Differences of arteria carotis in patients with Hodgkin's lymphoma

Radiotherapy increases the risk of cardiovascular morbidity. We examined arteria carotis atherosclerosis and stenosis in Hodgkin's lymphoma patients. We examined arteria carotis of 120 Hodgkin's lymphoma patients who have been in complete remission for at least 5 years. 70 patients received neck irradiation (mean age at the time of the examination was 44.6 years). Twenty-four (34.3%) of them had carotis sclerosis or stenosis, and it was significantly more than in the control group [8 out of 60 patients 13.3%)]. Twelve patients of the 50 who did not receive radiotherapy had carotis lesions, and there was no significant difference compared to the control group. Significant stenosis (>50%) was detected in only 3 patients (in the irradiated group). TIA, stroke or amaurosis fugax did not occur. Carotis stenosis does not seem to play a role in late mortality in Hodgkin's lymphoma, but if the patient has an increased risk for atherosclerotic changes, then regular examinations are necessary, and other risk factors (smoking, hypertension, diabetes mellitus, hypothyroidism, early menopause) need to be treated.     

Plasma biomarkers for detecting Hodgkin's lymphoma in HIV patients

The lifespan of people with human immunodeficiency virus (HIV) infection has increased as a result of effective antiretroviral therapy, and the incidences of the AIDS-defining cancers, non-Hodgkin''s lymphoma and Kaposi sarcoma, have declined. Even so, HIV-infected individuals are now at greater risk of other cancers, including Hodgkin''s lymphoma (HL). To identify candidate biomarkers for the early detection of HL, we undertook an accurate mass and elution time tag proteomics analysis of individual plasma samples from either HIV-infected patients without HL (controls; n = 14) and from HIV-infected patient samples with HL (n = 22). This analysis identified 60 proteins that were statistically (p<0.05) altered and at least 1.5-fold different between the two groups. At least three of these proteins have previously been reported to be altered in the blood of HL patients that were not known to be HIV positive, suggesting that these markers may be broadly useful for detecting HL. Ingenuity Pathway Analysis software identified “inflammatory response” and “cancer” as the top two biological functions associated with these proteins. Overall, this study validated three plasma proteins as candidate biomarkers for detecting HL, and identified 57 novel candidate biomarkers that remain to be validated. The relationship of these novel candidate biomarkers with cancer and inflammation suggests that they are truly associated with HL and therefore may be useful for the early detection of this cancer in susceptible populations.     

Anticipation in familial Hodgkin's lymphoma

Anticipation is discussed in relation to Hodgkin's lymphoma, non-Hodgkin's lymphoma, and familial cancer.     

Lipid peroxidation and protein oxidation in patients affected by Hodgkin's lymphoma

A dysregulation of the redox homoeostasis has been reported in various neoplastic disorders. Malondialdehyde/4-hydroxy-2,3-nonenal (MDA/HNE) and protein carbonyl groups represent in vivo indexes of lipid peroxidation and protein oxidation, respectively, suitable to investigate radical-mediated physio-pathological conditions. We evaluated MDA/HNE and protein carbonyl groups in sera of untreated Hodgkin's lymphoma (HL) patients in advanced disease stages, in order to quantify the oxidative stress. HL patients displayed significantly higher levels of both MDA/HNE and protein carbonyl groups as compared with healthy controls. This is the first evidence that a strong increase in HL is one of the most common haematological malignancies, representing approximately 30% of all lymphomas in the circulating protein carbonyl content in HL. These findings may contribute to a better definition of the redox homoeostasis dysregulation in HL.     

Evaluation of the small bowel in patients with Hodgkin's lymphoma during and late after chemoradiation therapy

The paper describes the experience in using capsule endoscopy to diagnose small bowel lesions during and after chemoradiation therapy in patients with diagnosed Hodgkin's lymphoma and an attempt to compare the current views of normal tissue response to ionizing radiation, as well as drugs used for chemotherapy.     

Depressed cytotoxic T-cell responses in previously treated Hodgkin's and non-Hodgkin's lymphoma patients

Summary Peripheral blood lymphocytes from 62 previously treated Hodgkin's and non-Hodgkin's lymphoma patients were tested for their ability to generate cytotoxic T lymphocytes in response to stimulation with allogeneic cells in mixed leukocyte culture. In most patients, including some in long-term unmaintained remission, extremely low cytotoxic responses were generated. To test whether these patients have circulating cells that suppress autologous lymphocytes from responding to alloantigens, patients' responding cells were passaged over columns of sepharose beads conjugated with histamine-rabbit serum albumin (Hist-RSA). This procedure has been shown to remove mouse suppressor cells and Concanavalin A(ConA)-induced human suppressor cells. Passage of patients' cells, prior to allogeneic stimulation, over columns of sepharose beads conjugated with Hist-RSA but not over control RSA columns, resulted in the isolation of lymphocytes that generated increased cytotoxic responses to alloantigens in 18 of 22 patients with initially low cytotoxic responses. These results suggest that the impaired ability of treated Hodgkin's and non-Hodgkin's lymphoma patients' lymphocytes to differentiate into cytotoxic T lymphocytes is at least in part due to the presence of circulating suppressor cells that bear histamine receptors.Scholar of the Leukemia Society of America     

Treatment failures and severe complications in children with Hodgkin's disease

Therapy failures and severe complications in the treatment of 46 children affected with Hodgkin's disease are reported. All children were treated with polychemotherapy (modified MVPP scheme) and radiotherapy (high voltage therapy X-ray 210 KV; involved field radiotherapy). 42 patients came into a complete remission, with a median of 58 months in 37 patients (10--97 months). 6 patients 14.3%) suffered from a recidive, 5 of them came into a second remission. Life-threatening infections appeared in 3 patients. After 9 MVPP cycles an encephalopathy appeared in 2 boys, one of them died. After local radiotherapy a severe laryngitis developed in two patients. An azoospermia existed in 6 adolescent boys examined.     

Hodgkin's Disease in Patients with Previous Infectious Mononucleosis: 30 Years' Experience

Seventeen out of 17,073 people in Denmark who had had a positive reaction to a Paul-Bunnell test between the years 1940 and 1969 developed Hodgkin''s disease after an interval of at least 12 months. This number was significantly (P < 0·0002) greater than the expected number of two women and four men. Sixteen of those developing Hodgkin''s disease were men. Case records, which were available for 12 of them, confirmed that they had had infectious mononucleosis. The number of cases of leukaemia that developed in the sample population was no greater than expected.     

The intrauterine origins of Hodgkin's lymphoma

Background: Both small and large body size at birth are now known to predict a range of chronic disorders in adult life, including certain cancers. These associations are thought to reflect “fetal programming.” This may lead to impairment of a small number of key systems including the immune system. Hodgkin's lymphoma is a disease of the immune system. We have therefore examined the association between Hodgkin's lymphoma and early development. Our hypothesis was that the disease would be associated with markers of poor fetal growth, specifically small body size or small placental size at birth. Methods: Using the Finnish Cancer Registry we identified patients with Hodgkin's disease in a cohort of 20,431 people born in Helsinki during 1924–44. Each person has a detailed birth record. Results: There were 12 patients with Hodgkin's disease, giving an incidence comparable to international rates. The disease was associated with prolonged gestation. For every additional week of gestation the hazard ratio was 1.37 (95% CI 1.00–1.87; p = 0.05). The disease was also associated with a short placental surface. After allowing for gestation, for each centimetre increase in surface length, the hazard ratio was 0.70 (0.53–0.92; p = 0.01). The disease was not associated with birth weight or length or maternal body size. Conclusions: We have shown that Hodgkin's lymphoma is associated with prolonged gestation and a short length of the placental surface. We speculate that Hodgkin's lymphoma is initiated by two events in fetal life. One, which is an immune event, is associated with prolonged gestation, while the other is associated with growth faltering.     

Treatment results of childhood Hodgkin's lymphoma in Hungary

Lymphomas are the third most frequent malignancies in childhood. The Hungarian Pediatric Oncology Group was founded in 1971, and since then the same chemotherapeutic protocols have been used in the whole country. In this study we analyzed the data of childhood Hodgkin's lymphoma in Hungary in the last 11 years (1988-1998). We also compared our results with the international (German) data. The incidence of Hodgkin's lymphoma (0-15 years) was 7.1/1,000,000 child/year (the same for non-Hodgkin's lymphoma was 7.5/1,000,000/year); 5.5% of all pediatric malignancies in Hungary). The patients were treated according to the German DAL-HD-82 and 90 protocols. The therapy consisted of 2-6 cytostatic blocks, depending on the stage, followed by involved field irradiation. The overall survival was 94.7+/-2.0% at 5 years and 91.9+/-2.7% at 10 years. These results are very similar to the German data: 94% at 5 years and 93% at 10 years. The good results are due to the well organised network and the uniformed treatment. The results may be ameliorated by using autologous bone marrow transplantation.     

Prevention of infectious complications in patients with acute bone marrow depression]

Clinical efficacy of intravenous gentamicin in combination with oral use of gentamicin, ristomycin and nystatin was studied in 1977. In 1980-1984 two antiinfectious regimens were tested: intravenous administration of gentamicin in combination with total decontamination (oral use of gentamicin and nystatin) and selective decontamination (biseptol with nystatin of amphoglucamine). It was shown that the incidence of severe infections in the patients under the observation dropped against the controls. The incidence and spectrum of infectious complications in cases with acute myelodepressions were proved to depend on the intestinal autoflora inhibition.     

Infectious complications following breast reconstruction with expanders and implants

The incidence of infection following breast reconstruction with expanders and implants ranges from 1 to 24 percent. Numerous factors associated with infection have been described; however, a one-variable at time setting and multifactorial analysis have not been performed. The purpose of this study was to analyze a set of factors that may predispose women to infection of the expander or implant. Between 1997 and 2000, a total of 168 implant reconstructions were performed in 130 women at a single institution. The mean age for all women was 48.2 years (range, 25 to 77 years). The factors that were analyzed included axillary lymph node dissection, chemotherapy, radiation therapy, tumor stage, timing of implant insertion, number of sides (unilateral versus bilateral), tobacco use, and presence or absence of diabetes mellitus. Statistical analysis was performed with stepwise logistic regression. Mean time to follow-up for all patients was 29 months (range, 12 to 47 months). Infectious complications occurred in 10 women (7.7 percent) and in 10 expanders or implants (5.9 percent). Infected implants were removed an average of 116 days following insertion (range, 14 to 333 days). Cultured bacteria included Staphylococcus aureus and Serratia marcescens. A significant association (p < 0.04) was detected between implant infection and radiation therapy. The chance for implant infection was 4.88 times greater for implants that were exposed to radiation therapy compared with those that were not. In addition, there was suggestive (p < 0.09) evidence that the chance of implant infection following lymph node dissection was 6.29 times higher than when no lymph nodes were removed. No significant association between implant infection and age, diabetes, tobacco use, tumor stage, timing of implant insertion, or chemotherapy was found.     

Characterization of T lymphocyte defects in patients with Hodgkin's disease using enzyme chemical markers]

Patients suffering from lymphogranulomatosis were studied with respect to cellular immune deficiencies. For this purpose, mononuclear cells from venous blood were separated and subjected to analysis of lymphocyte markers. T-lymphocytes were enumerated by means of the sheep erythrocyte (SE) rosette test. T cell subpopulations were determined using enzyme cytochemical staining for dipeptidyl peptidase IV (DP IV) and unspecific acid alphanaphthylacetate esterase (ANAE). In 18 patients with M. Hodgkin a significant reduction in the T lymphocyte count in peripheral blood was found. This T cell defect is due to a selective decrease in the TM-subpopulation as identified by enzyme cytochemical markers DP IV and ANAE (focal reaction). From these results it is concluded that patients with lymphogranulomatosis have characteristic abnormalities in the immune system in the sense of a disturbed equilibrium of immune regulatory cells.     

The molecular mechanisms of classic Hodgkin's lymphoma

Classic Hodgkin's lymphoma is characterized by the appearance of giant abnormal cells called Hodgkin and Reed-Sternberg (HRS) cells. HRS cells arise from germinal center B lymphocytes and in about 50 percent of patients, are infected with Epstein-Barr Virus. In addition, HRS cells show constitutive NF-kappaB activation and are resistant to apoptosis. This paper reviews several recent studies that for the first time implicate specific molecules in the pathogenesis of classic Hodgkin's lymphoma. Targeting these molecules could lead to the development of novel therapies for this disease.