determined by real time quantitative polymerase chain
reaction (RQ-PCR) as recently described. Before treatment, EBV DNA was
detected in the plasma of 13/24 EBV-seropositive HD patients, whereas in
plasma of healthy controls no EBV DNA was detectable (P<0.001). After
treatment, no EBV genomes were found in the plasma of 6 HD patients in
stable and complete remission. In contrast, 2/5 HD patients with relapse
of disease were positive for EBV DNA in the plasma. In PBMCs, no
differences were found in EBV load measured in HD patients before or
after treatment and healthy controls. A high EBV load was found in both
the plasma and PBMCs of all immunosuppressed patients with primary EBV
infection. Thus, EBV DNA detection in the plasma of paediatric HD
patients might be of value for non-invasive diagnostic, prognostic and
follow-up tests for HD.
40
UI - 21471799
AU - Schroeder AA; Derkay CS; Warner AL
TI -
Pathology quiz case: nodular sclerosing Hodgkin lymphoma.
SO - Arch Otolaryngol Head Neck Surg 2001 Oct;127(10):1281-2
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