Hope for a Better Future

2019 ◽  
pp. 181-192
Author(s):  
Arthur M. Diamond
Keyword(s):  
Technological Progress ◽  
Hodgkin’S Lymphoma ◽  
Childhood Leukemia ◽  
Hodgkin's Lymphoma ◽  
Trial And Error ◽  
Double Blind ◽  
The Face

Pessimists predict the end of technological progress, but secular (long-term) stagnation is due to bad policies, not to having picked the low-hanging fruit, as illustrated by innovative medical entrepreneurs who have been constrained from bringing us quicker and better cures for cancer. Funded researchers must stick to their original protocols even in the face of promising serendipitous discoveries. Medical incumbents protect their turf by mandating costly double-blind studies for innovations, and then refusing to enroll their patients in the studies. Trial-and-error experimental tinkering allowed Emil Freireich and his Society of Jabbering Idiots to develop the chemotherapy cocktail that allowed many to be cured of childhood leukemia, and allowed Vincent DeVita to develop the chemotherapy cocktail that allowed many to be cured of Hodgkin’s lymphoma. Yet FDA protocols restrict trial-and-error experimentation, resulting in many needless deaths. In medicine, as elsewhere, our future will be better if we unbind the innovative entrepreneur.

Sexual Functioning in Long-Term Survivors of Hodgkin's Lymphoma

2008 ◽  
Author(s):  
Veronica Sanchez Varela ◽  
Sharon Bober ◽  
Andrea Ng ◽  
Peter Mauch ◽  
Christopher Recklitis
Keyword(s):  
Sexual Functioning ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Long Term Survivors

scholarly journals Rationale and design of a cohort study on primary ovarian insufficiency in female survivors of Hodgkin’s lymphoma: influence on long-term adverse effects (SOPHIA)

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e018120
Author(s):  
Inge M Krul ◽  
Annemieke W J Opstal-van Winden ◽  
Josée M Zijlstra ◽  
Yolande Appelman ◽  
Sanne B Schagen ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Hodgkin’S Lymphoma ◽  
Primary Ovarian Insufficiency ◽  
Hodgkin's Lymphoma ◽  
Reverse Causality ◽  
Mineral Density ◽  
Cvd Risk ◽  
Ovarian Insufficiency

IntroductionHodgkin’s lymphoma (HL) has become the prototype of a curable disease. However, many young survivors suffer from late adverse effects of treatment. Both chemotherapy (CT) and radiotherapy (RT) may induce primary ovarian insufficiency (POI), which has been associated with reduced bone mineral density (BMD), neurocognitive dysfunction and possibly cardiovascular disease (CVD). While the general assumption is that POI increases CVD risk, other hypotheses postulate reverse causality, suggesting that cardiovascular risk factors determine menopausal age or that biological ageing underlies both POI and CVD risk. None of these hypotheses are supported by convincing evidence. Furthermore, most studies on POI-associated conditions have been conducted in women with early natural or surgery-induced menopause with short follow-up times. In this study, we will examine the long-term effects of CT-induced and/or RT-induced POI on BMD, cardiovascular status, neurocognitive function and quality of life in female HL survivors.Methods and analysisThis study will be performed within an existing Dutch cohort of HL survivors. Eligible women were treated for HL at ages 15–39 years in three large hospitals since 1965 and survived for ≥8 years after their diagnosis. Women visiting a survivorship care outpatient clinic will be invited for a neurocognitive, cardiovascular and BMD assessment, and asked to complete several questionnaires and to provide a blood sample. Using multivariable regression analyses, we will compare the outcomes of HL survivors who developed POI with those who did not. Cardiovascular status will also be compared with women with natural POI.Ethics and disseminationThis study has been approved by the Institutional Review Board of the Netherlands Cancer Institute and has been registered at ‘Toetsingonline’ from the Dutch Central Committee on Research involving Human Subjects (file no. NL44714.031.13). Results will be disseminated through peer-reviewed publications and will be incorporated in follow-up guidelines for HL survivors.

scholarly journals Hodgkin’s Lymphoma: Impacts And Changes In Life Of Carriers Undergoing Treatment

10.3823/2437 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Cristiane Nobre Silva ◽  
Diane Sousa Sales ◽  
Carla Suellen Pires De Sousa ◽  
Antonio Dean Barbosa Marques ◽  
Priscila França De Araújo ◽  
...  
Keyword(s):  
Young Adult ◽  
Hodgkin’S Lymphoma ◽  
Northeastern Brazil ◽  
Hodgkin's Lymphoma ◽  
Social Changes ◽  
Reference Hospital ◽  
The Face ◽  
Intention To Return ◽  
The Impact

Diagnosis and treatment of Hodgkin’s lymphoma introduce a new routine, and the habitual life of the young adult is interrupted because the treatment imposes on patients withdrawing from their environment, their productive activities, their relatives and their daily life. The aim of the present is study is to understand the reality of the young adult carrier of Hodgkin’s lymphoma in the face of treatment. This is a qualitative study; subjects were patients diagnosed with Hodgkin’s lymphoma at a reference hospital in northeastern Brazil. Inclusion criteria were being undergoing treatment or follow-up of Hodgkin’s lymphoma, and aged 18 to 35 years. The information was collected through an interview at the home of each subject in the period from August and September 2015. The interviews were recorded, transcribed in full and analyzed through thematic analysis. The study was approved by the Research Ethics Committee. The subjects went through a rather individual pathway to discover the disease. After reading the interviews, the following category emerged: Impact and changes in life with cancer. They feel the impact of cancer and of the process of illness and treatment that promote physical and social changes. They reveal the coping of the disease with liveliness, and present strategies for this process, such as the support of family and friends. They recognize the existence of difficult moments and face situations of death, but they show intention to return to their daily activities and have perspectives for cure. 

scholarly journals Bone Involvement in Hodgkin’s Lymphoma: Clinical Features and Outcome

2018 ◽  
Vol 140 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Francesco Gaudio ◽  
Pasquale Pedote ◽  
Artor Niccoli Asabella ◽  
Giuseppe Ingravallo ◽  
Paola Sindaco ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Bone Involvement ◽  
Hodgkin's Lymphoma ◽  
Bone Lesions ◽  
Advanced Stages ◽  
Primary Bone ◽  
Long Term Prognosis ◽  
Time Of Presentation

Hodgkin’s lymphoma (HL) is now a highly curable disease, with an improving 5-year survival rate that has now reached 86%. At the time of presentation, HL is usually almost entirely confined to the lymph nodes. We performed a retrospective single-institution study of 384 cases with a median follow-up of 44 months, with the aim of identifying clinical and radiological characteristics and outcomes of patients with bone HL; 32 patients (8%) had primary bone involvement, always with concurrent nodal disease. These included 22 men (69%) and 10 women (31%) with the median age as 41 years. Advanced stages and nodular sclerosis histology prevailed among the subgroup. Radiographic features of bone HL are not specific but indicate a destructive malignant process with osteosclerosis and/or osteolysis. With current chemotherapeutic regimens, the long-term prognosis of patients with osseous HL appears good. The presence of bone lesions in HL should not be interpreted as implying a worse prognosis than without bone involvement.

scholarly journals Association between B Cell Growth Factors and Primary Sjögren’s Syndrome-Related Autoantibodies in Patients with Non-Hodgkin’s Lymphoma

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Zhenhua Xian ◽  
Dehua Fu ◽  
Shuang Liu ◽  
Yang Yao ◽  
Chun Gao
Keyword(s):  
Cell Growth ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Lymphoma Patient ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
B Cell Growth Factor ◽  
Diagnostic Panel

Despite the overall success of using R-CHOP for the care for non-Hodgkin’s lymphoma patients, it is clear that the disease is quite complex and new insight is needed to further stratify the patient for a better personized treatment. In current study, based on previous studies from animal model, new panels combining well-established cytokine (BAFF) and autoantibodies (anti-SSA/Ro) with newly identified cytokine (IL14) and autoantibodies (TSA) were used to evaluate the association between B cell growth factor and Sjögren’s related autoantibodies in NHL patients. The result clearly indicates that there was a unique difference between BAFF and IL14 in association with autoantibodies. While serum BAFF was negatively associated with the presence of both traditional anti-SSA/Ro and novel TSA antibodies in GI lymphoma patient, IL14 was positively associated with the presence of both traditional anti-SSA/Ro and novel TSA antibodies in non-GI lymphoma patient. Long-term follow-ups on these patients and evaluation of their response to the R-CHOP treatment and recurrence rate will be very interesting. Our result provides a solid evidence to support using novel diagnostic panel to better stratify the NHL patients.

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