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Amraee A, Evazi MR, Shakeri M, Roozbeh N, Ghazanfarpour M, Ghorbani M, Ansari J, Darvish L. Efficacy of nivolumab as checkpoint inhibitor drug on survival rate of patients with relapsed/refractory classical Hodgkin lymphoma: a meta-analysis of prospective clinical study. Clin Transl Oncol 2019; 21:1093-1103. [DOI: 10.1007/s12094-018-02032-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
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Petroianu A. Subtotal splenectomy preserving the inferior splenic pole for the treatment of Hodgkin's lymphoma. Int J Surg Case Rep 2017; 36:1-3. [PMID: 28486174 PMCID: PMC5423331 DOI: 10.1016/j.ijscr.2017.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Splenectomy is helpful in the management of selected patients with Hodgkin's lymphoma (HL), but in some cases this procedure is accompanied by a greater morbidity and mortality mainly due to sepsis. This is the first published case of subtotal splenectomy preserving the inferior splenic pole without the maintenance of the splenic vascular pedicle. PRESENTATION OF CASE A 53-year-old man with HL refractory to chemo and radiotherapy associated to a very large spleen was successfully treated with subtotal splenectomy, preserving the inferior splenic pole supplied only by the left gastroepiploic and inferior splenic pole vessels. After an eleven year uneventful postoperative follow-up, the dimensions and function of the spleen are still preserved, and the disease is under control with chemo- and radiotherapy. CONCLUSION Subtotal splenectomy is efficacious to preserve the splenic functions and to prevent adverse effects of a large spleen on the treatment of Hodgkin's lymphoma confined to superior pole and producing significant abdominal symptoms and hematological effects.
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Affiliation(s)
- Andy Petroianu
- Department of Surgery of the Medical School of the Federal University of Minas Gerais, Brazil.
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Bacterial Infections Following Splenectomy for Malignant and Nonmalignant Hematologic Diseases. Mediterr J Hematol Infect Dis 2015; 7:e2015057. [PMID: 26543526 PMCID: PMC4621170 DOI: 10.4084/mjhid.2015.057] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 10/03/2015] [Indexed: 01/19/2023] Open
Abstract
Splenectomy, while often necessary in otherwise healthy patients after major trauma, finds its primary indication for patients with underlying malignant or nonmalignant hematologic diseases. Indications of splenectomy for hematologic diseases have been reducing in the last few years, due to improved diagnostic and therapeutic tools. In high-income countries, there is a clear decrease over calendar time in the incidence of all indication splenectomy except nonmalignant hematologic diseases. However, splenectomy, even if with different modalities including laparoscopic splenectomy and partial splenectomy, continue to be a current surgical practice both in nonmalignant hematologic diseases, such as Immune Thrombocytopenic Purpura (ITP), Autoimmune Hemolytic Anemia (AIHA), Congenital Hemolytic Anemia such as Spherocytosis, Sickle Cell Anemia and Thalassemia and Malignant Hematological Disease, such as lymphoma. Today millions of people in the world are splenectomized. Splenectomy, independently of its cause, induces an early and late increase in the incidence of venous thromboembolism and infections. Infections remain the most dangerous complication of splenectomy. After splenectomy, the levels of antibody are preserved but there is a loss of memory B cells against pneumococcus and tetanus, and the loss of marginal zone monocytes deputed to immunological defense from capsulated bacteria. Commonly, the infections strictly correlated to the absence of the spleen or a decreased or absent splenic function are due to encapsulated bacteria that are the most virulent pathogens in this set of patients. Vaccination with polysaccharide and conjugate vaccines again Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis should be performed before the splenectomy. This practice reduces but does not eliminate the occurrence of overwhelming infections due to capsulated bacteria. At present, most of infections found in splenectomized patients are due to Gram-negative (G-) bacteria. The underlying disease is the most important factor in determining the frequency and severity of infections. So, splenectomy for malignant diseases has the major risk of infections.
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Lowe GC, Hocker TL, Comfere NI, Lehman JS. Skin involvement with Hodgkin disease: a rare condition late in the course of Hodgkin lymphoma. Am J Hematol 2013; 88:979. [PMID: 23686913 DOI: 10.1002/ajh.23479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 04/28/2013] [Accepted: 04/30/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Nneka I. Comfere
- Assistant Professor of Dermatology, Mayo Clinic; Rochester Minnesota
| | - Julia S. Lehman
- Assistant Professor of Dermatology, Mayo Clinic; Rochester Minnesota
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Navarro A, Muñoz C, Gaya A, Díaz-Beyá M, Gel B, Tejero R, Díaz T, Martinez A, Monzó M. MiR-SNPs as markers of toxicity and clinical outcome in Hodgkin lymphoma patients. PLoS One 2013; 8:e64716. [PMID: 23705004 PMCID: PMC3660374 DOI: 10.1371/journal.pone.0064716] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/17/2013] [Indexed: 12/22/2022] Open
Abstract
Background In recent years, microRNA (miRNA) pathways have emerged as a crucial system for the regulation of tumorogenesis. miR-SNPs are a novel class of single nucleotide polymorphisms that can affect miRNA pathways. Design and Methods We analyzed eight miR-SNPs by allelic discrimination in 141 patients with Hodgkin lymphoma and correlated the results with treatment-related toxicity, response, disease-free survival (DFS) and overall survival (OS). Results The KRT81 (rs3660) GG genotype was associated with an increased risk of neurological toxicity (P = 0.016), while patients with XPO5 (rs11077) AA or CC genotypes had a higher rate of bleomycin-associated pulmonary toxicity (P = 0.048). Both miR-SNPs emerged as independent factors in the multivariate analysis. The XPO5 AA and CC genotypes were also associated with a lower response rate (P = 0.036). XPO5 (P = 0.039) and TRBP (rs784567) (P = 0.022) genotypes emerged as prognostic markers for DFS, and XPO5 was also associated with OS (P = 0.033). In the multivariate analysis, only XPO5 emerged as an independent prognostic factor for DFS (HR: 2.622; 95%CI 1.039–6.620; P = 0.041). Given the influence of XPO5 and TRBP as individual markers, we then investigated the combined effect of these miR-SNPs. Patients with both the XPO5 AA/CC and TRBP TT/TC genotypes had the shortest DFS (P = 0.008) and OS (P = 0.008). Conclusion miR-SNPs can add useful prognostic information on treatment-related toxicity and clinical outcome in Hodgkin lymphoma and can be used to identify patients likely to be chemoresistant or to relapse.
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Affiliation(s)
- Alfons Navarro
- Molecular Oncology and Embryology Laboratory, Human Anatomy Unit, School of Medicine, University of Barcelona, IDIBAPS, Barcelona, Spain.
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Ediz M, Avcıbaşı U, Ünak P, Müftüler FZB, Medine Eİ, Yurt Kılçar A, Demiroğlu H, Gümüşer FG, Sakarya S. Investigation of Therapeutic Efficiency of Bleomycin and Bleomycin-Glucuronide Labeled with 131I on the Cancer Cell Lines. Cancer Biother Radiopharm 2013; 28:310-9. [DOI: 10.1089/cbr.2012.1316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Melis Ediz
- Department of Chemistry, Faculty of Art and Science, Celal Bayar University, Manisa, Turkey
| | - Uğur Avcıbaşı
- Department of Chemistry, Faculty of Art and Science, Celal Bayar University, Manisa, Turkey
| | - Perihan Ünak
- Department of Nuclear Applications, Ege University, Institute of Nuclear Sciences, Izmir, Turkey
| | | | - Emin İlker Medine
- Department of Nuclear Applications, Ege University, Institute of Nuclear Sciences, Izmir, Turkey
| | - Ayfer Yurt Kılçar
- Department of Nuclear Applications, Ege University, Institute of Nuclear Sciences, Izmir, Turkey
| | - Hasan Demiroğlu
- Department of Chemistry, Faculty of Art and Science, Celal Bayar University, Manisa, Turkey
| | - Fikriye Gül Gümüşer
- Department of Nuclear Medicine, Celal Bayar University, School of Medicine, Manisa, Turkey
| | - Serhan Sakarya
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
- Adnan Menderes University, ADUBILTEM Science and Technology Research and Development Center, Aydin, Turkey
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Altés A, Paré L, Esquirol A, Xicoy B, Rámila E, Vicente L, López R, Orriols J, Vall-llovera F, Sánchez-González B, del Río E, Sureda A, Páez D, Baiget M. Pharmacogenetic analysis in the treatment of Hodgkin lymphoma. Leuk Lymphoma 2013; 54:1706-12. [DOI: 10.3109/10428194.2012.752080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Demiroğlu H, Avcıbaşı U, Ünak P, Müftüler FZB, İçhedef Ç, Gümüşer FG, Sakarya S. Radiolabeling of Bleomycin-Glucuronide with 131I and Biodistribution Studies Using Xenograft Model of Human Colon Tumor in Balb/C Mice. Cancer Biother Radiopharm 2012; 27:371-83. [DOI: 10.1089/cbr.2011.1157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hasan Demiroğlu
- Department of Chemistry, Faculty of Art and Science, Celal Bayar University, Manisa, Turkey
| | - Ugur Avcıbaşı
- Department of Chemistry, Faculty of Art and Science, Celal Bayar University, Manisa, Turkey
| | - Perihan Ünak
- Department of Nuclear Applications, Institute of Nuclear Sciences, Ege University, Bornova, Izmir, Turkey
| | | | - Ç.A. İçhedef
- Department of Nuclear Applications, Institute of Nuclear Sciences, Ege University, Bornova, Izmir, Turkey
| | - Fikriye Gül Gümüşer
- Department of Nuclear Medicine, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Serhan Sakarya
- Department of Infectious Diseases and Clinical Microbiology, Adnan Menderes University School of Medicine, Aydin, Turkey
- ADUBILTEM Science and Technology Research and Development Center, Adnan Menderes University, Aydin, Turkey
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Introcaso CE, Kantor J, Porter DL, Junkins-Hopkins JM. Cutaneous Hodgkin's disease. J Am Acad Dermatol 2008; 58:295-8. [PMID: 18222326 DOI: 10.1016/j.jaad.2005.11.1055] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2005] [Revised: 10/31/2005] [Accepted: 11/12/2005] [Indexed: 02/04/2023]
Abstract
Cutaneous Hodgkin's disease is a rare condition that usually occurs late in the course of Hodgkin's lymphoma. This rare condition is thought to have decreased in incidence in recent decades, likely owing to improved treatment of patients with Hodgkin's disease, who are receiving improved chemotherapy and radiation therapy, and the advent of peripheral blood stem cell transplantation. We present the case of a man who developed specific cutaneous Hodgkin's lymphoma 6 months after nonmyeloablative allogenic stem cell transplantation for his recurrent systemic disease. The patient's manifestation of relapse was cutaneous dissemination of the tumor, manifested by erythematous papules and ulcerated nodules. At the time of the cutaneous relapse he had minimal systemic disease. This case illustrates an example of this complication of Hodgkin's disease and stresses the importance of a timely diagnosis to direct appropriate therapy. A review of the literature demonstrates that the patient's lesion morphology and distribution are typical of specific manifestations of cutaneous Hodgkin's disease.
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Affiliation(s)
- Camille E Introcaso
- Department of Dermatology, the University of Pennsylvania, Philadelphia, USA
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Benekli M, Smiley SL, Younis T, Czuczman MS, Hernandez-Ilizaliturri F, Bambach B, Battiwalla M, Padmanabhan S, McCarthy PL, Hahn T. Intensive conditioning regimen of etoposide (VP-16), cyclophosphamide and carmustine (VCB) followed by autologous hematopoietic stem cell transplantation for relapsed and refractory Hodgkin's lymphoma. Bone Marrow Transplant 2007; 41:613-9. [DOI: 10.1038/sj.bmt.1705951] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- Nancy L Bartlett
- Washington University, Siteman Cancer Center, Division of Medical Oncology 660 South Euclid Street, St. Louis, MO 63110, USA
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Hahn T, Benekli M, Wong C, Moysich KB, Hyland A, Michalek AM, Alam A, Baer MR, Bambach B, Czuczman MS, Wetzler M, Becker JL, McCarthy PL. A prognostic model for prolonged event-free survival after autologous or allogeneic blood or marrow transplantation for relapsed and refractory Hodgkin's disease. Bone Marrow Transplant 2005; 35:557-66. [PMID: 15665852 DOI: 10.1038/sj.bmt.1704789] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There are several prognostic models for Hodgkin's disease (HD) patients, but none evaluating patient characteristics at time of blood and marrow transplantation (BMT). We developed a prognostic model for event-free survival (EFS) post-BMT based on HD patient characteristics measured at the time of autologous (auto) or allogeneic (allo) BMT. Between 1/1991 and 12/2001, 64 relapsed or refractory HD patients received an auto (n=46) or allo (n=18) BMT. A multivariate prognostic model was developed measuring time to relapse, progression or death. Median follow-up was 51.7 months; median EFS for auto and allo BMT was 36 and 3 months, respectively (P=0.001). Significant multivariate predictors of shorter EFS were chemotherapy-resistant disease, KPS <90 and > or =3 chemotherapy regimens pre-BMT. Patients with two to three adverse factors had significantly shorter EFS at 2 years (58 vs 11% in auto; 38 vs 0% in allo BMT patients). Despite a selection bias favoring auto BMT, the model was valid in both auto and allo BMT groups. We were able to differentiate patients at high vs low risk for adverse outcomes post-BMT. This prognostic model may prove useful in predicting patient outcomes and identifying high-risk patients for novel treatment strategies. Validation of this model in a larger cohort of patients is warranted.
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Affiliation(s)
- T Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
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Rueda Domínguez A, Márquez A, Gumá J, Llanos M, Herrero J, de Las Nieves MA, Miramón J, Alba E. Treatment of stage I and II Hodgkin's lymphoma with ABVD chemotherapy: results after 7 years of a prospective study. Ann Oncol 2004; 15:1798-804. [PMID: 15550585 DOI: 10.1093/annonc/mdh465] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chemotherapy with ABVD (doxorubicin, bleomycin, vinblastine and darcarbacine) schedule is the standard treatment for advanced Hodgkin's lymphoma. Certain facts, including a low toxicity compared with MOPP/ABV (mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin and vinblastine) and minimal potential for inducing second neoplasias or patient sterility, support the use of ABVD to treat early disease stages. In the present study, we prospectively evaluated the long-term efficacy and toxicity of six cycles of ABVD as treatment for early-stage Hodgkin's lymphoma. PATIENTS AND METHODS From January 1990 to June 2002, 95 patients with stage I and II Hodgkin's lymphoma were treated with six ABVD cycles. Fifteen patients who met the criteria for mediastinal bulky disease also received further radiotherapy on the mediastinum. RESULTS After six cycles, 89 patients (94%) showed a complete response (CR) and six patients (6%) showed a partial response (PR). These PRs became CRs after radiotherapy. After a median follow-up of 78 months, 14 patients had relapsed and three had died. Overall survival and progression-free survival rates at 7 years were 96% and 84%, respectively. For patients with stage IA and IIA without mediastinal bulky disease, the survival rates were 97% and 88%, respectively. CONCLUSIONS The administration of six ABVD cycles is an effective and safe treatment in patients with stage I and II Hodgkin's lymphoma.
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Affiliation(s)
- A Rueda Domínguez
- Servicio de Oncología, Hospital Clínico Universitario, Málaga, Spain.
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Thomas C, Cans C, Pelletier R, De Robertis C, Hazzouri M, Sele B, Rousseaux S, Hennebicq S. No Long-Term Increase in Sperm Aneuploidy Rates after Anticancer Therapy. Clin Cancer Res 2004; 10:6535-43. [PMID: 15475441 DOI: 10.1158/1078-0432.ccr-04-0582] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Lymphomas and testicular cancers are the most frequent malignancies among young men. With recent improvement of survival rates, for many patients, the question is raised of the consequences of the anticancer treatments on their fertility and more specifically of a potential genetic risk for the offspring. This article presents the study of sperm aneuploidy rates in the largest population of cancer-treated patients studied thus far. EXPERIMENTAL DESIGN In the present study, 38 patients were initially included 7 months to 5 years after a cancer treatment by chemotherapy and/or radiotherapy for testicular cancer (n = 19) or lymphoma (n = 19). Twelve of them were azoospermic. Sperm aneuploidy rates of chromosomes X, Y, 13, 18, and 21 were analyzed by multicolor fluorescent in situ hybridization in the 26 other patients. RESULTS In most cases, the disomy/diploidy rates after cancer therapy did not significantly differ from those observed in the group of control healthy donors. Only five patients (one lymphoma and four testicular cancer) showed significant but still moderate increases in disomic and/or diploid sperm. For the lymphoma patient, the short posttherapeutic delay after the treatment could explain the elevated aneuploidy rates, whereas no risk factor in the clinical, biological, or therapeutic records could be identified in any of the four testicular cancer patients with elevated sperm aneuploidy rates. CONCLUSIONS These data suggest an absence of long-term effect of anticancer therapy on sperm aneuploidy rates, and therefore, no long-term increased risk of aneuploidy for the offspring obtained either spontaneously or after assisted reproductive techniques.
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Affiliation(s)
- Claire Thomas
- Centre d'étude et de Conservation des Oeufs et du Sperme humain, Service de génétique, CHU Grenoble, Grenoble 9, France
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Warburton G, Childs RC, Charles M, Brahim JS. Hodgkin's lymphoma: a case report involving the mandible. J Oral Maxillofac Surg 2003; 61:1492-6. [PMID: 14663818 DOI: 10.1016/j.joms.2002.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gary Warburton
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
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Rodeheaver PF, Taylor AG, Lyon DE. Incorporating Patients' Perspectives in Complementary and Alternative Medicine Clinical Trial Design. J Altern Complement Med 2003; 9:959-67. [PMID: 14736366 DOI: 10.1089/107555303771952299] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe the importance and process of gathering the perspectives of former patients when designing clinical studies for complementary and alternative medicine (CAM) therapies and to describe how this information was used to guide the planning of a clinical study using complementary modalities to reduce symptom distress and enhance quality of life during the autologous stem cell transplantation (ASCT) process. DESIGN Structured interviews with former ASCT patients to identify preferences, opinions, and other issues that may affect a clinical study in this population. SETTING University of Virginia Health System Stem Cell Transplant Clinic. SUBJECTS Ten (10) patients who had undergone ASCT within the previous year. RESULTS In general, the 10 study participants interviewed reported that they would have been more receptive to receiving gentle Swedish massage than using guided imagery tapes during the ASCT process, although neither modality would have been particularly welcome during those treatment phases with highest physical or emotional/mental stress. Personal experiences, treatment side-effects, "personality," and life situation all had an influence on not only what was considered most stressful for the patient but also why it was perceived as stressful. CONCLUSION Eliciting the views of persons who have undergone significant medical events is a necessary step in rigorous clinical trial development aimed at testing the efficacy of CAM modalities for symptom management. Consideration of patient preferences and motivations may ensure the best fit between interventions and the desired outcomes.
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Affiliation(s)
- Pamela F Rodeheaver
- Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, Charlottesville, VA 22908, USA
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Abstract
Endobronchial presentation of Hodgkin lymphoma is exceedingly rare and can be confused clinically with pulmonary small cell carcinoma. Because of the dramatic implications in treatment and prognosis, endobronchial Hodgkin lymphoma, despite its uncommon occurrence, should be considered in the differential of small cell carcinoma and necrotizing vasculitides with pulmonary involvement, especially in a relatively young patient with cough, hemoptysis, atelectasis, and hilar or mediastinal lymphadenopathy. The use of photodynamic laser therapy or stent placement for palliative treatment of life-threatening airway obstruction may be required prior to or as an initial adjunct to tumor-specific therapy.
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Affiliation(s)
- Bahram Kiani
- Department of Pathology, The Ohio State University College of Medicine and Public Health, Columbus, OH 43210, USA
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Abstract
Hodgkin's and non-Hodgkin's lymphomas are an important part of the differential diagnosis of head and neck tumors. Their diagnosis begins with a complete history and physical examination and is confirmed with an appropriately obtained and prepared pathologic specimen. Prognosis and therapy of the lymphomas vary depending on stage and the characteristics of each particular subtype of lymphoma. Low-grade lymphomas and chronic lymphocytic leukemia are characterized by long survival times and are most often treated with palliative intent. More aggressive high-grade lymphomas are treated for cure. Although chemotherapy and radiotherapy remain the mainstays of treatment, immunotherapy demonstrates increasing promise.
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Affiliation(s)
- Laxmeesh M Nayak
- Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
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Duraiswamy J, Sherritt M, Thomson S, Tellam J, Cooper L, Connolly G, Bharadwaj M, Khanna R. Therapeutic LMP1 polyepitope vaccine for EBV-associated Hodgkin disease and nasopharyngeal carcinoma. Blood 2003; 101:3150-6. [PMID: 12468425 DOI: 10.1182/blood-2002-10-3092] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Development of an epitope-based vaccination strategy designed to enhance Epstein-Barr virus (EBV)-specific CD8(+) cytotoxic T lymphocytes (CTLs) is increasingly being considered as a preferred approach for the treatment of EBV-associated relapsed Hodgkin disease (HD) and nasopharyngeal carcinoma (NPC). EBV-encoded latent membrane proteins, LMP1 and LMP2, are the only target antigens available for therapeutic augmentation of CTL responses in patients with HD and NPC. Here, we describe preclinical studies using a recombinant poxvirus vaccine that encodes a polyepitope protein comprising 6 HLA A2-restricted epitopes derived from LMP1. Human cells infected with this recombinant polyepitope construct were efficiently recognized by LMP1-specific CTL lines from HLA A2 healthy individuals. Furthermore, immunization of HLA A2/K(b) mice with this polyepitope vaccine consistently generated strong LMP1-specific CTL responses to 5 of the 6 epitopes, which were readily detected by both ex vivo and in vitro assays. More important, this polyepitope vaccine successfully reversed the outgrowth of LMP1-expressing tumors in HLA A2/K(b) mice. These studies provide an important platform for the development of an LMP-based polyepitope vaccine as an immunotherapeutic tool for the treatment of EBV-associated HD and NPC.
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Affiliation(s)
- Jaikumar Duraiswamy
- Cooperative Research Centre for Vaccine Technology, Tumour Immunology Laboratory, Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Australia
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