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1.
Rev. Soc. Bras. Clín. Méd ; 15(3): 192-193, 20170000.
Article in Portuguese | LILACS (Americas) | ID: biblio-875533

ABSTRACT

O linfoma é uma neoplasia originária do sistema linfático, a partir de células linfocitárias. A sintomatologia mais comum é febre, tosse, sudorese noturna, perda de peso, fraqueza e linfoadenopatia indolor. A etiologia ainda permanece desconhecida, tendo sido relacionada ao vírus Epstein-Barr. O diagnóstico se baseia na visualização das células de Reed-Sternberg. O esquema adriamicina, bleomicina, vinblastina e dacarbazina (ABVD) ainda é o tratamento preconizado, associado ou não à radioterapia. Relatamos um caso de linfoma de Hodgkin de apresentação atípica, cujo diagnóstico só foi possível por esplenectomia.(AU)


The lymphoma is a cancer of the lymphatic system originating from lymphocyte cells. The most common symptoms are fever, cough, night sweats, weight loss, weakness, and painless lymphadenopathy. The etiology remains unknown, having been related to the Epstein Barr virus. The diagnosis is based on visualization of Reed Sternberg cells. The adriamycin, bleomicin, vinblastine and dacarbazine (ABVD) regimen is still the preferred treatment, with or without radiation therapy. We report a case of Hodgkin's lymphoma of atypical presentation, the diagnosis of which was only possible through splenectomy.(AU)


Subject(s)
Humans , Male , Aged , Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide/administration & dosage , Hodgkin Disease/diagnosis , Hodgkin Disease/drug therapy , Reed-Sternberg Cells , Vinblastine/administration & dosage
2.
Rev. cuba. estomatol ; 52(2): 196-201, ilus, tab
Article in English | LILACS (Americas) | ID: lil-751796

ABSTRACT

Oral side effects must be expected during cancer treatment on pediatric patients. Monitoring side effects on oral cavity of antineoplastic therapy is desirable but sometimes performed without criteria. The purpose of this article is to describe an oral monitoring in an male with Hodgkin lymphoma during chemotherapy treatment using an Oral Assessment Guide. An 11-yr-old male was assisted during all treatment of chemotherapy against Hodgkin's lymphoma in the dental sector of a hospital of reference of João Pessoa, Paraíba, Brazil. The Oral Assessment Guide was applied by a calibrate examiner and was observed the emergence of ulcerative lesions on the labial mucosa emerged on two different periods (D15- primary cycle; D15-second cycle) and the major values of oral mucositis were verified in D1 e D15 periods of second cycle of chemotherapy. Monitoring oral side effects during antineoplastic therapy could prevent severe oral complications and avoid to associate systemic complications(AU)


Los efectos secundarios orales se manifiestan durante el tratamiento del cáncer en los pacientes pediátricos. El monitoreo de los efectos secundarios en la cavidad oral de la terapia antineoplásica es deseable, pero a veces se realiza sin criterios. El propósito de este artículo es describir un monitoreo oral en un niño con linfoma de Hodgkin durante el tratamiento de quimioterapia, empleando una guía de evaluación oral. Un niño de 11 años de edad fue asistido durante todo el tratamiento de quimioterapia contra un linfoma de Hodgkin en el sector odontológico de un hospital de referencia de João Pessoa, Paraíba, Brasil. La guía de evaluación oral fue aplicada por un examinador calibrado. Se observó la aparición de lesiones ulcerosas en la mucosa labial que aparecieron en dos períodos diferentes (D15- primer ciclo; D15-segundo ciclo) y los valores más altos de la mucositis oral se verificaron en períodos D1 e D15 del segundo ciclo de quimioterapia. El seguimiento de los efectos secundarios orales durante la terapia antineoplásica podría prevenir las complicaciones orales graves y evitar complicaciones sistémicas asociadas(AU)


Subject(s)
Humans , Male , Child , Stomatitis/complications , Hodgkin Disease/drug therapy , Mouth Mucosa/injuries
3.
Mem. Inst. Oswaldo Cruz ; 110(2): 166-173, 04/2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-744479

ABSTRACT

Despite recent advances in the treatment of some forms of leishmaniasis, the available drugs are still far from ideal due to inefficacy, parasite resistance, toxicity and cost. The wide-spectrum antimicrobial activity of 2-nitrovinylfuran compounds has been described, as has their activity against Trichomonas vaginalis and other protozoa. Thus, the aim of this study was to test the antileishmanial activities of six 2-nitrovinylfurans in vitro and in a murine model of leishmaniasis. Minimum parasiticide concentration (MPC) and 50% inhibitory concentration (IC50) values for these compounds against the promastigotes of Leishmania amazonensis, Leishmania infantum and Leishmania braziliensis were determined, as were the efficacies of two selected compounds in an experimental model of cutaneous leishmaniasis (CL) caused by L. amazonensis in BALB/c mice. All of the compounds were active against the promastigotes of the three Leishmania species tested. IC50 and MPC values were in the ranges of 0.8-4.7 µM and 1.7-32 µM, respectively. The compounds 2-bromo-5-(2-bromo-2-nitrovinyl)-furan (furvina) and 2-bromo-5-(2-methyl-2-nitrovinyl)-furan (UC245) also reduced lesion growth in vivo at a magnitude comparable to or higher than that achieved by amphotericin B treatment. The results demonstrate the potential of this class of compounds as antileishmanial agents and support the clinical testing of Dermofural(r) (a furvina-containing antifungal ointment) for the treatment of CL.


Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Hodgkin Disease/drug therapy , Hodgkin Disease/pathology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Bleomycin/adverse effects , Bleomycin/therapeutic use , Combined Modality Therapy , Decision Making , Dacarbazine/adverse effects , Dacarbazine/therapeutic use , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Hodgkin Disease/mortality , Neoplasm Staging , Practice Guidelines as Topic , Risk Assessment , Treatment Outcome , Vinblastine/adverse effects , Vinblastine/therapeutic use
4.
Iranian Journal of Cancer Prevention. 2015; 8 (5): 59-66
in English | IMEMR (Eastern Mediterranean) | ID: emr-175782

ABSTRACT

Background: Chemotherapy for lymph nodes cancer is often composed of several drugs that are used in a treatment program


Objectives: The aim of this study was to perform a cost-utility analysis of IEV regimen [ifosfamide, epirubicin and etoposide] versus ESHAP regimen [etoposide, methylprednisolone, high-dose cytarabine, and cisplatin] in patients with lymphoma in the south of Iran


Patients and Methods: This was a cost-utility analysis done as a cross-sectional study in the south of Iran. Using decision tree, expected costs, quality -adjusted life years [QALYs] and the incremental cost-effectiveness ratio [ICER] were estimated. In addition, the robustness of results was examined by sensitivity analysis


Results: The results of this study indicated that the total lymphoma patients were about 65 people that 27 patients received IEV regimen and 38 patients ESHAP [43 patients with Hodgkin's and 22 with non-Hodgkin lymphoma]. The results of decision tree showed that in the IEV arm, the expected cost was dollar 20952.93 and the expected QALYs was 3.89 and in the ESHAP arm, the expected cost was dollar 31691.74 and the expected QALYs was 3.86. Based on the results of the study, IEV regimen was cost-effective alternative to the ESHAP regimen


Conclusions: According to the results of this study, it is recommended that oncologists use IEV instead of ESHAP in the treatment of patients with lymphoma and because of high costs of IEV drug costs, it is suggested that IEV drugs should be covered by insurance


Subject(s)
Humans , Male , Female , Adult , Lymphoma, Non-Hodgkin/drug therapy , Hodgkin Disease/drug therapy , Ifosfamide , Epirubicin , Etoposide , Methylprednisolone , Cytarabine , Cisplatin , Cross-Sectional Studies
5.
Rev. chil. obstet. ginecol ; 79(5): 439-442, oct. 2014. ilus
Article in Spanish | LILACS (Americas) | ID: lil-729409

ABSTRACT

Las neoplasias hematológicas en el embarazo conllevan un gran riesgo para la madre y el feto. El linfoma, Hodgkin (LH) y no Hodgkin (LNH), es la cuarta causa más frecuente de cáncer diagnosticado en el embarazo. El tipo más frecuente es el LH, mientras que la incidencia de LNH es muy baja. Presentamos dos casos de gestantes de 29 y 25 años, diagnosticadas en el segundo trimestre de la gestación de LNH mediastínico de células B y LH tipo esclerosis nodular respectivamente. Ambas fueron tratadas con quimioterapia desde el diagnóstico hasta dos semanas antes del parto, con buen resultado perinatal.


Haematological cancer in pregnancy poses a substantial risk to both, mother and fetus. Lymphoma, including Hodgkin's lymphoma (HL) and Non-Hodgkin's lymphoma (NHL), is the fourth most frequent malignancy diagnosed during pregnancy. The most common type of lymphoma in this setting is HL, and the incidence of pregnancy associated NHL is very low. In this report we describe two cases of a 29-year-old woman and a 25-year-old woman both in the second trimester of pregnancy, diagnosed with mediastinal B-cell NHL and nodular-sclerosis HL respectively. They were managed with chemotherapy since the diagnosis as far as two weeks before the delivery, both with a successful fetal outcome.


Subject(s)
Humans , Adult , Pregnancy Complications, Neoplastic/drug therapy , Hodgkin Disease/complications , Hodgkin Disease/drug therapy , Lymphoma, Non-Hodgkin/complications , Lymphoma, Non-Hodgkin/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use
6.
Rev. Esc. Enferm. USP ; 47(2): 355-361, abr. 2013. tab
Article in Portuguese | LILACS (Americas) | ID: lil-675964

ABSTRACT

Estudo descritivo, transversal desenvolvido com objetivo de associar aspectos socio demográficos e clínicos aos domínios de qualidade de vida relacionada à saúde (QVRS), para avaliar pacientes onco-hematológicos submetidos à quimioterapia. Na coleta de dados utilizou-se um instrumento sociodemográfico e clínico e o European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C-30. A amostra foi constituída de 32 pacientes, sendo oito (25%) com diagnóstico de linfoma de Hodgkin, nove (28,12%) linfoma não Hodgkin e 15 (46,87%) leucemia. Os dados foram analisados pelo software Statistical Package for Social Science (SPSS). O QLQ-C-30 mostrou média das funções física, cognitiva, emocional, social e desempenho de papel de 54,81 a 41,18, demonstrando um nível pouco satisfatório. Nas escalas de sintomas, houve predomínio de fadiga média 64,57 seguida de insônia (56,90) e perda de apetite (50,71). Esses sintomas interferiram nas funções físicas, emocionais e cognitivas demonstrando que efeitos colaterais do tratamento influenciam negativamente na QVRS dos pacientes.


This descriptive and cross-sectional study aimed to examine the socio-demographic/clinical aspects of health-related quality of life (HRQoL) and assess the HRQoL of onco- hematological patients undergoing chemotherapy. The data collection instrument was a socio-demographic/clinical questionnaire, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C-30. The sample consisted of 32 patients, eight of whom (25%) were diagnosed with Hodgkin's lymphoma; nine (28.12%), with non-Hodgkin's lymphoma; and 15 (46.87%), with leukemia. The data were analyzed using SPSS software. For the functional scales of the QLQ-C-30 (physical, cognitive, emotional, social and role performance), the mean scores ranged from 54.81 to 41.18, demonstrating an unsatisfactory level of functioning. In the symptom scales, there was a predominance of fatigue (64.57), insomnia (56.90) and loss of appetite (50.71). These symptoms interfered with the patients' physical functioning, demonstrating that the emotional and cognitive side effects of the treatment negatively influenced the HRQoL of the patients.


Estudio descriptivo, transversal, objetivando asociar aspectos sociodemográficos y clínicos a dominios de calidad de vida relacionada a la salud (QVRS), para evaluar pacientes oncohematológicos sometidos a quimioterapia. Datos recolectados mediante instrumento sociodemográfico-clínico y European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C-30. Muestra de 32 pacientes, ocho de ellos (25%) con diagnóstico de linfoma de Hodgkin, nueve (28,12%) con linfoma no Hodgkin y 15 (46,87%) con leucemia. Los datos se analizaron con software Statistical Package for Social Science (SPSS). El QLQ-C-30 expresó promedio de funciones física, cognitiva, emocional, social y desempeño de papel de 54,81 a 41,18, mostrando nivel poco satisfactorio. En las escalas de síntomas hubo predominio de fatiga promedio 64,57, seguida de insomnio (56,90) y pérdida del apetito (50,71). Tales síntomas interfirieron en las funciones físicas, emocionales y cognitivas, demostrando que los efectos colaterales del tratamiento influyen negativamente en la QVRS del paciente.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Hodgkin Disease/drug therapy , Leukemia/drug therapy , Lymphoma, Non-Hodgkin/drug therapy , Quality of Life , Cross-Sectional Studies
7.
Rev. chil. infectol ; 30(1): 23-30, feb. 2013. graf, tab
Article in Spanish | LILACS (Americas) | ID: lil-665580

ABSTRACT

Introduction: Hodgkin lymphomas (HL) and non Hodgkin lymphomas (NHL) are frequently associated to acquired immunodeficiency syndrome in adults. Objective: To systematize the clinical features and histological characteristics of lymphomas in AIDS patients, its treatment and outcomes in our institution. Patients and Methods: Retrospective analysis of patients with HIV-associated lymphoma between January 2001 and December 2008 at the San Borja Arriarán Hospital complex. Results: Information was obtained from 30 patients with NHL and 7 with HL, with a median of 40 years. The majority of tumors were Burkitt lymphoma (47%), diffuse large cell lymphoma B-cell (37%) and NHL of T lineage (10%). There was no CNS or cavities lymphoma. Almost all patients (86.7%) with NHL were treated with CHOP chemotherapy, 57% of those receiving treatment had progression or relapse from complete remission. A rescue chemotherapy was indicated in 4 patients. 73% of patients receiving CHOP, complete 5 to 6 cycles of chemotherapy. The use of CHOP chemotherapy for the subgroup of patients with Burkitt lymphoma achieved low rates of complete remission and frequent relapse and disease progression, showing that CHOP was ineffective in improving survival, especially in high risk patients. We found statistically significant differences in survival according to IPIae (International prognostic Index age-adjusted). Conclusion: Non-Hodgkin lymphoma in HIV patients treated with chemotherapy protocols PAlNDA persists in our environment as a disease with a poor prognosis compared with findings in the international literature. The incorporation of new drugs of proven utility as rituximab and specific schemes chemotherapy could improve these results. The establishment of prognostic groups established by IPIae can guide clinical work for the use of chemotherapy tailored to their specific risk and optimized according to histological type.


Introducción: Los linfomas de Hodgkin (LH) y no Hodgkin (LNH) se asocian con alta frecuencia al síndrome de inmunodeficiencia humana en adultos. Objetivo: Sistematizar los aspectos clínicos e histológicos de los linfoma que afectan a pacientes con SIDA, su tratamiento y resultados globales en nuestra institución. Pacientes y Métodos: Análisis retrospectivo de pacientes con linfoma asociado a VIH entre enero de 2001 y diciembre de 2008 en el complejo hospitalario San Borja Arriarán. Resultados: Se obtuvo información de 30 pacientes con LNH y 7 LH, con una mediana de 40 años. Los tipos histológicos predominantes fueron linfoma de Burkitt (47 %), linfoma difuso de células grandes de estirpe B (37 %) y LNH de estirpe T (10%). No se diagnosticaron LNH del SNC ni linfoma de cavidades. Casi la totalidad de los pacientes (86,7%) con LNH se trataron con esquema CHOP, 57% de quienes recibieron tratamiento presentaron progresión o recaída desde remisión completa, ofreciéndoles una quimioterapia de rescate a cuatro pacientes. El 73% de los pacientes que recibieron CHOP lograron completar entre cinco y seis ciclos de quimioterapia. El uso de quimioterapia CHOP para el subgrupo de pacientes con linfoma de Burkitt alcanzó bajos porcentajes de remisión completa y mayoritariamente progresó la enfermedad, siendo esta quimioterapia, inefectiva para mejorar la sobrevida, especialmente en los pacientes de riesgo alto. Se encontraron diferencias estadísticamente significativas en sobrevida según el IPIae (índice internacional pronóstico ajustado por edad) al ingreso. Conclusión: El LNH en los pacientes con VIH tratados con los protocolos de quimioterapia PANDA persiste en nuestro medio como una enfermedad de muy mal pronóstico comparado con los resultados en la literatura internacional. La incorporación de nuevos fármacos de demostrada utilidad como rituximab y esquemas específicos de quimioterapia podrían mejorar estos resultados. El establecimiento de grupos pronósticos establecidos por IPIae puede orientar el trabajo clínico para el uso de quimioterapia ajustada a su riesgo específico y optimizado según tipo histológico.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Hodgkin Disease , Lymphoma, AIDS-Related , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chile/epidemiology , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Hodgkin Disease/drug therapy , Hodgkin Disease/mortality , Hodgkin Disease/pathology , Lymphoma, AIDS-Related/drug therapy , Lymphoma, AIDS-Related/mortality , Lymphoma, AIDS-Related/pathology , Neoplasm Staging , Prognosis , Prednisone/therapeutic use , Retrospective Studies , Survival Analysis , Treatment Outcome , Vincristine/therapeutic use
8.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2013; 23 (10): 752-753
in English | IMEMR (Eastern Mediterranean) | ID: emr-140816

ABSTRACT

Hodgkin's lymphoma has been traditionally defined as a hematopoietic neoplasm composed of diagnostic Reed-Sternberg cells. More than 70% of the cases involve cervical or supraclavicular lymph nodes. Isolated sub-diaphragmatic lymphadenopathy or organ involvement is rare. We present the case of Hodgkin's lymphoma in a 51 years old female, who presented with obstructive jaundice and lymphadenopathy, empirically treated previously as a case of tuberculosis. Chemotherapy with modified ABVD protocol was given with dose modification according to LFT's. Her liver functions returned to normal levels after the first cycle. The main purpose of reporting the case is to stress definitive diagnosis of the disease before initiating treatment and the modified chemotherapy regimen used in this infrequent presentation of the disease


Subject(s)
Humans , Female , Hodgkin Disease/drug therapy , Jaundice, Obstructive , Lymphatic Diseases
9.
Rev. méd. Chile ; 140(7): 902-905, jul. 2012. ilus
Article in Spanish | LILACS (Americas) | ID: lil-656362

ABSTRACT

Background: The initial presentation of Hodgkin lymphoma with liver involvement is rare. In these patients, the standard first-line therapy with ABVD (Adriamycin, Bleomycine, Vinblastine, Dacarbazine) imply an additional risk for liver toxicity. We report a 64-year-old woman who presented with jaundice, choluria, malaise and weight loss. In the initial evaluation she had jaundice and palpable groin lymph nodes. An obstructive biliary disease was ruled out with magnetic resonance imaging studies. A lymph node biopsy showed a Hodgkins lymphoma, Mixed-cellularity subtype. Considering the liver dysfunction, an alternative scheme of chemotherapy with dexamethasone, gemcitabine and cisplatin (GDP) was administered. After 4 cycles, a significant improvement in liver hepatic function tests was reached and a conventional chemotherapy (ABVD) was begun. While the literature provides some low toxicity protocols for patients with liver involvement, favorable results of our clinical case report allows us to postulate GDP as an alternative for salvage therapy in these patients.


Subject(s)
Female , Humans , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Hodgkin Disease/drug therapy , Liver Diseases/complications , Cisplatin/administration & dosage , Deoxycytidine/administration & dosage , Deoxycytidine/analogs & derivatives , Dexamethasone/administration & dosage , Salvage Therapy
10.
Rev. bras. mastologia ; 21(4): 178-180, out.-dez. 2011. ilus
Article in Portuguese | LILACS (Americas) | ID: lil-722476

ABSTRACT

O linfoma primário de mama (LPM) é um tumor raro, correspondente a até 0,5% dos cânceres de mama. Apresenta-se o caso de uma paciente do sexo feminino, de 56 anos, que apresentava um nódulo em união dos quadrantes laterais de mama direita, medindo 4,0x3,0 cm, de aparecimento há cerca de dois anos, com aumento progressivo e sem outros sintomas associados. Na axila direita havia sinais clínicos e ultrassonográficos de comprometimento linfonodal. A mamografia identificou três nódulos em mama direita, lobulados e definidos, confirmados à ultrassonografia. O diagnóstico inicial, feito através de punção aspirativa por agulha fina (PAAF) e biópsia por agulha grossa (BAG), foi de um carcinoma ductal invasor de mama. O exame imuno-histoquímico para definição de receptores hormonais, acompanhado de revisão de lâminas, evidenciou um linfoma difuso de grandes células com fenótipo B e CD20 positivo. A paciente foi submetida à quimioterapia com rituximab, vincristina, prednisona e ciclofosmamida (R-CHOP), com resposta clínica completa e, posteriormente, à radioterapia da mama. O tipo mais comum de LPM é o linfoma não Hodgkin difuso de grandes células, que corresponde a aproximadamente 2% de todos os linfomas extranodais. O tratamento do LPM consiste de quimioterapia e radioterapia, estando a cirurgia reservada para casos selecionados.


Subject(s)
Humans , Female , Middle Aged , Hodgkin Disease/drug therapy , Hodgkin Disease/radiotherapy , Breast Neoplasms/drug therapy , Breast Neoplasms/radiotherapy , Biopsy, Fine-Needle , Biopsy, Needle
11.
Einstein (Säo Paulo) ; 9(2)abr.-jun. 2011. tab, ilus
Article in English, Portuguese | LILACS (Americas) | ID: lil-594933

ABSTRACT

The peak frequency of Hodgkin?s disease converges matches with women of reproductive fertility age. Currently, this disease is the fourth more diagnosed neoplasia during pregnancy. In addition, there is no consensus in the literature on how to treat pregnant women because of the risks of chemotherapy for mothers and for fetuses.We report three cases of pregnant women with Hodgkin?' disease. A review of the literature was made aiming to suggest a protocol to treat these patients.


O pico de incidência do linfoma de Hodgkin coincide com a idade fértil feminina, sendo atualmente a quarta neoplasia mais diagnosticada na gravidez. Entretanto, não existe consenso na literatura sobre como tratar essas pacientes, devido aos riscos da quimioterapia tanto para a gestante quando para o feto. Relatamos três casos de gestantes acometidas por linfoma de Hodgkin e realizamos a revisão de literatura com o objetivo sugerir um protocolo de tratamento para essas pacientes.


Subject(s)
Hodgkin Disease/drug therapy , Pregnancy Complications, Neoplastic
12.
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-139153

ABSTRACT

Background. We analysed data on patients of Hodgkin and non-Hodgkin lymphoma treated with high dose chemotherapy followed by autologous stem cell transplantation to determine the toxicity, pattern of infections and long term outcome. Methods. There were 34 male and 10 female patients (median age 35 years, range 15–67 years). Before transplantation, 31 patients (70.5%) had chemosensitive disease and 13 (29.5%) had chemoresistant disease. Granulocyte-colony stimulating factor mobilized peripheral blood stem cells were used as the source of stem cells. The patients received high dose chemotherapy using CBV (cyclophosphamide, BCNU and VP- 16 [etoposide] n=38), BEAM (BCNU, etoposide, cytosine arabinoside and melphalan, n=3), cytosine arabinoside, etoposide and melphalan (n=2) and melphalan alone (n=1). Prophylaxis with antifungal drugs (fluconazole/itraconazole) and acyclovir was used. Results. Following transplant, 32 patients (72.7%) responded; complete response was achieved in 25 patients (56.8%) and partial response in 7 (15.9%). The rate of complete response was higher for patients with pre-transplant chemosensitive disease (23/31 [74.2%] v. 2/13 [15.4%], p<0.001). Gastrointestinal toxicity, and renal and liver dysfunctions were major non-haematological toxicities; 3 patients (7%) died of regimen-related toxicity. Infections (predominantly Gram-negative) accounted for 2 deaths (4.5%) seen before day 30. At a median follow up of 79 months (range 14–168 months), median overall and event-free survival were 78 months and 28 months, respectively. Estimated mean (SE) overall and event-free survival at 60 months were 54.34% (0.07) and 34.3% (9.88), respectively. Conclusion. Patients with pre-transplant chemosensitive disease and those who achieved complete response following transplant had a significantly better chance of survival.


Subject(s)
Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chi-Square Distribution , Female , Hematopoietic Stem Cell Transplantation/adverse effects , Hodgkin Disease/drug therapy , Hodgkin Disease/therapy , Humans , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Prognosis , Survival Rate , Transplantation Conditioning/methods , Transplantation, Autologous , Treatment Outcome
13.
Medical Principles and Practice. 2010; 19 (5): 344-347
in English | IMEMR (Eastern Mediterranean) | ID: emr-105269

ABSTRACT

Our purpose was to investigate the efficacy of and establish a toxicity profile for a modified regimen of dexamethasone, cytarabine and cisplatin [DHAP] for lymphoma outpatients. Fifty-one lymphoma patients, 26 with Hodgkin's disease and 25 with non-Hodgkin's lymphoma, were included. The patients' median age was 32 years [range: 17-61]. Twenty had progressive/refractory disease and 31 relapsed disease. Twenty-five were in clinical stage I/II and 26 in clinical stage III/IV before the initiation of salvage chemotherapy. DHAP consisted of dexamethasone [40 mg i.v. on days 1-4], cytarabine [2 g/m[2] i.v. as 3-hour infusion on days 2 in the evening and 3 in the morning] and cisplatin [35 mg/m[2] as 2-hour infusion on days 1-3] were administered every 21 days. A total of 154 cycles of modified DHAP were administered, with a median of 3 cycles per patient [range: 2-4]. The main toxicity was myelosuppression. WHO grade III-IV neutropenia and grade III-IV thrombocytopenia were observed in 27 [52.9%] and 21 [41%] patients, respectively. The overall response rate [85% for Hodgkin's disease and 95% for non-Hodgkin's lymphoma] was 88.3% [39.2% complete response and 49.1% partial response]. The results showed that this outpatient schedule of DHAP was well tolerated and an effective salvage regimen


Subject(s)
Humans , Male , Female , Hodgkin Disease/drug therapy , Dexamethasone/administration & dosage , Lymphoma, Non-Hodgkin/drug therapy , Cytarabine/administration & dosage , /administration & dosage , Salvage Therapy , Treatment Outcome , Infusions, Intravenous
14.
Indian J Cancer ; 2009 Jul-Sept; 46(3): 237-239
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-144246

ABSTRACT

Occurrence of primary Hodgkin's lymphoma (PHL) of the liver is extremely rare. We report on a case of a 60-year-old male who presented with liver mass and B-symptomatology. Hepatoma or hepatic metastasis from a gastrointestinal primary was initially suspected. Tumor markers like AFP, CEA, Total PSA, and CA-19.9 were within normal limits. Positron Emission Tomography / Computerized Tomography (PET/CT) revealed a large hepatic lesion and a nodal mass in the porta hepatis. A liver biopsy was consistent with Hodgkin's lymphoma. There was complete regression of the hepatic lesion and evidence of shrinkage of the nodal mass following four cycles of chemotherapy. 18F Fluro -de-oxy Glucose (FDG) PET / CT in this case helped in establishing a primary hepatic lymphoma by demonstrating the absence of pathologically hypermetabolic foci in any other nodes or organs. PET / CT scan is a useful adjunct to conventional imaging and histopathology, not only to establish the initial diagnosis, but also to monitor treatment response in PHL.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Fluorodeoxyglucose F18/diagnosis , Hodgkin Disease/drug therapy , Hodgkin Disease/pathology , Humans , Liver Neoplasms/drug therapy , Liver Neoplasms/pathology , Male , Middle Aged , Positron-Emission Tomography , Prognosis , Radiopharmaceuticals/diagnosis , Tomography, X-Ray Computed
15.
J. bras. patol. med. lab ; 45(3): 247-252, jun. 2009. ilus, tab
Article in Portuguese | LILACS (Americas) | ID: lil-523357

ABSTRACT

INTRODUÇÃO: A significância prognóstica do marcador imunológico CD 20 no linfoma de Hodgkin clássico (LHc) ainda é incerta, particularmente no que se refere à refratariedade ao tratamento inicial. OBJETIVOS: Avaliar a influência da positividade do marcador CD 20 na refratariedade do LHc ao tratamento poliquimioterápico inicial, com o esquema doxorubicina 25 mg/m², bleomicina 10 mg/m², vinblastina 6 mg/m² e dacarbazina 375 mg/m² (ABVD), no Ceará, Brasil. MATERIAL E MÉTODOS: Estudo analítico incluindo 97 pacientes com diagnóstico de LHc firmado entre janeiro de 2000 e dezembro de 2004. A análise foi realizada avaliando variáveis demográficas, clínicas e laboratoriais. RESULTADOS: Foi evidenciada uma positividade do CD 20 em 38,1 por cento dos pacientes. Na análise bivariada, CD 20 positivo (razão de chance [RC] = 4,02; intervalo de confiança [IC] = 1,09 - 8,54; p = 0,02), a presença de sintomas B (RC = 4,02; IC = 1,18-17,51; p = 0,01) e a elevação da desidrogenase lática (mediana não-refratários 248,5 [200,5 - 389,5]; mediana refratários 356 [208,5 - 545]; p = 0,03) apresentaram relação de pior prognóstico quanto à refratariedade. Na regressão logística, o CD 20 positivo (RC ajustada = 3,6; IC = 0,99 - 13,09; p = 0,05) e a presença de sintomas B (RC ajustada = 5,41; IC = 1,16 - 25,34; p = 0,03) continuaram apresentando pior prognóstico. DISCUSSÃO: Esses dados coincidem com a literatura, em que a positividade do marcador CD 20 está relacionada com pior resposta ao tratamento com ABVD. CONCLUSÃO: Os nossos dados indicam que o tratamento com ABVD não é completamente adequado para a abordagem terapêutica inicial deste subgrupo de pacientes e novas pesquisas precisam ser realizadas no sentido de aperfeiçoar o tratamento destes pacientes.


INTRODUCTION: The prognostic value of CD20 antigen expression in classical Hodgkin lymphoma (cHL) is uncertain, particularly regarding the refractoriness to first-line treatment. OBJECTIVES: To assess the influence of CD20 positiveness on the refractoriness of cHL to first-line chemotherapy with ABVD protocol in Ceará State, Brazil. MATERIAL AND METHODS: Analytical study including 97 patients diagnosed with cHL between January/2000 and December/2004. The analysis was performed evaluating demographic, clinical and laboratory variables. RESULTS: CD20 antigen expression was positive in 38.1 percent of the patients. In the bivariate analysis, CD20 antigen expression (OR = 4.02; CI = 1.09 - 8.54; p = 0.02), the presence of B-symptoms (OR = 4.02; CI = 1.18-17.51; p = 0.01) and an elevated lactate dehydrogenase level (median not refractory 248.5 [200.5 - 389.5]; median refractory 356 [208.5-545]; p = 0.03) showed worse prognosis as to refractoriness. In the logistic regression analysis, the presence of CD 20 (OR = 3.6; CI = 0.99-13.09; p = 0.05) and B-symptoms (OR = 5.41; CI = 1.16-25.34; p = 0.03) continued to show worse prognosis. DISCUSSION: These findings coincide with literature data indicating that CD 20 antigen expression is associated with low response to treatment with ABVD. CONCLUSION: Our data show that the treatment with ABVD is not totally appropriate for the initial therapeutic approach in this subgroup of patients and that further studies are required to optimize their treatment.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Hodgkin Disease/diagnosis , Hodgkin Disease/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bleomycin/administration & dosage , Dacarbazine/administration & dosage , Doxorubicin/administration & dosage , Biomarkers, Tumor , Prognosis , Prospective Studies , Retrospective Studies , Vinblastine/administration & dosage
16.
J. pediatr. (Rio J.) ; 85(3): 236-242, maio-jun. 2009. graf, tab
Article in English, Portuguese | LILACS (Americas) | ID: lil-517871

ABSTRACT

OBJETIVO: Determinar se o número de áreas anatômicas envolvidas pode modificar os grupos de risco padrão no linfoma de Hodgkin pediátrico, identificando as crianças que poderiam se beneficiar de uma redução da intensidade do tratamento. MÉTODOS: Estudo retrospectivo com avaliação de idade, sexo, histologia, classificação de Ann-Arbor, presença de sintomas B, número de áreas anatômicas envolvidas, grupos de risco (favorável versus desfavorável) e exames laboratoriais. Todos os pacientes receberam quimioterapia com doxorrubicina. Os pacientes em remissão completa por 5 anos ou mais foram avaliados para a detecção de efeitos tardios. RESULTADOS: Sessenta e nove pacientes (2-18 anos) foram incluídos, sendo que 68 por cento pertenciam ao grupo de risco desfavorável. A sobrevida global e a sobrevida livre de eventos foram de 94 e 87 por cento, respectivamente. Os efeitos tardios foram detectados em 46 casos. Estágio avançado e > quatro áreas anatômicas envolvidas tiveram impacto negativo sobre a sobrevida livre de eventos, enquanto que o número de áreas anatômicas envolvidas apresentou significância estatística de acordo com a análise de Cox (razão de risco = 6,4; IC95 por cento = 1,08-38,33; p = 0,04). Os grupos de risco foram ajustados por número de áreas anatômicas envolvidas (< quatro/> quatro áreas anatômicas envolvidas), com uma significativa realocação de pacientes (p = 0,008). Dos 30 pacientes com efeitos tardios, 21 estavam no grupo de risco desfavorável original, e 14 poderiam ter sido realocados para o grupo de risco favorável com base no número de áreas anatômicas envolvidas. CONCLUSÃO: Se uma reestratificação tivesse sido aplicada, um número considerável de crianças teria recebido tratamento de menor intensidade e, consequentemente, poderia ter tido menores chances de apresentar efeitos tardios. Um estudo prospectivo poderia definir se o ajuste de grupos de risco pelo número de áreas anatômicas envolvidas teria algum impacto sobre ...


OBJECTIVE: To determine if the number of involved anatomic areas can modify the standard risk groups in pediatric Hodgkin's lymphoma, identifying children who would benefit from a reduction in treatment intensity. METHODS: Retrospective study evaluating age, sex, histology, Ann-Arbor stage, presence of B symptoms, number of involved anatomic areas, risk grouping (favorable vs. unfavorable), and laboratory exams. All patients received doxorubicin-containing chemotherapy. Patients in complete remission for 5 years or longer were evaluated as for late effects. RESULTS: Sixty-nine patients (2-18 years) were included, 68 percent belonged to the unfavorable risk group. Overall survival and event-free survival were 94 and 87 percent, respectively. Late effects were screened in 46 cases. Advanced stage and > four involved anatomic areas had negative impact on event-free survival, while only the number of involved anatomic areas retained statistical significance when using Cox analysis (hazard ratio = 6.4, 95 percentCI = 1.08-38.33; p = 0.04). Risk groups were adjusted by number of involved anatomic areas (< four/> four involved anatomic areas), with a significant reallocation of patients (p = 0.008). Of the 30 patients with late effects, 21 were in the original unfavorable risk group and 14 (66.6 percent) could have been reallocated to the favorable risk group based on the number of involved anatomic areas. CONCLUSION: If re-stratification had been applied, a considerable number of children would have received less intensive treatment and, consequently, could have had lower chances of late effects. A prospective study could define if adjustment of risk group by number of involved anatomic areas would have any impact on survival rates.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Antibiotics, Antineoplastic/adverse effects , Endocrine System Diseases/prevention & control , Heart Diseases/prevention & control , Hodgkin Disease/drug therapy , Hodgkin Disease/pathology , Age Factors , Antibiotics, Antineoplastic/therapeutic use , Doxorubicin/adverse effects , Doxorubicin/therapeutic use , Epidemiologic Methods , Endocrine System Diseases/chemically induced , Heart Diseases/chemically induced , Prognosis , Risk Factors , Sex Factors , Treatment Outcome
17.
Article in Portuguese | LILACS (Americas), BDENF | ID: lil-489734

ABSTRACT

The high occurrence rates of Hodgkin's Lymphomas and the treatment-associated complications as well as the complication of the disease itself evidence the need for a technical-scientific training of nurses in order to provide health care to this population. In this sense, this study had the aim to identify the nursing care described in the literature for these patients subject to chemotherapy treatment. An integrative review of the 15 eligible articles was carried out. Findings show that the generated knowledge is aimed at the epidemiological aspects of the disease, therapeutic forms, besides nursing interventions. Regarding the latter, the teaching process, use of coping and technical-technological procedures were found appropriate and feasible.


As altas taxas de ocorrência de Linfoma de Hodgkin (LH) e as complicações relacionadas ao tratamento e à própria doença evidenciam a necessidade de que os enfermeiros tenham capacitação técnico-científica para prestar assistência a essa clientela. Neste sentido, buscou-se identificar os cuidados de enfermagem arrolados na literatura a esses pacientes submetidos a tratamento quimioterápico. Foi realizada revisão integrativa dos 15 artigos elegíveis. Os achados mostram que o conhecimento produzido está voltado para os aspectos epidemiológicos da doença, modalidades terapêuticas, além das intervenções de enfermagem. Destas, o ensino, o uso de coping e de procedimentos técnico-tecnológicos mostraram-se adequados e viáveis.


Las altas tasas de ocurrencia de los Linfomas de Hodgkin (LH) y las complicaciones relacionadas al tratamiento y a la propia enfermedad evidencian la necesidad de que los enfermeros tengan una capacitación técnico-científica para prestar asistencia a esa clientela. En este sentido, el estudio buscó identificar los cuidados de enfermería relacionados en la bibliografia a estos pacientes sujetos a tratamiento quimioterápico. Una revisión integrativa de los 15 artículos elegibles fue realizada. Hallazgos muestran que el conocimiento producido está direccionado para los aspectos epidemiológicos de la enfermedad, modalidades terapéuticas, y para las intervenciones de enfermería. De los últimos, la enseñanza, el uso de coping y de procedimientos técnico-tecnológicos se mostraron adecuados y viables.


Subject(s)
Humans , Nursing Care , Hodgkin Disease/drug therapy , Antineoplastic Combined Chemotherapy Protocols , Hodgkin Disease
18.
Acta Med Indones ; 2007 Oct-Dec; 39(4): 153-6
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-47182

ABSTRACT

AIM: autophagy is a pivotal physiological process for survival during starvation, differentiation and normal growth control. It is defined as the process of sequestrating cytoplasmic proteins or even entire organelles into the lytic compartment (lysosome/vacuole). This study investigates the expression of autophagy in Hodgkin lymphoma cells treated with various anti-cancer drugs. METHODS: Hodgkin's lymphoma cells (HD-My-Z cells) were cultured with various anti-cancer drugs, such as bleomycin, adriamycin, gemcitabine and paclitaxel. Autophagy was detected by fluorescent pattern of light chain 3(LC3) proteins and the apoptotic cell death was determined by annexin V binding. RESULTS: autophagy was detected in HD-My-Z cells treated with gemcitabine, but not with bleomycin, adriamycin and paclitaxel. Adriamycin exhibited the strongest cytotoxic action, and the cytotoxic action of bleomycin and gemcitabine was less marked compared with adriamycin. Paclitaxel did not cause significant cell death in the cells. CONCLUSION: autophagy was differentially expressed in Hodgkin lymphoma cells treated with anti-cancer drugs and the expression did not correspond to the apoptotic cell death.


Subject(s)
Annexin A5 , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Apoptosis/drug effects , Autophagy/drug effects , Bleomycin/administration & dosage , Cell Culture Techniques , Cell Survival , Cytotoxins/therapeutic use , Deoxycytidine/administration & dosage , Doxorubicin/administration & dosage , Hodgkin Disease/drug therapy , Humans , Paclitaxel/administration & dosage , Pilot Projects
20.
Rev. chil. infectol ; 24(2): 117-124, abr. 2007. graf, tab
Article in Spanish | LILACS (Americas) | ID: lil-471961

ABSTRACT

The association of HIV infection and lymphoma in patients attending at the South Health Metropolitan Reference Centre is presented. Objective: to analyse its incidence, clinical and pathologic manifestations, treatment and outcome. Period of study: January 1990 to December 2002. Results: 14 cases were detected, 10 non Hodgkin lymphoma patients (7 with high malignancy and 50 percent in stages III-IVB) and 4 with Hodgkin lymphoma (3 with mixed cellularity, 2 in stage IVB). The annual incidence was 0.68 percent. Ten patients were classified under stage C3 of AIDS CDC criteria, the mean CD4 count was 139 cells/mm³ and mean CV was 5,32 log. Eighty six percent of patients presented with unique or multiples lymphonodes, with predominance of advanced lymphoma stage. Conventional CHOP chemotherapy was the treatment for high risk and extended non Hodgkin lymphomas and for extended Hodgkin lymphomas the ABVD protocol was administered. Six patients received antiretroviral therapy, 4 simultaneously with chemotherapy. Global mortality in this series was 71 percent, attributable to tumor disease per se or to sepsis. Four patients survived (18 to 50 months) in complete remission, 2 non Hodgkin lymphomas and 2 Hodgkin lymphomas. The low incidence of lymphoma and AIDS association and the high frequency of lymphomas with localized or generalized lymphonodes in this series are remarkable.


Se revisó la asociación de linfoma e infección por VIH en un complejo hospitalario de la Región Metropolitana Sur de Santiago de Chile, su incidencia, características clínicas y patológicas, terapia y evolución en 14 casos. La incidencia acumulada (enero 1990 y diciembre 2002) fue de 0,68 por ciento. Diez pacientes tenían linfoma no Hodgkin (siete de alto grado de malignidad y 50 por ciento en estadios III-IVB) y cuatro Hodgkin (tres con celularidad mixta, dos en estadio IVB). Diez pacientes con linfoma estaban en etapa C3 de SIDA según criterios del CDC, con un promedio de CD4 de 139 células/mm³ y carga viral de 212.600 copias de ARN/ml. Ochenta y seis por ciento tenía afección ganglionar, localizada o generalizada. El tratamiento de los linfomas no Hodgkin de alto grado y extendidos fue con quimioterapia CHOP convencional, y en los linfomas de Hodgkin avanzados se aplicó el esquema ABVD. Seis pacientes recibieron tratamiento antiretroviral, cuatro simultáneamente con quimioterapia. La mortalidad global fue de 71 por ciento, por progresión tumoral y/o sepsis. Cuatro pacientes sobreviven (18 a 50 meses) en remisión completa, dos linfomas no Hodgkin y dos Hodgkin. Se discuten la baja incidencia de la asociación linfoma y SIDA y la mayor frecuencia de linfomas con adenopatías localizadas o generalizadas.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Lymphoma, AIDS-Related , Lymphoma, Non-Hodgkin , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chile/epidemiology , Hodgkin Disease/diagnosis , Hodgkin Disease/drug therapy , Hodgkin Disease/epidemiology , Incidence , Lymphoma, AIDS-Related/diagnosis , Lymphoma, AIDS-Related/drug therapy , Lymphoma, AIDS-Related/epidemiology , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/epidemiology , Neoplasm Staging , Retrospective Studies , Survival Analysis , Viral Load
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