Résumé
Background: Hodgkin lymphoma is a highly curable disease. Aim: To evaluate the clinical characteristics and the treatment results of Hodgkin lymphoma patients of the National Cancer Program in Chile. Patients and methods: Prospective assessment of 682 patients treated in 18 adult cancer centers. Progression free survival (PFS) and overall survival (OS) were calculated. Median follow up was 127, 95, 87, 72 and 50 months for C-MOPP, radiotherapy (RT), C-MOPP/ABV, NOVP and ABVD, respectively. Results: Median age was 37 years (15-84). Nodular sclerosis and mixed cellularity were equally expressed. Advanced stages (III & IV) were present at diagnosis in 61 percent of cases. Age over 40 was an adverse prognostic factor (p <0.001). The rate of PFS at 5 and 10 years for early stages was 73 percent and 66 percent with RT, 80 percent and 74 percent with C-MOPP+RT, 73 percent and 71 percent with C-MOPP/ABV, 59 percent and 59 percent with NOVP+RT, and 81 percent with ABVD+RT, at 5 years, being significantly lower for NOVP (p =0.02). The rate of OS at 5 and 10 years for advanced stages was 82 percent and 70 percent with RT, 82 percent and 76 percent with C-MOPP+RT, 82 percent and 80 percent with C-MOPP/ABV, 68 percent and 60 percent with NOVP, and 85 percent with ABVD at 5 years, also significantly lower for NOVP (p =0.04). For advanced stages, the rate of PFS at 5 and 10 years was 49 percent and 43 percent with C-MOPP, 69 percent and 62 percent with C-MOPP/ABVD or C-MOPP/ABV, and 71 percent at 5 years with ABVD, significantly lower for C-MOPP (p =0.01). The rate of OS at 5 and 10 years was 52 percent and 46 percent with C-MOPP, 70 percent and 63 percent with C-MOPP/ABVD or C-MOPP/ABV and 76 percent with ABVD at 5 years, significantly lower for C-MOPP (p =0.0002). Conclusions: Age over 40 years was an adverse prognostic factor. C-MOPP/ABVD, C-MOPP/ABV and ABVD had comparable results and reached a high tumor control and overall survival in both early...
Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Mâle , Adulte d'âge moyen , Protocoles de polychimiothérapie antinéoplasique/usage thérapeutique , Maladie de Hodgkin/traitement médicamenteux , Programmes nationaux de santé , Protocoles de polychimiothérapie antinéoplasique/administration et posologie , Bléomycine/administration et posologie , Loi du khi-deux , Chili , Cyclophosphamide/administration et posologie , Dacarbazine/administration et posologie , Survie sans rechute , Doxorubicine/administration et posologie , Études de suivi , Maladie de Hodgkin/radiothérapie , Mitoxantrone/administration et posologie , Prednisolone/administration et posologie , Prednisone/administration et posologie , Procarbazine/administration et posologie , Études prospectives , Résultat thérapeutique , Vinblastine/administration et posologie , Vincristine/administration et posologieRésumé
Severe aplastic anemia has an elevated mortality if treatment is unsatisfactory. Immunosuppression is the treatment of choice in adults, comparable with allogeneic bone marrow transplant in children. We report two adult patients (both males, aged 59 and 67 years old) who were treated successfully with lymphoglobulin and cyclosporine. The initial response started within 3 months of treatment and was almost complete after 2 years, when cyclosporine was stopped. After three years, both patients have almost normal blood counts, with minor sequels: avascular necrosis of both femoral heads due to the use steroids, that recovered spontaneously in 1 patient and reduced vision due to thrombocytopenic retinal hemorrhages, in the other (Rev Méd Chile 2003; 131: 1439-43).