‘Health isn’t making everybody into a Greek ideal’

2019 ◽  
pp. 249-264
Author(s):  
Ruth MacDonald
Keyword(s):  
Hodgkin Lymphoma ◽  
Real Life ◽  
Non Hodgkin Lymphoma ◽  
Life Threatening Illness ◽  
Life Threatening

Presented as a variation of Homer’s Odyssey rewritten from the perspective of a cancer patient’s spouse, Gwyneth Lewis’s A Hospital Odyssey (2010) has its roots in her husband’s real-life diagnosis with non-Hodgkin lymphoma. In thus reconfiguring the hero’s homecoming as a wife’s quest to find and cure her sick husband, the poet is able to chart her journey in coming to terms with her husband’s condition and treatment. Although the voyage towards healing and marital reconciliation is at times difficult and fraught with danger, the poem’s protagonist is buoyed along her way through a series of affirming encounters with other characters. Reading the text alongside Julia Kristeva’s concept of the abject, the chapter considers the ways in which Lewis interrogates contemporary attitudes towards the sick, as well as what it means to care for someone diagnosed with a life-threatening illness.

scholarly journals Low-Stage Gastric MALT Lymphoma Causing Life-Threatening Upper Gastrointestinal Bleeding

2019 ◽  
Vol 13 (3) ◽  
pp. 376-384 ◽  
Author(s):  
Muhammad Begawan Bestari ◽  
Ivonne Golda Palungkun ◽  
Bethy Suryawathy Hernowo ◽  
Siti Aminah Abdurachman ◽  
Eka Surya Nugraha
Keyword(s):  
Hodgkin Lymphoma ◽  
Malt Lymphoma ◽  
Gastric Lymphoma ◽  
Hemodynamic Instability ◽  
Endoscopic Hemostasis ◽  
Gastric Malt Lymphoma ◽  
Gi Bleeding ◽  
Gradual Improvement ◽  
Non Hodgkin Lymphoma ◽  
Life Threatening

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is an uncommon tumor of the stomach that only comprises around 1–6% of all tumors of the stomach. Non-Hodgkin lymphoma more commonly affects the lymph nodes and may spread to the spleen and bone marrow, whereas extranodal non-Hodgkin lymphoma is less common. Primary gastric lymphoma is further divided based on histologic features; one of the types is MALT lymphoma, which is strongly associated with Helicobacter pylori infection. The first sign of the disease is usually mimicking gastritis. However, in the case reported here, the first sign of gastric MALT lymphoma was massive gastrointestinal (GI) bleeding with hemodynamic instability in a 75-year-old male. The patient came to the emergency department and was immediately resuscitated, intubated, and admitted to the intensive care unit. Urgent endoscopy (<6 h) was done to identify the source of bleeding, which were oozing ulcerated polypoid masses; endoscopic hemostasis was done, which successfully stopped the bleeding. However, the next day, rebleeding occurred and a second endoscopic hemostasis was performed. The bleeding stopped and the patient showed gradual improvement. The biopsy result of a gastric MALT lymphoma of grade IE1 with H. pylori infection warranted a treatment regimen for Helicobacter eradication. The patient recovered, with follow-up endoscopy at 3 months, at 6 months, and yearly thereafter with no sign of recurrence. This case shows that gastric MALT lymphoma, even at a low stage (1E1), can cause life-threatening upper GI bleeding that requires aggressive resuscitation and urgent endoscopy.

Bendamustine-Rituximab (BR) Replaces R-CHOP As “Standard of Care” in the Treatment of Indolent Non-Hodgkin Lymphoma in German Hematology Outpatient Centres

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3666-3666 ◽  
Author(s):  
Wolfgang Ulrich Knauf ◽  
Wolfgang Abenhardt ◽  
Arnd Nusch ◽  
Renate Grugel ◽  
Norbert Marschner
Keyword(s):  
Hodgkin Lymphoma ◽  
Real Life ◽  
Stage Iv ◽  
Standard Of Care ◽  
Low Grade ◽  
Line Treatment ◽  
Clinical Registry ◽  
Non Hodgkin Lymphoma ◽  
Systemic Treatments ◽  
The Impact

Abstract Abstract 3666 Introduction With the FDA and EMA approval of Bendamustine a new treatment option has recently become available to patients (pts) with indolent (low-grade) non-Hodgkin lymphoma (iNHL). Clinical registries provide insight into real-life treatment of pts. They can help to answer the question whether patients may benefit from new research findings. Methods The clinical registry on lymphoid neoplasms (TLN Registry), conducted by iOMEDICO in collaboration with the Arbeitskreis Klinische Studien (AKS) and the Kompetenznetz Maligne Lymphome (KML), prospectively collects data on the treatment of pts with lymphoid B-cell neoplasms as administered in hematology outpatient centres in Germany. Pts are followed for 5 years. A broad set of data regarding patient and tumor characteristics, comorbidities, all systemic treatments, response rates, progression-free survival and overall survival are recorded. Since May 2009, 106 sites have actively recruited a total of 2579 pts. Results From the overall sample, 645 pts received systemic 1st-line treatment for indolent Non-Hodgkin lymphoma (iNHL). 53% of pts are male, mean age at time of primary diagnosis was 65 years (yrs) and at start of therapy 66 yrs. Tumor stage was 7% Stage I, 15% Stage II, 25% Stage III and 54% Stage IV. 61% of pts (n=387) were diagnosed with at least one comorbidity, mainly hypertension (33%) or diabetes (12%); the average Charlson Comorbity Index of 0.6 indicates that pts have few comorbities. Rituximab is part of the 1st-line treatment in 94% (n=606) of pts with iNHL. Bendamustine is part of the 1st-line treatment in 71% (n=455) of pts with iNHL. It is mostly applied in combination with Rituximab (BR, 66%, n=428). Further 2% (n=10) receive Bendamustin as monotherapy. Rituximab/Cyclophosphamide/Doxorubicin/Vincristine/Prednisone (R-CHOP) as 1st-line treatment is applied in 16% (n=105) of pts with iNHL. Pts receiving BR or R-CHOP differ. Pts characteristics indicate that BR is applied preferably in elderly pts (mean 67.3 vs. 60.9 yrs). However, BR is the preferred treatment also in pts younger than 66 yrs (60% vs. 23%). The use of BR has increased from 62% in 2009 to 68% in 2011, whereas the rate of R-CHOP has decreased from 19% in 2009 to 15% in 2011. Of all pts with iNHL, 121 have received 2nd-line treatment. Rituximab is part of the 2nd-line treatment in 84% (n=102) of pts with iNHL. Bendamustine is part of the 2nd-line treatment in 68% (n=82) of pts with iNHL. It is mostly applied in combination with Rituximab (BR, 60%, n=72). Further 7% (n=9) receive Bendamustin as monotherapy. R-CHOP as 2nd-line treatment is applied in 7% (n=9) of pts with iNHL. Conclusion BR is the most frequently used systemic treatment for pts with iNHL in German hematology outpatient centres. The use of BR has continuously increased since 2009. In contrast, the use of R-CHOP has decreased. This indicates that in Germany R-CHOP can no longer be considered as “standard of care” for pts with iNHL. These data also show that results from clinical trials are quickly implemented into daily practice. The impact of BR on quality of life and survival remains to be of central interest in the future. Disclosures: Knauf: Mundipharma GmbH: Honoraria, Membership on an entity's Board of Directors or advisory committees.

COMBINED CHEMOTHERAPY AND TRACHEOBRONCHIAL STENTING FOR LIFE-THREATENING AIRWAY OBSTRUCTION IN A CHILD WITH ENDOBRONCHIAL NON-HODGKIN LYMPHOMA

2004 ◽  
Vol 21 (8) ◽  
pp. 725-729 ◽  
Author(s):  
I-Anne Huang ◽  
Shao-Hsuan Hsia ◽  
Chang-Teng Wu ◽  
Tang-Her Jaing ◽  
Shen-Hao Lai ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Hodgkin Lymphoma ◽  
Combined Chemotherapy ◽  
Non Hodgkin Lymphoma ◽  
Life Threatening

scholarly journals A Life-Threatening Presentation of Primary Small Cell Colorectal Non-Hodgkin Lymphoma as Cardiac Tamponade and Its Challenging Management

2021 ◽  
Author(s):  
Amr Elkammash ◽  
Mohamed Ayman Abdel-Hay ◽  
Saleh Kanaan ◽  
Mustafa Alsinan ◽  
Yosra Taha ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Hodgkin Lymphoma ◽  
Small Cell ◽  
Whole Body ◽  
Tumour Mass ◽  
Non Hodgkin Lymphoma ◽  
Large Pericardial Effusion ◽  
Life Threatening

Colorectal NHL is quite aggressive and rare, forming only less than 1% of all cases of colorectal cancer. The pericardium is an extremely rare first site of metastasis. Cardiac tamponade can be a life-threatening initial presentation. We report a 55-year-old lady who presented with severe shortness of breath, intermittent abdominal pain and altered bowel habits. She had low blood pressure with congested neck veins. Her echocardiogram showed pericardial and cardiac infiltration with tumour mass; a large pericardial effusion with signs of cardiac tamponade. There was no safe window for percutaneous drainage, and the patient was not physically fit for surgical drainage. A multidisciplinary approach was used to diagnose and manage the case involving a cardiologist, gastroenterologist, pathologist, radiologist and oncologist. CT scans of the whole body showed a large rectosigmoid mass infiltrating the uterus and adnexa. Flexible sigmoidoscopy showed a large bleeding mass at the rectosigmoid junction. The biopsy confirmed small cell non-Hodgkin lymphoma (NHL). Urgent three cycles of chemotherapy were commenced over a period of 5 weeks ( one cycle of CVP; two cycles of CHOP). The patient showed significant symptomatic improvement. A five-week follow-up echocardiogram showed that the d pericardial tumour had disappeared and only a small rim of pericardial effusion. Effusion did not recollect in her follow-up echocardiography. A year later, she was referred to the palliative care team due to the further spreading of her lymphoma. In conclusion, colorectal small cell NHL might initially present as cardiac tamponade. Urgent initiation of chemotherapy can be a treatment option whenever a drainage procedure is unsafe.

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