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  1. Hodgkin lymphoma

    MedlinePlus

    Lymphoma - Hodgkin; Hodgkin disease; Cancer - Hodgkin lymphoma ... of Hodgkin lymphoma (there are different forms of Hodgkin lymphoma) The stage (where the disease has spread) Whether the tumor is more than ...

  2. Hodgkin's Lymphoma

    MedlinePlus

    Hodgkin's lymphoma (Hodgkin's disease) Overview By Mayo Clinic Staff Hodgkin's lymphoma — formerly known as Hodgkin's disease — is a cancer ... is part of your immune system. In Hodgkin's lymphoma, cells in the lymphatic system grow abnormally and ...

  3. Hodgkin's Lymphoma

    MedlinePlus

    ... as Hodgkin's disease — is a cancer of the lymphatic system, which is part of your immune system. In Hodgkin's lymphoma, cells in the lymphatic system grow abnormally and may spread beyond the lymphatic ...

  4. Hodgkin's disease

    SciTech Connect

    Portlock, C.S.

    1984-05-01

    The outlook for patients with Hodgkin's disease has improved dramatically over the past 20 years. The question is no longer whether cure is possible, but rather, how can cure be best achieved. With better understanding of the biology of Hodgkin's disease and with continued evolution of treatment approaches, the goal of curing all patients with Hodgkin's disease is clearly within reach. This article provides a summary of current concepts in the biology and management of Hodgkin's disease. Staging, treatment options, and complications of therapy are discussed.

  5. Hodgkin lymphoma

    PubMed Central

    Küppers, Ralf; Engert, Andreas; Hansmann, Martin-Leo

    2012-01-01

    Hodgkin lymphoma (HL), a B cell–derived cancer, is one of the most common lymphomas. In HL, the tumor cells — Hodgkin and Reed-Sternberg (HRS) cells — are usually very rare in the tissue. Although HRS cells are derived from mature B cells, they have largely lost their B cell phenotype and show a very unusual co-expression of markers of various hematopoietic cell types. HRS cells show deregulated activation of multiple signaling pathways and transcription factors. The activation of these pathways and factors is partly mediated through interactions of HRS cells with various other types of cells in the microenvironment, but also through genetic lesions. The transforming events involved in the pathogenesis of HL are only partly understood, but mutations affecting the NF-κB and JAK/STAT pathways are frequent. The dependency of HRS cells on microenvironmental interactions and deregulated signaling pathways may offer novel strategies for targeted therapies. PMID:23023715

  6. Treating Nodular Lymphocyte Predominant Hodgkin Disease (NLPHD)

    MedlinePlus

    ... Lymphoma Treating Hodgkin Lymphoma Treating Nodular Lymphocytic Predominant Hodgkin Lymphoma (NLPHL) Because this rare type of Hodgkin ... Children Treating Hodgkin Lymphoma in Pregnancy More In Hodgkin Lymphoma About Hodgkin Lymphoma Causes, Risk Factors, and ...

  7. Jonathan Hodgkin.

    PubMed

    Hodgkin, Jonathan

    2004-04-06

    Jonathan Hodgkin graduated from Oxford in 1971 and then did a PhD with Sydney Brenner at MRC LMB in Cambridge, studying behavioural genetics in the nematode Caenorhabditis elegans. Later, after a couple of years working with myxobacteria as a postdoc in Dale Kaiser's lab at Stanford, he returned to LMB as a staff member, where he remained for most of the subsequent two decades. In the year 2000, he moved to Oxford as Professor of Genetics in the Department of Biochemistry, switching his major research interests from developmental genetics and sex determination to the study of host-pathogen interactions in the worm. For the past ten years, he has acted as curator of the C. elegans genetic map and gene nomenclature, and he is currently President of the Genetics Society of Great Britain.

  8. Non-Hodgkin lymphoma

    MedlinePlus

    ... January 26, 2015. cancer.gov/cancertopics/pdq/treatment/child-non-hodgkins/HealthProfessional . Accessed March 17, 2016. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: non-Hodgkin lymphomas. Version 2.2016. www.nccn. ...

  9. Hodgkin Lymphoma (For Kids)

    MedlinePlus

    ... Dictionary of Medical Words En Español What Other Kids Are Reading Taking Care of Your Ears Taking ... Getting an X-ray Hodgkin Lymphoma KidsHealth > For Kids > Hodgkin Lymphoma Print A A A What's in ...

  10. What Happens After Treatment for Hodgkin Disease?

    MedlinePlus

    ... material. For reprint requests, please see our Content Usage Policy . After Treatment Living As a Hodgkin Lymphoma Survivor Second Cancers After Hodgkin Lymphoma Late and Long-term Side Effects of Hodgkin Lymphoma Treatment More In Hodgkin Lymphoma ...

  11. Non-Hodgkin's Lymphoma

    MedlinePlus

    ... Hodgkin lymphoma, is cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body. ... can also spread to other parts of your lymphatic system. These include the lymphatic vessels, tonsils, adenoids, spleen, ...

  12. Non-Hodgkin Lymphoma

    MedlinePlus

    ... Lymphoma? A lymphoma is a cancer of the lymphatic system , which is a part of the body's immune ... non-Hodgkin lymphoma, cancer cells form in the lymphatic system and start to grow. Most of the time, ...

  13. What Are the Key Statistics for Hodgkin Disease?

    MedlinePlus

    ... Hodgkin Lymphoma What Are the Key Statistics About Hodgkin Lymphoma? The American Cancer Society’s estimates for Hodgkin ... in Hodgkin Lymphoma Research and Treatment? More In Hodgkin Lymphoma About Hodgkin Lymphoma Causes, Risk Factors, and ...

  14. Dorothy Crowfoot Hodgkin

    NASA Astrophysics Data System (ADS)

    Montalvo, Jessica

    2009-10-01

    Born in 1910 in Cairo, Egypt, Dorothy Crowfoot Hodgkin would later be known as the third woman in history to win the Nobel Prize in Chemistry for her research on the structure of vitamin B-12. Her X-ray crystallography work also included discovering the molecular structure of penicillin and insulin. Dr. Hodgkin's work has aided in determining the structures of molecules for others to expand the technology necessary for today's medicine.

  15. Association of HHV-6 with Hodgkin and non Hodgkin lymphoma.

    PubMed

    Kiani, Hadis; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Teimoori, Ali; Nisi, Niloofar; Mehravaran, Hamide; Radmehr, Hashem; Hosseini, Zeinab; Haghi, Azadeh; Shahani, Toran; Varnaseri, Mehran; Ranjbari, Nastran

    2016-04-01

    Human Herpes 6 virus (HHV-6) could remain latent and chronic in the host cells after primary infection. HHV-6 genome encodes certain transactivation proteins which may results in development of malignant lymphoma. The association of human herpes six virus (HHV-6) infection and Hodgkin and Non-Hodgkin lymphomas is strongly supported by epidemiological studies. The aim of this study was to determine the prevalence of HHV-6 among the patients with Hodgkin, Non-Hodgkin's lymphoma. Overall 44 blocks of formalin-fixed, paraffin-embedded of the patients including 22(50%) Hodgkin and 22(50%) Non-Hodgkin Lymphoma were collected. Initially the section of 5μm-thickness were prepared from the formalin-fixed, paraffin-embedded tissue blocks. Then the deparaphinazation was carried out for each sample. The DNA was extracted, followed by nested PCR for detection of HHV-6. Based on PCR product size and sequencing, the HHV-6 A or B subtypes were characterized. 12/22(54.54%) cases of Hodgkin and 8/22 (36.36%) Non-Hodgkin's lymphoma were shown as positive for HHV-6. Out of 12 positive HHV-6 in Hodgkin lymphoma, 10 patients (45.45%) belonged to variant A while 2 cases (9.09%) were found positive for both HHV-6A and HHV-6B. All the Non Hodgkin samples (n=8, 36.36%) showed positive for HHV-6 variant A. High prevalence of HHV-6 was found among the patients with Hodgkin and Non-Hodgkin's lymphoma. Two patients with Hodgkin lymphoma had mixed HHV-6A and HHV-6B infections. It is recommended patients with Hodgkin and Non-Hodgkin should be screened for HHV-6 detection before chemotherapy.

  16. [Hodgkin's lymphoma and radiotherapy].

    PubMed

    Datsenko, P V; Panshin, G A

    2015-01-01

    After a median observation time of 4,5 years, 440 patients with Hodgkin's lymphoma stage I-IV to the Ann Arbor classification were treated with radiotherapy (2200 lymph areas) and ABVD (n=204) or BEACOPP (n=117) or CEA/ABVD (lomustine, etoposide, adriamycine, bleomycine, vinblastine and dacarbacine; n=119) regimens in 1995-2012. Correct allocation of groups with "CR or PR ≥80%" and "PR: 0-79%", after first-line chemotherapy, is extremely important for following RT planning. Adaptation of patients with Hodgkin's lymphoma can take place only after successful treatment, the probability of relapse and fear of repeated courses strongly interfere with this process, especially in the first years after its closure. Duration of remission period, especially in young people, is no less important than the criteria for overall survival. It is impossible to build recommendations for treatment for Hodgkin's lymphoma, based only on long-term survival rates. Importance of radiotherapy in reducing the number of relapses is undeniable, so the idea that the development of the role of chemotherapy in the treatment of the ray method Hodgkin's lymphoma gradually becomes secondary is in serious doubt. Our findings suggest the importance of both maintaining a high disease-free survival and reducing long-term complications in designing treatments of Hodgkin's lymphoma.

  17. Vorinostat in Treating Patients With Relapsed or Refractory Advanced Hodgkin's Lymphoma

    ClinicalTrials.gov

    2014-05-07

    Adult Favorable Prognosis Hodgkin Lymphoma; Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Adult Unfavorable Prognosis Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma

  18. What Are the Key Statistics about Non-Hodgkin Lymphoma?

    MedlinePlus

    ... Lymphoma What Are the Key Statistics About Non-Hodgkin Lymphoma? Non-Hodgkin lymphoma (NHL) is one of ... Hodgkin Lymphoma Research and Treatment? More In Non-Hodgkin Lymphoma About Non-Hodgkin Lymphoma Causes, Risk Factors, ...

  19. SGN-30 and Combination Chemotherapy in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma

    ClinicalTrials.gov

    2015-02-10

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma

  20. Nivolumab and Brentuximab Vedotin in Treating Older Patients With Untreated Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-04-05

    Classical Hodgkin Lymphoma; Stage IB Hodgkin Lymphoma; Stage II Hodgkin Lymphoma; Stage IIA Hodgkin Lymphoma; Stage IIB Hodgkin Lymphoma; Stage III Hodgkin Lymphoma; Stage IIIA Hodgkin Lymphoma; Stage IIIB Hodgkin Lymphoma; Stage IV Hodgkin Lymphoma; Stage IVA Hodgkin Lymphoma; Stage IVB Hodgkin Lymphoma

  1. Non-Hodgkin's lymphoma.

    PubMed

    Pearce, Lynne

    2016-09-14

    Essential facts Non-Hodgkin's lymphoma (NHL) is a cancer of the lymphatic system. According to Cancer Research UK, it is the sixth most common cancer in the UK, with 13,413 new cases diagnosed in 2013. There were 4,801 deaths from NHL in 2014. The disease has many subtypes, with two main broad categories: high-grade or aggressive and low-grade or indolent.

  2. Autoimmune hemolytic anaemia in Hodgkin's lymphoma.

    PubMed

    Shah, Mihir B; Nanjapp, Veena; Devaraj, H S; Sindhu, K S

    2013-07-01

    Autoimmune hemolytic anaemia is a rare presentation of Hodgkin's lymphoma though its association with Non- Hodgkin's lymphoma is well known. It is usually detected at the time of diagnosis when it accompanies Hodgkin's and rarely precedes it. It is a warm immune hemolytic anemia which is responsive to steroids and rituximab. We hereby report a case of advanced Hodgkin's disease who presented as AIHA.

  3. Iodine I 131 Monoclonal Antibody BC8 Before Autologous Stem Cell Transplant in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-06-10

    Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Hodgkin Lymphoma; Recurrent T-Cell Non-Hodgkin Lymphoma; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Hodgkin Lymphoma; Refractory T-Cell Non-Hodgkin Lymphoma

  4. Immunohistochemical Profile of Hodgkin and Non-Hodgkin Lymphoma.

    PubMed

    Shahid, Ruqaiya; Gulzar, Rubina; Avesi, Lubna; Hassan, Saba; Danish, Farheen; Mirza, Talat

    2016-02-01

    To analyze the frequencies of histological types of lymphoma, diagnosed with complete immunohistochemical profile in younger and older age group. Cross-sectional analytical study. Dow Diagnostic Research and Reference Laboratory, Dow University of Health Sciences, Karachi, from January 2009 to September 2013. Consecutive cases of lymphomas, which were diagnosed using immunohistochemistry, were analyzed according to WHO classification. Frequency and percentages for different types of lymphomas were calculated. Hodgkin and non-Hodgkin lymphomas characteristics in two age groups of less than and more than 40 years were compared, applying chi-square test. Out of the 318 cases, 79 (25%) were Hodgkin Lymphomas (HL) and 239 (75%) were Non-Hodgkin Lymphomas (NHL). Mixed Cellularity Hodgkin Lymphoma (MCHL) was the commonest (n=48). Amongst the NHL, 215 (89.95%) were B cell lymphomas and 24 (10.05%) were T-cell lymphomas. Diffuse Large B-Cell Lymphoma (DLBCL) was the commonest lymphoma (n=165, 69.95% of NHL). Anaplastic T-Cell Lymphoma (ALCL, n=10) was the commonest T-cell lymphoma. The frequency of HLwas significantly higher in the younger age group and that of NHLwas higher in the older age group (p < 0.001). Primary lymph node involvement was reported in 175 (55%) and cervical lymph node was the most frequent site. Extra nodal involvement was seen in 93 (29%) of all cases and was reported in 87 (36.4%) of NHLand 6 (7.5%) of HL. The most common extra nodal site was the gastrointestinal tract. Hodgkin lymphoma comprises 25% and non-Hodgkin lymphoma comprises 75% of all lymphomas. Both occur in younger age groups than reported in the West. B-cell NHLis three times more common than T-cell lymphoma. DLBCLis the most frequent lymphoma. ALCLis the most common T-cell, and mixed cellularity is the most common Hodgkin lymphoma.

  5. Lenalidomide and Temsirolimus in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-09-04

    AIDS-Related Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Follicular Lymphoma; Recurrent Lymphoplasmacytic Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Non-Hodgkin Lymphoma; Recurrent T-Cell Non-Hodgkin Lymphoma; Waldenstrom Macroglobulinemia

  6. [Pulmonary alterations in Hodgkin lymphoma].

    PubMed

    Jóna, Ádám; Illés, Árpád; Szemes, Katalin; Miltényi, Zsófia

    2016-01-31

    Most of Hodgkin lymphoma patients survive due to combined chemo/radiotherapy. Improved survival brings long-term side effects to the front, which may determine the patients' subsequent quality of life and expected lifetime. This manuscript aims to analyze lung manifestations of Hodgkin lymphoma and treatment related pulmonary complications, demonstrated with own cases. The lung involvement in Hodgkin lymphoma is often secondary, and primary pulmonary involvement is very rare. The authors found 8-12% of lung involvement among their patients. Side effects of treatment consist of pulmonary infections in conjuction with immunosuppression, while on the other hand bleomycin and chest irradiation as part of current standard of care induced pneumonitis and fibrosis are reported. The pulmonary involvement in Hodgkin lymphoma may cause differential diagnostic difficulty. Lung involvement could modify stage and consequently treatment, and the development of side effects might determine later quality of life and expected lifetime. Therefore, identification of lung involvement is crucial.

  7. Proton therapy for Hodgkin lymphoma.

    PubMed

    Rutenberg, Michael S; Flampouri, Stella; Hoppe, Bradford S

    2014-09-01

    Hodgkin lymphoma has gone from an incurable disease to one for which the majority of patients will be cured. Combined chemotherapy and radiotherapy achieves the best disease control rates and results in many long-term survivors. As a result, a majority of long-term Hodgkin lymphoma survivors live to experience severe late treatment-related complications, especially cardiovascular disease and second malignancies. The focus of research and treatment for Hodgkin lymphoma is to maintain the current high rates of disease control while reducing treatment-related morbidity and mortality. Efforts to reduce late treatment complications focus on improvements in both systemic therapies and radiotherapy. Herein we review the basis for the benefits of proton therapy over conventional X-ray therapy. We review outcomes of Hodgkin lymphoma treated with proton therapy, and discuss the ability of protons to reduce radiation dose to organs at risk and the impact on the most significant late complications related to the treatment.

  8. [Thomas Hodgkin and his disease].

    PubMed

    van Gijn, Jan; Gijselhart, Joost P

    2012-01-01

    Thomas Hodgkin (1798-1866), born into a family of Quakers, would remain faithful all his life to the principles and rules of the 'Society of Friends'. He studied pharmacy and medicine in London, Edinburgh and Paris. As curator for the museum of pathological anatomy of Guy's Hospital (1825-1837) he introduced modern, organ-based, medicine in England, together with the clinicians Richard Bright and Thomas Addison. In 1832 Hodgkin reported autopsy findings of seven patients who had shown swollen lymph glands and an enlarged spleen, without evidence of tuberculosis, purulent inflammation or cancer. Later the diagnosis 'Hodgkin's disease' would be restricted to lymphomas with giant, multinucleated Reed-Sternberg cells on microscopic examination. Especially in his later years, Hodgkin devoted much time and effort to the emancipation of oppressed or destitute minorities, especially abroad. He died of dysentery on a journey to Palestine and lies buried in Jaffa.

  9. Gemcitabine and Bendamustine in Patients With Relapsed or Refractory Hodgkin's Lymphoma

    ClinicalTrials.gov

    2017-07-10

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma

  10. A Phase II Trial of Panobinostat and Lenalidomide in Patients With Relapsed or Refractory Hodgkin's Lymphoma

    ClinicalTrials.gov

    2017-01-24

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma

  11. Combination Chemotherapy Followed by Radiation Therapy in Treating Young Patients With Newly Diagnosed Hodgkin's Lymphoma

    ClinicalTrials.gov

    2016-12-16

    Childhood Favorable Prognosis Hodgkin Lymphoma; Childhood Lymphocyte Depletion Hodgkin Lymphoma; Childhood Mixed Cellularity Hodgkin Lymphoma; Childhood Nodular Sclerosis Hodgkin Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage II Childhood Hodgkin Lymphoma

  12. Hodgkin Lymphoma: Diagnosis and Treatment.

    PubMed

    Ansell, Stephen M

    2015-11-01

    Hodgkin lymphoma is a rare B-cell malignant neoplasm affecting approximately 9000 new patients annually. This disease represents approximately 11% of all lymphomas seen in the United States and comprises 2 discrete disease entities--classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Within the subcategorization of classical Hodgkin lymphoma are defined subgroups: nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte-rich Hodgkin lymphoma. Staging of this disease is essential for the choice of optimal therapy. Prognostic models to identify patients at high or low risk for recurrence have been developed, and these models, along with positron emission tomography, are used to provide optimal therapy. The initial treatment for patients with Hodgkin lymphoma is based on the histologic characteristics of the disease, the stage at presentation, and the presence or absence of prognostic factors associated with poor outcome. Patients with early-stage Hodgkin lymphoma commonly receive combined-modality therapies that include abbreviated courses of chemotherapy followed by involved-field radiation treatment. In contrast, patients with advanced-stage Hodgkin lymphoma commonly receive a more prolonged course of combination chemotherapy, with radiation therapy used only in selected cases. For patients with relapse or refractory disease, salvage chemotherapy followed by high-dose treatment and an autologous stem cell transplant is the standard of care. For patients who are ineligible for this therapy or those in whom high-dose therapy and autologous stem cell transplant have failed, treatment with brentuximab vedotin is a standard approach. Additional options include palliative chemotherapy, immune checkpoint inhibitors, nonmyeloablative allogeneic stem cell transplant, or participation in a clinical trial testing novel agents.

  13. PET-Directed Therapy With Pembrolizumab and Combination Chemotherapy in Treating Patients With Previously Untreated Classical Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-07-19

    Classical Hodgkin Lymphoma; Lymphocyte-Depleted Classical Hodgkin Lymphoma; Lymphocyte-Rich Classical Hodgkin Lymphoma; Mixed Cellularity Classical Hodgkin Lymphoma; Nodular Sclerosis Classical Hodgkin Lymphoma

  14. Brentuximab Vedotin and Combination Chemotherapy in Treating Patients With Stage II-IV HIV-Associated Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-09-12

    AIDS-Related Hodgkin Lymphoma; Classical Hodgkin Lymphoma; HIV Infection; Stage II Hodgkin Lymphoma; Stage IIA Hodgkin Lymphoma; Stage IIB Hodgkin Lymphoma; Stage III Hodgkin Lymphoma; Stage IIIA Hodgkin Lymphoma; Stage IIIB Hodgkin Lymphoma; Stage IV Hodgkin Lymphoma; Stage IVA Hodgkin Lymphoma; Stage IVB Hodgkin Lymphoma

  15. Brentuximab Vedotin and Combination Chemotherapy in Treating Older Patients With Previously Untreated Stage II-IV Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-09-27

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage IV Adult Hodgkin Lymphoma

  16. Clinical and Pathologic Studies in Non-Hodgkin's Lymphoma Patients Receiving Antibody Treatment

    ClinicalTrials.gov

    2011-05-31

    Lymphoma, Non-Hodgkin; Lymphomas: Non-Hodgkin; Lymphomas: Non-Hodgkin Cutaneous Lymphoma; Lymphomas: Non-Hodgkin Diffuse Large B-Cell; Lymphomas: Non-Hodgkin Follicular / Indolent B-Cell; Lymphomas: Non-Hodgkin Mantle Cell; Lymphomas: Non-Hodgkin Marginal Zone; Lymphomas: Non-Hodgkin Peripheral T-Cell; Lymphomas: Non-Hodgkin Waldenstr Macroglobulinemia

  17. Hodgkin's disease presenting as idiopathic thrombocytopenic purpura.

    PubMed Central

    Murphy, W. G.; Allan, N. C.; Perry, D. J.; Stockdill, G.

    1984-01-01

    A case of Hodgkin's disease presenting as idiopathic thrombocytopenic purpura in a 23-year-old male is reported. This is a rare presentation of Hodgkin's disease having been previously described in only two cases. PMID:6541338

  18. Lymphomagenesis in Hodgkin lymphoma.

    PubMed

    Matsuki, Eri; Younes, Anas

    2015-10-01

    Hodgkin lymphoma (HL) accounts for approximately 0.6% of all new cancer cases, 10% of all lymphomas in the USA, leading to an approximate 9000 new cases per year. It is very unique in that the neoplastic Hodgkin and Reed-Sternberg (HRS) cells of classical HL account for only 1% of the tumor tissue in most cases, with various inflammatory cells including B-cells, T-cells, mast cells, macrophages, eosinophils, neutrophils, and plasma cells comprising the tumor microenvironment. Recent research has identified germinal center B-cells to be the cellular origin of HRS cells. Various transcription factor dysregulation in these neoplastic cells that explains for the loss of B-cell phenotype as well as acquisition of survival and anti-apoptotic features of HRS cells has been identified. Aberrant activation of nuclear factor-kappa B (NF-κB), Janus kinase (JAK)/signal transducer and activator of transcription (STAT), and phosphoinositide 3-kinase (PI3K) pathways play a central role in HL pathogenesis. Both intrinsic genetic mechanisms as well as extrinsic signals have been identified to account for the constitutive activation of these pathways. The extrinsic factors that regulate the activation of transcription pathways in HRS cells have also been studied in detail. Cytokines and chemokines produced both by the HRS cells as well as cells of the microenvironment of HL work in an autocrine and/or paracrine manner to promote survival of HRS cells as well as providing mechanisms for immune escape from the body's antitumor immunity. The understanding of various mechanisms involved in the lymphomagenesis of HL including the importance of its microenvironment has gained much interest in the use of these microenvironmental features as prognostic markers as well as potential treatment targets. In this article, we will review the pathogenesis of HL starting with the cellular origin of neoplastic cells and the mechanisms supporting its pathogenesis, especially focusing on the

  19. Transformative Clinical Trials in Non-Hodgkin and Hodgkin Lymphomas.

    PubMed

    Abramson, Jeremy S

    2015-06-01

    Dramatic progress in the understanding of underlying disease biology and the development of novel therapeutics has yielded a revolution that is poised to transform the face of lymphoma treatment across a broad spectrum of histologies. Ongoing randomized clinical trials are poised to unseat long-entrenched standards of care in diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma, and Hodgkin lymphoma. Emerging treatment approaches are reviewed, including optimization of existing chemoimmunotherapy platforms, development of chemotherapy-sparing immunotherapy for follicular lymphoma, biologically targeted therapy for subsets of diffuse large B-cell lymphoma, and incorporation of novel agents into the treatment of mantle cell lymphoma and peripheral T-cell lymphoma. Novel therapies in early stage trials with future promise of redefining standards of care are also reviewed for non-Hodgkin and Hodgkin lymphomas, including small molecule pathway inhibitors and advances in immunotherapy.

  20. Managing Risk in Hodgkin Lymphoma.

    PubMed

    Armitage, James O; Chen, Robert W; Moskowitz, Craig H; Sweetenham, John

    2015-02-01

    Approximately 90% of patients with limited-stage Hodgkin lymphoma are cured. The cure rate in advanced-stage Hodgkin lymphoma is dramatically better than it once was, but it is still lower than the rate in patients with limited disease. The choice of treatment is based on several factors, including symptoms, disease stage, extent of tumor burden, and prognosis. Positron emission tomography scanning can be used to assess the patient's stage of disease, which can allow further individualization of therapy. Traditional frontline treatment options include doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and, for high-risk patients, bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP). Autologous stem cell transplantation cures approximately 50% of patients. The antibody-drug conjugate brentuximab vedotin is very active in relapsed/refractory Hodgkin lymphoma. Data presented at the 2014 meeting of the American Society of Hematology (ASH) showed that brentuximab vedotin was beneficial in several settings, including as consolidation therapy posttransplant in patients at high risk for relapse, as first-line salvage therapy in relapsed/refractory Hodgkin lymphoma prior to autologous hematopoietic cell transplantation, and in combination with bendamustine in relapsed/refractory disease. The ASH meeting also offered promising data on novel agents, such as the programmed cell death 1 (PD-1) inhibitors. In this monograph, 4 experts in the management of Hodgkin lymphoma discuss various aspects of the disease and provide their perspectives on the new data presented at the ASH meeting.

  1. Pathobiology of Hodgkin Lymphoma

    PubMed Central

    Piccaluga, Pier Paolo; Agostinelli, Claudio; Gazzola, Anna; Tripodo, Claudio; Bacci, Francesco; Sabattini, Elena; Sista, Maria Teresa; Mannu, Claudia; Sapienza, Maria Rosaria; Rossi, Maura; Laginestra, Maria Antonella; Sagramoso-Sacchetti, Carlo A.; Righi, Simona; Pileri, Stefano A.

    2011-01-01

    Despite its well-known histological and clinical features, Hodgkin's lymphoma (HL) has recently been the object of intense research activity, leading to a better understanding of its phenotype, molecular characteristics, histogenesis, and possible mechanisms of lymphomagenesis. There is complete consensus on the B-cell derivation of the tumor in most cases, and on the relevance of Epstein-Barr virus infection and defective cytokinesis in at least a proportion of patients. The REAL/WHO classification recognizes a basic distinction between lymphocyte predominance HL (LP-HL) and classic HL (cHL), reflecting the differences in clinical presentation and behavior, morphology, phenotype, and molecular features. cHL has been classified into four subtypes: lymphocyte rich, nodular sclerosing, with mixed cellularity, and lymphocyte depleted. The borders between cHL and anaplastic large-cell lymphoma have become sharper, whereas those between LP-HL and T-cell-rich B-cell lymphoma remain ill defined. Treatments adjusted to the pathobiological characteristics of the tumor in at-risk patients have been proposed and are on the way to being applied. PMID:21253495

  2. Checkpoint inhibitors in Hodgkin's lymphoma.

    PubMed

    Jezeršek Novaković, Barbara

    2016-04-01

    Hodgkin's lymphoma is unusual among cancers in that it consists of a small number of malignant Hodgkin/Reed-Sternberg cells in a sea of immune system cells, including T cells. Most of these T cells are reversibly inactivated in different ways and their reactivation may induce a very strong immune response to cancer cells. One way of reactivation of T cells is with antibodies blocking the CTLA-4 and especially with antibodies directed against PD-1 or the PD-L1 ligand thereby reversing the tumor-induced downregulation of T-cell function and augmenting antitumor immune activity at the priming (CTLA-4) or tissue effector (PD-1) phase. Immune checkpoint inhibitors have been evidenced as an additional treatment option with substantial effectiveness and acceptable toxicity in heavily pretreated patients with Hodgkin's lymphoma. Particularly, PD-1 blockade with nivolumab and pembrolizumab has demonstrated significant single-agent activity in this select population.

  3. Hodgkin Lymphoma in Childhood

    PubMed Central

    Sherief, Laila M.; Elsafy, Usama R.; Abdelkhalek, Elhamy R.; Kamal, Naglaa M.; Elbehedy, Rabab; Hassan, Tamer H.; Sherbiny, Hanan S.; Beshir, Mohamed R.; Saleh, Safaa H.

    2015-01-01

    Abstract Hodgkin lymphoma (HL) accounts for 5% to 6% of all childhood cancer. It displays characteristic epidemiological, clinical, and pathological features according to various geographic areas. We aimed to assess the epidemiological aspects, clinicopathological features, and treatment outcome of pediatric HL treated at 2 Egyptian centers: Zagazig University Pediatric Oncology Unit and Benha Special Hospital Pediatric Oncology Unit. We carried a cross-sectional retrospective study by reviewing medical records for all patients admitted with the diagnosis of HL over 8 years in 2 oncology units during the period from January 2004 to January 2012. Age of the patients at presentation ranged from 3 to 14 years (median 6 years) and male: female ratio 1.7:1. Lymphadenopathy was the most common presentation (96.6%). Mixed cellularity subtype was dominant (50.8%), followed by nodular sclerosis (28.9%), lymphocyte-rich (18.6%) with lymphocyte depletion being the least dominant (1.7%). More than half of patients (55.9 %) had advanced disease (Ann Arbor stage III/IV disease). The duration of follow-up ranged from 5 to 87 months (mean 39.8 ± 24.1 months). The 5-year overall survival and event-free survival for patients were 96.6% and 84.7% respectively. In Egypt, HL occurs in young age group, with a higher incidence of mixed cellularity subtype and advanced disease. None of the clinical, epidemiological, or pathological characteristics had a significant association with the overall survival. The outcomes of HL in our 2 centers were satisfactory approaching the international percentage. PMID:25881843

  4. Drugs Approved for Hodgkin Lymphoma

    Cancer.gov

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for Hodgkin lymphoma. The list includes generic names, brand names, and common drug combinations, which are shown in capital letters. The drug names link to NCI's Cancer Drug Information summaries.

  5. [Lung infiltrations in Hodgkin lymphoma].

    PubMed

    Ciurea-Löchel, A; Ciurea, A; Stey, C; Pestalozzi, B

    2001-08-02

    We report the case of a young patient presenting with cervical lymphadenopathy and interstitial pulmonary infiltrates due to Hodgkin's Disease. Although lung involvement regressed under chemotherapy, we observed new alveolar infiltrates during treatment. Steroid administration after exclusion of an infectious cause was followed by rapid clinical and radiological improvement, indicating the probable presence of pulmonary bleomycine toxicity.

  6. What's New in Hodgkin Disease Research and Treatment?

    MedlinePlus

    ... and Treatment? Hodgkin Lymphoma About Hodgkin Lymphoma What's New In Hodgkin Lymphoma Research and Treatment? Important research ... yet still cure as many patients as possible. New chemotherapy (chemo) combinations of as many as 10 ...

  7. What's New in Non-Hodgkin Lymphoma Research and Treatment?

    MedlinePlus

    ... Non-Hodgkin Lymphoma About Non-Hodgkin Lymphoma What’s New in Non-Hodgkin Lymphoma Research and Treatment? Research ... done on NHL is focused on looking at new and better ways to treat this disease. Chemotherapy ...

  8. Bortezomib, Ifosfamide, and Vinorelbine Tartrate in Treating Young Patients With Hodgkin's Lymphoma That is Recurrent or Did Not Respond to Previous Therapy

    ClinicalTrials.gov

    2014-06-18

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Childhood Lymphocyte Depletion Hodgkin Lymphoma; Childhood Lymphocyte Predominant Hodgkin Lymphoma; Childhood Mixed Cellularity Hodgkin Lymphoma; Childhood Nodular Lymphocyte Predominant Hodgkin Lymphoma; Childhood Nodular Sclerosis Hodgkin Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Childhood Hodgkin Lymphoma

  9. Pediatric Hodgkin Lymphoma

    PubMed Central

    Ferrari, Cristina; Niccoli Asabella, Artor; Merenda, Nunzio; Altini, Corinna; Fanelli, Margherita; Muggeo, Paola; De Leonardis, Francesco; Perillo, Teresa; Santoro, Nicola; Rubini, Giuseppe

    2017-01-01

    Abstract We investigated the prognostic value of interim 18F-FDG PET/CT (PET-2) in pediatric Hodgkin lymphoma (pHL), evaluating both visual and semiquantitative analysis. Thirty pHL patients (age ≤16) underwent serial 18F-FDG PET/CT: at baseline (PET-0), after 2 cycles of chemotherapy (PET-2) and at the end of first-line chemotherapy (PET-T). PET response assessment was carried out visually according to the Deauville Score (DS), as well as semiquantitatively by using the semiquantitative parameters reduction from PET-0 to PET-2 (ΔΣSUVmax0–2, ΔΣSUVmean0–2). Final clinical response assessment (outcome) at the end of first-line chemotherapy was the criterion standard, considering patients as responders (R) or nonresponders (NR). Disease status was followed identifying patients with absence or relapsed/progression disease (mean follow-up: 24 months, range 3–78). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of visual and semiquantitative assessment were calculated; furthermore, Fisher exact test was performed to evaluate the association between both visual and semiquantitative assessment and outcome at the end of the first-line chemotherapy. The prognostic capability of PET-2 semiquantitative parameters was calculated by ROC analysis and expressed as area under curve (AUC). Finally, progression-free survival (PFS) was analyzed according to PET-2 results based on the 5-point scale and semiquantitative criteria, using the Kaplan–Meier method. Based on the outcome at the end of first-line chemotherapy, 5 of 30 patients were NR, the remnant 25 of 30 were R. Sensitivity, specificity, PPV, NPV, and accuracy of visual analysis were 60%,72%,30%,90%,70%; conversely, sensitivity, specificity, PPV, NPV, and accuracy of semiquantitative assessment were 80%, 92%, 66.7%, 95.8%, 90%. The highest AUC resulted for ΔΣSUVmax0–2 (0.836; cut-off <12.5; sensitivity 80%; specificity 91%). The association between

  10. Care of the Adult Hodgkin Lymphoma Survivor

    PubMed Central

    Thompson, Carrie A.; Mauck, Karen; Havyer, Rachel; Bhagra, Anjali; Kalsi, Henna; Hayes, Sharonne N.

    2011-01-01

    Of those individuals diagnosed with Hodgkin lymphoma, 85% will survive and may be affected by residual effects of their cancer and its therapy (chemotherapy, radiation therapy, stem cell transplantation). Hodgkin lymphoma survivors are at risk of developing secondary malignancies, cardiovascular disease, pulmonary disease, thyroid disease, infertility, premature menopause, chronic fatigue, and psychosocial issues. These conditions usually have a long latency and therefore present years or decades after Hodgkin lymphoma treatment, when the patient’s care is being managed by a primary care provider. This review summarizes these unique potential medical and psychological sequelae of Hodgkin lymphoma, and provides screening and management recommendations. PMID:22114824

  11. Primary multifocal osseous Hodgkin's lymphoma

    PubMed Central

    Langley, Clare R; Garrett, Simon JW; Urand, Jill; Kohler, Janice; Clarke, Nick MP

    2008-01-01

    Background Hodgkin's disease (HD) most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. A few children have systemic symptoms and weight loss. At the time of diagnosis, osseous involvement is uncommon Case presentation A case is described of Primary Multifocal Osseous Hodgkin's Lymphoma in a seven-year-old boy. He presented with a painful swelling in the sternum, and further investigations revealed deposits in his L1 vertebra, the left sacro-iliac joint and the right acetabulum. Conclusion The clinical, radiological and histological features of this disease can mimic other medical conditions, including Tuberculosis, making the diagnosis difficult and often leading to delays in treatment. This is a very rare condition and we believe this to be the youngest reported case in the literature. PMID:18346271

  12. Hodgkin lymphoma: answers take time!

    PubMed

    Friedberg, Jonathan W

    2011-05-19

    In this issue of Blood, Straus and colleagues on behalf of the Cancer and Leukemia Group B (CALGB) present the outcome of a phase 2 trial of doxorubicin, vinblastine,and gemcitabine for patients with early-stage, non-bulky, Hodgkin lymphoma.The complete response rate and progression-free survival were inferior to comparable series, emphasizing the challenges of improving outcome in this highly curable population.

  13. Hodgkin lymphoma: Pathology and biology.

    PubMed

    Mathas, Stephan; Hartmann, Sylvia; Küppers, Ralf

    2016-07-01

    The Hodgkin and Reed-Sternberg (HRS) tumor cells of classical Hodgkin lymphoma (HL), as well as the lymphocyte predominant (LP) cells of nodular lymphocyte predominant HL (NLPHL), are derived from mature B cells. However, HRS cells have largely lost their B-cell phenotype and show a very unusual expression of many markers of other hematopoietic cell lineages, which aids in the differential diagnosis between classical HL (cHL) and NLPHL and distinguishes cHL from all other hematopoietic malignancies. The bi- or multinucleated Reed-Sternberg cells most likely derive from the mononuclear Hodgkin cells through a process of incomplete cytokinesis. HRS cells show a deregulated activation of numerous signaling pathways, which is partly mediated by cellular interactions in the lymphoma microenvironment and partly by genetic lesions. In a fraction of cases, Epstein-Barr virus contributes to the pathogenesis of cHL. Recurrent genetic lesions in HRS cells identified so far often involve members of the nuclear factor-κB (NF-κB) and JAK/STAT pathways and genes involved in major histocompatibility complex expression. However, further lead transforming events likely remain to be identified. We here discuss the current knowledge on HL pathology and biology.

  14. Hodgkin's disease: update of findings.

    PubMed

    Pileri, S; Sabattini, E; Tazzari, P L; Gherlinzoni, F; Zucchini, L; Bigerna, B; Leoncini, L; Rosso, R; Stein, H; Falini, B

    1991-01-01

    The authors critically review the problem of Hodgkin's disease (HD) in the light of new morphological, immunohistochemical, kinetic, genotypic, and virological findings. These support the lymphoid origin of neoplastic Hodgkin's and Reed-Sternberg cells, because of regular expression of the CD30 lymphoid activation antigen and frequent detection of B- or T-cell phenotypic and/or genotypic markers. It is possible to hypothesize the release of cytokines by tumoral elements as well as the presence of specific cytokine receptors on their surface. This might explain some clinical and pathological features, such as fever, loss of weight, eosinophilia and attraction of reactive elements that make up the composite cellular milieu of typical HD. Integration of monoclonal EBV in the genoma of neoplastic elements has repeatedly been shown, and this might play an essential role in the pathogenesis of the disease. On the basis of present concepts, the borderlines between HD and some categories of non-Hodgkin's lymphomas--especially the anaplastic large cell forms--have become somewhat blurred. Additional research work in the field of HD is desirable and might pave the way for new and more effective therapeutic approaches, designed on the basis of the natural history of the neoplasm.

  15. Simultaneous presentation of relapsing Hodgkin's disease and treatment-related non-Hodgkin's lymphoma

    SciTech Connect

    Perri, R.T.; Allen, J.I.; Oken, M.M.; Limas, C.; Kay, N.E.

    1985-01-01

    A 55-year-old white man was diagnosed in 1975 with Hodgkin's disease stage IIA, mixed cellularity. He was treated with 4,500 rads to an inverted-Y field followed by six cycles of MOPP and remained in complete remission. In 1983 a right axillary lymph node biopsy showed recurrent Hodgkin's disease, mixed cellularity. While receiving his initial chemotherapy he developed persistent epigastric distress. Endoscopic gastric biopsy demonstrated a diffuse large-cell non-Hodgkin's lymphoma. Surface marker studies confirmed the separate identity of these two malignant lymphoproliferative processes. This represents the first reported simultaneous occurrence of relapsing Hodgkin's disease with treatment-related non-Hodgkin's lymphoma.

  16. Pembrolizumab and Combination Chemotherapy in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-03-08

    Lymphocyte-Rich Classical Hodgkin Lymphoma; Recurrent Lymphocyte-Depleted Classical Hodgkin Lymphoma; Recurrent Mixed Cellularity Classical Hodgkin Lymphoma; Recurrent Nodular Sclerosis Classical Hodgkin Lymphoma; Refractory Lymphocyte-Depleted Classical Hodgkin Lymphoma; Refractory Mixed Cellularity Classical Hodgkin Lymphoma; Refractory Nodular Sclerosis Classical Hodgkin Lymphoma

  17. [Therapy in Hodgkin disease and non-Hodgkin lymphomas].

    PubMed

    Sréter, Lídia

    2009-04-05

    The therapy of malignant lymphoproliferative diseases has changed many times in recent years. Treatment strategy of Hodgkin's disease is now based on risk adaptation, including not only the results of pretreatment diagnostic and prognostic factors but also the repeated PET/CT (restaging) made in the early treatment period. Possible reduction of irradiation therapy may contribute to lower the risk of secondary tumors, which are common late complications of radiochemotherapy. Autologous stem cell transplantation is the therapy of choice in chemosensitive relapsing patients. The complete remission rate today in Hodgkin's disease is around 85%. In the heterogenic group of Non-Hodgkin Lymphomas, progression of indolent lymphomas (CLL, multiple myeloma, hairy cell leukemia, cutaneous lymphomas, etc.) is slow in case of natural course. Their therapy is mostly palliative and complete remission with the latest treatment modalities is not possible. Aggressive lymphomas are characterized with rapid progression and early death without treatment.Most of them respond to chemotherapy and irradiation.With an adequate therapy, 60-70% of patients reach complete remission (CR) and 40-50% of them remain in remission. Using immune- and radioimmune therapy in indolent and aggressive NHL groups gives possibility to influence G0 tumor cells as well. Their use in combination with classic chemotherapy leads to more complete remissions and better therapy results. The introduction of routine PET/CT made the first and repeated staging of NHL more precise and contributed to more effective treatment. Using autologous stem cell transplantation in chemosensitive patients may improve outcome in selected patients.

  18. Surfaceome of classical Hodgkin and non-Hodgkin lymphoma.

    PubMed

    Hofmann, Andreas; Thiesler, Thore; Gerrits, Bertran; Behnke, Silvia; Sobotzki, Nadine; Omasits, Ulrich; Bausch-Fluck, Damaris; Bock, Thomas; Aebersold, Ruedi; Moch, Holger; Tinguely, Marianne; Wollscheid, Bernd

    2015-08-01

    Classical Hodgkin lymphoma (cHL) is characterized by a low percentage of tumor cells in a background of diverse, reactive immune cells. cHL cells commonly derive from preapoptotic germinal-center B cells and are characterized by the loss of B-cell markers and the varying expression of other hematopoietic lineage markers. This phenotypic variability and the scarcity of currently available cHL-specific cell surface markers can prevent clear distinction of cHL from related lymphomas. We applied the cell surface capture technology to directly measure the pool of cell surface exposed proteins in four cHL and four non-Hodgkin lymphoma (NHL) cell lines. More than 1000 membrane proteins, including 178 cluster of differentiation annotated proteins, were identified and allowed the generation of lymphoma surfaceome maps. The functional properties of identified cell surface proteins enable, but also limit the information exchange of lymphoma cells with their microenvironment. Selected candidate proteins with potential diagnostic value were evaluated on a tissue microarray (TMA). Primary lymphoma tissues of 126 different B cell-derived lymphoma cases were included in the TMA analysis. The TMA analysis indicated gamma-glutamyltranspeptidase 1 as a potential additional marker that can be included in a panel of markers for differential diagnosis of cHL versus NHL. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Hodgkin disease of the trachea.

    PubMed

    Boujaoude, Ziad; Malin, Jessica; Abouzgheib, Wissam

    2012-07-01

    Endobronchial Hodgkin disease (HD) is very rare. We report the case of a women who presented with life-threatening airway obstruction. She was diagnosed with HD 4 years earlier and was in remission after treatment with a combination of chemotherapy and radiation. Bronchoscopy showed a polypoid mass obstructing the tracheal lumen almost completely. The mass was resected using an electrocautery snare loop, providing immediate relief of symptoms. Pathology and staging investigations revealed HD isolated to the trachea. This presentation and treatment is extremely unique for HD.

  20. [Breast cancer after Hodgkin disease].

    PubMed

    Guillaume, A; Morin, B; Mathelin, C

    2012-01-01

    Secondary breast cancer represents 6 to 9% of secondary neoplasia after treatments for Hodgkin Disease (HD). Mostly, they appear 10 years after the end of treatments for HD. The most important risk factors are mantle field irradiation and the young age. The means of screening and treatments are still in discussion. We report a case of bilateral intraductal and invasive carcinoma that occurred 16 years after treatments for HD, developing its particularities in diagnosis and treatment, particularly place of conservative treatments and sentinel lymph node biopsy. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Chemotherapy With or Without Additional Chemotherapy and/or Radiation Therapy in Treating Children With Newly Diagnosed Hodgkin's Disease

    ClinicalTrials.gov

    2017-03-15

    Childhood Lymphocyte-Depleted Classical Hodgkin Lymphoma; Childhood Mixed Cellularity Classical Hodgkin Lymphoma; Childhood Nodular Lymphocyte Predominant Hodgkin Lymphoma; Childhood Nodular Sclerosis Classical Hodgkin Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage IV Childhood Hodgkin Lymphoma

  2. Hodgkin disease with spinal cord compression.

    PubMed

    Gupta, Vineeta; Srivastava, Arvind; Bhatia, Baldev

    2009-10-01

    Hodgkin disease is a nodal disease. Spinal cord or root compression is a rare complication and usually seen in the setting of progressive, advanced disease. We report 2 cases of Hodgkin disease in pediatric patients who presented with neurologic signs. One patient had paravertebral masses and involvement of thoracic vertebrae, which was initially misdiagnosed as spinal tuberculosis. The second patient who presented with paraplegia and bladder and bowel involvement had an epidural mass with collapse of thoracic vertebra. Lymph node biopsy revealed Hodgkin disease, mixed cellularity in both the cases. Both were treated with chemotherapy followed by radiotherapy.

  3. Meningioma after radiotherapy for Hodgkin's disease.

    PubMed

    Deutsch, M; Rosenstein, M; Figura, J H

    1999-08-01

    The most common second primary tumors after treatment of childhood Hodgkin's disease are leukemia, lymphoma, breast cancer, soft tissue sarcoma, and thyroid cancer. Although intracranial meningioma has been reported after radiotherapy to the scalp for benign conditions and for intracranial primary brain tumors, this appears to be an extremely rare sequelae of treatment for Hodgkin's disease. The authors describe a 15-year-old boy who underwent radiotherapy for Hodgkin's disease and in whom a meningioma developed in the posterior fossa 27 years later.

  4. Cutaneous Melanoma, Hodgkin's Lymphoma and non-Hodgkin's Lymphoma: Common Risk Factors?

    PubMed

    Allam, Mohamed Farouk; Serrano, Pablo Fernández-Crehuet; Serrano, José Luis Fernández-Crehuet; Abd Elaziz, Khaled Mahmoud; Del Castillo, Amparo Serrano; Navajas, Rafael Fernández-Crehuet

    2015-06-01

    An epidemiological cross-sectional study was conducted to evaluate the association between cutaneous melanoma, Hodgkin's lymphoma and non-Hodgkin's lymphoma in 40 European countries. Incidence rates were obtained from the database of the International Agency for Research of Cancer (IARC). We analyzed age-adjusted and gender-stratified incidence rates for cutaneous melanoma, Hodgkin's lymphoma and non-Hodgkin's lymphoma in 40 European countries. All European countries included had registration systems that fulfilled the quality criteria of IARC. Normal distribution of the variables was examined using Kolmorov-Smirnov test before calculating their correlations using Pearson's Correlation test. In males, positive correlations were found between cutaneous melanoma, Hodgkin's lymphoma (r=0.14, p=0.38), and non-Hodgkin's lymphoma (r=0.64, p<0.001). In females, negative correlation was found between cutaneous melanoma and Hodgkin's lymphoma (r=0.28, p=0.08), however, positive correlation was found between cutaneous melanoma and non-Hodgkin's lymphoma (r=0.72, p<0.001). Our findings raise the hypothesis about common risk factors for cutaneous melanoma and non-Hodgkin's lymphoma. New epidemiological and genetic studies are needed to identify possible common risk factors. Copyright© by the National Institute of Public Health, Prague 2015.

  5. Nodular lymphocyte-predominant Hodgkin lymphoma.

    PubMed

    Savage, Kerry J; Mottok, Anja; Fanale, Michelle

    2016-07-01

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma with distinct clinicopathologic features. It is typified by the presence of lymphocyte predominant (LP) cells, which are CD20(+) but CD15(-) and CD30(-) and are found scattered amongst small B lymphocytes arranged in a nodular pattern. Despite frequent and often late or multiple relapses, the prognosis of NLPHL is very favorable. There is an inherent risk of secondary aggressive non-Hodgkin lymphoma (NHL) and studies support that risk is highest in those with splenic involvement at presentation. Given disease rarity, the optimal management is unclear and opinions differ as to whether treatment paradigms should be similar to or differ from those for classical Hodgkin lymphoma (CHL). This review provides an overview of the existing literature describing pathological subtypes, outcome and treatment approaches for NLPHL.

  6. Primary extra nodal Hodgkin disease: Bone presentation.

    PubMed

    Nikolica, Goran; Badnjar, Zorka; Cadjenovic, Tanja; Raceta-Masic, Dijana

    2014-01-01

    Extra nodal and extra lymphatic propagation of Hodgkin's disease is a characteristic of the fourth stage of disease when the organs are affected. Primary appearances of the disease outside the lymph node is a rare event. Therefore, it makes diagnostic problem. Skeletal system is possible localization of primary extra nodal Hodgkin's disease. Women, 42-years-old, was admitted to hospital because of swelling and pain in the right shoulder. After imaging and histological examination diagnosed Hodgkin's nodular sclerosing histological subtype disease has been established. The patient starts to receive chemotherapy. Primary extra nodal Hodgkin's disease of bone is manifested with painful swelling in geared area. Imaging method shows destruction of the affected bone, with swelling of the soft tissues. Propagation in soft tissue is not accompanied by their destruction, but rather manifested swelling of the surrounding soft tissue.

  7. Persistent Hypoglycemia in Patient with Hodgkin's Disease

    PubMed Central

    Lim, Harold Cinco; Munshi, Lubna Bashir; Sharon, David

    2015-01-01

    Hypoglycemia is a rare complication of Hodgkin's disease. Several explanations have been postulated but the exact pathophysiology is not well understood. We are presenting a case of newly diagnosed Stage IV Hodgkin's disease that developed persistent and recurrent hypoglycemia despite giving glucagon, repeated 50% dextrose, and D5 and D10 continuous infusion. Hypoglycemia workup showed the C-peptide level to be low. Patient was suspected of having hypoglycemia related to lymphoma and was given a trial of prednisone which resolved the hypoglycemic episodes and made the patient euglycemic for the rest of his hospital stay. The presence of a substance that mimicked the effects of insulin was highly suspected. Several case reports strengthen the hypothesis of an insulin-like growth factor or antibodies secreted by the cancer cells causing hypoglycemia in Hodgkin's disease but none of them have been confirmed. Further investigation is warranted to more clearly define the pathophysiology of persistent hypoglycemia in patients with Hodgkin's disease. PMID:26839722

  8. Non-Hodgkin Lymphoma (For Parents)

    MedlinePlus

    ... Hodgkin A lymphoma is a cancer of the lymphatic system, which is a part of the body's immune ... not aware of the inner workings of our lymphatic systems unless the lymph nodes , or glands, become swollen. ...

  9. On the aetiology of Hodgkin lymphoma.

    PubMed

    Hjalgrim, Henrik

    2012-07-01

    The thesis is based on seven publications in English and a review of the literature. The studies were carried out to contribute to the understanding of Hodgkin lymphoma epidemiology through descriptions of its occurrence and its association with Epstein-Barr virus (EBV) infection presenting as infectious mononucleosis. The investigations were supported by the Danish Cancer Society, the Swedish Cancer Society, the Danish Cancer Research Foundation, the Nordic Cancer Union, the Lundbeck Foundation, Plan Danmark, Danish National Research Foundation, Lily Benthine Lund's Foundation, Aase og Ejnar Danielsen's Foundation, Grosserer L. F. Foght's Foundation, the Leukaemia Reseach Fund, the Kay Kendall Leukaemia Fund, and the U.S. National Institutes of Health. The work was carried out in the period 1999-2010 during my employment at the Department of Epidemiology Research at Statens Serum Institut. The employed study designs included population-based incidence surveys of Hodgkin lymphoma in the Nordic countries and in Singapore, register-based cohort studies to characterise the pattern of cancer occurrence in patients with infectious mononucleosis and their first degree relatives, a register-based cohort and a population-based case-control study to characterise the association between infectious mononucleosis and Hodgkin lymphoma taking tumour EBV-status into consideration, and a case-series analysis to assess the association between HLA class I alleles and EBV-positive and EBV-negative Hodgkin lymphomas. Analyses of Nordic incidence data demonstrated that the occurrence of Hodgkin lymphoma had increased markedly younger adults in the period 1978-97, whereas it had decreased among older adults. In combination, these developments led to an accentuation of the younger adult Hodgkin lymphoma incidence peak, which has been a hallmark of Hodgkin lymphoma epidemiology in the Western hemisphere for more than a half century. The opposing incidence trends in younger and older

  10. Novel agents in classical Hodgkin lymphoma.

    PubMed

    Borchmann, Sven; von Tresckow, Bastian

    2017-10-01

    Classical Hodgkin lymphoma (cHL) is the most common hematological malignancy in young adults and can be cured in most cases. However, relapsed and refractory Hodgkin lymphoma, certain patient groups, such as elderly patients, and toxicity of first-line treatment still pose significant challenges. Consequently, new treatment options are needed. Recently, many new treatment concepts have been evaluated in clinical trials. Targeted drug-antibody conjugates and immune checkpoint inhibitors have decisively changed treatment approaches. This review aims to give a comprehensive overview of novel agents in Hodgkin lymphoma that have been recently or are currently being evaluated in clinical trials. In addition to dedicated sections on brentuximab vedotin (BV) and immune checkpoint inhibitors, other emerging substances and concepts are discussed. In doing so, this review compares trial results regarding safety and efficacy. A special focus lies on the effect novel agents will have on the different treatment settings faced by clinicians involved in the treatment of Hodgkin lymphoma.

  11. Population Encoding With Hodgkin-Huxley Neurons.

    PubMed

    Lazar, Aurel A

    2010-02-01

    The recovery of (weak) stimuli encoded with a population of Hodgkin-Huxley neurons is investigated. In the absence of a stimulus, the Hodgkin-Huxley neurons are assumed to be tonically spiking. The methodology employed calls for 1) finding an input-output (I/O) equivalent description of the Hodgkin-Huxley neuron and 2) devising a recovery algorithm for stimuli encoded with the I/O equivalent neuron(s). A Hodgkin-Huxley neuron with multiplicative coupling is I/O equivalent with an Integrate-and-Fire neuron with a variable threshold sequence. For bandlimited stimuli a perfect recovery of the stimulus can be achieved provided that a Nyquist-type rate condition is satisfied. A Hodgkin-Huxley neuron with additive coupling and deterministic conductances is first-order I/O equivalent with a Project-Integrate-and-Fire neuron that integrates a projection of the stimulus on the phase response curve. The stimulus recovery is formulated as a spline interpolation problem in the space of finite length bounded energy signals. A Hodgkin-Huxley neuron with additive coupling and stochastic conductances is shown to be first-order I/O equivalent with a Project-Integrate-and-Fire neuron with random thresholds. For stimuli modeled as elements of Sobolev spaces the reconstruction algorithm minimizes a regularized quadratic optimality criterion. Finally, all previous recovery results of stimuli encoded with Hodgkin-Huxley neurons with multiplicative and additive coupling, and deterministic and stochastic conductances are extended to stimuli encoded with a population of Hodgkin-Huxley neurons.

  12. Procarbazine for non-Hodgkin's lymphoma.

    PubMed

    Chaar, Bassem T; Salem, Pascale; Petruska, Paul J

    2006-04-01

    Procarbazine hydrochloride is an oral alkylating agent with activity against lymphoma. It is most commonly used in the treatment of Hodgkin's disease. The use of procarbazine-containing chemotherapeutic regimens in non-Hodgkin's lymphoma fell out of favor with the advent of CHOP. We report two patients with relapsed and/or refractory follicular lymphoma that achieved a complete and durable remission with a prolonged course of daily procarbazine.

  13. Relapsed Hodgkin Lymphoma: Management Strategies

    PubMed Central

    Montanari, Francesca; Diefenbach, Catherine

    2016-01-01

    Although Hodgkin lymphoma (HL) is largely curable with first-line therapy, approximately one-third of patients will not have a complete response to frontline treatment or will subsequently relapse. Only 50 % of these patients will be effectively salvaged with conventional therapies. The prognosis is particularly poor for those patients with chemotherapy refractory disease, who are unable to obtain even transient disease control, and for patients who relapse following high dose chemotherapy and autologous stem cell transplant. In this review, we summarize the most recent updates on the management of patients with relapsed HL, the role of novel therapies such as brentuximab vedotin, and an overview of promising new agents currently under investigation. We also discuss the role of consolidation strategies such as high-dose chemotherapy and autologous stem cell transplant, and reduced-intensity allogeneic hematopoietic stem cell transplant, and the need for new strategies in the elderly patient population. PMID:24942298

  14. [The molecular pathology of classical Hodgkin lymphoma].

    PubMed

    Asano, Naoko

    2015-10-01

    In 1832, Dr. Thomas Hodgkin reported the first cases with this malignancy, which came to be named Hodgkin's disease. The cells that are a hallmark of this disease, Hodgkin and Reed-Sternberg (HRS) cells, account for only 1% of those in tumor tissues, with the majority of cells in Hodgkin lymphoma being of various inflammatory types. Advances in molecular techniques have contributed to molecular biological analysis of HRS cells. Intriguingly, HRS cells are derived from germinal center B-cells, but have lost their B-cell gene-expression and co-express non-B-cell genes. Multiple signaling pathways, including the NFκB and JAK/STAT pathways, show deregulated activity in HRS cells, suggesting an important role for these pathways in the pathogenesis of Hodgkin lymphoma. This article describes the molecular pathological characteristics of HRS cells: 1) the cellular origin of HRS cells, 2) deregulated gene expression in HRS cells, 3) genetic alterations and 4) epigenetic alterations in HRS cells, 5) the lost B-cell phenotype of HRS cells, 6) the role of EBV in Hodgkin lymphoma pathogenesis, and 7) micro-environmental interactions between HRS and reactive cells.

  15. Hodgkin's disease of the thoracic vertebrae.

    PubMed

    Uehara, Masashi; Takahashi, Jun; Hirabayashi, Hiroki; Kitahara, Jun; Kamijyo, Tetsuyoshi; Ebara, Sohei; Kato, Hiroyuki

    2013-08-01

    Hodgkin's disease rarely occurs in the spine, which is usually a setting for the advanced form of the disease. To describe an unusual case of isolated, primary spinal Hodgkin's disease and to draw attention to this disease as a possible diagnosis in patients with mixed inflammatory cell infiltrate lesions located in the thoracic spine. A case report of a 28-year-old woman who presented with back pain and progressive weakness in the lower extremities as a result of spinal cord compression from Hodgkin's disease of the thoracic vertebrae. We report a new case of spinal cord compression resulting from Hodgkin's disease of the thoracic vertebrae. Decompression surgery was performed in the patient, followed by antibiotic treatment. Antibiotic therapy temporarily improved inflammation and fever. However, magnetic resonance imaging (MRI) evaluation showed that the inflammatory reaction in the lesion was not completely resolved. The disease progressed and later investigations revealed Hodgkin's disease, which improved with a course of chemotherapy and radiation. Hodgkin's disease should be considered in the differential diagnosis of spinal neoplastic lesions with clinical features similar to spondylitis. Because MRI evaluation showed that the vertebral disc was maintained in this case, the presence of a tumor rather than inflammation should have been suspected. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Study of ADCT-301 in Patients With Relapsed or Refractory Hodgkin and Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-04-27

    Hodgkin Lymphoma; Non-Hodgkin Lymphoma; Burkitt's Lymphoma; Chronic Lymphocytic Leukemia; Small Lymphocytic Lymphoma; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Follicular; Lymphoma, Mantle-Cell; Lymphoma, Marginal Zone; Waldenstrom's Macroglobulinaemia; Lymphoma,T-cell Cutaneous; Lymphoma, T-Cell, Peripheral

  17. Radiation-induced splenic atrophy in patients with Hodgkin's disease and non-Hodgkin's lymphomas

    SciTech Connect

    Dailey, M.O.; Coleman, C.N.; Kaplan, H.S.

    1980-01-24

    Effective treatment of Hodgkin's disease requires the determination of the extent of the disease. This usually involves staging laparotomy, which includes splenectomy and biopsies of the para-aortic lymph nodes, liver, and bone marrow. Absence of the spleen predisposes a person to fulminant septicemia from encapsulated bacteria, a risk even greater in patients undergoing treatment for Hodgkin's disease. For this reason, some investigators have suggested that spleens not be removed for diagnosis but, rather, that they be included within the fields of radiation, which would preserve normal splenic function. We present a case of fatal spontaneous pneumococcal sepsis in a patient with splenic atrophy; the sepsis occurred 12 years after successful treatment of Hodgkin's disease by total nodal and splenic irradiation. A retrospective study of patients treated for Hodgkin's and non-Hodgkin's lymphomas indicated that atrophy and functional asplenia may be an important sequela of splenic irradiation.

  18. Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas.

    PubMed

    Graus, Francesc; Ariño, Helena; Dalmau, Josep

    2014-05-22

    Paraneoplastic neurological syndromes (PNSs) rarely associate with Hodgkin lymphoma (HL) and non-HLs (NHLs). Except for paraneoplastic cerebellar degeneration (PCD) in HL and dermato/ polymyositis in both HL and NHL, other PNSs are uncommon and have only been reported as isolated case reports or short series. There are several important differences in PNSs when occurring in association with HL and NHL compared with those associated with solid tumors. First, some PNSs such as sensory neuronopathy or Lambert-Eaton myasthenic syndrome rarely occur in lymphomas, whereas others, such as granulomatous angiitis, are only described in HL. Second, onconeural antibodies are absent in most PNSs associated with lymphomas with the exceptions of Tr (δ/notch-like epidermal growth factor-related receptor) in PCD and mGluR5 in limbic encephalitis (LE). The antigens recognized by these antibodies are not expressed in lymphoma cells, suggesting the tumor itself does not trigger the PNS. Third, unlike patients with solid tumors in patients with lymphoma, the PNSs often develops at advanced stages of the disease. Furthermore, the type and frequency of PNSs are different between HL and NHL; whereas LE and PCD occur almost exclusively in patients with HL, sensorimotor neuropathies and dermatomyositis are more frequent in NHL.

  19. Non-Hodgkin's lymphoma among Vietnam veterans.

    PubMed

    Dalager, N A; Kang, H K; Burt, V L; Weatherbee, L

    1991-07-01

    In light of findings suggesting an increase in the risk for non-Hodgkin's lymphoma among men exposed to phenoxyherbicides and concerns among veterans over Agent Orange exposure, a hospital-based case-control study was undertaken to examine the association between military service in Vietnam and non-Hodgkin's lymphoma. The cases consisted of 201 Vietnam-era veteran patients who were treated in one of 172 Department of Veterans Affairs hospitals from 1969 through 1985 with a diagnosis of non-Hodgkin's lymphoma. 358 Vietnam-era veteran patients with a diagnosis other than malignant lymphoma served as a comparison group. Military service information was obtained from a review of the veteran's military personnel records. Service in Vietnam did not increase the risk of non-Hodgkin's lymphoma either in general (branch adjusted odds ratio = 1.03, 95% confidence interval = 0.70-1.50) or with increased latency period as defined as the duration in years from first service in Vietnam to hospital discharge. Surrogate measures of potential Agent Orange exposure such as service in a specific military branch, in a certain region within Vietnam, or in a combat role as determined by military occupational speciality were not associated with any increased risk of non-Hodgkin's lymphoma.

  20. Hodgkin's disease and Vietnam service.

    PubMed

    Dalager, N A; Kang, H K; Burt, V L; Weatherbee, L

    1995-09-01

    Earlier studies that showed an association between exposure to phenoxy herbicides and the risk of malignant lymphomas have sparked concerns among Vietnam veterans over Agent Orange exposure. The Department of Veterans Affairs (VA) undertook a hospital-based case-control study to examine the association between military service in Vietnam and several histologic types of malignant lymphomas. This is a report of 283 Vietnam-era veteran patients who were treated in one of 172 VA hospitals from 1969 to 1985 with a diagnosis of Hodgkin's Disease (HD). Four hundred and four Vietnam-era veteran patients with diagnosis other than malignant lymphoma served as a comparison group. Military service in Vietnam was not associated with any significant increase in the risk of HD (adjusted odds ratio = 1.28; 95% confidence interval = 0.94, 1.76). Surrogate measures of potential Agent Orange exposure such as service in a specific military branch, in a certain region within Vietnam, in a combat role, or extended Vietnam service time were not associated with any significant increased risk of HD.

  1. Pembrolizumab in classical Hodgkin's lymphoma.

    PubMed

    Maly, Joseph; Alinari, Lapo

    2016-09-01

    Pembrolizumab is a humanized monoclonal antibody directed against programmed cell death protein 1 (PD-1), a key immune-inhibitory molecule expressed on T cells and implicated in CD4+ T-cell exhaustion and tumor immune-escape mechanisms. Classical Hodgkin's lymphoma (cHL) is a unique B-cell malignancy in the sense that malignant Reed-Sternberg (RS) cells represent a small percentage of cells within an extensive immune cell infiltrate. PD-1 ligands are upregulated on RS cells as a consequence of both chromosome 9p24.1 amplification and Epstein-Barr virus infection and by interacting with PD-1 promote an immune-suppressive effect. By augmenting antitumor immune response, pembrolizumab and nivolumab, another monoclonal antibody against PD-1, have shown significant activity in patients with relapsed/refractory cHL as well as an acceptable toxicity profile with immune-related adverse events that are generally manageable. In this review, we explore the rationale for targeting PD-1 in cHL, review the clinical trial results supporting the use of checkpoint inhibitors in this disease, and present future directions for investigation in which this approach may be used.

  2. Allogeneic transplantation for Hodgkin lymphoma.

    PubMed

    Peggs, Karl S; Anderlini, Paolo; Sureda, Anna

    2008-11-01

    The majority of patients with Hodgkin lymphoma (HL) can now expect to be cured with conventional chemo- and/or radio-therapy. However, a subgroup still exists that have poor outcomes, even following dose escalation and autologous stem cell transplantation. Furthermore, patients relapsing after autografting have limited therapeutic options available. Whilst the application of allogeneic transplantation strategies has historically been limited by prohibitive transplant-related mortality, the exploration of reduced intensity approaches has demonstrated the feasibility of delivering allogeneic immunotherapies with more acceptable mortality rates. Although its role remains controversial, we are beginning to re-evaluate the use of allogeneic transplantation in the management of patients with HL and to address a number of critical questions. These include whether a clinically relevant graft-versus-tumour response occurs in HL, and whether subgroups of patients who might benefit from allogeneic approaches can be identified in order to inform development of rational clinical studies. This review focuses on evaluating recent experience with reduced intensity allogeneic approaches in HL in order to inform opinion on its current role and to highlight areas for future investigation.

  3. Study of the Association of Mutant HBsAg Gene and Hodgkin and Non-Hodgkin Lymphoma.

    PubMed

    Makvandi, Kamyar; Ranjbari, Nastaran; Makvandi, Manoochehr; Ashraf Teimori, Ali; Neisi, Niloofar; Rasti, Mojtaba; Alipour, Vida; Albokord, Mostafa; Kanani, Malek; Ahadi, Ramezan; Habibian, Ala

    2015-11-01

    Hepatitis B Virus (HBV) is responsible for chronic, acute, and fulminant hepatitis, which are prevalent worldwide. Chronic HBV may lead to cirrhosis and hepatocellular carcinoma. Several epidemiological studies have indicated that hepatitis B virus is involved in B-cell Hodgkin and Non-Hodgkin Lymphoma (NHL). The aim of this study was to evaluate the association between hepatitis B infection and Hodgkin and non-Hodgkin Lymphoma. Paraffin embedded of 41 block samples including 12 (29.26%) Hodgkin and 29 (70.73%) non-Hodgkin patients were collected. Next, DNA extraction was carried out for all the samples followed by HBV DNA detection by the nested polymerase chain reaction (PCR). The positive HBV DNA samples were sequenced, and HBV genotypes and HBV subtypes were determined. Three out of 12 (25%) Hodgkin samples and seven out of 29 (24.13%) non-Hodgkin showed positive HBV DNA results. The results of sequencing revealed that the D genotype was predominant among the positive HBV patients. Interestingly an unpredictable amino acid proline was detected in position 88 of the HBs gene, which indicates a new mutation in the "S" region of HBV DNA in patients with Hodgkin and non-Hodgkin lymphoma. A high rate of 25% and 24.13% of HBV DNA was detected among patients with Hodgkin and non-Hodgkin lymphoma, respectively.

  4. Bilateral breast cancer after cured Hodgkin's disease

    SciTech Connect

    Anderson, N.; Lokich, J. )

    1990-01-15

    Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions were Stage I pathologically without evidence of axillary nodal involvement. It is recommended that female patients with Hodgkin's disease who have received mantle irradiation as part of the therapy for their Hodgkin's disease and who are observed for 10 or more years after completion of mantle irradiation be considered at risk for the development of breast cancer. Such patients should be monitored appropriately by routine bilateral mammograms to increase the early detection of early stage lesions.

  5. Hodgkin Lymphoma, Version 2.2015

    PubMed Central

    Hoppe, Richard T.; Advani, Ranjana H.; Ai, Weiyun Z.; Ambinder, Richard F.; Aoun, Patricia; Bello, Celeste M.; Benitez, Cecil M.; Bierman, Philip J.; Blum, Kristie A.; Chen, Robert; Dabaja, Bouthaina; Forero, Andres; Gordon, Leo I.; Hernandez-Ilizaliturri, Francisco J.; Hochberg, Ephraim P.; Huang, Jiayi; Johnston, Patrick B.; Khan, Nadia; Maloney, David G.; Mauch, Peter M.; Metzger, Monika; Moore, Joseph O.; Morgan, David; Moskowitz, Craig H.; Mulroney, Carolyn; Poppe, Matthew; Rabinovitch, Rachel; Seropian, Stuart; Tsien, Christina; Winter, Jane N.; Yahalom, Joachim; Burns, Jennifer L.; Sundar, Hema

    2016-01-01

    Hodgkin lymphoma (HL) is an uncommon malignancy involving lymph nodes and the lymphatic system. Classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma are the 2 main types of HL. CHL accounts for most HL diagnosed in the Western countries. Chemotherapy or combined modality therapy, followed by restaging with PET/CT to assess treatment response using the Deauville criteria (5-point scale), is the standard initial treatment for patients with newly diagnosed CHL. Brentuximab vedotin, a CD30-directed antibody-drug conjugate, has produced encouraging results in the treatment of relapsed or refractory disease. The potential long-term effects of treatment remain an important consideration, and long-term follow-up is essential after completion of treatment. PMID:25964641

  6. Late complications of Hodgkin's disease management

    SciTech Connect

    Young, R.C.; Bookman, M.A.; Longo, D.L. )

    1990-01-01

    In the past several decades, Hodgkin's disease has been transformed from a uniformly fatal illness to one that can be treated with the expectation of long-term remission or cure in the majority of patients. Because patients now survive for long periods after curative intervention, various complications have been identified. The spectrum of complications following curative therapy is quite diverse and includes immunologic, cardiovascular, pulmonary, thyroid, and gonadal dysfunction. In addition, second malignant neoplasms in the form of acute leukemia as well as secondary solid tumors have now been documented to occur with increased frequency in patients cured of Hodgkin's disease. 80 references.

  7. Langerhans cell histiocytosis followed by Hodgkin's lymphoma.

    PubMed

    Park, Ik Soo; Park, In Keun; Kim, Eun Kyoung; Kim, Shin; Jeon, Sang Ryong; Huh, Joo Ryung; Suh, Cheol Won

    2012-12-01

    A 22-year-old man was referred to our institution due to lower back pain and was diagnosed with Langerhans cell histiocytosis of the thoracic and lumbar spine. The patient achieved complete remission with radiotherapy and chemotherapy. One year later, right cervical lymphadenopathy was observed and Hodgkin's lymphoma was confirmed on biopsy. The patient was treated with chemotherapy and autologous stem cell transplantation, and experienced no further symptoms. Further, no evidence of recurrence was observed on follow-up imaging. This report discusses the association between Langerhans cell histiocytosis and Hodgkin's lymphoma.

  8. Intermittency in the Hodgkin-Huxley model.

    PubMed

    Cano, Gaspar; Dilão, Rui

    2017-06-14

    We show that action potentials in the Hodgkin-Huxley neuron model result from a type I intermittency phenomenon that occurs in the proximity of a saddle-node bifurcation of limit cycles. For the Hodgkin-Huxley spatially extended model, describing propagation of action potential along axons, we show the existence of type I intermittency and a new type of chaotic intermittency, as well as space propagating regular and chaotic diffusion waves. Chaotic intermittency occurs in the transition from a turbulent regime to the resting regime of the transmembrane potential and is characterised by the existence of a sequence of action potential spikes occurring at irregular time intervals.

  9. [Pulmonary Langerhans histiocytosis and Hodgkin's lymphoma].

    PubMed

    Paris, A; Dib, M; Rousselet, M-C; Urban, T; Tazi, A; Gagnadoux, F

    2011-09-01

    Pulmonary Langerhans histiocytosis (PLH) is a rare disease due to the accumulation of Langerhans cells at the level of the bronchioles. These dendritic immunocytes form granulomata and destroy the wall of the airway. We report a case of PLH developing at the same time as Hodgkin's lymphoma in a young woman who smoked tobacco and cannabis. We observed a complete remission of the PLH lesions parallel to the remission of the Hodgkin's lymphoma after chemotherapy, in the absence of any change in the consumption of tobacco and cannabis. This observation leads us to discuss the potential relationships between PLH on one hand, and smoking, the lymphoma and its treatment on the other.

  10. Undifferentiated Nasopharyngeal Carcinoma Mimicking Hodgkin Lymphoma With CD30 Expression.

    PubMed

    Jabbour, Mark N; Nassif, Samer; Chakhachiro, Zaher

    2016-12-01

    The presence of CD30-expressing Hodgkin-like cells with a background of inflammation and eosinophils in a young adolescent is usually diagnostic of classical Hodgkin lymphoma. Herein we present the case of a 12-year-old boy presenting with enlarged cervical lymph node characterized by the presence of Hodgkin-like cells expressing CD30 and EBV-LMP1 with a Hodgkin-like background. The Hodgkin-like cells were negative for CD15, CD20, CD45, and Pax-5. The tumor cells, however, expressed several cytokeratins, confirming the diagnosis of an undifferentiated carcinoma nasopharyngeal type. This case highlights the importance of possessing a high index of suspicion when encountering lymph nodes with Hodgkin-like cells and a Hodgkin-like background, even with CD30 expression, as the differential can include undifferentiated carcinoma nasopharyngeal type. © The Author(s) 2016.

  11. Novel Targeted Agents in Hodgkin and Non-Hodgkin Lymphoma Therapy

    PubMed Central

    Grover, Natalie S.; Park, Steven I.

    2015-01-01

    There has been a recent emergence of novel targeted agents for treatment of Hodgkin and non-Hodgkin lymphoma. In particular, antibodies and antibody-drug conjugates directed against surface antigens, agents that block immune checkpoint pathways, and small molecule inhibitors directed against cell signaling pathways have shown significant promise in patients with relapsed and refractory disease and in the frontline setting. With the development of these new therapies, cytotoxic chemotherapy may be avoided entirely in some clinical settings. This review will present the latest information on these novel treatments in Hodgkin and non-Hodgkin lymphoma and will discuss both recently approved agents as well as drugs currently being studied in clinical trials. PMID:26393619

  12. T-cell non-Hodgkin's lymphoma after radiotherapy and chemotherapy for Hodgkin's disease

    SciTech Connect

    Lowenthal, R.M.; Harlow, R.W.H.; Mead, A.E.; Tuck, D.; Challis, D.R.

    1981-10-01

    A rapidly fatal T-cell lymphoma developed in a 25-year-old man who, over a period of seven years, had been treated with radiotherapy and combination chemotherapy for Hodgkin's disease (HD). Non-Hodgkin's lymphoma (NHL) is increasingly being recognized as a late sequel of therapy for HD, but this is the first case in which NHL of T-cell type has been identified in such circumstances.

  13. Fluorine-18 fluorodeoxyglucose PET-CT for extranodal staging of non-Hodgkin and Hodgkin lymphoma.

    PubMed

    Ömür, Özgür; Baran, Yusuf; Oral, Aylin; Ceylan, Yeşim

    2014-01-01

    We aimed to evaluate the role of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) involving care-dose unenhanced CT to detect extranodal involvement in patients with non-Hodgkin and Hodgkin lymphoma. Lymphoma patients (35 Hodgkin lymphoma, 75 non-Hodgkin lymphoma) who were referred for 18F-FDG PET-CT imaging, following a diagnostic contrast-enhanced CT (CE-CT) performed within the last month, were included in our study. A total of 129 PET-CT images, and all radiologic, clinical, and pathological records of these patients were retrospectively reviewed. In total, 137 hypermetabolic extranodal infiltration sites were detected by 18F-FDG PET-CT in 62 of 110 patients. There were no positive findings by CE-CT that reflected organ involvement in 40 of 137 18F-FDG-positive sites. The κ statistics revealed fair agreement between PET-CT and CE-CT for the detection of extranodal involvement (κ=0.60). The organs showing a disagreement between the two modalities were the spleen, bone marrow, bone, and thyroid and prostate glands. In all lesions that were negative at CE-CT, there was a diffuse 18F-FDG uptake pattern in the PET-CT images. The frequency of extranodal involvement was 51% and 58% in Hodgkin and non-Hodgkin lymphoma patients, respectively. There was a high positive correlation between the maximum standardized uptake values of the highest 18F-FDG-accumulating lymph nodes and extranodal sites (r=0.67) in patients with nodal and extranodal involvement. 18F-FDG PET-CT is a more effective technique than CE-CT for the evaluation of extranodal involvement in Hodgkin and non-Hodgkin lymphoma patients. PET-CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to CE-CT.

  14. Aneuploidy in sperm of Hodgkin`s disease patients receiving NOVP chemotherapy

    SciTech Connect

    Robbins, W.A.; Cassel, M.J.; Wyrobek, A.J.

    1994-09-01

    Induction of genetic damage in germ cells of young patients receiving chemo- or radiotherapy for cancers with probable cure, such as Hodgkin`s disease, is cause for concern. These young patients may someday desire children, and germ cell alterations presenting as numerical chromosomal abnormalities in sperm may place their future offspring at risk. To address this concern, we measured aneuploidy in sperm from eight young Hodgkin`s disease patients: four pre-treatment, four during treatment, and three over a 45 month period following treatment with NOVP (Novantrone, Oncovin, Vinblastine and Prednisone). Patients ranged in stage of disease from IA-IIEB and none had received prior radiation or chemotherapy. Using multi-chromosome sperm FISH with repetitive sequence probes specific for chromosomes X, Y and 8, we found a significant 2-4 fold increase in particular numerical chromosomal abnormalities during treatment which were limited in persistence post-treatment. Additionally, pre-treatment Hodgkin`s disease patients showed elevations in some numerical chromosomal abnormalities when compared to a healthy reference group. In several men, the fraction of aneuploid sperm did not return to healthy reference group levels even after completion of therapy. These results show that elevated sperm aneuploidy occurs in germ cells of young cancer patients during chemotherapy and suggest caution to prevent conceptions during this period. The elevated sperm aneuploidy appears transient, but in some cases never returns to healthy reference group levels.

  15. Potential benefits of therapeutic splenectomy for patients with Hodgkin's disease and non-Hodgkin's lymphomas

    SciTech Connect

    Schreiber, D.P.; Jacobs, C.; Rosenberg, S.A.; Cox, R.S.; Hoppe, R.T.

    1985-01-01

    Thirty-four patients with Hodgkin's disease and non-Hodgkin's lymphoma underwent therapeutic splenectomies to improve hematologic tolerance for chemotherapy. The mean age was 40 years; there were 16 males and 18 females. Fourteen had Hodgkin's disease, 19 had non-Hodgkin's lymphoma, and 1 had malignant histocytosis. Nineteen had palpable splenomegaly, 19 had marrow involvement and 20 had splenic involvement by lymphoma. The following data were analyzed before and after splenectomy: mean white blood cell count (WBC) and platelet count on planned first day of cycle, delay ratio of chemotherapy delivery and percent maximal dose rate. Thirteen patients had non-Hodgkin's lymphoma, splenomegaly and positive bone marrow and showed significant benefit in all of the aforementioned parameters. Of the patients with prior irradiation, only those who completed their radiation greater than six months prior to splenectomy showed benefit. Ten patients had Hodgkin's disease, negative bone marrow and no splenomegaly. This group showed significant improvement in mean platelet count but more limited benefit in delay ratio and percent maximal dose rate. Thus, selected patients with lymphoma who are experiencing delays in chemotherapy because of poor count tolerance may benefit from splenectomy.

  16. [Molecular biology aspects of Hodgkin's disease].

    PubMed

    Macák, J

    1998-06-01

    Immunohistological methods did not elucidate the etiology and pathogenesis of Hodgkin's disease. In "classical" cases the immunophenotype is based on evidence of three markers: CD30+, CD15+, CD20-. Despite the use of more recent methodical approaches a considerable percentage of Hodgkin and RS cells with CD15 antibody is negative. The Epstein-Barr virus (EBV) plays an important part in the development of malignant disease and at the same time a number of nuclear antigens can be detected: EBNA-1, EBNA-2, EBNA-3a,-3b,-3c,LP. Also latent membrane proteins LMP-1, -2a, -2b and two small ribonucleic acids described as EBER-1, EBER-2. Bcl-2 protein was detected in the majority of malignant lymphomas which reduces its value in differential diagnostic reflections. In Hodgkin and RS cells its positivity is not due to translocation or other disorders of the cell genoma. In these cells the expression of mRNA for bcl-2 is much more constant. Most probably there is no cooperation of bcl-2 and p53. Co-expression of the two genes was found only in a small percentage of patients with m.Hodgkin. The varied morphological picture in particular in the mixed type of m. Hodgkin is most probably associated with the formation and release of cytokines, factors which stimulate cell colonies (IL-3, GM-CSF, G-CSF, M-CSF). Non-tumourous cells chemotactically attracted to sites of tumour cells release further cytokines e.g. TGF-beta, IL-1, Il-2, which participate in the overall morphological appearance of the lesion.

  17. Frequency of epstein-barr virus in classical hodgkin Lymphoma.

    PubMed

    Azhar, Muhammad; Din, Hafeez Ud; Muhammad, Iqbal; Hashmi, Shoaib Naiyar; Akhtar, Farhan

    2016-01-01

    Epstein-Barr virus plays an important role in pathogenesis of Hodgkin lymphoma. The first patient with Epstein-Barr positive Reed Sternberg cells was described in 1985. Since then association between Epstein-Barr virus and Hodgkin lymphoma has been shown in many parts of the world and its occurrence shows significant variation from continent to continent and from country to country. The study was carried out at department of histopathology, Armed Forces Institute of Pathology from 27th April 2013 to 10th March 2014. A total of 55 cases of classical Hodgkin lymphoma were included in the study. Out of 55 patients, 38 (69%) were male and 17 (31%) were female. The age of the patients ranged between 4-67 years with an average age of 29.4±21.72 years. Out of these, 44 cases (80%) were positive for latent membrane protein-1. Among positive cases 32 (72.72%) were male and 12 (27.28%) were female. Based upon histological subtypes MCHL was the commonest as a whole accounting for 87.3% as well as among both genders. Out of total 55 cases, 79.16% (38/48) of mixed cellularity Hodgkin lymphoma cases showed positivity for latent membrane protein-1 while 83.33% (5/6) cases of nodular sclerosis Hodgkin lymphoma and 100% (1/1) cases of lymphocyte depleted Hodgkin lymphoma showed positivity. No case of lymphocyte predominant classical Hodgkin lymphoma was diagnosed during the study. 80% of our classical Hodgkin lymphoma cases showed association with EBV expression. A total of 79.16% cases of mixed cellularity Hodgkin lymphoma showed LMP1 expression while 100% of lymphocyte depleted Hodgkin lymphoma showed LMP1 expression. The highest expression seen in lymphocyte depleted Hodgkin lymphoma subtype in contrast to mixed cellularity requires to be confirmed by a larger scale study comprising of substantial number of patients of lymphocyte depleted Hodgkin lymphoma and lymphocyte rich classical Hodgkin lymphoma.

  18. Selinexor Plus Combination Chemotherapy in Treating Patients With Advanced B Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-05-12

    Diffuse Large B-Cell Lymphoma; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Extranodal Marginal Zone Lymphoma; Recurrent Follicular Lymphoma; Recurrent Indolent Adult Non-Hodgkin Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Waldenstrom Macroglobulinemia; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Extranodal Marginal Zone Lymphoma; Refractory Follicular Lymphoma; Refractory Mantle Cell Lymphoma; Stage III Non-Hodgkin Lymphoma; Stage IV Non-Hodgkin Lymphoma; Transformed Recurrent Non-Hodgkin Lymphoma

  19. Immune Response Genotypes and Risk of Young Adult Hodgkin Lymphoma

    DTIC Science & Technology

    2007-09-01

    TECHNICAL OBJECTIVES 1) To identify, enroll and collect blood specimens from 368 adolescents and young adults 18-to 45 years old diagnosed with Hodgkin... Young Adult Hodgkin Lymphoma PRINCIPAL INVESTIGATOR: Wendy Cozen Victoria Cortessis, Ph.D. David Conti, Ph.D. David...Genotypes and Risk of Young Adult Hodgkin Lymphoma 5b. GRANT NUMBER W81XWH-06-1-0683 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Wendy Cozen

  20. Development of Hodgkin's disease in a patient with leprosy.

    PubMed

    Weshler, Z; Leviatan, A; Gordon, R; Kopolovic, J

    1978-01-01

    We present a patient with leprosy who developed Hodgkin's disease of the nodular sclerosing type. There are two previous reports describing the combination of leprosy and Hodgkin's disease in a single patient [3, 9]. Hodgkin's disease was diagnosed 14 months after the complete disappearance of mycobacterium leprae from the skin lesions, under treatment with DDS (diamino-diphenyl-sulfone). Hodgkin's disease was treated by irradiation and chemotherapy. Obstructive jaundice developed which resolved under treatment by irradiation of the hilar area of the liver, chemotherapy and hormones. During two years of immuno-suppressive therapy, without DDS, no exacerbation of the leprosy occurred.

  1. Rituximab in lymphocyte-predominant Hodgkin disease.

    PubMed

    Azim, Hatem A; Pruneri, Giancarlo; Cocorocchio, Emilia; Cinieri, Saverio; Raviele, Paola R; Bassi, Simona; Preda, Lorenzo; Martinelli, Giovanni; Peccatori, Fedro A

    2009-01-01

    Lymphocyte-predominant Hodgkin disease (LPHD) differs in biology and clinical behaviour from classic Hodgkin disease. Almost 100% of LPHD neoplastic cells express CD20 and thus rituximab could be effective; yet limited data are available. We performed a retrospective analysis on patients with LPHD who were treated with rituximab at our institution to determine the magnitude of benefit offered by this drug. Seven patients were identified; 4 received the drug as single agent while the rest received it in combination with chemotherapy. All except 2 received the drug in the salvage setting. Response rate was 100% with 6 of 7 patients achieving complete remission. At a median follow-up of 2 years, 4 patients are still disease free while the rest relapsed at a median time of 27 months. Rituximab is effective in LPHD and should be considered; however, the optimal schedule remains to be determined.

  2. Diagnostic laparotomy in non-Hodgkin's lymphoma.

    PubMed Central

    Jelliffe, A. M.

    1975-01-01

    Twenty patients with non-Hodgkin's lymphoma (NHL) were investigated by diagnostic laparotomy. These patients were seen over a 3 1/2 year period during which a total of 78 patients with NHL were seen. Laparotomy was considered unsuitable in 58 patients, either because widespread disease was easily demonstrated by simpler means or because of their poor general medical condition. Laparotomy revealed more extensive disease in 14 patients. Although laparotomy is proving to be a worthwhile investigative procedure, it is less likely to be useful as a routine investigation than is the case with Hodgkin's disease. Widespread involvement of mesenteric lymph nodes is common and among the 10 patients with a poor histological grade of tumour, 2 with negative laparotomy findings developed disease in the abdomen within 3 months of operation. PMID:1182072

  3. Prevalence of Hepatitis C virus Genotype 3a in patients with Hodgkin and Non-Hodgkin Lymphoma.

    PubMed

    Radmehr, Hashem; Makvandi, Manoochehr; Samarbafzadeh, Alireza; Teimoori, Ali; Neisi, Niloofar; Rasti, Mojtaba; Abasifar, Sara; Soltani, Hasan; Abbasi, Samaneh; Kiani, Hadis; Mehravaran, Hamide; Azaran, Azarakhsh; Shahani, Toran

    2016-12-01

    Hepatitis C virus (HCV) is a major public health problem worldwide. Replication and persistence of HCV genome have been described in the liver tissue as well as B cells lymphocyte. Several investigations have reported that long-term persistence of HCV in B cells may result in Hodgkin and Non-Hodgkin lymphoma. This study was aimed to determine frequency of HCV RNA in histological tissues obtained from patients suffered from Hodgkin and Non-Hodgkin lymphoma. 52 formalin-fixed paraffin-embedded tissue blocks including 23 (44.3%) Hodgkin and 29 (55.7%) Non-Hodgkin samples were collected and five micrometer sections were prepared. RNA was extracted and cDNA was synthesized. Two consecutive Nested RT-PCR assays were carried out for detection of HCV 5' UTR and core gene. RT-PCR products were sequenced and aligned to construct HCV phylogenic tree to evaluate the homology of sequences in comparison to the reference sequences retrieved from Genbank. Overall, 6 Non-Hodgkin (20.6%) and 3 Hodgkin lymphoma (13.04%) samples showed positive PCR results for both 5' UTR and HCV core RNA via nested PCR (P<0.469). Sequencing results revealed that all detected HCV RNA samples belonged to the genotype 3a. Despite low prevalence of HCV infection in Iran, high frequency of HCV RNA genotypes 3a (17.3%) has been found in patients with Hodgkin and Non-Hodgkin lymphoma. To improve treatment regimens, screening of HCV RNA in patients suffered from Hodgkin or Non-Hodgkin lymphoma is recommended which can be done through highly sensitive molecular means before and after immunosuppression status.

  4. Infection-associated non-Hodgkin lymphomas.

    PubMed

    Suarez, F; Lecuit, M

    2015-11-01

    Non-Hodgkin lymphomas (NHLs) are malignant proliferations of lymphoid cells. Lymphoid cells proliferate in a physiological manner in response to antigen-dependent and antigen-independent signals. Some lymphotropic viruses, such as Epstein-Barr virus and human T-lymphotropic virus 1, as well as pathogens leading to chronic antigenic stimulation (such as Helicobacter pylori and hepatitis C virus), are associated with NHL. We review here some of the pathophysiological features of infection-associated NHL.

  5. Hodgkin's lymphoma--patient's assessment and staging.

    PubMed

    Gospodarowicz, Mary K

    2009-01-01

    Hodgkin's lymphoma is one of the most curable malignancies today. But treatment is associated with significant toxicity. The objective of high-quality management is to minimize treatment exposure while maximizing cure of disease. Principles of cancer staging and patient's assessment taxonomy are important to improve communication. An orderly patient evaluation and systematic recording of disease extent using the Ann Arbor classification forms the basis for treatment decision, response assessment, and clinical trials. The practice of staging in Hodgkin's lymphoma evolved over the past 40 years from clinical examination and plain imaging to modern anatomic and functional imaging. Although useful in the past, staging laparotomy, lymphangiograms, and Gallium scintigraphy have now been abandoned. Computerized tomography combined with 2-[18F]fluoro-2-deoxyglucose-positron emission tomography form the basis for anatomic disease extent assessment. Although patients' evaluation and staging at diagnosis are important, the management of Hodgkin's lymphoma involves a complex series of algorithms requiring interim and overall response assessment, careful follow-up, repeat assessment, and salvage management of recurrent disease.

  6. Evaluation of Occupational Risk Factors in Non-Hodgkin Lymphoma and Hodgkin's Disease in Iranian Men

    PubMed Central

    Aminian, Omid; Abedi, Ali; Chavoshi, Farzaneh; Ghasemi, Mohammad; Rahmati-Najarkolaei, Fatemeh

    2012-01-01

    Background Lymphoma is a malignancy, arises from lymphoid tissue. Nowadays, it is the ninth most common cancer in Iran. The risk factors of malignant lymphomas have not well determined, but since 20 years ago till now, too many epidemiological researches have been concerning either Non-Hodgkin Lymphoma (NHL) or Hodgkin's Disease (HD). It is a common usual hypothesis that idiosyncratic reaction to common physical, chemical, and viral agents could lead to lymphoma without obvious immune deficiency. Some occupations has reported to cause increasing "NHL" risks, such as rubber industry, veterinaries, uranium mining, metal working, asbestos exposing, farming, textile industry, and benzene exposing. The roles of ionizing radiation, benzene and other environmental agents have not been clear, because of the lack of confirmed evidences for relation between the occupational and environmental agents with "HD". Methods A case-control study with 150 cases of malignant lymphoma and 150 controls have performed in Tehran. Data have selected through face-to-face interviews about the medical and occupational histories. Results In this study, there was a significantly increased risk for Non-Hodgkin Lymphoma in these occupations; welders, metal workers, founders, aluminium workers OR=4.6 [Confidence Interval (CI): 1.47-14.35] and increased risk for Hodgkin's Disease in drivers OR=2.34 [(CI):0.86-6.35]. We have found out decreased NHL risk in office workers OR=0.54 [(CI):0.29-1.02] and also found out a non-significant increased NHL risk in farmers OR=1.58 [(CI):0.82-3.03]. In this study, we have found no relation between smoking and HD, or NHL. Conclusion The results of this study suggest that several occupations could alter the risk of Non-Hodgkin Lymphoma and Hodgkin's Disease. PMID:25352969

  7. Screening for Celiac disease in Hodgkin and non-Hodgkin lymphoma patients.

    PubMed

    Cil, Timuçin; Altintaş, Abdullah; Işikdoğan, Abdurrahman; Paşa, Semir; Bayan, Kadim; Batun, Sabri; Büyükbayram, Hüseyin

    2009-06-01

    Celiac disease is an abnormal T cell-mediated immune response against dietary gluten in genetically predisposed individuals. The aim of our prospective study was to evaluate the frequency of Celiac disease in patients with lymphoma and to determine the usefulness of the anti-gliadin and anti-endomysial antibodies (EMA) for diagnosis of Celiac disease in this patient group. We studied 119 patients with previously or newly diagnosed non-Hodgkin's lymphoma and 60 patients with Hodgkin's lymphoma who presented at the hematology and medical oncology divisions of Dicle University Hospital in Turkey between December 2002 and January 2006. Serological screening for Celiac disease was performed in all patients by searching for serum anti-gliadin immunoglobulin A and immunoglobulin G, and EMA immunoglobulin A and immunoglobulin G. In the Hodgkin's lymphoma group, anti-gliadin immunoglobulin A was detected in 9 (15%) patients (3 male, 6 female), and antigliadin immunoglobulin G was detected in 21 (35%) patients (15 male, 6 female). In the non-Hodgkin's lymphoma group, antigliadin immunoglobulin A was detected in 6 (5%) patients (2 M male 4 female), and anti-gliadin immunoglobulin G was detected in 30 (25.2%) patients (18 male, 12 female). EMA immunoglobulin A and immunoglobulin G were not detected in the Hodgkin's lymphoma and non-Hodgkin's lymphoma groups. Our report is the first to describe the frequency of Celiac disease in patients with lymphoma in the southeast region of Turkey. In our study, there was no evidence that Celiac disease is a pre-malignant condition for lymphoma. Serological screening for Celiac disease in lymphoma patients does not seem to be necessary.

  8. Development of non-Hodgkin's lymphoma following therapy for Hodgkin's disease

    SciTech Connect

    Kim, H.D.; Bedetti, C.D.; Boggs, D.R.

    1980-12-15

    Three patients developed non-Hodgkin's lymphoma (NHL) 3 to 6 years after treatment for Hodgkin's disease (HD). In no instance was there evidence of recurrence of HD following the initial chemotherapy or radiotherapy. None of these patients had received both radiation therapy and chemotherapy. All patients responded well to conventional chemotherapy for NHL and are alive at 23 +, 37 +, and 65+ months after that secondary diagnosis. This report, when coupled with at least ten other such reported patients, suggests that NHL may be a relatively uncommon but significant complication of therapy for HD and must be distinguished for recurrence of HD.

  9. Interleukin-12 in Treating Patients With Previously Treated Non-Hodgkin's Lymphoma or Hodgkin's Disease

    ClinicalTrials.gov

    2015-04-14

    Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Waldenström Macroglobulinemia

  10. Mammary carcinoma developing after radiotherapy and chemotherapy for Hodgkin's disease

    SciTech Connect

    Janjan, N.A.; Wilson, J.F.; Gillin, M.; Anderson, T.; Greenberg, M.; Schewe, K.; Cox, J.D.

    1988-01-15

    Two patients developed breast cancer after treatment of Hodgkin's disease. Both had received mediastinal irradiation 13 to 15 years, respectively, before the diagnosis of breast carcinoma. One patient had synchronous bilateral breast cancer when the diagnosis was made. Discussed is the risk of mammary carcinoma as a second malignant neoplasm in patients treated for Hodgkin's disease.

  11. Neuralgic amyotrophy in association with radiation therapy for Hodgkin's disease

    SciTech Connect

    Malow, B.A.; Dawson, D.M. )

    1991-03-01

    We describe 4 patients with Hodgkin's disease who developed neuralgic amyotrophy in the setting of radiation therapy. In contrast to tumor progression or radiation plexopathy, the symptom onset was abrupt and occurred within days to weeks of receiving radiation treatments. There is an association between Hodgkin's disease, radiation therapy, and neuralgic amyotrophy.

  12. Hodgkin's disease of the prostate: a detailed case report

    SciTech Connect

    Klotz, L.H.; Herr, H.W.

    1986-06-01

    Malignant lymphoma of the prostate is an unusual entity, and nonHodgkin's lymphoma constitutes most reported cases. We report a well documented case of Hodgkin's lymphoma, initially involving the gastrointestinal tract and spleen, which recurred in the prostate following initial remission with chemotherapy. Treatment with external beam radiotherapy resulted in a rapid complete response that has been sustained for 18 months.

  13. Immune Response Genotypes and Risk of Young Adult Hodgkin Lymphoma

    DTIC Science & Technology

    2008-09-01

    1) To identify, enroll and collect blood specimens from 368 adolescents and young adults 18 years of age or older at the time of participation... Young Adult Hodgkin Lymphoma PRINCIPAL INVESTIGATOR: Wendy Cozen, Victoria Cortessis...COVERED 1 Sep 2007 – 31 Aug 2008 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Genotypes and Risk of Young Adult Hodgkin Lymphoma 5b

  14. Dendritic Cell Therapy, Cryosurgery, and Pembrolizumab in Treating Patients With Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-03-21

    Aggressive Non-Hodgkin Lymphoma; Indolent Non-Hodgkin Lymphoma; Recurrent Adult Non-Hodgkin Lymphoma; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mediastinal (Thymic) Large B-Cell Cell Lymphoma; Recurrent T-Cell Non-Hodgkin Lymphoma; Small Lymphocytic Lymphoma

  15. CPI-613 and Bendamustine Hydrochloride in Treating Patients With Relapsed or Refractory T-Cell Non-Hodgkin Lymphoma or Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-03-13

    Adult Lymphocyte Depletion Hodgkin Lymphoma; Adult Lymphocyte Predominant Hodgkin Lymphoma; Adult Mixed Cellularity Hodgkin Lymphoma; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Adult Nodular Sclerosis Hodgkin Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Hepatosplenic T-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; T-cell Adult Acute Lymphoblastic Leukemia; T-cell Large Granular Lymphocyte Leukemia

  16. Improved survival time trends in Hodgkin's lymphoma.

    PubMed

    Koshy, Matthew; Fairchild, Andrew; Son, Christina H; Mahmood, Usama

    2016-06-01

    There have been dramatic changes in the staging and treatment of Hodgkin's lymphoma (HL) over the past 30 years. We undertook this study to determine if a stage migration had occurred and also examined if treatment associated with later years has improved survival. Patients with stage I-IV HL between 1983 and 2011 were selected from the Surveillance, Epidemiology, and End Results database. Multivariable analysis (MVA) was performed using Cox proportional hazards modeling. The study cohort included 35,680 patients. The stage breakdown in 1983 according to A and B symptoms was follows: 18%, 21%, 12%, and 5% for stage IA, IIA, IIIA, and IVA disease, respectively, and 6%, 11%, 12%, and 15% for stage IB, IIB, IIIB, and IVB disease. The stage breakdown in 2011 according to A and B symptoms was follows: 9%, 29%, 10%, and 6% for stage IA, IIA, IIIA, and IVA disease, respectively, and 4%, 16%, 12%, and 13% for stage IB, IIB, IIIB, and IVB disease. The median follow-up for the entire cohort is 6.1 years. On MVA, the HR for mortality of patients diagnosed in 2006 was 0.60 (95% Confidence Interval (CI): 0.52-0.70) compared to 1983. For stage I and II patients diagnosed in 2006 the HR was 0.62 (95% CI: 0.44-0.87) and 0.40 (95% CI: 0.30-0.55), respectively, compared to patients diagnosed in 1983. For stage III and IV patients diagnosed in 2006 the HR was 0.72 (95% CI: 0.53-0.98) and 0.74 (95% CI: 0.56-0.99), respectively, compared to patients diagnosed in 1983. This is the first study to demonstrate a significant stage migration in early stage Hodgkin's lymphoma. Furthermore, these results demonstrate an improvement in survival over time for patients with Hodgkin's lymphoma which was particularly notable for those with early stage disease.

  17. Adrenal involvement in non-Hodgkin lymphoma

    SciTech Connect

    Paling, M.R.; Williamson, B.R.J.

    1983-08-01

    Adrenal masses are described in seven cases of non-Hodgkin lymphoma in a series of 173 patients. In all seven patients the lymphoma was diffuse rather than nodular. Three patients had adrenal masses at the time of presentation, whereas in four cases the adrenal gland was a site of tumor recurrence after therapy. Three patients had simultaneous bilateral adrenal involvement by tumor. No characteristic features were recognized that might have distinguished these tumors from other adrenal masses. Appropriate therapy successfully resolved the adrenal masses in all but one case. The latter patient was the only one with evidence of adrenal insufficiency.

  18. Combination chemoradiotherapy in early Hodgkin lymphoma.

    PubMed

    André, Marc P E

    2014-02-01

    Combination chemoradiotherapy achieves excellent results for the treatment of localized Hodgkin lymphoma. However, late toxic effects occur, mostly related to the radiotherapy administered after the standard adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy. The most serious sequelae are radiation-induced secondary cancers. Reducing radiotherapy has not yet prevented late malignancies. However, when radiotherapy was omitted, tumor control was inferior, with more relapses necessitating rescue treatment including high-dose chemotherapy with stem cell support. Early fluorodeoxyglucose positron emission tomography performed after a few cycles of ABVD is evaluated in several randomized trials to identify patients who might be safely treated with chemotherapy alone.

  19. Management of Hodgkins Lymphoma: ICMR Consensus Document.

    PubMed

    Radhakrishnan, Venkatraman; Kapoor, Gauri; Arora, Brijesh; Bansal, Deepak; Vora, Tushar; Prasad, Maya; Chinnaswamy, Girish; Laskar, Siddharth; Agarwala, Sandeep; Kaur, Tanvir; Rath, G K; Bakhshi, Sameer

    2017-03-30

    Pediatric Hodgkins lymphoma is a highly curable disease even in the developing world. Current treatment paradigms follow a risk and response based approach. The goal is to minimise treatment related short and long-term toxicity while maintaining excellent survival. A confirmed histopathological diagnosis and full staging work-up are essential prior to embarking on treatment and guidelines for these are provided in the text. All patients require combination chemotherapy while radiotherapy is usually reserved for a select subgroup depending on the protocol used. It is important to follow these patients for relapse in the first five years and life-long for late effects as most of them will be cured.

  20. [Treatment options in non-Hodgkin lymphomas].

    PubMed

    Tilly, Hervé

    2010-01-20

    Histological diagnosis according to WHO classification and determination of usual prognostic factors are necessary to choose between treatment options in non-Hodgkin lymphomas. If an observation period could be frequently proposed to patients with indolent lymphoma, first line treatment usually includes the anti-CD20 monoclonal antibody rituximab (in type B lymphoma or CD20-expressing). A complete remission must be obtained in patients with aggressive lymphoma and the association of chemotherapy and rituximab, in B-cell subtype, is the standard therapeutic approach.

  1. Quantitative analysis of non-Hodgkin's lymphoma.

    PubMed Central

    Abbott, C R; Blewitt, R W; Bird, C C

    1982-01-01

    A preliminary attempt has been made to characterise a small series of non-Hodgkin's lymphomas (NHL) by morphometric means using the Quantimet 720 Kontron MOP/AMO3 image analysis systems. In most cases it was found that the distribution of nuclear area and correlation between mean nuclear area and frequency per unit field, corresponded closely with tumour classification determined by light microscopy. These results suggest that it may be possible to devise an objective and reproducible grading system for NHL using quantitative morphometric techniques. PMID:7040479

  2. Non-Hodgkin's lymphomas: clinical governance issues.

    PubMed

    Fields, P A; Goldstone, A H

    2002-09-01

    Every patient in every part of the world has the right to expect the best possible quality of care from health care providers. Non-Hodgkin's lymphomas (NHL) are an extremely heterogeneous group of conditions which require important decisions to be taken at many points along the treatment pathway. To get this right every time requires that high-quality standards are instituted and adhered to, so that the best possible outcome is achieved. In the past this has not always been the case because of the failure of clinicians sometimes to adhere to an optimal management plan. In 1995, the UK government commissioned an inquiry into the running of cancer services in the United Kingdom, which culminated in a series of recommendations to improve them. Subsequently, these recommendations were implemented as objectives of the NHS Cancer Plan which is the framework by which the UK government wishes to improve cancer services. Concurrently another general concept has emerged which is designed to ensure that the highest quality standards may be achieved for all patients across the whole National Health Service (NHS). This concept, termed 'clinical governance', brings together a corporate responsibility of all health care workers to deliver high quality standards, in the hope that this will translate into better long-term survival of patients with malignant disease. This chapter focuses on the issues surrounding clinical governance and how the principles of this concept relate to non-Hodgkin's lymphomas.

  3. [New therapy outlooks in Hodgkin lymphoma].

    PubMed

    Rossi, Cédric; Casasnovas, René-Olivier

    2017-02-01

    Classical Hodgkin lymphoma (HL) is a curable disease in 80% of advanced and 90% of localized stages. An improvement of the HL curability is still possible with the emergence of first-line therapy with a better balance between efficacy and toxicity and early identification patients with high risk of failure requiring specific treatment. 18FDG PET-CT gained a major role in the baseline staging and response assessment to HL treatment. The prognostic value of early PET-CT allowed to develop PET-CT guided therapies able to optimize the balance between efficacy and toxicity including the modulation of the chemotherapy intensity or the omission of radiotherapy for some localized diseases. New drugs emerged in the treatment of relapse or refractory HL (brentuximab vedotine [BV], immunological checkpoint inhibitor anti-PD1). Although their place in the strategies of salvage therapy is still debated several trials have reported relevant efficacy in some unmet medical need: refractory patients or relapses after auto/allograft. This review addresses the questions of PET-CT-based therapeutic strategies in first-line and the impact of new drugs targeting the micro-environment (anti-PD1) or the Hodgkin Reed Sternberg cells (BV).

  4. Second cancers following non-Hodgkin's lymphoma

    SciTech Connect

    Travis, L.B.; Curtis, R.E.; Boice, J.D. Jr.; Hankey, B.F.; Fraumeni, J.F. Jr. )

    1991-04-01

    The risk of second malignancies following non-Hodgkin's lymphoma (NHL) was estimated in 29,153 patients diagnosed with NHL between 1973 and 1987 in one of nine areas participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Compared with the general population, NHL patients were at a significantly increased risk of developing second cancers (observed/expected (O/E) = 1.18; O = 1231). The O/E ratio increased significantly with time to reach 1.77 in 10-year survivors. Significant excesses were noted for acute nonlymphocytic leukemia (O/E = 2.88), cancers of the bladder (O/E = 1.30), kidney (O/E = 1.47), and lung (O/E = 1.57), malignant melanoma (O/E = 2.44), and Hodgkin's disease (O/E = 4.16). Chemotherapy appeared related to subsequent acute nonlymphocytic leukemia (ANLL) and bladder cancer. Radiation therapy was associated with ANLL and possibly cancers of the lung, bladder, and bone. Malignant melanoma was not clearly related to initial NHL treatment.

  5. Thymic cysts following radiation therapy for Hodgkin disease

    SciTech Connect

    Baron, R.L.; Sagel, S.S.; Baglan, R.J.

    1981-12-01

    In 3 patients, benign thymic cycsts developed following radiation therapy for Hodgkin disease. Autopsy or surgical specimens provided a diagnosis in all 3 cases; computed tomographic (CT) scans obtained in two of the patients provided a preoperative diagnosis. The etiology of these cysts is uncertain; they may arise following successful radiation treatment of Hodgkin disease involving the thymus. When an anterior mediastinal mass develops in a patient with Hodgkin disease following radiation therapy, careful evaluation to exclude a benign process is indicated prior to initiating additional therapy.

  6. Morphologic changes in the thyroid after irradiation for Hodgkin's and non-Hodgkin's lymphoma

    SciTech Connect

    Carr, R.F.; LiVolsi, V.A.

    1989-08-15

    Four cases of thyroidectomy for suspected thyroid carcinoma after previous irradiation for Hodgkin's or non-Hodgkin's lymphoma are reviewed. The patients ranged in age from 18 to 33 years at the time of thyroid surgery with an average latency period of 12 years (range, 8-20 years) from radiation therapy to thyroidectomy. All patients had a clinically palpable thyroid nodule, and pathologically showed a pattern of multiple adenomatous nodules with cytologic atypia. The microscopic changes were sufficiently striking to cause the primary pathologist to request consultation to rule out thyroid carcinoma in each case. Fine-needle aspiration was performed in one case and suggested a thyroid neoplasm. The pathologic findings are reviewed and distinction of this lesion from thyroid carcinoma is discussed.

  7. [Radiological diagnostics of Hodgkin- and non-Hodgkin lymphomas of the thorax].

    PubMed

    Uffmann, M; Schaefer-Prokop, C

    2004-05-01

    Malignant lymphomas belong to the most important malignant diseases in western countries with an increasing incidence of Non-Hodgkin lymphoma. The thorax is the location of primary manifestation especially in patients with Hodgkin's disease. Progression of disease and therapy associated complications are frequently located in the chest. Based on morphological imaging criteria the two types of lymphoma cannot be differentiated, helpful for differentiation is, however, the way of disease spread. Primary and secondary thoracic lymphoma represent a diagnostic challenge in radiology: the patterns are variable in radiography as well as in computed tomography and alter under therapy. Radiological studies, especially CT, are an integral part of the staging process. MRI is considered advantageous for chest wall disease. PET as functional imaging technique has its proven role for staging of high grade lymphomas, the combination of functional and morphological information provided by PET-CT will become the first diagnostic standard in the future.

  8. Checkpoint Inhibitors and Other Immune Therapies for Hodgkin and Non-Hodgkin Lymphoma.

    PubMed

    Matsuki, Eri; Younes, Anas

    2016-06-01

    Treatment for relapsed/refractory (R/R) Hodgkin and non-Hodgkin lymphoma remains challenging. The introduction of rituximab to B cell non-Hodgkin lymphoma (B-NHL) treatment significantly improved patients' response rate and survival; however, approximately one third of patients with diffuse large B cell lymphoma, the most common B-NHL subtype, still have a relapse or become refractory after first-line therapy. More recently, antibody therapies and small-molecule inhibitors were approved for treating R/R lymphomas; these agents include brentuximab vedotin, ibrutinib, and idelalisib. Immune checkpoint inhibitors and other immune therapies are emerging treatments currently being evaluated in various clinical trials for their efficacy against lymphoid malignancies. Striking results from these treatment modalities have been observed in solid tumors, and evidence is accumulating to support their use in various lymphomas. The most exciting results from immune checkpoint inhibitor therapy have been seen in patients with R/R Hodgkin lymphoma, in whom the overall response rate has reached 60-80 %. Results in NHL are more similar to those seen in other solid malignancies, ranging between 20 and 40 %, depending on the histology. Formal approval of these drugs is being awaited, as are the results of combination therapy with checkpoint inhibitors and other treatment modalities, including conventional chemotherapy, small-molecule inhibitors, and other immune therapies. Although response rates have been promising, attention must be paid to the management of unique immune-related adverse events, which warrant close monitoring in some cases. Identification of biomarkers that predict response or severe adverse events using either the tumor specimen or peripheral blood would aid in selecting patients suited for these types of treatment as well as determining the ideal sequence of treatment within the realm of immune therapies.

  9. Hodgkin disease and non-Hodgkin lymphomas in children: utilization of radiological modalities

    SciTech Connect

    Cohen, M.D.; Siddiqui, A.; Weetman, R.; Provisor, A.; Coates, T.

    1986-02-01

    If costs of medical care are to be reduced, the choice of which imaging modality to use must be made as carefully as possible. This study was done to show how radiological modalities were used to evaluate patients with Hodgkin disease and non-Hodgkin lymphoma. We kept a record of every radiological study performed on 66 children with both diseases seen in the past 6 1/3 years. The results of these studies were analyzed to see which areas of the body were studied, which imaging modality was used, how frequently the studies were repeated, and how frequently the studies gave abnormal results. Our findings disclosed that radiological studies have been appropriately performed in anatomic regions of the body in which disease is present. New imaging modalities have been introduced, and the use of some of the older modalities has been decreased. With some modalities, such as skeletal survey, liver/spleen scan, whole-lung tomography, contrast studies of the bowel, and excretory urography, utilization is higher than it ought to be in view of the fact that the yield of positive results is low and the information is obtainable in many cases from other more sensitive procedures. These studies should not be performed as a routine on initial evaluation or follow-up of all patients with Hodgkin or non-Hodgkin lymphomas. On initial presentation all patients should undergo chest radiography and CT scanning of both chest and abdomen. A problem area is that the timing of follow-up studies has been somewhat erratic, with some inappropriate studies particularly 3 or 4 years after diagnosis. Too many imaging procedures have probably been done in follow-up of our patients.

  10. Hodgkin Lymphoma Survivors Face Risk of Second Cancer

    MedlinePlus

    ... risk to Hodgkin lymphoma survivors, to improve early diagnosis of second cancers," he concluded. The study was published March 13 in the Journal of Clinical Oncology . SOURCE: The Institute of Cancer ...

  11. The Hodgkin-Huxley heritage: from channels to circuits.

    PubMed

    Catterall, William A; Raman, Indira M; Robinson, Hugh P C; Sejnowski, Terrence J; Paulsen, Ole

    2012-10-10

    The Hodgkin-Huxley studies of the action potential, published 60 years ago, are a central pillar of modern neuroscience research, ranging from molecular investigations of the structural basis of ion channel function to the computational implications at circuit level. In this Symposium Review, we aim to demonstrate the ongoing impact of Hodgkin's and Huxley's ideas. The Hodgkin-Huxley model established a framework in which to describe the structural and functional properties of ion channels, including the mechanisms of ion permeation, selectivity, and gating. At a cellular level, the model is used to understand the conditions that control both the rate and timing of action potentials, essential for neural encoding of information. Finally, the Hodgkin-Huxley formalism is central to computational neuroscience to understand both neuronal integration and circuit level information processing, and how these mechanisms might have evolved to minimize energy cost.

  12. Primary extranodal, extralymphatic hodgkin lymphoma of the mandible.

    PubMed

    Gonzalez-Fontal, Guido Ricardo; Rosales, Joaquin D; Jaramillo, Roberto; Henao-Martinez, Andres F

    2011-01-01

    Primary extranodal, extralymphatic Hodgkin lymphomas (PEEHLs) are a rare occurrence. When they are encountered, they become diagnostic challenges. We are describing the uniqueness of a case of PEEHL affecting the mandible with his early response to the available chemotherapy.

  13. [Diagnosis and treatment of primary testicular non-Hodgkin lymphoma].

    PubMed

    Romics, Miklós; Demeter, Judit; Romics, Imre; Nyirády, Péter

    2014-01-12

    The primary testicular non-Hodgkin lymphoma, which has been first described in 1866, is a very uncommon type of urological neoplasia occuring mostly in the elderly ages. It only gives 5% of the testicular tumors, 2% of extranodal lymphomas, and barely 1% of all non-Hodgkin diseases. Patients with testicular non-Hodgkin lymphomas need prompt multidisciplinary aid because without treatment the outcome can be unfavorable. The authors discuss the attributes, diagnostic modalities and treatment options of the primary testicular non-Hodgkin lymphoma and present a case of a 68-year-old patient who underwent orchiectomy, chemo- and radiotherapy after having been diagnosed with the tumor. The follow-up PET-CT and cerebrospinal fluid analysis found no further sign of the disease, and complete remission has been achieved.

  14. What Are the Risk Factors for Hodgkin Disease?

    MedlinePlus

    ... 20s) and in late adulthood (after age 55). Gender Hodgkin lyphoma occurs slightly more often in males ... would like to unsubscribe/opt out from our communications, please follow this link: http://www.cancer.org/ ...

  15. Combination chemotherapy of childhood non-Hodgkin's lymphomas

    SciTech Connect

    Mott, M.G.

    1981-01-01

    The rationale for the treatment of the non-Hodgkin's lymphomas in childhood is discussed. Results from recent trials of combination chemotherapy are given, and the treatment strategy of the United Kingdom Children's Cancer Study Group is described.

  16. Nodular lymphocyte predominant hodgkin lymphoma: biology, diagnosis and treatment.

    PubMed

    Goel, Anupama; Fan, Wen; Patel, Amit A; Devabhaktuni, Madhuri; Grossbard, Michael L

    2014-08-01

    Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an uncommon variant of classical Hodgkin lymphoma. It is characterized histologically by presence of lymphohistiocytic cells which have B-cell phenotype, are positive for CD19, CD20, CD45, CD79a, BOB.1, Oct.2, and negative for CD15 and CD30. Patients often present with early stage of disease and do not have classical B symptoms. The clinical behavior appears to mimic that of an indolent non-Hodgkin lymphoma more than that of classical Hodgkin disease. The purpose of the present report is to define the biology of NLPHL, review its clinical presentation, and summarize the available clinical data regarding treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Current approaches to the management of pediatric Hodgkin lymphoma.

    PubMed

    Freed, Jennifer; Kelly, Kara M

    2010-04-01

    Hodgkin lymphoma is one of the few cancers that affect both adults and children. Cure rates for Hodgkin lymphoma remain among the best for pediatric cancers. However, cure is often associated with significant delayed effects of therapy, including an elevated risk for second malignancies, cardiotoxicity, pulmonary toxicity, and gonadal and non-gonadal endocrine dysfunction. Therefore, the aim of current treatment strategies is to further improve outcomes while minimizing therapy-related complications. At diagnosis, patients are classified into risk groups based on disease stage, and the presence of clinical, biologic, and serologic risk factors. In general, the most recent trials have intensified therapy in those patients with high-risk disease to improve disease control, and have limited therapy in those patients with low-risk disease to avoid secondary effects. In low-risk patients, multiple studies have been conducted to investigate limiting either radiation therapy or chemotherapy to prevent long-term side effects without affecting the excellent cure rate. In intermediate- and high-risk patients, many studies have examined intensifying therapy to improve event-free survival rates. In addition, response assessment by fluorine-18-2-fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) may be particularly important in pediatric Hodgkin lymphoma; it may allow modification of treatment to maximize treatment efficacy and minimize late effects of chemotherapy and radiation therapy. Despite the improvements in treatment for all stages of Hodgkin lymphoma, there is still a subgroup of patients who do not enter remission with initial therapy or relapse after initial response to therapy. Unfortunately, standard-dose salvage chemotherapy for relapsed disease has disappointing results in terms of overall survival since patients have typically already received intensive therapy. While there is no standard of care in terms of salvage chemotherapy, high

  18. Endobronchial non-Hodgkin's lymphoma presenting as mass lesion.

    PubMed

    Mohapatra, P R; Bhuniya, S; Garg, S; Dimri, K; Janmeja, A K

    2009-01-01

    A 40-year-old male presented with clinical and radiological manifestations of right lung atelectasis and post-obstructive pneumonia. Flexible bronchoscopy revealed gross narrowing of the right upper lobe bronchus and a smooth, white endobronchial mass completely occluding the right lower lobe bronchus. Endobronchial biopsy from the mass lesion yielded low grade B-cell non-Hodgkin's lymphoma. This is one of the rarest presentation of non-Hodgkin's lymphoma.

  19. LGALS3 as a prognostic factor for classical Hodgkin's lymphoma.

    PubMed

    Koh, Young Wha; Jung, Se Jin; Park, Chan-Sik; Yoon, Dok Hyun; Suh, Cheolwon; Huh, Jooryung

    2014-10-01

    LGALS3, a member of the lectin family, has an important role in tumor progression through inhibition of apoptosis. LGALS3 shares several significant structural properties with BCL2. In this study, we examined the prognostic significance of LGALS3 and BCL2 in uniformly treated classical Hodgkin's lymphoma. Diagnostic tissues from 110 patients with uniformly treated classical Hodgkin's lymphoma were evaluated retrospectively by immunohistochemical analysis of LGALS3 and BCL2 expression. The median follow-up time was 6.2 years (range, 0.2-17.3 years). Twenty-seven patients (25%) expressed LGALS3 protein in Hodgkin/Reed-Sternberg cells, which was associated with poor overall survival and event-free survival (P=0.007 and P<0.001). Fifteen patients (14%) expressed BCL2 protein in Hodgkin/Reed-Sternberg cells, which was not associated with overall survival and event-free survival (P=0.928 and P=0.900).There was no correlation between LGALS3 and BCL2 expression (P=0.193). Multivariate analysis identified LGALS3 protein as an independent prognostic factor for event-free survival (P=0.007). Subgroup analysis according to the Ann Arbor stage of classical Hodgkin's lymphoma showed that LGALS3 protein expression had a prognostic value in limited-stage classical Hodgkin's lymphoma (P<0.001). The results of this study suggest that LGALS3 is an independent prognostic factor in classical Hodgkin's lymphoma, and may allow the identification of a subgroup of patients with limited-stage classical Hodgkin's lymphoma who require more intensive therapy.

  20. Hodgkin Disease and the Role of the Immune System

    PubMed Central

    Kennedy-Nasser, Alana A.; Hanley, Patrick; Bollard, Catherine M.

    2011-01-01

    Hodgkin disease (HD) is a malignancy of primarily B lymphocytes, which has the unique ability to cause immunodeficiency, as well as provide immune evasion mechanisms to avoid self-destruction. In this review, we will discuss Hodgkin disease, its association with EBV, the immune deficiency caused by HD, tumor immune evasion mechanisms. Specifically, we will closely evaluate the roles of regulatory T cells in HD, cytotoxic T cells, cytokine and chemokine secretion, downregulation of Fas ligand and IDO secretion. PMID:21381869

  1. [Eosinophilic pneumonia revealing B-cell non-Hodgkin lymphoma].

    PubMed

    Fikal, Siham; Sajiai, Hafsa; Serhane, Hind; Aitbatahar, Salma; Amro, Lamyae

    2016-01-01

    The diagnosis of eosinophilic pneumonia is rare and malignant etiology remains exceptional. Eosinophilic pneumonia etiology varies and is mainly dominated by allergic and drug causes. We report the case of a 61-year-old patient with B-cell non-Hodgkin lymphoma revealed by eosinophilic pneumonia. The diagnosis of eosinophilic pneumonia was confirmed by eosinophil count of 56% in bronchoalveolar lavage. Immunohistochemical examination of bone marrow biopsy revealed malignant Small B cells non-Hodgkin lymphoma.

  2. Autoimmune hemolytic anemia terminating seven years later in Hodgkin's disease

    PubMed Central

    Cazenave, Jean-Pierre; Gagnon, Joseph A. E.; Girouard, E.; Bastarache, Alfred

    1973-01-01

    A 64-year-old woman was treated during 7½ years for an isolated AIHA by transfusions, prednisone and splenectomy. The autoantibody was a warm-type IgG with anti-e specificity. At autopsy, generalized Hodgkin's disease of mixed cellularity was found. Only 11 similar cases of hemolytic anemia preceding the development of Hodgkin's disease have been reported in the literature. This association suggests a possible underlying defect in the immune system of the host. PMID:4746134

  3. Hodgkin and the action potential 1935-1952.

    PubMed

    Huxley, A F

    2002-01-01

    It is naturally very gratifying that the Editors of The Journal of Physiology have decided to make available online a paper that Alan Hodgkin and I published 50 years ago (Hodgkin & Huxley, 1952). This was the final paper in the series on the voltage clamp experiments by us and Bernard Katz. In this note, I will set out the background against which this work was done.

  4. CT demonstration of peripelvic and periureteral non-Hodgkin lymphoma

    SciTech Connect

    McMillin, K.I.; Gross, B.H.

    1985-05-01

    Abdominal CT is often performed for the staging of lymphoma. Retroperitoneal lymphadenopathy is the most common abnormality identified, but various extranodal sites of lymphomatous involvement have been reported, especially in non-Hodgkin lymphoma. Renal involvement is not rare, but peripelvic or periureteral involvement in the absence of renal parenchymal involvement or contiguous abdominal adenopathy is extremely unusual. Two recent patients with non-Hodgkin lymphoma who did show these findings are presented.

  5. Heuristics for the Hodgkin-Huxley system.

    PubMed

    Hoppensteadt, Frank

    2013-09-01

    Hodgkin and Huxley (HH) discovered that voltages control ionic currents in nerve membranes. This led them to describe electrical activity in a neuronal membrane patch in terms of an electronic circuit whose characteristics were determined using empirical data. Due to the complexity of this model, a variety of heuristics, including relaxation oscillator circuits and integrate-and-fire models, have been used to investigate activity in neurons, and these simpler models have been successful in suggesting experiments and explaining observations. Connections between most of the simpler models had not been made clear until recently. Shown here are connections between these heuristics and the full HH model. In particular, we study a new model (Type III circuit): It includes the van der Pol-based models; it can be approximated by a simple integrate-and-fire model; and it creates voltages and currents that correspond, respectively, to the h and V components of the HH system.

  6. Role of chemotherapy in Hodgkin's lymphoma.

    PubMed

    Seam, Pamela; Janik, John E; Longo, Dan L; Devita, Vincent T

    2009-01-01

    The development of curative chemotherapy regimens for the treatment of Hodgkin's lymphoma (HL) is one of the true success stories in oncology. Most patients diagnosed with HL today can be cured. The major task remaining before us is curing as many patients as possible with their initial therapeutic approach while minimizing the acute toxicities and limiting the lifetime risks of important secondary events such as cardiovascular complications and secondary malignancies. In the 40 years since DeVita et al. developed the mechlorethamine, vincristine, procarbazine, and prednisone chemotherapy regimen, we have learned a great deal about risk stratification to minimize treatment-related toxicity. Positron emission tomography may further assist us in reducing radiation treatment without compromising cures. This review will discuss the development of the chemotherapy regimens used in the management of early and advanced stage HL and the advantages and disadvantages of their use in combination with radiation therapy.

  7. Characteristics in youth indicative of adult-onset Hodgkin's disease.

    PubMed

    Paffenbarger, R S; Wing, A L; Hyde, R T

    1977-05-01

    From the college entrance health data of 50,000 male former students, the records of 45 who eventually died of Hodgkin's disease were compared with those of 180 surviving classmates with reference to certain indicator characteristics. Risk ratios of Hodgkin's disease tended to be lower for men who had experienced various common contagious diseases in childhood. This reduced incidence of clinical contagions may signify that: 1) Inadequate early challenge of immune mechanisms left subjects more susceptible to later Hodgkin's disease, whether or not it is of infectious origin; 2) heightened immune mechanisms that led to subclinical attacks of early contagious diseases promoted an autoimmune response that evolved as Hodgkin's disease; or 3) early childhood infections eliminated some subjects who otherwise would have attended college and ultimately developed adult-onset Hodgkin's disease. Also, Hodgkin's disease risk was higher for students who had reported early death of a parent, particularly from cancer. Moreover, the risk tended to be increased among collegians who were obese, heavy cigarette smokers, and coffee drinkers. None of these indicator characteristics was associated with 89 fatal lymphomas of other types that occurred in the same study population.

  8. Antigen presentation by Hodgkin's disease cells.

    PubMed

    Fisher, R I; Cossman, J; Diehl, V; Volkman, D J

    1985-11-01

    The L428 tumor cell line is a long-term tissue culture of Reed-Sternberg cells which was derived from the pleural effusion of a patient with Hodgkin's disease. The L428 cells express all known cell surface antigens, cytochemical staining, and cytologic features of freshly explanted Reed-Sternberg cells. In addition to the previously described HLA-DR cell surface antigens, the L428 cells are now demonstrated to express both DS and SB alloantigens. Thus, the L428 cells express all of the known subclasses of the human immune response genes that are located in the major histocompatibility complex. Furthermore, the L428 cells are capable of presenting soluble antigen to T cells in a genetically restricted fashion. T cell lines were established from normal donors previously immunized with tetanus toxoid. The T cells utilized were incapable of tetanus toxoid-induced proliferation unless antigen-presenting cells were added to the cultures. However, T cells from the two normal donors, which like the L428 cells expressed HLA-DR 5, demonstrated significant proliferative responses when cultured with tetanus toxoid and L428 cells. No proliferative response was observed when the L428 cells were used as antigen-presenting cells for a DR (4,-), DR (2,-) or DR (1,7) T cell line. The tetanus toxoid dose-response curve was similar regardless of whether autologous mononuclear leukocytes or L428 cells were used as antigen-presenting cells. The T cell proliferation induced by soluble antigen was also blocked by anti-HLA-DR antibody. Thus, functionally, Hodgkin's disease may be classified as a tumor of antigen-presenting cells.

  9. Isolated CNS Hodgkin's lymphoma: implications for tissue diagnosis.

    PubMed

    Martinez, Derek L; Gujrati, Meena; Geoffroy, Francois; Tsung, Andrew J

    2014-11-01

    CNS involvement in the setting of lymphoid neoplasia is a clinical situation that requires specific diagnosis due to the disparate treatment regimens recommended for neoplasms of specific lymphoid cell types. Cerebrospinal fluid (CSF) sampling may provide sufficient information to determine the presence of abnormal lymphoid cells but may not be able to further specify the malignant cellular population. In cases where abnormal clinical or radiographic features are present, accurate tissue diagnosis is essential. In this report, we define a rare case of primary CNS intramedullary Hodgkin's lymphoma without leptomeningeal dissemination diagnosed via resectional biopsy of a conus medullaris lesion. The patient received post-resection radiation therapy and subsequently demonstrated radiographic and clinical improvement. Lymphoid neoplasia within the CNS comprises a diverse group with varying response and survival rates. Treatment hinges upon accurate diagnosis as chemotherapy varies widely among Hodgkin's and non-Hodgkin's lymphoma. While CSF sampling may yield a positive result with sufficiency to diagnose an abnormal lymphoid cell population, tissue is necessary for further defining cellular pathology. In this report, we define a rare case of primary CNS intramedullary Hodgkin's lymphoma without leptomeningeal dissemination via resectional biopsy of a conus medullaris lesion. In cases where abnormal enhancement is found in eloquent CNS regions and lymphoid neoplasia is suspected, management often entails either stereotactic biopsy or CSF sampling. While CSF analysis may differentiate malignancy at a low rate, tissue diagnosis via paraffin block immunohistochemistry is necessary to further classify malignancy as primary or peripheral, Hodgkin's or non-Hodgkin's lymphoma, or other such as metastatic leptomeningeal dissemination and glioma. Within the subtypes of lymphoid neoplasms, treatment regimens vastly differ and thus accurate tissue diagnosis is paramount. We

  10. Management of Early-stage Hodgkin Lymphoma: A Practice Guideline.

    PubMed

    Herst, J; Crump, M; Baldassarre, F G; MacEachern, J; Sussman, J; Hodgson, D; Cheung, M C

    2017-01-01

    In the past, treatment for patients with early-stage Hodgkin lymphoma consisted mainly of radiotherapy. Now, chemotherapy alone and chemoradiotherapy are treatment options. These guidelines aim to provide recommendations on the optimal management of early-stage Hodgkin lymphoma. We conducted a systematic review searching MEDLINE, EMBASE, the Cochrane Library and other literature sources from 2003 to 2015, and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Two authors independently reviewed and selected studies, and appraised the evidence quality. The document underwent internal and external review by content, methodology experts, a patient representative and clinicians in Ontario. We have issued recommendations for patients with classical Hodgkin lymphoma and with nodular lymphocyte predominant Hodgkin lymphoma; with favourable and unfavourable prognosis; and for the use of positron emission tomography to direct treatment. We have provided our interpretation of the evidence and considerations for implementation. Examples of recommendations are: 'Patients with early-stage classical Hodgkin lymphoma should not be treated with radiotherapy alone'; 'chemotherapy plus radiotherapy or chemotherapy alone are recommended treatment options for patients with early-stage non-bulky Hodgkin lymphoma'; 'The Working Group does not recommend the use of a negative interim positron emission tomography scan alone to identify patients with early-stage Hodgkin lymphoma for whom radiotherapy can be omitted without a reduction in progression-free survival'. Through the use of GRADE, recommendations were geared towards patient important outcomes and their strength reflected the available evidence and its interpretation from the patients' point of view. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group.

    PubMed

    Klimm, Beate; Franklin, Jeremy; Stein, Harald; Eichenauer, Dennis A; Haverkamp, Heinz; Diehl, Volker; Fuchs, Michael; Borchmann, Peter; Engert, Andreas

    2011-10-10

    To investigate the clinical characteristics and treatment outcome of patients with lymphocyte-depleted classical Hodgkin's lymphoma (LDCHL) compared with other histologic subtypes of Hodgkin's lymphoma (HL). From a total of 12,155 evaluable patients with biopsy-proven HL treated within the German Hodgkin Study Group trials HD4 to HD15, 10,019 patients underwent central expert pathology review. Eighty-four patients with LDCHL (< 1%) were identified and confirmed. The median follow-up time was 67 months. Patients with LDCHL, compared with patients with other histologic subtypes, presented more often with advanced disease (74% v 42%, respectively; P < .001) and "B" symptoms (76% v 41%, respectively; P < .001). Other risk factors were also more frequent in patients with LDCHL. Complete remission or unconfirmed complete remission was achieved in 82% of patients with LDCHL compared with 93% of patients with other HL subtypes (P < .001), and more patients with LDCHL had progressive disease. At 5 years, progression-free survival (PFS) and overall survival (OS) were significantly lower in patients with LDCHL compared with patients with other HL subtypes (PFS, 71% v 85%, respectively; P < .001; OS, 83% v 92%, respectively; P = .0018). However, when analyzing the subgroup of patients who underwent treatment with intensified or dose-dense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, patients with LDCHL (n = 39) had similar outcomes when compared with patients with other subtypes of HL (n = 3,564; P = .61). LDCHL has a different pattern from other HL subtypes with more clinical risk factors at initial diagnosis and significantly poorer prognosis. Patients with LDCHL should be treated with modern dose-intense treatment strategies.

  12. Non-Hodgkin and Hodgkin lymphomas select for overexpression of BCLW.

    PubMed

    Adams, Clare M; Mitra, Ramkrishna; Gong, Jerald; Eischen, Christine M

    2017-08-29

    B-cell lymphomas must acquire resistance to apoptosis during their development. We recently discovered BCLW, an anti-apoptotic BCL2 family member thought only to contribute to spermatogenesis, was overexpressed in diffuse large B-cell lymphoma (DLBCL) and Burkitt lymphoma. To gain insight into the contribution of BCLW to B-cell lymphomas and its potential to confer resistance to BCL2 inhibitors, we investigated the expression of BCLW and the other anti-apoptotic BCL2 family members in six different B-cell lymphomas. We performed a large-scale gene expression analysis of data sets comprising approximately 2300 lymphoma patient samples, including non-Hodgkin and Hodgkin lymphomas as well as indolent and aggressive lymphomas. Data were validated experimentally with qRT-PCR and immunohistochemistry. We report BCLW is significantly overexpressed in aggressive and indolent lymphomas, including DLBCL, Burkitt, follicular, mantle cell, marginal zone, and Hodgkin lymphomas. Notably, BCLW was preferentially overexpressed over that of BCL2 and negatively correlated with BCL2 in specific lymphomas. Unexpectedly, BCLW was overexpressed as frequently as BCL2 in follicular lymphoma. Evaluation of all five anti-apoptotic BCL2 family members in six types of B-cell lymphoma revealed that BCL2, BCLW, and BCLX were consistently overexpressed, whereas MCL1 and A1 were not. Additionally, individual lymphomas frequently overexpressed more than one anti-apoptotic BCL2 family member. Our comprehensive analysis indicates B-cell lymphomas commonly select for BCLW overexpression in combination with or instead of other anti-apoptotic BCL2 family members. Our results suggest BCLW is likely equally as important in lymphomagenesis as BCL2 and that targeting BCLW in lymphomas should be considered. Copyright ©2017, American Association for Cancer Research.

  13. Whole-body FDG-PET imaging for staging of Hodgkin`s disease and lymphoma

    SciTech Connect

    Hoh, C.K.; Glaspy, J.; Rosen, P.

    1997-03-01

    Accurate staging of Hodgkin`s disease (HD) and non-Hodgkin`s lymphoma (NHL) is important for treatment management. In this study, the utility of 2-[{sup 18}F]fluoro-2-deoxy-D-glucose (FDG) wholebody PET was evaluated as an imaging modality for initial staging or restaging of 7 HD and 11 NHL patients. Whole-body PET-based staging results were compared to the patient`s clinical stage based on conventional staging studies, which included combinations of CT of the chest, abdomen and pelvis, MRI scans, gallium scans, lymphangiograms, staging laparatomies and bone scans. Accurate staging was performed in 17 of 18 patients using a whole-body PET-based staging algorithm compared to the conventional staging algorithm in 15 of 18 patients. In 5 of 18 patients, whole-body PET-based staging showed additional lesions not detected by conventional staging modalities, whereas conventional staging demonstrated additional lesions in 4 of 18 patients not detected by whole-body PET. The total cost of conventional staging was $66,292 for 16 CT chest scans, 16 CT abdominal/pelvis scans, three limited MRI scans, four bone scans, give gallium scans, two laparotomies and one lymphangiogram. In contrast, scans cost $36,250 for 18 whole-body PET studies and additional selected correlative studies: one plain film radiograph, one limited CT, one bone marrow san, one upper GI and one endoscopy. A whole-body FDG-PET-based staging algorithm may be an accurate and cost-effective method for staging or restaging HD and NHL. 10 refs., 7 figs., 2 tabs.

  14. Everolimus and Lenalidomide in Treating Patients With Relapsed or Refractory Non-Hodgkin or Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-03-21

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Splenic Marginal Zone Lymphoma; Waldenstrom Macroglobulinemia

  15. Prevalence of HIV Infection among U.S. Hodgkin lymphoma cases.

    PubMed

    Shiels, Meredith S; Koritzinsky, Erik H; Clarke, Christina A; Suneja, Gita; Morton, Lindsay M; Engels, Eric A

    2014-02-01

    Hodgkin lymphoma is uncommon in the U.S. general population; however, Hodgkin lymphoma risk is elevated in people with human immunodeficiency virus (HIV) infection. Thus, despite the low HIV prevalence in the United States, the HIV epidemic may have contributed substantially to the general population burden of Hodgkin lymphoma. We used data from 14 U.S. cancer registries in the Surveillance, Epidemiology, and End Results Program that recorded HIV status of Hodgkin lymphoma cases at diagnosis during 2000 to 2010. We computed the HIV prevalence in Hodgkin lymphoma cases by demographic and tumor characteristics, the proportion of deaths among Hodgkin lymphoma cases because of HIV, and 5-year mortality by HIV status. Of 22,355 Hodgkin lymphoma cases, 848 (3.79%) were HIV infected at diagnosis. HIV prevalence in Hodgkin lymphoma cases was greater among males than females (6.0% vs. 1.2%). Among males, HIV prevalence was greatest among 40- to 59-year-olds (14.2%), non-Hispanic blacks (16.9%), Hispanics (9.9%), and among cases of lymphocyte-depleted (15.1%), and mixed cellularity Hodgkin lymphoma (10.5%). Eight percent of male and 1.5% of female Hodgkin lymphoma cases died from HIV. Five-year mortality was two-fold higher in HIV-infected Hodgkin lymphoma cases (36.9% vs. 17.5%). In the United States, a substantial proportion of lymphocyte-depleted and mixed cellularity Hodgkin lymphoma cases and Hodgkin lymphoma cases among non-Hispanic black, Hispanic, and middle-aged men are HIV infected. In addition, HIV is an important cause of death among Hodgkin lymphoma cases. Clinicians should be aware of the high prevalence of HIV in certain subgroups of patients with Hodgkin lymphoma and routine HIV testing should be recommended for all patients presenting with Hodgkin lymphoma.

  16. Oral and maxillofacial non-Hodgkin lymphomas

    PubMed Central

    Deng, Da; Wang, Ying; Liu, Weisong; Qian, Yong

    2017-01-01

    Abstract Rationale: Lymphomas take up about 14% of all head-neck malignancies, out of which 97% are non-Hodgkin lymphomas (NHL). The clinical courses, treatment responses, and prognoses of NHLs vary with different subtypes and anatomic sites. In the Chinese population (including the Taiwanese), head-neck NHLs are often seen with the tonsils, nasal cavity, nasal sinus, and the nasopharynx. However, oral NHLs are relatively rare. Delay of diagnosis is also often seen in clinical practice. Thus, we present 4 cases with delayed diagnosis of oral maxillofacial NHLs and discuss their clinical manifestations so as to draw a clue that can remind the doctors to take biopsies in time. Patient concerns: Four cases, including 3 males and 1 female aged between 43 and 70 years old with oral lesions (ulcerations and/or masses) and accompanying cervical lymphadenopathies and/or skin erythemas presented to the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China from January 2010 to January 2015. Diagnoses: The diagnoses of non-Hodgkin lymphomas were made by pathology, including nasal type extranodal NK/T-cell lymphoma, mycosis fungoides, subcutaneous panniculitis-like T-cell lymphoma, and extranodal marginal B-cell lymphoma of mucosa-associated lymphatic tissue. Their clinical courses until confirmed diagnosis varied between 2 months and 1 year and the follow-up/survival time from diagnosis ranged between 2 and 24 months. None of the biopsies was taken at the patients’ initial medical consultations. Interventions: Cyclophosphamide, hydroxydaunorubicin, vincristine and prednisone (CHOP) and Rituximab, CHOP (R-CHOP) regimens were given to 2 (Cases 1 and 4) and 1 patient (Case 3), respectively. One patient refused further treatment. Outcomes: Two patients, including the one who refused treatment, died at 2-2.5 months from diagnosis. The other two patients survived until their last follow-ups at 13 and 24 months

  17. 59 FR- Claims Based on Exposure to Ionizing Radiation (Lymphomas Other Than Hodgkin's Disease and Cancer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1994-11-25

    ... Hodgkin's Disease and Cancer of the Rectum) AGENCY: Department of Veterans Affairs. ACTION: Proposed rule... disease. Based on this review, VACEH recommended that VA add lymphomas other than Hodgkin's disease and... than Hodgkin's disease. * * * * * [FR Doc. 94-29072 Filed 11-23-94; 8:45 am] BILLING CODE 8320-01-P...

  18. [Diagnostics, prognosis factors, and treatment of malignant lymphoproliferative disease, Hodgkin Disease].

    PubMed

    Sivkovich, S O; Kysel'ova, O A

    2012-01-01

    Data are presented about modern histomorphological, cytological, radiological methods of diagnostics of malignant lymphoproliferative diseases (illness of Hodgkin). Principles and methods of treatment are presented are charts of polychimiotherapy their quality and amount, sequence of realization of radial therapy. Onkomarker being most perspective and studied presently is described, factors of prognosis at non-Hodgkin's malignant lymphadenomas, illness of Hodgkin, - galectin-1, galectin-3.

  19. [Hodgkin disease and autoimmunity in children: 11 case reports].

    PubMed

    Jarrassé, C; Pagnier, A; Edan, C; Landman-Parker, J; Mazingue, F; Mansuy, L; Bertrand, Y; Paillard, C; Pellier, I; Margueritte, G; Plantaz, D

    2011-04-01

    The association of lymphoma and autoimmune manifestations has been predominantly studied in adults affected by non-Hodgkin lymphoma. Few publications exist in the literature concerning Hodgkin lymphoma, particularly in children and adolescents. The objectives of this study were to define the characteristics of the link between Hodgkin disease and autoimmunity in childhood. The present 25-year retrospective study was conducted in all centers affiliated with the French Society of Paediatric Oncology (SFCE). Eleven children with Hodgkin disease presented manifestations of disimmunity preceding or following their diagnosis. Four patients had thrombocytopenic purpura, the remaining 7 each had a different autoimmune pathology: lupus syndrome, antiphospholipid syndrome with transient ischemic attack, Evans syndrome, leukocytoclastic vasculitis, autoimmune hemolytic anemia, autoimmune thyroiditis, and juvenile idiopathic arthritis. Lymphoma relapse occurred in 3 patients. Two children died, death being directly attributed to the autoimmune disease in 1 case. Our data suggest that development of autoimmunity is related to significant morbidity. Possible pathophysiological mechanisms include lymphocyte proliferation secondary to chronic inflammation, cell-mediated immune deficiency in Hodgkin disease, molecular mimetics, and antineoplastic phenomena are discussed. A study with a larger patient population is needed to identify the group of children at high risk of autoimmunity for whom additional investigations and modified therapy may be indicated.

  20. Second malignant lesions after therapy for Hodgkin's disease

    SciTech Connect

    Schomberg, P.J.; Evans, R.G.; Banks, P.M.; White, W.L.; O'Connell, M.J.; Earle, J.D.

    1984-07-01

    Among 169 adult pathologically staged patients with Hodgkin's disease who were treated at the Mayo Clinic between 1974 and 1978, four cases of second malignant lesions were identified. The median duration of follow-up after diagnosis for the entire population was 4.1 years. Of the 169 patients, 73 received irradiation only, 19 received chemotherapy only, and 77 received both chemotherapy and radiation therapy. In all four patients with second malignant lesions, Hodgkin's disease was in apparent remission at the time of diagnosis of the second tumor. These four patients had received either total nodal irradiation or six or more cycles of chemotherapy as initial treatment (and one of them had received both treatment modalities). Thus, intensive therapy might be hypothesized to have played a role in the development of the second malignant tumor. The development of non-Hodgkin's lymphoma within a previously irradiated field after treatment of Hodgkin's disease with radiation therapy only is not know to have been reported previously. Although further studies with longer follow-up should be conducted, this analysis supports a definite risk for development of a second malignant lesion not only after combined-modality treatment or chemotherapy for Hodgkin's disease but also after irradiation only.

  1. Lymphangiogenesis in Classical Hodgkin Lymphoma - Preliminary Study with Clinicopathological Correlations

    PubMed Central

    Benharroch, Daniel; Prinsloo, Isebrand; Gopas, Jacob; Lazarev, Irena

    2016-01-01

    A role for lymphangiogenesis in metastatic breast and prostate cancers has been suggested recently. The relevance of lymphangiogenesis in cancer as a rule, and more specifically in classical Hodgkin lymphoma, is poorly understood in comparison with that of angiogenesis. In a preliminary (pilot) study we have investigated the role of lymphatic vessels growth in 19 cases of classical Hodgkin lymphoma stained with the D2-40 (podoplanin) antibody. In each case, three lymphatic vessels hot spots were scrutinized twice. Of the 57 hot spots thus identified, we chose 15 at random for photography, microvessel counting and image analysis. We determined the mean perimeter, surface area, major axis length and complexity factor for each hot spot and correlated them with clinical and biological features of classical Hodgkin lymphoma. No correlations were found with clinical features. No associations were noted with the standard immuno-markers of classical Hodgkin lymphoma. However, significant inverse correlations were shown with pRb, BAX and IκB-α expression. The mean lymphatic major axis length was inversely correlated with the complexity factor. Last, we carried out an additional clinicopathological correlation of the expression of pRb, BAX and IκB-α in a cohort of classical Hodgkin lymphoma patients previously published. PMID:27877228

  2. Primary Non-Hodgkin's Lymphoma of the Vulva

    PubMed Central

    Clemente, Nicolò; Alessandrini, Lara; Rupolo, Maurizio; Bulian, Pietro; Lucia, Emilio; Canzonieri, Vincenzo; Sopracordevole, Francesco

    2016-01-01

    Abstract The aim of this study was to add a new case of primary non-Hodgkin's malignant lymphoma of the vulva to the literature and to review the current literature. We searched the PubMed/MEDLINE databases for previous case reports using the key words “non-Hodgkin's malignant lymphoma of the vulva,” “vulvar lymphoma,” and “primary vulvar non-Hodgkin's lymphoma.” We found 29 cases of primary vulvar non-Hodgkin's malignant lymphoma of the vulva reported until 2015. Among them, only 8 cases of diffuse large B-cell lymphoma (DLBCL), classified according to the most recent 2008 WHO classification, were reported. Moreover, only few studies reported the therapeutic management and clinical follow-up of patients affected by this condition. Due to its uncommon presentation, the primary non-Hodgkin's malignant lymphoma of the vulva can be undiagnosed; thus gynecologists, oncologists, and pathologists should be aware of this condition, as a correct diagnosis is essential for an appropriate therapeutic management. PMID:26962826

  3. The genetics of Hodgkin lymphoma: an overview and clinical implications.

    PubMed

    Borchmann, Sven; Engert, Andreas

    2017-09-01

    The goal of this review is to give an overview of the genetics of classical Hodgkin lymphoma. Copy number changes, somatic mutations, genome-wide association studies, changes in gene expression, familial classical Hodgkin lymphoma and epigenetic changes will be reviewed. In doing so, special focus is placed on the way recent discoveries have influenced clinical research, diagnostics, treatment and remission monitoring. Furthermore, emphasis is put on how these advances can help to advance the treatment of elderly patients who have a markedly worse prognosis than younger patients. Frequent amplifications of the 9p24.1 locus in classical Hodgkin lymphoma could be the basis for the success of immune checkpoint inhibitors targeting PD-1 or PD-L1 in this disease. The same amplification also affects the JAK/STAT pathway, which has also been targeted in recent clinical trials. Hodgkin lymphoma-specific copy number alterations and mutations have recently been found to be detectable in cell-free DNA. This could provide the basis for advances in the detection of residual disease during treatment and while monitoring patients in remission. The advent of new technologies such as massive parallel sequencing has improved our understanding of the genetics of classical Hodgkin lymphoma. Some of these discoveries are now being translated into clinical research in the form of new diagnostics and treatments.

  4. Checkpoint Inhibition in Hodgkin Lymphoma: Saving the Best for Last?

    PubMed

    Lin, Richard J; Diefenbach, Catherine S

    2016-10-15

    Hodgkin lymphoma is a unique disease entity characterized by a low number of neoplastic tumor cells surrounded by an inflammatory microenvironment composed of dysfunctional immune cells. Recent molecular and genetic studies have revealed that upregulation of the immune checkpoint pathway programmed death 1/programmed death ligand 1 is a key oncogenic driver of Hodgkin lymphoma. Corroborating these mechanistic studies, early-phase clinical trials using the checkpoint inhibitors nivolumab and pembrolizumab in treatment regimens for relapsed and/or refractory Hodgkin lymphoma have demonstrated impressive response rates, a promising durability of response, and a favorable side-effect profile. Given its targeted mechanism of action, acceptable safety, and clinically meaningful activity, the checkpoint inhibitor nivolumab was recently approved by the US Food and Drug Administration as therapy for classical Hodgkin lymphoma that has relapsed or progressed after autologous stem cell transplantation (ASCT) and post-ASCT consolidation therapy with brentuximab vedotin. In this article we review the scientific rationale, preclinical evidence, and most recent clinical data for the use of checkpoint inhibitor therapy in patients with relapsed Hodgkin lymphoma.

  5. Intensive investigation in management of Hodgkin's disease.

    PubMed Central

    Sutcliffe, S B; Wrigley, P F; Smyth, J F; Webb, J A; Tucker, A K; Beard, M E; Irving, M; Stansfeld, A G; Malpas, J S; Crowther, D; Whitehouse, J M

    1976-01-01

    Ninety-eight patients with clinically localised Hodgkin's disease underwent laparotomy and splenectomy to determine the extent of microscopic spread. In 68 patients the procedure was carried out for untreated disease apparently confined above the diaphragm. Abdominal disease cannot be confidently excluded on the basis of non-invasive investigation at presentation. Clinical assessment of splenic disease was unreliable unless gross splenomegaly was present. Pedal lymphography was accurate in assessing para-aortic and iliac disease but of no value in assessing other intra-abdominal lymph node involvement, including that of the mesenteric lymph node. Trephine bone marrow biopsy findings were normal in all patients before surgery, and only one patient was found to have diseased bone marrow by Stryker-saw biopsy at operation. Liver disease was identified at operation in nine patients, some of whom were asymptomatic with clinically undetectable splenic and nodal disease. Detailed clinical staging failed to detect disease in one-third of patients who underwent laparotomy. These studies show that if radiotherapy is to remain the treatment of choice for disease truly localised to lymph nodes a detailed staging procedure, including laparotomy and splenectomy, remains essential. The value of this potentially curative treatment is considerably diminished in the patient who has been inadequately staged. PMID:1000227

  6. Clonality in lymphocyte predominance Hodgkin's disease.

    PubMed

    Weiss, L M; Arber, D A; Chang, K L

    1997-01-01

    Abundant evidence has led to the clinical and biological separation of lymphocyte predominance from other types of Hodgkin's disease. However, it is still not clear whether lymphocyte predominance represents a polyclonal reactive lesion (possibly representing an abnormal immune disorder), a polyclonal or oligoclonal preneoplastic disorder or a monoclonal neoplastic disorder. The clinical and histological features are distinctive, but they do not provide clear indications of the nature of lymphocyte predominance. Some immunohistochemical and in situ hybridization studies have shown monotypic light chain restriction in the L&H cells, almost always of kappa type, implying a monoclonal process. Southern blotting studies are of limited utility, given their relatively low sensitivity and the rarity of L&H cells within involved tissues. Polymerase chain reaction studies have yielded conflicting results. Some, but not all, have demonstrated monoclonal populations in tissue extracts. Single cell PCR studies have generally not found monoclonal populations, although one case stands as an exception. Cases of large cell lymphoma complicating lymphocyte predominance have been monoclonal by polymerase chain reaction and clonospecific primers derived from these clones have demonstrated similar populations in the corresponding lymphocyte predominance tissues in some, but not all, studies.

  7. Chemotherapy of advanced non-Hodgkin's lymphoma.

    PubMed

    Skarin, A T; Canellos, G P

    1979-10-01

    From the therapuetic point of view, non-Hodgkin's lymphomas can be classified into two groups: favourable prognosis histology (DWDL, NWDL, NPDL, and NM) and unfavourable prognosis histology (DPDL, DM, DH, NH, DU). The latter group also includes lymphoblastic lymphoma (T cell) and Burkitt's lymphoma (B cell). Further classification by immunological markers (T, B, monocyte, null cell) and functional categories (T-cell subsets) may reveal prognostic groups which require separate consideration. Intensive chemotherapy of unfavourable histoligies can result in long-term disease-free survival as reported in several series. It would appear that the 10 year survival rates will not differ greatly between several multi-drug regimens. At the present time, the histopathological subtype permits selection of patients for a trial of intensive chemotherapy. The progress in the future will be made with improved techniques for the management of bulky abdominal disease and central nervous system invasion. Although the above may result in some statistical improvement in survival of the unfavourable group, the vast majority of patients with favourable histology lymphoma require new approaches. These may take the form of treatment with immunological manoeuvres such as idiotypic-specific antibodies and/or the use of intensive chemotherapy, especially when there is convincing evidence of a change in the biology of the disease.

  8. Evidence of Inbreeding in Hodgkin Lymphoma.

    PubMed

    Thomsen, Hauke; Inacio da Silva Filho, Miguel; Fuchs, Michael; Ponader, Sabine; Pogge von Strandmann, Elke; Eisele, Lewin; Herms, Stefan; Hoffmann, Per; Engert, Andreas; Hemminki, Kari; Försti, Asta

    2016-01-01

    Genome-wide association studies (GWASs) have identified several, mainly co-dominantly acting, single-nucleotide polymorphisms (SNPs) associated with Hodgkin lymphoma (HL). We searched for recessively acting disease loci by performing an analysis of runs of homozygosity (ROH) based on windows of homozygous SNP-blocks and by calculating genomic inbreeding coefficients on a SNP-wise basis. We used data from a previous GWAS with 906 cases and 1217 controls from a population with a long history of no matings between relatives. Ten recurrent ROHs were identified among 25 055 ROHs across all individuals but their association with HL was not genome-wide significant. All recurrent ROHs showed significant evidence for natural selection. As a novel finding genomic inbreeding among cases was significantly higher than among controls (P = 2.11*10-14) even after correcting for covariates. Higher inbreeding among the cases was mainly based on a group of individuals with a higher average length of ROHs per person. This result suggests a correlation of higher levels of inbreeding with higher cancer incidence and might reflect the existence of recessive alleles causing HL. Genomic inbreeding may result in a higher expression of deleterious recessive genes within a population.

  9. Hodgkin's Lymphoma in an elite endurance athlete.

    PubMed

    Schumacher, Yorck Olaf; Muser, Klaus; Hirschberger, Barbara; Roecker, Kai; Dickhuth, Hans Herrmann; Pottgiesser, Torben

    2008-03-01

    Cancer is a life-threatening condition. We describe the case of a 22-yr-old world-class endurance athlete who presented with mild local lymphadenopathy but without any systemic complaints or impaired performance. He was subsequently diagnosed with stage III A (S) Hodgkin's lymphoma. A complete physiological workup before the diagnosis revealed high aerobic capacity. Immediately after six courses of escalated BEACOPP chemotherapy in an identical test setting, aerobic capacity was markedly reduced (-42%), mainly because of a decrease in total hemoglobin mass (-37%), despite maintaining a certain amount of endurance training. Other potentially performance-limiting systems such as heart, lung, or aerobic metabolism did not show any signs of impairment. Two months after chemotherapy, the athlete had recovered his hemoglobin mass, and his aerobic performance was almost back to pretherapy levels. This case illustrates that advanced malignancies can be present in elite athletes without affecting performance, and that aerobic capacity can be regained within a short time after systemic chemotherapy.

  10. Alternative Models to Hodgkin-Huxley Equations.

    PubMed

    Deng, Bo

    2017-06-01

    The Hodgkin and Huxley equations have served as the benchmark model in electrophysiology since 1950s. But it suffers from four major drawbacks. Firstly, it is only phenomenological not mechanistic. Secondly, it fails to exhibit the all-or-nothing firing mechanism for action potential generation. Thirdly, it lacks a theory for ion channel opening and closing activation across the cell membrane. Fourthly, it does not count for the phenomenon of voltage-gating which is vitally important for action potential generation. In this paper, a mathematical model for excitable membranes is constructed by introducing circuit characteristics for ion pump exchange, ion channel activation, and voltage-gating. It is demonstrated that the model is capable of re-establishing the Nernst resting potentials, explicitly exhibiting the all-or-nothing firing mechanism, and most important of all, filling the long-lasting theoretical gap by a unified theory on ion channel activation and voltage-gating. It is also demonstrated that the new model has one half fewer parameters but fits significantly better to experiment than the HH model does. The new model can be considered as an alternative template for neurons and excitable membranes when one looks for simpler models for mathematical studies and for forming large networks with fewer parameters.

  11. Hodgkin's disease: thyroid dysfunction following external irradiation

    SciTech Connect

    Tamura, K.; Shimaoka, K.

    1981-01-01

    The thyroid gland is commonly included in the field of radiation therapy for patients with malignant lymphoma and with head and neck tumors. The radiation dose for malignant diseases varies considerably depending on the purpose of treatment and the institutional policies. A substantial number of these patients are developing subclinical and clinical hypothyroidism. The risk of developing hypothyroidism after a moderate radiation dose of 2000 to 4500 rads has been reported to be 10 to 20 percent. In addition, subclinical hypothyroidism is induced further in one third of the patients. There are also suggestions that external irradiation of the thyroid gland in patients with malignant lymphomas, as well as internal irradiation with radioiodine of the normal and hyperthyroid human thyroid glands, would induce elevations of serum antithyroid autoantibody titers. However, only a few cases of Graves disease following irradiation to the thyroid gland have been reported. We encountered a young woman who received radiation therapy to the mantle field for her Hodgkin's disease and developed hypothyroxinemia without overt signs and symptoms of hypothyroidism, followed by appearance of nodular goiter and then full-blown Graves disease.

  12. [Hodgkin and non-Hodgkin lymphoma of adolescents and young adults].

    PubMed

    Garciaz, Sylvain; Coso, Diane; Brice, Pauline; Bouabdallah, Réda

    2016-12-01

    Lymphoma is one of the most frequent cancers in adolescent and young adults. Hodgkin Lymphoma is curable in more than 90% of cases. Recent pediatric and adults protocols aimed to decrease long term toxicities (mostly gonadic and cardiovascular) and secondary malignancies, reducing the use of alkylating agents and limiting radiation fields. Risk-adapted strategies, using positron emission tomography staging, are about to become a standard, both in adult and pediatric protocols. These approaches allow obtaining excellent results in adolescents with Hodgkin lymphoma. On the other hand, treatment of adolescents with diffuse large B-cell lymphoma raises some questions. Even through children have good outcomes when treated with risk-adapted strategies, adolescents who are between 15 and 18 years old seem to experience poorer survivals, whereas patients older than 18 years old have globally the same outcome than older adults. This category of patient needs a particular care, based on a tight coordination between adults and pediatric oncologists. Primary mediastinal lymphomas, a subtype of BLDCL frequent in young adult population, exhibits poorer outcomes in children or young adolescent population than in older ones. Taking together, B-cell lymphoma benefited from recent advances in immunotherapy (in particular with the extended utilization of rituximab) and metabolic response-adapted strategies. In conclusion, adolescent and young adult's lymphomas are very curable diseases but require a personalized management in onco-hematological units.

  13. FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease.

    PubMed

    Paes, Fabio M; Kalkanis, Dimitrios G; Sideras, Panagiotis A; Serafini, Aldo N

    2010-01-01

    The term extranodal disease refers to lymphomatous infiltration of anatomic sites other than the lymph nodes. Almost any organ can be affected by lymphoma, with the most common extranodal sites of involvement being the stomach, spleen, Waldeyer ring, central nervous system, lung, bone, and skin. The prevalence of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease has increased in the past decade. The imaging characteristics of extranodal involvement can be subtle or absent at conventional computed tomography (CT). Imaging of tumor metabolism with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) has facilitated the identification of affected extranodal sites, even when CT has demonstrated no lesions. More recently, hybrid PET/CT has become the standard imaging modality for initial staging, follow-up, and treatment response assessment in patients with lymphoma and has proved superior to CT in these settings. Certain PET/CT patterns are suggestive of extranodal disease and can help differentiate tumor from normal physiologic FDG activity, particularly in the mucosal tissues, bone marrow, and organs of the gastrointestinal tract. Familiarity with the different extranodal manifestations in various locations is critical for correct image interpretation. In addition, a knowledge of the differences in FDG avidity among the histologic subtypes of lymphoma, appropriate timing of scanning after therapeutic interventions, and use of techniques to prevent brown fat uptake are essential for providing the oncologist with accurate information.

  14. Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma are highly dependent on oxidative phosphorylation.

    PubMed

    Birkenmeier, Katrin; Dröse, Stefan; Wittig, Ilka; Winkelmann, Ria; Käfer, Viktoria; Döring, Claudia; Hartmann, Sylvia; Wenz, Tina; Reichert, Andreas S; Brandt, Ulrich; Hansmann, Martin-Leo

    2016-05-01

    The metabolic properties of lymphomas derived from germinal center (GC) B cells have important implications for therapeutic strategies. In this study, we have compared metabolic features of Hodgkin-Reed-Sternberg (HRS) cells, the tumor cells of classical Hodgkin's lymphoma (cHL), one of the most frequent (post-)GC-derived B-cell lymphomas, with their normal GC B cell counterparts. We found that the ratio of oxidative to nonoxidative energy conversion was clearly shifted toward oxidative phosphorylation (OXPHOS)-linked ATP synthesis in HRS cells as compared to GC B cells. Mitochondrial mass, the expression of numerous key proteins of oxidative metabolism and markers of mitochondrial biogenesis were markedly upregulated in cHL cell lines and in primary cHL cases. NFkappaB promoted this shift to OXPHOS. Functional analysis indicated that both cell growth and viability of HRS cells depended on OXPHOS. The high rates of OXPHOS correlated with an almost complete lack of lactate production in HRS cells not observed in other GC B-cell lymphoma cell lines. Overall, we conclude that OXPHOS dominates energy conversion in HRS cells, while nonoxidative ATP production plays a subordinate role. Our results suggest that OXPHOS could be a new therapeutic target and may provide an avenue toward new treatment strategies in cHL. © 2015 UICC.

  15. Long-term pulmonary function in survivors of childhood Hodgkin disease and non-Hodgkin lymphoma.

    PubMed

    Oguz, Aynur; Tayfun, Tayyar; Citak, Elvan Caglar; Karadeniz, Ceyda; Tatlicioglu, Turkan; Boyunaga, Oznur; Bora, Huseyin

    2007-10-15

    The aim of our study was to evaluate the long-term effects of chemotherapy and/or radiotherapy on lung function in 75 childhood Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) survivors several years after treatment. We studied 37 HD and 38 NHL survivors. These patients were divided into two groups according to the treatment protocols applied. Group I consisted of 23 patients who were treated with both chemotherapy and thoracic irradiation and Group II consisted of 52 patients who were treated with chemotherapy and no thoracic irradiation. A detailed history of smoking habits, respiratory symptoms, and diseases was recorded. Complete physical examinations and pulmonary function tests [PFT, including spirometry, lung volume, and diffusion capacity for carbon monoxide (DLCO)] were performed on all subjects. No patients reported acute or chronic respiratory symptoms or diseases. Pulmonary function abnormality (reduced lung volume and diffusion capacity) was found in 13% of patients at a median 5 years after diagnosis. The percentage of predicted normal value of forced expiratory volume in the 1st sec (FEV(1)), residual volume (RV), and DLCO were significantly lower in Group I than these values for Group II. There were no significant differences in PFT parameters between patients with HD and NHL (P > 0.05). It appears that the risk of reduced lung function was greater the younger the patient in therapy. Chemotherapy or chemo-radiotherapy-induced pulmonary sequalae in childhood may remain asymptomatic for many years. (c) 2007 Wiley-Liss, Inc.

  16. Breast Cancer After Treatment of Hodgkin's Lymphoma: General Review

    SciTech Connect

    Alm El-Din, Mohamed A.; El-Badawy, Samy A.; Taghian, Alphonse G.

    2008-12-01

    The improved survival rates among patients with Hodgkin's lymphoma over the past few decades have come with increased incidence of second malignancies. One of the major concerns among female survivors is the significantly elevated risk of breast cancer that appears with extended follow-up. In this review, we include the published literature regarding the risk of breast cancer after irradiation for Hodgkin's lymphoma. We also present the possible long-term surveillance strategies and the optimal time to start screening these women. This could potentially help in early detection of secondary breast cancers and consequently improve outcomes. Furthermore, because of prior radiotherapy, the management of the breast cancer among this unique population has been controversial. We discuss the characteristics of breast cancer that occurs after Hodgkin's lymphoma and also treatment options that could be implemented.

  17. The Hodgkin-Huxley Heritage: From Channels to Circuits

    PubMed Central

    Catterall, William A.; Raman, Indira M.; Robinson, Hugh P. C.; Sejnowski, Terrence J.; Paulsen, Ole

    2012-01-01

    The Hodgkin-Huxley studies of the action potential, published 60 years ago, are a central pillar of modern neuroscience research, ranging from molecular investigations of the structural basis of ion channel function to the computational implications at circuit level. In this Symposium Review, we aim to demonstrate the ongoing impact of Hodgkin’s and Huxley’s ideas. The Hodgkin-Huxley model established a framework in which to describe the structural and functional properties of ion channels, including the mechanisms of ion permeation, selectivity, and gating. At a cellular level, the model is used to understand the conditions that control both the rate and timing of action potentials, essential for neural encoding of information. Finally, the Hodgkin-Huxley formalism is central to computational neuroscience to understand both neuronal integration and circuit level information processing, and how these mechanisms might have evolved to minimize energy cost. PMID:23055474

  18. Vera Peters and the curability of Hodgkin disease

    PubMed Central

    Cowan, D.H.

    2008-01-01

    The middle of the 20th century hailed the realization that patients with Hodgkin disease could be cured. Through the groundbreaking work of Vera Peters, patients with a localized form of the disorder, previously thought to be incurable, were shown to be cured by extended-field radiotherapy. This important observation, although not immediately accepted, opened the minds of physicians to take more positive investigative and therapeutic approaches. Peters also introduced and championed the concept of tumour staging in Hodgkin disease and the use of prognostic factors in clinical decision-making. This novel approach led to high cure rates with radiotherapy in localized disease and provided a scientific basis for the subsequent use of chemotherapy in disseminated disease, resulting in a very high cure rate in patients with all stages of Hodgkin disease. PMID:19008994

  19. Female reproductive potential after treatment for Hodgkin's disease

    SciTech Connect

    Horning, S.J.; Hoppe, R.T.; Kaplan, H.S.; Rosenberg, S.A.

    1981-06-01

    The probability of maintaining ovarian function, becoming pregnant, and delivering a normal child is important to young women anticipating successful therapy for Hodgkin's disease. In this study, reproductive function was retrospectively examined in 103 women 40 years old or younger who had undergone treatment for Hodgkin's disease with total-lymphoid irradiation (TLI) alone, combination chemotherapy, or combined TLI and chemotherapy. Infertility was directly related to gonadal exposure to therapy and to age at treatment. Twenty women became pregnant after receiving total-nodal irradiation or combination chemotherapy or both. No fetal wastage occurred, and no birth defects were seen in the 24 infants born to these women. Even after intensive treatment programs, women successfully treated for Hodgkin's disease have become pregnant and delivered phenotypically normal children.

  20. Breast cancer after treatment of Hodgkin's lymphoma: general review.

    PubMed

    Alm El-Din, Mohamed A; El-Badawy, Samy A; Taghian, Alphonse G

    2008-12-01

    The improved survival rates among patients with Hodgkin's lymphoma over the past few decades have come with increased incidence of second malignancies. One of the major concerns among female survivors is the significantly elevated risk of breast cancer that appears with extended follow-up. In this review, we include the published literature regarding the risk of breast cancer after irradiation for Hodgkin's lymphoma. We also present the possible long-term surveillance strategies and the optimal time to start screening these women. This could potentially help in early detection of secondary breast cancers and consequently improve outcomes. Furthermore, because of prior radiotherapy, the management of the breast cancer among this unique population has been controversial. We discuss the characteristics of breast cancer that occurs after Hodgkin's lymphoma and also treatment options that could be implemented.

  1. Hodgkin's Lymphoma Revealed by Hemophagocytic Lymphohistiocytosis in a Child

    PubMed Central

    Benmiloud, Sarra; Hbibi, Mohamed; Chaouki, Sana; Abourazzak, Sana; Hida, Moustapha

    2014-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening disorder, responsible for extensive phagocytosis of hematopoietic cells and causing a multisystem organ failure. If lymphomas are common causes of HLH, the association with Hodgkin's lymphoma is rarely described in children. We report a case of a 9-year-old boy presenting with HLH as an initial manifestation of Hodgkin's lymphoma. He has been suffering from persistent high fever, asthenia, weight loss, and hepatosplenomegaly with no lymphadenopathy. The diagnosis of HLH secondary to infectious disease was initially worn. The patient received high-dose intravenous immunoglobulin with broad-spectrum antibiotics. However, his state got worse with the onset of dry cough and pleural effusion. Histopathologic examination of pleural fluid showed the presence of Reed-Sternberg cells. The outcome was favorable after treatment by corticosteroid and chemotherapy. Hodgkin's lymphoma revealed by HLH is a source of delayed diagnosis and should be borne in mind in children. PMID:25328742

  2. Analysis of antigen receptor genes in Hodgkin's disease.

    PubMed Central

    Angel, C A; Pringle, J H; Naylor, J; West, K P; Lauder, I

    1993-01-01

    AIM--To analyse the configuration of the antigen receptor genes in Hodgkin's disease. METHODS--DNA extracted from 45 samples of Hodgkin's disease was analysed using Southern blotting and DNA hybridisation, using probes to the joining region of the immunoglobulin heavy chain gene, the constant region of kappa immunoglobulin light chain gene, and the constant region of the beta chain of the T cell receptor gene. RESULTS--A single case of nodular sclerosing disease showed clonal rearrangement of the immunoglobulin heavy and light chain genes, all other samples having germline immunoglobulin genes. The nature of the clonal population in the diseased tissue is uncertain, because the intensity of the rearranged bands did not correlate with the percentage of Reed-Sternberg cells present. The T cell receptor genes were in germline configuration in all the samples. CONCLUSIONS--Antigen receptor gene rearrangement is a rare finding in unselected cases of Hodgkin's disease. Images PMID:8388407

  3. Non-Hodgkin lymphomas in childhood: how to move on?

    PubMed

    Dokmanović, Lidija; Rodić, Predrag; Krstovski, Nada; Lazić, Jelena; Dragana, Janić

    2014-01-01

    Non-Hodgkin lymphomas of childhood represent a diverse group of neoplasms with different clinical, pathological, immunophenotypical and genetic features. A vast majority of childhood non-Hodgkin lymphomas could be classified into one of the three major histological subgroups: mature B-cell neoplasms, lymphoblastic lymphomas or anaplastic large cell lymphomas. Modern therapeutic strategies lead to cure in more than 80% of patients. Conversely, refractory diseases, as well as disease relapse convey a dismal prognosis. This fact requires much better stratification based on prognostic markers which would ideally recognize distinct groups of patients requiring different therapeutic regimens. Defining novel diagnostic and prognostic markers should improve diagnosis and prognosis as well as patient follow-up. It should also allow introduction of individually tailored treatment regimens in selected groups of patients with non-Hodgkin lymphomas, with the main goal of improving treatment results and decreasing short- and long-term complications.

  4. [Hodgkin's lymphoma in nuclear medicine: diagnostic and therapeutic aspects].

    PubMed

    Staak, J O; Dietlein, M; Engert, A; Weihrauch, M R; Schomäcker, K; Fischer, Th; Eschner, W; Borchmann, P; Diehl, V; Schicha, H; Schnell, R

    2003-02-01

    Today, diagnostic and therapeutic strategies of Hodgkin lymphoma (HL) with positron emission tomography and radioimmunotherapy include state-of-the-art nuclear medicine which require the cooperation between oncology and nuclear medicine. The benefit of FDG-PET in HL patients with residual tumor masses consists of its high negative predictive value in the therapy control of the disease. The concept of waitful watching in patients with PET-negative residual masses after BEACOPP-chemotherapy will be evaluated in a large multicenter trial of the GHSG (German Hodgkin Study Group). Radioimmunotherapy has been performed in patients with CD20-positive Non-Hodgkin lymphoma for 10 years with promising results. HL is also an excellent target for immunotherapy due to the expression of antigens such as CD25 and CD30. Thus, a new radioimmunoconstruct consisting of the murine anti-CD30 antibody Ki-4 labeled with iodine-131 was developed for patients with relapsed or refractory HL.

  5. Autologous hematopoietic stem cell transplantation in classical Hodgkin's lymphoma

    PubMed Central

    Cortez, Afonso José Pereira; Dulley, Frederico Luiz; Saboya, Rosaura; Mendrone Júnior, Alfredo; Amigo Filho, Ulisses; Coracin, Fabio Luiz; Buccheri, Valéria; Linardi, Camila da Cruz Gouveia; Ruiz, Milton Artur; Chamone, Dalton de Alencar Fischer

    2011-01-01

    Background Hodgkin's lymphoma has high rates of cure, but in 15% to 20% of general patients and between 35% and 40% of those in advanced stages, the disease will progress or will relapse after initial treatment. For this group, hematopoietic stem cell transplantation is considered one option of salvage therapy. Objectives To evaluate a group of 106 patients with Hodgkin's lymphoma, who suffered relapse or who were refractory to treatment, submitted to autologous hematopoietic stem cell transplantation in a single transplant center. Methods A retrospective study was performed with data collected from patient charts. The analysis involved 106 classical Hodgkin's lymphoma patients who were consecutively submitted to high-dose chemotherapy followed by autologous transplants in a single institution from April 1993 to December 2006. Results The overall survival rates of this population at five and ten years were 86% and 70%, respectively. The disease-free survival was approximately 60% at five years. Four patients died of procedure-related causes but relapse of classical Hodgkin's lymphoma after transplant was the most frequent cause of death. Univariate analysis shows that sensitivity to pre-transplant treatment and hemoglobin < 10 g/dL at diagnosis had an impact on patient survival. Unlike other studies, B-type symptoms did not seem to affect overall survival. Lactic dehydrogenase and serum albumin concentrations analyzed at diagnosis did not influence patient survival either. Conclusion Autologous hematopoietic stem cell transplantation is an effective treatment strategy for early and late relapse in classical Hodgkin's lymphoma for cases that were responsive to pre-transplant chemotherapy. Refractory to treatment is a sign of worse prognosis. Additionally, a hemoglobin concentration below 10 g/dL at diagnosis of Hodgkin's lymphoma has a negative impact on the survival of patients after transplant. As far as we know this relationship has not been previously reported

  6. Hodgkin's disease with hypercalcemia detected by thallium-201 scintigraphy

    SciTech Connect

    Linde, R.; Basso, L.

    1987-01-01

    A 53-yr-old man with hypercalcemia was referred after an unsuccessful operative attempt to find a parathyroid adenoma. Metabolic evaluation showed relatively suppressed levels of parathyroid hormone with an elevation of serum 1,25-dihydroxyvitamin D. Thallium-technetium dual isotope imaging revealed localized mediastinal thallium uptake. A vascular mediastinal lesion was then demonstrated by arteriography, with subsequent surgical removal of a mass that proved to be lymphocyte predominant Hodgkin's disease. This case is noteworthy for the finding of isolated lymphocyte predominant Hodgkin's disease in the chest, the association of elevated serum 1,25-dihydroxyvitamin D with hypercalcemia that resolved postoperatively, and the uptake of thallium by the tumor.

  7. Immune thrombocytopenic purpura at the diagnosis of Hodgkin disease.

    PubMed

    Dahlqvist, C; Betomvuko, P; Verdebout, J M; Mineur, P

    2010-01-01

    We describe the case of a 76-year-old male presenting a thrombocytopenia at the diagnosis of Hodgkin disease. Basing on bone marrow biopsy and evolution, we diagnosed an immune thrombocytopenia and treated with intravenous gammaglobulins. The platelet count normalized in a few days under this therapy. Immune thrombocytopenia purpura (ITP) is a rare complication of Hodgkin disease (HD). It seems to be due to the production of antibodies directed against platelet membrane proteins. The patient's and the lymphoma's characteristics are not predictive for it to happen. The evolution of HD is also not influenced by its occurrence. Various treatments (including corticoids and immunomodulating agents) have been tried with different efficiencies.

  8. Hodgkin disease and the role of the immune system.

    PubMed

    Kennedy-Nasser, Alana A; Hanley, Patrick; Bollard, Catherine M

    2011-04-01

    Hodgkin disease (HD) is a malignancy of primarily B lymphocytes that has the unique ability to cause immunodeficiency, as well as provide immune evasion mechanisms to avoid self-destruction. In this review, the authors discuss Hodgkin disease, its association with Epstein-Barr virus (EBV), the immune deficiency caused by HD, and tumor immune evasion mechanisms. Specifically, the authors closely evaluate the roles of regulatory T cells in HD, cytotoxic T cells, cytokine and chemokine secretion, down-regulation of Fas ligand, and indoleamine 2,3-dioxygenase (IDO) secretion.

  9. Lymphocyte-predominant Hodgkin disease: a comprehensive overview.

    PubMed

    Bose, Sumit; Ganesan, Chitra; Pant, Manish; Lai, Catherine; Tabbara, Imad A

    2013-02-01

    Lymphocyte-predominant Hodgkin disease is a rare form of Hodgkin lymphoma that is recognized as a separate histopathological entity. This disease tends to have multiple relapses, but has an overall good prognosis. Owing to its rarity, and the prolonged time period between recurrence and transformation events, there is no consensus regarding optimal management. However, the National Comprehensive Cancer Network guidelines indicate that for early stages, appropriate treatment is radiotherapy. Several management options have been reported including observation, radiation, chemotherapy, combined chemoradiotherapy, and anti-CD20 antibody therapy. Salvage therapy remains effective in inducing prolonged remission in patients with relapsed/refractory disease.

  10. Paediatric non-Hodgkin lymphoma - perspectives in translational biology.

    PubMed

    Shiramizu, Bruce; Mussolin, Lara; Woessmann, Wilhelm; Klapper, Wolfram

    2016-05-01

    Exciting advances have been achieved for infants, children and adolescents diagnosed with, and treated for, non-Hodgkin lymphoma (NHL). In spite of these successes, new frontiers are being paved to improve the prognosis for those who relapse or have resistant disease. This review summarizes some of the novel approaches and ideas in NHL monitoring, diagnosis and treatment as discussed at the 5th International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma on October 22nd-24th 2015 in Varese, Italy. © 2016 John Wiley & Sons Ltd.

  11. Paediatric non-Hodgkin lymphoma - perspectives in translational biology

    PubMed Central

    Shiramizu, Bruce; Mussolin, Lara; Woessmann, Wilhelm; Klapper, Wolfram

    2016-01-01

    Summary Exciting advances have been achieved for infants, children and adolescents diagnosed with, and treated for, non-Hodgkin lymphoma (NHL). In spite of these successes, new frontiers are being paved to improve the prognosis for those who relapse or have resistant disease. This review summarizes some of the novel approaches and ideas in NHL monitoring, diagnosis and treatment as discussed at the 5th International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma on October 22nd to 24th 2015 in Varese, Italy. PMID:27009921

  12. Orbital involvement by non-Hodgkin lymphoma NK T cells.

    PubMed

    Hervás-Ontiveros, A; España-Gregori, E; Hernández-Martínez, P; Vera-Sempere, F J; Díaz-Llopis, M

    2014-11-01

    The case is presented of 37 year-old male with a history of nasal obstruction with right rhinorrhea, headache, hearing loss and right exophthalmos of 4 months progression. The MRI revealed that the ethmoidal and maxillary sinuses contained inflammatory tissue extending into the orbital region. The biopsy confirmed a non-Hodgkin lymphoma of natural killer (NK) T cells. Non-Hodgkin's T NK lymphoma is a rare tumor in the orbital area that requires an early detection and multi-disciplinary care to ensure appropriate monitoring and treatment. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  13. Panobinostat and Everolimus in Treating Patients With Recurrent Multiple Myeloma, Non-Hodgkin Lymphoma, or Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-04-19

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; B-cell Adult Acute Lymphoblastic Leukemia; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Primary Central Nervous System Non-Hodgkin Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Multiple Myeloma; Splenic Marginal Zone Lymphoma; T-cell Adult Acute Lymphoblastic Leukemia; Waldenström Macroglobulinemia

  14. HODGKIN LYMPHOMA: AN UPDATE ON ITS BIOLOGY WITH NEWER INSIGHTS INTO CLASSIFICATION

    PubMed Central

    Mani, Haresh; Jaffe, Elaine S.

    2009-01-01

    In the last few years, there has been a greater understanding of the spectrum and biology of Hodgkin lymphoma. In standard texts, Hodgkin lymphoma is classified as two distinct entities, namely nodular lymphocyte predominant Hodgkin lymphoma and classical Hodgkin lymphoma. However, recent evidence suggests that classical Hodgkin lymphoma is not a single disease. While the mixed cellularity and lymphocyte depleted subtypes may be part of a biologic continuum, the nodular sclerosis subtype has a distinct epidemiology, clinical presentation and histology. Nodular sclerosis Hodgkin lymphoma may also be related to primary mediastinal B-cell lymphoma and mediastinal grey zone lymphomas. We present an update on the pathobiology of Hodgkin lymphoma and discuss these biologic and clinical differences in this review. PMID:19525189

  15. Thyroid Malignancies in Survivors of Hodgkin Lymphoma

    SciTech Connect

    Michaelson, Evan M.; Chen, Yu-Hui; Silver, Barbara; Tishler, Roy B.; Marcus, Karen J.; Stevenson, Mary Ann; Ng, Andrea K.

    2014-03-01

    Purpose: To quantify the incidence of thyroid cancer after Hodgkin lymphoma (HL) and determine disease characteristics, risk factors, and treatment outcomes. Methods and Materials: Thyroid cancer cases were retrospectively identified from a multi-institutional database of 1981 HL patients treated between 1969 and 2008. Thyroid cancer risk factors were evaluated by a Poisson regression model. Results: With a median follow-up duration of 14.3 years (range, 0-41.2 years), 28 patients (1.4%) developed a thyroid malignancy. The overall incidence rate (expressed as the number of cases per 10,000 person-years) and 10-year cumulative incidence of thyroid cancer were 9.6 and 0.26%, respectively. There were no observed cases of thyroid malignancy in patients who received neck irradiation for HL after age 35 years. Age <20 years at HL diagnosis and female sex were significantly associated with thyroid cancer. The incidence rates of females aged <20 at HL diagnosis in the first 10 years, ≥10 years, ≥15 years, and ≥20 years after treatment were 5, 31, 61, and 75 cases per 10,000 person-years of follow-up, respectively. At a median follow-up of 3.5 years after the thyroid cancer diagnosis, 26 patients (93%) were alive without disease, 1 (4%) was alive with metastatic disease, and 1 (4%) died of metastatic disease, at 6 and 3.6 years after the thyroid cancer diagnosis, respectively. Conclusions: Although HL survivors have an increased risk for thyroid cancer, the overall incidence is low. Routine thyroid cancer screening may benefit females treated at a young age and ≥10 years from HL treatment owing to their higher risk, which increases over time.

  16. Histologic progression in non-hodgkin's lymphoma

    SciTech Connect

    Hubbard, S.M.; Chabner, B.A.; DeVita, V.T., Jr.; Simon, R.; Berard, C.W.; Jones, R.B.; Garvin, A.J.; Canellos, G.P.; Osborne, C.K.; Young, R.C.

    1982-02-01

    The clinical course and biopsy specimens from 515 consecutive non-Hodgkin's lymphoma patients was evaluated retrospectively in an attempt to determine the clinical importance of documented changes in histology over time. Two-hundred and five of these patients has an initial diagnosis of nodular lymphoma and were reviewed for this anaysis. Sixty-three underwent a repeat biopsy greater than 6 mo after initial diagnosis. In 23 patients, these repeat biopsies revealed a change in histology to a diffuse pattern and/or a change to a larger ''histiocytic'' cell type, while repeat biopsies for the other 40 (63%) disclosd persistence of a nodular pattern and no clear change in basic cell type. Progression from nodular lymphoma to diffuse histiocytic, mixed, or undifferentiated types of lymphomas of Rappaport was found in repeate biopsies obtained from 19 patients (30%). Prognosis for survival following a biopsy that demonstrated histologic change was related to the histology demonstrated at the most recent biopsy and to the response to subsequent drug treatment. Survival following repeat biopsy for these 19 patients was significantly shorter than for the 40 patients whose histology remained nodular (p < 0.001). However, attainment of a complete remission with intensive combination chemotherapy was associated with prolonged survival in eight patients and prolonged disease-free survival in one patient. Since prior treatment may compromise the ability to achieve a complete response to chemotherapy in patients with nodular lymphoma who develop an aggressive diffuse histology, the likelihood of histologic progression must be considered in the design of future clinical trials in nodular lymphoma. Histologic progression does not preclude attainment of a complete response to intensive chemotherapy.

  17. Vaccine therapies for non-Hodgkin's lymphoma.

    PubMed

    Timmerman, John M

    2002-08-01

    Various clinical observations suggest that non-Hodgkin's lymphomas (NHLs), particularly those of low histologic grade, can be controlled by immunologic mechanisms. Although many effective therapies exist for the initial treatment of low grade lymphomas, none are curative and most have significant toxic side effects. Several promising lymphoma tumor antigen vaccines are being studied at medical centers throughout North America. I favor the scientific evaluation of a therapeutic strategy for follicular NHL that places immune-based therapies forward in the treatment algorithm to the initial therapeutic decision point. Active immunotherapies (therapeutic tumor vaccines) are instituted in tandem with initial cytoreductive chemotherapy, and followed by passive monoclonal antibody therapies. The tumor-specific idiotype vaccines are favored because of their demonstrated potential for clinical activity in numerous human studies and their lack of significant toxic side effects. Rituximab and other monoclonal antibodies directed at normal B-cell antigens are known to abrogate the host's ability to mount primary humoral immune responses, including antitumor antibodies evoked by tumor vaccines. Therefore, one should consider deferring the use of these agents until after an attempt at generating a host humoral antitumor response using investigational tumor vaccines. Chemotherapy regimens containing highly immunosuppressive agents (ie, fludarabine) or organ dose-limiting toxicities (ie, doxorubicin) may be best reserved for later in the disease course for those failing the more conservative approaches and for cases with adverse prognostic features. This strategy may give patients the greatest chance at prolonged remission or cure while minimizing acute and chronic toxicities, although its impact on overall survival has not been proven. Low grade NHLs remain the proving ground for this treatment philosophy. Hopefully, in the future, similar strategies may be applicable to NHLs of

  18. Hodgkin-like peripheral T-cell lymphoma (PTCL) with preserved Hodgkin-like lesions at autopsy: a case report with an interesting clinical course.

    PubMed

    Mori, Daisuke; Matsuishi, Eijo; Akashi, Michiaki; Shibaki, Masami; Hirano, Takayuki; Ide, Mikiko; Tsutsumi, Yoko; Tsukiji, Hidenori; Gondo, Hisashi

    2015-01-01

    The presence of the so-called Hodgkin and Reed-Sternberg (H-RS) like cells may occur in T-cell non-Hodgkin lymphoma. Reported herein is the autopsy case of Hodgkin-like peripheral T-cell lymphoma (PTCL) in a 77-year-old male with gradual submandibular lymph node enlargement. The first biopsy showed Hodgkin-like PTCL, initially misdiagnosed as classical Hodgkin lymphoma. Although he was treated with a regimen of ABVD, his disease recurred with cervical lymph node enlargement. A second biopsy showed angioimmunoblastic T-cell lymphoma (AITL) and H-RS like cells became obscure. Despite treatment with the CHOP regimen, he died. An autopsy confirmed that only Hodgkin-like lesions preserved while the AITL component had disappeared. This clinical course is very interesting in that only the Hodgkin-like lesions were systematically exacerbated and became the main cause of death. There are no reports of Hodgkin-like PTCL following AITL and finally preserved Hodgkin-like lesions in autopsy. Copyright © 2014 Elsevier GmbH. All rights reserved.

  19. Prevalence of Common Non-Hodgkin Lymphomas and Subtypes of Hodgkin Lymphoma by Nodal Site of Involvement

    PubMed Central

    Laurent, Camille; Do, Catherine; Gourraud, Pierre-Antoine; de Paiva, Geisilene Russano; Valmary, Séverine; Brousset, Pierre

    2015-01-01

    Abstract Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) represent a heterogeneous group of malignant lymphoid tumors, which have distinct histological and/or biological characteristics with preferential nodal involvement. However, none of the previous studies have assessed the prevalence of common NHL and HL subtypes at each nodal site of involvement. The aim of our study was to determine the prevalence of HL and NHL subtypes depending on their nodal sites of involvement. We conducted a single-center retrospective study of 938 lymphoma cases diagnosed in the Pathology Department of Toulouse Purpan Hospital in France between 2001 and 2008, taking into account the site that corresponded to the diagnostic biopsy. The most frequent sites were cervical lymph nodes (36.8% of all cases), inguinal lymph nodes (16.4%), axillary lymph nodes (11.9%), and supraclavicular lymph nodes (11%). We found an unexpected association between intraparotid nodes and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and between inguinal nodes and follicular lymphoma. The risk of having classical Hodgkin lymphoma (CHL) was 15 times greater in patients with mediastinal lymphoma compared to those with other sites of involvement. Regarding HL, nodal and extranodal mediastinal sites and supraclavicular nodes were more likely to be involved by nodular sclerosis Hodgkin lymphoma (NSCHL). In addition, intra-abdominal lymph nodes were more frequently involved by lymphocyte depleted Hodgkin lymphoma compared to inguinal nodes where NLPHL predominated. Our study shows that some lymph node sites have a disproportionate prevalence of specific subtypes of lymphoma. Identifying these sites may aid to diagnose and better elucidate the pathogenesis of these tumors. PMID:26107683

  20. Refractory or relapsed Hodgkin's disease and non-Hodgkin's lymphoma: optimizing involved-field radiotherapy in transplant patients.

    PubMed

    Kahn, Shannon T; Flowers, Christopher R; Lechowicz, Mary Jo; Hollenbach, Kathryn; Johnstone, Peter A S

    2005-01-01

    This study assessed efficacy, optimal dosage and timing, and toxicity of involved-field radiotherapy used in conjunction with high-dose chemotherapy and stem cell transplantation for patients with refractory/relapsed Hodgkin's disease and non-Hodgkin's lymphoma. 306 patients with refractory or relapsed Hodgkin's disease and non-Hodgkin's lymphoma were analyzed. Forty-one patients underwent involved-field radiotherapy in conjunction with high-dose chemotherapy and bone marrow or peripheral stem cell transplantation. Thirty-three patients received involved-field radiotherapy prior to stem cell transplantation directed at symptomatic and/or bulky sites; eight patients received involved-field radiotherapy after stem cell transplantation directed at sites of persistent disease. The other 265 patients with refractory/relapsed non-Hodgkin's lymphoma and Hodgkin's disease received high-dose chemotherapy/stem cell transplantation, but not involved-field radiotherapy. Data were analyzed using Cox proportional hazards regression to determine the risk of death among patients treated with stem cell transplantation compared with that among patients treated with stem cell transplantation and involved-field radiotherapy. There were 124 deaths during the follow-up period, including 17% of the patients treated with involved-field radiotherapy and 44.2% of the patients receiving chemotherapy without involved-field radiotherapy. Multivariate analysis found that patients who did not receive involved-field radiotherapy were 2.09 times more likely to die during the follow-up period than patients who received involved-field radiotherapy (P = 0.066; adjusted for age, stem cell transplantation type, stage I/II vs stage III/IV, refractory vs relapsed, and Hodgkin's disease vs non-Hodgkin's lymphoma). When patients were treated with involved-field radiotherapy prior to stem cell transplantation, 27 (79.4%) of the 34 patients achieved local control; when involved-field radiotherapy followed

  1. Three cases demonstrating the role of gallium scanning in relapsing Hodgkin's disease and non-Hodgkin lymphoma

    SciTech Connect

    Zollars, L.E.; Nagel, J.S.; Tumeh, S.S.

    1987-10-01

    Restaging of Hodgkin's disease and non-Hodgkin lymphoma for chemotherapy traditionally requires chest radiograph and abdominal computerized tomogram (CT) for routine follow-up examination. Although gallium scanning has had a poor record in the past, recent studies suggest that improved techniques have given this method high sensitivity. We present three cases in which gallium correctly staged lymphoma that had been missed or misinterpreted by chest radiographs and abdominal CT. Gallium imaging is useful in follow-up of lymphoma patients especially when the CT scan is difficult to interpret.

  2. Yttrium Y 90 Basiliximab and Combination Chemotherapy Before Stem Cell Transplant in Treating Patients With Mature T-cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-11-09

    Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Recurrent Mature T- and NK-Cell Non-Hodgkin Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Recurrent Cutaneous T-Cell Non-Hodgkin Lymphoma; Refractory Cutaneous T-Cell Non-Hodgkin Lymphoma

  3. Hodgkin's lymphoma in adolescents treated with adult protocols: a report from the German Hodgkin study group.

    PubMed

    Eichenauer, Dennis A; Bredenfeld, Henning; Haverkamp, Heinz; Müller, Horst; Franklin, Jeremy; Fuchs, Michael; Borchmann, Peter; Müller-Hermelink, Hans-Konrad; Eich, Hans T; Müller, Rolf-Peter; Diehl, Volker; Engert, Andreas

    2009-12-20

    PURPOSE The standard of care for adolescent patients with Hodgkin's lymphoma (HL) is undefined, particularly the choice between pediatric and adult protocols. Thus, we compared risk factors and outcome of adolescents and young adults treated within study protocols of the German Hodgkin Study Group (GHSG). PATIENTS AND METHODS Three thousand seven hundred eighty-five patients treated within the GHSG studies HD4 to HD9 were analyzed; 557 patients were adolescents age 15 to 20 years, and 3,228 patients were young adults age 21 to 45 years. Results Large mediastinal mass and involvement of three or more lymph node areas were more frequent in adolescents (P < .001). The incidence of other risk factors did not differ significantly between age groups. With a median observation time of 81 months for freedom from treatment failure (FFTF) and 85 months for overall survival (OS), log-rank test showed no significant differences between age groups regarding FFTF (P = .305) and a superior OS (P = .008) for adolescents. Six-year estimates for FFTF and OS were 80% and 94%, respectively, for adolescents and 80% and 91%, respectively, for young adults. After adjustment for other predictive factors, Cox regression analysis revealed age as a significant predictor for OS (P = .004), with a higher mortality risk for young adults. Secondary malignancies were more common in young adults (P = .037). CONCLUSION Outcome of adolescent and young adult patients treated within GHSG study protocols is comparable. These data suggest that adult treatment protocols exhibit a safe and effective treatment option for adolescent patients with HL. However, longer follow-up, including assessment of late toxicity, is necessary for final conclusions.

  4. Season of birth and risk of Hodgkin and non-Hodgkin lymphoma.

    PubMed

    Crump, Casey; Sundquist, Jan; Sieh, Weiva; Winkleby, Marilyn A; Sundquist, Kristina

    2014-12-01

    Infectious etiologies have been hypothesized for Hodgkin and non-Hodgkin lymphoma (HL and NHL) in early life, but findings to date for specific lymphomas and periods of susceptibility are conflicting. We conducted the first national cohort study to examine whether season of birth, a proxy for infectious exposures in the first few months of life, is associated with HL or NHL in childhood through young adulthood. A total of 3,571,574 persons born in Sweden in 1973-2008 were followed up through 2009 to examine the association between season of birth and incidence of HL (943 cases) or NHL (936 cases). We found a sinusoidal pattern in NHL risk by season of birth (p = 0.04), with peak risk occurring among birthdates in April. Relative to persons born in fall (September-November), odds ratios for NHL by season of birth were 1.25 [95% confidence interval (CI), 1.04-1.50; p = 0.02] for spring (March-May), 1.22 (95% CI, 1.01-1.48; p = 0.04) for summer (June-August) and 1.11 (95% CI, 0.91-1.35; p = 0.29) for winter (December-February). These findings did not vary by sex, age at diagnosis or major subtypes. In contrast, there was no seasonal association between birthdate and risk of HL (p = 0.78). In this large cohort study, birth in spring or summer was associated with increased risk of NHL (but not HL) in childhood through young adulthood, possibly related to immunologic effects of delayed infectious exposures compared with fall or winter birth. These findings suggest that immunologic responses in early infancy may play an important role in the development of NHL. © 2014 UICC.

  5. Does Radiation Have a Role in Advanced Stage Hodgkin's or Non-Hodgkin Lymphoma?

    PubMed

    Specht, Lena

    2016-01-01

    Radiation therapy (RT) is one of the most effective agents available in the treatment of lymphomas. However, it is a local treatment, and today, with systemic treatments assuming a primary role for induction of response, RT is primarily used for consolidation. For advanced stage lymphomas, the indications for the use of RT have been questioned and debated, and proper randomized evidence is sparse. RT has significant long-term side effects, and the very extended RT fields of the past yielded unacceptable toxicity in many patients. Modern advanced imaging and conformal RT techniques now enable treatment of larger and anatomically more challenging target volumes with much less radiation to normal tissues and consequently much lower risks of long-term complications. The modern concept of involved site radiation therapy (ISRT) has now been accepted as standard in lymphomas. In advanced Hodgkin lymphoma (HL), RT to residual disease and/or initial bulk benefits some patients, depending on the chemotherapy regimen used. The more intensive the chemotherapy regimen, the fewer patients benefit from RT. In advanced aggressive non-Hodgkin lymphoma (NHL), most of the evidence comes from the most common type, the diffuse large B cell lymphoma (DLBCL). In patients treated with modern immunochemotherapy, RT to initial bulky disease or extralymphatic involvement is beneficial. For both HL and aggressive NHL, RT to residual masses after systemic treatment is of benefit. The role of PET in the evaluation and indication for RT to residual masses has not been tested in randomized trials. In advanced indolent NHL, very low dose RT offers excellent palliation with very few side effects. Modern RT in advanced lymphomas warrants further evaluation in randomized trials.

  6. Acute toxoplasmosis-etiological factor for development of Hodgkin's lymphoma?

    PubMed

    Snopkova, Svatava; Pohanka, Miroslav; Polak, Pavel; Havlickova, Katerina; Jarkovsky, Jiři; Moulis, Mojmir; Stroblova, Hana; Husa, Petr

    2013-12-01

    The case of an HIV-positive man treated for acute toxoplasmosis with no traces of malignancy is reported. A second lymph node extirpation was performed after 5 months, which identified the presence of Hodgkin and Reed-Sternberg (HRS) cells. This case suggests that toxoplasmosis may cause changes in the regulation of surrounding cells and induce neoplastic proliferation.

  7. Brentuximab Vedotin Treatment for Primary Refractory Hodgkin Lymphoma

    PubMed Central

    Yeh, Shyh-An; Chen, Huei-Yung

    2013-01-01

    Up to 40% of patients with advanced Hodgkin lymphoma (HL) become refractory or relapsed after current standard chemotherapy, among which primary refractory HL confers a particularly poor outcome. With intensive salvage chemotherapy and autologous stem cell transplantation, the long-term remission rate for these patients was only 30%, but more selective treatments with higher therapeutic index are needed. We report the experience of using a new anti-CD30 immunotoxin, brentuximab vedotin, in salvage treatment of a 30-year-old woman with primary refractory Hodgkin lymphoma. The patient presented with SVC syndrome due to the bulky mediastinal tumor and was confirmed to have classical Hodgkin lymphoma, nodular sclerosis type, stage IIIA. The tumor responded to induction chemotherapy transiently, but local progression was noted during subsequent cycles of treatment. Salvage radiotherapy to the mediastinal tumor, obtained no remission but was followed by rapid in-field progression and then lung metastasis. She declined stem cell transplantation and received salvage brentuximab vedotin (BV) therapy, which induced dramatic shrinkage of tumor without significant side effects. Serial followup of PET/CT imaging confirmed a rapid and continuous complete remission for 12 months. Although durability of the remission needs further observation, this case illustrates the excellent efficacy of brentuximab vedotin in primary refractory Hodgkin lymphoma. PMID:24198983

  8. Brentuximab vedotin treatment for primary refractory hodgkin lymphoma.

    PubMed

    Wu, Hung-Bo; Yeh, Shyh-An; Chen, Huei-Yung

    2013-01-01

    Up to 40% of patients with advanced Hodgkin lymphoma (HL) become refractory or relapsed after current standard chemotherapy, among which primary refractory HL confers a particularly poor outcome. With intensive salvage chemotherapy and autologous stem cell transplantation, the long-term remission rate for these patients was only 30%, but more selective treatments with higher therapeutic index are needed. We report the experience of using a new anti-CD30 immunotoxin, brentuximab vedotin, in salvage treatment of a 30-year-old woman with primary refractory Hodgkin lymphoma. The patient presented with SVC syndrome due to the bulky mediastinal tumor and was confirmed to have classical Hodgkin lymphoma, nodular sclerosis type, stage IIIA. The tumor responded to induction chemotherapy transiently, but local progression was noted during subsequent cycles of treatment. Salvage radiotherapy to the mediastinal tumor, obtained no remission but was followed by rapid in-field progression and then lung metastasis. She declined stem cell transplantation and received salvage brentuximab vedotin (BV) therapy, which induced dramatic shrinkage of tumor without significant side effects. Serial followup of PET/CT imaging confirmed a rapid and continuous complete remission for 12 months. Although durability of the remission needs further observation, this case illustrates the excellent efficacy of brentuximab vedotin in primary refractory Hodgkin lymphoma.

  9. Comparison of staging methods for Hodgkin's disease in children

    SciTech Connect

    Lally, K.P.; Arnstein, M.; Siegel, S.; Miller, J.H.; Gilsanz, V.; Ettinger, L.; Atkinson, J.B.

    1986-10-01

    Potential long-term complications of radiotherapy and chemotherapy in the pediatric patient with Hodgkin's disease necessitate accurate staging. To determine the accuracy of abdominal computed tomography (CT) and gallium citrate Ga 67 scans in staging Hodgkin's disease, we reviewed the charts of all children with Hodgkin's disease seen at Childrens Hospital of Los Angeles from 1975 to 1985. Patients with pathologically proved stage IV disease (ie, bone marrow involvement) and those who only underwent staging laparotomy were excluded. A total of 40 children underwent staging by laparotomy and staging by abdominal CT and/or /sup 67/Ga scan. The CT and /sup 67/Ga scans were reviewed by radiologists in a blinded manner and compared with the results of a formal staging laparotomy. Of the 38 patients whose disease was staged with /sup 67/Ga scan, disease in ten was understaged and in four overstaged, for a 37% incorrect staging rate. Of the 14 patients whose disease was staged by CT scan, disease in three was understaged and in one overstaged, for a 29% incorrect staging rate. In view of the inaccuracy of noninvasive studies and the impact of incorrect staging on treatment, we recommend that a staging laparotomy be performed in all children with Hodgkin's disease who are not proved to have stage IV disease.

  10. [Two cases of severe pruritus revealing Hodgkin's disease in children].

    PubMed

    Amy de la Bretèque, M; Bilan, P; Galesowski, A; Chevallier, B; Drouot, D; Sigal, M-L; Mahé, E

    2014-12-01

    Pruritus in children is a frequent reason for consultation, most often related to a common dermatosis. Where dermatological investigation fails to reveal a dermatological cause, a general cause may be suspected. We report three cases of pruritus revealing Hodgkin's lymphoma in children. Case 1: a 14-year-old girl presented pruritus with diffuse scratching lesions present for 6 months, associated with right cervical lymph nodes occurring after the onset of pruritus. Tomodensitometry revealed involvement of the supra- and sub-diaphragmatic lymph nodes as well as pulmonary involvement. Lymph node biopsy confirmed nodular sclerosing Hodgkin's lymphoma. Case 2: a 14-year-old boy was hospitalized for suspected psychogenic pruritus. He presented intense itching, predominantly in the lower extremities and at night, occurring over the previous 6 months as well as night sweats. Examination showed that the patient had lost 5kg in 1 month and had a low-grade fever of 38°C; he presented linear striated scratching lesions on both legs. Cervical and inguinal lymphadenopathy was seen. The chest scan also revealed supra-diaphragmatic adenomegalies. The biopsy confirmed Hodgkin's lymphoma. Systemic causes of pruritus in children are poorly described in the literature. In these two cases, pruritus allowed a diagnosis of Hodgkin's lymphoma to be made, emphasizing the important role of dermatologists in the early diagnosis of haematological malignancy. Copyright © 2014. Published by Elsevier Masson SAS.

  11. Presternal soft tissue calcifications following mediastinal radiotherapy for Hodgkin's disease

    SciTech Connect

    Vainright, J.R.; Diaconis, J.N.; Haney, P.J.

    1987-01-01

    A patient is described in whom dense calcifications developed in the presternal soft tissues of the chest four years after mediastinal radiotherapy. This is believed to represent dystrophic calcification in previously normal but incidentally radiated tissues following standard dose radiotherapy to the mediastinum for stage IIA Hodgkin's disease.

  12. Retinal involvement in uveitis associated with Hodgkin disease.

    PubMed

    Ohta, Kouichi; Yoshida, Akiko; Sato, Atsuko; Fukui, Emi; Kikuchi, Takanobu

    2014-01-01

    To describe a patient with Hodgkin disease with posterior uveitis who also had a thinning of the retina and an antiretinal autoantibody in his serum. Our patient was a 58-year-old man who had been diagnosed with Hodgkin disease. He had a complete ophthalmologic examination including fluorescein angiography, electroretinography, perimetry, and spectral-domain optical coherence tomography. A search for antiretinal antibodies in the serum was made by Western blot analysis, and the retinal sites reactive to the antibodies were determined by immunohistochemistry. The ocular signs were mild cellular infiltration in the anterior chamber and vitreous, and small, round chorioretinal lesions in the peripheral retina. The electroretinograms were slightly reduced. Small ring-like scotomas were detected in the Goldmann visual fields. An antiretina-specific 116-kDa antibody was detected in the serum by Western blot analysis, and the antibody reacted with the ganglion cell and inner nuclear layers of mice retinas. Although the visual acuities were maintained for over eight years, the macular thickness measured in the spectral-domain optical coherence tomography images was reduced. The presence of an antiretinal autoantibody, granulomatous uveitis, and retinal thinning in a patient with Hodgkin disease suggests that the patient had a granulomatous uveitis associated with Hodgkin disease or lymphoma-associated uveitis with retinal involvement.

  13. A difficult diagnosis of Hodgkin lymphoma due to immune thrombocytopenia

    PubMed Central

    Marino, Silvia; Di Cataldo, Andrea; Magro, Gaetano; D'Amico, Salvatore; La Spina, Milena; Di Benedetto, Vincenzo; Meli, Mariaclaudia; Moscheo, Carla; Russo, Giovanna

    2015-01-01

    Key Clinical Message We report a rare clinical presentation of childhood Hodgkin lymphoma with immune thrombocytopenia. Diagnostic biopsy of the abdominal mass was performed after administration of intravenous immunoglobulins, steroids, and platelet transfusion. Concomitant thrombocytopenia complicated the whole diagnosis work up and the initial management of neoplasia. PMID:25838909

  14. Primary Extranodal, Extralymphatic Hodgkin Lymphoma of the Mandible

    PubMed Central

    Gonzalez-Fontal, Guido Ricardo; Rosales, Joaquin D.; Jaramillo, Roberto; Henao-Martinez, Andres F.

    2011-01-01

    Primary extranodal, extralymphatic Hodgkin lymphomas (PEEHLs) are a rare occurrence. When they are encountered, they become diagnostic challenges. We are describing the uniqueness of a case of PEEHL affecting the mandible with his early response to the available chemotherapy. PMID:21765842

  15. Radiation Plus Chemotherapy in Early-Stage Hodgkin Lymphoma

    Cancer.gov

    Adding radiation therapy to chemotherapy may improve outcomes in patients with early-stage Hodgkin lymphoma, according to a paper published in the Cochrane Database of Systematic Reviews in February 2011, but the long-term effects of this regimen are not

  16. Radiation Plus Chemotherapy in Early-Stage Hodgkin Lymphoma

    Cancer.gov

    Adding radiation therapy to chemotherapy may improve outcomes in patients with early-stage Hodgkin lymphoma, according to a paper published in the Cochrane Database of Systematic Reviews in February 2011, but the long-term effects of this regimen are not

  17. Risk of non-Hodgkin's lymphoma following tuberculosis

    PubMed Central

    Askling, J; Ekbom, A

    2001-01-01

    To study the association between chronic infections and non-Hodgkin's lymphoma (NHL), we assessed the risk of NHL in a Swedish cohort of 5050 individuals with tuberculosis 1939–1960. The overall relative risk was moderately increased, largely accounted for by high risks following severe tuberculosis diagnosed a long time ago. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11139323

  18. Monoamine oxidase A is highly expressed in classical Hodgkin lymphoma.

    PubMed

    Li, Pei Chuan; Siddiqi, Imran N; Mottok, Anja; Loo, Eric Y; Wu, Chieh Hsi; Cozen, Wendy; Steidl, Christian; Shih, Jean Chen

    2017-10-01

    Monoamine oxidase A (MAOA) is a mitochondrial enzyme that catalyzes oxidative deamination of neurotransmitters and dietary amines and produces H2 O2 . It facilitates the progression of gliomas and prostate cancer, but its expression and functional relevance have not been studied in lymphoma. Here, we evaluated MAOA in 427 cases of Hodgkin and non-Hodgkin lymphoma and in a spectrum of reactive lymphoid tissues by immunohistochemistry on formalin-fixed, paraffin-embedded specimens. MAOA was expressed by Hodgkin Reed-Sternberg (HRS) cells in the majority of classical Hodgkin lymphomas (cHLs) (181/241; 75%), with 34.8% showing strong expression. Weak MAOA was also noted in a minority of primary mediastinal large B-cell lymphomas (8/47; 17%) and in a mediastinal gray-zone lymphoma. In contrast, no MAOA was found in non-neoplastic lymphoid tissues, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL; 0/8) or any other non-Hodgkin lymphomas studied (0/123). MAOA was more common in Epstein-Barr virus (EBV)-negative compared to EBV-positive cHL (p < 0.0001) and was especially prevalent in the EBV-negative nodular sclerosing subtype. Similar to primary human lymphoma specimens, most cHL-derived cell lines displayed MAOA activity, whereas non-Hodgkin-lymphoma-derived cell lines did not. The MAOA inhibitor clorgyline reduced the growth of L1236 cells and U-HO1 cells, and shRNA knockdown of MAOA reduced the growth of L1236 cells. Conversely, ectopic overexpression of MAOA increased the growth of MAOA-negative HDLM2 cells. Combined treatment with clorgyline and ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) was more effective in reducing cell growth than either regimen alone. In summary, MAOA is highly expressed in cHL and may reflect the distinct biology of this lymphoma. Further studies on the potential utility of MAOA as a diagnostic marker and therapeutic target are warranted. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John

  19. Pathology of Hodgkin's disease: anything new?

    PubMed

    Wright, D H

    1989-01-01

    This presentation deals with the gross and microscopic pathology of HD. Recent advances in immunohistochemistry, gene rearrangement studies and cell culture are not discussed, except where they shed light on the pathology. Clinical and pathological experience, over the past 2 decades, suggests that HD should be divided into six subtypes, as originally proposed by Lukes et al. (1966b), rather than the four subtypes included in the Rye classification. Nodular lymphocyte/histiocyte predominant HD forms a clinicopathological entity separate from the other subtypes. It most frequently presents at a single nodal site and, even without therapy, progresses only slowly over a period of many years. A proportion of the patients (in the region of 10%) develop large cell NHL and a smaller number develop other types of Hodgkin's disease. This progression is not due to therapy since it most frequently occurs in untreated patients. Characteristic polylobated RS cell variants are seen in NLPHD. These differ from classic RS cells in that they have a B-cell phenotype, they do not show light chain restriction and, therefore, they do not appear to be a clonal proliferation. Although current dogma states that classic RS cells must be identified before a diagnosis of HD, including NLPHD, is made, it is the author's contention, supported by immunohistochemistry, that this type of RS cell does not occur in NLPHD. Polylobated RS cell variants in the appropriate cellular setting are, in themselves, diagnostic of NLPHD. They also serve to differentiate NLPHD from progressive transformation of germinal centres, an unusual proliferative expansion that may occur in association with HD but which, in itself, appears to be an entirely benign, reactive process. Diffuse lymphocyte/histiocyte predominant HD (DLPHD) differs from NLPHD in its diffuse growth pattern and the frequent presence of larger numbers of histiocytes. Polylobated RS cells are characteristic of both diseases. In some biopsies

  20. Association between simian virus 40 and non-Hodgkin lymphoma

    NASA Technical Reports Server (NTRS)

    Vilchez, Regis A.; Madden, Charles R.; Kozinetz, Claudia A.; Halvorson, Steven J.; White, Zoe S.; Jorgensen, Jeffrey L.; Finch, Chris J.; Butel, Janet S.

    2002-01-01

    BACKGROUND: Non-Hodgkin lymphoma has increased in frequency over the past 30 years, and is a common cancer in HIV-1-infected patients. Although no definite risk factors have emerged, a viral cause has been postulated. Polyomaviruses are known to infect human beings and to induce tumours in laboratory animals. We aimed to identify which one of the three polyomaviruses able to infect human beings (simian virus 40 [SV40], JC virus, and BK virus) was associated with non-Hodgkin lymphoma. METHODS: We analysed systemic non-Hodgkin lymphoma from 76 HIV-1-infected and 78 HIV-1-uninfected patients, and non-malignant lymphoid samples from 79 HIV-1-positive and 107 HIV-1-negative patients without tumours; 54 colon and breast carcinoma samples served as cancer controls. We used PCR followed by Southern blot hybridisation and DNA sequence analysis to detect DNAs of polyomaviruses and herpesviruses. FINDINGS: Polyomavirus T antigen sequences, all of which were SV40-specific, were detected in 64 (42%) of 154 non-Hodgkin lymphomas, none of 186 non-malignant lymphoid samples, and none of 54 control cancers. This difference was similar for HIV-1-infected patients and HIV-1-uninfected patients alike. Few tumours were positive for both SV40 and Epstein-Barr virus. Human herpesvirus type 8 was not detected. SV40 sequences were found most frequently in diffuse large B-cell and follicular-type lymphomas. INTERPRETATION: SV40 is significantly associated with some types of non-Hodgkin lymphoma. These results add lymphomas to the types of human cancers associated with SV40.

  1. Childhood determination of Hodgkin lymphoma among U.S. servicemen.

    PubMed

    Mack, Thomas M; Norman, James E; Rappaport, Edward; Cozen, Wendy

    2015-11-01

    Hodgkin lymphoma in young adults is inexplicably linked to economic development. We conducted a nested case-control study of the 656 servicemen with Hodgkin lymphoma diagnosed between ages 17 to 32 while on active duty in the U.S. military during 1950-68. Controls, chosen randomly from the servicemen on duty at the time, were matched on service, birth year, and induction date. Information came from preinduction records and military records for the period ending at onset or the equivalent date. Risk was independently increased with small sib-ship size [OR, 2.3; confidence interval (CI), 1.6-3.5], low birth order (OR, 1.9; CI, 1.4-2.6), and an interval of at least 5 years between birth and that of a previous or subsequent sibling (OR, 2.1; CI, 1.5-3.1). Other factors independently and significantly associated with elevated risk of Hodgkin lymphoma were: tallness, high body mass index, more education (but not higher income) in the county of birth, BB or AB blood type, and past infectious mononucleosis (but a deficit of other childhood viral infections). Early fatherhood conveyed high risk (OR, 2.6; CI, 1.4-4.8), especially if with a high-risk sibling configuration. Factors unrelated to risk included personal education, preinduction or military occupation, induction test score, and rank. Findings were similar for nodular sclerosis and mixed cell histologic subtypes. Protection from the environment in childhood, but not in adulthood, increases the likelihood of young adult Hodgkin lymphoma, which may result from nonspecific isolation from early infections and/or exposure to late infection by a specific but unidentified ubiquitous childhood virus. Events in childhood protect against later Hodgkin lymphoma. ©2015 American Association for Cancer Research.

  2. Association between simian virus 40 and non-Hodgkin lymphoma

    NASA Technical Reports Server (NTRS)

    Vilchez, Regis A.; Madden, Charles R.; Kozinetz, Claudia A.; Halvorson, Steven J.; White, Zoe S.; Jorgensen, Jeffrey L.; Finch, Chris J.; Butel, Janet S.

    2002-01-01

    BACKGROUND: Non-Hodgkin lymphoma has increased in frequency over the past 30 years, and is a common cancer in HIV-1-infected patients. Although no definite risk factors have emerged, a viral cause has been postulated. Polyomaviruses are known to infect human beings and to induce tumours in laboratory animals. We aimed to identify which one of the three polyomaviruses able to infect human beings (simian virus 40 [SV40], JC virus, and BK virus) was associated with non-Hodgkin lymphoma. METHODS: We analysed systemic non-Hodgkin lymphoma from 76 HIV-1-infected and 78 HIV-1-uninfected patients, and non-malignant lymphoid samples from 79 HIV-1-positive and 107 HIV-1-negative patients without tumours; 54 colon and breast carcinoma samples served as cancer controls. We used PCR followed by Southern blot hybridisation and DNA sequence analysis to detect DNAs of polyomaviruses and herpesviruses. FINDINGS: Polyomavirus T antigen sequences, all of which were SV40-specific, were detected in 64 (42%) of 154 non-Hodgkin lymphomas, none of 186 non-malignant lymphoid samples, and none of 54 control cancers. This difference was similar for HIV-1-infected patients and HIV-1-uninfected patients alike. Few tumours were positive for both SV40 and Epstein-Barr virus. Human herpesvirus type 8 was not detected. SV40 sequences were found most frequently in diffuse large B-cell and follicular-type lymphomas. INTERPRETATION: SV40 is significantly associated with some types of non-Hodgkin lymphoma. These results add lymphomas to the types of human cancers associated with SV40.

  3. Dorothy Reed and Hodgkin's disease: a reflection after a century.

    PubMed

    Zwitter, Matjaz; Cohen, Joel R; Barrett, Ann; Robinton, Elizabeth D

    2002-06-01

    It has now been 100 years since Dorothy Reed, at the age of 28, wrote her paper on Hodgkin's disease. Her biography reveals the difficult lives of women entering the hitherto male-dominated field of medicine, let alone medical research. Her historic paper on Hodgkin's disease is remarkable for its brilliant observations and concise scientific reasoning. Nevertheless, she was told that as a woman she could not hope for a career as an academic pathologist. After marriage to Charles Elwood Mendenhall, Professor of Physics at the University of Wisconsin and after giving birth to four children, the second part of her career began. Motivated by the loss of her firstborn, she began a study of infant mortality, an interest that lasted throughout her career. In 1926, Mendenhall undertook a survey comparing infant and maternal mortality rates in Denmark and the United States. This influential study concluded that American mortality rates were higher because of unnecessary interference in the natural process of childbirth and recommended the education of midwives follow the Danish model. In 1937, her efforts were rewarded when Madison, WI received recognition for having the lowest infant mortality of any city in the United States. Reading Reed's paper on Hodgkin's disease, we see that her observations go far beyond a description of a specific cell. Her presentation of macroscopic and microscopic features is remarkable for the distinction between "young" and "old" growths: Reed saw Hodgkin's disease as a process, rather than the spreading of a cancer. She was the first to note that those most commonly affected are boys or young adults, especially those whose general health before the disease had been excellent. She was also the first to note anergy to tuberculin. Dorothy Reed defined Hodgkin's disease in relation to tuberculosis, described its pathologic features, and offered comments on its pathogenesis, epidemiology, and immunology that still deserve to be discussed.

  4. Tumor necrosis factor alpha and lymphotoxin production in Hodgkin's disease.

    PubMed

    Kretschmer, C; Jones, D B; Morrison, K; Schlüter, C; Feist, W; Ulmer, A J; Arnoldi, J; Matthes, J; Diamantstein, T; Flad, H D

    1990-08-01

    It is likely that the characteristic histologic features of Hodgkin's disease reflect cytokine production by the tumor cell population. Tumor necrosis factor alpha (TNF-alpha) and lymphotoxin (tumor necrosis factor beta [TNF-beta]) are important inflammatory mediators with wide-ranging effects within the lymphoreticular system. The aim of the present study was to investigate TNF-alpha and lymphotoxin production in the Hodgkin's disease-derived cell lines L428 and L540. At the product level, both cytokines could be demonstrated by immunostaining with specific monoclonal antibodies. TNF-alpha could be demonstrated by means of an enzyme-linked immunosorbent assay in culture supernatants from both cell lines as well as in cell lysates of L428 and L540 cells. Cytotoxic activity could be achieved only in L428 supernatants. This cytotoxic activity could not be blocked by the addition of a polyclonal antibody against TNF-alpha, but was partially inhibited with the monoclonal antibody against lymphotoxin. Synthesis of TNF-alpha and lymphotoxin in both L428 and L540 was confirmed by demonstrating the intracellular-specific messenger RNA (mRNA) using specific cDNA clones in Northern blot analysis. In situ hybridization studies with the TNF-alpha cDNA probe gave positive hybridization signals in L428 and in L540. These results demonstrate the transcription, translation, and export of TNF-alpha and lymphotoxin in cultured Hodgkin's disease-derived cell lines. In addition, results of preliminary experiments are presented in which we demonstrate Reed-Sternberg cells positive for TNF-alpha protein and mRNA in different Hodgkin's disease tissue biopsies, indicating that, at least for TNF-alpha, our cell line data are relevant to the neoplastic population present in Hodgkin's disease tissue.

  5. Radiation-induced malignant tumors of bone in patients with Hodgkin's disease

    SciTech Connect

    Woodard, H.Q.; Huvos, A.G.; Smith, J.

    1988-10-01

    Sixteen cases of radiogenic malignant bone tumors which developed in patients 4 to 31 y after they had received radiation therapy for Hodgkin's disease are compared with 70 similar cases occurring after radiation exposure for other causes. No significant differences in age at irradiation, latent period, histology of tumors or radiographic characteristics were found between the Hodgkin's cases and those of the comparison series. Fourteen of the 16 tumors in Hodgkin's patients, or 87%, were diagnosed in the 15-y period between 1971 and 1985 in contrast to only 34% of the larger non-Hodgkin's series. This difference appears significant and is associated with a doubling of the proportion of Hodgkin's patients who are now living past the minimum latent period for such tumors. The median dose in the Hodgkin's patients, 4000 cGy, is less than the 5100-cGy median in the other patients, and the range and protraction of the total doses are much less. In Hodgkin's patients who have received total nodal irradiation, the volume of osseous tissue which is exposed may reach 25% of the total in the body. This is much greater than in most other treatment plans. Six of the Hodgkin's patients received chemotherapy within a few months of irradiation; only three of 70 non-Hodgkin's patients did so. All of the last factors may have modified the risk of radiation carcinogenesis in the Hodgkin's patients but the data are not yet adequate for quantitation of the effect.

  6. Experimental treatment of human Hodgkin's disease with ricin A-chain immunotoxins.

    PubMed

    Engert, A; Gottstein, C; Winkler, U; Amlot, P; Pileri, S; Diehl, V; Thorpe, P

    1994-05-01

    In the present paper we describe the evaluation of ricin A-chain immunotoxins for clinical application in Hodgkin's disease. The immunotoxins were constructed by chemically linking deglycosylated ricin-A to monoclonal antibodies (MoAb) recognising lymphocyte activation markers CD25, CD30, or IRac, which are expressed by Hodgkin's and Reed-Sternberg (H-RS) cells. The cytotoxic effects of the immunotoxins were investigated in vitro against L540Cy Hodgkin cells and in vivo against Hodgkin's tumors in nude mice and disseminated Hodgkin's tumors in SCID mice. MoAbs were evaluated for crossreactivity with normal human tissues and staining of sections from Hodgkin's disease tissue. Of 32 MoAbs, eight showed little crossreactivity with vital human organs and produced highly active immunotoxins. The most effective immunotoxin, RFT5 gamma l.dgA (CD25), inhibits the growth of H-RS cells at concentrations of 7 x 10(-12) M. RFT5 gamma l.dgA destroys about 60% of solid Hodgkin's tumors of 0.5 cm diameter in nude mice and induces complete remissions in 95% of SCID mice with disseminated Hodgkin's tumors when administered one day after tumor challenge. This immunotoxin binds to all H-RS cells in more than 90% of patients with Hodgkin's disease. Patients with refractory Hodgkin's disease are currently being treated in a phase-I/II clinical trial.

  7. Genetically Modified Peripheral Blood Stem Cell Transplant in Treating Patients With HIV-Associated Non-Hodgkin or Hodgkin Lymphoma

    ClinicalTrials.gov

    2015-05-06

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; AIDS-related Diffuse Large Cell Lymphoma; AIDS-related Diffuse Mixed Cell Lymphoma; AIDS-related Diffuse Small Cleaved Cell Lymphoma; AIDS-related Immunoblastic Large Cell Lymphoma; AIDS-related Lymphoblastic Lymphoma; AIDS-related Peripheral/Systemic Lymphoma; AIDS-related Small Noncleaved Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; HIV-associated Hodgkin Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Hairy Cell Leukemia; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage I AIDS-related Lymphoma; Stage II AIDS-related Lymphoma; Stage III AIDS-related Lymphoma; Stage IV AIDS-related Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

  8. Dose Monitoring of Busulfan and Combination Chemotherapy in Hodgkin or Non-Hodgkin Lymphoma Undergoing Stem Cell Transplant

    ClinicalTrials.gov

    2015-08-12

    Adult Grade III Lymphomatoid Granulomatosis; Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Childhood Burkitt Lymphoma; Childhood Diffuse Large Cell Lymphoma; Childhood Grade III Lymphomatoid Granulomatosis; Childhood Immunoblastic Large Cell Lymphoma; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Contiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Contiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Grade 3 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Contiguous Stage II Marginal Zone Lymphoma; Contiguous Stage II Small Lymphocytic Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma; Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma; Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Grade 3 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Noncontiguous Stage II Marginal Zone Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult

  9. Bruton's tyrosine kinase (Btk) is a useful marker for Hodgkin and B cell non-Hodgkin lymphoma.

    PubMed

    Fernández-Vega, Iván; Quirós, Luis M; Santos-Juanes, Jorge; Pane-Foix, María; Marafioti, Teresa

    2015-02-01

    Bruton's tyrosine kinase (Btk) is a member of the Tec family of protein tyrosine kinases involved in B cell development and proliferation in neoplastic human lymphoid tissues. We used immunohistochemistry to evaluate a polyclonal anti-Btk antibody on formalin-fixed paraffin-embedded tissue blocks. The tested samples included normal lymphoid tissues, tissue samples of 395 different lymphomas and 14 malignant lymphoid cell lines. Btk was expressed more often in B cell lymphomas than in T cell lymphomas. This correlated well with the results obtained on B cell lymphoma cell lines, which strongly expressed Btk, in contrast to T cell lymphoma cell lines. More than 60% of myelomas expressed Btk. Among Hodgkin lymphomas, the nodular lymphocyte predominant variant was more often positive (14/16) than the classical variant (6/27). Only one out of three Hodgkin lymphoma-derived cell lines showed a few atypical large cells expressing Btk. Btk represents a useful marker to identify B cell non-Hodgkin lymphomas. Furthermore, Btk might help to distinguish the nodular lymphocyte predominant variant of Hodgkin lymphomas from the classical form. Finally, in view of the recently discovered therapeutic potential of Btk inhibitors in lymphoma, we report the pattern of expression of Btk in a large collection of different types of lymphoma.

  10. Hodgkin and sternberg-reed cell antigen(s) detected by an antiserum to a cell line (L428) derived from Hodgkin's disease.

    PubMed

    Stein, H; Gerdes, J; Kirchner, H; Schaadt, M; Diehl, V

    1981-10-15

    Antisera to the cell line L428, derived from Hodgkin's disease, were raised in rabbits by injecting L428 cells intravenously and subcutaneously. The anti-L428 cell serum that did not react with HLA-DR was absorbed with tonsil cell plus acute myeloid leukemia cells or tonsil cells plus neutrophils, monocytes, and blood lymphocytes. Then it was tested for its ability to discriminate between L428 cells, Hodgkin and Sternberg-Reed cells, and various other cells. It was found that the anti L428 cell serum absorbed with tonsil cells plus acute myeloid leukemia cells stained only L428 cells, Hodgkin and Sternberg-Reed cells, and neutrophils. The anti L428 cell serum absorbed with tonsil cell plus neutrophils, monocytes, and blood lymphocytes reacted with L428 cells and Hodgkin and sternberg-Reed cells from 13 cases of Hodgkin's disease. It did not react with any other cell type present in the blood or in lymphoid tissue or with cells from five cases of non-Hodgkin's lymphoma. The absorbed anti-L428 cell serum also failed to stain Daudi and HRIK cell line cells. We conclude that the anti-L428 cell serum defines an antigen that is apparently restricted in expression to L428 cells and Hodgkin and Sternberg-Reed cells. This is a strong indication that the L428 cell line cells are derived from Hodgkin and Sternberg-Reed cells.

  11. Nab-paclitaxel/Rituximab-coated Nanoparticle AR160 in Treating Patients With Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-03-15

    Aggressive Non-Hodgkin Lymphoma; CD20 Positive; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Small Lymphocytic Lymphoma

  12. Autologous Peripheral Blood Stem Cell Transplant Followed by Donor Bone Marrow Transplant in Treating Patients With High-Risk Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Multiple Myeloma, or Chronic Lymphocytic Leukemia

    ClinicalTrials.gov

    2017-01-06

    B-Cell Prolymphocytic Leukemia; Hypodiploidy; Loss of Chromosome 17p; Plasma Cell Leukemia; Progression of Multiple Myeloma or Plasma Cell Leukemia; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Non-Hodgkin Lymphoma; Recurrent Childhood Hodgkin Lymphoma; Recurrent Childhood Non-Hodgkin Lymphoma; Recurrent Chronic Lymphocytic Leukemia; Recurrent Plasma Cell Myeloma; Recurrent Small Lymphocytic Lymphoma; Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Non-Hodgkin Lymphoma; Refractory Plasma Cell Myeloma; Refractory Small Lymphocytic Lymphoma; t(14;16); t(4;14); T-Cell Prolymphocytic Leukemia; Waldenstrom Macroglobulinemia

  13. Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease

    SciTech Connect

    van Leeuwen, F.E.; Somers, R.; Taal, B.G.; van Heerde, P.; Coster, B.; Dozeman, T.; Huisman, S.J.; Hart, A.A.

    1989-08-01

    The risk of second cancers (SCs) was assessed in 744 patients with Hodgkin's disease (HD) admitted to The Netherlands Cancer Institute from 1966 to 1983. Sixty-nine SCs were observed one month or more after start of first treatment. These included 14 cases of lung cancer, nine cases of non-Hodgkin's lymphoma (NHL), 16 cases of leukemia, and six cases of the myelodysplastic syndrome (MDS). The median interval between the diagnosis of HD and that of second lung cancer, NHL, and leukemia was 8.1, 13.3, and 5.7 years, respectively. The overall relative risks (RR) (observed/expected (O/E) ratios) of developing lung cancer, NHL, and leukemia were 4.9 (95% confidence limit (CL), 2.7 to 8.2), 31.0 (95% CL, 14.2 to 58.9) and 45.7 (95% CL, 26.1 to 74.2), respectively. At 15 years the cumulative risk of developing an SC amounted to 20.6% +/- 2.9%. The 15-year estimates of lung cancer, NHL, and leukemia were 6.2% +/- 1.9%, 5.9% +/- 2.1% and 6.3% +/- 1.7%, respectively. Increased lung cancer risk following HD has not frequently been clearly demonstrated before; that we were able to demonstrate such risk may be due to the completeness of follow-up over long periods that could be achieved in this study. Excess lung cancer risk was only noted in treatment regimens with radiotherapy (RT); also, all lung cancers arose in irradiation fields. Excess risk of leukemia was only found in treatment regimens involving chemotherapy (CT). For NHL, combined modality treatment was shown to be the most important risk factor. Risk of lung cancer and NHL increased with time since diagnosis. A time-dependent covariate analysis (Cox model) performed on leukemia and MDS showed an increasing risk with intensity of CT, age (greater than 40 years), and a splenectomy.

  14. Maternal and Fetal Outcomes After Therapy for Hodgkin or Non-Hodgkin Lymphoma Diagnosed During Pregnancy.

    PubMed

    Pinnix, Chelsea C; Osborne, Eleanor M; Chihara, Dai; Lai, Peter; Zhou, Shouhao; Ramirez, Mildred M; Oki, Yasuhiro; Hagemeister, Frederick B; Rodriguez, Alma M; Samaniego, Felipe; Fowler, Nathan; Romaguera, Jorge E; Turturro, Francesco; Fayad, Luis; Westin, Jason R; Nastoupil, Loretta; Neelapu, Sattva S; Cheah, Chan Y; Dabaja, Bouthaina S; Milgrom, Sarah A; Smith, Grace L; Horace, Patricia; Milbourne, Andrea; Wogan, Christine F; Ballas, Leslie; Fanale, Michelle A

    2016-08-01

    The management of lymphoma diagnosed during pregnancy is controversial and has been guided largely by findings from case reports and small series. To determine maternal and fetal outcomes of women diagnosed with Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL) during pregnancy. This retrospective analysis studied a cohort of 39 pregnant women diagnosed with HL and NHL (31 HL and 8 NHL) at a single specialized cancer institution between January 1991 and December 2014. We examined data on disease and treatment characteristics, as well as maternal and fetal complications and outcomes. The Kaplan-Meier method was used to compare progression free survival (PFS) and overall survival (OS) according to receipt of antenatal therapy and other clinical factors. Univariate and multivariate analyses were performed by using Cox proportional hazard regression models to identify potential associations between clinical and treatment factors and survival. The median (range) age of the 39 women in the patient cohort was 28 (19-38) years; 32 women (82%) had stage I or II disease at diagnosis, and 13 had bulky disease. Three women electively terminated the pregnancy to allow immediate systemic therapy; of the remaining 36 women, 24 received antenatal therapy (doxorubicin based combination chemotherapy in 20 of 24 patients), and 12 deferred therapy until after delivery. Four women experienced miscarriage, all of whom had received antenatal systemic therapy and 2 during the first trimester. Delivery occurred at a median (range) of 37 (32-42) weeks and was no different based on receipt of antenatal (median [range], 37 [33-42] weeks) vs postnatal (median [range], 37 [32-42] weeks) therapy (P = .21). No gross fetal malformations or anomalies were detected. At a median (range) follow-up time of 67.9 (8.8-277.5) months since the diagnosis of lymphoma, 5-year rates of PFS and OS were 74.7% and 82.4%, respectively; these rates did not differ according to timing of therapy. On univariate

  15. Risk and outcome of non-Hodgkin lymphoma among classical Hodgkin lymphoma survivors.

    PubMed

    Xavier, Ana C; Armeson, Kent E; Hill, Elizabeth G; Costa, Luciano J

    2013-09-15

    Survivors of classical Hodgkin lymphoma (cHL) are at an increased risk of developing secondary non-Hodgkin lymphomas (sNHLs). To the authors' knowledge, the outcome of patients with sNHL compared with their de novo counterparts (dnNHL) is unknown. Data from 26,826 cases of HL from the Surveillance, Epidemiology, and End Results (SEER) program that were diagnosed between 1992 and 2009 were used to obtain the risk of further development of different subtypes of sNHL. The survival of patients with sNHL was compared with that of matched patients with dnNHL. The estimated cumulative incidence of sNHL was 2.50% (95% confidence interval [95% CI], 2.10-2.89) at 15 years from the diagnosis of cHL. The standardized incidence ratio was 10.5 (95% CI, 8.9-12.4) for aggressive B-cell NHL, 4.0 (95% CI, 3.1-5.1) for indolent B-cell NHL, and 14.6 (95% CI, 10.3-20.1) for T-cell NHL. Patients with indolent B-cell sNHL had a worse overall survival compared with their dnNHL counterparts (hazards ratio [HR] of death, 2.7; 95% CI, 1.3-5.7). Survival was not significantly different between patients with sNHL and those with dnNHL with regard to aggressive B-cell NHL (HR, 1.3; 95% CI, 0.6-2.7) or T-cell NHL (HR, 0.8; 95% CI, 0.3-1.8). The risk of developing sNHL after cHL is substantial. Although patients with indolent B-cell sNHL have inferior survival, patients with aggressive B-cell sNHL and T-cell sNHL have survival comparable to that of their de novo counterparts. © 2013 American Cancer Society.

  16. Nivolumab and Ipilimumab in Treating Patients With HIV Associated Relapsed or Refractory Classical Hodgkin Lymphoma or Solid Tumors That Are Metastatic or Cannot Be Removed by Surgery

    ClinicalTrials.gov

    2017-09-04

    Advanced Malignant Solid Neoplasm; Anal Carcinoma; HIV Infection; Kaposi Sarcoma; Lung Carcinoma; Metastatic Malignant Solid Neoplasm; Recurrent Classical Hodgkin Lymphoma; Refractory Classical Hodgkin Lymphoma; Unresectable Solid Neoplasm

  17. Sideroblastic anemia as a preleukemic event in patients treated for Hodgkin's disease

    SciTech Connect

    Kitahara, M.; Cosgriff, T.M.; Eyre, H.J.

    1980-05-01

    Sideroblastic anemia after treatment for Hodgkin's disease was seen in two patients 3 years after completion of radiation therapy and chemotherapy. This was followed in both by the development of myelomonoblastic leukemia. No evidence of recurrent Hodgkin's disease was present in either patient. Our observation suggests that development of sideroblastic anemia in patients previously treated for Hodgkin's disease is probably secondary to the treatment and is a preleukemic event.

  18. Symptomatic pericardial effusion in Hodgkin's lymphoma: a rare occurrence. Case report and review of the literature.

    PubMed

    Adler, Adam C; Cestero, Cesar

    2012-01-01

    Pericardial effusion is observed in approximately 5% of patients with Hodgkin's lymphoma but is rarely symptomatic. We report a case in which a 21-year-old woman with newly diagnosed Hodgkin's lymphoma was found to have symptoms and radiographic evidence of pericardial effusion. Symptomatic pericardial effusion in patients with Hodgkin's lymphoma is extremely rare, with few reports in the literature. The mechanism for the heart and pericardial involvement is reviewed along with a description of the presenting symptoms and differential diagnosis.

  19. Rapid separation of mononuclear hodgkin from multinuclear reed-sternberg cells.

    PubMed

    Kongruttanachok, Narisorn; Cayre, Yvon E; Knecht, Hans; Mai, Sabine

    2014-03-01

    We describe a method to isolate small mononucleated Hodgkin (H) cells from multinucleated Reed Sternberg (RS) cells of Hodgkin lymphoma using the ScreenCell filter device. This filtration-based approach lends itself to future clinical applications in that it enables the separation of H and RS cells from lymph node biopsies, bone marrow aspirates, pleural effusions, and blood, including the isolation of monoclonal Hodgkin precursor cells from the blood.

  20. Necrotizing retinitis caused by opportunistic virus infection in a patient with Hodgkin's disease.

    PubMed

    Diddie, K R; Schanzlin, D J; Mausolf, F A; Minckler, D S; Trousdale, M D

    1979-10-01

    A 33-year-old woman with Hodgkin's disease developed a painless progressive loss of vision in both eyes. Despite an ophthalmoscopic appearance of white-yellow retinal necrosis and retinal hemorrhage similar to that described with Hodgkin's disease, no sign of the disorder was found at autopsy. Instead, widespread evidence of Herpesviridae family virus infection was present in several organs, including the retinas. Opportunistic infection, including herpes simplex and cytomegalovirus, should be considered when retinitis complicates Hodgkin's disease.

  1. Primary T-Cell Non-Hodgkin Lymphoma of the Vagina

    PubMed Central

    Herraiz, J. L.; Llueca, A.; Maazouzi, Y.; Piquer, D.; Palmeiro, A.; Calpe, E.

    2015-01-01

    The primary vaginal T-cell non-Hodgkin lymphoma is a rare form of lymphoma. Most of the previously published cases were about B-cell non-Hodgkin lymphomas. We present the case of a vaginal mass in an 82-year-old patient presenting vaginal bleeding. The results of the immunohistological studies of the mass revealed the presence of a cytotoxic T-cell non-Hodgkin lymphoma, which is the least common subtype. PMID:26101677

  2. Recent Advances in the Pathobiology of Hodgkin's Lymphoma: Potential Impact on Diagnostic, Predictive, and Therapeutic Strategies

    PubMed Central

    Banerjee, Diponkar

    2011-01-01

    From its first description by Thomas Hodgkin in 1832, Hodgkin's disease, now called Hodgkin's lymphoma, has continued to be a fascinating neoplasm even to this day. In this review, historical aspects, epidemiology, diagnosis, tumor biology, new observations related to host-microenvironment interactions, gene copy number variation, and gene expression profiling in this complex neoplasm are described, with an exploration of chemoresistance mechanisms and potential novel therapies for refractory disease. PMID:21318045

  3. Serum IgA to Epstein-Barr virus early antigen-diffuse identifies Hodgkin's lymphoma.

    PubMed

    McAllister, Shane C; Shedd, Duane; Mueller, Nancy E; Chang, Ellen T; Miller, George; Bhaduri-McIntosh, Sumita

    2014-09-01

    Hodgkin's lymphoma is associated with immune dysregulation. Immune impairment often results in aberrant immune responses and lytic reactivation of ubiquitous Herpesviruses, such as Epstein-Barr virus (EBV) in mucosal tissues. Accordingly, the specificity of IgA to EBV early lytic antigens, which are important for reactivation, was evaluated to determine Hodgkin's lymphoma-specific sero-reactive patterns. Sera from 42 patients with Hodgkin's lymphoma were compared to sera from 17 patients with infectious mononucleosis (IM), another EBV-related condition that often presents in a similar manner; and to sera from 15 healthy EBV-seropositive subjects. Flow cytometry analysis demonstrated that like IM sera, most Hodgkin's lymphoma sera contained IgA that labeled cells expressing EBV early lytic antigens whereas healthy EBV-seropositive sera did not. Further evaluation to distinguish Hodgkin's lymphoma from IM showed that IgA in most Hodgkin's lymphoma, irrespective of the presence of EBV in primary tumors, detected only modified forms of EBV lytic Early Antigen-Diffuse (EA-D) while IM sera detected the un-modified form as well, further supporting the presence of immune dysregulation in Hodgkin's lymphoma patients. This IgA pattern distinguished Hodgkin's lymphoma from IM sera with a sensitivity of 92.9%, specificity 100%, positive predictive value 100%, and negative predictive value 85%. Our findings lay the groundwork for additional scientific and clinical investigation, particularly into the potential for developing Hodgkin's lymphoma-associated diagnostic and prognostic biomarkers.

  4. Increased serum IgD concentrations in patients with Hodgkin's disease.

    PubMed

    Corte, G; Ferrarini, M; Tonda, P; Bargellesi, A

    1977-05-01

    Serum IgD concentrations have been determined in twenty-one patients with Hodgkin's disease, in eight patients with non-Hodgkin's lymphomas and in twenty-eight normal (control) individuals by both a solidphase radio-immuno-assay and radial-immunodiffusion. Fourteen of the Hodgkin's patients displayed three to forty-five-fold increased serum IgD levels as compared to control individuals, while in the remaining seven patients IgD concentrations were practically normal. Patients with non-Hodgkin's lymphomas had decreased IgD concentrations.

  5. Perinatal and Family Risk Factors for Hodgkin Lymphoma in Childhood Through Young Adulthood

    PubMed Central

    Crump, Casey; Sundquist, Kristina; Sieh, Weiva; Winkleby, Marilyn A.; Sundquist, Jan

    2012-01-01

    The incidence of Hodgkin lymphoma has increased among adolescents and young adults in recent decades, but the relevant risk factors in early life are still unknown. A national cohort study was conducted of 3,571,574 individuals born in Sweden in 1973–2008 and followed up for Hodgkin lymphoma incidence through 2009, to examine perinatal and family risk factors for Hodgkin lymphoma in childhood through young adulthood (ages 0–37 years). There were 943 Hodgkin lymphoma cases identified in 66.3 million person-years of follow-up. High fetal growth was associated with an increased risk of Hodgkin lymphoma after adjustment for gestational age at birth and other potential confounders (Ptrend = 0.005). Family history of Hodgkin lymphoma in a sibling or parent also was strongly associated with an increased risk, with adjusted hazard ratios = 8.83 (95% confidence interval: 3.67, 21.30) and 7.19 (95% confidence interval: 3.58, 14.44), respectively. No association was found between gestational age at birth, birth order, twinning, parental age, or parental education and Hodgkin lymphoma. These findings did not vary by age at Hodgkin lymphoma diagnosis. Similar associations were found for nodular sclerosis and mixed cellularity subtypes. These findings suggest that perinatal factors including possible growth factor pathways may contribute to the risk of Hodgkin lymphoma in childhood through young adulthood. PMID:23171883

  6. Serum IgA to Epstein-Barr virus Early Antigen-Diffuse identifies Hodgkin's Lymphoma

    PubMed Central

    McAllister, Shane C.; Shedd, Duane; Mueller, Nancy E.; Chang, Ellen T.; Miller, George; Bhaduri-McIntosh, Sumita

    2013-01-01

    Hodgkin's lymphoma is associated with immune dysregulation. Immune impairment often results in aberrant immune responses and lytic reactivation of ubiquitous Herpesviruses such as Epstein-Barr virus (EBV) in mucosal tissues. Accordingly, the specificity of IgA to EBV early-lytic antigens, which are important for reactivation, was evaluated to determine Hodgkin's lymphoma-specific sero-reactive patterns. Sera from 42 previously described patients with Hodgkin's lymphoma were compared to sera from 17 patients with infectious mononucleosis (IM), another EBV-related condition that often presents in a similar manner; and to sera from 15 healthy EBV-seropositive subjects. Flow cytometry analysis demonstrated that like IM sera, most Hodgkin's lymphoma sera contained IgA that labeled cells expressing EBV early-lytic antigens whereas healthy EBV-seropositive sera did not. Further evaluation to distinguish Hodgkin's lymphoma from IM showed that IgA in most Hodgkin's lymphoma, irrespective of the presence of EBV in primary tumors, detected only modified forms of EBV lytic Early Antigen-Diffuse (EA-D) while IM sera detected the un-modified form as well, further supporting the presence of immune dysregulation in Hodgkin's lymphoma patients. This IgA pattern distinguished Hodgkin's lymphoma from IM sera with a sensitivity of 92.9%, specificity 100%, positive predictive value 100%, and negative predictive value 85%. Our findings lay the groundwork for additional scientific and clinical investigation, particularly into the potential for developing Hodgkin's lymphoma -associated diagnostic and prognostic biomarkers. PMID:24122847

  7. A novel immunohistochemical classifier to distinguish Hodgkin lymphoma from ALK anaplastic large cell lymphoma.

    PubMed

    Döring, Claudia; Hansmann, Martin-Leo; Agostinelli, Claudio; Piccaluga, Pier P; Facchetti, Fabio; Pileri, Stefano; Küppers, Ralf; Newrzela, Sebastian; Hartmann, Sylvia

    2014-10-01

    Classical Hodgkin lymphoma and ALK(-) anaplastic large cell lymphoma share many features like strong CD30 expression and usually loss of B- and T-cell markers. However, their clinical course is dramatically different with curability rates of >90% for classical Hodgkin lymphoma and an unfavorable prognosis for anaplastic large cell lymphoma. Classical Hodgkin lymphoma and ALK(-) anaplastic large cell lymphoma can usually be distinguished by PAX5 expression in the Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma and expression of cytotoxic molecules in tumor cells of anaplastic large cell lymphoma. However, in some cases the differential diagnosis is difficult owing to absence of established markers. To be able to better classify these cases, we reevaluated gene expression data of microdissected tumor cells of both lymphomas for differentially expressed genes. A classifier was established, comprising four genes strongly expressed in Hodgkin and Reed-Sternberg cells of classical Hodgkin lymphoma (MDC/CCL22, CD83, STAT3, and TUBB2B). Applying this classifier to a test cohort, Hodgkin lymphoma was successfully distinguished from ALK(-) anaplastic large cell lymphoma with an accuracy of 97% (43/44). MDC/CCL22, CD83, and STAT3 have also been found to be expressed in antigen-presenting cells. Therefore, based on our established classifier, Hodgkin and Reed-Sternberg cells differ from tumor cells of anaplastic large cell lymphoma, which can successfully be applied for practical purposes in histopathologic diagnostics.

  8. [Hodgkin disease revealed by a nephrotic syndrome: A case report].

    PubMed

    Cheptou, M; Pichault, V; Campagni, R; Vodoff, M-V; Fischbach, M; Paillard, C

    2015-12-01

    Pediatric nephrotic syndrome (NS) is most often idiopathic or primary but in rare cases, it can be secondary to neoplasia. We report on a case of steroid-resistant NS revealing as a paraneoplastic syndrome of Hodgkin disease (HD) in a 12-year-old boy. The onset of the NS can be earlier, later, or simultaneous to the HD. Treatment of the lymphoma allows the disappearance of the NS. In the case we observed, the diagnosis of HD was delayed because HD presented with an isolated, hilar adenopathy in the absence of retroperitoneal or peripheral locations. In children aged 10 years or more presenting with NS, steroid-resistant or otherwise, a possible paraneoplastic origin such as Hodgkin lymphoma should always be taken into consideration and eventually eliminated.

  9. Unusual thoracic radiographic findings in children treated for Hodgkin's disease

    SciTech Connect

    Jochelson, M.S.; Tarbell, N.J.; Weinstein, H.J.

    1986-06-01

    Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

  10. Multimodality therapy of favorable prognosis non-Hodgkin's lymphoma

    SciTech Connect

    Corder, M.P.; Leimert, J.T.; Tewfik, H.H.; Lovett, J.M.

    1983-07-01

    Twenty-seven previously untreated patients with favorable prognosis non-Hodgkin's lymphoma were treated with a combination of total body irradiation followed by cyclophosphamide - vincristine - prednisone (CVP). The dose of total body irradiation was planned to be 150 rad followed by 6 cycles of chemotherapy. The complete response rate was 59%; the complete plus partial response rate, 93%. The 50% disease-free survival was 8 months. The actuarial projected 5 year survival was 60% and the disease-free survival at 5 years was 27%. The program was well tolerated by the majority of patients. It is possible for some patients with favorable non-Hodgkin's lymphomas to achieve prolonged periods of disesase-free survival when treated with combinations of irradiation plus chemotherapy.

  11. Thyroid neoplasia following radiation therapy for Hodgkin's lymphoma

    SciTech Connect

    McHenry, C.; Jarosz, H.; Calandra, D.; McCall, A.; Lawrence, A.M.; Paloyan, E.

    1987-06-01

    The question of thyroid neoplasia following high-dose radiation treatment to the neck and mediastinum for malignant neoplasms such as Hodgkin's lymphoma in children and young adults has been raised recently. Five patients, 19 to 39 years old, were operated on for thyroid neoplasms that developed following cervical and mediastinal radiation therapy for Hodgkin's lymphoma. Three patients had papillary carcinomas and two had follicular adenomas. The latency period between radiation exposure and the diagnosis of thyroid neoplasm ranged from eight to 16 years. This limited series provided strong support for the recommendation that children and young adults who are to receive high-dose radiation therapy to the head, neck, and mediastinum should receive suppressive doses of thyroxine prior to radiation therapy in order to suppress thyrotropin (thyroid-stimulating hormone) and then be maintained on a regimen of suppression permanently.

  12. Nodular Lymphocyte Predominant Hodgkin Lymphoma of the Thyroid

    PubMed Central

    Cassis, João; Simões, Helder; Sequeira Duarte, João

    2016-01-01

    Thyroid lymphomas are rare clinical entities that may result from either the primary intrathyroid de novo or secondary thyroid gland involvement of a lymphoma. Among these, the Hodgkin's subtype is quite uncommon, accounting for 0.6–5% of all thyroid malignancies. The authors report on a 76-year-old female presenting with a thyroid nodule that, upon surgical excision, was found to be a nodular lymphocyte predominant Hodgkin lymphoma of the thyroid. So far, thyroid involvement by this variant has never been reported. Upon reporting on this clinical case, the authors emphasize the difficulties usually found in establishing the diagnosis and in defining the best management strategy. A thorough review of the available literature is done. PMID:28044111

  13. Graves disease with ophthalmopathy following radiotherapy for Hodgkin's disease

    SciTech Connect

    Jacobson, D.R.; Fleming, B.J.

    1984-12-01

    The number of patients achieving long-term survival following neck irradiation for Hodgkin's disease and other malignancies is increasing. Paralleling this increase in survivors is the development of late complications of the therapy itself. Eleven patients have previously been reported who developed Graves ophthalmopathy 18 months to seven years after receiving neck radiotherapy for nonthyroidal malignancies. The seven patients who had HLA typing were all HLA-B8 negative, despite the reported association of the HLA-B8 antigen with Graves disease. A patient who is HLA-B8 positive who developed Graves ophthalmopathy and hyperthyroidism nine years after receiving mantle radiotherapy for Hodgkin's disease is reported. It is recommended that Graves disease be included among the thyroid diseases that receive consideration during follow-up of patients who have received mantle radiotherapy.

  14. Reed-Sternberg-Like Cells in Non-Hodgkin Lymphomas.

    PubMed

    Gomez-Gelvez, Juan C; Smith, Lauren B

    2015-10-01

    Large atypical cells with morphologic and immunophenotypic features resembling Reed-Sternberg cells can be seen in the background of reactive lymphadenopathies as well as non-Hodgkin lymphomas. The presence of these cells is an important diagnostic pitfall that must be recognized by pathologists who regularly interpret lymph node biopsies. A thorough evaluation of the morphologic and immunophenotypic features of these cells and the cellular milieu is crucial in achieving the correct diagnosis. In this review, examples of lymphomas presenting with Reed-Sternberg-like cells will be provided. Additionally, a detailed description of the common morphologic and immunophenotypic features of these cells, as well as strategies that can be used to distinguish them from the Reed-Sternberg cells of classical Hodgkin lymphoma, will be emphasized.

  15. [Limphomatous meningitis as recurrence site in Hodgkin's disease].

    PubMed

    Greco, Martín; Valsecchi, Matías; Niccodemi, Cecilia; Presas, José; Corrado, Claudia; Winkel, Martín

    2006-01-01

    Intracraneal manifestations of Hodgkin's Disease (HD) are extremely rare, with an estimated incidence rate of approximately 0.5%. They can be classified as: 1) treatment-related leucoencephalopathy, 2) central nervous system infections, 3) paraneoplasic syndromes and 4) intracraneal lymphomas, which could be sub-classified into intraparenchymal or intradural masses. We describe a case of a 40 year-old male with mixed cellularity type HD who developed neurological manifestations as relapsed disease. Magnetic resonance imaging suggested leptomeningeal metastases and atypical cells were found in cerebrospinal fluid. The patient died from progressive disease refractory to third line chemotherapy. There are less than 50 similar cases reported in the literature. We review the clinical features and differential diagnosis of leptomeningeal metastases in Hodgkin's disease.

  16. [Treatment of relapsed Hodgkin lymphoma after autologous stem cell transplantation].

    PubMed

    Illés, Árpád; Simon, Zsófia; Udvardy, Miklós; Magyari, Ferenc; Jóna, Ádám; Miltényi, Zsófia

    2017-08-01

    Approximately 10-30% of Hodgkin lymphoma patients relapses or experience refractory disease after first line treatment. Nowadays, autologous stem cell transplantation can successfully salvage half of these patients, median overall survival is only 2-2.5 years. Several prognostic factors determine success of autologous stem cell transplantation. Result of transplantation can be improved considering these factors and using consolidation treatment, if necessary. Patients who relapse after autologous transplantation had worse prognosis, treatment of this patient population is unmet clinical need. Several new treatment options became available in the recent years (brentuximab vedotin and immuncheckpoint inhibitors). These new treatment options offer more chance for cure in relapsed/refractory Hodgkin patients. Outcome of allogenic stem cell transplantation can be improved by using haploidentical donors. New therapeutic options will be discussed in this review. Orv Hetil. 2017; 158(34): 1338-1345.

  17. Brentuximab vedotin desensitization in a patient with refractory Hodgkin's lymphoma.

    PubMed

    Arora, Anubha; Bhatt, Vijaya Raj; Liewer, Susanne; Armitage, James O; Bociek, R Gregory

    2015-10-01

    Brentuximab vedotin has emerged as a useful treatment option for relapsed or refractory Hodgkin's lymphoma; however, uncommon cases of anaphylactic reactions may require its permanent discontinuation. We report a 29-yr-old woman with refractory Hodgkin's lymphoma, who developed an anaphylactic reaction during the second dose of brentuximab vedotin. A 12-step desensitization protocol was followed; after premedicating with antihistaminic agents, methylprednisolone and montelukast, a total dose of 156 mg of brentuximab vedotin (1.8 mg/kg) was given as three infusions with increasing rate and concentration. Such desensitization protocol can allow safe administration of brentuximab vedotin and may have a broader applicability in managing hypersensitivity reactions with other monoclonal antibodies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Development of Graves' disease following radiation therapy in Hodgkin's disease

    SciTech Connect

    Loeffler, J.S.; Tarbell, N.J.; Garber, J.R.; Mauch, P.

    1988-01-01

    Radiation-related thyroid dysfunction is a common occurrence in patients with Hodgkin's disease treated with mantle field radiation. Although chemical and clinical hypothyroidism are most commonly seen, Graves' disease has also been described. We have examined the records of 437 surgically staged patients who received mantle field irradiation between April 1969 and December 1980 to ascertain the frequency of manifestations of Graves' disease. Within this group, seven patients developed hyperthyroidism accompanied by ophthalmic findings typical of those seen in Graves' disease. The actuarial risk of developing Graves' disease at 10 years following mantle irradiation for Hodgkin's disease was 3.3% in female patients and 1% in male patients in this study. The observed/expected ratios were 5.9 and 5.1 for female and male patients, respectively. This observed risk significantly exceeded that seen in the general population.

  19. An efficient method for solving fractional Hodgkin-Huxley model

    NASA Astrophysics Data System (ADS)

    Nagy, A. M.; Sweilam, N. H.

    2014-06-01

    In this paper, we present an accurate numerical method for solving fractional Hodgkin-Huxley model. A non-standard finite difference method (NSFDM) is implemented to study the dynamic behaviors of the proposed model. The Grünwald-Letinkov definition is used to approximate the fractional derivatives. Numerical results are presented graphically reveal that NSFDM is easy to implement, effective and convenient for solving the proposed model.

  20. Arthritis as a presenting feature of non-Hodgkin's lymphoma

    PubMed Central

    Falcini, F.; Bardare, M.; Cimaz, R.; Lippi, A.; Corona, F.

    1998-01-01

    Leukaemia can present with joint swelling in the absence of abnormal haematological findings. Arthritis as a presenting sign of lymphoma, however, is extremely rare. Three children with non-Hodgkin's lymphoma who had joint swelling at the onset of their disease are reported. Two cases showed histological features of anaplastic large cell lymphoma (Ki-l/CD30 positive), and one of angioimmunoblastic T cell lymphoma. In all patients the unusual presentation delayed correct diagnosis.

 PMID:9623403

  1. EXPONENTIAL TIME DIFFERENCING FOR HODGKIN-HUXLEY-LIKE ODES.

    PubMed

    Börgers, Christoph; Nectow, Alexander R

    2013-01-01

    Several authors have proposed the use of exponential time differencing (ETD) for Hodgkin-Huxley-like partial and ordinary differential equations (PDEs and ODEs). For Hodgkin-Huxley-like PDEs, ETD is attractive because it can deal effectively with the stiffness issues that diffusion gives rise to. However, large neuronal networks are often simulated assuming "space-clamped" neurons, i.e., using the Hodgkin-Huxley ODEs, in which there are no diffusion terms. Our goal is to clarify whether ETD is a good idea even in that case. We present a numerical comparison of first- and second-order ETD with standard explicit time-stepping schemes (Euler's method, the midpoint method, and the classical fourth-order Runge-Kutta method). We find that in the standard schemes, the stable computation of the very rapid rising phase of the action potential often forces time steps of a small fraction of a millisecond. This can result in an expensive calculation yielding greater overall accuracy than needed. Although it is tempting at first to try to address this issue with adaptive or fully implicit time-stepping, we argue that neither is effective here. The main advantage of ETD for Hodgkin-Huxley-like systems of ODEs is that it allows underresolution of the rising phase of the action potential without causing instability, using time steps on the order of one millisecond. When high quantitative accuracy is not necessary and perhaps, because of modeling inaccuracies, not even useful, ETD allows much faster simulations than standard explicit time-stepping schemes. The second-order ETD scheme is found to be substantially more accurate than the first-order one even for large values of Δt.

  2. Tracking and control of neuronal Hodgkin-Huxley dynamics.

    PubMed

    Ullah, Ghanim; Schiff, Steven J

    2009-04-01

    Nonlinear ensemble state estimation offers a paradigm-shifting improvement in our ability to observe, predict, and control the state of spiking neuronal systems. We use an ensemble Kalman filter to predict hidden states and future trajectories in the Hodgkin-Huxley equations, reconstruct ion dynamics, control neuronal activity including a strategy for dynamic conductance clamping, and show the feasibility of controlling pathological cellular activity such as seizures.

  3. B-cell Non-Hodgkin Lymphomas with Plasmacytic Differentiation.

    PubMed

    Harmon, Charles M; Smith, Lauren B

    2016-03-01

    B-cell non-Hodgkin lymphomas with plasmacytic differentiation are a diverse group of entities with extremely variable morphologic features. Diagnostic challenges can arise in differentiating lymphoplasmacytic lymphoma from marginal zone lymphoma and other low-grade B-cell lymphomas. In addition, plasmablastic lymphomas can be difficult to distinguish from diffuse large B-cell lymphoma or other high-grade lymphomas. Judicious use of immunohistochemical studies and molecular testing can assist in appropriate classification.

  4. Spleen in Hodgkin disease: diagnostic value of CT

    SciTech Connect

    Strijk, S.P.; Wagener, D.J.T.; Bogman, M.J.J.T.; de Pauw, B.E.; Wobbes, T.

    1985-03-01

    Findings of CT of the spleen were compared with those of histologic examination in 35 patients who had Hodgkin disease. CT provides a simple way to calculate splenic size. This index is also of value in the assessment of the histologic state of the spleen. An accuracy rate of 91%, specificity of 94%, and a sensitivity of 89% in diagnosing splenic localization of lymphoma was found in this study.

  5. Non-Hodgkin's lymphoma: case control epidemiological study in Yorkshire.

    PubMed

    Cartwright, R A; McKinney, P A; O'Brien, C; Richards, I D; Roberts, B; Lauder, I; Darwin, C M; Bernard, S M; Bird, C C

    1988-01-01

    This paper reports the results of a case control study of non-Hodgkin's lymphoma in the Yorkshire Health Region. In all, 437 cases and 724 controls were interviewed. Risk factors associated with past skin conditions, family history of cancer and infectious mononucleosis, aspects of social life and contact with wood dust and epoxy glues all emerge. A comparison of high and low grade morphological forms of disease reveal contrasting risks and suggest separate aetiologies for these conditions.

  6. The role of FDG-PET in Hodgkin lymphoma

    PubMed Central

    Hałka, Janusz; Dziuk, Mirosław

    2017-01-01

    18-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is currently the most valuable imaging technique in Hodgkin lymphoma. Since its first use in lymphomas in the 1990s, it has become the gold standard in the staging and end-of-treatment remission assessment in patients with Hodgkin lymphoma. The possibility of using early (interim) PET during first-line therapy to evaluate chemosensitivity and thus personalize treatment at this stage holds great promise, and much attention is now being directed toward this goal. With high probability, it is believed that in the near future, the result of interim PET-CT would serve as a compass to optimize treatment. Also the role of PET in pre-transplant assessment is currently evolving. Much controversy surrounds the possibility of detecting relapse after completed treatment with the use of PET in surveillance in the absence of symptoms suggestive of recurrence and the results of published studies are rather discouraging because of low positive predictive value. This review presents current knowledge about the role of 18-FDG-PET/CT imaging at each point of management of patients with Hodgkin lymphoma. PMID:28947879

  7. Role of the gallium scan in Hodgkin's disease

    SciTech Connect

    Hagemeister, F B; Fesus, S M; Lamki, L M; Haynie, T P

    1990-03-01

    The reports of 240 gallium scans on 165 patients with Hodgkin's disease were reviewed to compare results with higher doses with those in earlier studies that employed lower doses. Tracer concentrations in specific sites were correlated with radiologic and pathologic reports and with the clinical courses of the patients studied. There were no significant differences in overall results between newer and older gallium scanning techniques. For untreated patients, the overall sensitivity was only 64%, but the overall specificity was 98%. For untreated patients and for patients with relapsing disease, the presence of gallium concentration in a specific site was highly predictive of active Hodgkin's disease at that site. However, for routine follow-up of treated patients, 95% of unsuspected relapses were missed by the scan, indicating the limited usefulness of negative scan results in this setting. For patients with residual abnormalities after therapy, demonstrated by other radiographic means, increased uptake of gallium in abdominal or peripheral lymph nodes also indicated active disease, although lack of uptake was reliable only in the mediastinum. Based on these results, it appears that the higher doses used in this study have not substantially improved the role of gallium scanning in this disease. Although it is potentially useful in providing confirmatory data at diagnosis or in patients with new or residual objective abnormalities after treatment, routine use of gallium scanning in Hodgkin's disease is not recommended.

  8. Primary non-Hodgkin's lymphoma of the mediastinum

    SciTech Connect

    Levitt, L.J.; Aisenberg, A.C.; Harris, N.L.; Linggood, R.M.; Poppema, S.

    1982-12-01

    Non-Hodgkin's lymphoma localized to the mediastinum and adjacent structures occurred in 12 of 215 (6%) non-Hodgkin's lymphoma patients seen at the Massachusetts General Hospital between 1975 and 1979. Lymphangiography, radionuclide scanning and whole body computerized tomography were used to exclude patients with extrathoracic disease at presentation. Eleven of the 12 patients presented with extensive contiguous extranodal disease (Stage II/sub E/) with involvement of either the pericardium, sternum, chest wall, pulmonary parenchyma or, in four cases, with superior venacaval obstruction. Diffuse large cell lymphoma (eight cases) and diffuse poorly differentiated lymphocytic lymphoma (four cases) were the prevalent histologic subtypes; no instances of lymphoblastic lymphoma without extra-thoracic spread were encountered. None of four lymphomas studied could be characterized as either B- or T-cell tumors utilizing conventional surface marker techniques. Ten of the 12 patients achieved complete remissions, either after treatment with combination chemotherapy alone (three patients) or after both chemotherapy and mediastinal irradiation (seven patients). Two of these ten have subsequently relapsed, but median survival has not been reached after a mean period of observation of 28 months. Primary nonlymphoblastic non-Hodgkin's lymphoma of the mediastinum is more common than previously realized, displays aggressive contiguous spread within the chest and responds well to combination chemotherapy with or without adjuvant mediastinal irradiation.

  9. Action Potential Initiation in the Hodgkin-Huxley Model

    PubMed Central

    Colwell, Lucy J.; Brenner, Michael P.

    2009-01-01

    A recent paper of B. Naundorf et al. described an intriguing negative correlation between variability of the onset potential at which an action potential occurs (the onset span) and the rapidity of action potential initiation (the onset rapidity). This correlation was demonstrated in numerical simulations of the Hodgkin-Huxley model. Due to this antagonism, it is argued that Hodgkin-Huxley-type models are unable to explain action potential initiation observed in cortical neurons in vivo or in vitro. Here we apply a method from theoretical physics to derive an analytical characterization of this problem. We analytically compute the probability distribution of onset potentials and analytically derive the inverse relationship between onset span and onset rapidity. We find that the relationship between onset span and onset rapidity depends on the level of synaptic background activity. Hence we are able to elucidate the regions of parameter space for which the Hodgkin-Huxley model is able to accurately describe the behavior of this system. PMID:19148265

  10. [No Hodgkin Linfoma diagnosis with intra-atrial infiltration].

    PubMed

    Alcocer Gamba, Marco Antonio; León González, Salvador; Castro Montes, Eliodoro; Loarca Piña, Luis Martín; Lugo Gavidia, Leslie Marisol; García Hernández, Enrique; González Galindo, Ulises; Paredes Serrano, Miguel Isaías

    2012-09-01

    Cardiac tumors are rare entities in clinical practice, with an incidence of 0.05%. Approximately 75% are benign and 25% malignant. Among these, Lymphomas are uncommon, representing about 0.25%. The non-Hodgkin lymphomas can occur in extranodal tissues in 20% of the cases and 80% of these non-Hodgkin lymphomas are composed of diffuse B cells. The extranodal presentation is most frequent in young adults, with a high degree of malignancy and rapid growth. It can present with primary infiltration of various organs; cardiac involvement occurs in 20 to 28% of cases, usually located in the right chambers and with nonspecific symptoms, depending on the location and extent of the tumor. The diagnostic test in these cases is undoubtedly the biopsy of the lymph node or the affected tissue. We present the case of non-Hodgkin disease of diffuse large cells, with right intra-atrial involvement in a 23-year-old-female patient, who presented with progressive dyspnea. A transesophageal echocardiography was performed and an intra-atrial tumor mass was detected. A biopsy was performed, by femoral venous catheterization, allowing the establishment of the histopathological diagnosis and treatment. At a one year follow up, the patient shows complete remission.

  11. [Novel treatment options in relapsed and refracter Hodgkin lymphomas].

    PubMed

    Illés, Árpád; Jóna, Ádám; Simon, Zsófia; Udvardy, Miklós; Miltényi, Zsófia

    2015-11-08

    Hodgkin lymphoma is a curable lymphoma with an 80-90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Retrospective analysis of data was performed. A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure.

  12. Siltuximab and hematologic malignancies. A focus in non Hodgkin lymphoma.

    PubMed

    Ferrario, Andrea; Merli, Michele; Basilico, Claudia; Maffioli, Margherita; Passamonti, Francesco

    2017-03-01

    The role of interleukin-6 (IL-6) in tumorigenesis and in particular in haematological malignancies is crucial. On the basis of the favourable results obtained in the subset of multicentric Castleman disease (MCD), Siltuximab, a chimeric, human-murine, immunoglobulin (Ig) Gk monoclonal antibody directed against human IL-6 has been evaluated in haematological malignancies such as multiple myeloma, myelodisplastic syndromes and non Hodgkin lymphomas. Areas covered: This review discusses available data related to the role of IL-6 as a therapeutic target, the characteristics of Siltuximab in term pharmacokinetics and pharmacodynamics properties and a detailed analysis of the studies involving haematological malignancies with a peculiar focus on non Hodgkin lymphoma. Expert opinion: The results obtained with Siltuximab in haematological malignancies and in particular with non Hodgkin lymphoma are inferior to those obtained in MCD. The complex interaction between malignant clones, inflammatory background and host response could justify this difference. New interesting areas of study are the role of Siltuximab in early phase of multiple myeloma (smoldering multiple myeloma) and if there may be a possible future application in the treatment of Waldenström macroglobulinemia.

  13. Action potential initiation in the hodgkin-huxley model.

    PubMed

    Colwell, Lucy J; Brenner, Michael P

    2009-01-01

    A recent paper of B. Naundorf et al. described an intriguing negative correlation between variability of the onset potential at which an action potential occurs (the onset span) and the rapidity of action potential initiation (the onset rapidity). This correlation was demonstrated in numerical simulations of the Hodgkin-Huxley model. Due to this antagonism, it is argued that Hodgkin-Huxley-type models are unable to explain action potential initiation observed in cortical neurons in vivo or in vitro. Here we apply a method from theoretical physics to derive an analytical characterization of this problem. We analytically compute the probability distribution of onset potentials and analytically derive the inverse relationship between onset span and onset rapidity. We find that the relationship between onset span and onset rapidity depends on the level of synaptic background activity. Hence we are able to elucidate the regions of parameter space for which the Hodgkin-Huxley model is able to accurately describe the behavior of this system.

  14. [Predictive value of Hodgkin's lymphoma tumor burden in present].

    PubMed

    Kulyova, S A; Karitsky, A P

    2014-01-01

    Today approximately 70% of patients with Hodgkin lymphoma can be cured with the combined-modality therapy. Tumor burden, the importance of which was demonstrated 15 years ago for the first time, is a powerful prognostic factor. Data of literature of representations on predictive value of Hodgkin's lymphoma tumor burden are shown in the article. The difficult immunological relations between tumor cells and reactive ones lead to development of the main symptoms. Nevertheless, the collective sign of tumor burden shows the greatest influence on survival and on probability of resistance, which relative risk can be predicted on this variable and treatment program. Patients with bulky disease need escalated therapy with high-dose chemotherapy. Integration into predictive models of the variable will change an expected contribution of clinical and laboratory parameters in the regression analyses constructed on patients with Hodgkin's lymphoma. Today the role of diagnostic functional methods, in particular a positron emission tomography, for metabolic active measurement is conducted which allows excluding a reactive component.

  15. Functional hyposplenia after splenic irradiation for Hodgkins's disease

    SciTech Connect

    Coleman, C.N.; McDougall, I.R.; Dailey, M.O.; Ager, P.; Bush, S.; Kaplan, H.S.

    1982-01-01

    We previously reported a patient who developed fulminant pneumococcal sepsis 12 years after successful treatment for Hodgkin's disease, which included splenic irradiation. We have since evaluated splenic size and function in 25 patients who had received splenic irradiation 5 to 16 years previously either for Hodgkin's disease (n = 19) or non-Hodgkin's lymphoma (n = 6). Mean maximum splenic diameter as measured on a /sup 99//sup m/Tc-sulfur colloid liver-spleen scan was 6.2 cm in the irradiated group and 9.7 cm in a control group (p < 0.001). The mean percentage of erythrocytes containing pits when observed with interference phase microscopy was 13.0% in the irradiated group, which was significantly different (p < 0.001) from the levels found in each of the control groups: normal subjects, 0.9%; unstaged and untreated lymphoma patients, 0.6%; and patients after splenectomy, 33.7%. Patients who have had splenic irradiation should be considered at risk of developing overwhelming pneumococcal sepsis.

  16. Functional hyposplenia after splenic irradiation for Hodgkin's disease

    SciTech Connect

    Coleman, C.N.; McDougall, I.R.; Dailey, M.O.; Ager, P.; Bush, S.; Kaplan, H.S.

    1982-01-01

    We previously reported a patients who developed fulminant pneumococcal sepsis 12 years after successful treatment for Hodgkin's disease, which included splenic irradiation. We have since evaluated splenic size and function in 25 patients who had received splenic irradiation 5 to 16 years previously either for Hodgkin's disease (n . 19) or non-Hodgkin's lymphoma (n . 6). Mean maximum splenic diameter as measured on a 99mTc-sulfur colloid liver-spleen scan was 6.2 cm in the irradiated group and 9.7 cm in a control group (p less than 0.001). The mean percentage of erythrocytes containing pits when observed with interference phase microscopy was 13.0% in the irradiated group, which was significantly different (p less than 0.001) from the levels found in each of the control groups: normal subjects, 0.9%; unstaged and untreated lymphoma patients, 0.6%; and patients after splenectomy, 33.7%. Patients who have had splenic irradiation should be considered at risk of developing overwhelming pneumococcal sepsis.

  17. Fluorine-18 fluorodeoxyglucose PET/CT patterns of extranodal involvement in patients with Non-Hodgkin lymphoma and Hodgkin's disease.

    PubMed

    Even-Sapir, Einat; Lievshitz, Genady; Perry, Chava; Herishanu, Yair; Lerman, Hedva; Metser, Ur

    2007-07-01

    Lymphoma may originate in extranodal sites. Extranodal lymphoma may also be secondary to and accompany nodal disease. Fluorine-18 fluorodeoxyglucose (18F-FDG) imaging has an essential role in the staging of lymphoma, in monitoring the response to therapy, and in detection of recurrence. The introduction of 18F-FDG PET/CT hybrid imaging allows for accurate localization of disease and may be specifically beneficial for the detection of unexpected extranodal sites of disease or exclusion of disease in the presence of nonspecific extranodal CT findings. Accurate staging and localization often dictate the appropriate treatment strategy in patients with lymphoma. Therefore, at any stage in the course of the disease, the potential presence of extranodal disease should be considered when interpreting 18F-FDG PET/CT studies in patients with non-Hodgkin lymphoma and Hodgkin's disease.

  18. Four Lymphomas in 1 Patient: A Unique Case of Triple Composite Non-Hodgkin Lymphoma Followed by Classical Hodgkin Lymphoma.

    PubMed

    Tennese, Alysa; Skrabek, Pamela J; Nasr, Michel R; Sekiguchi, Debora R; Morales, Carmen; Brown, Theresa C; Weisenburger, Dennis D; Perry, Anamarija M

    2017-05-01

    Composite lymphomas consist of 2 or more distinct lymphomas occurring in a single anatomical site or simultaneously in different sites and can be composed of any combination of B-cell non-Hodgkin lymphoma (NHL), T-cell NHL, or Hodgkin lymphoma (HL). Cases of composite lymphomas with more than 2 lymphomas are extremely rare, with only 4 reports in the literature. We report the case of a 49-year-old man with a triple composite lymphoma in a single lymph node, consisting of small lymphocytic lymphoma, follicular lymphoma, and mantle cell lymphoma in situ. The patient received multiple courses of chemotherapy and an autologous stem cell transplant, which resulted in complete remission. Then, 6 years after the stem cell transplant, he developed classical HL. This unique case is, to our knowledge, the first report of a patient with triple composite lymphoma consisting of 3 small mature B-cell NHLs, who subsequently developed a fourth lymphoma.

  19. Echocardiographic evaluation of acute cardiotoxicity in the treatment of Hodgkin disease according to the German Hodgkin's Lymphoma Study Group.

    PubMed

    Krupicka, J; Marková, J; Pohlreich, D; Kozák, T; Línková, H; Diehl, V

    2002-12-01

    Echocardiography is a sensitive method for detecting wall motion abnormalities, as well as for monitoring cardiotoxicity during treatment with anthracyclines. Using echocardiography, this study investigated possible acute cardiotoxicty associated with primary treatment of Hodgkin's disease according to German Hodgkin's Lymphoma Study Group (GHSG) clinical trial protocols for adults. A group of 88 patients (48 men) was registered in the prospective, randomized clinical trial involving the treatment of Hodgkin's disease using third and fourth generation GHSG protocols. These patients were monitored by echocardiography. The average age was 34 years (range, 18-65; median, 32). The average anthracycline dose was 174 mg/m2 (median 200 mg/m2), and the average mediastinum irradiation dose was 21 Gy (median 30 Gy). Left ventricle end-systolic diameter (ESD) and left ventricle end-diastolic diameter (EDD), as well as fractional shortening (FS) and ejection fraction (EF) (M-mode calculation) were evaluated, as was the presence of pericardial effusion and wall motion abnormalities. The examinations were conducted before and at the end of therapy (up to 2 months). Results show that all evaluated parameters changed from one follow-up examination to the other, but these changes did not reach statistical significance. ESD increased from 30 +/- 4 to 31 +/- 4 mm. EDD increased from 49 +/- 4 to 49 +/- 5 mm. Ejection fraction changed from 69 +/- 7 to 66 +/- 7% and fractional shortening was unchanged (from 38 +/- 7 to 38 +/- 7%). In seven patients (8%), we observed new wall motion abnormalities characterized by hypokinesis without decrease of left ventricular function. Significant changes in the amount of pericardial effusion were not observed. In four patients (5%), there was progression of Hodgkin's disease. In conclusion, treatment according to third and fourth generation clinical trial protocols of the GHSG leads only to minimal wall motion changes, without concomitant reduction of

  20. Chronic Lymphocytic Leukemia With Hodgkin and Reed-Sternberg (HRS) Cells: A Potential Diagnostic Pitfall in Lymph Node Biopsies.

    PubMed

    Agrawal, Parimal; Bal, Amanjit; Das, Ashim; Sachdeva, ManUpdesh; Prakash, Gaurav

    2017-01-01

    Chronic lymphocytic leukemia (CLL) is known to undergo Richter transformation in a proportion of cases. Transformation into Hodgkin lymphoma has been described in a minority of the cases. However, CLL rarely also shows Hodgkin and Reed-Sternberg cells with a classic morphology and the immunophenotype of Hodgkin lymphoma, even when not in transformation. The presence of these Hodgkin and Reed-Sternberg cells in CLL can cause a diagnostic dilemma.

  1. Matrix metalloproteinase-9 expression by Hodgkin-Reed-Sternberg cells is associated with reduced overall survival in young adult patients with classical Hodgkin lymphoma.

    PubMed

    Campos, Antonio Hugo; Vassallo, Jose; Soares, Fernando Augusto

    2013-01-01

    Previous studies have investigated the prognostic relevance of MMP9 in classical Hodgkin lymphoma (cHL), with negative results. However, we have found that MMP9 immunoistochemical expression by Hodgkin-Reed-Sternberg cells is associated with reduced overall survival in a subset of young adult Brazilian patients diagnosed with cHL. Additionally, we have observed that MMP9 expression by neoplastic cells in cHL is associated with EBV positivity. These results may support a rational basis for additional studies on the role of this metalloproteinase as a target for therapy in classical Hodgkin lymphoma.

  2. Checkpoint inhibitors and radiation treatment in Hodgkin's lymphoma : New study concepts of the German Hodgkin Study Group.

    PubMed

    Baues, C; Semrau, R; Gaipl, U S; Bröckelmann, P J; Rosenbrock, J; Engert, A; Marnitz, S

    2017-02-01

    Patients with classical Hodgkin's lymphoma (cHL) have a good prognosis even in advanced stages. However, combined chemo- and radiotherapy, as the standard of care, is also associated with treatment-related toxicities such as organ damage, secondary neoplasias, infertility, or fatigue and long-term fatigue. Many patients suffer from this burden although their cHL was cured. Therefore, the efficacy of immune checkpoint inhibitors like anti-PD1/PD-L1 antibodies in the treatment of solid cancers and also in HL offers new options. A remarkable and durable response rate with a favorable toxicity profile was observed in heavily pretreated cHL patients. Planning to perform prospective randomized clinical trials in the content of radio-immune treatment in patients with Hodgkin's lymphoma (HL), we transferred the results of preliminary clinical studies and basic research in clinical relevant study concepts. Based on these promising early phase trial data, the German Hodgkin Study Group (GHSG) will investigate innovative treatment regimens in upcoming phase II trials. The therapeutic efficacy and potential synergies of anti-PD1 antibodies in combination with chemo- or radiotherapy will be investigated in various settings of HL.

  3. Vorinostat and Lenalidomide in Treating Patients With Relapsed or Refractory Hodgkin Lymphoma or Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2010-12-08

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Peripheral T-Cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Testicular Lymphoma; Waldenstrom Macroglobulinemia

  4. Sexual quality of life in Hodgkin Lymphoma: a longitudinal analysis by the German Hodgkin Study Group

    PubMed Central

    Behringer, K; Müller, H; Görgen, H; Flechtner, H-H; Brillant, C; Halbsguth, T V; Thielen, I; Eichenauer, D A; Schober, T; Nisters-Backes, H; Fuchs, M; Engert, A; Borchmann, P

    2013-01-01

    Background: Health-related quality of life (HRQoL) comprises different domains of physical, mental, and social well-being. In this analysis, we focus on sexual quality of life in Hodgkin Lymphoma (HL) patients. Methods: Four-thousand one-hundred and sixty patients enroled in the HD10–HD12 trials underwent HRQoL assessment. Instruments included the Quality of Life Questionnaire for survivors (QLQ-S), combining the European Organisation for Research and Treatment of Cancer QLQ-C30, Multidimensional fatigue (FA) inventory (MFI-20) and an additional sexual functioning (SX) scale. We describe SX up to 27 months after therapy and analyse relationship to stage, age, gender, FA, social functioning, and therapy. Statistical methods range from descriptive statistics to a classification of SX courses, and a longitudinal structural equations model with full information maximum likelihood estimation of missing data. In the analysis, a score below 50 was used to describe severe sexual dysfunction. Results: Three-thousand two-hundred and eight patients provided data on SX. Patients in advanced stages reported lower SX than patients in early stages both, before and after the treatment. During follow-up, an improvement of SX compared with baseline was detected, except for those ⩾50 years. Patients in early stages reached normal SX, whereas advanced-stage patients remained below the reference value for healthy controls. Sexual functioning during follow-up was significantly and strongly related to previous SX, other HRQoL measures, age, and stage, and to lesser degree with gender and chemotherapy. Conclusion: Overall, HL patients have a decreased sexual quality of life at baseline, which improves after therapy and normalises in early-stage patients. Importantly, long-term SX is more closely related to patient characteristics and SX at baseline than to the intensity of treatment. PMID:23321510

  5. 60 FR 53276 - Claims Based on Exposure to Ionizing Radiation (Lymphomas Other Than Hodgkin's Disease and Cancer...

    Federal Register 2010, 2011, 2012, 2013, 2014

    1995-10-13

    ... Hodgkin's Disease and Cancer of the Rectum) AGENCY: Department of Veterans Affairs. ACTION: Final rule... implement a decision by the Secretary of Veterans Affairs that lymphomas other than Hodgkin's disease and... add lymphomas other than Hodgkin's disease and rectal cancer to the list of diseases VA will...

  6. Silicon Phthalocyanine 4 and Photodynamic Therapy in Stage IA-IIA Cutaneous T-Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2015-12-03

    Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IA Mycosis Fungoides/Sezary Syndrome; Stage IB Mycosis Fungoides/Sezary Syndrome; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IIA Mycosis Fungoides/Sezary Syndrome

  7. Impact of highly effective antiretroviral therapy on the risk for Hodgkin lymphoma among people with human immunodeficiency virus infection

    PubMed Central

    Goedert, James J.; Bower, Mark

    2013-01-01

    Purpose of review To estimate the impact of highly effective antiretroviral therapy (ART) on the incidence and prognosis of Hodgkin lymphoma among people with human immunodeficiency virus infection or AIDS (PWHA). Recent findings Age-adjusted incidence of Hodgkin lymphoma in PWHA is unchanged and is still five-fold to fifteen-fold higher than in the general population. Aging of the PWHA population with ART may account for increasing numbers of Hodgkin lymphoma cases. CD4 cell count has a complex relationship to Hodgkin lymphoma risk in PWHA. Depending on the time of measurement, Hodgkin lymphoma risk is highest with 50–249 CD4cells/µl, and falling CD4 count on ART may be a harbinger of Hodgkin lymphoma onset. HIV load appears irrelevant to Hodgkin lymphoma. For obscure reasons, Hodgkin lymphoma risk may be elevated soon after starting ART, but the risk is probably modestly reduced with 6 or more months on ART. For PWHA who develop Hodgkin lymphoma, ART and ABVD chemotherapy can be administered safely, with one recent study demonstrating equivalent outcomes for HIV-positive and HIV-negative Hodgkin lymphoma patients. Summary Vigilance for Hodgkin lymphoma is needed for immune-deficient PWHA, including those on ART. ART with opportunistic infection prophylaxis enables the delivery of effective chemotherapy for Hodgkin lymphoma, leading to a good prognosis. PMID:22729154

  8. Alisertib in Treating Patients With Relapsed or Refractory Peripheral T-Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2016-02-09

    Adult Nasal Type Extranodal NK/T-Cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-Cell Lymphoma; Hepatosplenic T-Cell Lymphoma; Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Recurrent Adult Non-Hodgkin Lymphoma; Recurrent Adult T-Cell Leukemia/Lymphoma

  9. B cell non-Hodgkin's lymphoma in a girl with the DiGeorge anomaly

    PubMed Central

    Ramos, J.; Lopez-Laso, E.; Ruiz-Contreras, J.; Giancaspro, E.; Madero, S.

    1999-01-01

    The DiGeorge anomaly (DGA) is occasionally associated with cellular immunodeficiency. We report a female infant diagnosed with complete DGA, who developed fatal, high grade, non-Hodgkin's lymphoma that expressed Epstein-Barr virus (EBV). Non-Hodgkin's lymphoma should be considered in children with DGA.

 PMID:10519724

  10. Potential role of hypoxia in early stages of Hodgkin lymphoma pathogenesis.

    PubMed

    Wein, Frederik; Otto, Teresa; Lambertz, Pascal; Fandrey, Joachim; Hansmann, Martin-Leo; Küppers, Ralf

    2015-10-01

    A unique feature of the germinal center B cell-derived Hodgkin and Reed/Sternberg cells of classical Hodgkin lymphoma is their lost B cell phenotype and the aberrant expression of factors of other hematopoietic cell types, including ID2 and NOTCH1. As cellular dedifferentiation and upregulation of ID2 and NOTCH1 are typical consequences of a hypoxic response, we wondered whether hypoxia may impose an HRS cell-like phenotype in B cells. Culturing normal B cells or cell lines of germinal center-type diffuse large B-cell lymphoma under hypoxic conditions caused partial downregulation of several B cell markers, ID2 upregulation, and increased NOTCH1 activity. The hypoxic cells acquired further features of Hodgkin and Reed/Sternberg cells, including increased JUN expression, and enhanced NFκB activity. The Hodgkin and Reed/Sternberg cell-expressed epigenetic regulators KDM4C and PCGF2, as well as the phosphatase DUSP1 were partially induced in hypoxic B cells. Inhibition of DUSP1 was toxic for classical Hodgkin lymphoma cell lines. Thus, hypoxia induces key Hodgkin and Reed/Sternberg cell characteristics in mature B cells. We speculate that hypoxic conditions in the germinal center may impose phenotypic changes in germinal center B cells, promoting their survival and initiating their differentiation towards a Hodgkin and Reed/Sternberg cell-like phenotype. These may then be stabilized by transforming events in the Hodgkin and Reed/Sternberg precursor cells. Copyright© Ferrata Storti Foundation.

  11. [Hodgkin's disease revealed by a nephrotic syndrome: a case report with literature review].

    PubMed

    Nafil, Hatim; Tazi, Illias; Mahmal, Lahoucine

    2011-01-01

    The association between paraneoplasic nephrotic syndrome and Hodgkin's disease is rare. We report a case of Hodgkin's lymphoma in a young female patient with nephrotic syndrome. A 40-year-old woman presented with the clinical symptoms of nephrotic syndrome, kidney biopsy revealed minimal change glomerulonephritis. A treatment with prednisone was started but the response was partial. Twenty-four months after the diagnostic of nephrotic syndrome was made, she presented prolonged fever and weight loss, the physical examination showed cervical lymphadenopathy, which lymph node biopsy revealed Hodgkin lymphoma of the nodular sclerosing type. The patient was treated for Hodgkin disease stage IVB with ABVD regimen, and was in complete remission of both Hodgkin's disease and nephrotic syndrome.

  12. The immune microenvironment in Hodgkin lymphoma: T cells, B cells, and immune checkpoints.

    PubMed

    Vardhana, Santosha; Younes, Anas

    2016-07-01

    Classical Hodgkin lymphoma is curable in the majority of cases with chemotherapy and/or radiation. However, 15-20% of patients ultimately relapse and succumb to their disease. Pathologically, classical Hodgkin lymphoma is characterized by rare tumor-initiating Reed-Sternberg cells surrounded by a dense immune microenvironment. However, the role of the immune microenvironment, particularly T and B cells, in either promoting or restricting Classical Hodgkin lymphoma growth remains undefined. Recent dramatic clinical responses seen using monoclonal antibodies against PD-1, a cell surface receptor whose primary function is to restrict T cell activation, have reignited questions regarding the function of the adaptive immune system in classical Hodgkin lymphoma. This review summarizes what is known regarding T cells, B cells, and immune checkpoints in classical Hodgkin lymphoma. Copyright© Ferrata Storti Foundation.

  13. The immune microenvironment in Hodgkin lymphoma: T cells, B cells, and immune checkpoints

    PubMed Central

    Vardhana, Santosha; Younes, Anas

    2016-01-01

    Classical Hodgkin lymphoma is curable in the majority of cases with chemotherapy and/or radiation. However, 15–20% of patients ultimately relapse and succumb to their disease. Pathologically, classical Hodgkin lymphoma is characterized by rare tumor-initiating Reed-Sternberg cells surrounded by a dense immune microenvironment. However, the role of the immune microenvironment, particularly T and B cells, in either promoting or restricting Classical Hodgkin lymphoma growth remains undefined. Recent dramatic clinical responses seen using monoclonal antibodies against PD-1, a cell surface receptor whose primary function is to restrict T cell activation, have reignited questions regarding the function of the adaptive immune system in classical Hodgkin lymphoma. This review summarizes what is known regarding T cells, B cells, and immune checkpoints in classical Hodgkin lymphoma. PMID:27365459

  14. Mechanisms of Idelalisib-Associated Diarrhea in Patients With Relapsed Chronic Lymphocytic Leukemia, Indolent Non-hodgkin Lymphoma, or Small Lymphocytic Lymphoma

    ClinicalTrials.gov

    2016-10-06

    Absence of Signs or Symptoms; B-Cell Non-Hodgkin Lymphoma; Digestive System Signs and Symptoms; Indolent Adult Non-Hodgkin Lymphoma; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Chronic Lymphocytic Leukemia; Recurrent Indolent Adult Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma

  15. Clinicopathological features of classical Hodgkin lymphoma in patients ≥ 40 years old, with special reference to composite cases.

    PubMed

    Maeshima, Akiko Miyagi; Taniguchi, Hirokazu; Nomoto, Junko; Makita, Shinichi; Kitahara, Hideaki; Fukuhara, Suguru; Munakata, Wataru; Suzuki, Tatsuya; Maruyama, Dai; Kobayashi, Yukio; Tobinai, Kensei

    2015-10-01

    Classical Hodgkin lymphoma shows a peak incidence at 15-35 years, and a second peak in elderly patients; however, pathological characteristics of elderly patients with classical Hodgkin lymphoma have not been analyzed enough. In a total of 154 patients with classical Hodgkin lymphoma, we analyzed the clinicopathological characteristics of classical Hodgkin lymphoma patients aged ≥ 40 years old, with special reference to the incidence, histopathology and outcome of patients with composite classical Hodgkin lymphoma. Of 154 patients with classical Hodgkin lymphoma, 50 (32%) were ≥ 40 years old. The 5-year progression-free and overall survival rates were 59 and 86%, respectively. Thirty-eight patients (76%) had non-composite classical Hodgkin lymphoma, 10 patients (20%) had composite (6 simultaneous and 4 consecutive) classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma and 2 patients (4%) had methotrexate-associated classical Hodgkin lymphoma. Of 10 patients with composite classical Hodgkin lymphoma, composite lymphomas were detected throughout the staging procedure of the upper gastrointestinal tract or bone marrow in 4 patients. Fluorescence in situ hybridization revealed that the composite lymphomas of 4, 1 and 5 patients were related, unrelated and of unknown correlation status, respectively. The treatments after the diagnosis of a classical Hodgkin lymphoma component varied, and three patients died of lymphoma. We found that the incidence of composite classical Hodgkin lymphoma in patients ≥ 40 years old was 20%. Correct diagnosis and optimal treatment for patients with composite classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma is highly important in this patient population. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Detection of genomic imbalances in microdissected Hodgkin and Reed-Sternberg cells of classical Hodgkin's lymphoma by array-based comparative genomic hybridization.

    PubMed

    Hartmann, Sylvia; Martin-Subero, José I; Gesk, Stefan; Hüsken, Julia; Giefing, Maciej; Nagel, Inga; Riemke, Jennifer; Chott, Andreas; Klapper, Wolfram; Parrens, Marie; Merlio, Jean-Philippe; Küppers, Ralf; Bräuninger, Andreas; Siebert, Reiner; Hansmann, Martin-Leo

    2008-09-01

    Cytogenetic analysis of classical Hodgkin's lymphoma is limited by the low content of the neoplastic Hodgkin-Reed-Sternberg cells in the affected tissues. However, available cytogenetic data point to an extreme karyotype complexity. To obtain insights into chromosomal imbalances in classical Hodgkin's lymphoma, we applied array-based comparative genomic hybridization (array comparative genomic hybridization) using DNA from microdissected Hodgkin-Reed-Sternberg cells. To avoid biases introduced by DNA amplification for array comparative genomic hybridization, cHL cases rich in Hodgkin-Reed-Sternberg cells were selected. DNA obtained from approximately 100,000 microdissected Hodgkin-Reed-Sternberg cells of each of ten classical Hodgkin's lymphoma cases was hybridized onto commercial 105 K oligonucleotide comparative genomic hybridization microarrays. Selected imbalances were confirmed by interphase cytogenetics and quantitative polymerase chain reaction analysis and further studied in an independent series of classical Hodgkin's lymphoma. Gains identified in at least five cHL affected 2p12-16, 5q15-23, 6p22, 8q13, 8q24, 9p21-24, 9q34, 12q13-14, 17q12, 19p13, 19q13 and 20q11 whereas losses recurrent in at least five cases involved Xp21, 6q23-24 and 13q22. Copy number changes of selected genes and a small deletion (156 kb) of the CDKN2B (p15) gene were confirmed by interphase cytogenetics and polymerase chain reaction analysis, respectively. Several gained regions included genes constitutively expressed in cHL. Among these, gains of STAT6 (12q13), NOTCH1 (9q34) and JUNB (19p13) were present in additional cHL with the usual low Hodgkin-Reed-Sternberg cell content. The present study demonstrates that array comparative genomic hybridization of microdissected Hodgkin-Reed-Sternberg cells is suitable for identifying and characterizing chromosomal imbalances. Regions affected by genomic changes in Hodgkin-Reed-Sternberg cells recurrently include genes constitutively

  17. Treatment of patients with minimal stage IIIA Hodgkin's disease

    SciTech Connect

    Powlis, W.D.; Mauch, P.; Goffman, T.; Goodman, R.L.

    1987-10-01

    Treatment recommendations for patients with upper abdominal Stage IIIA Hodgkin's (III1A) disease have varied widely. The current study reports on a combined institutional retrospective review of 85 patients with surgically staged III1A Hodgkin's disease. Twenty-two patients received combined modality therapy (CMT), 36 patients were treated initially with total nodal irradiation (TNI), and 27 with mantle and para-aortic radiotherapy (MPA). Patients treated with CMT had an actuarial 8-year freedom from relapse (FFR) of 96% as compared to a FFR of 51% in TNI treated patients (p = 0.002), and a FFR of 54% in MPA treated patients (p = 0.004). Of the 11 relapses in MPA treated patients, 7 had a component of their failure in the untreated pelvic or inguinal nodes. The patients treated with CMT had an 8-year actuarial survival of 100% as compared to 79% in TNI treated patients (p = 0.055) and 78% in patients treated with MPA (p = 0.025). Histology and the number of splenic nodules were the most important prognostic variables. Patients with MC/LD histology and greater than or equal to 5 splenic nodules have a high risk of relapse (10/13) when treated with radiation alone (TNI or MPA). We recommend CMT for this group of patients. Patients with NS/LP histology and 1-4 splenic nodules represent a favorable subset of Stage III1A patients. Only 4/21 patients have relapsed and all 21 patients are currently alive without disease regardless of treatment. We currently feel that patients with Stage III1A Hodgkin's disease with NS/LP histology and splenic disease limited to 1-4 nodules are good candidates for MPA as an alternative to TNI or CMT.

  18. The role of allogeneic stem cell transplantation in Hodgkin's lymphoma.

    PubMed

    Sureda, Anna; Domenech, E; Schmitz, N; Dreger, P

    2014-06-01

    The treatment of patients with classical Hodgkin's lymphoma relapsing after autologous stem cell transplantation represents a clear unmet need. Overall long-term outcome is not the same in these patients and therapeutic options in this setting are very heterogeneous and include salvage CT and/or RT followed or not by a second stem cell transplantation, palliative care, new drugs, or biological agents. Despite the absence of prospective, randomized, clinical trials, allogeneic stem cell transplantation either from a HLA identical sibling or a matched, unrelated donor represents an attractive option for those young patients with chemosensitive disease after being treated with a salvage protocol. The use of reduced intensity conditioning regimens has been able to drastically decrease nonrelapse mortality, although relapse rate remains a significant issue in this setting. More intense conditioning protocols could eventually decrease the relapse rate after the allogeneic procedure and, as indicated by a recent retrospective analysis of the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation, nonrelapse mortality does not represent a major problem nowadays for patients with multiply relapsed Hodgkin's lymphoma. Brentuximab vedotin is an antibody-drug conjugate that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. Its use has been approved recently for patients with Hodgkin's lymphoma relapsing after autologous stem cell transplantation. As a single dose, brentuximab vedotin is able to achieve an objective response rate of 75 % with 34 % of the patients achieving a complete remission. Its widespread use will most certainly change the treatment paradigm of this subgroup of patients, either avoiding the allogeneic procedure in some patients or by increasing the group of potential candidates to an allogeneic transplant being used as a "bridge to allo." Additional information on long

  19. Hodgkin lymphoma in Tyrol-a population-based study.

    PubMed

    Fong, Dominic; Steurer, Michael; Greil, Richard; Gunsilius, Eberhard; Spizzo, Gilbert; Gastl, Guenther; Tzankov, Alexandar

    2009-05-01

    We aimed to analyze the epidemiology, clinical characteristics, and outcome of patients with Hodgkin lymphoma (HL) diagnosed in Tyrol. All patients with newly diagnosed HL between 1993 and 2005 were included in this study. Among the 158 cases included, nodular lymphocytic predominant HL (nodular paragranuloma) was identified in ten cases (6%) whereas the majority of patients had classical Hodgkin lymphoma. Age (p < 0.01), sex (p = 0.03), risk groups according to the German Hodgkin Study Group stratification (p < 0.01), and bone marrow infiltration (p < 0.01) were of prognostic significance considering overall survival (OS) whereas histological subtype and bulky disease were not. The 5- and 10-year OS rates for the total group were 89% and 85%, respectively. Notably, in patients with advanced-stage HL (n = 49), combined modality treatment resulted in significantly better OS than chemotherapy alone (p = 0.01). Three patients developed a second hematological malignancy and one patient developed breast cancer. However, five patients (3%) had a malignant hematological disorder before occurrence of HL. Concerning treatment-related toxicity, bleomycin-associated lung toxicity was observed in six (4%) patients and five (3%) developed lethal treatment-related infectious complications. Our results provide evidence that the incidence rate of HL in Tyrol is comparable to other Western countries. Modern risk-adapted treatment results in excellent long-term prognosis but may be complicated by serious nonhematological side effects, in particular, infections and bleomycin-induced lung toxicity. Furthermore, 3% of HL patients had an antecedent malignant hematological disease before occurrence of HL.

  20. [Hodgkin's Lymphoma and Autoimmunity: Is There a Relationship?].

    PubMed

    Jerónimo, Mónica; Silva, Sónia; Benedito, Manuela; Brito, Manuel João

    2015-01-01

    Introdução: A relação entre linfomas e doenças autoimunes é descrita na literatura como bidirecional, existindo poucos dados em idade pediátrica. Este trabalho tem como objetivo avaliar a prevalência de doenças autoimunes em crianças e adolescentes com linfoma de Hodgkin seguidos num Serviço de Oncologia Pediátrica. Material e Métodos: Ao rever a casuística do Serviço de linfomas de Hodgkin nos últimos 16 anos (dados colhidos prospetivamente), constatou-se uma incidência aparentemente elevada de doenças autoimunes nas raparigas pelo que se realizou um estudo retrospetivo, com atualização do seguimento fora de tratamento, relativamente à existência de doenças autoimunes. Avaliaram-se: idade, sexo, tipo de doença autoimune, relação temporal com o linfoma, estádio e grupo histológico do linfoma e terapêutica efetuada. Resultados: Incluíram-se 52 casos de linfoma de Hodgkin, dos quais sete (13,5%), todos do sexo feminino, tiveram uma doença autoimune diagnosticada previamente, em simult'neo ou posteriormente ao linfoma. As doenças autoimunes encontradas foram: artrite idiopática juvenil, doença inflamatória intestinal, doença de Behçet, hepatite autoimune, lúpus eritematoso sistémico, tiroidite de Hashimoto e púrpura trombocitopénica idiopática. Em quatro doentes o diagnóstico foi posterior ao linfoma, em dois, prévio, e num simult'neo. Todos os casos, exceto o diagnóstico simult'neo, estão fora de tratamento e sem recidiva da doença oncológica. Não se verificaram óbitos. Discussão: Verificou-se uma importante prevalência de doenças autoimunes nas raparigas com linfoma de Hodgkin. Apresentamos os dados e discutimos possíveis causas desta relação com base numa revisão bibliográfica. Conclusões: Esta associação deve ser evocada, sendo necessário mais estudos, sobretudo em idade pediátrica.

  1. SNPs Array Karyotyping in Non-Hodgkin Lymphoma

    PubMed Central

    Etebari, Maryam; Navari, Mohsen; Piccaluga, Pier Paolo

    2015-01-01

    The traditional methods for detection of chromosomal aberrations, which included cytogenetic or gene candidate solutions, suffered from low sensitivity or the need for previous knowledge of the target regions of the genome. With the advent of single nucleotide polymorphism (SNP) arrays, genome screening at global level in order to find chromosomal aberrations like copy number variants, DNA amplifications, deletions, and also loss of heterozygosity became feasible. In this review, we present an update of the knowledge, gained by SNPs arrays, of the genomic complexity of the most important subtypes of non-Hodgkin lymphomas. PMID:27600240

  2. Sezary syndrome after successful treatment of Hodgkin's Disease

    SciTech Connect

    Buechner, S.A.

    1981-01-01

    A patient had a cutaneous T-cell lymphoma, appearing clinically as Sezary syndrome, that developed two years after successful treatment of Hodgkin's disease with combined radiotherapy and chemotherapy. Clinical, histologic, and electron microscopic observations were made during the course of the Sezary syndrome. The malignant cells in the cell infiltrates and in the peripheral blood were characterized as T cells. There is a possible relationship of the cutaneous T-cell lymphoma to impaired immune surveillance in this patient and to the potential carcinogenicity of combined radiotherapy and chemotherapy.

  3. Breast cancer after Hodgkin's disease in two sisters

    SciTech Connect

    Li, F.P.; Corkery, J.; Canellos, G.; Neitlich, H.W.

    1981-01-01

    Two sisters had breast cancer at four years and 11 years after diagnosis of Hodgkin's disease. The affected breast tissues had received several hundred rads of scatter radiation during treatment of the lymphoma. Family history revealed breast cancer in a third sister and five other women in the paternal line. Cytogenetic and HLA studies showed no markers of susceptibility to neoplasia. Development of second primary neoplasms of the breast in the two sisters may have resulted from interactions between genetic factors and carcinogenic effects of radiation exposure.

  4. Esophageal obstruction 14 years after treatment for Hodgkin's disease

    SciTech Connect

    Kaplinsky, C.; Kornreich, L.; Tiomny, E.; Cohen, I.J.; Loven, D.; Zaizov, R. )

    1991-08-15

    The incidence of late radiation injury of the esophagus is not precisely determined but, overall, the occurrence of clinically apparent damage is infrequent. The authors report a complete esophageal obstruction in a 21-year-old man, 14 years after chemo-radiation therapy for Hodgkin's lymphoma. Although endoscopy failed to demonstrate a gross morphologic abnormality, an esophagogram detected abnormal peristalsis and stricture, and esophageal manometry coupled with dynamic isotopic study clearly demonstrated a multilevel secondary neuronal damage. Data in the literature suggest that alteration in motility is by far the most frequent radiologic manifestation. Further prospective studies will probably clarify the actual incidence of late esophageal damage after chemo-radiation therapy.

  5. [Combined therapy and radiotherapy in stage-II Hodgkin disease].

    PubMed

    Il'in, N V; Vinogradova, Iu N; Nikolaeva, E N; Ivanova, E I; Shenderova, I A; Smirnova, E V; Izomov, B M; Trishkina, E V; Kritskaia, A V; Leenman, E E

    2010-01-01

    The aim of the study was to raise efficacy of combined treatment of stage II Hodgkin's disease by optimization of fractionation and volume of irradiation. It included 179 patients with involvement of supradiaphragmatic lymph nodes treated in 1986-2006. It was found that multi-fractionation was followed by lower frequency of relapse as compared with standard regimens as well as rates of early ones. The most efficient dosage was 30-36 Gy as far as frequency, term of relapse occurrence and recurrence-free survival were concerned.

  6. Development of Hodgkin lymphoma in a patient with sarcoidosis.

    PubMed

    Gediz, F; Yilmaz, A F; Payzin, B; Yuksel, T; Calli, A O; Kobak, S

    2017-08-03

    Sarcoidosis is a chronic granulomatous disease of unknown etiology characterized by non-caseified granulomas in many different organs and systems. The disease most frequently manifests with bilateral hilar lymphadenopathy and infiltrations in the lungs and skin, as well as with eye lesions. It may mimic a number of systemic diseases and/or accompany them. The development of lymphoma in patients with sarcoidosis or the co-occurrence of both diseases is rarely reported in the literature. In this paper we report a female patient followed up with sarcoidosis for three years who developed Hodgkin lymphoma, according to the results of the investigations and biopsy results.

  7. Primary non-hodgkin B cell lymphoma in a man.

    PubMed

    Alhabshi, Sh M I; Ismail, Z; Arasaratnam, Sh A

    2011-03-01

    Malignant breast lymphoma is a rare condition and primary breast lymphoma is extremely rare in the male population. We present a case of a 26-year-old man (transgender) who presented with a large palpable mass in the right breast. This mass was rapidly growing in size associated with right axillary lymphadenopathy. Ultrasound and MRI findings were consistent with BIRADS IV lesion which was suspicious of malignancy. Core biopsy was performed and histopathology confirmed the diagnosis of primary non Hodgkin B cell lymphoma of the breast.

  8. [Intraoral non-Hodgkin's lymphoma. Presentation of 4 clinical cases].

    PubMed

    Contreras, E; Bagán, J V; Lloria, E; Borja, A; Millán, M A; Jiménez, Y

    2001-10-01

    The non-Hodgkin lymphomas (NHL) represent an heterogeneous group of malignancies of lymphoreticular histogenesis. In most cases, they initially arise within lymph nodes but so-called extranodal lymphomas are also found. The NHL has low incidence in the oral cavity. It may involve bone and/or soft tissues as a primary or secondary manifestation. We present a review of the literature and four clinical cases of intraoral NHL. The first couple of cases are primary forms, the third one is associated to HIV infection and the last one is an oral presentation as a component of more widely disseminated disease.

  9. The role of angiogenesis in human non-Hodgkin lymphomas.

    PubMed

    Ribatti, Domenico; Nico, Beatrice; Ranieri, Girolamo; Specchia, Giorgina; Vacca, Angelo

    2013-03-01

    The role of angiogenesis in the growth of lymphomas and survival of patients with leukemias and other hematological malignancies has become evident since 1994. Angiogenic factors, such as vascular endothelial growth factor and its receptors together with other tumor microenvironment components, including myelo-monocytic cell, mast cells, endothelial progenitor cells, and circulating endothelial cells, have been shown to be important in the progression and maintenance of lymphoproliferative disorders. In this review article, we present an overview of the literature focusing on the relationship between angiogenesis and disease progression and the recent advantages in the antiangiogenic treatment in human non-Hodgkin lymphomas.

  10. FPA micro spectral imaging of non-Hodgkin lymphomas

    NASA Astrophysics Data System (ADS)

    Burattini, E.; Malvezzi-Campeggi, F.; Chilosi, M.; Conti, C.; Ferraris, P.; Monti, F.; Sabbatini, S.; Tosi, G.; Zamò, A.

    2007-05-01

    A FT-IR microspectroscopy study on reactive lymph nodes and non-Hodgkin lymphomas is reported. Mid infrared absorption spectra collected at diffraction limit spatial resolution from reactive and neoplastic lymph nodes resulted sufficiently different once analysed by multivariate pattern recognition analysis to distinguish tumoral from non tumoral samples. The potential of infrared spectroscopy as a post-operative screening is gained by the use of a multielement Focal Plane Array detector. Spectral differences between normal and malignant spectra were mainly in the methyl stretching and in the low frequency region.

  11. Customized Targeted Therapy in Hodgkin Lymphoma: Hype or Hope?

    PubMed Central

    Diefenbach, Catherine; Advani, Ranjana

    2014-01-01

    Synopsis Although the majority of patients with Hodgkin lymphoma (HL) are cured with primary therapy, patients with primary refractory disease or relapse after initial treatment have poor outcomes and represent an unmet medical need. Recent advances in unraveling the biology of HL have yielded a plethora of novel targeted therapies. This review provides an overview of the data behind the hype generated by these advances and addresses the question of whether or not clinically these targeted therapies offer hope for patients with HL. PMID:24287071

  12. Late onset progressive multifocal leukoencephalopathy in Hodgkin lymphoma.

    PubMed

    Aamodt, Whitley W; Siegler, James E; Viaene, Angela N; Rubenstein, Michael N

    2017-09-01

    Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from infection of oligodendrocytes in the central nervous system with John Cunningham virus. Although PML is commonly diagnosed in immunocompromised patients with human immunodeficiency virus, it can also arise in other immunodeficient states. In this report, we present an unusual case of PML occurring 40years after chemoradiation therapy for Hodgkin lymphoma in a patient with normal total lymphocyte counts on annual surveillance. Although current guidelines recommend annual complete blood counts for patients in remission, this testing may be insufficient to monitor patients with chronic CD4+ lymphopenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Classical Hodgkin lymphoma, lymphocyte depleted type: clinicopathological analysis and prognostic comparison with other types of classical Hodgkin lymphoma.

    PubMed

    Karube, Kennosuke; Niino, Daisuke; Kimura, Yoshizo; Ohshima, Koichi

    2013-04-01

    The lymphocyte-depleted type (LD) is a morphological subtype of classical Hodgkin lymphoma (CHL), but its rarity and heterogeneous morphological character makes a definite clinicopathological identification difficult. To characterize this disease, LD cases were compared with other types of CHL. From 1982 to 2006, we collected 310 CHL cases. Among them, 29 cases were diagnosed as LD. We could additionally analyze clinical data of 157 CHL cases (including 28 LD cases) and the immunophenotype of 150 CHL cases (including 28 LD cases). We compared clinicopathological data between LD cases and other types of CHL cases and determined prognostic factors by univariate and multivariate analysis. LD showed a more progressive disease stage (stage 3/4, 64%) than other types of CHL (stage 3/4, 30%; P<0.001), more frequent B symptoms (89% vs. 40%; P<0.001) and extranodal invasion (50% vs. 11%; P<0.001), older age (median: 66 vs. 33; P<0.001), higher serum soluble interleukin 2 receptor levels (median: 8240U/ml vs. 1705U/ml; P<0.001), and much poorer prognosis regardless of the international prognostic score (IPS) (five-year overall survival: 29% vs. 86%; P<0.001). The morphological subtype of LD represented an independent prognostic factor as did age and IPS by multivariate analysis. Immunohistochemistry showed that the characteristics of Hodgkin and Reed-Sternberg (HRS) cells of LD are basically not different from those of other types of CHL in terms of CD30, CD15, and chemokine receptors, except for high-level EB-virus infection (72% vs. 41%; P=0.002). LD should be distinguished from other types of classical Hodgkin lymphoma because of its definitive clinicopathological characters. Copyright © 2013 Elsevier GmbH. All rights reserved.

  14. Circulating immune complexes of Hodgkin's disease contain an antigen that is present in Hodgkin and Reed-Sternberg cells.

    PubMed

    Bepler, G; Zhen, Q Y; Havemann, K

    1985-01-01

    Circulating immune complexes (CIC), isolated from the serum of a patient with Hodgkin's disease (HD) and from control serum (CS) of healthy adults, were used to generate heterologous antisera in rabbits. The antiserum directed against CIC from HD (AS-HD) and the antiserum directed against CIC from CS (AS-CS) were used to identify immunoglobulins, complement factors and alpha2-macroglobulin as immune complex components. After adsorbing both antisera with normal human sera, we found that the adsorbed AS-HD was immunoreactive with radio-labelled CIC from HD serum but not with radiolabelled CIC from CS. Sera of patients with different diseases and sera of healthy adults were assessed for the occurrence of this Hodgkin immune complex-associated antigen (HIC-Ag). The HIC-Ag was present in 37% (12/33) of sera from patients with HD, 8% (8/101) of sera from patients with nonmalignant diseases, and 0% (0/6) of sera from healthy adults. This antigen was equally distributed among HD patients with and without symptoms, but its occurrence correlated with an advanced clinical stage of the disease. Using the adsorbed AS-HD in the immunoperoxidase technique, we identified the HIC-Ag as a cytoplasmic antigen in Hodgkin and Reed-Sternberg cells; whereas, the adsorbed AS-CS did not reveal any staining. These data indicate the presence of an HIC-Ag in the sera of patients with HD and suggest that the adsorbed AS-HD might be useful for isolation and characterization of this antigen for future use as a tumour marker.

  15. Myeloma, Hodgkin disease, and lymphoid leukemia after renal transplantation: characteristics, risk factors and prognosis.

    PubMed

    Caillard, Sophie; Agodoa, Lawrence Y; Bohen, Erin M; Abbott, Kevin C

    2006-03-27

    Hodgkin disease and myeloma were recently included in the classification of posttransplant lymphoproliferative disorder (PTLD). However, because their incidence is low, not much is known about their particular features. The incidence, characteristics, risk, and prognostic factors of myeloma, Hodgkin disease, and lymphoid leukemia using the United States Renal Data System from 1991 to 2000 among 66,159 Medicare patients were analyzed. In all, 1,169 recipients developed a lymphoid disease: 823 (1.2%) non-Hodgkin's lymphomas (NHL), 160 (0.24%) myelomas, 60 (0.1%) Hodgkin lymphomas, and 126 (0.2%) lymphoid leukemias. Older age was associated with an increased risk of myeloma and leukemia. The incidence of hepatitis C virus infection was higher in recipients with myeloma (6.9 vs. 3.9%, P=0.05). Induction therapy was associated with a greater risk of myeloma and leukemia, but not Hodgkin disease. Azathioprine was associated with a lower risk of myeloma, and tacrolimus with a lower risk of Hodgkin disease. According to the type of malignancy, ten-year survival rates were significantly different: 42, 26, 55 and 39% respectively for NHL, myeloma, Hodgkin disease, and leukemia. These results support specific features and risk factors related to the occurrence of each type of lymphoid-proliferation and suggest for the first time a possible association between hepatitis C virus and myeloma in kidney transplant recipients.

  16. Atypical prediagnosis Epstein-Barr virus serology restricted to EBV-positive Hodgkin lymphoma

    PubMed Central

    Chang, Ellen T.; Ambinder, Richard F.; Lennette, Evelyne T.; Rubertone, Mark V.; Mann, Risa B.; Borowitz, Michael; Weir, Edward G.; Abbondanzo, Susan L.; Mueller, Nancy E.

    2012-01-01

    An altered anti–Epstein-Barr virus (EBV) serologic profile preceding diagnosis is associated with an increased risk of Hodgkin lymphoma. It is unknown whether this atypical pattern predicts Hodgkin lymphoma risk further subdivided by determination of EBV in tumor cells. A nested case-control study of 128 incident Hodgkin lymphoma cases and 368 matched controls from active-duty military personnel with archived serum in the US Department of Defense Serum Repository was conducted to determine whether a panel of anti-EBV antibody titers differed in EBV+ and EBV− Hodgkin lymphoma. Among 40 EBV+ Hodgkin lymphoma cases and matched controls, statistically significant increased risks were associated with elevated anti-EBV VCA IgG antibody titers (relative risk = 3.1; 95% confidence interval [CI], 1.1-8.7), and an anti–EBNA-1/anti–EBNA-2 antibody ratio ≤ 1.0 versus > 1.0 (relative risk = 4.7; 95% CI, 1.6-13.8). In contrast, no significant associations were found among 88 EBV− Hodgkin lymphoma cases relative to their matched controls. In case-case analysis, EBV+ disease was significantly associated with a low anti–EBNA-1/anti–EBNA-2 antibody ratio. This distinc-tive serologic response to EBV latent antigens, indicative of immune dysfunction in other clinical settings, is associated with an increased risk of developing EBV+ but not EBV− Hodgkin lymphoma. PMID:22972983

  17. [Stevens-Johnson syndrome and Hodgkin's disease: A fortuitous association or paraneoplastic syndrome?].

    PubMed

    Schoeffler, A; Levy, E; Weinborn, M; Cuny, J-F; Schmutz, J-L; Barbaud, A; Cribier, B; Bursztejn, A-C

    2014-02-01

    Hodgkin's disease has been associated with a variety of cutaneous symptoms. We report two cases of Stevens-Johnson syndrome (SJS) associated with Hodgkin's disease. Case 1: a 22-year-old man was hospitalized for a second erythematous vesicular eruption with intense mucosal involvement. Histopathological examination confirmed the diagnosis of Stevens-Johnson syndrome. He also developed enlarged cervical lymph nodes that revealed Hodgkin's disease. The latter diagnosis was followed by two recurrent rashes. Treatment consisted of systemic chemotherapy. Complete remission was obtained with no signs of cutaneous recurrence after 24 months of regular follow-up. Case 2: a 29-year-old man was admitted for a generalized erythematous and bullous rash with intense mucosal involvement. Histopathological examination confirmed the diagnosis of Stevens-Johnson syndrome. He then developed muco-cutaneous icterus that was secondary to Hodgkin's disease. Under specific hematologic treatment, no cutaneous relapse was noticed. These cases illustrate the rare association of SSJ revealing Hodgkin's disease. In these cases, no evidence was found of infectious disease or drug-induced cutaneous effects. Only one case of toxic epidermal necrolysis associated with Hodgkin's disease had previously been reported. The link between both diseases may be immunosuppression induced by Hodgkin's disease, which could favor infection inducing SJS or secretion by tumor cells granulysin, a mediator responsible for damage to keratinocytes. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  18. [Role of radiotherapy in the management of non-Hodgkin lymphomas].

    PubMed

    Gastaud, L; Rossignol, B; Peyrade, F; Ré, D; Thariat, J; Thyss, A; Doyen, J

    2016-05-01

    The purpose of this review was to summarize recent data about lastest retrospective and prospective studies dealing with radiotherapy of non-Hodgkin lymphoma, in order to precise the schedule and the role of this treatment. A systematic review was done by searching studies on the website http://www.pubmed.gov (Medline) using the following keywords: radiotherapy, radiation therapy, non-Hodgkin lymphoma. The management of non-Hodgkin lymphoma varies a lot according to the histological type and stage. The dose of radiotherapy has been studied in only one randomized trial, which concluded that there was no difference between the low dose and the high dose arms. Radiotherapy is a very good option in follicular, cutaneous, digestive or orbital non-Hodgkin lymphoma. A recent post hoc analysis of randomized trials on radiotherapy for high-grade non-Hodgkin lymphoma strongly suggested a benefit of additional radiotherapy after chemotherapy in some situations. Radiotherapy of low-grade non-Hodgkin lymphoma is a very good option, while its use on high-grade non-Hodgkin lymphoma is sometimes recommended but further randomized trials are ongoing to better understand its role. Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  19. Overcoming the Immunosuppressive Tumor Microenvironment of Hodgkin Lymphoma Using Chimeric Antigen Receptor T Cells.

    PubMed

    Ruella, Marco; Klichinsky, Michael; Kenderian, Saad S; Shestova, Olga; Ziober, Amy; Kraft, Daniel O; Feldman, Michael; Wasik, Mariusz A; June, Carl H; Gill, Saar

    2017-10-01

    Patients with otherwise treatment-resistant Hodgkin lymphoma could benefit from chimeric antigen receptor T-cell (CART) therapy. However, Hodgkin lymphoma lacks CD19 and contains a highly immunosuppressive tumor microenvironment (TME). We hypothesized that in Hodgkin lymphoma, CART should target both malignant cells and the TME. We demonstrated CD123 on both Hodgkin lymphoma cells and TME, including tumor-associated macrophages (TAM). In vitro, Hodgkin lymphoma cells convert macrophages toward immunosuppressive TAMs that inhibit T-cell proliferation. In contrast, anti-CD123 CART recognized and killed TAMs, thus overcoming immunosuppression. Finally, we showed in immunodeficient mouse models that CART123 eradicated Hodgkin lymphoma and established long-term immune memory. A novel platform that targets malignant cells and the microenvironment may be needed to successfully treat malignancies with an immunosuppressive milieu.Significance: Anti-CD123 chimeric antigen receptor T cells target both the malignant cells and TAMs in Hodgkin lymphoma, thereby eliminating an important immunosuppressive component of the tumor microenvironment. Cancer Discov; 7(10); 1154-67. ©2017 AACR.This article is highlighted in the In This Issue feature, p. 1047. ©2017 American Association for Cancer Research.

  20. Treatment of early-stage Hodgkin lymphoma.

    PubMed

    Engert, Andreas; Raemaekers, John

    2016-07-01

    Hodgkin lymphoma (HL) has become one of the best curable malignancies today. This is particularly true for patients with early-stage disease. Today, most patients in this risk group are treated with a combination of chemotherapy followed by small-field radiotherapy. More recent clinical trials such as the German Hodgkin Study Group (GHSG) HD10 study demonstrated, that even two cycles of ABVD followed by 20 Gy involved-field radiation therapy (IF-RT) are sufficient and result in more than 90% of patients being cured. The current treatment for early unfavorable patients is either four cycles of ABVD plus 30 Gy IF-RT or two cycles of BEACOPPbaseline followed by two cycles of ABVD plus IF-RT. Here, the European Organization for Research and Treatment of Cancer (EORTC) demonstrated that in positron emission tomography (PET)-positive patients after two cycles of ABVD, treatment switched to two cycles of BEACOPPbaseline plus radiotherapy results in significantly improved outcomes. Other aspects including attempts to further reduce intensity of treatment will be discussed.

  1. Pericarditis and myocardial infarctions after Hodgkin's disease therapy

    SciTech Connect

    Cosset, J.M.; Henry-Amar, M.; Pellae-Cosset, B.; Carde, P.; Girinski, T.; Tubiana, M.; Hayat, M. )

    1991-07-01

    From 1971 to 1984, 499 patients with all stages of Hodgkin's disease received mediastinal irradiation at the Institut Gustave-Roussy by 25 MV photons from a linear accelerator. Thirty-five pericarditis (10-year cumulative incidence rate of 9.5%) and 13 myocardial infarctions (MI) (10-year cumulative incidence rate of 3.9%) were observed. In contrast, no cases were diagnosed in a parallel series of 138 Hodgkin's disease patients treated without mediastinal irradiation during the same period of time (p less than 0.005 for pericarditis, p less than 0.05 for MI). By multivariate analysis, the role of total radiation dose given to the mediastinum and that of fraction size were evaluated, adjusting for age, sex, mediastinal involvement, and type of chemotherapy. The pericarditis risk was significantly increased with total dose greater than or equal to 41 Gy (relative risk (RR) = 3.25, p = 0.006) and with dose per fraction greater than or equal to 3.0 Gy (RR = 2.0, p = 0.06). The myocardial infarction risk was not found to be related to total dose nor to fraction size in this series, possibly because of the small number of events.

  2. Plasma Biomarkers for Detecting Hodgkin's Lymphoma in HIV Patients

    SciTech Connect

    Varnum, Susan M.; Webb-Robertson, Bobbie-Jo M.; Hessol, Nancey; Smith, Richard D.; Zangar, Richard C.

    2011-12-16

    The lifespan of AIDS patients has increased as a result of aggressive antiretroviral therapy, and the incidences of the AIDS-defining cancers, Hodgkin's lymphoma and Kaposi sarcoma, are declining, Still, the increased longevity of AIDS patients is now associated with increased incidence of other cancers, including Hodgkin's lymphoma (HL). In order to determine if we could identify biomarkers for the early detection of HL, we undertook an accurate mass and elution time tag proteomics analysis of individual plasma samples from AIDS patients without HL (n=14) and with HL (n=22). This analysis identified 33 proteins, included C-reactive protein and three serum amyloid proteins, that were statistically (p<0.05) altered by at least 1.5-fold between the two groups. At least three of these proteins have previously been reported to be altered in the blood of HL patients. Ingenuity Pathway Analysis software identified 'inflammatory response' and 'cancer' as the top two, biological functions commonly associated with these proteins. The clear association of these proteins with cancer and inflammation suggests that they are truly associated with HL and that they would be useful in the detection of this disease.

  3. Time to first spike in stochastic Hodgkin Huxley systems

    NASA Astrophysics Data System (ADS)

    Tuckwell, Henry C.; Wan, Frederic Y. M.

    2005-06-01

    The time to first spike is an experimentally observed quantity in laboratory experiments. In the auditory, somatic and visual sensory modalities, the times of first spikes in the corresponding cortical neurons have been implicated as coding much of the information about stimulus properties. We describe an analytical approach for determining the time to first spike from a given initial state which may be applied to a general nonlinear stochastic model neuron. We illustrate with a standard Hodgkin-Huxley model with a Gaussian white-noise input current whose drift parameter is μ and whose variance parameter is σ. Partial differential equations (PDEs) of second order are obtained for the first two moments of the time taken for the depolarization to reach a threshold value from rest state, as functions of the initial values. Simulation confirms that for small noise amplitudes a 2-component model is reasonably accurate. For small values of the noise parameter σ, including the deterministic case σ=0, perturbation methods are used to find the moments of the firing time and the results compare favorably with those from simulation. The approach is accurate for almost all σ when μ is above threshold for action potentials in the absence of noise and over a considerable range of values of σ when μ is as small as 2. The same methods may be applied to models similar to Hodgkin-Huxley which involve channels for additional or different ionic currents.

  4. The Management of Classical Hodgkin's Lymphoma: Past, Present, and Future

    PubMed Central

    Richardson, S. E.; McNamara, C.

    2011-01-01

    The management of classical Hodgkin's lymphoma (CHL) is a success story of modern multi-agent haemato-oncology. Prior to the middle of the twentieth century CHL was fatal in the majority of cases. Introduction of single agent radiotherapy (RT) demonstrated for the first time that these patients could be cured. Developments in chemotherapy including the mechlorethamine, vincristine, procarbazine and prednisolone (MOPP) and Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD) regimens have resulted in cure rates of over 80%. Even in relapse, CHL patients can be salvaged with high dose chemotherapy and autologous haematopoietic stem cell transplantation (ASCT). Challenges remain, however, in finding new strategies to manage the small number of patients who continue to relapse or progress. In addition, the young age of many Hodgkin's patients forces difficult decisions in balancing the benefit of early disease control against the survival disadvantage of late toxicity. In this article we aim to summarise past trials, define the current standard of care and appraise future developments in the management of CHL. PMID:21687653

  5. A case of Langerhans' cell histiocytosis following Hodgkin's disease

    PubMed Central

    LI, XIN; DENG, QI; LI, YU-MING

    2016-01-01

    Langerhans' cell histiocytosis (LCH) is a group of disorders in various tissues characterized by the proliferation of Langerhans cells. It is rarely observed in adults. Langerhans cells are dendritic cells that express cluster of differentiation 1a (CD1a) and S100 protein, and contain Birbeck granules. Its etiopathogenesis remains to be elucidated. One possible etiological cause is a reactive proliferation of Langerhans cells following chemotherapy or radiotherapy for Hodgkin's disease (HD). A number of cases of LCH associated with malignant lymphoma have been reported previously. It may follow after the malignant lymphoma, or occur with it. However, fewer cases have been reported where the LCH followed after HD. In the present case report, a patient was diagnosed with HD following chemotherapy for LCH. As LCH was diagnosed, the patient was treated with a combination of various chemotherapeutic agents in two cycles of cyclophosphamide, vincristine, and prednisolone (COP), and eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP). The patient went into a successful clinical remission. One year later, computed tomographic (CT) scans of the thorax and abdomen revealed augmentation of the tumor mass in the mediastinum. An excisional biopsy of the right inguinal lymph node was performed. The patient was diagnosed with nodular sclerosing Hodgkin's disease. Following four cycles of doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy, a whole-body positron emission tomographic CT scan revealed a decrease in tumor mass in the mediastinum. At present, the patient remains in treatment, and the prognosis has yet to be fully determined. PMID:27330759

  6. Memristor, Hodgkin-Huxley, and edge of chaos.

    PubMed

    Chua, Leon

    2013-09-27

    From a pedagogical point of view, the memristor is defined in this tutorial as any 2-terminal device obeying a state-dependent Ohm's law. This tutorial also shows that from an experimental point of view, the memristor can be defined as any 2-terminal device that exhibits the fingerprints of 'pinched' hysteresis loops in the v-i plane. It also shows that memristors endowed with a continuum of equilibrium states can be used as non-volatile analog memories. This tutorial shows that memristors span a much broader vista of complex phenomena and potential applications in many fields, including neurobiology. In particular, this tutorial presents toy memristors that can mimic the classic habituation and LTP learning phenomena. It also shows that sodium and potassium ion-channel memristors are the key to generating the action potential in the Hodgkin-Huxley equations, and that they are the key to resolving several unresolved anomalies associated with the Hodgkin-Huxley equations. This tutorial ends with an amazing new result derived from the new principle of local activity, which uncovers a minuscule life-enabling 'Goldilocks zone', dubbed the edge of chaos, where complex phenomena, including creativity and intelligence, may emerge. From an information processing perspective, this tutorial shows that synapses are locally-passive memristors, and that neurons are made of locally-active memristors.

  7. Circulating clonotypic B cells in classic Hodgkin lymphoma.

    PubMed

    Jones, Richard J; Gocke, Christopher D; Kasamon, Yvette L; Miller, Carole B; Perkins, Brandy; Barber, James P; Vala, Milada S; Gerber, Jonathan M; Gellert, Lan L; Siedner, Mark; Lemas, M Victor; Brennan, Sarah; Ambinder, Richard F; Matsui, William

    2009-06-04

    Although Hodgkin and Reed-Sternberg (HRS) cells are B lymphoid cells, they are unlike any normal cells of that lineage. Moreover, the limited proliferative potential of HRS cells belies the clinical aggressiveness of Hodgkin lymphoma (HL). More than 20 years ago, the L428 HL cell line was reported to contain a small population of phenotypic B cells that appeared responsible for the continued generation of HRS cells. This observation, however, has never been corroborated, and such clonotypic B cells have never been documented in HL patients. We found that both the L428 and KM-H2 HL cell lines contained rare B-cell subpopulations responsible for the generation and maintenance of the predominant HRS cell population. The B cells within the HL cell lines expressed immunoglobulin light chain, the memory B-cell antigen CD27, and the stem cell marker aldehyde dehydrogenase (ALDH). Clonal CD27(+)ALDH(high) B cells, sharing immunoglobulin gene rearrangements with lymph node HRS cells, were also detected in the blood of most newly diagnosed HL patients regardless of stage. Although the clinical significance of circulating clonotypic B cells in HL remains unclear, these data suggest they may be the initiating cells for HL.

  8. Recurrent Somatic Loss of TNFRSF14 in Classical Hodgkin Lymphoma

    PubMed Central

    Salipante, Stephen J.; Adey, Andrew; Thomas, Anju; Lee, Choli; Liu, Yajuan J.; Kumar, Akash; Lewis, Alexandra P.; Wu, David; Fromm, Jonathan R.; Shendure, Jay

    2015-01-01

    Investigation of the genetic lesions underlying classical Hodgkin lymphoma (CHL) has been challenging due to the rarity of Hodgkin and Reed-Sternberg (HRS) cells, the pathognomonic neoplastic cells of CHL. In an effort to catalog more comprehensively recurrent copy number alterations occurring during oncogenesis, we investigated somatic alterations involved in CHL using whole-genome sequencing-mediated copy number analysis of purified HRS cells. We performed low-coverage sequencing of small numbers of intact HRS cells and paired non-neoplastic B lymphocytes isolated by flow cytometric cell sorting from 19 primary cases, as well as two commonly used HRS-derived cell lines (KM-H2 and L1236). We found that HRS cells contain strikingly fewer copy number abnormalities than CHL cell lines. A subset of cases displayed non-integral chromosomal copy number states, suggesting internal heterogeneity within the HRS cell population. Recurrent somatic copy number alterations involving known factors in CHL pathogenesis were identified (REL, the PD-1 pathway, and TNFAIP3). In eight cases (42%) we observed recurrent copy number loss of chr1:2,352,236-4,574,271, a region containing the candidate tumor suppressor TNFRSF14. Using flow cytometry, we demonstrated reduced TNFRSF14 expression in HRS cells from five of 22 additional cases (23%) and in two of three CHL cell lines. These studies suggest that TNFRSF14 dysregulation may contribute to the pathobiology of CHL in a subset of cases. PMID:26650888

  9. Non-Hodgkin lymphomas in pregnancy: tackling therapeutic quandaries.

    PubMed

    Avivi, Irit; Farbstein, Dan; Brenner, Benjamin; Horowitz, Netanel A

    2014-09-01

    Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) often present with systemic symptoms such as fatigue, shortness of breath and night sweats, mimicking pregnancy-related features which may result in delayed disease diagnosis. Furthermore, the wish to avoid investigational imaging, aiming to protect the fetus from radiation exposure, may lead to a further delay, which does not often result in significant changes in HL clinical nature and patient outcome. In contrast, a more aggressive behavior (i.e., advanced disease stage and reproductive organ involvement) of most NHL types diagnosed in pregnancy may require urgent therapeutic intervention to prevent disease progression. Current management of pregnancy-associated NHL depends on histological subtype of the disease, gestational stage at diagnosis and the urgency of treatment for a specific patient. Patients diagnosed with indolent lymphoma may often be just followed, whereas those presenting with aggressive or highly aggressive disease need to be urgently treated with chemoimmunotherapy, either after undergoing an elective pregnancy termination if diagnosed at an early gestational stage, or with pregnancy preservation, if diagnosed later. Supportive care of NHL is also important; however, granulocyte colony stimulating factor (G-CSF) which is commonly used outside of pregnancy, should be cautiously employed, considering its established teratogenicity in animals, though this is less proven in humans. In conclusion, given the paucity of studies prospectively evaluating the outcome of pregnant women with NHL, international efforts are warranted to elucidate critical issues and develop guidelines for the management of such patients.

  10. Memristor, Hodgkin-Huxley, and Edge of Chaos

    NASA Astrophysics Data System (ADS)

    Chua, Leon

    2013-09-01

    From a pedagogical point of view, the memristor is defined in this tutorial as any 2-terminal device obeying a state-dependent Ohm’s law. This tutorial also shows that from an experimental point of view, the memristor can be defined as any 2-terminal device that exhibits the fingerprints of ‘pinched’ hysteresis loops in the v-i plane. It also shows that memristors endowed with a continuum of equilibrium states can be used as non-volatile analog memories. This tutorial shows that memristors span a much broader vista of complex phenomena and potential applications in many fields, including neurobiology. In particular, this tutorial presents toy memristors that can mimic the classic habituation and LTP learning phenomena. It also shows that sodium and potassium ion-channel memristors are the key to generating the action potential in the Hodgkin-Huxley equations, and that they are the key to resolving several unresolved anomalies associated with the Hodgkin-Huxley equations. This tutorial ends with an amazing new result derived from the new principle of local activity, which uncovers a minuscule life-enabling ‘Goldilocks zone’, dubbed the edge of chaos, where complex phenomena, including creativity and intelligence, may emerge. From an information processing perspective, this tutorial shows that synapses are locally-passive memristors, and that neurons are made of locally-active memristors.

  11. Predicting treatment outcome in classical Hodgkin lymphoma: genomic advances

    PubMed Central

    2011-01-01

    Classical Hodgkin lymphoma is considered a highly curable disease; however, 20% of patients cannot be cured with standard first-line chemotherapy and have a dismal outcome. Current clinical parameters do not allow accurate risk stratification, and personalized therapies are lacking. In fact, Hodgkin lymphoma (HL) is often over- or undertreated because of this lack of accurate risk stratification. In recent years, the early detection of chemoresistance by fluorodeoxyglucose positron emission tomography has become the most important prognostic tool in the management of HL. However, to date, no prognostic scores or molecular markers are available for the early identification of patients at very high risk of failure of induction therapy. In the last decade, many important advances have been made in understanding the biology of HL. In particular, the development of new molecular profiling technologies, such as SNP arrays, comparative genomic hybridization, and gene-expression profiling, have allowed the identification of new prognostic factors that may be useful for risk stratification and predicting response to chemotherapy. In this review, we focus on the prognostic tools and biomarkers that are available for newly diagnosed HL, and we highlight recent advances in the genomic characterization of classical HL and potential targets for therapy. PMID:21542892

  12. Primary non-Hodgkin's lymphoma of the female genital tract.

    PubMed

    Amichetti, M; Chiappe, E; Mussari, S; Busana, L; Caffo, O; Botto, F; Galligioni, E; Tomio, L

    1999-01-01

    Genital tract lymphoma is a rare disease; information on diagnosis, treatment and outcome are limited. We report on eight patients affected by non-Hodgkin's lymphoma of the genital tract, five from the cervix, two from the vagina and one from the vulva collected between 1987 and 1998. Age at presentation ranged from 36 to 82 (median 67) years. The commonest initial symptom was vaginal bleeding, post coital in 1 patient. Three patients complained of vescical symptoms. Ann Arbor classification was stage IAE for 6 patients. Histology, according to the IWF, was either intermediate grade (4 patients), or high grade (3 patients), not evaluable in one case. Seven patients were treated with chemotherapy (anthracycline based in four) followed by pelvic radiotherapy in five; one patient received irradiation alone. Five patients are currently alive and free of disease with follow-up ranging from 8 to 126 months. Based on our experience in this series, we support a management scheme of combination chemotherapy and radiotherapy for patients with non-Hodgkin's lymphoma of the genital tract.

  13. Hodgkin Lymphoma and Castleman Disease: When One Blood Disease Can Hide Another.

    PubMed

    Filliatre-Clement, L; Busby-Venner, H; Moulin, C; Roth-Guepin, G; Perrot, A

    2017-01-01

    We describe a rare case of Castleman disease associated de novo with Hodgkin lymphoma. The incidence of Castleman disease is rare; only a few studies have described it in de novo association with Hodgkin lymphoma. The patient described here complained of unique evolutionary axillary adenopathy. A positron-emission tomography/computed tomography scan revealed hypermetabolic activity in this area. Diagnosis was based on a total excision biopsy of the adenopathy. The patient underwent complete remission with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy for treating Hodgkin lymphoma after surgical excision of the unicentric Castleman disease lesion.

  14. Rituximab as potential therapy for paraneoplastic cerebellar degeneration in pediatric Hodgkin disease.

    PubMed

    Yeo, Kee Kiat; Walter, Andrew W; Miller, Robin E; Dalmau, Josep

    2012-06-01

    Paraneoplastic cerebellar degeneration (PCD) is a rare neurological syndrome associated with lung cancer, breast adenocarcinoma,ovarian adenocarcinoma, and Hodgkin disease. It is rarely seen in pediatrics. We report a case of a 10-year-old boy with a 2-year prodrome that led to a diagnosis of PCD in association with stage IV Hodgkin disease. He received radiation and chemotherapy for his Hodgkin disease with resolution of his lymphoma. Based on promising data in adults on the efficacy of rituximab over other immuno suppressive agents in paraneoplastic disorders, he was treated with rituximab with marked improvement of the cerebellar syndrome.

  15. Hodgkin Lymphoma and Castleman Disease: When One Blood Disease Can Hide Another

    PubMed Central

    Busby-Venner, H.; Moulin, C.; Roth-Guepin, G.; Perrot, A.

    2017-01-01

    We describe a rare case of Castleman disease associated de novo with Hodgkin lymphoma. The incidence of Castleman disease is rare; only a few studies have described it in de novo association with Hodgkin lymphoma. The patient described here complained of unique evolutionary axillary adenopathy. A positron-emission tomography/computed tomography scan revealed hypermetabolic activity in this area. Diagnosis was based on a total excision biopsy of the adenopathy. The patient underwent complete remission with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy for treating Hodgkin lymphoma after surgical excision of the unicentric Castleman disease lesion. PMID:28197347

  16. Pembrolizumab and Ibrutinib in Treating Patients With Relapsed or Refractory Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-01-13

    B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classical Hodgkin Lymphoma; Grade 1 Follicular Lymphoma; Grade 2 Follicular Lymphoma; Grade 3a Follicular Lymphoma; Mediastinal Lymphoma; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Burkitt Lymphoma; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Lymphoplasmacytic Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Waldenstrom Macroglobulinemia; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Burkitt Lymphoma; Refractory Diffuse Large B-Cell Lymphoma; Refractory Follicular Lymphoma; Refractory Lymphoplasmacytic Lymphoma; Refractory Mantle Cell Lymphoma

  17. Analysis of ploidy and proliferative activity in childhood non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD).

    PubMed

    Coad, N A; Jones, T J; Muir, K R; Parkes, S E; Smith, K; Raafat, F; Mann, J R

    1997-01-01

    We have performed DNA analysis by means of fluorescence-activated cell cytometry on paraffin-embedded tissue from the diagnostic biopsy specimens in 40 cases of non-Hodgkin's lymphoma (NHL) and 25 of Hodgkin's disease (HD) and from 50 normal tonsils as controls. For HD cases, aneuploidy was found in 7 of 25 (28%), a higher proportion than in two previous studies of mainly adult patients. Diploid tumors showed S-phase fractions (SPFs) similar to those of controls. In the NHL cases aneuploidy was found in 12 of 40 (30%) with no significant association with site, stage, histopathology, immunophenotype, or prognosis. SPFs were highest in abdominal and chest primary sites but were not related to stage. Burkitt's lymphomas had the highest SPFs relative to lymphoblastic (P < .01) and centroblastic lymphomas (P < .05). Significantly higher SPFs were found in B cell than in T cell tumors (P < .001). There was considerable heterogeneity for SPFs within each NHL subgroup. Survival was worse at 5 years for those with high SPFs compared with those with normal SPFs (P = .04). These results suggest that tumor DNA analysis may be useful in the evaluation of children with NHL. Larger studies are needed to define its role as an independent prognostic variable.

  18. Quality of Radiotherapy Reporting in Randomized Controlled Trials of Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma: A Systematic Review

    SciTech Connect

    Bekelman, Justin E. Yahalom, Joachim

    2009-02-01

    Purpose: Standards for the reporting of radiotherapy details in randomized controlled trials (RCTs) are lacking. Although radiotherapy (RT) is an important component of curative therapy for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), we postulated that RT reporting may be inadequate in Phase III HL and NHL trials. Methods and Materials: We searched PubMed and the Cochrane registry for reports of RCTs involving RT and either HL or NHL published between 1998 and 2007. We screened 133 titles and abstracts to identify relevant studies. We included a total of 61 reports. We assessed these reports for the presence of six quality measures: target volume, radiation dose, fractionation, radiation prescription, quality assurance (QA) process use, and adherence to QA (i.e., reporting of major or minor deviations). Results: Of 61 reports, 23 (38%) described the target volume. Of the 42 reports involving involved-field RT alone, only 8 (19%) adequately described the target volume. The radiation dose and fractionation was described in most reports (54 reports [89%] and 39 reports [64%], respectively). Thirteen reports specified the RT prescription point (21%). Only 12 reports (20%) described using a RT QA process, and 7 reports (11%) described adherence to the QA process. Conclusion: Reporting of RT in HL and NHL RCTs is deficient. Because the interpretation, replication, and application of RCT results depend on adequate description and QA of therapeutic interventions, consensus standards for RT reporting should be developed and integrated into the peer-review process.

  19. Prevalence of antineutrophil cytoplasmic antibody positivity in patients with Hodgkin's and non-Hodgkin lymphoma: a single center experience.

    PubMed

    Cil, Timucin; Altintas, Abdullah; Isikdogan, Abdurrahman; Batun, Sabri

    2009-07-01

    Hematological malignancies are associated with the release of different autoantibodies and rheumatological manifestations. Systemic vasculitides are rare in hematological malignancies, and antineutrophil cytoplasmic antibodies (ANCA) have not been described sufficiently in hematological malignancies. In this present prospective study, we examined the prevalence of ANCA and related disease in Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) patients in the southeast region of Turkey. We examined 119 patients with previously or newly diagnosed NHL and 60 patients with HL for the presence of ANCA and related autoimmune diseases between December 2002 and February 2007. ANCA positivity was detected in only 8 patients (4.4%); and all of these ANCA positivities were detected in patients in the HL group (13.3%); p-ANCA positivity was detected in 6 patients (3.3%); and c-ANCA positivity was detected in 2 patients (1.1%). There was statistically significant difference between patients with HL and NHL in terms of p-ANCA (p = 0.001) but none in c-ANCA (p = 0.111) positivity. None of the ANCA positive patients had vasculitides or rheumatic manifestations. In addition, we did not detect any ANCA positivity in the NHL group. In conclusion, ANCA positivities were detected only in HL patients; but we did not detect the association between ANCA positivities and rheumatic manifestations or vasculitis and also the different treatment responses in HL patients.

  20. SB-715992 in Treating Patients With Metastatic or Unresectable Solid Tumors or Hodgkin's or Non-Hodgkin's Lymphoma

    ClinicalTrials.gov

    2013-01-11

    Adult Grade III Lymphomatoid Granulomatosis; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Stage IV Adult Burkitt Lymphoma; Stage IV Adult Diffuse Large Cell Lymphoma; Stage IV Adult Diffuse Mixed Cell Lymphoma; Stage IV Adult Diffuse Small Cleaved Cell Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult Immunoblastic Large Cell Lymphoma; Stage IV Adult Lymphoblastic Lymphoma; Stage IV Grade 1 Follicular Lymphoma; Stage IV Grade 2 Follicular Lymphoma; Stage IV Grade 3 Follicular Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Marginal Zone Lymphoma; Stage IV Small Lymphocytic Lymphoma; Unspecified Adult Solid Tumor, Protocol Specific; Waldenström Macroglobulinemia

  1. Gene expression profiling of microdissected Hodgkin Reed-Sternberg cells correlates with treatment outcome in classical Hodgkin lymphoma.

    PubMed

    Steidl, Christian; Diepstra, Arjan; Lee, Tang; Chan, Fong Chun; Farinha, Pedro; Tan, King; Telenius, Adele; Barclay, Lorena; Shah, Sohrab P; Connors, Joseph M; van den Berg, Anke; Gascoyne, Randy D

    2012-10-25

    In classical Hodgkin lymphoma (CHL), 20%-30% of patients experience relapse or progressive disease after initial treatment. The pathogenesis and biology of treatment failure are still poorly understood, in part because the molecular phenotype of the rare malignant Hodgkin Reed-Sternberg (HRS) cells is difficult to study. Here we examined microdissected HRS cells from 29 CHL patients and 5 CHL-derived cell lines by gene expression profiling. We found significant overlap of HL-specific gene expression in primary HRS cells and HL cell lines, but also differences, including surface receptor signaling pathways. Using integrative analysis tools, we identified target genes with expression levels that significantly correlated with genomic copy-number changes in primary HRS cells. Furthermore, we found a macrophage-like signature in HRS cells that significantly correlated with treatment failure. CSF1R is a representative of this signature, and its expression was significantly associated with progression-free and overall survival in an independent set of 132 patients assessed by mRNA in situ hybridization. A combined score of CSF1R in situ hybridization and CD68 immunohistochemistry was an independent predictor for progression-free survival in multivariate analysis. In summary, our data reveal novel insights into the pathobiology of treatment failure and suggest CSF1R as a drug target of at-risk CHL.

  2. Utility of FDG-PET/CT in follow-up of children treated for Hodgkin and non-Hodgkin lymphoma.

    PubMed

    Rhodes, Melissa M; Delbeke, Dominique; Whitlock, James A; Martin, William; Kuttesch, John F; Frangoul, Haydar A; Shankar, Sadhna

    2006-05-01

    Positron emission tomography using F-flurodeoxyglucose (FDG-PET) is considered an excellent tool for staging and monitoring disease status in adults with lymphoma. We retrospectively reviewed results of PET/CT and diagnostic computed tomography (CT) scans performed during follow-up after completion of therapy in 41 children <18 years of age with Hodgkin lymphoma and non-Hodgkin lymphoma. PET/CT scan with uptake greater than that of the liver was considered positive. Uptake that increased over the background but less than in the liver was equivocal. Clinical outcomes were obtained from medical records. Thirteen (32%) had a positive PET/CT scan and an equal number had equivocal scans in a median follow-up of 2.3 years. Diagnostic CT scans revealed new findings in 13 (32%) and persistent abnormalities in 21 (51%) of the children. Five children developed recurrent disease, and one developed a second cancer. No children with equivocal positivity developed recurrent disease. PET/CT scan was 95% sensitive, with a positive predictive value (PPV) of 53%. Diagnostic CT was 79% sensitive, with a PPV of 52%. We conclude that a negative PET/CT scan during routine follow-up for lymphoma in children strongly suggests absence of recurrence but a positive PET/CT and diagnostic CT scans have low PPV and should be interpreted with caution in this setting.

  3. [New perspectives in oncology: is selective destruction of tumor cells with immunotoxins in Hodgkin's disease an additional therapeutic alternative?].

    PubMed

    Engert, A; Gottstein, C; Winkler, U; Schön, G; Amlot, P; Thorpe, P; Diehl, V

    1992-10-15

    In the present paper, the authors describe the production and testing of immunotoxins for clinical application in Hodgkin's disease. The immunotoxins were constructed by chemical coupling of deglycolysated ricin-A to monoclonal antibodies against antigens on Hodgkin's and Reed-Sternberg cells (CD25, CD30, IRac). The cytotoxic effect of the immunotoxins was investigated in vitro against Hodgkin's and Reed-Sternberg cells (H-RS) and in vivo against solid Hodgkin's tumors in nude mice and disseminated Hodgkin's tumors in SCID mice. Cross-reactivity with normal tissue and the staining behaviour observed in sections of Hodgkin's tissue of various subtypes proved important parameters for the assessment of clinical applicability. Of more than 30 evaluated MoAb's, eight immunotoxins were produced, of which six showed both, cytotoxic effects of considerable potency against Hodgkin's tumor cells and low cross-reactivity with vital human organs. The most effective immunotoxin, RFT5 gamma 1.dgA, (CD25) inhibits the growth of H-RS cells at concentrations of 7 pMol and destroys about 60% of solid Hodgkin's tumors of 0.5 cm in diameter in nude mice. This immunotoxin binds to virtually all tumor cells in more than 90% of patients with Hodgkin's disease. Sufficient quantities of RFT5 gamma 1.dgA were produced for the treatment of patients with refractory Hodgkin's disease. These patients are currently being treated in a phase I clinical trial.

  4. Mimicry of the Hodgkin-associated IRAC antigen by an anti-idiotype network: potential use in active immunotherapy of Hodgkin's lymphoma.

    PubMed

    Schobert, I; Renner, C; Pfreundschuh, M; Diehl, V; Pohl, C

    1994-05-01

    The murine monoclonal antibody anti-IRac, defining a surface-antigen structure (MW 70 kDa) on Hodgkin-Reed-Sternberg and interdigitating reticulum cells, was used to generate a cascade of anti-idiotypic antibodies as well as a cellular immunity against Hodgkin-Reed-Sternberg cells in syngeneic BALB/c-mice. The anti-idiotypic antibody monoclonal antibody 4B4 demonstrated characteristics of an "internal image" or network antibody (Ab2 beta). Ab2 beta 4B4 bound specifically to anti-IRac and inhibited anti-IRac-binding to antigen-bearing cells effectively. 4B4 induced an IRac-specific humoral polyclonal immune response in BALB/c-mice and New Zealand white rabbits as judged by Flow cytometric and histochemical analysis. Moreover, BALB/c-mice immunized with 4B4 showed statistically significant (p > 0.01) delayed-type hypersensitivity reaction against IRac-expressing Hodgkin cell-lines. Ab2 beta 4B4 induced in syngeneic BALB/c mice a monoclonal anti-anti-idiotypic antibody (Ab3) termed 3G10, which mimicked the specificities of Ab1 anti-IRac and thus confirms the internal image nature of Ab2 beta 4B4. The anti-idiotype-induced tumor cell specific T- and B-cell mediated immune response even across species barriers via the Hodgkin related IRac-antigen may play an important part in active specific immunotherapy of Hodgkin's disease.

  5. Management of Non-Hodgkin Lymphoma: ICMR Consensus Document.

    PubMed

    Thacker, Nirav; Bakhshi, Sameer; Chinnaswamy, Girish; Vora, Tushar; Prasad, Maya; Bansal, Deepak; Agarwala, Sandeep; Kapoor, Gauri; Radhakrishnan, Venkatraman; Laskar, Siddharth; Kaur, Tanvir; Rath, G K; Dhaliwal, Rupinder Singh; Arora, Brijesh

    2017-04-05

    Hitherto poor outcomes, paucity of data and heterogeneity in International approach to Pediatric NHL (Non-Hodgkin Lymphoma) prompted the need for guidelines for Indian population with vast variability in access, affordability and infrastructure across the country. These guidelines are based on consensus among the experts and best available evidence applicable to Indian setting. Evaluation of NHL should consist of easily doable and rapid tissue diagnosis (biopsy or flow cytometry of peripheral blood/malignant effusions), St Jude/IPNHLSS (International Pediatric Non-Hodgkin Lymphoma Staging System) and risk grouping with CSF (Cerebro-spinal fluid), bone marrow, whole body imaging [CECT (Contrast enhanced computerized tomography) ± MRI (Magnetic resonance imaging)] and blood investigations for LDH (Lactate dehydrogenase), TLS (Tumor lysis syndrome) and organ functions. Life threatening complications like SVCS (Superior vena cava syndrome)/Mediastinal syndrome and TLS need to pre-empted and promptly managed. All children with poor general condition, co-morbidities, metabolic or obstructive complications should receive a steroid or chemotherapy pro-phase first. For mature B-NHL (B cell - Non-Hodgkin lymphoma), in centres with good infrastructure and methotrexate levels, FAB-LMB-96 (French-American-British/Lymphomes Malins B) or BFM (Berlin-Frankfurt-Münster)-NHL-95 protocols may be used. In centres with limited infrastructure and/or no methotrexate levels; CHOP (Cyclophosphamide-hydroxydaunomycin-oncovin-prednisolone) (early stage) or MCP (Multi-centre protocol)-842 [all stages except CNS (Central nervous system) disease] may be used. Patients with poor early response should have escalated therapy. High-Risk B-NHL will benefit with addition of Rituximab to standard chemotherapy. Radiotherapy (RT) is not warranted. For lymphoblastic lymphoma, in centres with good infrastructure and methotrexate levels, BFM-95 protocol may be used. In centres with limited

  6. Second malignancies after Hodgkin's disease: the Munich experience.

    PubMed

    Munker, R; Grützner, S; Hiller, E; Aydemir, U; Enne, W; Dietzfelbinger, H; Busch, M; Haas, R; Emmerich, B; Schmidt, M; Dühmke, E; Hölzel, D; Wilmanns, W

    1999-12-01

    The occurrence of second malignancies (SM) is an important late event following the treatment of Hodgkin's disease (HD). We sought to determine the incidence, the risk factors, and the prognosis of SM in our population of patients with HD. A total of 1120 patients diagnosed with HD were registered at six participating institutions in Munich (calendar period 1974-1994). The mean follow-up for the development of SM was 9.1 years. A cumulative treatment score was calculated for both radio- and chemotherapy. The relative and absolute risks of SM were established. All SM were investigated for response to treatment and outcome. We observed 85 SM [eight leukemias, 22 non-Hodgkin's lymphomas (NHL), two plasma cell neoplasias, and 53 solid tumors]. Five patients developed third malignancies. The relative risk of developing a second neoplasm was compared with that within the normal population and was 3.1-fold. The risk varied according to the category of SM. Higher relative risks (20.5 and 25.9-fold), but lower absolute risks were observed for leukemias and non-Hodgkin's lymphomas. Solid tumors had lower relative risks (1.8-fold). Splenectomy increased the risk of SM (relative risk 4.4-fold versus 2.7-fold). The risk of SM did not correlate with the initial treatment (radio- or chemotherapy) and did not decrease with prolonged follow-up. The cumulative intensity of radiotherapy, chemotherapy, or the two modalities combined correlated with the risk of SM. Since some cases occurred early after diagnosis, not all second neoplasms can be considered treatment-associated. After 15 years, an actuarial risk of 11.7% was calculated for all SM, of 1.0% for leukemias, of 3.0% for NHL, and of 7.7% for solid tumors. The prognosis of SM varied between good (thyroid cancer, melanoma: median survival 5+ years), average (breast cancer, NHL), and poor (acute myeloid leukemias, lung cancers: median survival 9 months). With the exception of NHL, second cancers often occurred in topographic

  7. Late Effects May Not Warrant Using Radiation to Treat Early-Stage Hodgkin Lymphoma

    Cancer.gov

    Patients with early-stage Hodgkin lymphoma who were treated with multidrug chemotherapy alone were more likely to be alive 12 years later than patients who received treatment that included radiation therapy, according to findings from a clinical trial.

  8. What Are the Risk Factors for Non-Hodgkin Lymphoma in Children?

    MedlinePlus

    ... known risk factors that can be changed. Age, gender, and race Non-Hodgkin lymphoma is rare in ... than in black children. The reasons for these gender and racial differences are not known. Having a ...

  9. Microenvironment-related biomarkers and novel targets in classical Hodgkin's lymphoma.

    PubMed

    Carlo-Stella, Carmelo; Santoro, Armando

    2015-01-01

    Classical Hodgkin's lymphoma accounts for approximately 10% of all malignant lymphomas. Although most patients can be cured with modern treatment strategies, approximately 25% of them experience either primary or secondary chemorefractoriness or disease relapse, thus requiring novel treatments. Increasing preclinical and clinical evidences have demonstrated the role of microenvironment in the molecular pathogenesis of classical Hodgkin's lymphoma and elucidated the complex cross-talk between the malignant Hodgkin Reed-Sternberg cells and the nonmalignant, reactive cells of the microenvironment, strongly supporting novel therapeutic approaches aimed at targeting Hodgkin's Reed-Sternberg cells along with reactive cells in order to overcome chemorefractoriness. In the near future, these novel therapies will also be tested in chemosensitive patients to reduce long-term toxicities of chemo-radiotherapy.

  10. Case report of non-Hodgkin's lymphoma involving the lacrimal glands demonstrated by computed tomography

    SciTech Connect

    Kniskern, J.A.; Hart, K.; Decker, D.A.; Harris, J.H.

    1981-12-15

    A case of bilateral lacrimal gland infiltration by diffuse, mixed histiocytic-lymphocytic lymphoma demonstrated by computed tomography is reported. Non-Hodgkin's lymphomatous involvement of the lacrimal gland is uncommon. Computed tomography provides precise delineation of perioccular neoplasia.

  11. Detection of Epstein-Barr virus genomes in Hodgkin's disease: relation to age.

    PubMed Central

    Jarrett, R F; Gallagher, A; Jones, D B; Alexander, F E; Krajewski, A S; Kelsey, A; Adams, J; Angus, B; Gledhill, S; Wright, D H

    1991-01-01

    An investigation as to whether any particular subgroup of patients with Hodgkin's disease was particularly likely to be Epstein-Barr virus (EBV) genome positive was made on samples from 95 patients. These were grouped according to age and Hodgkin's disease subtype, and analysed using Southern blot analysis. Most samples from children or adults aged 50 years or over contained detectable EBV genomes; samples from young adults were only rarely positive. The differences in EBV positivity by age were highly significant, but there was no significant association between EBV and histological subtype after allowing for the effect of age. The results support the hypothesis that Hodgkin's disease in different age groups may have different aetiologies, and suggest that EBV does have a pathogenetic role in Hodgkin's disease in children and older age groups. Images PMID:1660054

  12. Late Effects May Not Warrant Using Radiation to Treat Early-Stage Hodgkin Lymphoma

    Cancer.gov

    Patients with early-stage Hodgkin lymphoma who were treated with multidrug chemotherapy alone were more likely to be alive 12 years later than patients who received treatment that included radiation therapy, according to findings from a clinical trial.

  13. Gene Therapy and Combination Chemotherapy in Treating Patients With AIDS-Related Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-02-23

    AIDS-Related Burkitt Lymphoma; AIDS-Related Diffuse Large B-cell Lymphoma; AIDS-Related Plasmablastic Lymphoma; AIDS-Related Primary Effusion Lymphoma; HIV Infection; AIDS Related Non-Hodgkin Lymphoma

  14. Immunotherapy After Chemotherapy in Treating Patients With Relapsed or Refractory B Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-10-06

    CD20 Positive; Recurrent B-Cell Non-Hodgkin Lymphoma; Recurrent Chronic Lymphocytic Leukemia; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Follicular Lymphoma; Recurrent Lymphoplasmacytic Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Refractory B-Cell Non-Hodgkin Lymphoma; Refractory Transformed Indolent Lymphoma; Refractory Diffuse Large B-Cell Lymphoma; Refractory Follicular Lymphoma; Refractory Lymphoplasmacytic Lymphoma; Refractory Mantle Cell Lymphoma

  15. Lenalidomide and Blinatumomab in Treating Patients With Relapsed Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2017-09-12

    B-Cell Lymphoma, Unclassifiable, With Features Intermediate Between Diffuse Large B-Cell Lymphoma and Classical Hodgkin Lymphoma; CD19 Positive; Mediastinal Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Diffuse Large B-Cell Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Non-Hodgkin Lymphoma; Recurrent Small Lymphocytic Lymphoma

  16. Primary non-Hodgkin's lymphoma of the lumbar vertebrae mimicking tuberculous spondylitis: a case report.

    PubMed

    Huang, Bo; Li, Chang-Qing; Liu, Tao; Zhou, Yue

    2009-12-01

    Primary non-Hodgkin lymphoma (PHL) of the spine is very rare. A case of a 44-year-old patient with PHL originating from a single lumbar vertebra was initially misdiagnosed as tuberculous spondylitis. After surgical decompression and biopsy, the patient was confirmed as primary B-cell non-Hodgkin lymphoma of the lumbar vertebrae and was further treated with chemotherapy. It warrants attention that PHL from the spine may be misdiagnosed as tuberculous spondylitis.

  17. [ABVD chemotherapy for Hodgkin lymphoma at a single institute].

    PubMed

    Ohshima, Rika; Motomura, Shigeki; Hashimoto, Chizuko; Miyazaki, Takuya; Ito, Satomi; Takasaki, Hirotaka; Hyo, Rie; Koharazawa, Hideyuki; Takemura, Sachiya; Yamazaki, Etsuko; Fujimaki, Katsumichi; Tomita, Naoto; Fujita, Hiroyuki; Fujisawa, Shin; Harano, Hiroshi; Kanamori, Heiwa; Ishigatsubo, Yoshiaki

    2010-12-01

    Fifty-eight newly diagnosed patients with Hodgkin lymphoma were treated with ABVD chemotherapy at Yokohama City University Hematology group from October 1996 to June 2005. The median age of patients age was 41 years old and ranged from 15 to 75. Thirty-eight patients were in the early stage and 20 patients were in the advanced stage. Patients in the early stage received 3 cycles of ABVD chemotherapy and involved-field radiation therapy, while those in the advanced stage received 6 cycles of ABVD chemotherapy. The overall response rate in patients was 100% (CR 87%, PR 13%) in the early stage and 95% in the advanced stage. With a median follow-up of 44 months, the 3-year progression-free survival and overall survival were 89% and 95% in the early stage, and 70% and 81% in the advanced stage, respectively. The results of this study were similar to those previously reported in Western countries.

  18. The evolving role of radiation therapy in pediatric Hodgkin's disease.

    PubMed

    Fredman, Elisha; Mansur, David B; Russo, Suzanne

    2016-06-01

    Identifying the optimal treatment of pediatric Hodgkin's disease has been at the forefront of clinical investigation in recent years. Results of a number of large clinical trials have driven paradigm shifts in how physicians approach this often curable disease. In an effort to balance the goals of maximizing survival while minimizing acute toxicities and late complications, the recommended indications, targets, doses and schedules of chemotherapy and radiation have and continue to evolve. Recent attempts to decrease the total volume of tissue receiving radiation without requiring a significant escalation in cytotoxic chemotherapy have shown promise in low, intermediate and high risk patients. Utilizing risk-adapted, response-based treatment, researchers hope to uncover a subpopulation that may not require previously considered standard treatment modalities.

  19. Marathon of eponyms: 8 Hodgkin disease or lymphoma.

    PubMed

    Scully, C; Langdon, J; Evans, J

    2010-03-01

    The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in diseases of the head and neck is found mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This document summarizes data about Hodgkin disease.

  20. Tsukamurella inchonensis infection in a child with Hodgkin's lymphoma.

    PubMed

    Ochi, Fumihiro; Tauchi, Hisamichi; Moritani, Kyoko; Miyamoto, Hitoshi; Ohkusu, Kiyofumi; Ishii, Eiichi

    2015-01-01

    Tsukamurella spp. infection is a rare but important cause of bacteremia in immunocompromised patients. The organism is an aerobic, Gram-positive, weakly acid-fast bacillus that is difficult to differentiate from other aerobic Actinomycetales by standard laboratory methods. Here, we report on the case of a 14-year-old patient with Hodgkin's lymphoma who, after intensive chemotherapy, developed Tsukamurella inchonensis bacteremia, which was identified on the peripherally inserted central venous catheter (PICC) using 16S rRNA sequencing analysis. The bacteremia was successfully controlled with antimicrobial therapy and subsequent removal of the PICC. This is the first report of bacteremia by Tsukamurella inchonensis in immunocompromised children. Careful observation and prompt analysis of opportunistic infection, including Tsukamurella spp., is very important in immunocompromised children. © 2015 Japan Pediatric Society.

  1. Thyroid function after mantle irradiation in Hodgkin's disease

    SciTech Connect

    Smith, R.E. Jr.; Adler, R.A.; Clark, P.; Brinck-Johnsen, T.; Tulloh, M.E.; Colten, T.

    1981-01-02

    The thyroid function of 64 patients with Hodgkin's disease who received mantle irradiation during the period 1966 to 1976 was studied. More than two-thirds (44 to 64) had some thyroid dysfunction. Twenty had mild dysfunction manifested by an abnormal thyroid-stimulating hormone response to thyrotropin-releasing hormone. Twenty had what could be termed compensated hypothyroidism while four were overtly hypothyroid. The severity of dysfunction was not related to age, sex, or chemotherapy. We found, however, that decreased thyroid function was inversely proportional to the length of time between a diagnostic lymphangiogram and the radiation therapy. These results are consistent with the hypothesis that the iodine load of the lymphangiogram renders the thyroid gland more radiosensitive. Thyroxine suppression of the thyroid gland during the period from the lymphangiogram through the termination of radiation therapy is suggested as a means of avoiding thyroid injury.

  2. Combating the epigenome: epigenetic drugs against non-Hodgkin's lymphoma.

    PubMed

    Hassler, Melanie R; Schiefer, Ana-Iris; Egger, Gerda

    2013-08-01

    Non-Hodgkin's lymphomas (NHLs) comprise a large and diverse group of neoplasms of lymphocyte origin with heterogeneous molecular features and clinical manifestations. Current therapies are based on standard chemotherapy, immunotherapy, radiation or stem cell transplantation. The discovery of recurrent mutations in epigenetic enzymes, such as chromatin modifiers and DNA methyltransferases, has provided researchers with a rationale to develop novel inhibitors targeting these enzymes. Several clinical and preclinical studies have demonstrated the efficacy of epigenetic drugs in NHL therapy and a few specific inhibitors have already been approved for clinical use. Here, we provide an overview of current NHL classification and a review of the present literature describing epigenetic alterations in NHL, including a summary of different epigenetic drugs, and their use in preclinical and clinical studies.

  3. Langerhans cell histiocytosis followed by hodgkin lymphoma: a case report.

    PubMed

    Safaei, Akbar; Bagheri, Mandana; Shahryari, Jahanbanoo; Noori, Sadat; Esmailzade, Elmira

    2015-05-01

    Langerhans cell histiocytosis (LCH) is a rare neoplasm defined as the proliferation of bone marrow langerhans cells, which is a kind of dendritic cells. The major pathological features of LCH are expression of CD1a and S100 as well as Birbeck granules. Its presentation can differ from a mild bone lesion to a multi-systemic evolved malignant neoplasm; however, the latter outcome is almost rare. Thus, LCH is mostly known as a benign neoplasm. In this study, we present a case of LCH followed by Hodgkin lymphoma (HL). Accompaniment of this disease with malignant lymphoma is rare and considered as case report. Several cases in which malignant lymphoma occurred prior to LCH are reported; however, few cases can be found with LCH followed by malignant lymphomas.

  4. Cardiac Tamponade as Initial Presentation of Hodgkin Lymphoma

    PubMed Central

    Hajra, Adrija; Bandyopadhyay, Dhrubajyoti; Layek, Manas; Mukhopadhyay, Sabyasachi

    2015-01-01

    Cardiac involvement in malignant lymphoma is one of the least investigated subjects. Pericardial effusion is rarely symptomatic in patients of Hodgkin lymphoma (HL). Few case reports are available in the literature. There are case reports of diagnosed HL patients presenting with pericardial effusion. HL patients who present with recurrent episodes of pericardial effusion have also been reported. Pericardial effusion has also been reported in cases of non HL. However, pericardial effusion leading to cardiac tamponade as an initial presentation of HL is extremely rare. Very few such cases are there in the literature. Here, we present a case of a 26-year-old male patient who presented with cardiac tamponade and in due course was found to be a case of classical type of HL. This case is interesting because of its presentation. PMID:26900491

  5. Hodgkin lymphoma: Late effects of treatment and guidelines for surveillance.

    PubMed

    Ng, Andrea K; van Leeuwen, Flora E

    2016-07-01

    Long-term survivors of Hodgkin lymphoma (HL) are at risk for a range of late effects, with second malignant neoplasm and cardiovascular diseases being the leading causes of death in these patients. The excess risks remain significantly elevated decades after treatment, and are clearly associated with extent of treatment exposures. Other late effects have also been identified, such as pulmonary dysfunction, endocrinopathies, muscle atrophy, and persistent fatigue. Systemic documentation of late effects and recognition of treatment- and patient-related risk factors are important, as they inform optimal surveillance and risk-reduction strategies, as well as guide therapeutic modifications in newly diagnosed patients to minimize treatment-related complications. As HL therapy evolves over time, with adoption of novel agents and contemporary treatment techniques, late effect risks and follow-up recommendations need to be continuously updated. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Edge detection based on Hodgkin-Huxley neuron model simulation.

    PubMed

    Yedjour, Hayat; Meftah, Boudjelal; Lézoray, Olivier; Benyettou, Abdelkader

    2017-04-03

    In this paper, we propose a spiking neural network model for edge detection in images. The proposed model is biologically inspired by the mechanisms employed by natural vision systems, more specifically by the biologically fulfilled function of simple cells of the human primary visual cortex that are selective for orientation. Several aspects are studied in this model according to three characteristics: feedforward spiking neural structure; conductance-based model of the Hodgkin-Huxley neuron and Gabor receptive fields structure. A visualized map is generated using the firing rate of neurons representing the orientation map of the visual cortex area. We have simulated the proposed model on different images. Successful computer simulation results are obtained. For comparison, we have chosen five methods for edge detection. We finally evaluate and compare the performances of our model toward contour detection using a public dataset of natural images with associated contour ground truths. Experimental results show the ability and high performance of the proposed network model.

  7. Hodgkin-Huxley neurons with defective and blocked ion channels

    NASA Astrophysics Data System (ADS)

    Pang, James Christopher S.; Bantang, Johnrob Y.

    2015-03-01

    We utilize the original Hodgkin-Huxley (HH) model to consider the effects of defective ion channels to the temporal response of neurons. Statistics of firing rate and inter-spike interval (ISI) reveal that production of action potentials (APs) in neurons is not sensitive to changes in membrane conductance for sodium and potassium ions, as well as to the reversal potential for sodium ions, as long as the relevant parameters do not exceed 13% from their normal levels. We also found that blockage of a critical fraction of either sodium or potassium channels (dependent on constant input current) respectively limits the firing activity or increases spontaneous spiking activity of neurons. Our model may be used to guide experiment designs related to ion channel control drug development.

  8. SEOM clinical guidelines for the treatment of Hodgkin's lymphoma.

    PubMed

    Rueda Domínguez, A; Alfaro Lizaso, J; de la Cruz Merino, L; Gumá I Padró, J; Quero Blanco, C; Gómez Codina, J; Llanos Muñoz, M; Martinez Banaclocha, N; Rodriguez Abreu, D; Provencio Pulla, M

    2015-12-01

    Hodgkin lymphoma (HL) is an uncommon B cell lymphoid malignancy representing approximately 10-15 % of all lymphomas. HL is composed of two distinct disease entities; the more commonly diagnosed classical HL and the rare nodular lymphocyte-predominant HL. An accurate assessment of the stage of disease and prognostic factors that identify patients at low or high risk for recurrence are used to optimize therapy. Patients with early stage disease are treated with combined modality strategies using abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, while those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. Brentuximab vedotin should be considered for patients who fail HDCT with ASCT.

  9. Coronary heart disease mortality after irradiation for Hodgkin's disease

    SciTech Connect

    Boivin, J.F.; Hutchison, G.B.

    1982-01-01

    The authors conducted a study designed to evaluate the hypothesis that irradiation to the heart in the treatment for Hodgkin's disease (HD) is associated with increased coronary heart disease (CHD) mortality. This report describes 957 patients diagnosed with HD in 1942-75 and analyzes follow-up findings through December 1977. Twenty-five coronary heart disease deaths have been observed, and 4258.2 person-years of experience at risk have been accrued. The relative death rate (RDR), defined as the CHD mortality for heart-irradiated subjects divided by the mortality for nonirradiated subjects, was estimated. After adjustment for the effect of interval of observation, age, stage, and class, the RDR estimate is 1.5 but does not differ significantly from unit (95% confidence limits: 0.59, 3.7).

  10. Multivariate analysis of prognostic factors in early stage Hodgkin's disease

    SciTech Connect

    Tubiana, M.; Henry-Amar, M.; van der Werf-Messing, B.; Henry, J.; Abbatucci, J.; Burgers, M.; Hayat, M.; Somers, R.; Laugier, A.; Carde, P.

    1985-01-01

    A multivariate analysis of the prognostic factors was carried out with a Cox model on 1,139 patients with clinical Stage I + II Hodgkin's disease included in three controlled clinical trials. The following indicators had been prospectively registered: aged, sex, systemic symptoms, erythrocyte sedimentation, results of staging laparotomy when performed, as well as the date and type of treatment. A linear logistic analysis showed that most of the indicators are interrelated. This emphasizes the necessity of a multivariate analysis in order to assess the independent influence of each of them. The two main prognostic indicators for relapse-free survival are systemic symptoms and/or ESR and number of involved areas. The only significant factor for survival after relapse is age. Sex has a small but significant influence on relapse-free survival. The relative influence of each indicator varies with the type of treatment and these variations may help in understanding the biologic significance of the indicators.

  11. Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion.

    PubMed

    Pereira, Débora Lima; Fernandes, Diego Tetzner; Santos-Silva, Alan Roger; Vargas, Pablo Agustin; de Almeida, Oslei Paes; Lopes, Márcio Ajudarte

    2015-10-01

    Non-Hodgkin lymphomas are a group of disorders involving malignant monoclonal proliferation of lymphoid cells, which appear at extranodal sites in approximately 40% of the cases, particularly in the gastrointestinal tract. Intraosseous lymphomas of the head and neck region are extremely rare and can mimic other diseases such as periodontitis or periapical pathologies. This report presents an additional case of intraosseous lymphoma that was previously misdiagnosed as periapical disease. In addition, a literature review was made based on PubMed, and all cases of periapical lymphoma were analyzed. After the diagnosis of lymphoma, the current patient was treated with 6 cycles of chemotherapy and showed satisfactory outcome. The literature review displayed 29 cases of lymphoma affecting the periapical region, and in 51.7% of them endodontic treatment was performed previously to the diagnosis of lymphoma. Although lymphoma is uncommon in the oral cavity, some symptoms can assist the dentist to suspect malignant conditions, mainly in cases presenting numb chin syndrome.

  12. Non-Hodgkin lymphoma response evaluation with MRI texture classification

    PubMed Central

    Harrison, Lara CV; Luukkaala, Tiina; Pertovaara, Hannu; Saarinen, Tuomas O; Heinonen, Tomi T; Järvenpää, Ritva; Soimakallio, Seppo; Kellokumpu-Lehtinen, Pirkko-Liisa I; Eskola, Hannu J; Dastidar, Prasun

    2009-01-01

    Background To show magnetic resonance imaging (MRI) texture appearance change in non-Hodgkin lymphoma (NHL) during treatment with response controlled by quantitative volume analysis. Methods A total of 19 patients having NHL with an evaluable lymphoma lesion were scanned at three imaging timepoints with 1.5T device during clinical treatment evaluation. Texture characteristics of images were analyzed and classified with MaZda application and statistical tests. Results NHL tissue MRI texture imaged before treatment and under chemotherapy was classified within several subgroups, showing best discrimination with 96% correct classification in non-linear discriminant analysis of T2-weighted images. Texture parameters of MRI data were successfully tested with statistical tests to assess the impact of the separability of the parameters in evaluating chemotherapy response in lymphoma tissue. Conclusion Texture characteristics of MRI data were classified successfully; this proved texture analysis to be potential quantitative means of representing lymphoma tissue changes during chemotherapy response monitoring. PMID:19545438

  13. Metabolic susceptibility to agricultural pesticides and non-Hodgkin's lymphoma.

    PubMed

    Schroeder, Jane C

    2005-01-01

    Epidemiologic studies have failed to establish clearly whether agricultural pesticides contribute to the genesis of non-Hodgkin's lymphoma (NHL). Discordant results may be related to variation in susceptibility factors, including metabolism gene polymorphisms that might influence lymphocyte exposures to active pesticide metabolites. Associations between NHL and polymorphisms that may be relevant to pesticide metabolism have been assessed, including CYP1A1 and glutathione S-transferase variants, but the results are not highly informative because estimates were based on small numbers and convenience samples of cases and controls. Butyrylcholinesterase and paraoxonase (PON1) enzyme variants associated with altered activity and acute organophosphate toxicity are strong candidate susceptibility factors for pesticides and NHL, but others may be identified as knowledge of pesticide metabolism and relevant polymorphisms improves. Studies of metabolic susceptibility must be large and include information on specific exposures and subtypes of NHL for results to further the understanding of the relation between agricultural pesticides and NHL.

  14. Non-Hodgkin's lymphoma associated with Gaucher's disease.

    PubMed

    Perales, M; Cervantes, F; Cobo, F; Montserrat, E

    1998-11-01

    Gaucher's disease is an uncommon disorder which has been reported to be associated with an increased risk of lymphoproliferative disorders, including Non-Hodgkin's lymphoma (NHL). A new instance of such an association is described here. This was a 58 year-old-patient with adult type I Gaucher's disease who, one and a half year after the above diagnosis, presented with supraclavicular lymphadenopathy, massive splenomegaly, prominent retroperitoneal lymphadenopathy and increased serum LDH levels. This led to the diagnosis of large-cell NHL of B-cell type, successfully treated with chemotherapy. The previously published cases of Gaucher's disease associated with NHL as well as the possible mechanisms leading to this association are reviewed here.

  15. Hodgkin's disease: case control epidemiological study in Yorkshire.

    PubMed Central

    Bernard, S. M.; Cartwright, R. A.; Darwin, C. M.; Richards, I. D.; Roberts, B.; O'Brien, C.; Bird, C. C.

    1987-01-01

    This is the first report of a case-control epidemiological study on lymphomas and leukaemias occurring in Yorkshire during 1979-84. This paper deals with the results of the Hodgkin's disease analysis comprising 248 cases and 489 controls. The results indicate support for previous work with respect to small family size and past history of infectious mononucleosis. Positive observations made in a previous pilot study are also confirmed and extended with respect to associations with certain chronic skin lesions, dental anaesthesia and familial factors. Negative associations are described with respect to X-ray exposures and cigarette smoking. It is proposed that these results fit into a general hypothesis that these conditions are the result of interaction between infectious agents and altered immunity in those persons genetically predisposed. PMID:3814482

  16. Hodgkin's disease: case control epidemiological study in Yorkshire.

    PubMed

    Bernard, S M; Cartwright, R A; Darwin, C M; Richards, I D; Roberts, B; O'Brien, C; Bird, C C

    1987-01-01

    This is the first report of a case-control epidemiological study on lymphomas and leukaemias occurring in Yorkshire during 1979-84. This paper deals with the results of the Hodgkin's disease analysis comprising 248 cases and 489 controls. The results indicate support for previous work with respect to small family size and past history of infectious mononucleosis. Positive observations made in a previous pilot study are also confirmed and extended with respect to associations with certain chronic skin lesions, dental anaesthesia and familial factors. Negative associations are described with respect to X-ray exposures and cigarette smoking. It is proposed that these results fit into a general hypothesis that these conditions are the result of interaction between infectious agents and altered immunity in those persons genetically predisposed.

  17. A rare presentation of central nervous system in a pediatric patient with Hodgkin disease: cavernous sinus syndrome.

    PubMed

    Alioglu, Bulent; Ustun, Huseyin; Sonmez, Akif; Kaplan, Hacer; Arikan, Fatma Inci; Dallar, Yildiz

    2009-10-01

    Intracranial involvement by Hodgkin disease is rare. We report a pediatric patient with Hodgkin disease who had intracranial disease at presentation. The patient was referred to our hospital with a suspicion of central nervous system tumor. Although the most common presenting feature of intracranial Hodgkin disease is cranial nerve palsy with brain parenchyma being the most common intracranial site of involvement, to our best knowledge no pediatric case of Hodgkin disease presented with isolated cavernous sinus syndrome reported. We report this rare case because of its unusual presentation, in which Hodgkin disease presented with cavernous sinus syndrome. Physicians should consider the probability of Hodgkin disease in children of all ages who present with cavernous sinus syndrome.

  18. Weight Changes In Patients With Hodgkin Lymphoma Following Treatment: Experience From A Cancer Hospital.

    PubMed

    Ali, Jamshed; Siddiqui, Neelam; Hameed, Abdul

    2016-01-01

    Some recent studies have suggested that patients with Hodgkin lymphoma who undergo remission following treatment are likely to experience significant weight gain and may become overweight or obese. The association between treatment for Hodgkin lymphoma and subsequent weight gain has not been explored in Pakistan. We undertook a review of weight changes in adult Hodgkin lymphoma patients who received treatment at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. In this longitudinal study, we collected and analysed secondary data including adult patients who received treatment for Hodgkin lymphoma at our institute from January 2010 till December 2013. We retrospectively noted baseline demographic, clinical characteristics, details about treatment received and change in weight from baseline at start of treatment to 6, 12, and 18 months after start of treatment. A total of 470 patients registered for Hodgkin lymphoma at our centre. Data were available for 402 patients who were included in this study. Progressive increase in weight was observed in patients after treatment. The mean weight gain from the start of treatment to 6, 12, and 18 months was 3.1 kg, 7.1 kg, and 9.5 kg, respectively. Weight gain was not significantly associated with age or sex of patients. Weight gain was significantly associated with higher stages of cancer, response to treatment and B symptoms. The evaluation of Hodgkin lymphoma patients after treatment demonstrated considerable tendency for weight gain. Further work is warranted to explore this association and its impact on HL survivors.

  19. Current developments in the treatment of early-stage classical Hodgkin lymphoma.

    PubMed

    Borchmann, Sven; von Tresckow, Bastian; Engert, Andreas

    2016-09-01

    After presenting the current treatment recommendations for early-stage Hodgkin lymphoma, we give an overview on recently published clinical trials in this setting. Furthermore, the potential influence of current trials on the treatment of early-stage Hodgkin lymphoma and integration of newly emerging drugs into treatment protocols will be discussed. Trials attempting treatment de-escalation and omission of radiotherapy on the basis of early interim PET-scans have been disappointing so far, but results of some large trials employing this strategy are still awaited. In contrast, a more defensive strategy of starting treatment with less aggressive doxorubicine, bleomycin, vinblastine, dacarbazine (ABVD) chemotherapy and intensifying treatment in early interim PET-positive patients has shown encouraging results. New drugs such as brentuximab vedotin and immune checkpoint inhibitors have shown promising results in relapsed and refractory Hodgkin lymphoma. Clinical trials of brentuximab vedotin in early-stage Hodgkin lymphoma have been initiated. Additionally, biomarker-based treatment de-escalation might be a possible route for future improvements. The challenge for future clinical research in early-stage Hodgkin lymphoma is to continue to cure the majority of patients with first-line treatment while reducing long-term toxicity. New strategies to achieve that goal are currently being developed and will further refine treatment of early-stage Hodgkin lymphoma.

  20. The significance of abnormal circulating cells in patients with Hodgkin's disease.

    PubMed

    Schiffer, C A; Levi, J A; Wiernik, P H

    1975-10-01

    Buffy coat preparations of peripheral blood from two patients with Stage IVB Hodgkin's disease, 33 patients with Hodgkin's disease undergoing complete staging including laparotomy, 12 normal controls and eight patients with viral upper respiratory infections were examined for the presence of abnormal cells. Primitive histiocytic cells were seen in the two patients with IVB disease and in two patients with IIIB disease all of whom proved to be refractory to chemotherapy. Reed-Sternberg cells were seen in one IVB patient. Large cells with basophilic, agranular cytoplasm and moderately convoluted nuclei often with a perinuclear halo and nucleoli were detected in 30 of 35 patients with Hodgkin's disease, five of eight patients with viral infections but in none of 12 normal controls. Other abnormal large cells with round nuclei, occasional prominent nucleoli, grey to lightly eosinophilic cytoplasm and diffuse granulation were seen almost exclusively in Hodgkin's disease. There was no correlation between histology, stage, splenic involvement, skin test positivity and response to therapy with the presence or frequency of either of these cell types. This observation suggests that these cells are more likely to be 'reactive' rather than malignant. It is unusual for abnormal histiocytic cells to circulate in Hodgkin's disease and their presence may be a poor prognostic sign. The presence of other types of large atypical cells is not indicative of either haematogenous spread of Hodgkin's disease or of poor prognosis after treatment with radiotherapy alone.

  1. Second lymphoid malignant neoplasms occurring in patients treated for Hodgkin's disease

    SciTech Connect

    Armitage, J.O.; Dick, F.R.; Goeken, J.A.; Foucar, M.K.; Gingrich, R.D.

    1983-03-01

    Patients who have been treated for Hodgkin's disease are at increased risk for second malignant neoplasms, particularly acute nonlymphoblastic leukemia and non-Hodgkin's lymphoid malignant neoplasms (NHLMs). We diagnosed five cases of NHLM in 242 patients initially treated for Hodgkin's disease between 1973 and 1980, giving a minimum incidence for this occurrence of 2.1%. The initial therapy for Hodgkin's disease, irradiation in three patients and chemotherapy in two patients, resulted in a complete remission in each case. The NHLM appeared 12, 13, 26, 30, and 54 months after the diagnosis of Hodgkin's disease. The cell type of NHLM and immunologic phenotype were as follows: large cell, immunoblastic T; large cell, immunoblastic null; large cell, cleaved and noncleaved B; large cell, cleaved and noncleaved (not studied); and lymphoblastic T. A review of 24 other cases of NHLMs, occurring in patients treated for Hodgkin's disease, reported in the literature, confirm the morphologic and immunologic heterogeneity. The poor response to therapy in our patients and those previously described demonstrate the seriousness of this phenomenon.

  2. Role of mast cells in fibrosis of classical Hodgkin lymphoma.

    PubMed

    Nakayama, Shoko; Yokote, Taiji; Hiraoka, Nobuya; Nishiwaki, Uta; Hanafusa, Toshiaki; Nishimura, Yasuichiro; Tsuji, Motomu

    2016-12-01

    The underlying mechanism of fibrosis in classical Hodgkin lymphoma (CHL) remains uncertain. This study aimed to investigate the association of fibrosis in the lymph nodes of patients with CHL through histological examination of the expression of cytokines associated with fibrosis and mast cell proliferation. Additionally, we sought to determine the degree of mast cell infiltration in a nodular sclerosis subtype of CHL (NSCHL) compared with that in non-NSCHL. We analyzed lymph nodes from 22 patients with CHL, of which eight were of the NSCHL and 14 of the non-NSCHL subtype, using immunohistochemical staining of forkhead box P3 (FOXP3), transforming growth factor (TGF)-β, interleukin (IL)-3, IL-13, and stem cell factor (SCF). Mast cells were positive for TGF-β and IL-13, and FOXP3-positive cells were negative for TGF-β. Only the expression of IL-13 in Hodgkin and Reed-Sternberg (HRS) cells was significantly more frequently observed in NSCHL than that in non-NSCHL (P = 0.0028) and was associated with a higher rate of fibrosis (P = 0.0097). The number of mast cells was significantly higher in NSCHL than that in non-NSCHL (P = 0.0001). A significantly positive correlation was observed between the rate of fibrosis and the number of mast cells (correlation coefficient, 0.8524; 95% CI, 0.6725-0.9372) (P <0.0001). The number of mast cells was significantly higher in the group with IL-13-positive HRS cells than that in the group with IL-13-negative HRS cells (P = 0.0157). Based on these findings, we hypothesize that IL-13 production by HRS cells may lead to fibrosis, and furthermore, promote mast cell proliferation and infiltration. This in turn might further produce the fibrotic cytokines IL-13 and TGF-β, resulting in fibrosis typical of NSCHL.

  3. The composite lymphoma: chronic lymphocytic leukemia--classic Hodgkin's lymphoma.

    PubMed

    Badea, M; Dobrea, Camelia; Badea, Daniela; Genunche-Dumitrescu, Amelia; Mitruţ, P; Duţă, Doriana

    2010-01-01

    The composite lymphoma (CL) is defined by the presence in the same tissue or organ of two distinct histological aspects of non-Hodgkin's lymphoma (NHL), or NHL and Hodgkin's lymphoma (HL). The definition of the CL has evolved, requesting the identification of the immunophenotypic pattern and clonal distinct aspects for the two-lymphoproliferative lesions. We present a case of a 73-year-old farmer who presented with B-symptoms and multiple adenomegaly. The biopsy of a left cervical lymph node reveal a CL: a histological and immunophenotypic aspect of HL-mixed cellularity (CD15+, CD30+, CD20-) and a diffuse small cell infiltrate which meet the criteria for B-CLL (CD20+, CD23+, and CD5+). The lymphocytes in peripheral blood over 15 000/mm(3) and marrow infiltrate with small lymphocytes also sustain the B-CLL diagnosis. The relationship between the two lymphoproliferations is discussed reported to the case above, but also considering the literature data. In most of the cases the two proliferative processes are clonal related which means they have a commune lymphoid progenitor, pre-GC or early-GC with individual detachment and transit through GC (also, the afferent related processes). It is also possible that the two proliferations, which form the composite lesion to have different cellular origins, possibility sustained by the analysis of the IgH rearrangements and of the somatic mutations identified in the two clones. The EBV-role in HL-pathogeny is related to the way of salvage or/and initiation of a clonal process in a GC-cell which has major deletions in the variable part of IgH.

  4. Classical Hodgkin Lymphoma Arising Adjacent to a Breast Implant.

    PubMed

    Ryan, Ciara; Ged, Yasser; Quinn, Fiona; Walker, Jan; Kennedy, John; Gillham, Charles; Pittaluga, Stefania; McDermott, Ronan; Vandenberghe, Elisabeth; Grant, Cliona; Flavin, Richard

    2016-08-01

    Breast implant-associated lymphoma has recently gained wide recognition. Anaplastic large cell lymphoma (ALCL) is the most frequently diagnosed subtype in this setting but the spectrum is broadening. A 66-year-old woman developed swelling and itch around her saline implant 6 years after its insertion. Imaging revealed a fluid collection surrounding the implant with an adjacent mass. Microscopy showed sclerotic tissue punctuated by discrete cellular nodules comprising small lymphocytes, eosinophils and interspersed large atypical Hodgkin Reed-Sternberg (HRS)-like cells. The HRS-like cells stained positively for CD30 and CD15 by immunohistochemistry. Small T-lymphocytes formed rosettes around HRS-like cells. Appearances were consistent with classical Hodgkin lymphoma (HL). Multiplex polymerase chain reaction demonstrated no clonal rearrangements of immunoglobulin or T-cell receptor genes, however, a t(14;18)(q32;q21)BCL2-JH translocation involving the major breakpoint region of the bcl2 gene was present. Staging positron emission tomography-computed tomography scan revealed FDG-avid masses in the right axilla and pelvis. Subsequent pathological examination identified low-grade follicular lymphoma (FL) with a t(14;18) translocation at these sites. To our knowledge, this is the first case of HL arising adjacent to a breast implant. An awareness of this diagnosis is important as classical HL, with its prominent mixed inflammatory background, may be overlooked as a reactive process when histologically assessing capsulectomy specimens. It is also important in the differential diagnosis for implant-associated ALCL as both contain large atypical CD30-positive cells highlighting the need for full immunohistochemical and molecular workup in such cases. This case also adds to the large body of literature regarding the association between HL and FL. © The Author(s) 2016.

  5. The role of interleukin-3 in classical Hodgkin's disease.

    PubMed

    Aldinucci, Donatella; Olivo, Karin; Lorenzon, Debora; Poletto, Dalisa; Gloghini, Annunziata; Carbone, Antonino; Pinto, Antonio

    2005-03-01

    Classical Hodgkin's disease (HD) is a peculiar form of lymphoma characterized by a low frequency of tumor cells, the so-called Hodgkin (H) and Reed/Sternberg (RS) cells, embedded in a background of non-neoplastic (reactive) cells believed to be recruited and activated by H-RS cell-derived cytokines/chemokines. How these tumor cells can survive in such a seemingly hostile environment has confused researchers. We have previously identified interleukin (IL)-3 receptor (R) expression as a common feature of classical HD and unveiled the potential role of IL-3 as a growth and anti-apoptotic factor for H-RS cells. More then 90% of malignant cells of classical HD usually express the alpha chain of the IL-3R (IL-3R(alpha)), as evidenced by immunostaining of frozen sections and cell suspensions from neoplastic lymph nodes. Consistently, HD-derived cell lines (L428, KMH2, HDLM2 and L1236) express the alpha and beta chains that form IL-3R, both at the mRNA and protein level, with a molecular size of IL-3R(alpha) identical (70 kDa) to that expressed by human myeloid cells. Exogenous IL-3 promotes the growth of cultured H-RS cells, such an effect being potentiated by IL-9 and stem cell factor (SCF) co-stimulation, and is able to partially rescue tumor cells from apoptosis induced by serum deprivation. Finally, cultured H-RS cells are able to increase the production of IL-3 by pre-activated T cells, suggesting an involvement of IL-3/IL-3R interactions in the cellular growth of HD through paracrine mechanisms. This review will outline the biological activity of IL-3 and summarize the evidence indicating IL-3 as a growth and anti-apoptotic factor for H-RS cells in classical HD.

  6. Non-Hodgkin's lymphomas and occupation in Sweden.

    PubMed

    Cano, M I; Pollán, M

    2001-08-01

    To investigate whether there is a risk excess of non-Hodgkin's lymphoma among Swedish workers associated with particular occupations. The base population was made up of Swedish men (1,779,646) and women (1,101,669) who were gainfully employed at the time of the 1970 census, had also been present in the 1960 census and were still alive and older than 24 years as of 1 January, 1971. They were followed up for 19 years until the end of 1989. Age-period standardised incidence ratios were computed in a dataset linking cancer diagnoses from the Swedish national cancer register to occupational and demographic data obtained in the census of 1970. Log-linear Poisson models were fitted, allowing for geographical area. Risk estimators per occupation were also computed for workers reporting the same occupation in 1960 and 1970, a more specifically exposed group. There were 7,610 non-Hodgkin's lymphomas reported in the study cohort, 5,391 cases in men and 2,219 in women. A relative risk of over 1.20 and statistically significant was observed in men among accountants and auditors, secretaries and typists, auctionists, non-specified rail and road transport workers, telecommunications traffic officers, telegraph and radio operators, photographic-laboratory workers and other production and related work. The risk excess was confirmed in men with the same occupation in both censuses. In women, only three occupations achieved statistical significance: metal platers and coaters, truck and conveyor operators and store and warehouse workers. The risk excess observed in telecommunication and transport workers could be explained by electromagnetic radiation exposure. We did not find a risk excess in agricultural occupations, that has been largely documented by other study groups.

  7. Cardiopulmonary toxicity of different chemoradiotherapy combined regimens for Hodgkin's disease.

    PubMed

    Busia, Alessandra; Laffranchi, Alberto; Viviani, Simonetta; Bonfante, Valeria; Villani, Fabrizio

    2010-10-01

    The majority of patients with Hodgkin's disease can be cured by combination of polychemotherapy and radiotherapy (RT) that can produce late toxic pulmonary and cardiac effects which often remain at a subclinical level. The aim of the present investigation was to compare the late pulmonary and cardiac toxicity of three chemotherapeutic regimens combined with RT and particularly doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD), vincristine, epirubicin, cyclophosphamide, etoposide and prednisone (VEBEP) and ABVD with mechloretamine, vincristine, procarbazine and prednisone (MOPP). We investigated 147 patients suffering from Hodgkin's disease after a follow-up of at least 5 years from the completion of CT-RT. Seventy-eight patients were submitted to ABVD-RT, 36 to VEBEP-RT and 33 to MOPP-ABVD-RT. Patients underwent spirometry, 2D-doppler echocardiography at rest, cardiopulmonary exercise test on cycloergometer and determination of cardiac output by a non invasive method. Patients of the three different treatment groups showed tolerance to exercise, and oxygen consumption significantly lower than the predicted values but there were no statistically significant difference between the three groups. Nevertheless, patients treated with VEBEP and with MOPP-ABVD showed an ejection fraction at rest lower than those observed in the ABVD group and patients treated with VEBEP showed a cardiac output for oxygen uptake lower than those observed in the ABVD and MOPP-ABVD treatment groups. These data confirm that the combination of mediastinal RT with the more commonly used polychemotherapy regimens produce late toxic effects. The lower exercise capacity seems to be due to a combination of decreased cardiac performance and impairment of ventilation. The VEBEP regimens could be potentially more toxic for the heart, probably because of the higher cumulative dose of anthracyclines.

  8. Non-invasive detection of genomic imbalances in Hodgkin/Reed-Sternberg cells in early and advanced stage Hodgkin's lymphoma by sequencing of circulating cell-free DNA: a technical proof-of-principle study.

    PubMed

    Vandenberghe, Peter; Wlodarska, Iwona; Tousseyn, Thomas; Dehaspe, Luc; Dierickx, Daan; Verheecke, Magali; Uyttebroeck, Anne; Bechter, Oliver; Delforge, Michel; Vandecaveye, Vincent; Brison, Nathalie; Verhoef, Gregor E G; Legius, Eric; Amant, Frederic; Vermeesch, Joris R

    2015-02-01

    Hodgkin's lymphoma is one of the most common lymphoid neoplasms in young adults, but the low abundance of neoplastic Hodgkin/Reed-Sternberg cells in the tumour hampers the elucidation of its pathogenesis, biology, and diversity. After an incidental observation that genomic aberrations known to occur in Hodgkin's lymphoma were detectable in circulating cell-free DNA, this study was undertaken to investigate whether circulating cell-free DNA can be informative about genomic imbalances in Hodgkin's lymphoma. We applied massive parallel sequencing to circulating cell-free DNA in a prospective study of patients with biopsy proven nodular sclerosis Hodgkin's lymphoma. Genomic imbalances in Hodgkin/Reed-Sternberg cells were investigated by fluorescence in-situ hybridisation (FISH) on tumour specimens. By non-invasive prenatal testing, we observed several genomic imbalances in circulating cell-free DNA of a pregnant woman, who was subsequently diagnosed with early-stage nodular sclerosis Hodgkin's lymphoma stage IIA during gestation. FISH on tumour tissue confirmed corresponding genomic imbalances in Hodgkin/Reed-Sternberg cells. We prospectively studied circulating cell-free DNA of nine nodular sclerosis Hodgkin's lymphoma cases: eight at first diagnosis and one at first relapse. Seven patients had stage IIA disease and two had stage IVB disease. In eight, genomic imbalances were detected, including, among others, gain of chromosomes 2p and 9p, known to occur in Hodgkin's lymphoma. These gains and losses in circulating cell-free DNA were extensively validated by FISH on Hodgkin/Reed-Sternberg cells in biopsy samples. Initiation of chemotherapy induced normalisation of circulating cell-free DNA profiles within 2-6 weeks. The cell cycle indicator Ki67 and cleaved caspase-3 were detected in Hodgkin/Reed-Sternberg cells by immunohistochemistry, suggesting high turnover of Hodgkin/Reed-Sternberg cells. In early and advanced stage nodular sclerosis Hodgkin's lymphoma, genomic

  9. Radiotherapy of Hodgkin and Non-Hodgkin Lymphoma: A Nonrigid Image-Based Registration Method for Automatic Localization of Prechemotherapy Gross Tumor Volume.

    PubMed

    Zaffino, P; Ciardo, D; Piperno, G; Travaini, L L; Comi, S; Ferrari, A; Alterio, D; Jereczek-Fossa, B A; Orecchia, R; Baroni, G; Spadea, M F

    2016-04-01

    To improve the contouring of clinical target volume for the radiotherapy of neck Hodgkin/non-Hodgkin lymphoma by localizing the prechemotherapy gross target volume onto the simulation computed tomography using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography. The gross target volume delineated on prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography images was warped onto simulation computed tomography using deformable image registration. Fifteen patients with neck Hodgkin/non-Hodgkin lymphoma were analyzed. Quality of image registration was measured by computing the Dice similarity coefficient on warped organs at risk. Five radiation oncologists visually scored the localization of automatic gross target volume, ranking it from 1 (wrong) to 5 (excellent). Deformable registration was compared to rigid registration by computing the overlap index between the automatic gross target volume and the planned clinical target volume and quantifying the V95 coverage. The Dice similarity coefficient was 0.80 ± 0.07 (median ± quartiles). The physicians' survey had a median score equal to 4 (good). By comparing the rigid versus deformable registration, the overlap index increased from a factor of about 4 and the V95 (percentage of volume receiving the 95% of the prescribed dose) went from 0.84 ± 0.38 to 0.99 ± 0.10 (median ± quartiles). This study demonstrates the impact of using deformable registration between prechemotherapy [18F]-fluorodeoxyglucose positron emission tomography/computed tomography and simulation computed tomography, in order to automatically localize the gross target volume for radiotherapy treatment of patients with Hodgkin/non-Hodgkin lymphoma. © The Author(s) 2015.

  10. Prevalence of Common Non-Hodgkin Lymphomas and Subtypes of Hodgkin Lymphoma by Nodal Site of Involvement: A Systematic Retrospective Review of 938 Cases.

    PubMed

    Laurent, Camille; Do, Catherine; Gourraud, Pierre-Antoine; de Paiva, Geisilene Russano; Valmary, Séverine; Brousset, Pierre

    2015-06-01

    Non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) represent a heterogeneous group of malignant lymphoid tumors, which have distinct histological and/or biological characteristics with preferential nodal involvement. However, none of the previous studies have assessed the prevalence of common NHL and HL subtypes at each nodal site of involvement. The aim of our study was to determine the prevalence of HL and NHL subtypes depending on their nodal sites of involvement.We conducted a single-center retrospective study of 938 lymphoma cases diagnosed in the Pathology Department of Toulouse Purpan Hospital in France between 2001 and 2008, taking into account the site that corresponded to the diagnostic biopsy. The most frequent sites were cervical lymph nodes (36.8% of all cases), inguinal lymph nodes (16.4%), axillary lymph nodes (11.9%), and supraclavicular lymph nodes (11%). We found an unexpected association between intraparotid nodes and nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and between inguinal nodes and follicular lymphoma. The risk of having classical Hodgkin lymphoma (CHL) was 15 times greater in patients with mediastinal lymphoma compared to those with other sites of involvement. Regarding HL, nodal and extranodal mediastinal sites and supraclavicular nodes were more likely to be involved by nodular sclerosis Hodgkin lymphoma (NSCHL). In addition, intra-abdominal lymph nodes were more frequently involved by lymphocyte depleted Hodgkin lymphoma compared to inguinal nodes where NLPHL predominated.Our study shows that some lymph node sites have a disproportionate prevalence of specific subtypes of lymphoma. Identifying these sites may aid to diagnose and better elucidate the pathogenesis of these tumors.

  11. Histopathological features and their prognostic impact in nodular lymphocyte-predominant Hodgkin lymphoma--a matched pair analysis from the German Hodgkin Study Group (GHSG).

    PubMed

    Hartmann, Sylvia; Eichenauer, Dennis A; Plütschow, Annette; Mottok, Anja; Bob, Roshanak; Koch, Karoline; Bernd, Heinz-Wolfram; Cogliatti, Sergio; Hummel, Michael; Feller, Alfred C; Ott, German; Möller, Peter; Rosenwald, Andreas; Stein, Harald; Hansmann, Martin-Leo; Engert, Andreas; Klapper, Wolfram

    2014-10-01

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity. We performed a matched-pair analysis to evaluate the prognostic impact of several histopathological features in this distinct Hodgkin lymphoma subtype. Lymph node samples of NLPHL patients were tested for CD15, IgD, phosphorylated STAT6, ICOS and Epstein-Barr virus status of the malignant lymphocyte-predominant cells as well as epithelioid cell clusters and activated T cells in the microenvironment. None of these features was associated with a particular clinical outcome. However, patients presenting with epithelioid cell clusters showed a non-significant trend towards a lower relapse rate, justifying further evaluation of this marker.

  12. Prognostic relevance of DHAP dose-density in relapsed Hodgkin lymphoma: an analysis of the German Hodgkin-Study Group.

    PubMed

    Sasse, Stephanie; Alram, Magdalena; Müller, Horst; Smardová, Lenka; Metzner, Bernd; Doehner, Hartmut; Fischer, Thomas; Niederwieser, Dietger W; Schmitz, Norbert; Schäfer-Eckart, Kerstin; Raemaekers, John M M; Schmalz, Oliver; Tresckow, Bastian V; Engert, Andreas; Borchmann, Peter

    2016-05-01

    Only 50% of patients with relapsed Hodgkin lymphoma (HL) can be cured with intensive induction chemotherapy, followed by high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). Based on the results of the HDR2 trial two courses of DHAP and subsequent HDCT/ASCT are the current standard of care in relapsed HL. In order to assess the prognostic relevance of DHAP dose density, we performed a retrospective multivariate analysis of the HDR2 trial (N=266). In addition to four risk factors (early or multiple relapse, stage IV disease or anemia at relapse, and grade IV hematotoxicity during the first cycle of DHAP) a delayed start of the second cycle of DHAP>day 22 predicted a significantly poorer progression-free survival (PFS, p=0.0356) and overall survival (OS, p=0.0025). In conclusion, our analysis strongly suggests that dose density of DHAP has a relevant impact on the outcome of relapsed HL patients.

  13. Study of ADCT-402 in Patients With Relapsed or Refractory B-cell Lineage Non Hodgkin Lymphoma (B-NHL)

    ClinicalTrials.gov

    2017-08-18

    Non-Hodgkin Lymphoma; Burkitt's Lymphoma; Chronic Lymphocytic Leukemia; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Follicular; Lymphoma, Mantle-Cell; Lymphoma, Marginal Zone; Waldenstrom Macroglobulinemia

  14. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification.

    PubMed

    Cheson, Bruce D; Fisher, Richard I; Barrington, Sally F; Cavalli, Franco; Schwartz, Lawrence H; Zucca, Emanuele; Lister, T Andrew

    2014-09-20

    The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.

  15. Cigarette smoking and risk of lymphoma in adults: a comprehensive meta-analysis on Hodgkin and non-Hodgkin disease.

    PubMed

    Sergentanis, Theodoros N; Kanavidis, Prodromos; Michelakos, Theodoros; Petridou, Eleni Th

    2013-03-01

    The aim of the present meta-analysis was to examine comprehensively the association between smoking and lymphoma [Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL)] in adults. Eligible studies were identified, and pooled-effect estimates (odds ratios and relative risks) were calculated for ever, current and former smoking, separately by lymphoma subtype and gender. Metaregression analysis with percentage of male patients, mean age, duration (years of smoking), intensity (pack-years and cigarettes per day) and years since quitting was carried out. Out of the 50 eligible articles, 41 used a case-control design (20 143 NHL cases, 4340 HL cases and 61 517 controls), whereas nine used a cohort design (5748 incident NHL cases, 334 HL cases, total cohort size comprising 1 530 833 smokers). Ever smoking was associated with increased risk for NHL [pooled-effect estimate=1.05, 95% confidence interval (CI): 1.00-1.09] mainly because of the association with T-NHL (pooled-effect estimate=1.23, 95% CI: 1.09-1.38). Ever smoking was also associated with increased risk for HL (pooled-effect estimate=1.15, 95% CI: 1.02-1.30); sizeable associations were observed regarding both nodular sclerosis and mixed cellularity subtypes. Although male study arms pointed to predominantly increased risk for HL, metaregression did not confirm the male preponderance. Dose-response patterns were particularly evident for HL. Cigarette smoking seems to be associated with increased lymphoma risk, especially HL and T-NHL. Further well-designed studies seem to be needed so as to investigate the risk thoroughly, especially for T-NHL subentities, and the extent to which confounding may interfere with gender-related disparities.

  16. High cytokine expression and reduced ovarian reserve in patients with Hodgkin lymphoma or non-Hodgkin lymphoma.

    PubMed

    Paradisi, Roberto; Vicenti, Rossella; Macciocca, Maria; Seracchioli, Renato; Rossi, Stefania; Fabbri, Raffaella

    2016-10-01

    To investigate the ovarian reserve in female lymphoma patients and the potential relationships with the cytokine network. Age-matched control study. Women's university hospital. Seventy-three lymphoma patients (57 with classic Hodgkin lymphoma [HL] and 16 with non-Hodgkin lymphoma [NHL]), approaching our center for ovarian tissue cryopreservation (study group) were compared with 25 age-matched healthy volunteers (control group). Measurements of antimüllerian hormone (AMH), soluble interleukin-2 receptor (SIL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) levels. The AMH and cytokine levels of the lymphoma patients and the healthy volunteers were compared. Correlations between AMH with SIL-2R, IL-6, and IL-8 levels were performed. The AMH showed significant lower concentrations in lymphoma patients than in the control group. Higher significant concentrations in lymphoma patients than in control group were found for SIL-2R and IL-6. No differences were observed comparing HL and NHL groups and within the stages of HL group for AMH and all the cytokines analyzed. Finally, significant inverse correlations were observed in lymphoma patients between AMH and SIL-2R, IL-6, and IL-8 levels, but not with TNF-α levels. Positive correlations between SIL-2R with IL-6, and IL-6 with IL-8 were also shown. In patients with HL or NHL at baseline the cytokine network is particularly active and the ovarian reserve is reduced. A strong negative correlation between AMH and SIL-2R, IL-6, and IL-8 has been also evidenced. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Predictors of radiation pneumonitis in patients receiving intensity modulated radiation therapy for Hodgkin and non-Hodgkin lymphoma.

    PubMed

    Pinnix, Chelsea C; Smith, Grace L; Milgrom, Sarah; Osborne, Eleanor M; Reddy, Jay P; Akhtari, Mani; Reed, Valerie; Arzu, Isidora; Allen, Pamela K; Wogan, Christine F; Fanale, Michele A; Oki, Yasuhiro; Turturro, Francesco; Romaguera, Jorge; Fayad, Luis; Fowler, Nathan; Westin, Jason; Nastoupil, Loretta; Hagemeister, Fredrick B; Rodriguez, M Alma; Ahmed, Sairah; Nieto, Yago; Dabaja, Bouthaina

    2015-05-01

    Few studies to date have evaluated factors associated with the development of radiation pneumonitis (RP) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), especially in patients treated with contemporary radiation techniques. These patients represent a unique group owing to the often large radiation target volumes within the mediastinum and to the potential to receive several lines of chemotherapy that add to pulmonary toxicity for relapsed or refractory disease. Our objective was to determine the incidence and clinical and dosimetric risk factors associated with RP in lymphoma patients treated with intensity modulated radiation therapy (IMRT) at a single institution. We retrospectively reviewed clinical charts and radiation records of 150 consecutive patients who received mediastinal IMRT for HL and NHL from 2009 through 2013. Clinical and dosimetric predictors associated with RP according to Radiation Therapy Oncology Group (RTOG) acute toxicity criteria were identified in univariate analysis using the Pearson χ(2) test and logistic multivariate regression. Mediastinal radiation was administered as consolidation therapy in 110 patients with newly diagnosed HL or NHL and in 40 patients with relapsed or refractory disease. The overall incidence of RP (RTOG grades 1-3) was 14% in the entire cohort. Risk of RP was increased for patients who received radiation for relapsed or refractory disease (25%) versus those who received consolidation therapy (10%, P=.019). Several dosimetric parameters predicted RP, including mean lung dose of >13.5 Gy, V20 of >30%, V15 of >35%, V10 of >40%, and V5 of >55%. The likelihood ratio χ(2) value was highest for V5 >55% (χ(2) = 19.37). In using IMRT to treat mediastinal lymphoma, all dosimetric parameters predicted RP, although small doses to large volumes of lung had the greatest influence. Patients with relapsed or refractory lymphoma who received salvage chemotherapy and hematopoietic stem cell transplantation

  18. Predictors of Radiation Pneumonitis in Patients Receiving Intensity-Modulated Radiation Therapy for Hodgkin and Non-Hodgkin Lymphoma

    PubMed Central

    Pinnix, Chelsea C.; Smith, Grace L.; Milgrom, Sarah; Osborne, Eleanor M.; Reddy, Jay P.; Akhtari, Mani; Reed, Valerie; Arzu, Isidora; Allen, Pamela K.; Wogan, Christine F.; Fanale, Michele A.; Oki, Yasuhiro; Turturro, Francesco; Romaguera, Jorge; Fayad, Luis; Fowler, Nathan; Westin, Jason; Nastoupil, Loretta; Hagemeister, Fredrick B.; Rodriguez, Alma; Ahmed, Sairah; Nieto, Yago; Dabaja, Bouthaina

    2015-01-01

    Purpose Few studies to date have evaluated factors associated with the development of radiation pneumonitis (RP) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), especially in patients treated with contemporary radiation techniques. These patients represent a unique group owing to the often large radiation target volumes within the mediastinum and to the potential to receive several lines of chemotherapy that add to pulmonary toxicity for relapsed or refractory disease. Our objective was to determine the incidence and clinical and dosimetric risk factors associated with RP in lymphoma patients treated with intensity modulated radiation therapy (IMRT) at a single institution. Methods We retrospectively reviewed clinical charts and radiation records of 150 consecutive patients who received mediastinal IMRT for HL and NHL from 2009 through 2013. Clinical and dosimetric predictors associated with RP per the Radiation Therapy Oncology Group (RTOG) acute toxicity criteria were identified in univariate analysis using the Pearson χ2 test and logistic multivariate regression. Results Mediastinal radiation was administered as consolidation therapy in 110 patients with newly diagnosed HL or NHL and in 40 patients with relapsed or refractory disease. The overall incidence of RP (RTOG grade 1–3) was 14% in the entire cohort. Risk of RP was increased for patients who received radiation for relapsed or refractory disease (25%) versus those who received consolidation (10%, P=0.019). Several dosimetric parameters predicted RP, including mean lung dose (MLD) >13.5 Gy, V20 >30%, V15 >35%, V10 >40% and V5>55%. The likelihood ratio (LR) χ2 value was highest for V5< 55% (LR χ2=19.37). Conclusions In using IMRT to treat mediastinal lymphoma, all dosimetric parameters predicted RP, although small doses to large volumes of lung had the greatest influence. Patients with relapsed or refractory lymphoma who received salvage chemotherapy and hematopoietic stem cell

  19. FACTORS ASSOCIATED WITH INCREASED RED BLOOD CELLS TRANSFUSION REQUIREMENTS IN PATIENTS WITH HODGKIN AND NON-HODGKIN LYMPHOMA.

    PubMed

    Ali, Sheeraz; Ali, Mussadique; Badar, Farhana; Basit, Abdul; Hameed, Abdul

    2015-01-01

    Anaemia is a common feature of lympho-proliferative disorders and is an important cause of poor quality of life in these patients. When indicated, packed red blood cells (PRBC) units are transfused to treat anaemia. Objective of this study was to identify risk factors associated with PRBC transfusions in lymphoma patients. This was a retrospective study done on Hodgkin lymphoma (HL) and Non-Hodgkin lymphoma (NHL) patients who had PRBC transfusions during chemotherapy. Information regarding gender, type of lymphoma, stage, baseline haemoglobin, marrow involvement and total number of PRBC units transfused was collected. A total of 481 patients with diagnosis of HL and NHL were registered during one year period. Out of these, 108 (22.4%) had PRBC transfusions during treatment. HL and NHL patients were 30 (27.8%) and 78 (72.2%) respectively. NHL patients were older than HL (37 vs. 32 years), (p=0.03). HL patients had lower mean haemoglobin 9.3 +/- 2.56 g/dl as compared to NHL 11.33 +/- 2.42 g/dl, (p<0.05). There was significant difference in number of PRBC units transfused based on lymphoma type (NHL 6.74 +/- 5.69 vs. HL 3.97 +/- 3.0 units, p<0.05). Bone marrow involvement resulted in increased transfusion requirements (7.84 +/- 4.36 vs. 5.26 +/- 5.49 units, p<0.05) while stage of disease didn't affected significantly (I/II--4.88 +/- 4.85 and III/IV 6.30 +/- 5.33 units p=0.2). A significant number of lymphoma patients need PRBC transfusions during chemotherapy. NHL patients and bone marrow involvement makes patients at higher risk for transfusions. In places, where blood bank support is not adequate, patients should be informed right from beginning to arrange donors for possible transfusions during chemotherapy.

  20. Clinical characteristics and prognostic factors in Chinese patients with Hodgkin's lymphoma.

    PubMed

    Zhu, Ying-Jie; Sun, Yue-Li; Xia, Yi; Jiang, Wen-Qi; Huang, Jia-Jia; Huang, Hui-Qiang; Lin, Tong-Yu; Guan, Zhong-Zhen; Li, Zhi-Ming

    2012-06-01

    The aim of our study is to investigate the clinical characteristics and prognostic factors in Chinese Hodgkin's lymphoma patients. It is known that clinical characteristics and epidemiology of Hodgkin's lymphoma in China are different from Western countries. In total, 137 consecutive, previously untreated patients with Hodgkin's lymphoma at Sun Yat-Sen University Cancer Center were enrolled. Among these patients, 92 were male and 45 were female, with a median age of 28 (range: 2-76) years. The bimodal age curve of classical Hodgkin's lymphoma analyzed from our patients was not obvious as the Western population, showing an early peak in 25 years and a second peak in 45 years. Most of the patients (41.6%) were classified as nodular sclerosis classic Hodgkin's lymphoma. Results showed that the 5-year overall survival, event-free survival, and disease-free survival rates were 97.7, 85.0, and 94.0%, respectively. Lymphopenia at diagnosis was related to poorer overall survival (P = 0.015) and event-free survival (P < 0.001) in all-stage Hodgkin's lymphoma patients. Multivariate analysis showed that lymphopenia as an independent unfavorable prognostic factor influenced event-free survival (P = 0.015). The international prognostic score ≥ 5 was also the only independent prognostic factor of disease-free survival in advanced-stage patients (P = 0.046). Our findings demonstrated that some clinical characteristics of Hodgkin's lymphoma in China were different from those in the Western countries. Lymphopenia was an effective prognostic predictor in both early stage and advanced stage.

  1. Plasma Epstein Barr virus (EBV) DNA as a biomarker for EBV associated Hodgkin lymphoma.

    PubMed

    Dinand, Veronique; Sachdeva, Anupam; Datta, Sanghamitra; Bhalla, Sunita; Kalra, Manas; Wattal, Chand; Radhakrishnan, Nita

    2015-08-01

    To assess plasma Epstein-Barr virus (EBV) DNA as a biomarker of tumour burden at diagnosis and during therapy in children with Hodgkin lymphoma. Case-control study, with prospective follow-up of the Hodgkin lymphoma cohort (2007-2012). Pediatric Hematology Oncology unit of a tertiary care hospital in Delhi. Thirty children with Hodgkin lymphoma and 70 sex and age-matched controls (benign lymphadenopathy 19, non-lym-phoid malignancy 29, Burkitt lymphoma 5, healthy children 17). Positive EBV-staining on immunohistochemistry was defined as EBV-associated Hodgkin lymphoma. Plasma EBV real-time quantitative polymerase chain reaction (PCR) was tested at presentation, after first and last chemotherapy cycles, and on follow-up. Plasma EBV quantitative PCR was compared between cases and controls. Its kinetics was assessed during and after chemotherapy. EBV quantitative PCR was positive in 19 (63%) Hodgkin lymphoma cases (range 500 to 430,000 copies/mL), with 87.5% accuracy (kappa=0.69) as compared with EBV immunohistochemistry. Sensitivity and specificity of the quantitative PCR were 87.5% and 81.8%, respectively. Only boys showed positive EBV immunohistochemistry and,or quantitative PCR positivity. All controls were quantitative PCR negative. All quantitative PCR positive cases with follow up blood sample showed EBV clearance after the first cycle. A quantitative PCR negative case in long-term remission became positive at relapse. EBV status did not influence survival. Plasma EBV-DNA, detectable in EBV-associated Hodgkin lymphoma, becomes undetectable early after initiating therapy. It can be used as a biomarker of treatment response in EBV-associated Hodgkin lymphoma.

  2. Alisertib in Combination With Vorinostat in Treating Patients With Relapsed or Recurrent Hodgkin Lymphoma, B-Cell Non-Hodgkin Lymphoma, or Peripheral T-Cell Lymphoma

    ClinicalTrials.gov

    2016-12-26

    Adult B Acute Lymphoblastic Leukemia; Adult T Acute Lymphoblastic Leukemia; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-Cell Lymphoma; Chronic Lymphocytic Leukemia; Cutaneous B-Cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue; Hepatosplenic T-Cell Lymphoma; Intraocular Lymphoma; Lymphomatous Involvement of Non-Cutaneous Extranodal Site; Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma; Nodal Marginal Zone Lymphoma; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-Cell Leukemia/Lymphoma; Recurrent Cutaneous T-Cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides and Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Small Intestinal Lymphoma; Splenic Marginal Zone Lymphoma; T-Cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenstrom Macroglobulinemia

  3. Pediatric MATCH: Ensartinib in Treating Patients With Relapsed or Refractory Advanced Solid Tumors, Non-Hodgkin Lymphoma, or Histiocytic Disorders With ALK or ROS1 Genomic Alterations

    ClinicalTrials.gov

    2017-09-25

    Advanced Malignant Solid Neoplasm; ALK Fusion Protein Expression; ALK Gene Mutation; ALK Gene Translocation; Histiocytosis; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Childhood Non-Hodgkin Lymphoma; Recurrent Malignant Solid Neoplasm; Recurrent Neuroblastoma; Refractory Central Nervous System Neoplasm; Refractory Malignant Solid Neoplasm; Refractory Neuroblastoma; Refractory Non-Hodgkin Lymphoma; ROS1 Fusion Positive; ROS1 Gene Mutation; ROS1 Gene Translocation; Stage III Childhood Non-Hodgkin Lymphoma; Stage IV Childhood Non-Hodgkin Lymphoma

  4. Pediatric MATCH: Selumetinib in Treating Patients With Relapsed or Refractory Advanced Solid Tumors, Non-Hodgkin Lymphoma, or Histiocytic Disorders With Activating MAPK Pathway Mutations

    ClinicalTrials.gov

    2017-09-25

    Advanced Malignant Solid Neoplasm; BRAF Gene Mutation; GNA11 Gene Mutation; GNAQ Gene Mutation; Histiocytosis; HRAS Gene Mutation; KRAS Gene Mutation; NF1 Gene Mutation; NRAS Gene Mutation; Recurrent Childhood Central Nervous System Neoplasm; Recurrent Childhood Non-Hodgkin Lymphoma; Recurrent Malignant Solid Neoplasm; Recurrent Neuroblastoma; Refractory Central Nervous System Neoplasm; Refractory Malignant Solid Neoplasm; Refractory Neuroblastoma; Refractory Non-Hodgkin Lymphoma; Stage III Childhood Non-Hodgkin Lymphoma; Stage IV Childhood Non-Hodgkin Lymphoma

  5. Propiedades biomecánicas de la membrana limitante interna tras recibir tratamiento intravítreo con ocriplasmina.

    PubMed

    Vielmuth, Franziska; Schumann, Ricarda G; Spindler, Volker; Wolf, Armin; Scheler, Renate; Mayer, Wolfgang J; Henrich, Paul B; Haritoglou, Christos

    2017-01-01

    Objetivo: Evaluar la rigidez de la membrana limitante interna (MLI) humana y evaluar los posibles cambios de las propiedades mecánicas tras administrar una inyección intravítrea de ocriplasmina para tratar la tracción vitreomacular. Métodos: Este estudio se compone de una serie de casos intervencionales y comparativos de 12 muestras de MLI extraídas mediante cirugía y obtenidas de forma consecutiva de 9 ojos de 9 pacientes después de someterse sin éxito a vitreólisis farmacológica con ocriplasmina. Durante el mismo periodo de tiempo, 16 muestras de otros 13 ojos sin tratamiento con ocriplasmina se obtuvieron mediante vitrectomía y sirvieron como controles. Todos los pacientes presentaron agujeros maculares o tracción vitreomacular y se sometieron a vitrectomía con disección de la MLI tanto con tinción con azul brillante (AB) como sin ella. Todas las muestras se analizaron con un microscopio de fuerza atómica con imágenes de las regiones de 25 × 25 μm. En todas las muestras, se analizaron tanto la parte de la retina como la del vítreo de la MLI. Resultados: La microscopia de fuerza atómica no reveló diferencias significativas en cuanto a elasticidad de las muestras de MLI extraídas de ojos con o sin tratamiento con ocriplasmina. Las áreas onduladas de la parte de la retina presentaron una mayor rigidez que la parte del vítreo de la MLI. La cartografía topográfica tanto de la parte del vítreo como de la retina de la MLI no mostró ninguna alteración aparente de la morfología en ojos tratados con ocriplasmina en comparación con los ojos no tratados. La tinción con azul brillante conllevó un aumento de la rigidez tisular. Conclusiones: Las inyecciones intravítreas de ocriplasmina no varían las propiedades biomecánicas de la MLI humana. No existen pruebas de un posible efecto enzimático que interfiera con la rigidez de esta membrana basal. © 2017 S. Karger AG, Basel.

  6. Leukemia and non-Hodgkin's lymphoma and residential proximity to industrial plants

    SciTech Connect

    Linos, A.; Blair, A.; Gibson, R.W.; Everett, G.; Van Lier, S.; Cantor, K.P.; Schuman, L.; Burmeister, L. )

    1991-03-01

    The risks of developing leukemia and non-Hodgkin's lymphoma from living near industrial facilities were evaluated among men from Iowa and Minnesota in a population-based, case-control study. We found a statistically significant increase in the risk of developing non-Hodgkin's lymphoma (RR = 1.4) and a slight, nonsignificant excess for leukemia (RR = 1.2) among individuals who lived .8-3.2 km (1/2-2 miles) from a factory. Risks were greater for certain histologic types: follicular lymphoma (RR = 1.5), acute lymphocytic leukemia (RR = 5.4), and acute myelocytic leukemia (RR = 2.2). For non-Hodgkin's lymphoma (but not for leukemia), the relative risks for those living within .8 km (1/2 mile) of a factory were similar or slightly larger than for those living .8-3.2 km (1/2-2 miles) from a factory. Risks did not increase with duration of residence near a factory. The elevated risks of non-Hodgkin's lymphoma were particularly associated with residing near stone, clay, or glass industry facilities. The risk of developing leukemia was greater among persons who resided near chemical and petroleum plants. These preliminary findings raise the possibility that general environmental exposure associated with certain industrial activities may elevate the risk of developing leukemia and non-Hodgkin's lymphoma. Evaluation of data on proximity to industrial plants from studies in other geographic locations is needed to determine whether our results represent a meaningful association.

  7. Radiographic enlargement of mandibular canal as first feature of non-Hodgkin's lymphoma.

    PubMed

    Buric, N; Jovanovic, G; Radovanovic, Z; Buric, M; Tijanic, M

    2010-09-01

    Non-Hodgkin's lymphoma has the propensity to affect non-lymphoid tissue including oral tissue. Primary non-Hodgkin's lymphoma of the mandible mistreated as chronic periodontitis with diffuse enlargement of the mandibular canal and ice-cold numbness is very rarely described in English medical literature. A 57-year-old patient presented with a painful swelling on the left side of the mandible with a clinically chronic periodontitis associated with ice-cold numbness. A panoramic radiograph showed a diffuse uniform enlargement of the mandibular canal. Histological examination showed that the lesion was a primary intraosseous non-Hodgkin's lymphoma of the mandible. Immunohistochemical examination showed a positive reaction for CD20+, Ki-67+. Seven months after chemotherapy the patient was observed for possible life-threatening propagation of the disease. In conclusion, primary (extra-nodal) non-Hodgkin's lymphoma of the mandible usually clinically presents with bone swelling, teeth mobility and neurological disturbance. Radiographic features presenting as diffuse enlargement of the mandibular canal could be considered as non-Hodgkin's lymphoma.

  8. Is severe cardiac dysfunction a contraindication for complex combined oncotherapy of Hodgkin's lymphoma? Not any more.

    PubMed

    Netuka, Ivan; Stepankova, Pavla; Urban, Marian; Maly, Jiri; Szarszoi, Ondrej; Dorazilova, Zora; Kotulak, Tomas; Pirk, Jan

    2013-01-01

    Hodgkin's lymphoma is a quite frequent diagnosis, particularly in younger patients, which is normally treated effectively with combined chemotherapy and radiotherapy. Cardiomyopathy induced by these treatments is not uncommon and may progress to advanced-stage heart failure. Due to the cardiotoxicity of chemotherapy for Hodgkin's disease, preexisting heart failure precludes usual therapy. We present a novel strategy of hemodynamic stabilization with an implantable left ventricular assist device (LVAD) prior to radical oncotherapy for Hodgkin's lymphoma. A 33-year-old man with a short history of progressive heart failure was hospitalized due to progressive symptoms. An echocardiogram revealed a dilated left ventricle with an ejection fraction of 18%, moderate right ventricular dysfunction, and moderate to severe tricuspid regurgitation. Supradiaphragmatic-stage Hodgkin's lymphoma was also diagnosed. Due to severe cardiac dysfunction, the patient was not a candidate for the usual chemotherapy and radiotherapy prescribed for this diagnosis. After multidisciplinary consultation and consent from the patient, an LVAD was implanted with tricuspid valve repair. Additionally, affected lymph nodes from the ventral upper mediastinum were excised, and pathological analysis confirmed the lymphoma diagnosis. The patient recovered from surgery and the postoperative course was uneventful. With LVAD support and normalized hemodynamics, chemotherapy and radiotherapy for his Hodgkin's lymphoma were completed, and the patient remains in complete remission documented by positron emission tomography/computed tomography and is well one since LVAD implantation.

  9. Classical Hodgkin lymphoma masquerading as chronic recurrent multifocal osteomyelitis: a case report.

    PubMed

    Pham, Michael; Ressler, Steven; Rosenthal, Allison; Kelemen, Katalin

    2017-02-18

    Hodgkin lymphoma is a hematologic malignancy usually confined to lymphatic structures and commonly associated with constitutional symptoms. Bony involvement and musculoskeletal symptoms are uncommon and typically seen in advanced disease. In this case, we report an unusual presentation of classical Hodgkin lymphoma and highlight diagnostic challenges leading to the misdiagnosis and treatment as chronic recurrent multifocal osteomyelitis. A 38-year-old white man presented with lower extremity musculoskeletal pain. Imaging studies revealed multifocal lytic and sclerotic osseous axial lesions. Multiple core needle bone marrow and excisional lymph node biopsies were non-diagnostic. Having met the criteria, a tentative diagnosis of chronic recurrent multifocal osteomyelitis was given. He was treated with non-steroidal anti-inflammatory medications with partial clinical response but had persistent symptoms. A second medical opinion was pursued. An open bone marrow biopsy was performed and yielded a diagnosis of classical Hodgkin lymphoma after 13 months of diagnostic uncertainty. A chemotherapy regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine was instituted with complete symptomatic and radiologic response. This case illustrates diagnostic difficulties of a musculoskeletal presentation of Hodgkin lymphoma, challenges of non-diagnostic bone marrow and lymph node biopsies, and resultant diagnostic delays in delivering a potentially curative therapy. Had the additional open bone marrow biopsy not been performed, the diagnosis and treatment of Hodgkin lymphoma would have been missed.

  10. Tumorigenic potential of mononucleated small cells of Hodgkin lymphoma cell lines.

    PubMed

    Ikeda, Jun-ichiro; Mamat, Suhana; Tian, Tian; Wang, Yi; Rahadiani, Nur; Aozasa, Katsuyuki; Morii, Eiichi

    2010-12-01

    Tumor cells with tumorigenic potential are limited to a small cell population known as cancer stem cells (CSCs). CSCs yield both CSCs and non-CSCs, whereas non-CSCs do not yield CSCs. CSCs have not been identified in any malignant lymphomas. Hodgkin lymphoma (HL) is a mostly B-cell neoplasm that can be diagnosed by the presence of multinucleated (Reed-Sternberg; RS) cells admixed with Hodgkin cells with distinct nucleoli and various inflammatory cells. Here, the tumorigenic potential of cells with a single nucleus (S) and cells with multiple nuclei (M), which may be equivalent to Hodgkin and RS cells, respectively, was examined in HL cell lines L1236 and L428. Cultures of single S cells yielded both S and M cells, whereas M cell cultures yielded only M cells. When either cultured in methylcellulose or inoculated into NOD/SCID mice, the colony number and tumor size were both larger in S than in M cells. Concentrations of intracellular reactive oxygen species (ROS) were at low levels in a portion of S cells that abundantly expressed FoxO3a, a transcription factor that regulates ROS-degrading enzymes. In clinical samples of HL, FoxO3a was expressed in mononuclear Hodgkin cells but not in multinucleated RS cells. These findings suggest that smaller cells or Hodgkin cells that show low-ROS concentrations and high FoxO3a expression levels might be candidates for HL CSCs.

  11. The hematopoietic stem cell transplantation in Hodgkin's disease: questions and controversies.

    PubMed

    Fleury, J; Legros, M; Cure, H; Tortochaux, J; Condat, P; Dionet, C; Travade, P; Belembaogo, E; Tavernier, F; Kwiatkowski, F

    1994-11-01

    Most patients with Hodgkin's disease (HD) are cured with chemotherapy and/or radiotherapy. However, half of those with advanced stage disease (IIIB, IV) do not respond adequately to treatment or relapse. Salvage therapy used in such cases gives from 10% to 50% complete remission but only 10% long term survival. The results of bone marrow transplantation reported in acute leukemia and non-Hodgkin's lymphoma encouraged some authors to develop this new therapeutic strategy in Hodgkin's disease. In the early 1980's promising results were achieved when refractory and relapsed patients were selected to receive myeloablative therapy followed by bone marrow transplantation. Today, high dose chemotherapy with hematopoietic stem cell transplantation (HSCT) is used more and more often in poor prognosis Hodgkin's disease. After a review of the literature concerning the results of transplantation in Hodgkin's disease, we develop the numerous problems associated with this procedure which remain to be solved such as: the optimal indication, the timing of HSCT, the type of graft, the conditioning regimen, the place of radiotherapy and the optimal use of hematopoietic growth factors. We conclude with future prospects.

  12. Loss of expression of LyGDI (ARHGDIB), a rho GDP-dissociation inhibitor, in Hodgkin lymphoma.

    PubMed

    Ma, Liya; Xu, Gaixiang; Sotnikova, Anna; Szczepanowski, Monika; Giefing, Maciej; Krause, Kristina; Krams, Matthias; Siebert, Reiner; Jin, Jie; Klapper, Wolfram

    2007-10-01

    The guanosine triphosphatase (GTPase) inhibitor LyGDI (ARHGDIB, Ly/D4-GDI, RhoGDIb or RhoGDI 2) is abundantly expressed in haematopoetic cells and possibly plays a role in the onset of apoptosis. Gene expression profiling of Hodgkin cell lines revealed that LyGDI expression was downregulated in these cell lines. The present study evaluated the expression of LyGDI in Hodgkin cells in vivo and studied the function of LyGDI in Hodgkin cell lines in vitro. Our results showed that virtually all Hodgkin and Reed-Sternberg cells in classical Hodgkin lymphoma lacked LyGDI protein expression. On the other hand, almost all non-Hodgkin lymphomas, except for anaplastic large cell lymphomas, expressed LyGDI protein. Transfection of the classical Hodgkin cell line L428 with a vector containing full-length LyGDI-induced apoptosis in a subset of cells. However, the majority of Hodgkin cells with transgenic expression of LyGDI escaped apoptosis. Our data show that lack of LyGDI expression is a frequent feature of cHL but that it is not of vital importance for the growth and survival of these cells.

  13. Genome-wide homozygosity signature and risk of Hodgkin lymphoma

    PubMed Central

    Sud, Amit; Cooke, Rosie; Swerdlow, Anthony J.; Houlston, Richard S.

    2015-01-01

    Recent studies have reported that regions of homozygosity (ROH) in the genome are detectable in outbred populations and can be associated with an increased risk of malignancy. To examine whether homozygosity is associated with an increased risk of developing Hodgkin lymphoma (HL) we analysed 589 HL cases and 5,199 controls genotyped for 484,072 tag single nucleotide polymorphisms (SNPs). Across the genome the cumulative distribution of ROH was not significantly different between cases and controls. Seven ROH at 4q22.3, 4q32.2, 7p12.3–14.1, 7p22.2, 10p11.22–23, 19q13.12-2 and 19p13.2 were associated with HL risk at P < 0.01. Intriguingly 4q22.3 harbours an ROH to which the nuclear factor NF-kappa-B p105 subunit (NFKB1) maps (P = 0.002). The ROH at 19q13.12-2 has previously been implicated in B-cell precursor acute lymphoblastic leukaemia. Aside from these observations which require validation, it is unlikely that levels of measured homozygosity caused by autozygosity, uniparental isodisomy or hemizygosity play a major role in defining HL risk in predominantly outbred populations. PMID:26391888

  14. Extranodal non-Hodgkin's lymphoma presenting as gingival mass

    PubMed Central

    Manjunatha, B. S.; Gowramma, R.; Nagarajappa, D.; Tanveer, Ahmed

    2011-01-01

    Non-Hodgkin's lymphoma (NHL) commonly presents as non-tender, enlarged lymph nodes, accompanied by diffuse symptoms of fatigue and low-grade intermittent fever and it is derived predominantly from the cells of the B lymphocyte series. NHL cases occur extra-nodally and in 3% of these cases the initial presentation may be in the oral cavity. Though extra-nodal NHL of the oral cavity is a rare finding, patients with oral lesions of NHL commonly present at the dental clinic in the first instance. A careful clinical evaluation supported by histopathological and other laboratory investigations will help in identifying the disease at an early stage, resulting in better prognosis. Any delay in diagnosis has important implications on the morbidity and mortality of the condition. Due to the rarity of intraoral NHL, we present one such a case with a complaint of tumor-like mass on the gingiva of lower molar region. The lesion was clinically thought as pyogenic granuloma and later diagnosed as extra nodal NHL of the oral cavity. PMID:22368372

  15. Health Practice in Long-Term Survivors of Hodgkin's Lymphoma

    SciTech Connect

    Ng, Andrea K. Li Sigui; Recklitis, Christopher; Diller, Lisa R.; Neuberg, Donna; Silver, Barbara; Mauch, Peter M.

    2008-06-01

    Purpose: To compare the health practice of Hodgkin's lymphoma (HL) survivors and their siblings, and to assess the impact of socioeconomic status and disease history on health practice of HL survivors. Methods and Materials: We conducted a questionnaire study on long-term HL survivors and their siblings on health care utilization, health habits, and screening behavior. Results: A total of 511 HL survivors (response rate of 50%, including survivors lost to contact) and 224 siblings (response rate, 58%) participated. Median time from HL diagnosis was 15 years. Significantly more survivors than siblings had a physical examination in the past year (63% vs. 49%, p = 0.0001). Male survivors were significantly more likely than siblings to perform monthly self-testicular examinations (19% vs. 9%, p = 0.02). Among survivors, higher household income (p = 0.01) independently predicted for having had a physical examination in the past year. Lower educational level (p = 0.0004) and history of relapsed HL (p = 0.03) were independent predictors for smoking, moderate/heavy alcohol use, and/or physical inactivity. Conclusions: Compared with siblings, long-term HL survivors have a higher level of health care utilization and better screening practice. Survivors from lower socioeconomic background had lower adherence to routine health care and greater report of unhealthy habits. Survivors with history of relapsed HL were also more likely to engage in unhealthy habits.

  16. The ISI distribution of the stochastic Hodgkin-Huxley neuron

    PubMed Central

    Rowat, Peter F.; Greenwood, Priscilla E.

    2014-01-01

    The simulation of ion-channel noise has an important role in computational neuroscience. In recent years several approximate methods of carrying out this simulation have been published, based on stochastic differential equations, and all giving slightly different results. The obvious, and essential, question is: which method is the most accurate and which is most computationally efficient? Here we make a contribution to the answer. We compare interspike interval histograms from simulated data using four different approximate stochastic differential equation (SDE) models of the stochastic Hodgkin-Huxley neuron, as well as the exact Markov chain model simulated by the Gillespie algorithm. One of the recent SDE models is the same as the Kurtz approximation first published in 1978. All the models considered give similar ISI histograms over a wide range of deterministic and stochastic input. Three features of these histograms are an initial peak, followed by one or more bumps, and then an exponential tail. We explore how these features depend on deterministic input and on level of channel noise, and explain the results using the stochastic dynamics of the model. We conclude with a rough ranking of the four SDE models with respect to the similarity of their ISI histograms to the histogram of the exact Markov chain model. PMID:25339894

  17. Blind Deconvolution of Hodgkin-Huxley neuronal model.

    PubMed

    Lankarany, M; Zhu, W-P; Swamy, M N S; Toyoizumi, Taro

    2013-01-01

    Neuron transforms information via a complex interaction between its previous states, its intrinsic properties, and the synaptic input it receives from other neurons. Inferring synaptic input of a neuron only from its membrane potential (output) that contains both sub-threshold and action potentials can effectively elucidate the information processing mechanism of a neuron. The term coined blind deconvolution of Hodgkin-Huxley (HH) neuronal model is defined, for the first time in this paper, to address the problem of reconstructing the hidden dynamics and synaptic input of a single neuron modeled by the HH model as well as estimating its intrinsic parameters only from single trace of noisy membrane potential. The blind deconvolution is accomplished via a recursive algorithm whose iterations contain running an extended Kalman filtering followed by the expectation maximization (EM) algorithm. The accuracy and robustness of the proposed algorithm have been demonstrated by our simulations. The capability of the proposed algorithm makes it particularly useful to understand the neural coding mechanism of a neuron.

  18. Advances in the Treatment of Relapsed or Refractory Hodgkin's Lymphoma

    PubMed Central

    2012-01-01

    Hodgkin's lymphoma (HL) is diagnosed in 20,000 men and women annually in North America and Europe. Despite treatment advancements for HL resulting in an overall survival rate of 80%, patients with advanced stage disease continue to have suboptimal outcomes, with relapse rates of 30%–40%. An additional 10%–15% of patients present with primary refractory disease. For patients who relapse after initial treatment, salvage chemotherapy followed by autologous stem cell transplant in those with chemotherapy-sensitive disease is the standard of care. Patients who relapse after second-line therapy have a median survival time in the range of 6–36 months, and the optimal management of these patients remains unclear. Unfortunately, there have been no new agents approved for relapsed HL treatment since the 1970s. Consequently, clinical decision making in this population is difficult. Recently however, several agents have emerged that have shown clinical promise in this poor-risk population. This review discusses the management of these patients and also discusses several newer agents showing clinical promise in the treatment of HL. PMID:22387318

  19. Long-term morbidity after staging laparotomy for Hodgkin lymphoma.

    PubMed

    Lobeck, Inna; Rymeski, Beth; Burns, Karen; Nagarajan, Rajaram; Correll, Judy; Kent, Debra; Dasgupta, Roshni

    2017-09-01

    A large cohort of Hodgkin lymphoma (HL) survivors exist. With patients transitioning from pediatric to adult care, practitioners should be aware of potential complications. The aim of this study was to describe the long-term complications of patients who had staging laparotomy for the treatment of HL. After institutional review board approval, a retrospective review of hospital records at our institution was performed. Data extracted included demographics, treatment course and long-term postoperative complications. 24 patients with HL underwent staging laparotomy from 1971 to 1994 with median follow-up of 27.9years. Six (33%) had intraabdominal disease. Three patients (17%) required four repeat laparotomies for bowel obstruction. Of these, one had radiation to the inguinal region for local control, one had mantle radiation. Five patients developed a second malignancy. There were no documented cases of postsplenectomy sepsis. Other late effects that were unlikely related to surgery included pulmonary fibrosis (4), heart failure (2), hypothyroidism (4), and dysphagia (3). One patient died of metastatic adenocarcinoma. Long-term follow-up of patients who underwent staging laparotomy for HL revealed an increased incidence of repeat laparotomy and secondary malignancy. This underscores the importance of a high index of suspicion and screening in this population. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Chemosensitive epidural spinal cord disease in non-Hodgkins lymphoma.

    PubMed

    Wong, E T; Portlock, C S; O'Brien, J P; DeAngelis, L M

    1996-06-01

    Epidural spinal cord disease (ESCD), an infrequent complication of systemic non-Hodgkins lymphoma (NHL), can occur at diagnosis or at relapse, and is usually treated with radiotherapy, or infrequently surgical decompression. We retrospectively analyzed 140 patients with intermediate-grade NHL (IG-NHL) who were treated on a dose-intense protocol using doxorubicin, vincristine, and high-dose cyclophosphamide (NHL-15). There were seven episodes of ESCD in six (4.3%) patients. Five episodes were asymptomatic at presentation; one patient had back pain, leg numbness, and tingling; and one had radicular pain and mild leg weakness. None had malignant cells in the CSF. One patient received high-dose dexamethasone after laminectomy for diagnostic biopsy; otherwise, dexamethasone was used only as an anti-emetic prior to chemotherapy. Patients who developed ESCD at diagnosis received the planned course of NHL-15 chemotherapy as treatment for ESCD, and those treated with NHL-15 who developed ESCD at relapse were given a regimen containing ifosfamide, carboplatin, and etoposide (ICE). After chemotherapy alone, five of seven episodes showed radiographic resolution of ESCD and improvement of neurologic deficits. One patient received consolidation radiotherapy (2,700 cGy) to the spine after ICE for relapsed ESCD and had a complete response. One patient had progression of systemic lymphoma and ESCD despite chemotherapy. These data suggest that chemotherapy may be effective as initial treatment of ESCD in IG-NHL and may reduce the potential complications of spinal surgery and radiotherapy.

  1. Cystic Odontoma in a Patient with Hodgkin's Lymphoma

    PubMed Central

    Costa, Victor; Caris, Adriana Rocha; León, Jorge Esquiche; Ramos, Carolina Judica; Jardini, Vaneska; Kaminagakura, Estela

    2015-01-01

    Cystic odontoma is a rare entity, which is characterized by the association of a cyst with complex/compound odontoma. The aim of this study was to report the case of a 5-year-old male patient diagnosed previously with Hodgkin's lymphoma and treated successfully with chemotherapy and radiotherapy, who developed a mandibular odontogenic lesion. Physical examination revealed a swelling on the right side of the mandible. Radiographically, a well-defined radiolucent area surrounded by radiopaque material was observed. An incisional biopsy was performed and microscopic analysis showed a cystic lesion consisting of an atrophic epithelium comprising 2-3 cell layers and the absence of inflammation in the cystic capsule. The cyst was decompressed and the lesion was removed after 3 months of follow-up. Microscopic analysis of the surgical specimen showed a cystic hyperplastic epithelium surrounded by an intense chronic inflammatory cell infiltrate, which was in close contact with mineralized tissue resembling dentin and cementum. The final diagnosis was cystic odontoma. Since chemotherapy can affect the growth and development of infant teeth, a relationship between chemotherapy-associated adverse events and cystic odontoma is suggested in the present case. PMID:26618008

  2. Spontaneous spiking in an autaptic Hodgkin-Huxley setup

    NASA Astrophysics Data System (ADS)

    Li, Yunyun; Schmid, Gerhard; Hänggi, Peter; Schimansky-Geier, Lutz

    2010-12-01

    The effect of intrinsic channel noise is investigated for the dynamic response of a neuronal cell with a delayed feedback loop. The loop is based on the so-called autapse phenomenon in which dendrites establish connections not only to neighboring cells but also to its own axon. The biophysical modeling is achieved in terms of a stochastic Hodgkin-Huxley model containing such a built in delayed feedback. The fluctuations stem from intrinsic channel noise, being caused by the stochastic nature of the gating dynamics of ion channels. The influence of the delayed stimulus is systematically analyzed with respect to the coupling parameter and the delay time in terms of the interspike interval histograms and the average interspike interval. The delayed feedback manifests itself in the occurrence of bursting and a rich multimodal interspike interval distribution, exhibiting a delay-induced reduction in the spontaneous spiking activity at characteristic frequencies. Moreover, a specific frequency-locking mechanism is detected for the mean interspike interval.

  3. The ISI distribution of the stochastic Hodgkin-Huxley neuron.

    PubMed

    Rowat, Peter F; Greenwood, Priscilla E

    2014-01-01

    The simulation of ion-channel noise has an important role in computational neuroscience. In recent years several approximate methods of carrying out this simulation have been published, based on stochastic differential equations, and all giving slightly different results. The obvious, and essential, question is: which method is the most accurate and which is most computationally efficient? Here we make a contribution to the answer. We compare interspike interval histograms from simulated data using four different approximate stochastic differential equation (SDE) models of the stochastic Hodgkin-Huxley neuron, as well as the exact Markov chain model simulated by the Gillespie algorithm. One of the recent SDE models is the same as the Kurtz approximation first published in 1978. All the models considered give similar ISI histograms over a wide range of deterministic and stochastic input. Three features of these histograms are an initial peak, followed by one or more bumps, and then an exponential tail. We explore how these features depend on deterministic input and on level of channel noise, and explain the results using the stochastic dynamics of the model. We conclude with a rough ranking of the four SDE models with respect to the similarity of their ISI histograms to the histogram of the exact Markov chain model.

  4. Health practice in long-term survivors of Hodgkin's lymphoma.

    PubMed

    Ng, Andrea K; Li, Sigui; Recklitis, Christopher; Diller, Lisa R; Neuberg, Donna; Silver, Barbara; Mauch, Peter M

    2008-06-01

    To compare the health practice of Hodgkin's lymphoma (HL) survivors and their siblings, and to assess the impact of socioeconomic status and disease history on health practice of HL survivors. We conducted a questionnaire study on long-term HL survivors and their siblings on health care utilization, health habits, and screening behavior. A total of 511 HL survivors (response rate of 50%, including survivors lost to contact) and 224 siblings (response rate, 58%) participated. Median time from HL diagnosis was 15 years. Significantly more survivors than siblings had a physical examination in the past year (63% vs. 49%, p = 0.0001). Male survivors were significantly more likely than siblings to perform monthly self-testicular examinations (19% vs. 9%, p = 0.02). Among survivors, higher household income (p = 0.01) independently predicted for having had a physical examination in the past year. Lower educational level (p = 0.0004) and history of relapsed HL (p = 0.03) were independent predictors for smoking, moderate/heavy alcohol use, and/or physical inactivity. Compared with siblings, long-term HL survivors have a higher level of health care utilization and better screening practice. Survivors from lower socioeconomic background had lower adherence to routine health care and greater report of unhealthy habits. Survivors with history of relapsed HL were also more likely to engage in unhealthy habits.

  5. Hemophagocytic Lymphohistiocytosis in a Patient with Classical Hodgkin Lymphoma

    PubMed Central

    Robbins, K. J.; Wilgus, N.; Grosso, L.

    2016-01-01

    Introduction. Hemophagocytic lymphohistiocytosis (HLH) is a rare hyperinflammatory syndrome that can be associated with inherited genetic mutations, malignancy, autoimmune disorders, and viral infections. Though the pathogenesis is not fully known, HLH is understood to be a reactive process in the setting of uncontrolled activation of macrophages, CD8+ cytotoxic lymphocytes, and other immune cells. Hallmark clinicopathological features of HLH include fevers, cytopenias, hepatosplenomegaly, and hemophagocytosis in the bone marrow. Case Presentation. A previously healthy 28-year-old Caucasian male presented with a one-month history of persistent fever, night sweats, and unintentional weight loss. He was diagnosed with classical Hodgkin Lymphoma (HL) by core-needle biopsy of an axillary lymph node. Both bone marrow involvement by HL and hemophagocytosis were seen on subsequent bone marrow biopsy. Other findings included pancytopenia, splenomegaly, and elevated serum ferritin. Extensive work-up for autoimmune and infectious etiologies was unremarkable. The patient had a complete response after chemotherapy with Adriamycin, bleomycin, vincristine, and dacarbazine. Conclusion. This report documents the exceedingly uncommon association between HLH and HL. HLH is a hyperinflammatory syndrome with high mortality, so it is imperative to identify and treat the underlying cause for secondary HLH. Malignancy-associated HLH should be considered in the differential diagnosis for cancer patients who present with fever, cytopenias, and splenomegaly. PMID:27803821

  6. Lymphoma classification update: B-cell non-Hodgkin lymphomas.

    PubMed

    Jiang, Manli; Bennani, N Nora; Feldman, Andrew L

    2017-05-01

    Lymphomas are classified based on the normal counterpart, or cell of origin, from which they arise. Because lymphocytes have physiologic immune functions that vary both by lineage and by stage of differentiation, the classification of lymphomas arising from these normal lymphoid populations is complex. Recent genomic data have contributed additional complexity. Areas covered: Lymphoma classification follows the World Health Organization (WHO) system, which reflects international consensus and is based on pathological, genetic, and clinical factors. A 2016 revision to the WHO classification of lymphoid neoplasms recently was reported. The present review focuses on B-cell non-Hodgkin lymphomas, the most common group of lymphomas, and summarizes recent changes most relevant to hematologists and other clinicians who care for lymphoma patients. Expert commentary: Lymphoma classification is a continually evolving field that needs to be responsive to new clinical, pathological, and molecular understanding of lymphoid neoplasia. Among the entities covered in this review, the 2016 revision of the WHO classification particularly impact the subclassification and genetic stratification of diffuse large B-cell lymphoma and high-grade B-cell lymphomas, and reflect evolving criteria and nomenclature for indolent B-cell lymphomas and lymphoproliferative disorders.

  7. Hodgkin lymphoma incidence in ethnic enclaves in California

    PubMed Central

    Glaser, Sally L.; Chang, Ellen T.; Clarke, Christina A.; Keegan, Theresa H.M.; Yang, Juan; Gomez, Scarlett Lin

    2016-01-01

    Hodgkin lymphoma (HL) incidence varies with migration and nativity, suggesting an influence of acculturation on risk. In population-based California data including 1,483 Hispanic and 348 Asian/Pacific Islander (API) HL cases, we examined HL rates in residential neighborhoods classified by ethnic enclave status (measuring degree of acculturation) and socioeconomic status (SES). Rates were inversely associated with enclave intensity, although associations varied by gender and race. In females, the enclave effect was stronger in low-SES settings, but rates were higher in less-ethnic/high-SES than more-ethnic/low-SES neighborhoods--diminishing enclave intensity affected rates more than higher SES. In Hispanics, associations were modest, and only females experienced SES modification of rates; in APIs, the enclave effect was much stronger. Thus, acculturation measured by residence in ethnic enclaves affects HL rates independently of neighborhood SES but in complex patterns. Living in less-ethnic neighborhoods may increase HL rates by facilitating social isolation and other gender-specific exposures implicated in risk. PMID:25899402

  8. Hodgkin lymphoma incidence in ethnic enclaves in California.

    PubMed

    Glaser, Sally L; Chang, Ellen T; Clarke, Christina A; Keegan, Theresa H M; Yang, Juan; Gomez, Scarlett Lin

    2015-01-01

    Hodgkin lymphoma (HL) incidence varies with migration and nativity, suggesting an influence of acculturation on risk. In population-based California data including 1483 Hispanic and 348 Asian/Pacific Islander (API) HL cases, we examined HL rates in residential neighborhoods classified by ethnic enclave status (measuring degree of acculturation) and socioeconomic status (SES). Rates were inversely associated with enclave intensity, although associations varied by gender and race. In females, the enclave effect was stronger in low-SES settings, but rates were higher in less-ethnic/high-SES than more-ethnic/low-SES neighborhoods--diminishing enclave intensity affected rates more than higher SES. In Hispanics, associations were modest, and only females experienced SES modification of rates; in APIs, the enclave effect was much stronger. Thus, acculturation measured by residence in ethnic enclaves affects HL rates independently of neighborhood SES but in complex patterns. Living in less-ethnic neighborhoods may increase HL rates by facilitating social isolation and other gender-specific exposures implicated in risk.

  9. Thyroid dysfunction after radiotherapy in children with Hodgkin's disease

    SciTech Connect

    Constine, L.S.; Donaldson, S.S.; McDougall, I.R.; Cox, R.S.; Link, M.P.; Kaplan, H.S.

    1984-02-15

    Thyroid function was measured in 119 children, 16 years of age or less, after radiotherapy (XRT) for Hodgkin's disease. Thyroid abnormalities developed in 4 of 24 children (17%) who received 2600 rad or less, and in 74 of 95 children (78%) who received greater than 2600 rad to the cervical area, including the thyroid. The abnormality in all but three (one with hyperthyroidism and two with thyroid nodules) included the development of elevated levels of thyroid stimulating hormone (TSH). Age, sex, and administration of chemotherapy were not significant factors in the development of thyroid dysfunction. All children had lymphangiograms (LAG) and no time relationship was noted between thyroid dysfunction and LAG-XRT interval. The mean interval from radiotherapy to documented thyroid dysfunction was 18 months in the low-dose group and 31 months in the high-dose group, with most patients becoming abnormal within 3 to 5 years. Of interest was a spontaneous return of TSH to within normal limits in 20 children and substantial improvement in another 7. This study confirms the occurrence of dose-related occult hypothyroidism in children following external irradiation of the neck.

  10. Combination chemotherapy and radiotherapy in non-Hodgkin's lymphomata.

    PubMed Central

    Bonadonna, G.; De Lena, M.; Lattuada, A.; Milani, F.; Monfardini, S.; Beretta, G.

    1975-01-01

    The results obtained with intensive chemotherapy and intensive chemotherapy plus radiotherapy in non-Hodgkin's lymphomata are reported. A quintuple drug regimen (mechloretamine, adriamycin, bleomycin, vincristine and prednisone) in histiocytic lymphomata (Stage III and IV) yielded complete remissions in 53% and complete plus partial remissions in 77%. These figures were 44% and 64% respectively in lymphocytic lymphoma. In Stage III complete responders after combination chemotherapy were subsequently irradiated (involved field irradiation). The median duration of complete remission after completion of radiotherapy was 9-5 months in histiocytic and 12-0 months in lymphocytic lymphomata. At 2 years actuarial survival in Stage III and IV was better in patients with the lymphocytic type and with nodular pattern than with histiocytic and diffuse patterns. A more recent trial compares, in Stage IV patients, cyclophosphamide, vincristine and prednisone (CVP) versus adriamycin, bleomycin and prednisone (ABP). Although the number of evaluable patients is still limited, there appears to be no difference in the response rate between CVP and ABP. In Stages I and II, 6 cycles of CVP were given as adjuvant treatment after radiotherapy. At the present moment, there is no statistical difference in the relapse rate between the group of patients treated with radiotherapy alone and that with radiotherapy plus CVP. PMID:52367

  11. Idelalisib for the treatment of non-Hodgkin lymphoma

    PubMed Central

    Gopal, Ajay; Graf, Solomon

    2016-01-01

    Introduction B-cell Non-Hodgkin lymphomas (B-NHLs) include a number of disease subtypes, each defined by the tempo of disease progression and the identity of the cancerous cell. Idelalisib is a potent, selective inhibitor of the delta isoform of phosphatidylinositol-3-kinase (PI3K), a lipid kinase whose over-activity in B-NHL drives disease progression. Idelalisib has demonstrated activity in indolent B-NHL (iB-NHL) and is approved for use as monotherapy in patients with follicular lymphoma and small lymphocytic lymphoma and in combination with rituximab in patients with chronic lymphocytic leukemia. Areas Covered Herein we review the development and pharmacology of idelalisib, its safety and efficacy in clinical studies of iB-NHL, and its potential for inclusion in future applications in iB-NHL and in combination with other therapies. Expert Opinion Idelalisib adds to the growing arsenal of iB-NHL pharmacotherapeutics and to the progression of the field toward precision agents with good efficacy and reduced toxicities. Nevertheless, idelalisib carries important risks that require careful patient counseling and monitoring. The appropriate sequencing of idelalisib with other proven treatment options in addition to its potential for combination with established or novel drugs will be borne out in ongoing and planned investigations. PMID:26818003

  12. The prognostic value of biological markers in paediatric Hodgkin lymphoma.

    PubMed

    Farruggia, Piero; Puccio, Giuseppe; Sala, Alessandra; Todesco, Alessandra; Buffardi, Salvatore; Garaventa, Alberto; Bottigliero, Gaetano; Bianchi, Maurizio; Zecca, Marco; Locatelli, Franco; Pession, Andrea; Pillon, Marta; Favre, Claudio; D'Amico, Salvatore; Provenzi, Massimo; Trizzino, Angela; Zanazzo, Giulio Andrea; Sau, Antonella; Santoro, Nicola; Murgia, Giulio; Casini, Tommaso; Mascarin, Maurizio; Burnelli, Roberta

    2016-01-01

    Many biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children. By using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens. On multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography. Using the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Aberrant expression of homeobox gene SIX1 in Hodgkin lymphoma

    PubMed Central

    Nagel, Stefan; Meyer, Corinna; Kaufmann, Maren; Drexler, Hans G.; MacLeod, Roderick A.F.

    2015-01-01

    In Hodgkin lymphoma (HL) we recently identified deregulated expression of homeobox genes MSX1 and OTX2 which are physiologically involved in development of the embryonal neural plate border region. Here, we examined in HL homeobox gene SIX1 an additional regulator of this embryonal region mediating differentiation of placodal precursors. SIX1 was aberrantly activated in 12 % of HL patient samples in silico, indicating a pathological role in a subset of this B-cell malignancy. In addition, SIX1 expression was detected in HL cell lines which were used as models to reveal upstream factors and target genes of this basic developmental regulator. We detected increased copy numbers of the SIX1 locus at chromosome 14q23 correlating with enhanced expression while chromosomal translocations were absent. Moreover, comparative expression profiling data and pertinent gene modulation experiments indicated that the WNT-signalling pathway and transcription factor MEF2C regulate SIX1 expression. Genes encoding the transcription factors GATA2, GATA3, MSX1 and SPIB – all basic lymphoid regulators - were identified as targets of SIX1 in HL. In addition, cofactors EYA1 and TLE4, respectively, contrastingly mediated activation and suppression of SIX1 target gene expression. Thus, the protein domain interfaces may represent therapeutic targets in SIX1-positive HL subsets. Collectively, our data reveal a gene regulatory network with SIX1 centrally deregulating lymphoid differentiation and support concordance of lymphopoiesis/lymphomagenesis and developmental processes in the neural plate border region. PMID:26473286

  14. Spontaneous spiking in an autaptic Hodgkin-Huxley setup.

    PubMed

    Li, Yunyun; Schmid, Gerhard; Hänggi, Peter; Schimansky-Geier, Lutz

    2010-12-01

    The effect of intrinsic channel noise is investigated for the dynamic response of a neuronal cell with a delayed feedback loop. The loop is based on the so-called autapse phenomenon in which dendrites establish connections not only to neighboring cells but also to its own axon. The biophysical modeling is achieved in terms of a stochastic Hodgkin-Huxley model containing such a built in delayed feedback. The fluctuations stem from intrinsic channel noise, being caused by the stochastic nature of the gating dynamics of ion channels. The influence of the delayed stimulus is systematically analyzed with respect to the coupling parameter and the delay time in terms of the interspike interval histograms and the average interspike interval. The delayed feedback manifests itself in the occurrence of bursting and a rich multimodal interspike interval distribution, exhibiting a delay-induced reduction in the spontaneous spiking activity at characteristic frequencies. Moreover, a specific frequency-locking mechanism is detected for the mean interspike interval.

  15. Energy and information in Hodgkin-Huxley neurons.

    PubMed

    Moujahid, A; d'Anjou, A; Torrealdea, F J; Torrealdea, F

    2011-03-01

    The generation of spikes by neurons is energetically a costly process and the evaluation of the metabolic energy required to maintain the signaling activity of neurons a challenge of practical interest. Neuron models are frequently used to represent the dynamics of real neurons but hardly ever to evaluate the electrochemical energy required to maintain that dynamics. This paper discusses the interpretation of a Hodgkin-Huxley circuit as an energy model for real biological neurons and uses it to evaluate the consumption of metabolic energy in the transmission of information between neurons coupled by electrical synapses, i.e., gap junctions. We show that for a single postsynaptic neuron maximum energy efficiency, measured in bits of mutual information per molecule of adenosine triphosphate (ATP) consumed, requires maximum energy consumption. For groups of parallel postsynaptic neurons we determine values of the synaptic conductance at which the energy efficiency of the transmission presents clear maxima at relatively very low values of metabolic energy consumption. Contrary to what could be expected, the best performance occurs at a low energy cost.

  16. New drugs for the treatment of non-Hodgkin lymphomas.

    PubMed

    Smith, Sonali M

    2015-03-01

    Non-Hodgkin lymphomas (NHL) are diverse diseases either of mature B-cell or T-cell derivation. Despite being generally chemosensitive diseases, the last decade has focused on developing more targeted agents based on improved insights of underlying biology. The hope is that more targeted and biologically rational treatments will improve both the efficacy and toxicity profile of standard approaches, with the ultimate goal of improving clinical outcomes. Among the newest agents to be approved are inhibitors of B-cell receptor (BCR) and PI3K signaling; however, a number of other classes of agents such as selective inhibitors of nuclear export (SINE), inhibitors of immune regulation such as PD1 inhibitors, and small molecule inhibitors of apoptosis are on the horizon. In addition, growing clinical evidence supports continued and new applications for immunomodulatory agents, proteasome inhibitors and histone deacetylase inhibitors. Altogether, this is an exciting time for NHL, with a number of promising agents and early clinical data. The key path forward will be to better apply these new agents in a personalized way, which will hopefully constitute the next generation of trials.

  17. Non-Hodgkin lymphoma with relapses in the lacrimal glands

    PubMed Central

    Couceiro, Rita; Proença, Helena; Pinto, Filomena; Fonseca, Ana; Monteiro-Grillo, Manuel

    2015-01-01

    Objective: To report an unusual case of systemic non-Hodgkin lymphoma (NHL) with repeated relapse in the lacrimal glands, in spite of complete remission for several years after treatment. Methods: A 78-year-old male with small lymphocytic B cell NHL, stage IV disease (lung invasion), was submitted to surgery and chemotherapy in 2001, with complete remission of the disease. In 2003 he developed a nodular lesion in the right lacrimal fossa. Pathology results revealed a local relapse of NHL. Radiation and chemotherapy were initiated and complete remission was again achieved. In 2012 the patient developed a new nodular lesion located in the left lacrimal fossa, resulting in diplopia, ptosis and proptosis of the left eye. Orbital computerized tomography (CT), ocular ultrasound and incisional biopsy were performed. Results: Orbital CT revealed a lesion infiltrating the left lacrimal gland and encircling the globe. Biopsy results confirmed a local relapse of B cell NHL. The patient was submitted to local radiation therapy with progressive resolution of ptosis, proptosis and diplopia. Response to treatment was monitored with ocular ultrasound. Conclusions: Patients with NHL diagnosis should be immediately investigated if ophthalmic or orbital symptoms develop. NHL extension to the orbit and adnexa is infrequent (5% of NHL cases) but may occur at any stage of the disease, including as a relapse site. In such cases, radiation and chemotherapy achieve good results, inducing long periods of remission. PMID:27625948

  18. Fundamentals of the management of non-Hodgkin lymphoma.

    PubMed

    Fadilah, S A W

    2009-12-01

    The incidence of Non-Hodgkin's lymphomas (NHL) is rising worldwide and if not adequately treated carries a high mortality rate. The pattern and frequency of NHL vary in different populations and geographical regions. It has considerable biologic and clinical heterogeneity and a definitive diagnosis can be made only after histopathogical examination. The histology and the extent of the lymphoma are the major determinants of optimal therapeutic regimen and treatment outcome. Additionally, the overall treatment strategies should be tailored according to medical status and preference of the patient. A holistic approach provided by a multi-disciplinary team of health care professionals is the cornerstone of ensuring successful treatment outcome. Importantly, therapy should be expedited and where possible performed in experienced centers. Patients achieving remission would require long-term monitoring for disease recurrence and late effects of cytotoxic chemotherapy and radiotherapy. Hence, clinicians should have a fundamental understanding in the biology and the principles of treatment of NHL. This review provides an evidence-based and systematic approach in designing therapeutic strategies for individual patients with newly diagnosed and relapsed NHL focusing on the common types of NHL with particular reference to the current practice within the local settings. The role of standard and novel therapeutic modalities in treatment will be summarized.

  19. Testicular non-Hodgkin's lymphoma presenting in a young adult

    PubMed Central

    Ratkal, Vishal; Chawla, Arun; Mishra, Dilip Kumar; Monappa, Vidya

    2015-01-01

    We report a case of a 27-year-old man who presented with a slowly growing left testicular swelling associated with mild pain over a period of 3 months. He was evaluated by his family physician with scrotal ultrasound and testicular tumour markers. He was diagnosed and treated as epididymo-orchitis and managed with antibiotics. When he later presented to us, he had an enlarged left testis with normal spermatic cord. Scrotal Doppler evaluation showed a globally enlarged left testis and epididymis with increased vascularity in the left testis, with the right testis being normal. Testicular tumour markers were normal. Fine-needle aspiration cytology of the left testis was suggestive of lymphoma. Exploration through an inguinal approach was carried out and a Chevassu manoeuvre with frozen section study was performed, which was reported as non-Hodgkin's lymphoma. Left radical orchidectomy was performed. Histopathology reported diffuse large B-cell lymphoma, of a germinal centre type. Contrast CT of the abdomen, chest and brain were normal. Sperm cryopreservation was carried out. The patient was started on chemotherapy with cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone (CHOP) regime. PMID:25795748

  20. Obinutuzumab for relapsed or refractory indolent non-Hodgkin's lymphomas.

    PubMed

    Gabellier, Ludovic; Cartron, Guillaume

    2016-04-01

    The use of anti-CD20 monoclonal antibodies (mAbs), such as rituximab, in CD20-positive B-cell malignancies has dramatically improved the outcome of chronic lymphoid leukemia and non-Hodgkin's lymphomas (NHL). However, the occurrence of relapse and development of rituximab-refractory disease highlight the need to develop novel anti-CD20 mAbs, with improved mechanisms of action. Obinutuzumab is the first humanized type II glycoengineered anti-CD20 mAb. In vitro and in vivo data suggested several differences compared with rituximab, including a low level of complement-dependent cytotoxicity and an increased direct nonapoptotic cell death. Moreover, the glycoengineered Fc-linked nonfucosylated oligosaccharide enhanced the Fc-Fcγ receptor (FcγR) IIIa interaction, resulting in improved antibody-dependent cellular cytotoxicity and phagocytosis. Preclinical models suggested that these differences translate into superior survival in murine lymphoma models. Phase I/II trials in monotherapy in relapsed or refractory B-cell NHL demonstrated that obinutuzumab has an acceptable safety profile, infusion-related reactions being the most common adverse event. In rituximab-refractory indolent NHL, the recent randomized phase III GADOLIN study demonstrated an improved median progression-free survival for patients treated with obinutuzumab plus bendamustine rather than bendamustine alone. Further trials are ongoing to determine the role of obinutuzumab as a first-line agent in the treatment of follicular lymphoma.

  1. Hodgkin lymphoma in the elderly, pregnant, and HIV-infected

    PubMed Central

    Bachanova, Veronika; Connors, Joseph M.

    2017-01-01

    Hodgkin lymphoma (HL) presenting in patients with co-incidental advanced age, pregnancy, or human immunodeficiency virus (HIV) infection is uniquely challenging to manage. In this article we integrate recent evidence and clinical expertise to present recommendations for diagnosis and therapeutic management. Older patients with HL need to be carefully evaluated for comorbidies after which judicious choice of chemotherapy should minimize functional compromise. A pregnant patient with concurrent HL should be staged with minimal use of imaging requiring ionizing radiation and treated in an individualized manner optimally combining the strategies of treatment deferral when appropriate, use of single-agent vinblastine for symptomatic disease and reservation of multi-agent chemotherapy for the small minority of patients with aggressive clinical presentation. Treatment of HL coincident with HIV infection requires a combination of highly active anti-retroviral agents (HAART), standard multi-agent chemotherapy with meticulous attention to drug–drug interactions, and vigorous supportive care to ensure the best chance of cure. PMID:27496312

  2. Non-Hodgkin's lymphomas in Saskatchewan: a clinicopathologic study

    PubMed Central

    Cherian, Thomas; Skinnider, Leo F.; Wright, Joanne L.; Komjathy, Gabriel

    1978-01-01

    In a retrospective clinical study of 208 previously untreated persons with non-Hodgkin's lymphomas the disorders were classified and staged according to the histopathologic criteria of Rappaport, Winter and Hicks and the Ann Arbor clinical staging classification. Nodular types constituted 22% and diffuse types 78% of the lymphomas. The nodular lymphomas were slightly more common in females and were clustered in the age range 30 to 90 years. The diffuse lymphomas were slightly more common in males; the age distribution was bimodal, with one peak in the age range 10 to 19 years and the other in the age range 60 to 69 years, but when the age distribution of the general population in which the lymphomas occurred was taken into account, the incidence of these lymphomas was found to be significantly higher (P < 0.001) in persons more than 69 years of age than in those 40 to 69 years of age. Survival correlated with histopathologic type: persons with nodular (follicular) lymphomas and diffuse lymphocytic well differentiated lymphomas had a significantly greater survival (P < 0.05) than those with other diffuse lymphomas. No significant difference in survival was noticed between persons with nodal and extranodal lymphomas. While Rappaport and colleagues' criteria are still very useful, it is important to recognize the nodular lymphoma as a specific entity requiring generally different management from diffuse lymphomas. Appreciation of the different biologic behaviour of the various lymphomas is important to clinicians planning therapy. PMID:356951

  3. Predictors of Radiation Pneumonitis in Patients Receiving Intensity Modulated Radiation Therapy for Hodgkin and Non-Hodgkin Lymphoma

    SciTech Connect

    Pinnix, Chelsea C.; Smith, Grace L.; Milgrom, Sarah; Osborne, Eleanor M.; Reddy, Jay P.; Akhtari, Mani; Reed, Valerie; Arzu, Isidora; Allen, Pamela K.; Wogan, Christine F.; Fanale, Michele A.; Oki, Yasuhiro; Turturro, Francesco; Romaguera, Jorge; Fayad, Luis; Fowler, Nathan; Westin, Jason; Nastoupil, Loretta; Hagemeister, Fredrick B.; Rodriguez, M. Alma [Department of Lymphoma and others

    2015-05-01

    Purpose: Few studies to date have evaluated factors associated with the development of radiation pneumonitis (RP) in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), especially in patients treated with contemporary radiation techniques. These patients represent a unique group owing to the often large radiation target volumes within the mediastinum and to the potential to receive several lines of chemotherapy that add to pulmonary toxicity for relapsed or refractory disease. Our objective was to determine the incidence and clinical and dosimetric risk factors associated with RP in lymphoma patients treated with intensity modulated radiation therapy (IMRT) at a single institution. Methods and Materials: We retrospectively reviewed clinical charts and radiation records of 150 consecutive patients who received mediastinal IMRT for HL and NHL from 2009 through 2013. Clinical and dosimetric predictors associated with RP according to Radiation Therapy Oncology Group (RTOG) acute toxicity criteria were identified in univariate analysis using the Pearson χ{sup 2} test and logistic multivariate regression. Results: Mediastinal radiation was administered as consolidation therapy in 110 patients with newly diagnosed HL or NHL and in 40 patients with relapsed or refractory disease. The overall incidence of RP (RTOG grades 1-3) was 14% in the entire cohort. Risk of RP was increased for patients who received radiation for relapsed or refractory disease (25%) versus those who received consolidation therapy (10%, P=.019). Several dosimetric parameters predicted RP, including mean lung dose of >13.5 Gy, V{sub 20} of >30%, V{sub 15} of >35%, V{sub 10} of >40%, and V{sub 5} of >55%. The likelihood ratio χ{sup 2} value was highest for V{sub 5} >55% (χ{sup 2} = 19.37). Conclusions: In using IMRT to treat mediastinal lymphoma, all dosimetric parameters predicted RP, although small doses to large volumes of lung had the greatest influence. Patients with relapsed

  4. Syncytial Variant of Nodular Sclerosis Classical Hodgkin Lymphoma of the Terminal Ileum in a Patient with Longstanding Crohn's Disease.

    PubMed

    Gibson, Bradley; Podoll, Mirna Bajramovic; Baumgartner, Erin Marie; Maley, Diana Haninger

    2016-01-01

    Primary Hodgkin lymphoma of the gastrointestinal tract is an uncommon malignancy with few reported cases. Here we describe a rare variant of Hodgkin lymphoma presented in the gastrointestinal tract in association with Crohn's Disease.The patient is a 58 year old male with a 40 year history of formerly well-controlled Crohn's disease who presented with abdominal discomfort and constitutional symptoms. Computed tomography showed a 10 cm thickened segment of ileum and a dilated segment of small bowel. The patient underwent segmental resection, revealing a mass, which was diagnosed by pathology as nodular sclerosis classical Hodgkin lymphoma, syncytial variant.There are only 29 reported cases of syncytial variant of nodular sclerosis classical Hodgkin lymphoma. This is the second documented case of primary gastrointestinal syncytial variant of nodular sclerosis classical Hodgkin lymphoma. Further characterization of this entity is necessary.

  5. ConSCRIPT

    PubMed Central

    Mottarella, Scott E.; Rosa, Mario; Bangura, Abdul; Bernstein, Herbert J.; Craig, Paul A.

    2011-01-01

    The aim of the Structural Biology Extensible Visualization Scripting Language (SBEVSL) project is to allow users who are experts in one scripting language to use that language in a second molecular visualization environment without requiring the user to learn a new scripting language. ConSCRIPT, the first SBEVSL release, is a plug-in for PyMOL that accepts RasMol scripting commands either as premade scripts or as line-by-line entries from PyMOL's own command line. The plug-in is available for download at http://sourceforge.net/projects/sbevsl/files in the ConSCRIPT folder. PMID:21567873

  6. In vivo somatic mutation in the lymphocytes of Hodgkin's disease patients

    SciTech Connect

    Caggana, M.; Liber, H.L.; Mauch, P.M.; Coleman, C.N.; Kelsey, K.T. )

    1991-01-01

    While current medical therapies for Hodgkin's disease are usually quite effective, it has become increasingly clear that some of the therapies utilized carry an inherent risk for the induction of secondary malignancies. In order to examine the cellular and genetic responses to therapy for Hodgkin's disease among individuals, the authors have determined the mutant frequency of T-lymphocytes in 3 cohorts of patients and in controls using a T-cell cloning assay selecting for 6-thioguanine resistance. Overall, the results indicated that the individual response to Hodgkin's disease therapy was a heterogeneous one with a sub-population of persons having elevated mutant frequencies even many years after their last treatment. The larger frequency of elevated MFs in those patients who received intensive therapy (chemotherapy and radiotherapy) is consistent with their increased risk for second cancer induction.

  7. Thoracic CT scanning for mediastinal Hodgkin's disease: results and therapeutic implications

    SciTech Connect

    Rostock, R.A.; Siegelman, S.S.; Lenhard, R.E.; Wharam, M.D.; Order, S.E.

    1983-10-01

    Thoracic CT scans were performed on 42 newly diagnosed patients with Hodgkin's disease. Five of 10 patients with negative chest X ray (CXR) had abnormal thoracic CT scans. Among the remaining 32 patients with mediastinal Hodgkin's disease (MHD) on CXR, pericardial (Ep) and chest wall invasion (Ec) were the two most common sites of involvement which were detectable by CT scan alone. Ep and Ec accounted for 16 of 19 of the changes in treatment portal or philosophy based on CT scan findings. Because of the high risk of cardiac or pulmonary radiation toxicity in Ep or Ec, radiation treatment alone may be inadequate. Treatment of mediastinal Hodgkin's disease is reviewed here. The use of CT scans for identification of Ep, Ec, and other abnormalities will allow for more precise treatment, further define the use of conventional radiotherapy, combined modality therapy or whole lung irradiation, and allow more accurate analysis of treatment results.

  8. Late effects of radiation therapy in the treatment of Hodgkin's disease

    SciTech Connect

    Kinsella, T.J.; Fraass, B.A.; Glatstein, E.

    1982-04-01

    In the last two decades, a considerable amount of clinical and experimental animal data has been accumulated regarding the tolerance of the major normal tissues and organs traversed by the radiation beams in treating Hodgkin's disease. Typically, the tolerance of several tissues and organs must be considered in designing the very large radiation portals such as the mantle. Today, sophisticated machinery such as computerized tomography scanners, simulators, computers, and linear accelerators are available to improve the radiation planning and treatment of Hodgkin's disease. In this paper, researchers discuss the late effects of radiation therapy to the lung, heart, thyroid, kidney, gastrointestinal tract, and the gonads of adults with Hodgkin's disease. Emphasis is placed on our recommendations for modifications of radiation technique to improve the complication-free cure rate.

  9. Hodgkin lymphoma in a patient with mosaic trisomy 18: First clinical observation.

    PubMed

    Motta, Serena; Sala, Debora; Sala, Alessandra; Cazzaniga, Giovanni; Giudici, Giovanni; Villa, Nicoletta; Biondi, Andrea; Selicorni, Angelo

    2016-03-01

    We report the case of a 17-year-old boy with a mosaic trisomy 18, who was diagnosed with Hodgkin lymphoma. The patient showed only poor growth and two muscular ventricular septal defects; no facial dysmorphims were present. He was admitted to our hospital because of asthenia and weight loss; a mediastinal enlargement was found and an histological diagnosis of nodular sclerosis Hodgkin lymphoma on mediastinal biopsy was performed. Contextually, a chromosomal analysis on bone marrow aspirate and on peripheral blood revealed a mosaic trisomy 18. This result was confirmed also with cytogenetic analysis on skin fibroblasts. While there is a well-documented association between trisomy 18 and solid cell tumors, this is, to our knowledge, the first reported case of Hodgkin lymphoma in a patient with a mosaic trisomy 18, enlarging the spectrum of possible oncologic manifestations of the disease.

  10. A note on the asymptotic reduction of the Hodgkin-Huxley equations for nerve impulses.

    PubMed

    Hinch, Robert

    2005-09-01

    The (standard) FitzHugh reduction of the Hodgkin-Huxley equations for the propagation of nerve impulses ignores the dynamics of the activation gates. This assumption is invalid and leads to an over-estimation of the wave speed by a factor of 5 and the wrong dependence of wave speed on sodium channel conductance. The error occurs because a non-dimensional parameter, which is assumed to be small in the FitzHugh reduction, is in fact large (approximately 18). We analyse the Hodgkin-Huxley equations for propagating nerve impulses in the limit that this non-dimensional parameter is large, and show that the analytical results are consistent with numerical simulations of the Hodgkin-Huxley equations.

  11. FDG-PET for Early Response Assessment in Lymphomas: Part 1-Hodgkin Lymphoma.

    PubMed

    Cheson, Bruce D; Kostakoglu, Lale

    2017-01-15

    Interim positron emission tomography (PET)/CT has shown encouraging results when used as a prognostic tool early in the course of treatment of advanced Hodgkin lymphoma, allowing for a reduction in treatment for patients with favorable characteristics, while suggesting a benefit from changing therapy for those with a positive scan. For patients with limited disease, a negative scan allows for a decrease in treatment; however, the benefits for those patients whose scans are positive are less certain. Here we critically analyze the role of PET/CT in the early assessment of Hodgkin lymphoma. In Part 2, we will review the role of interim PET/CT in diffuse large B-cell lymphoma (DLBCL), and also explore the question of whether new approaches to quantitative assessment improve the prognostic value of interim PET scans in both Hodgkin lymphoma and DLBCL.

  12. [Prognostic value of beta-2-microglobulin in Hodgkin disease in young adults].

    PubMed

    Fleury, J; Tortochaux, J; Legros, M; Cure, H; Kwiatkowski, F; Ferrière, J P; Travade, P; Dionet, C; Gaillard, G; Chassagne, J

    1994-07-01

    From 1977 to 1989, we measured serum beta-2-microglobulin (beta 2-MG) levels from 64 unselected and untreated patients, between 18 to 50-year-old, affected by Hodgkin's disease. Serum beta 2-MG level was measured by radioimmunoassay (Phadebas beta 2 microtest). Then, all patients received a chemotherapy such as MOPP or alternating MOPP/ABVD followed or not by radiotherapy. Elevated serum beta 2-MG level (> 2.4 mg/l) is associated with advanced stage disease (stage III-IV), presence of systemic symptoms and bulky tumor. Nevertheless, a multivariate analysis shows that the serum beta 2-MG level is the most significant prognostic indicator for disease free survival. The prognostic value of serum beta 2-MG is demonstrated for myeloma and non Hodgkin's lymphoma. A few authors have evaluated the prognostic impact of serum beta 2-MG in Hodgkin's disease. This study requires confirmation by multicentric and prospective trial.

  13. Thyroid cancer following radiotherapy for Hodgkin's disease: a case report and review of the literature

    SciTech Connect

    Moroff, S.V.; Fuks, J.Z.

    1986-01-01

    Improved survival resulting from advances in therapy in patients with Hodgkin's disease is associated with long-term morbidity, including the potential for the development of a second solid malignancy. We report a 44-year-old man with an unusually aggressive course of thyroid carcinoma 15 years after treatment for Hodgkin's disease. In a review of the English-language literature, we found 21 cases of thyroid cancer following radiotherapy for Hodgkin's disease, with latency periods ranging from 6 to 48 years. The development of secondary thyroid cancer after high-dose neck irradiation may be related to hypothyroidism, itself a complication of radiotherapy. Thyroid function should be measured at least once a year in all patients given neck irradiation, with initiation of thyroid hormone replacement if there is evidence of sustained hypothyroidism.

  14. Dose-intensification in early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD14 trial.

    PubMed

    von Tresckow, Bastian; Plütschow, Annette; Fuchs, Michael; Klimm, Beate; Markova, Jana; Lohri, Andreas; Kral, Zdenek; Greil, Richard; Topp, Max S; Meissner, Julia; Zijlstra, Josée M; Soekler, Martin; Stein, Harald; Eich, Hans T; Mueller, Rolf P; Diehl, Volker; Borchmann, Peter; Engert, Andreas

    2012-03-20

    In patients with early unfavorable Hodgkin's lymphoma (HL), combined modality treatment with four cycles of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) and 30 Gy involved-field radiotherapy (IFRT) results in long-term tumor control of approximately 80%. We aimed to improve these results using more intensive chemotherapy. Patients with newly diagnosed early unfavorable HL were randomly assigned to either four cycles of ABVD or an intensified treatment consisting of two cycles of escalated BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone) followed by two cycles of ABVD (2 + 2). Chemotherapy was followed by 30 Gy IFRT in both arms. The primary end point was freedom from treatment failure (FFTF); secondary end points included progression-free survival (PFS) and treatment-related toxicity. With a total of 1,528 qualified patients included, the 2 + 2 regimen demonstrated superior FFTF compared with four cycles of ABVD (P < .001; hazard ratio, 0.44; 95% CI, 0.30 to 0.66), with a difference of 7.2% at 5 years (95% CI, 3.8 to 10.5). The difference in 5-year PFS was 6.2% (95% CI, 3.0% to 9.5%). There was more acute toxicity associated with 2 + 2 than with ABVD, but there were no overall differences in treatment-related mortality or secondary malignancies. Intensified chemotherapy with two cycles of BEACOPP escalated followed by two cycles of ABVD followed by IFRT significantly improves tumor control in patients with early unfavorable HL.

  15. Non-Hodgkin lymphoma in Southern Africa: review of 487 cases from The International Non-Hodgkin Lymphoma Classification Project.

    PubMed

    Perry, Anamarija M; Perner, Yvonne; Diebold, Jacques; Nathwani, Bharat N; MacLennan, Kenneth A; Müller-Hermelink, Hans K; Bast, Martin; Boilesen, Eugene; Armitage, James O; Weisenburger, Dennis D

    2016-03-01

    Comparative data on the distribution of non-Hodgkin lymphoma (NHL) subtypes in Southern Africa (SAF) is scarce. In this study, five expert haematopathologists classified 487 consecutive cases of NHL from SAF using the World Health Organization classification, and compared the results to North America (NA) and Western Europe (WEU). Southern Africa had a significantly lower proportion of low-grade (LG) B-NHL (34·3%) and a higher proportion of high-grade (HG) B-NHL (51·5%) compared to WEU (54·5% and 36·4%) and NA (56·1% and 34·3%). High-grade Burkitt-like lymphoma was significantly more common in SAF (8·2%) than in WEU (2·4%) and NA (2·5%), most likely due to human immunodeficiency virus infection. When SAF patients were divided by race, whites had a significantly higher frequency of LG B-NHL (60·4%) and a lower frequency of HG B-NHL (32·7%) compared to blacks (22·5% and 62·6%), whereas the other races were intermediate. Whites and other races had a significantly higher frequency of follicular lymphoma and a lower frequency of Burkitt-like lymphoma compared to blacks. The median ages of whites with LG B-NHL, HG B-NHL and T-NHL (64, 56 and 67 years) were significantly higher than those of blacks (55, 41 and 34 years). Epidemiological studies are needed to better understand these differences.

  16. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study.

    PubMed

    Lazarovici, Julien; Dartigues, Peggy; Brice, Pauline; Obéric, Lucie; Gaillard, Isabelle; Hunault-Berger, Mathilde; Broussais-Guillaumot, Florence; Gyan, Emmanuel; Bologna, Serge; Nicolas-Virelizier, Emmanuelle; Touati, Mohamed; Casasnovas, Olivier; Delarue, Richard; Orsini-Piocelle, Frédérique; Stamatoullas, Aspasia; Gabarre, Jean; Fornecker, Luc-Matthieu; Gastinne, Thomas; Peyrade, Fréderic; Roland, Virginie; Bachy, Emmanuel; André, Marc; Mounier, Nicolas; Fermé, Christophe

    2015-12-01

    Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320-1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234-0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent.

  17. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

    PubMed Central

    Lazarovici, Julien; Dartigues, Peggy; Brice, Pauline; Obéric, Lucie; Gaillard, Isabelle; Hunault-Berger, Mathilde; Broussais-Guillaumot, Florence; Gyan, Emmanuel; Bologna, Serge; Nicolas-Virelizier, Emmanuelle; Touati, Mohamed; Casasnovas, Olivier; Delarue, Richard; Orsini-Piocelle, Frédérique; Stamatoullas, Aspasia; Gabarre, Jean; Fornecker, Luc-Matthieu; Gastinne, Thomas; Peyrade, Fréderic; Roland, Virginie; Bachy, Emmanuel; André, Marc; Mounier, Nicolas; Fermé, Christophe

    2015-01-01

    Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320–1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234–0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent. PMID:26430172

  18. Second neoplasms in patients with Hodgkin's disease following combined modality therapy--the Yale experience

    SciTech Connect

    Koletsky, A.J.; Bertino, J.R.; Farber, L.R.; Prosnitz, L.R.; Kapp, D.S.; Fischer, D.; Portlock, C.S.

    1986-03-01

    From 1969 to 1982, 183 patients with previously untreated stages IIIB and IV Hodgkin's disease and relapsing Hodgkin's disease after radiation therapy were treated with combination chemotherapy plus low-dose irradiation (CRT). One hundred fifty patients who achieved a complete response (CR) were analyzed for risk of developing a second neoplasm. Median follow-up has been 8.3 years. Actuarial survival of all patients is 74% at 10 years with a relapse-free survival of 68%. An additional 24 patients with stage IIIA disease were also treated with CRT. There were 22 CRs at risk who were analyzed. Median follow-up has been 3+ years with an actuarial survival of 90% at five years and a relapse-free survival of 83%. Second neoplasms have developed in 14 of 172 patients at risk: acute nonlymphocytic leukemia (ANLL; five patients); aggressive histology non-Hodgkin's lymphoma (NHL; three patients); and a variety of solid neoplasms (six patients). Time to second neoplasm diagnosis after initial treatment ranged from 12 to 141 months. Five patients were older than 40 years. At the time of diagnosis of the second malignancy, 11 patients were free of Hodgkin's disease (for 36 to 141 months) and three were receiving therapy for recurrent Hodgkin's disease. The 10-year actuarial risk (%) of developing ANLL was 5.9 +/- 2.8; for NHL, the risk was 3.5 +/- 2.4, and for solid neoplasms, 5.8 +/- 3.0. Our results suggest that combination chemotherapy plus low-dose irradiation does not appear to significantly increase the risk of developing second neoplasms above that already reported for combination chemotherapy when administered as either initial or salvage treatment of Hodgkin's disease.

  19. Fenretinide and Rituximab in Treating Patients With B-Cell Non-Hodgkin Lymphoma

    ClinicalTrials.gov

    2014-09-30

    Adult Nodular Lymphocyte Predominant Hodgkin Lymphoma; B-cell Chronic Lymphocytic Leukemia; Contiguous Stage II Adult Burkitt Lymphoma; Contiguous Stage II Adult Diffuse Large Cell Lymphoma; Contiguous Stage II Adult Lymphoblastic Lymphoma; Contiguous Stage II Grade 1 Follicular Lymphoma; Contiguous Stage II Grade 2 Follicular Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Stage II Marginal Zone Lymphoma; Stage II Small Lymphocytic Lymphoma; Extranodal Marginal Zone B-cell Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Adult Burkitt Lymphoma; Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma; Noncontiguous Stage II Adult Lymphoblastic Lymphoma; Noncontiguous Stage II Grade 1 Follicular Lymphoma; Noncontiguous Stage II Grade 2 Follicular Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Small Lymphocytic Lymphoma; Refractory Chronic Lymphocytic Leukemia; Splenic Marginal Zone Lymphoma; Stage I Adult Burkitt Lymphoma; Stage I Adult Diffuse Large Cell Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Adult Lymphoblastic Lymphoma; Stage I Chronic Lymphocytic Leukemia; Stage I Grade 1 Follicular Lymphoma; Stage I Grade 2 Follicular Lymphoma; Stage I Small Lymphocytic Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage II Chronic Lymphocytic Leukemia; Stage III Adult Burkitt Lymphoma; Stage III Adult Diffuse Large Cell Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult Lymphoblastic Lymphoma; Stage III Chronic Lymphocytic Leukemia; Stage III Grade 1 Follicular Lymphoma; Stage III Grade 2 Follicular Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Marginal Zone Lymphoma; Stage III Small Lymphocytic Lymphoma; Stage IV Adult

  20. Expression of p63 in anaplastic large cell lymphoma but not in classical Hodgkin's lymphoma☆

    PubMed Central

    Gualco, Gabriela; Weiss, Lawrence M.; Bacchi, Carlos E.

    2009-01-01

    Summary Immunohistochemical determination of p63 protein is frequently used in the pathologic diagnosis of nonhematological solid tumors. In malignant hematological disease, p63 expression has been reported in 22% of follicular lymphoma, about 35% of diffuse large B-cell lymphoma, 23% of chronic lymphocytic leukemia, and in some cases of blast crisis of chronic myelogenous leukemia. Anaplastic large cell lymphoma is a rare disease that accounts for less than 5% of all cases of non-Hodgkin's lymphoma. There is little information concerning p63 expression in this specific type of lymphoma. In some cases, the morphological and phenotypic features between anaplastic large cell lymphoma and classical Hodgkin's lymphoma are similar, making this differential diagnosis challenging. We studied p63 expression using a tissue microarray approach in 154 cases of anaplastic large cell lymphoma, including 38% anaplastic large cell kinase positive and 62% anaplastic large cell kinase negative, and 58 Hodgkin's lymphoma cases. Sixty-eight cases of anaplastic large cell lymphoma (44%) showed p63 nuclear positivity (41% of anaplastic large cell kinase positive and 47% of anaplastic large cell kinase negative). Of 130 cases of systemic-anaplastic large cell lymphoma, 42% showed p63 positivity. The neoplastic cells expressed p63 in 38% of the cases of CD45-negative/anaplastic large cell kinase–negative null cell–type anaplastic large cell lymphoma, a subgroup that offers the most difficulties in the differential diagnosis with classical Hodgkin's lymphoma. In contrast, none of the cases of classical Hodgkin's lymphoma demonstrated any p63 expression. These results demonstrate that p63 protein expression is frequently expressed in a subset of anaplastic large cell lymphoma cases and may be used as a potential tool in the differential diagnosis between anaplastic large cell lymphoma and classical Hodgkin's lymphoma. PMID:18620733

  1. Pretransplant FDG-PET in aggressive non-Hodgkin lymphoma: systematic review and meta-analysis.

    PubMed

    Adams, Hugo J A; Kwee, Thomas C

    2017-04-01

    This study aimed to systematically review and meta-analyze the value of pretransplant FDG-PET in predicting outcome after autologous stem cell transplantation in aggressive non-Hodgkin lymphoma. MEDLINE was systematically searched; included studies were methodologically assessed and meta-analyzed, when possible. Overall methodological quality of included studies (n = 11) was poor, with moderate risk of bias in the domains of study participation (n = 7) and prognostic factor measurement (n = 7), and high risk of bias in the domains of outcome measurement (n = 10), and study confounding (n = 11). In all aggressive non-Hodgkin lymphomas, pooled sensitivity and specificity were 54.0% and 73.1% in predicting treatment failure, and 54.5% and 68.7% in predicting death. Because of interstudy heterogeneity, additional subgroup analyses were performed. In newly diagnosed aggressive non-Hodgkin lymphoma, pooled sensitivity and specificity were 20.0% and 70.0% in predicting treatment failure, and 8.3% % and 30.5% in predicting death. In refractory/relapsed aggressive non-Hodgkin lymphoma, pooled sensitivity and specificity were 68.1% and 72.1% in predicting treatment failure, and 77.3% and 69.6% in predicting death. At present, pretransplant FDG-PET cannot be recommended in aggressive non-Hodgkin lymphoma, because available studies suffer from major methodological flaws, and reported prognostic estimates are low (i.e., poor in newly diagnosed and moderate in refractory/relapsed aggressive non-Hodgkin lymphoma). © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Mucosal bridges of the upper esophagus after radiotherapy for Hodgkin's disease

    SciTech Connect

    Papazian, A.; Capron, J.P.; Ducroix, J.P.; Dupas, J.L.; Quenum, C.; Besson, P.

    1983-05-01

    A 47-yr-old man developed dysphagia 4 yr after mediastinal radiotherapy for Hodgkin's disease. X-ray series, fiberoptic endoscopy, and computerized transverse tomography showed mucosal bridges in the upper esophagus. Histologically, these bridges were constituted from normal epithelium overlying a chronic inflammatory lamina propria, without evidence of Hodgkin's disease recurrence or of squamous cell carcinoma. Swallowing was improved by endoscopic electrocoagulation and Eder-Puestow dilatations. Several arguments favor the hypothesis that these mucosal bridges were the late sequelae of radiation esophagitis.

  3. Karyotype in secondary hematologic disorders after treatment for Hodgkin's disease. A study of 19 patients

    SciTech Connect

    Iurlo, A.; Mecucci, C.; Van Orshoven, A.; Michaux, J.L.; Boogaerts, M.; Van den Berghe, H.

    1988-12-01

    In 19 cases of secondary hematologic disorders in patients previously treated for Hodgkin's disease, chromosome aberrations were analyzed in relation to the type of previous chemo- and/or radiotherapy, age of the patients, histopathologic features of the Hodgkin's disease at diagnosis, time interval between the treatment and the occurrence of the secondary disorder, and survival. The karyotype was of significant prognostic value when three cytogenetic groups were considered: patients with normal karyotypes; patients with aberrations of chromosome 7 as the sole anomaly; and patients with complex rearrangements and translocations. The last group showed the lowest rate of survival. Bone marrow transplantation was successful in two patients with a normal karyotype.

  4. Methotrexate-induced Hodgkin disease in a patient with systemic lupus erythematosus.

    PubMed

    Sliesoraitis, Sarunas; Khan, Rizwan; Rothman, Jan

    2009-06-01

    Methotrexate sodium use in the management of various immunologic disorders has increased--as have the number of reported adverse effects associated with this therapy. While methotrexate has helped combat various autoimmune and cancerous disorders, the paradoxical risk of causing an often fatal malignancy may still occur as a result of the drug's effect on suppressing immune function. We present a case of methotrexate-induced Hodgkin disease in a 48-year-old man with a history of systemic lupus erythematosus (SLE). Discontinuation of methotrexate facilitated Hodgkin disease reversal. In addition, we review other lymphoproliferative hematologic malignancies caused by methotrexate.

  5. Roentgenographic aspects on non-Hodgkin's lymphomas presenting with osseous lesions

    SciTech Connect

    Spagnoli, I.; Gattoni, F.; Viganotti, G.

    1982-03-01

    Radiographs of 992 patients with previously untreated non-Hodgkin's lymphoma were reviewed, and bone involvement was found in 61. Ten patients had primary lymphoma of bone and 51 patients had concomitant lymph node and/or visceral involvement or several affected bones. Roentgenographic analysis of all the bone lesions showed that osteolysis predominated, but without specific diagnostic features, and that cortical destruction and soft tissue involvement carry an adverse prognosis. Routine skeletal X-ray survey in the initial staging of non-Hodgkin's lymphomas is essential.

  6. Lymph node non-Hodgkin's lymphoma incidentally discovered during a nephrectomy for renal cell carcinoma.

    PubMed

    Fernandez-Pello, Sergio; Rodriguez Villamil, Luis; Gonzalez Rodriguez, Ivan; Venta, Victoria; Cuervo, Javier; Menéndez, Carmen Luz

    2013-06-16

    We report the case of a left laparoscopic nephroureterectomy with the incidental discovery of a non-Hodgkin's lymphoma in one of the lymph nodes of the renal hilum. A laparoscopic nephroureterectomy was decided on for a 64-year-old man. Renal cell carcinoma in the kidney and one lymph node of the renal hilum with non-Hodgkin's lymphoma was found. Chemotherapy was not started for the lymphoma discovery. There are no signs of relapse after two years of follow up. Coexistence in the same patient is an extremely rare condition. We review the literature about this issue to clarify this association.

  7. [Non-Hodgkin's lymphoma: a differential diagnosis of otogenic facial paralysis].

    PubMed

    Laubert, A; Mausolf, A; Bernhards, J; Le Blanc, S; Werner, M

    1991-03-01

    Of all the neoplastic conditions of the lymphatic system, Non-Hodgkin's lymphoma (NHL) represents a heterogenous group. As well as lymph nodes NHL can involve extranodal sites, including regions in head and neck. The mouth and oropharynx are typical extranodal sites, and the ENT surgeon should be aware of this possibility of the swift diagnosis of NHL is to be made. We report two patients with rare invasion of the middle ear, facial nerve paresis, and asymptomatic cerebral involvement by Non-Hodgkin's lymphoma.

  8. Contribution of artificial intelligence to the knowledge of prognostic factors in Hodgkin's lymphoma.

    PubMed

    Buciński, Adam; Marszałł, Michał Piotr; Krysiński, Jerzy; Lemieszek, Andrzej; Załuski, Jerzy

    2010-07-01

    Hodgkin's lymphoma is one of the most curable malignancies and most patients achieve a lasting complete remission. In this study, artificial neural network (ANN) analysis was shown to provide significant factors with regard to 5-year recurrence after lymphoma treatment. Data from 114 patients treated for Hodgkin's disease were available for evaluation and comparison. A total of 31 variables were subjected to ANN analysis. The ANN approach as an advanced multivariate data processing method was shown to provide objective prognostic data. Some of these prognostic factors are consistent or even identical to the factors evaluated earlier by other statistical methods.

  9. Radiotherapy of stage I and II Hodgkin disease with inguinal presentation

    SciTech Connect

    Lanzillo, J.H.; Moylan, D.J.; Mohiuddin, M.; Kramer, S.

    1985-01-01

    Seventeen patients who presented with inguinal adenopathy were found to have stage I or II infradiaphragmatic Hodgkin disease. Two patients with stage IIB disease also received MOPP chemotherapy. Fifteen patients currently have no evidence of recurrence; one died of acute myelogenous leukemia 6 years after total nodal irradiation, while another died of cardiopulmonary disease but had no evidence of Hodgkin disease at autopsy. In one patient, progressive peripheral atherosclerosis developed in an irradiated inguinal area, requiring angioplasty. Patient characteristics and results of treatment are analyzed and implications for management presented.

  10. Radiological study of two disseminated maligant non-Hodgkin lymphomas affecting only the bones in children

    SciTech Connect

    Vanel, D; Rebibo, G.; Tamman, S.; Bayle, C.; Hartmann, O.

    1982-12-01

    Malignant non-Hodgkin lymphomas are a neoplastic proliferation of lymphoid cells whose clinical manifestations are extremely variable. All tissues can be affected. There may be localization in lymphoid organs (Waldeyer's ring, spleen, digestive tract), other localizations (lungs, pleura, liver, bone marrow, central nervous system) and unusual localizations. Although bone marrow is often affected, bone involvement is very rare in the early stages of the disease. This report concerns the radiological study of two disseminated malignant non-Hodgkin lymphomas affecting only the bone in children.

  11. Targeting CD30 Using Brentuximab Vedotin in the Treatment of Hodgkin Lymphoma

    PubMed Central

    Alperovich, Anna; Younes, Anas

    2016-01-01

    The expression of CD30 receptors is one of the defining characteristics of the malignant Reed-Sternberg cells of Hodgkin lymphoma. CD30 is rarely expressed by normal cells, and is rapidly internalized, making it an ideal therapeutic target for monoclonal antibodies and for antibody-drug conjugates (ADCs). Brentuximab vedotin is the first ADC to be approved by regulatory agencies for the treatment of patients with relapsed HL, with a single agent response rate of 75%. In this review article we will discuss the current and ongoing development of brentuximab vedotin in patients with relapsed and newly diagnosed Hodgkin lymphoma. PMID:26841013

  12. Primary Liver Sinusoidal Non-Hodgkin's Lymphoma Presenting as Acute Liver Failure

    PubMed Central

    Nagral, Aabha; Jhaveri, Ajay; Kalthoonical, Vilesh; Bhat, Ganapathi; Mahajan, Pravin; Borges, Anita

    2015-01-01

    We describe a case of a middle-aged woman, who presented to us with fever, anorexia, abdominal distension from a massive hepatomegaly, low hemoglobin, and acute liver failure. A liver biopsy revealed B cell non-Hodgkin's lymphoma predominantly in the sinusoids with CD10, CD20, and Bcl-2 positive on immunohistochemistry. She initially responded well to chemotherapy but succumbed 6 months later to the recurrence of disease. Sinusoidal non-Hodgkin's lymphoma of the liver should be considered in the differential diagnosis of a patient with large hepatomegaly presenting with acute liver failure. PMID:26900276

  13. Principal dynamic mode analysis of the Hodgkin-Huxley equations.

    PubMed

    Eikenberry, Steffen E; Marmarelis, Vasilis Z

    2015-03-01

    We develop an autoregressive model framework based on the concept of Principal Dynamic Modes (PDMs) for the process of action potential (AP) generation in the excitable neuronal membrane described by the Hodgkin-Huxley (H-H) equations. The model's exogenous input is injected current, and whenever the membrane potential output exceeds a specified threshold, it is fed back as a second input. The PDMs are estimated from the previously developed Nonlinear Autoregressive Volterra (NARV) model, and represent an efficient functional basis for Volterra kernel expansion. The PDM-based model admits a modular representation, consisting of the forward and feedback PDM bases as linear filterbanks for the exogenous and autoregressive inputs, respectively, whose outputs are then fed to a static nonlinearity composed of polynomials operating on the PDM outputs and cross-terms of pair-products of PDM outputs. A two-step procedure for model reduction is performed: first, influential subsets of the forward and feedback PDM bases are identified and selected as the reduced PDM bases. Second, the terms of the static nonlinearity are pruned. The first step reduces model complexity from a total of 65 coefficients to 27, while the second further reduces the model coefficients to only eight. It is demonstrated that the performance cost of model reduction in terms of out-of-sample prediction accuracy is minimal. Unlike the full model, the eight coefficient pruned model can be easily visualized to reveal the essential system components, and thus the data-derived PDM model can yield insight into the underlying system structure and function.

  14. Disseminated Rhodococcus equi infection in a patient with Hodgkin lymphoma.

    PubMed

    Mikić, Dragan; Djordjević, Zoran; Sekulović, Leposava; Kojić, Miroslav; Tomanović, Branka

    2014-03-01

    Rhodococcus (R) equi is an opportunistic, uncommon human pathogen that causes mainly infection in immunocompromised hosts. The disease is usually presented as subacute pneumonia that is mostly cavitary and sometimes bacteremic. We reported the extremly rare case of a 43-year-old woman with Hodgkin lymphoma, who developed R equi pulmonary infection after recieving multiple courses of chemotherapy. Secondary, the patient developed bacteremia, leading to sepsis and dissemination of R equi infection in many extrapulmonary sites. At addmission the patient was febrile, tachypnoic, tachycardic, hypotensive, with fa cial edema, splenomegaly, positive meningeal signs, left hemiparesis and paraparesis. Laboratory data included erythrocyte sedimentation rate (ESR) > 140 mm/h, C-reactive protein (CRP) 143.0 mg/L, red blood cells (RBC) 2.14 x 10(12)/L, whyite blood cells (WBC) 2.8 x 10(9)/L, lactate dehydrogenase (LDH) 706 U/L, serum albumin 26 g/L, sodium 127 mmol/L and potassium 2.7 mmol/L. Blood culture and culture of sputum and empyema were positive for R equi. Imaging studies demonstrated a large right cavitary pneumonia and abscess, empyema, pericarditis, mediastinal and intra-abdominal lymphadenopathy, brain and psoas abscesses, osteomyelitis and spondylodiscitis. The patient recovered completely after a 12-month treatment with combinations of parenteral and oral antibiotics (meropenem, vancomycin, teicoplanin, ciprofloxacin, rifampicin, macrolides etc), including drainage of abscesses and empyema. Eight years after completition of the treatment the patient was without recurrence of R equi infection and lymphoma. Since the eradication od R equi is very difficult, it is very important to make the diagnosis and initiate appropriate antibiotic therapy as soon as possible.

  15. [Pediatric Hodgkin disease in North Tunisia: clinical and therapeutic study].

    PubMed

    Kochbati, L; Fdhila, F; Belaid, I; Rifi, H; Barsaoui, S; Ben Romdhane, N; Bel Hadj Ali, Z; Mezlini, A; Oubich, F; Maalej, M

    2012-10-01

    To assess the epidemiological, clinical and therapeutic aspects of pediatric Hodgkin disease (HD) and to study prognosis factors. We retrospectively reviewed the medical records of children (≤18 years) with HD treated between 1st January 1994 and 31st December 2004. Chemotherapy was undertaken in different departments of hematology and oncology in the North of the country and radiotherapy was centralized at the Salah-Azaïz National Cancer Institute. One hundred fourteen consecutively treated patients were collected. Median age was 12 years (4-18 years) and sex-ratio was 2.25. Peripheral lymphadenopathy was the predominant circumstance of HD detection (82.5%). The predominant histologic type was nodular sclerosing (56%). Treatment included chemotherapy and involved-field radiotherapy. With a mean follow-up of 23.5 months, relapse rate was 12.2%. Five-year overall survival (OS) and event-free survival (EFS) rates were 95% and 76%, respectively. Five-year OS was 98.2% and 90.8% for early and advanced stages respectively. In multivariate analysis, stage IV (P=0.029) and early response to initial treatment (P=0.003) retained statistical significance for EFS whereas the only prognostic factor for OS was stage IV (P=0.002). The long-term side effects were rare. No secondary tumor was noted. Combined-modality therapy using chemotherapy and involved-field radiotherapy was effective and well-tolerated in early stage pediatric HD. Stage IV patients should be referred to specialized units for intensive treatment. The short median follow-up in our study cannot allow considering long-term effects. Copyright © 2012. Published by Elsevier SAS.

  16. Epidemiological Overview of Hodgkin Lymphoma across the Mediterranean Basin

    PubMed Central

    Salati, Massimiliano; Cesaretti, Marina; Macchia, Matteo; Mistiri, Mufid El; Federico, Massimo

    2014-01-01

    The epidemiology of Hodgkin lymphoma (HL) has always been a source of fascination to researchers due to its heterogeneous characteristics of presentation. HL is an uncommon neoplasm of B-cell origin with an incidence that varies significantly by age, sex, ethnicity, geographic location and socioeconomic status. This complex pattern was also found to be replicated among Mediterranean basin populations. HL incidence rates progressively decreased from industrialized European countries such as France (ASR=2.61) and Italy (ASR=2.39) to less developed nations such as Albania (ASR=1.34) and Bosnia Herzegovina (ASR=1.1). Regarding HL mortality we have found that countries with the lowest incidence rates show the highest number of deaths from this cancer and viceversa. Finally, a wide gap in terms of survival was showed across the Mediterranean basin with survival rates ranged from 82.3% and 85.1% among Italian men and women, to 53.3 % and 59.3% among Libyan men and women, respectively. Factors such as the degree of socio-economic development, the exposure to risk factors westernization-related, the availability of diagnostic practices along with different genetic susceptibilities to HL may explain its variation across Mediterranean countries. Furthermore, the lack of health resources decisively contribute to the poor prognosis recorded in less developed region. In the future, the introduction of appropriate and accessible treatment facilities along with an adequate number of clinical specialists in the treatment of HL and other cancers are warranted in order to improve the outcomes of affected patients and treat a largely curable type of cancer in disadvantaged regions. PMID:25045456

  17. Impact of Cardiovascular Counseling and Screening in Hodgkin Lymphoma Survivors

    SciTech Connect

    Daniëls, Laurien A.; Krol, Stijn D.G.; Graaf, Michiel A. de; Scholte, Arthur J.H.A.; Veer, Mars B. van 't; Putter, Hein; Roos, Albert de; Schalij, Martin J.; Poll-Franse, Lonneke V. van de; Creutzberg, Carien L.

    2014-09-01

    Purpose: Cardiovascular disease (CVD) is the most common nonmalignant cause of death in Hodgkin lymphoma (HL) survivors, especially after mediastinal irradiation. The role of screening for CVD in HL survivors is unclear, but confrontation with risks of CVD may have a negative influence on health-related quality of life (HRQL). As part of a phase 2 screening study using computed tomography angiography (CTA) among HL survivors, an HRQL analysis was done to evaluate the emotional and practical burden and perceived benefits of screening and the effect of CVD-specific counseling on patient satisfaction. Methods and Materials: Patients who participated in the screening study also took part in the HRQL study. The impact of undergoing screening was evaluated with a 9-item questionnaire, and impact on HRQL with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire C30, version 3.0. The effect of counseling of CVD on perceived provision of information was evaluated with EORTC INFO-25. All questionnaires were completed at baseline and after screening. Results: Baseline questionnaires were received from 48 participants, and 43 completed questionnaires after screening. Mean age was 47 years, and mean time since diagnosis was 21 years. Of the total, 93% of subjects were content with participating, and 80% did not find the emphasis placed on late effects burdensome, although screening did have a small impact on social functioning and global quality of life. Perceived information on disease, medical tests, and treatment increased significantly after screening (P<.01). Differences were clinically relevant. There were no differences in perceived information between patients with and without screen-detected CVD. Conclusions: Screening was evaluated favorably, whether CTA showed abnormalities or not. Extensive counseling resulted in substantially increased provision of information and improved information satisfaction. Screening by

  18. Epidemiology of Non-Hodgkin's Lymphoma in India.

    PubMed

    Nair, Reena; Arora, Neeraj; Mallath, Mohandas K

    2016-01-01

    Non-Hodgkin's lymphoma (NHL) is a common hematological malignancy. The age-adjusted incidence rates for NHL in men and women in India are 2.9/100,000 and 1.5/100,000, respectively. These are about one fourth of the incidence rates reported from Western Europe or North America. Within India, the incidence is several-fold higher in urban cancer registries compared to rural areas; the incidence being higher in metropolitan cities and Indian immigrants suggesting that urban lifestyles and economic progress may increase the cancer incidence. Compared to developed nations, the key differences in the presentation in India include: median age of 54 years (almost a decade less), higher male to female ratio, higher proportion of patients with B-symptoms (40-60 vs. 20-30%), poor ECOG performance status (≥2) at diagnosis (50 vs. 20-30%), higher frequency of diffuse large B-cell lymphomas (60-70 vs. <40%), lower frequency of follicular NHL (<20 vs. 30-40%) and T-cell type in 10-20 vs. <10%. The estimated mortality rate due to NHL is higher in India than in North America and Western Europe. Diagnostic and treatment delays, incorrect diagnosis and inappropriate or suboptimal treatment may be possible reasons for the poor outcome. Any improvement in the outcomes for NHL in India will require a nationwide approach, e.g. creation of several regional and district-level centers with expertise in lymphoma management. Collection of data on patient- and disease-related characteristics, treatment outcome, development of infrastructure, centralized review of histopathology subtype, novel treatment protocols, rigorous follow-up, training of staff, and financial support towards treatment could be possible strategies to improve the outcome.

  19. Characterization of the Microenvironment of Nodular Lymphocyte Predominant Hodgkin Lymphoma

    PubMed Central

    Visser, Lydia; Wu, Rui; Rutgers, Bea; Diepstra, Arjan; van den Berg, Anke

    2016-01-01

    Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is characterized by a low percentage of neoplastic lymphocyte predominant (LP) cells in a background of lymphocytes. The goal of this study is to characterize the microenvironment in NLPHL. Ten NLPHL cases and seven reactive lymph nodes (RLN) were analyzed by flow cytometry for the main immune cells and multiple specific subpopulations. To discriminate between cells in or outside the tumor cell area, we used CD26. We observed significantly lower levels of CD20+ B-cells and CD56+ NK cells and higher levels of CD4+ T-cells in NLPHL in comparison to RLN. In the subpopulations, we observed increased numbers of PD-1+CD4+ T follicular helper cells (TFH), CD69+CD4+ and CD69+CD8+ T-cells and CCR7-CD45RA-CD4+ effector memory T-cells, while FoxP3+CD4+ T regulatory cells (Tregs) and CCR7-CD45RA+ terminally differentiated CD4+ T-cells were decreased in NLPHL compared to RLN. CD69+ cells were increased in the tumor cell area in CD4+ and CD8+ T-cells, while FoxP3+CD25+CD4+ Tregs and CD25+CD8+ T-cells were significantly increased outside the tumor area. Thus, we show a markedly altered microenvironment in NLPHL, with lower numbers of NK cells and Tregs. PD-1+CD4+ and CD69+ T-cells were located inside, and Tregs and CD25+CD8+ cells outside the tumor cell area. PMID:27999289

  20. Cytopathology of "double-hit" non-Hodgkin lymphoma.

    PubMed

    Elkins, Camille T; Wakely, Paul E

    2011-08-25

    B-cell lymphomas with concurrent IGH-BCL2 and c-MYC rearrangements (so-called "double-hit lymphomas" [DHL]) are a relatively rare, recently described category in the 2008 World Health Organization classification of hematopoietic neoplasms. Response to chemotherapy and survival are poor. The authors reviewed files of cytogenetically documented DHL to identify cytologic features that would allow its possible recognition. Twelve fine-needle aspirates (FNAs), 2 pleural fluids, and 1 touch imprint of cytogenetically proven DHL were uncovered. Primary DHL was correctly recognized in 3 of 12 FNA cases using Ki-67 staining coupled with a positive bcl-2 result as the basis for performing fluorescence in situ hybridization (FISH) analysis of c-MYC and IGH-BCL2 rearrangements. Remaining FNAs and non-FNA cases were diagnosed as non-Hodgkin lymphoma, B-cell lymphoma, or atypical lymphocytosis. Ten cases had cell block material available. All cases had high cellularity with a dissociated smear pattern and background lymphoglandular bodies. Cell size ranged from intermediate to large. Nuclei were predominantly rounded or slightly irregular in contour; 4 FNAs had markedly cleaved nuclei. Some nuclei harbored discrete but small nucleoli, whereas in others coarse chromatin and indistinct or multiple small nucleoli existed. A variable number of mitotic figures, tingible body macrophages, and background apoptotic cells were also present. No specific cytomorphologic feature(s) were found to reliably identify DHL using FNA or exfoliative cytology. A high Ki-67 proliferation index and positive bcl-2 staining (on cytospin slides or cell block material) of cases not conforming to typical Burkitt lymphoma morphology should prompt FISH analysis for c-MYC and/or IGH-BCL2 rearrangements to identify DHL, particularly if tissue biopsy is not expected. Copyright © 2011 American Cancer Society.

  1. Pesticide use and non-Hodgkin's lymphoma mortality in Brazil.

    PubMed

    Boccolini, Patricia de M M; Boccolini, Cristiano Siqueira; Chrisman, Juliana de Rezende; Markowitz, Steven B; Koifman, Sergio; Koifman, Rosalina Jorge; Meyer, Armando

    2013-07-01

    Brazil is one of the major pesticide consumers in the world. The continuous exposure to these substances may be etiologically associated with the development of Non-Hodgkin's Lymphoma (NHL). Estimate the correlation between the per capita sales of pesticides in 1985 (exposure) and NHL mortality rates between 1996 and 2005 (outcome), by Brazilian micro-regions. In this ecological descriptive study, the per capita consumption of pesticides in 1985 was used as a proxy of the population exposure to these chemicals in Brazil. All deaths by NHL occurred in the 446 non-urban micro-regions, between 1996 and 2005, among individuals with ages between 20 and 69, of both sexes, were retrieved from the Brazilian Mortality Information System. Micro-regions were then categorized into low, medium, high and very high pesticide consumption, according to the quartiles of per capita consumption of pesticides. NHL mortality rates and rate ratios for each quartile were obtained using the lowest quartile as reference. In addition, the Spearman's correlation coefficient between pesticide consumption and NHL mortality rates was estimated. A moderate correlation between per capita pesticides consumption and standardized mortality rate for NHL was observed (r=0.597). In addition, using the lowest quartile of pesticide consumption as a reference, the higher the quartile of pesticide consumption, the higher was NHL mortality risk: men - (second quartile - MRR=1.69, CI 95% 1.68-1.84; third quartile - MRR=2.41, CI 95% 2.27-2.57; fourth quartile - MRR=2.92, CI 95% 2.74-3.11) and females (second quartile - MRR=1.87, CI 95% 1.69-2.06; third quartile - MRR=2.28, IC 95% 2.10-2.47; fourth quartile - MRR=3.20; CI 95% 2.98-3.43). Our results suggest that pesticide exposure may play a role in the etiology of NHL. Copyright © 2013 Elsevier GmbH. All rights reserved.

  2. ACR Appropriateness Criteria: follow-up of Hodgkin's lymphoma.

    PubMed

    Ng, Andrea; Constine, Louis S; Advani, Ranjan; Das, Prajnan; Flowers, Christopher; Friedberg, Jonathan; Hodgson, David C; Schwartz, Cindy L; Wilder, Richard B; Wilson, Lynn D; Yunes, Michael J

    2010-01-01

    In the follow-up of Hodgkin's lymphoma patients, the focus in the first 5 years is to detect recurrence, while after 5 years, the focus is on limiting and detecting late effects of treatment. In the first 5 years post-treatment, routine history and physical and computed tomography (CT) imaging (more frequent in the first 2 years) are generally appropriate. However, there are limited data to support the role of positron emission tomography scanning as routine follow-up. Beyond 5 years post-treatment, annual history and physical is appropriate, although there is no longer a role for routine imaging for recurrences. Women irradiated to the chest area at a young age (<35) would benefit from annual mammogram screening given the increased breast cancer risk. Magnetic resonance imaging can be considered, although there is a lack of data supporting its role in this population. Low-dose chest CT for lung cancer screening in patients with history of mediastinal irradiation and/or alkylating chemotherapy exposures and a smoking history can be considered, although data on its utility is lacking. Cardiac screening with echocardiogram and exercise tolerance tests in patients with history of mediastinal irradiation and/or adriamycin exposure may be appropriate, although the optimal screening interval would depend on mediastinal dose, adriamycin dose, presence of other cardiac risk factors and findings at the baseline screening. Patients at risk for cardiac disease due to treatment exposure would also benefit from lipid screening every 1-3 years. Copyright 2010 American College of Radiology. Published by Mosby, Inc. All rights reserved.

  3. Stomach cancer risk after treatment for hodgkin lymphoma.

    PubMed

    Morton, Lindsay M; Dores, Graça M; Curtis, Rochelle E; Lynch, Charles F; Stovall, Marilyn; Hall, Per; Gilbert, Ethel S; Hodgson, David C; Storm, Hans H; Johannesen, Tom Børge; Smith, Susan A; Weathers, Rita E; Andersson, Michael; Fossa, Sophie D; Hauptmann, Michael; Holowaty, Eric J; Joensuu, Heikki; Kaijser, Magnus; Kleinerman, Ruth A; Langmark, Frøydis; Pukkala, Eero; Vaalavirta, Leila; van den Belt-Dusebout, Alexandra W; Fraumeni, Joseph F; Travis, Lois B; Aleman, Berthe M; van Leeuwen, Flora E

    2013-09-20

    Treatment-related stomach cancer is an important cause of morbidity and mortality among the growing number of Hodgkin lymphoma (HL) survivors, but risks associated with specific HL treatments are unclear. We conducted an international case-control study of stomach cancer nested in a cohort of 19,882 HL survivors diagnosed from 1953 to 2003, including 89 cases and 190 matched controls. For each patient, we quantified cumulative doses of specific alkylating agents (AAs) and reconstructed radiation dose to the stomach tumor location. Stomach cancer risk increased with increasing radiation dose to the stomach (Ptrend < .001) and with increasing number of AA-containing chemotherapy cycles (Ptrend = .02). Patients who received both radiation to the stomach ≥ 25 Gy and high-dose procarbazine (≥ 5,600 mg/m(2)) had strikingly elevated stomach cancer risk (25 cases, two controls; odds ratio [OR], 77.5; 95% CI, 14.7 to 1452) compared with those who received radiation < 25 Gy and procarbazine < 5,600 mg/m(2) (Pinteraction < .001). Risk was also elevated (OR, 2.8; 95% CI, 1.3 to 6.4) among patients who received radiation to the stomach ≥ 25 Gy but procarbazine < 5,600 mg/m(2); however, no procarbazine-related risk was evident with radiation < 25 Gy. Treatment with dacarbazine also increased stomach cancer risk (12 cases, nine controls; OR, 8.8; 95% CI, 2.1 to 46.6), after adjustment for radiation and procarbazine doses. Patients with HL who received subdiaphragmatic radiotherapy had dose-dependent increased risk of stomach cancer, with marked risks for patients who also received chemotherapy containing high-dose procarbazine. For current patients, risks and benefits of exposure to both procarbazine and subdiaphragmatic radiotherapy should be weighed carefully. For patients treated previously, GI symptoms should be evaluated promptly.

  4. Immunophenotypic criteria for the diagnosis of non-Hodgkin's lymphoma.

    PubMed Central

    Picker, L. J.; Weiss, L. M.; Medeiros, L. J.; Wood, G. S.; Warnke, R. A.

    1987-01-01

    This study examines the immunohistologic profiles of a large series of histologically proven benign and malignant lymphoproliferative processes in order to define immunophenotypic criteria useful in the diagnosis of non-Hodgkin's lymphoma. Using a method of analysis relying solely on immunoarchitectural features of a given case, the authors were able to define immunologic criteria capable of differentiating benign from malignant lymphoid processes independent from conventional morphologic analysis. In general, these criteria involved identification of abnormal expression or loss of antigens in B- and T-lineage populations. Among B-lineage populations the following features were associated with malignant histology: 1) light-chain-restricted B lineage, 2) light chain -B lineage, 3) Leu-1+ B lineage, 4) L60+ B lineage, 5) 41H+, Ki-67+ B lineage, 6) loss of pan-B antigens, and 7) LFA-1-B lineage. Among T-cell populations outside the thymus, phenotypes associated with malignancy included 1) loss of pan-T antigens (including loss of the beta chain of the T-cell antigen receptor), 2) coexpression or loss of T-subset antigens, 3) Leu-6+ T-lineage, and 4) MB-1+ T lineage. Application of these criteria to a series of nearly 500 cases of lymphoma indicated that over 90% of B-lineage and about 80% of T-lineage neoplasms manifested immunophenotypic abnormalities that could distinguish them from benign, reactive lymphoid processes. It is concluded that immunophenotypic analysis of lymphoproliferative lesions is sufficiently sensitive and specific to confirm the histologic diagnosis of lymphoma in the vast majority of cases seen in clinical practice. Furthermore, in difficult cases or those with limited material or poor histology, immunophenotypic analysis may be the only means of making a definitive diagnosis. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:3111266

  5. Phytanic acid and the risk of non-Hodgkin lymphoma.

    PubMed

    Ollberding, Nicholas J; Aschebrook-Kilfoy, Briseis; Caces, Donne Bennett D; Wright, Margaret E; Weisenburger, Dennis D; Smith, Sonali M; Chiu, Brian C-H

    2013-01-01

    Greater consumption of red meat, processed meat and dairy products has been associated with an increased risk of non-Hodgkin lymphoma (NHL) in several previous reports. Phytanic acid, a saturated fatty acid obtained primarily through the consumption of ruminant meat and dairy products, may offer a potential underlying mechanism for these associations. In a population-based case-control study of 336 cases and 460 controls conducted in Nebraska during 1999-2002, we examined whether phytanic acid-containing foods or total phytanic acid intake, estimated from a food frequency questionnaire and the published phytanic acid values of 151 food items, were associated with increased NHL risk. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals for overall NHL and the common NHL histologic subtypes. In multivariable models, higher intakes of density-adjusted beef [OR(T3 vs. T1) = 1.5 (1.1-2.2); P(trend) = 0.02], total dairy products [OR = 1.5 (1.1-2.2); P(trend) = 0.02) and milk [OR = 1.6 (1.1-2.3); P(trend) = 0.01] were associated with an increased risk of NHL. Intake of total phytanic acid was positively associated with NHL risk [OR = 1.5 (1.0-2.1); P(trend) = 0.04]. In analyses stratified by NHL subtype, greater consumption of beef was associated with an increased risk of diffuse large B-cell lymphoma, and greater consumption of milk was associated with an increased risk of follicular lymphoma (FL). Total phytanic acid intake was associated with an increased risk of FL and small lymphocytic lymphoma/chronic lymphocytic leukemia. Our results provide support that total phytanic acid and phytanic acid-containing foods may increase NHL risk.

  6. Stomach Cancer Risk After Treatment for Hodgkin Lymphoma

    PubMed Central

    Morton, Lindsay M.; Dores, Graça M.; Curtis, Rochelle E.; Lynch, Charles F.; Stovall, Marilyn; Hall, Per; Gilbert, Ethel S.; Hodgson, David C.; Storm, Hans H.; Johannesen, Tom Børge; Smith, Susan A.; Weathers, Rita E.; Andersson, Michael; Fossa, Sophie D.; Hauptmann, Michael; Holowaty, Eric J.; Joensuu, Heikki; Kaijser, Magnus; Kleinerman, Ruth A.; Langmark, Frøydis; Pukkala, Eero; Vaalavirta, Leila; van den Belt-Dusebout, Alexandra W.; Fraumeni, Joseph F.; Travis, Lois B.; Aleman, Berthe M.; van Leeuwen, Flora E.

    2013-01-01

    Purpose Treatment-related stomach cancer is an important cause of morbidity and mortality among the growing number of Hodgkin lymphoma (HL) survivors, but risks associated with specific HL treatments are unclear. Patients and Methods We conducted an international case-control study of stomach cancer nested in a cohort of 19,882 HL survivors diagnosed from 1953 to 2003, including 89 cases and 190 matched controls. For each patient, we quantified cumulative doses of specific alkylating agents (AAs) and reconstructed radiation dose to the stomach tumor location. Results Stomach cancer risk increased with increasing radiation dose to the stomach (Ptrend < .001) and with increasing number of AA-containing chemotherapy cycles (Ptrend = .02). Patients who received both radiation to the stomach ≥ 25 Gy and high-dose procarbazine (≥ 5,600 mg/m2) had strikingly elevated stomach cancer risk (25 cases, two controls; odds ratio [OR], 77.5; 95% CI, 14.7 to 1452) compared with those who received radiation < 25 Gy and procarbazine < 5,600 mg/m2 (Pinteraction < .001). Risk was also elevated (OR, 2.8; 95% CI, 1.3 to 6.4) among patients who received radiation to the stomach ≥ 25 Gy but procarbazine < 5,600 mg/m2; however, no procarbazine-related risk was evident with radiation < 25 Gy. Treatment with dacarbazine also increased stomach cancer risk (12 cases, nine controls; OR, 8.8; 95% CI, 2.1 to 46.6), after adjustment for radiation and procarbazine doses. Conclusion Patients with HL who received subdiaphragmatic radiotherapy had dose-dependent increased risk of stomach cancer, with marked risks for patients who also received chemotherapy containing high-dose procarbazine. For current patients, risks and benefits of exposure to both procarbazine and subdiaphragmatic radiotherapy should be weighed carefully. For patients treated previously, GI symptoms should be evaluated promptly. PMID:23980092

  7. Brentuximab Vedotin: A Review in CD30-Positive Hodgkin Lymphoma.

    PubMed

    Scott, Lesley J

    2017-03-01

    Intravenous brentuximab vedotin (ADCETRIS(®)) is a targeted antibody-drug conjugate (ADC) active against CD30-positive cancer cells such as those associated with classical Hodgkin lymphoma (HL). In noncomparative, phase 2 trials and in the real-world setting, salvage therapy with brentuximab vedotin resulted in high objective response (complete plus partial remission) rates in patients with relapsed or refractory CD30-positive HL, including as retreatment in patients who had an objective response to previous brentuximab vedotin therapy and subsequently relapsed. These beneficial outcomes were durable during long-term follow-up. As consolidation therapy after autologous haematopoietic stem cell transplant (ASCT) in the multinational, phase 3 AETHERA trial, brentuximab vedotin prolonged progression-free-survival (PFS) compared with placebo at a median follow-up of 30 months (primary analysis), with a 43% reduction in the risk of disease progression or death. The beneficial effects of brentuximab vedotin consolidation therapy were maintained during long-term follow-up. In the clinical trial and real-world setting, brentuximab vedotin had an acceptable tolerability and safety profile, with most adverse events manageable with dose reductions and/or delays [including peripheral sensory neuropathy (PSN) and neutropenia]. With a paucity of treatments available for many patients with relapsed or refractory HL, brentuximab vedotin represents an important option for the management of patients who have failed high-dose chemotherapy/ASCT or at least two prior chemotherapy regimens and as post-ASCT consolidation therapy in patients who are at increased risk/high-risk of relapse or progression after ASCT.

  8. Economic evaluation of brentuximab vedotin for persistent Hodgkin lymphoma

    PubMed Central

    Babashov, V.; Begen, M.A.; Mangel, J.; Zaric, G.S.

    2017-01-01

    Background We conducted a cost-effectiveness analysis of brentuximab vedotin for the treatment of relapsed and refractory Hodgkin lymphoma (hl) in the post–autologous stem-cell transplantation (asct) failure period, from the perspective of the Canadian health care payer. Methods We developed a decision-analytic model to simulate lifetime costs and benefits of brentuximab vedotin compared with best supportive care for the treatment of patients with hl after failure of asct. Administrative data from Ontario were used to set the model parameters. Results In the base case, treatment with brentuximab vedotin resulted in incremental quality-adjusted life-years (qalys) of 0.544 and an incremental cost of $89,366 per patient, corresponding to an incremental cost-effectiveness ratio (icer) of $164,248 per qaly gained. The icer was sensitive to the cost of brentuximab vedotin, the hazard ratio used to assess the efficacy of brentuximab vedotin treatment, and health state utilities. Conclusions In light of the available information, brentuximab vedotin has an icer exceeding $100,000 per qaly gained, which is a level often classified as having “weak evidence for adoption and appropriate utilization” in Canada. However, it is worth noting that provincial cancer agencies take into account not only the costs and associated icer, but also other factors such as a lack of alternative treatment options and the clinical benefits of expensive cancer drugs. Pricing arrangements should be negotiated, and risk-sharing agreements or patient access schemes should be explored. PMID:28270727

  9. Risk of valvular heart disease after treatment for Hodgkin lymphoma.

    PubMed

    Cutter, David J; Schaapveld, Michael; Darby, Sarah C; Hauptmann, Michael; van Nimwegen, Frederika A; Krol, Augustinus D G; Janus, Cecile P M; van Leeuwen, Flora E; Aleman, Berthe M P

    2015-04-01

    Hodgkin lymphoma (HL) survivors are at increased risk of developing valvular heart disease (VHD). We evaluated the determinants of the risk and the radiation dose-response. A case-control study was nested in a cohort of 1852 five-year HL survivors diagnosed at ages 15 to 41 years and treated between 1965 and 1995. Case patients had VHD of at least moderate severity as their first cardiovascular diagnosis following HL treatment. Control patients were matched to case patients for age, gender, and HL diagnosis date. Treatment and follow-up data were abstracted from medical records. Radiation doses to heart valves were estimated by reconstruction of individual treatments on representative computed tomography datasets. All statistical tests were two-sided. Eighty-nine case patients with VHD were identified (66 severe or life-threatening) and 200 control patients. Aortic (n = 63) and mitral valves (n = 42) were most frequently affected. Risks increased more than linearly with radiation dose. For doses to the affected valve(s) of less than or equal to 30, 31-35, 36-40, and more than 40 Gy, VHD rates increased by factors of 1.4, 3.1, 5.4, and 11.8, respectively (P trend < .001). Approximate 30-year cumulative risks were 3.0%, 6.4%, 9.3%, and 12.4% for the same dose categories. VHD rate increased with splenectomy by a factor of 2.3 (P = .02). Radiation dose to the heart valves can increase the risk of clinically significant VHD, especially at doses above 30 Gy. However, for patients with mediastinal involvement treated today with 20 or 30 Gy, the 30-year risk will be increased by only about 1.4%. These findings may be useful for patients and doctors both before treatment and during follow-up. © The Author 2015. Published by Oxford University Press.

  10. Risk for Valvular Heart Disease After Treatment for Hodgkin Lymphoma

    PubMed Central

    Cutter, David J.; Schaapveld, Michael; Darby, Sarah C.; Hauptmann, Michael; van Nimwegen, Frederika A.; Krol, Augustinus D. G.; Janus, Cecile P. M.; van Leeuwen, Flora E.

    2015-01-01

    Background: Hodgkin lymphoma (HL) survivors are at increased risk for developing valvular heart disease (VHD). We evaluated the determinants of the risk and the radiation dose-response. Methods: A case-control study was nested in a cohort of 1852 five-year HL survivors diagnosed at ages 15 to 41 years and treated between 1965 and 1995. Case patients had VHD of at least moderate severity as their first cardiovascular diagnosis following HL treatment. Control patients were matched to case patients for age, gender, and HL diagnosis date. Treatment and follow-up data were abstracted from medical records. Radiation doses to heart valves were estimated by reconstruction of individual treatments on representative computed tomography datasets. All statistical tests were two-sided. Results: Eighty-nine case patients with VHD were identified (66 severe or life-threatening) and 200 control patients. Aortic (n = 63) and mitral valves (n = 42) were most frequently affected. Risks increased more than linearly with radiation dose. For doses to the affected valve(s) of less than or equal to 30, 31–35, 36–40, and more than 40 Gy, VHD rates increased by factors of 1.4, 3.1, 5.4, and 11.8, respectively (P trend < .001). Approximate 30-year cumulative risks were 3.0%, 6.4%, 9.3%, and 12.4% for the same dose categories. VHD rate increased with splenectomy by a factor of 2.3 (P = .02). Conclusions: Radiation dose to the heart valves can increase the risk for clinically significant VHD, especially at doses above 30 Gy. However, for patients with mediastinal involvement treated today with 20 or 30 Gy, the 30-year risk will be increased by only about 1.4%. These findings may be useful for patients and doctors both before treatment and during follow-up. PMID:25713164

  11. High incidence of Epstein-Barr virus (EBV)-positive Hodgkin lymphoma and Hodgkin lymphoma-like B-cell lymphoproliferations with EBV latency profile 2 in children with interleukin-2-inducible T-cell kinase deficiency.

    PubMed

    Bienemann, Kirsten; Borkhardt, Arndt; Klapper, Wolfram; Oschlies, Ilske

    2015-11-01

    Interleukin-2-inducible T-cell kinase (ITK) deficiency is an inherited T-cell deficiency characterized by the development of Epstein-Barr virus (EBV)-associated lymphoproliferations. We aimed to describe the histopathological features of lymphoproliferative processes arising in ITK deficiency, and to compare them with lymphoproliferations in otherwise immunocompromised patients. We revised the histopathological diagnoses of 12 biopsies of lymphoproliferations from seven ITK-deficient children according to the World Health Organization criteria, and determined the EBV latency types and lytic activity by staining for EBV-encoded small RNA, latent membrane protein 1, EBV nuclear antigen 2, and ZEBRA. We found polymorphic and borderline polymorphic to monomorphic B-cell lymphoproliferations with variable contents in large cells (five cases), a Hodgkin-like B-cell proliferation (one case), and classic mixed-cellularity Hodgkin lymphoma (six cases). All cases (12/12) were EBV-positive. The Hodgkin lymphoma-like and Hodgkin lymphoma, and all but one polymorphic B-cell lymphoproliferation, showed EBV latency type 2, as observed in classic EBV-positive Hodgkin lymphoma. The 100% EBV association, the high percentage of EBV-positive classic Hodgkin lymphoma and Hodgkin-like B-cell proliferations and the predominance of EBV latency type 2 even in polymorphic lesions are the main features of lymphoproliferations in patients with ITK deficiency, and suggest a unique pathomechanism of lymphomagenesis in this T-cell immunodeficiency. © 2015 John Wiley & Sons Ltd.

  12. Cancer-related fatigue in patients with and survivors of Hodgkin's lymphoma: a longitudinal study of the German Hodgkin Study Group.

    PubMed

    Kreissl, Stefanie; Mueller, Horst; Goergen, Helen; Mayer, Axel; Brillant, Corinne; Behringer, Karolin; Halbsguth, Teresa Veronika; Hitz, Felicitas; Soekler, Martin; Shonukan, Oluwatoyin; Rueffer, Jens Ulrich; Flechtner, Hans-Henning; Fuchs, Michael; Diehl, Volker; Engert, Andreas; Borchmann, Peter

    2016-10-01

    Patients with Hodgkin's lymphoma might have persistent fatigue even years after treatment. However, knowledge of the development of fatigue persisting long after completion of treatment is limited. Therefore, we did a detailed analysis of fatigue in our first-line clinical trials for early-stage favourable (HD13 trial), early-stage unfavourable (HD14 trial), and advanced-stage (HD15 trial) Hodgkin's lymphoma. Beyond the description of fatigue from diagnosis up to 5 years after treatment, we aimed to assess any effect of patient characteristics, disease characteristics, or treatment characteristics on persistent fatigue. In this longitudinal study, we included patients with early-stage favourable, early-stage unfavourable, and advanced-stage Hodgkin's lymphoma from the HD13, HD14, and HD15 trials, respectively, aged between 18 and 60 years. Eligible patients for these trials had newly diagnosed, histologically proven Hodgkin's lymphoma, an Eastern Cooperative Oncology Group performance status of 2 or lower, HIV negativity, and absence of comorbidity disallowing protocol treatment. We used the fatigue scale of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire to assess fatigue from diagnosis up to 5 years after the end of treatment. The primary outcomes of interest in this study were fatigue scores in the second and fifth year after end of treatment. We estimated the effect of different disease, patient, and treatment characteristics on fatigue with multiple regression analyses and identified fatigue trajectories with growth mixture models. The regression analyses and growth mixture models used robust and full information maximum likelihood estimates to account for missing data. The HD13, HD14, and HD15 trials are registered as international standard randomised controlled trials, ISRCTN63474366, ISRCTN04761296, and ISRCTN32443041, respectively. The HD13 trial enrolled patients with early-stage favourable disease from Jan 28

  13. Chromosome aberrations and aneuploidy in sperm of Hodgkin`s disease patients before and {approximately}15 years after MOPP-chemotherapy analyzed by multi-color FISH

    SciTech Connect

    Hummelen, P.V.; Lowe, X.; Wyrobek, A.J.

    1997-10-01

    MOPP-chemistry includes potent mutagens which induce chromosomal abnormalities in human somatic and rodent germ cells. Sperm samples five pre- and four rodent germ cells. Sperm samples (five pre- and four post-treatment) from 8 Hodgkin`s patients were analyzed using fluorescence in situ hybridization (FISH) to detect 3 categories of chromosomal defects in sperm: (1) terminal duplications of deletions in chr. 1p, (2) aneuploidy involving chr. 1 or 8, and (3) diploidy. In 3 pre-treatment and 2 post-treatment samples, each from a different donor, the levels of chromosomal damage were comparable to those of healthy controls. For one patient significantly higher proportions of sperm carrying structural chromosome aberrations were detected in a 15 years post-treatment sample, compared to his pre-treatment sample and pre-treatment samples of other patients. This patient also showed significantly elevated levels of hyperploid and diploid sperm in both his pre- and post-treatment samples. Elevated levels of diploid sperm were also observed in a pre-treatment sample of a second patient. In a 23 years post-treatment sample of another patient the fraction of sperm carrying chromosome aberrations was also significantly higher than in pre-treatment samples. To conclude, elevated frequencies of sperm with structural chromosome damage were observed in at least one patient, suggesting clonal outgrowth of chromosomal aberrant stem cells due to MOPP treatment. Although MOPP does not seem to increase numerical aberrations in sperm significant inter-individual differences were present among the Hodgkin`s patient.

  14. Hodgkin lymphoma variant of Richter transformation: morphology, Epstein-Barr virus status, clonality, and survival analysis-with comparison to Hodgkin-like lesion.

    PubMed

    Xiao, Wenbin; Chen, Wayne W; Sorbara, Lynn; Davies-Hill, Theresa; Pittaluga, Stefania; Raffeld, Mark; Jaffe, Elaine S

    2016-09-01

    Hodgkin/Reed-Sternberg (HRS) cells in the setting of chronic lymphocytic leukemia (CLL) exist in 2 forms: type I with isolated HRS cells in a CLL background (Hodgkin-like lesion) and type II with typical classic Hodgkin lymphoma, a variant of Richter transformation (CHL-RT). The clinical significance of the 2 morphological patterns is unclear, and their biological features have not been compared. We retrospectively reviewed 77 cases: 26 of type I and 51 of type II CHL-RT; 3 cases progressed from type I to type II. We examined clinical features, Epstein-Barr virus (EBV) status, and clonal relatedness after microdissection. Median age for type I was 62 years versus 73 years for type II (P=.01); 27% (type I) versus 73% (type II) had a history of CLL. HRS cells were positive for EBV in 71% (55/77), similar in types I and II. Clonality analysis was performed in 33 cases (type I and type II combined): HRS cells were clonally related to the underlying CLL in 14 and unrelated in 19. ZAP-70 expression of the CLL cells but not EBV status or morphological pattern was correlated with clonal relatedness: all 14 clonally related cases were ZAP-70 negative, whereas 74% (14/19) of clonally unrelated cases were ZAP-70 positive. Overall median survival (types I and II) after diagnosis was 44 months. Advanced age was an adverse risk factor for survival, but not histologic pattern, type I versus type II. HRS-like cells in a background of CLL carries a similar clinical risk to that of CHL-RT and may progress to classic Hodgkin lymphoma in some cases. Published by Elsevier Inc.

  15. Pityriasis rosea-like cutaneous eruption as the presenting symptom of Hodgkin lymphoma. Case report and review of the literature.

    PubMed

    Vrotsos, Elena; Dosal, Jacquelyn; Zaiac, Martin; Alexis, John

    2015-09-30

    Cutaneous involvement by Hodgkin lymphoma is extremely rare and usually follows extensive involvement of the lymph nodes. Cutaneous manifestations of Hodgkin lymphoma may be divided into specific and non-specific. Generalized pruritus is one of the most common non-specific presentations of Hodgkin lymphoma as is cutaneous granulomas. Such signs and symptoms should prompt thorough physical exam, including evaluation of lymph nodes, especially in a young patient. We report a case of a 22-year-old man who presented with night sweats, weight loss, dry cough, and generalized maculopapular eruption that started with a large patch in the center of the chest and spread to the extremities. Biopsy of the rash revealed pityriasis rosea-like findings. A computerized tomography scan of the chest revealed a mediastinal mass. Biopsy of the mediastinal mass revealed Reed-Sternberg cells in a fibrotic background, diagnostic of Hodgkin lymphoma, nodular sclerosis type. In conclusion, the presentation of Hodgkin lymphoma as a pityriasis rosea-like cutaneous eruption is rare and clinicians should be aware of this presentation. In this paper we review the non-specific cutaneous manifestations of Hodgkin lymphoma in an effort to raise awareness of the diversity of early cutaneous signs of Hodgkin lymphoma.

  16. Treatment with rituximab and brentuximab vedotin in a patient of common variable immune deficiency-associated classic Hodgkin lymphoma.

    PubMed

    Rael, Efren; Rakszawski, Kevin; Koller, Kristian; Bayerl, Michael; Butte, Manish; Zheng, Hong

    2016-01-01

    Patients with common variable immunodeficiency (CVID) have an increased risk of developing lymphoproliferative diseases, including non-Hodgkins lymphoma (Blood 116:1228-1234, 2010; Blood 119:1650-7, 2012). The incidence and prognosis of Hodgkin lymphoma in this population is not clear, with only a few case reports in the literature. Conventional cytotoxic chemotherapy, although highly efficacious in treating Hodgkin lymphoma in immune competent patients, is problematic in patients with CVID due to the increased risk of infectious complications (Ther Umsch 69:687-91, 2012; Pediatr Hematol Oncol 24:337-42, 2012). Rituximab and brentuximab vedotin are both targeted agents used to treat lymphomas that express CD20 and CD30, respectively. Compared to cytotoxic chemotherapy typically used in Hodgkin lymphoma, these agents are better tolerated with minimal side effects. This makes them an attractive option for treating lymphoma in patients who have significant co-morbidities, including those with immune deficiencies. Additionally, rituximab has been used safely to treat autoimmune cytopenias in patients with CVID5. However, the role of these targeted therapies in CVID-associated Hodgkin lymphoma has not been reported. Here we report the case of a 25 year old female diagnosed with CVID-associated classic Hodgkin lymphoma, who achieved a complete remission following treatment with rituximab followed by brentuximab vedotin. We demonstrate that rituximab and brentuximab are likely safe and effective in CVID-associated Hodgkin lymphoma, providing a feasible and potentially optimal treatment option for this patient population.

  17. The Con Test

    ERIC Educational Resources Information Center

    Fletcher, Michael

    2009-01-01

    In this article, the author describes the format of the Con Test, an Australian television game show which followed the same general rules and game play as the UK show PokerFace. At the end of each round a contestant needs to decide whether or not he or she should fold. A contestant needs to know how likely it is that he or she is in last place.…

  18. Utility of LRF/Pokemon and NOTCH1 protein expression in the distinction between nodular lymphocyte-predominant Hodgkin lymphoma and classical Hodgkin lymphoma.

    PubMed

    Bohn, Olga; Maeda, Takahiro; Filatov, Alexander; Lunardi, Andrea; Pandolfi, Pier Paolo; Teruya-Feldstein, Julie

    2014-02-01

    Classical Hodgkin lymphoma (CHL) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) are considered separate entities with different prognosis and treatment. However, morphologic features can be similar and immunohistochemical studies are essential in the distinction; thus, determination of additional biomarkers is of utmost importance. LRF/Pokemon is a proto-oncogene, an interacting partner co-expressed with BCL6 in germinal centers and highly expressed in diffuse large B-cell lymphoma and follicular lymphoma. Conversely, loss of the LRF gene in mouse hematopoietic stem cells results in complete block of early B cell development with concomitant Notch de-repression, indicating its critical role in B versus T cell fate decision at the hematopoietic stem cell stage. For the first time, we show that LRF/Pokemon is predominantly expressed in NLPHL cases as is BCL6 with low to absent NOTCH1 protein expression; while Hodgkin Reed-Sternberg (HRS) cells in CHL show low to absent BCL6 and LRF/Pokemon expression with higher NOTCH1 expression. We illustrate a potential functional interaction between LRF and BCL6 in NLPHL pathogenesis, and differential expression of LRF/Pokemon and NOTCH1 proteins in CHL thus showing differential expression, making for an additional diagnostic marker and therapeutic target.

  19. Differences in outcome of patients with syncytial variant Hodgkin lymphoma compared with typical nodular sclerosis Hodgkin lymphoma

    PubMed Central

    Sethi, Tarsheen; Nguyen, Van; Li, Shaoying; Morgan, David; Greer, John; Reddy, Nishitha

    2016-01-01

    Background: Nodular sclerosis Hodgkin lymphoma (NS-HL) is the most common subtype of HL and usually has a good prognosis. A variant of NS, the syncytial variant (SV) has well-established histopathologic features but little is known about its clinical behavior. Small case series have suggested that SV patients present with advanced disease and have a comparatively aggressive course. The objective of this study was to determine the clinical characteristics and outcome of SV patients Methods: A total of 167 adult patients with NS-HL including 43 patients with SV and 124 patients with typical NS (t-NS) were included in our analysis following institutional review board (IRB) approval. The Kaplan–Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Log-rank test was used to determine the differences in survival. Results: Of the 167 patients, 43 were confirmed as SV based on morphology and immunophenotype. Doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) was the most frequent induction regimen administered in 91% of all patients. The rate of complete response (CR) in the SV group was 74% versus 87% in the t-NS group (p = 0.05). At 49 months follow up, the PFS was 17 months in the SV group and not reached in the t-NS group [p < 0.0001; hazard ratio (HR) = 3.695; 95% confidence interval (CI) = 3.0, 11.07]. The median OS was not reached in both groups (p = 0.32). Conclusions: Our results show that SV histology represents a poor risk group with lower CR rate and shorter PFS and this should be considered in the risk stratification of classical HL patients. PMID:28042455

  20. Non-Hodgkin Lymphoma risk and insecticide, fungicide and fumigant use in the Agricultural Health Study

    EPA Science Inventory

    Farming and pesticide use have previously been linked to non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). We evaluated agricultural use of specific insecticides, fungicides, and fumigants and risk of NHL and NHL-subtypes (including CLL an...