Evaluation of some prognostic variables and 4 years survival in patients with advanced Hodghin's Disease treated by chemotherapy alone or chemotherapy with radiotherapy.

This study aimed to determine the significant prognostic factors in patients with advanced Hodgkin's disease [stage III B and IV] treated by chemotherapy alone or chemoradiotherapy and the evaluation of the results regarding the response to treatment and four years survival. Analysis of the results showed that there were five prognostic factors adversely affect the response to treatment and over all survival; age, anemia, number of extra nodal sites, LDH and lymphocytic count. 96.6% of cases of stage III B were in complete remission [CR] versus 53.6% only of stage IV cases. Patients at high risk whom had three or more adverse variables their response to the treatment was 57.6%, while patients with less than three adverse variables was 79%. The four years survival was 91.1% for patients with less than three adverse variables and was 78% for patients with more than three adverse variables

Evaluation of cardiovascular autonomic functions compared with clinical response in patients with malignant lymphomas before and after chemotherapy

54 patients presented with malignant lymphoma [20 cases with Hodgkin's disease, 11 with low grade non-HodgKin's lymphoma and 23 with high grade non-Hodgkin's lymphoma] were studied. All had advanced disease [stage II B, III and IV], requiring combination chemotherapy which included the use of vinca alkaloids. Clinical assessment and standard cardiovascular autonomic function tests were carried out prior to and following completion of chemotherapy treatment and 8 weeks after whenever possible. At presentation forty patients 40/54 [74%] had abnormal cardiovascular autonomic function tests and there was no correlation with the presence or absence of mediastinal disease. Significant improvement in autonomic scores at the end of treatment were recorded in 26/40 [65%] patients despite the use of drugs with known neurocardiac toxicity, but others 14/40 [35%] showed residual abnormalities of cardiovascular autonomic functions despite clinical resolution of the disease. After 8 weeks from completion of chemotherapy treatment autonomic scores showed further improvement in four patients [complete remission was achieved]. It was suggested that subclinical autonomic dysfunction is common in patients with malignant lymphoma and probably it may represent a paraneoplastic syndrome rather than toxic effects of the drugs used, but its pathogenesis and prevalence of which deserve further study. This phenomenon may predispose the patients with lymphoma to develop other autonomic dysfunction in gastrointestinal and genitourinary tract and should be considered during the evaluation of neurotoxicity of chemotherapy regimens used