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NCI CANCERLIT^® Search: Hodgkin's Lymphoma - August 2002

National Cancer Institute^®
Last Modified: August 1, 2002

The long-term consequences of therapy for Hodgkin's disease are still evolving.
Serum lipids in patients with Hodgkin's disease in complete remission.
Acute tumor lysis syndrome in Hodgkin disease.
Epstein-Barr virus in lymphoma. Protagonist or passenger?
Influence of Epstein-Barr virus genomes on patient survival in Hodgkin's disease.
When quality of life is the major challenge.
VAMP and low-dose, involved-field radiation for children and adolescents with favorable, early-stage Hodgkin's disease: results of a prospective
Treatment of unfavorable childhood Hodgkin's disease with VEPA and low-dose, involved-field radiation.
Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959-85: a cohort study.
Second malignancies after treatment for Hodgkin's disease.
Focal pulmonary uptake of gallium-67 due to radiation pneumonitis: the case for a misdiagnosis of Hodgkin's disease progression.
Multiple cutaneous granular cell tumors in a child in remission for Hodgkin's disease.
Neuropathic pain in a cancer patient responding to subcutaneously administered lignocaine.
European Jewish ancestry: activist doctor needs stem cell donation.
Male gonadal dysfunction in patients with Hodgkin's disease prior to treatment.
Testicular sperm extraction prior to treatment in azoospermic patients with Hodgkin's disease.
[Epstein-Barr virus in Hodgkin's disease: the example of central Tunisia]
False-positive Ga-67 citrate scan secondary to an inguinal hernia.
Hodgkin's disease.
PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin's disease.
Hodgkin's disease: prognostic role of gallium scintigraphy after chemotherapy.
Molecular biology of Hodgkin's lymphoma.
Assessment of Lymphoma Therapy Using (18)F-FDG PET.
Renal amyloidosis in a child with Hodgkin disease.
Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma: a report from the

1
UI - 9090956
AU - Gustavsson A
TI - The long-term consequences of therapy for Hodgkin's disease are still evolving.
SO - Acta Oncol 1997;36(1):1-2

2
UI - 9090971
AU - Munker R; Cremer P; Fries S; Hiller E
TI - Serum lipids in patients with Hodgkin's disease in complete remission.
SO - Acta Oncol 1997;36(1):75-7
AD - Unikliuikum Grosshadern der LMU, Medizinische Klinik III, Germany.

3
UI - 12116088
AU - Mahajan A; Nirmal S; English MW; Jenney ME; Lazda ED
TI - Acute tumor lysis syndrome in Hodgkin disease.
SO - Med Pediatr Oncol 2002 Jul;39(1):69-70

4
UI - 1326890
AU - Harris NL
TI - Epstein-Barr virus in lymphoma. Protagonist or passenger?
SO - Am J Clin Pathol 1992 Sep;98(3):278-81

5
UI - 1326892
AU - Fellbaum C; Hansmann ML; Niedermeyer H; Kraus I; Alavaikko MJ; Blanco G;
TI - Aine R; Busch R; Putz B; Fischer R; et al Influence of Epstein-Barr virus genomes on patient survival in Hodgkin's disease.
SO - Am J Clin Pathol 1992 Sep;98(3):319-23
AD - Institute of Pathology, School of Medicine, Technical University of Munich, Federal Republic of Germany.
In previous studies, Epstein-Barr virus was considered a possible etiologic factor in Hodgkin's disease. Two hundred twenty-nine cases of Hodgkin's disease were investigated for the presence of Epstein-Barr virus DNA using the polymerase chain reaction technique on formalin-fixed, paraffin-embedded lymph node tissue to clarify the clinical importance of the incidence of this genome. In 42 cases (18.3%), genomic DNA was not amplifiable. The remaining 187 cases included the following subtypes: lymphocyte-predominant type (n = 13), nodular sclerosis type (n = 98), mixed cellularity type (n = 68), and lymphocyte-depleted type (n = 8). Sixty-six cases (35.2%) were positive for Epstein-Barr virus DNA. In the statistical analysis of available follow-up data from 130 patients, no influence of a positive Epstein-Barr virus DNA finding on length of survival time was revealed. This was true within the cohort of all patients and within the histologically defined subtypes of Hodgkin's disease. In this investigation, detection of Epstein-Barr virus DNA by polymerase chain reaction showed no prognostic relevance for patients with Hodgkin's disease.

6
UI - 12118017
AU - Oberlin O
TI - When quality of life is the major challenge.
SO - J Clin Oncol 2002 Jul 15;20(14):3051-3

7
UI - 12118021
AU - Donaldson SS; Hudson MM; Lamborn KR; Link MP; Kun L; Billett AL; Marcus
TI - KC; Hurwitz CA; Young JA; Tarbell NJ; Weinstein HJ VAMP and low-dose, involved-field radiation for children and adolescents with favorable, early-stage Hodgkin's disease: results of a prospective clinical trial.
SO - J Clin Oncol 2002 Jul 15;20(14):3081-7
AD - Stanford University Medical Center, Stanford, CA, USA. sarah@reyes.stanford.edu
PURPOSE: To evaluate outcome and assess toxicity of children and adolescents with early-stage, favorable Hodgkin's disease treated with vinblastine, doxorubicin, methotrexate, and prednisone (VAMP) and low-dose, involved-field radiation. PATIENTS AND METHODS: One hundred ten patients with clinical stages I and II, favorable (nonbulky) Hodgkin's disease were treated with four cycles of VAMP chemotherapy and 15 Gy involved-field radiation for those who achieved a complete response, or 25.5 Gy for those who achieved a partial response to two cycles of VAMP. RESULTS: With a median follow-up of 5.6 years (range, 1.1 to 10.4 years), the 5-year survival and event-free survival were 99% (lower confidence limit [CL], 97.4%) and 93% (lower CL, 88.6%), respectively. Factors associated with event-free survival of 100% were complete response to two cycles of VAMP and histology other than nodular sclerosing Hodgkin's disease (NSHD). No serious early or late toxicity has been observed. Patients presenting with clinical stages I and IIA, nonbulky disease involving fewer than three nodal sites have a projected survival and event-free survival of 100% and 97% (lower CL, 93%), respectively, at 5 years. CONCLUSION: Risk-adapted, combined-modality therapy using only four cycles of VAMP chemotherapy with 15 to 25.5 Gy of involved-field radiation for patients with early-stage/favorable Hodgkin's disease is highly effective and without demonstrable late effects. These results indicate that pediatric patients with stages I and II favorable Hodgkin's disease can be cured with limited therapy that does not include an alkylating agent, bleomycin, etoposide, or high-dose, extended-field radiation therapy.

8
UI - 12118022
AU - Friedmann AM; Hudson MM; Weinstein HJ; Donaldson SS; Kun L; Tarbell NJ;
TI - Link MP Treatment of unfavorable childhood Hodgkin's disease with VEPA and low-dose, involved-field radiation.
SO - J Clin Oncol 2002 Jul 15;20(14):3088-94
AD - Pediatric Hematology/Oncology, Massachusetts General Hospital, Boston, MA 02114, USA. afriedmann@partners.org Hodgkin's disease were treated on a single-arm trial at three institutions with a regimen designed to maintain high cure rates while minimizing the potential late effects of treatment, such as infertility, second malignant neoplasms, and cardiopulmonary injury. PATIENTS AND METHODS: The regimen used combined-modality therapy with six cycles of vinblastine, etoposide, prednisone, and doxorubicin (VEPA) chemotherapy and low-dose, involved-field radiation. Unfavorable features comprised bulky presentations of localized (stage I or II) disease or advanced (stage III or IV) Hodgkin's disease. RESULTS: Of 56 patients enrolled, 26 (46%) had unfavorable presentations of stage I/II disease and 30 (54%) had advanced (stage III/IV) disease. Seventy-nine percent of the patients are alive without disease at a median follow-up time of 8.9 years from diagnosis. Nineteen patients had events at a median of 1.5 years (range, 0.4 to 7.9 years) from diagnosis; 17 patients relapsed, one died of cardiomyopathy, and one died of accidental injuries. Survival and event-free survival (EFS) estimates at 5 years for the entire cohort were 81.9% (SE, 5.2%) and 67.8% (SE, 6.3%), respectively. Five-year EFS by stage was 100% for stage I, 79.2% (SE, 8.3%) for stage II, 70% (SE, 14.5%) for stage III, and 49.5% (SE, 11.3%) for stage IV patients. CONCLUSION: Combined-modality therapy with VEPA chemotherapy and low-dose, involved-field radiation is adequate for disease control of early-stage patients with unfavorable features, but it is inferior to other standard regimens for advanced-stage patients.

9
UI - 12147369
AU - Swerdlow AJ; Higgins CD; Adlard P; Preece MA
TI - Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959-85: a cohort study.
SO - Lancet 2002 Jul 27;360(9329):273-7
AD - Section of Epidemiology, Institute of Cancer Research, Sutton SM2 5NG, UK. a.swerdlow@icr.ac.uk
BACKGROUND: Growth hormone raises serum concentrations of insulin-like growth factor IGF-I, which is mitogenic and antiapoptotic. There is evidence that raised endogenous levels of growth hormone and IGF-I might be associated with increased risk of certain solid cancers, but there have been no data on long-term risks of solid cancers after growth hormone treatment. METHODS: We did a cohort study to investigate cancer incidence and mortality in 1848 patients in the UK who were treated during childhood and early adulthood with human pituitary growth hormone during the period from 1959 to 1985. Patients were followed up for cancer incidence to December, 1995 and for mortality to December, 2000. Risk of cancer in the cohort was compared with that in the general population, controlling for age, sex, and calendar period. FINDINGS: Patients treated with human pituitary growth hormone had significantly raised risks of mortality from cancer overall (standardised mortality ratio 2.8, 95% CI 1.3-5.1; ten cases), colorectal cancer (10.8, 1.3-38.8; two cases), and Hodgkin's disease (11.4, 1.4-41.3; two cases). Incidence of colorectal cancer was also greatly raised (7.9, 1.0-28.7). After exclusion of patients whose original diagnosis rendered them at high risk of cancer, the significance and size of the risks of colorectal cancer incidence and mortality, and of Hodgkin's disease mortality were increased. INTERPRETATION: Although based on small numbers, the risk of colorectal cancer is of some concern and further investigation in other cohorts is needed. We have no evidence as to whether growth hormone in modern dosage regimens is associated with an increased risk of colorectal cancer.

10
UI - 11911408
AU - Varady E; Deak B; Molnar ZS; Rosta A; Schneider T; Esik O; Eckhardt S
TI - Second malignancies after treatment for Hodgkin's disease.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1275-81
AD - Department of Chemotherapy A, National Institute of Oncology, Budapest, Hungary. varadi@oncol.hu
The occurrence of treatment-related second malignancy following Hodgkin's disease (HD) has now been recognized as a major problem. The purpose of this study was to review our experience with second malignancies in patients treated for Hodgkin's disease, comparing the results with the international literature data. Six hundred and sixty five patients with HD were treated in our department, between 1978 and 1996. Second neoplasm developed in 32 cases (4.8%). Seven secondary hematological malignancies were observed: four acute nonlymphocytic leukemias, two non-Hodgkin's lymphomas and one chronic myeloid leukemia. Among patients with second hematological malignancies, the mean age at diagnosis of HD was 44 years and the mean interval until the development of second malignancy was 6.1 years. Five patients received chemo- and radiotherapy and in two cases chemotherapy was used. Three of the seven patients are alive. Twenty-five patients have had solid tumors, affecting lung (5), breast (3), colon (3), stomach (2), urinary bladder (2), head-and-neck (1), thyroid gland (1), esophagus (1), liver (1), pancreas (1), furthermore, three sarcomas and two malignant melanomas were observed. Their mean age at the diagnosis of HD was 46 years and the mean period of latency was 8.3 years. Chemotherapy was applied to nine patients, 16 patients received both chemo- and radiotherapy. Eleven patients had solid tumors in the region irradiated earlier. Ten out of the 25 patients are alive, three patients' present state is unknown. Since alkylating agents increase the risk of leukemia and irradiation contributes mainly to other malignancies, future treatment protocols should attempt to reduce the most serious consequence of therapy without compromising the survival. It is necessary to investigate the impact of additional risk factors. Careful, lifelong observation is indicated for patients with HD, with special attention given to new clinical signs and symptoms.

11
UI - 11911431
AU - Ruiz-Hernandez G; Gutierrez AM; Rodriguez J; Ferrer-Albiach E;
TI - Mateo-Navarro A; Garcia-Conde J Focal pulmonary uptake of gallium-67 due to radiation pneumonitis: the case for a misdiagnosis of Hodgkin's disease progression.
SO - Leuk Lymphoma 2001 Nov-Dec;42(6):1429-32
AD - Nuclear Medicine Department, Hospital Clinico of Valencia, Spain.
Gallium-67 scan is usually performed in patients with Hodgkin's disease and high-grade non-Hodgkin lymphoma for evaluation of disease status after treatment. We present a case of an asymptomatic woman in complete remission of Hodgkin's disease after treatment with chemotherapy and radiotherapy where a focal uptake of Gallium-67 was discovered two months after finishing treatment. As classical radiation pneumonitis can appear one to three months after finishing radiotherapy and normally has an asymptomatic course, this possibility should be considered in these cases, especially when prior chemotherapy was administered.

12
UI - 12140456
AU - De Raeve L; Roseeuw D; Otten J
TI - Multiple cutaneous granular cell tumors in a child in remission for Hodgkin's disease.
SO - J Am Acad Dermatol 2002 Aug;47(2 Suppl):S180-2
AD - Department of Dermatology, Academic Hospital Vrije Universiteit Brussel, Belgium. cdsnvxc@az.vub.ac.be
Multiple cutaneous granular cell tumors are uncommon among children. We describe a 13-year-old boy with Hodgkin's disease in remission for 3 years who had multiple cutaneous granular cell tumors. We wondered whether this association was real or a coincidence and whether this child was at increased risk of development of malignant granular cell tumors.

13
UI - 8219524
AU - Devulder JE; Ghys L; Dhondt W; Rolly G
TI - Neuropathic pain in a cancer patient responding to subcutaneously administered lignocaine.
SO - Clin J Pain 1993 Sep;9(3):220-3
AD - Department of Anesthesia-Section Pain Clinic, University Hospital Gent, Belgium.
OBJECTIVE: To demonstrate difficulties encountered in alleviating neuropathic pain in a terminally ill cancer patient, with the very tentative diagnosis of postherpetic neuralgia. SETTING: A multidisciplinary pain department in a university hospital. PATIENTS: A patient with Hodgkin's lymphoma and leiomyosarcoma in the liver developed an unusual manifestation of neuropathic pain. INTERVENTION: Oral drug treatment with morphine associated with amitriptyline, valproic acid, mexilitine, flufenazine, and methylprednisolone failed to suppress pain attacks. Only the subcutaneous instillation of lidocaine (2 mg/kg/h) could partially suppress pain. A dorsal root entry zone lesion intervention could only temporary stop the pain attacks. Infiltration and nervous stimulation techniques were not helpful. OUTCOME MEASURES: In determining pain control, the visual analog scale rating scale and the number of attacks per hour were considered. RESULTS: Only the subcutaneous administration of lignocaine could partially suppress pain. Because of the patient's poor hepatic circulation, variable lidocaine plasma concentrations were responsible for intolerable side effects. CONCLUSIONS: Subcutaneous lignocaine administration remains a useful method in treating neuropathic cancer pain. The poor metabolic condition of the patient can lead to deleterious high plasma levels. A dorsal root entry zone lesion could only temporarily stop the pain.

14
UI - 12171005
AU - James JS
TI - European Jewish ancestry: activist doctor needs stem cell donation.
SO - AIDS Treat News 2000 Dec 22;(357):2-3
Friends of Alan Berkman, M.D., who helped organize the movement to make AIDS and other medications available in developing countries, are seeking a genetically matched stem-cell donor. Persons of Eastern European Jewish ancestry can help Dr. Berkman and others by being tested and joining the registry of potential donors.

15
UI - 11697845
AU - Rueffer U; Breuer K; Josting A; Lathan B; Sieber M; Manzke O;
TI - Grotenhermen FJ; Tesch H; Bredenfeld H; Koch P; Nisters-Backes H; Wolf J; Engert A; Diehl V Male gonadal dysfunction in patients with Hodgkin's disease prior to treatment.
SO - Ann Oncol 2001 Sep;12(9):1307-11
AD - First Department of Internal Medicine, University Hospital Cologne, and the German Hodgkin's Study Group.
Infertility after treatment of patients with Hodgkin's disease (HD) is considered as a side effect of alkylating agent containing chemotherapy regimens. To investigate whether gonadal failure is related primarily to the toxic effect of chemotherapy or rather to the disease itself, we investigated the fertility status before the onset of treatment. PATIENTS AND METHODS: Semen quality and hormonal status were evaluated in 158 patients with first diagnosis of HD enrolled into trials of the German Hodgkin Lymphoma Study Group (GHSG). The median age of the patients was 28 years (range 16-52). Twenty patients (13%) were classified as early stage HD, 63 patients (40%) as intermediate stage, and 75 patients (47%)) as advanced stage according GHSG grading. Sixty-seven patients (42%) showed systemic symptoms. Semen analysis was performed according to WHO guidelines. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) plasma levels were measured by specific double-antibody radio-immune-assay (RIA) methods. RESULTS: Prior to treatment, severe damage of fertility, i.e.. azoospermia and oligoasthenoteratospermia (OAT-syndrome) was found in 13 (8%) and 20 patients (13%), respectively. Thirty-eight patients (24%) had single, i.e., oligo-(O), astheno-(A) or teratospermia-(T), and 40 patients (26%) showed combined damages, i.e., OA, OT or AT. In 47 patients (30%) a normal sperm count was found. Thus, III patients (70%) showed semen abnormalities before the onset of treatment. In a multivariate analysis elevated ESR (P < 0.003) and advanced stage of disease (P < 0.01) could be distinguished as prognostic factors for severe damage of fertility. No correlation was found between pre-therapeutic gonadotropine levels and fertility status. CONCLUSION: Patients with HD have an increased risk for inadequate semen quality even prior to treatment. Infertility is more frequent in patients with elevated ESR and advanced stage of disease. This association demonstrates the predominant influence of the disease on fertility. Assuming HD is the major initial cause for infertility efforts should be made to identify new non-gonadal toxic chemotherapies to be able to regain fertility after effective therapy. Further investigations have to be performed to clarify mechanisms inducing fertility defects in patients with HD.

16
UI - 11886015
AU - Schrader M; Muller M; Sofikitis N; Goessl C; Straub B; Miller K
TI - Testicular sperm extraction prior to treatment in azoospermic patients with Hodgkin's disease.
SO - Ann Oncol 2002 Feb;13(2):333

17
UI - 12124490
AU - Korbi S; Trimeche M; Sriha B; Yacoubi MT; Hmissa S; Mokni M; Delvenne P;
TI - Boniver J; Rammeh S [Epstein-Barr virus in Hodgkin's disease: the example of central Tunisia]
SO - Ann Pathol 2002 Apr;22(2):96-101
AD - Laboratoire d'Anatomie et de Cytologie Pathologiques, CHU Farhat Hached, 4000 Sousse, Tunisie, France. sadok.korbi@uc.mu.tn
The purpose of this study was to evaluate the prevalence of Epstein-Barr virus in Hodgkin disease in Tunisia through a series of 77 cases. Association with Epstein-Barr virus was demonstrated by Epstein-Barr encoded early RNA transcripts (EBER) in situ hybridization in 70% of cases and by latent membrane protein 1 (LMP1) immunohistochemistry in 58.4% of cases. EBER positive cases were more frequent in extreme age classes (<15 and>54 years) there was no correlation with sex, histologic sub-type and clinical stage. Our findings show a high prevalence for EBV infection in Tunisian Hodgkin's disease particularly among extreme ages.

18
UI - 12072788
AU - Fong W; Lim E
TI - False-positive Ga-67 citrate scan secondary to an inguinal hernia.
SO - Clin Nucl Med 2002 Jul;27(7):534-5
AD - Nuclear Medicine Department, Royal Brisbane Hospital, Herston, Queensland, Australia.

19
UI - 10803830
AU - Diehl V; Josting A
TI - Hodgkin's disease.
SO - Cancer J 2000 Apr;6 Suppl 2():S150-8
AD - First Department of Internal Medicine, University Hospital Cologne, Germany.
There is overwhelming evidence that at least a substantial number of cases, if not all, of Hodgkin's disease (HD) represent monoclonal B-cell disorders. The treatment of HD is changing strikingly. In early stages of disease, extended field irradiation has been the standard resulting in excellent cure rates. Due to the recognition of fatal long-term effects, however, especially the high rates of second solid tumors, extended field radiotherapy is now being abandoned by most study groups. Instead, mild chemotherapy for control of occult disease is combined with involved field irradiation. In intermediate stage HD, where combined modality treatment is the treatment of choice, extended field irradiation is substituted by involved field irradiation for the same reasons. In advanced stage HD, 8 cycles of polychemotherapy (plus additional radiotherapy for large tumor masses and residual lymphomas) for decades has cured only 50% to 60% of patients. The development of a new dose-intensified regimen (BEACOPP) for the first time has significantly improved that prognosis. In relapsed HD, recently published phase III studies suggest an improvement of relapse-free survival of patients using high-dose chemotherapy followed by autologous stem cell transplantation (ASCT).

20
UI - 12163626
AU - Kostakoglu L; Coleman M; Leonard JP; Kuji I; Zoe H; Goldsmith SJ
TI - PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin's disease.
SO - J Nucl Med 2002 Aug;43(8):1018-27
AD - Division of Nuclear Medicine, Department of Radiology, Weill Medical College of Cornell University and New York Presbyterian Hospital, New York, New York 10021, USA. lak2005@mail.med.cornell.edu
Early identification of chemotherapy-refractory lymphoma patients provides a basis for alternative treatment strategies. Metabolic imaging with (18)F-FDG PET offers functional tissue characterization that is useful for assessing response to therapy. Our objective was to determine the predictive value of (18)F-FDG PET early during chemotherapy (after 1 cycle) and at the completion of chemotherapy for subsequent progression-free survival (PFS) in patients with aggressive non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD). METHODS: (18)F-FDG PET (dual-head coincidence camera with attenuation correction) was performed before and after 1 cycle of chemotherapy on 30 patients (17 NHL, 13 HD; mean age, 52.3 +/- 16.0 y). For 23 of the 30 patients, (18)F-FDG PET data were also obtained after the completion of chemotherapy. The patients had a median follow-up of 19 mo (range, 18-24 mo). Follow-up of PFS was compared between patients with positive and negative (18)F-FDG PET results obtained after the first cycle of chemotherapy and at the completion of chemotherapy. RESULTS: Positive (18)F-FDG PET results obtained both after the first cycle and at the completion of therapy were associated with a shorter PFS (median, 5 and 0 mo, respectively) than were negative (18)F-FDG PET results (PFS medians not reached). A statistically significant difference in PFS between positive and negative (18)F-FDG PET results was obtained both after the first cycle and at the completion of chemotherapy (P < or = 0.001). The PFS and (18)F-FDG PET results obtained after the first cycle correlated better than those obtained after the completion of chemotherapy (r(2) = 0.45 vs. 0.17). (18)F-FDG PET had more false-negative results after the last cycle (6/17 cases, or 35%) than after the first cycle (2/13 cases, or 15%). Thus, (18)F-FDG PET had greater sensitivity and positive predictive values after the first cycle (82% vs. 45.5% and 90% vs. 83%, respectively) than after the last cycle. CONCLUSION: (18)F-FDG PET after 1 cycle of chemotherapy is predictive of 18-mo outcome in patients with aggressive NHL and HD and may earlier identify patients who would benefit from more intensive treatment programs.

21
UI - 11685490
AU - Brenot-Rossi I; Bouabdallah R; Di Stefano D; Bardou VJ; Stoppa AM;
TI - Camerlo J; Sauvan R; Gastaut JA; Pasquier J Hodgkin's disease: prognostic role of gallium scintigraphy after chemotherapy.
SO - Eur J Nucl Med 2001 Oct;28(10):1482-8
AD - Department of Nuclear Medicine, Institut Paoli-Calmettes, Regional Cancer Centre, Universite de la Mediterranee, Marseille, France. brenoti@marseille.fnclcc.fr
Evaluation of the response to therapy is important for optimal selection of treatment strategy in patients with Hodgkin's disease (HD). Refractory disease requires intensive high-dose chemotherapy, whereas unnecessary treatment should be avoided in patients in complete remission. The purpose of this study was to evaluate the contribution of gallium-67 scintigraphy in predicting the clinical outcome in patients with HD and mediastinal involvement on the basis of scan results at the end of chemotherapy. Seventy-four patients with HD and mediastinal involvement were retrospectively investigated with 67Ga scintigraphy 72 h after injection of 220 MBq 67Ga citrate (planar and single-photon emission tomographic studies) following the completion of chemotherapy. At the same time, they all underwent computed tomography (CT). Patients were followed up for an average of 63 months (range 28-124 months). The disease status was newly diagnosed disease in 64 of the patients and relapse in 10. Systemic symptoms were absent (A) in 34 cases and present (B) in 40 cases. Forty-one patients had stage I or II disease and 33 patients had stage III or IV disease. Twenty-two patients had bulky disease on initial diagnosis. At the end of chemotherapy, all 74 patients showed regression of the mass by more than 50% (50%-100%) on CT. Patients were divided into two groups according to the positivity or negativity of the gallium scan after chemotherapy: 61 patients had negative and 13 patients had positive gallium scans. In the gallium-negative group, 19.7% of the patients relapsed and 91.8% were alive at the end of the follow-up. Relapse occurred in 20% of the patients with residual mass and in 19.6% of the patients without residual mass. In the gallium-positive group, 84.6% of the patients had recurrent disease and 61.5% were alive after intensive chemotherapy. There was a statistically significant difference in overall survival between patients with positive and patients with negative gallium results (P=0.0034). Disease-free survival differed significantly between patients with positive and patients with negative gallium scans at the end of chemotherapy (P<0.0001). The relative risk of death was 5.2 and the relative risk of relapse was 11.3 for patients with positive gallium scans, in comparison to those with negative gallium scans. The positive and negative predictive values for predicting relapse were 85% and 87%, respectively. It is concluded that even if gallium scan is performed at the end of chemotherapy, it can predict outcome. Alternative therapy may be required on the basis of gallium scan results obtained after treatment.

22
UI - 11883530
AU - Kuppers R
TI - Molecular biology of Hodgkin's lymphoma.
SO - Adv Cancer Res 2002;84():277-312
AD - Institute for Genetics and Department of Internal Medicine I, University of Cologne, Germany.
Hodgkin's lymphoma (HL) is characterized by typical mononucleated Hodgkin and multinucleated Reed-Sternberg cells, which occur at low frequency in a mixed cellular infiltrate in the tumor tissue. Because of the rarity of these cells and their unusual immunophenotype, which is strikingly different from those of all normal hematopoietic cell types, the origin of these cells and their clonality have long been unclear. Single-cell studies of rearranged immunoglobulin genes showed that Hodgkin and Reed-Sternberg (HRS) cells represent clonal tumor-cell populations derived from germinal center B cells. In classical HL, the detection of obviously crippling immunoglobulin gene mutations in a fraction of the cases suggests that HRS cells may derive from germinal center B cells that have lost the capacity to be positively selected by antigen and that normally would have undergone apoptosis. In rare cases, HRS cells represent transformed T lymphocytes. The transforming events involved in malignant transformation of HRS cells are still largely unknown. Constitutive activation of the transcription factor NFkappaB, which can, for example, be induced through Epstein-Barr virus transformation of HRS cells or destructive somatic mutations of the inhibitor of NFkappaB, is likely to be a key event in HL pathogenesis. Significant progress has been made in our understanding of the cellular interactions in HL tissues, which are mainly mediated by a large variety of cytokines and chemokines.

23
UI - 12163627
AU - Lowe VJ; Wiseman GA
TI - Assessment of Lymphoma Therapy Using (18)F-FDG PET.
SO - J Nucl Med 2002 Aug;43(8):1028-30
AD - PET Imaging, Department of Radiology, Mayo Clinic Rochester, Minnesota 55905, USA. vlowe@mayo.edu

24
UI - 12147897
AU - Thavaraj V; Dawar R; Arya LS
TI - Renal amyloidosis in a child with Hodgkin disease.
SO - Indian Pediatr 2002 Jul;39(7):677-80
AD - Pediatric Oncology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India.

25
UI - 12093945
AU - Zebrack BJ; Zeltzer LK; Whitton J; Mertens AC; Odom L; Berkow R; Robison
TI - LL Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study.
SO - Pediatrics 2002 Jul;110(1 Pt 1):42-52
AD - Department of Pediatrics, University of California Los Angeles, School of Medicine, Los Angeles, California, USA. bzebrack@mednet.ucla.edu
OBJECTIVE: To evaluate and compare psychological outcomes in long-term survivors of pediatric leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma and sibling controls. METHODS: Adult survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma (N = 5736) and sibling controls (N = 2565) were administered a long-term follow-up questionnaire allowing assessment of symptoms associated with depression and somatic distress. RESULTS: The majority of respondents in this study did not demonstrate symptomatology indicative of depression or somatic distress. Survivors, however, were significantly more likely than sibling controls to report symptoms of depression and somatic distress. Women were significantly more likely to indicate symptoms of depression and somatic distress than were men; however, this difference did not vary by survivor/sibling status. Similarly, socioeconomic (SES) variables predicted symptomatic levels of depression and somatic distress for both survivors and siblings, and these effects did not vary by survivor/sibling status. Among leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma survivors, in addition to gender and SES, the only treatment variable that predicted scores indicating depressive symptomatology was exposure to intensive chemotherapy. Exposure to intensive chemotherapy also predicted scores indicative of somatic distress symptoms. No other medical variables, including diagnostic category, age at diagnosis, time since diagnosis, and duration of treatment, predicted symptomatic scores for depression and somatic distress. CONCLUSIONS: This large, sibling-controlled, multisite study of young adult survivors of childhood leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma found that survivors had significant increased risk for reporting symptoms of depression and somatic distress and that intensive chemotherapy added to this risk. However, being a cancer survivor did not compound the effects of gender and SES variables on the 2 outcomes measured. The ability of SES, gender, and treatment-related variables to predict psychological symptoms in this cohort of childhood survivors and sibling controls calls for future research into varied biological and psychosocial pathways by which cancer influences future psychosocial functioning.

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Find My Cancer Drug

NCI CANCERLIT^® Search: Hodgkin's Lymphoma - August 2002

Table of Contents

Cancer Types

View by Cancer Types

Cancer Treatment

Cancer Risk and Prevention

Cancer Drugs

Support

Healthcare Professionals

Clinical Trials

Oncolink Features

Find My Cancer Drug

NCI CANCERLIT® Search: Hodgkin's Lymphoma - August 2002

Table of Contents

OncoLink I wish u knew...

Find Your Cancer Drug - A

Find Your Cancer Drug - B

Find Your Cancer Drug - C

Find Your Cancer Drug - D

Find Your Cancer Drug - E

Find Your Cancer Drug - F

Find Your Cancer Drug - G

Find Your Cancer Drug - H

Find Your Cancer Drug - I

Find Your Cancer Drug - J

Find Your Cancer Drug - K

Find Your Cancer Drug - L

Find Your Cancer Drug - M

Find Your Cancer Drug - N

Find Your Cancer Drug - O

Find Your Cancer Drug - P

Find Your Cancer Drug - R

Find Your Cancer Drug - S

Find Your Cancer Drug - T

Find Your Cancer Drug - V

NCI CANCERLIT^® Search: Hodgkin's Lymphoma - August 2002