1/51. Endogenous thrombopoietin serum levels during multicycle chemotherapy.Little is known about the behaviour of endogenous thrombopoietin (TPO) serum levels during rapid sequences of dose-intensified chemotherapy. To characterize the relationship between TPO levels and platelet counts in this setting we serially measured both parameters over the entire treatment period of patients receiving multicycle polychemotherapy. We found TPO and platelet responses to be generally antagonistic through all cycles. However, a cross-correlation analysis indicated that TPO responses preceded platelet responses by approximately one day in all patients. The cumulative severity of thrombocytopenia observed over successive cycles was accompanied by an increasing TPO response which tended to grow overproportionally in relation to the degree of peripheral thrombocytopenia. These findings are consistent with a model suggesting that both platelet and megakaryocyte mass contribute to a receptor-dependent consumption process regulating the endogenous TPO level. In order to develop optimal schedules for exogenous TPO administration it might be important to consider endogenous TPO response characteristics.- - - - - - - - - - ranking = 1keywords = cycle (Clic here for more details about this article) |
2/51. Third malignancy after treatment of Hodgkin's disease.We present a case of 36-year-old man who was treated for IIB supradiaphragmatic lymphocyte-predominant Hodgkin's disease in 1972 (at the age of 11). The patient remained relapse-free after combined radiotherapy (irradiation of the right supraclavicular field) and chemotherapy (six MOPP cycles) and a 3-year supporting chemotherapy (Velbe). In 1993 he underwent spinal cord surgery for a right-sided "hour glass" schwannoma at C4-5 level. In 1996 a large formation histologically verified as "chondrosarcoma" occurred in the right supraclavicular and axillary regions. The pathogenesis of the second and third malignancies may be attributed to the histologic pattern of HD with long-term survival and increased cumulative risk, non-alternating MOPP courses and continued supporting therapy and radiotherapy given to the involved fields.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
3/51. Resolution of Ga-67 citrate uptake in the left neck mass of Hodgkin's disease and reversion of double scoliosis of cervical-thoracic and lower lumbar vertebrae.A 6-yr-old boy underwent a total body Ga-67 citrate imaging study because of a large mass of Hodgkin's lymphoma in the left neck and the left anterior chest wall region. The images showed intense uptake in the left neck extending anteroinferiorly to the left upper chest wall corresponding to the left neck and chest region. In addition, there was mild cervical-upper thoracic scoliosis with convexity to the right and mild scoliosis of the lower lumbar scoliosis with concavity to the left. After three cycles of chemotherapy, in the follow-up Ga-67 citrate total body images seven months after his first Ga-67 citrate imaging, the intense uptake in the left neck and the left upper chest wall had been resolved and the scoliosis of the cervical-thoracic and lower lumbar spine had also been reversed to normal. This case shows that a Ga-67 citrate imaging study is useful for first diagnosis and subsequent monitoring of the therapeutic effects in a follow-up imaging. Also Ga-67 citrate imaging provided evidence that the scoliosis had been reversed.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
4/51. achievement of complete remission in refractory Hodgkin's disease with prolonged infusion of gemcitabine.Although, in recent decades effective chemotherapy regimens have been developed for the treatment of Hodgkin's disease, the prognosis of patients who experience disease progression is still very poor. New treatment approaches are urgently required to salvage such patients. In a patient with Hodgkin's disease who failed to achieve complete remission with the escalated BEACOPP protocol, progression with bone marrow infiltration and B symptoms developed despite further treatment. Subsequently, gemcitabine was administered in a novel schedule as a four-hour infusion of 250 mg/m2 on days 1, 8, and 15, every four weeks. After the first cycle, the dose was reduced to 200 mg/m2 because of grade 3 neutropenia. The condition of the patient improved after the second cycle and no toxicity was observed during cycles 3-6. Complete remission was achieved. Two years after the end of gemcitabine therapy, the patient is in good clinical condition and in continuous complete remission without further treatment. This is the first report of the prolonged infusion of gemcitabine as a salvage therapy in Hodgkin's disease.- - - - - - - - - - ranking = 0.42857142857143keywords = cycle (Clic here for more details about this article) |
5/51. Transformation of Hodgkin's disease to high-grade B-cell lymphoma: remission after Rituximab monotherapy.PURPOSE: We demonstrate the usefulness of immunotherapy with the CD20 antibody Rituximab in a case of transformation of Hodgkin's disease (HD) to high-grade non-Hodgkin's lymphoma (NHL). CASE REPORT: A 45-year-old women suffering from lymphocyte predominant HD of paragranuloma type (stage IVb) since 1995 showed mediastinal relapse despite of 6 cycles of chemotherapy following the COPP/ABVD-protocol in 1998. Again complete remission could be achieved after escalated BEA-COPP II therapy in May 1998. Six months later chest radiograph and CT depicted pulmonary nodules. The non-typical resection of the lung revealed pulmonary involvement of a high-grade T-cell rich large B-cell lymphoma with 100% of the tumoral cells CD20 positive. Since the symptoms occurred shortly after the BEA-COPP-escalated protocol chemotherapy resistance had to be assumed. Because of this problems and supported by the refusal of a high-dose chemotherapy with stem-cell transplantation by the patient we decided to perform a mono-immunotherapy with the monoclonal CD20 antibody Rituximab. Today, 14 months later, the patient is still in complete remission including the absence of B symptoms. CONCLUSIONS: immunotherapy against CD20 positive cells in cases of sequential HD and NHL seems to be an effective therapy in chemotherapy resistant cases because of the suspected clonally relation of both diseases.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
6/51. Unusual case presentation of lichen simplex chronicus, Hodgkin's lymphoma, and nonpuerperal hyperprolactinemia-galactorrhea.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.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
7/51. Early recognition of hereditary motor and sensory neuropathy type 1 can avoid life-threatening vincristine neurotoxicity.Hereditary motor and sensory neuropathy type 1 (HMSN-1) is an autosomal dominant disorder, which is usually not associated with neoplastic diseases. The disease predisposes to severe vincristine neurotoxicity. We report a 31-year-old women with recurrent Hodgkin's lymphoma and unrecognized HMSN-1 who developed severe motor neuropathy 3 weeks after the first cycle of treatment including 2 mg of vincristine. HMSN is diagnosed in most cases retrospectively, usually suggested by the observation of foot abnormalities or family history. Recognizing early signs of HMSN, such as areflexia and pes cavus deformity, can prevent severe neurotoxicity of polychemotherapy by avoiding vincristine.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
8/51. Lymphographic demonstration of cyclic changes in lymph node size during Pel-Epstein fever.Pel-Epstein fever cycles, consisting of 1-2 weeks of high fever separated by afebrile periods of the same duration, are classically characteristic of Hodgkin's disease. Clinical observation has determined that the lymph nodes enlarge during periods of fever and reduce in size as the fever subsides. To our knowledge, the waxing and waning of lymph nodes in tempo with the fever cycle in Hodgkin's disease have never before been documented by lymphography. The alterations we verified radiographically resemble cyclic swings in classic autoimmune diseases. Speculations are offered regarding the observed changes.- - - - - - - - - - ranking = 0.28571428571429keywords = cycle (Clic here for more details about this article) |
9/51. Successful salvage therapy of irinotecan for relapsed Hodgkin's lymphoma.A 30-year-old man, who had a repeated history of relapsed Hodgkin's lymphoma over 7 years, developed bilateral pleural effusion and chest wall involvement. He was treated with weekly irinotecan hydrochloride (CPT-11; 80 mg/m2/week). Partial response was observed after two cycles of irinotecan. neutropenia and diarrhea were tolerable. This case demonstrated that irinotecan has a therapeutic effect in patients with relapsed Hodgkin's lymphoma.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
10/51. Hodgkin s disease with nephrotic syndrome as a complication of ulcerative colitis: case report.We describe a case of a 32-year-old patient with ulcerative colitis complicated by Hodgkin s disease who presented with nephrotic syndrome. The patient had suffered from relapsing ulcerative colitis for 6 years before he developed Hodgkin s lymphoma. He was treated for Hodgkin s disease with 9 cycles of combined chemotherapy (COPP/ABV) and achieved the stabile remission of lymphoma, nephrotic syndrome, and ulcerative colitis. To the best of our knowledge, this is the first report on ulcerative colitis associated with Hodgkin s disease and nephrotic syndrome.- - - - - - - - - - ranking = 0.14285714285714keywords = cycle (Clic here for more details about this article) |
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