scholarly journals Infection of lung cavitations in a young dog owner with Hodgkin’s lymphoma caused by Pasteurella multocida, without a dog bite: confirmed zoonotic transmission by tagmentation microbiome analysis

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-226646 ◽  
Author(s):  
Mirek van der Reijden ◽  
Lesley F V Riethoff ◽  
Wil A van der Reijden ◽  
Anita Griffioen-Keijzer
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Pasteurella Multocida ◽  
Stage Iv ◽  
Domestic Animal ◽  
Hodgkin's Lymphoma ◽  
Immunocompromised Patients ◽  
Dog Bite ◽  
Animal Contact ◽  
History Of ◽  
The Right

Pasteurella multocida is a known pathogen in humans, mostly reported after animal bite incidents. Atraumatic infections have been described, especially in immunocompromised patients. A 20-year-old patient with a history of stage IV Hodgkin’s lymphoma with cavitating pulmonary lesions presented with a bilateral pneumonia. Shortly after finishing antibiotic treatment, she quickly developed the same symptoms of pneumonia. Bronchoscopy showed a large cavity in the right upper lobe and P. multocida was isolated from all bronchial cultures. The transmission route of P. multocida via the patient’s dog was confirmed by sampling the full genome of the dog’s mouth, which matched the unique P. multocida sequences found in the patient. This case demonstrates the importance of accurately determining the aetiology of the patient’s symptoms, and Pasteurella infection should be considered in all immunocompromised patients with domestic animal contact, even without a bite incident.

scholarly journals Digital Ischemia as an Unusual Manifestation of Hodgkin’s Lymphoma

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Fiorella Villano ◽  
Adriana Peixoto ◽  
Eloísa Riva ◽  
Carina Di Matteo ◽  
Lilián Díaz
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Connective Tissue Diseases ◽  
Hodgkin's Lymphoma ◽  
Male Smoker ◽  
Digital Ischemia ◽  
Night Sweats ◽  
History Of ◽  
Painless Mass ◽  
The Right ◽  
Vascular Syndromes

Digital ischemia is associated with atherosclerotic, thromboembolic, or connective tissue diseases. Less often, it can be related to malignancy. Paraneoplastic vascular acrosyndromes (Raynaud’s syndrome, acrocianosis, and acronecrosis) are associated with adenocarcinoma and less frequently with hematological malignancies. We report the case of a 45-year-old male, smoker, with a 10-day history of pain, cyanosis, and progressive digital necrosis in both hands. In the previous four months, he noticed painless mass in the right axillary gap, drenching night sweats, and weight loss. Physical examination at admission highlighted necrotic lesions on the distal phalanges of both hands (except the thumbs), enlarged lymph nodes in right axillary, and right supraclavicular gaps. Arteriography of upper limbs demonstrated a distal stop in all bilateral digital arteries. Digital ischemia was interpreted as a paraneoplastic phenomenon after other common etiologies were ruled out. Amputation of three phalanges was required due to necrosis. Biopsy of axillary nodes demonstrated nodular sclerosis classical Hodgkin’s lymphoma (HL). The patient started conventional ABVD protocol (doxorubicin, bleomycin, vinblastine, and dacarbazine). After 6 cycles, he remained asymptomatic and symptoms of digital ischemia were completely resolved. It was concluded that the presence of acral vascular syndromes should alert the physician about the possibility of underlying malignant disease. Prompt investigation and treatment should be rapidly performed to avoid digital sequelae.

A Case of Non-Hodgkin's Lymphoma with Massive Involvement of the Right Atrium

2000 ◽  
Vol 30 (4) ◽  
pp. 492 ◽  
Author(s):  
Sang Bum Kang ◽  
Seung Won Jin ◽  
Eun Kyeong Lee ◽  
Yong Hyun Park ◽  
Yong Ho Choi ◽  
...  
Keyword(s):  
Right Atrium ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
The Right

The significance of bone marrow involvement in non-Hodgkin's lymphoma: the Eastern Cooperative Oncology Group experience.

1986 ◽  
Vol 4 (10) ◽  
pp. 1462-1469 ◽  
Author(s):  
J M Bennett ◽  
K C Cain ◽  
J H Glick ◽  
G J Johnson ◽  
E Ezdinli ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Hodgkin’S Lymphoma ◽  
Bone Marrow Involvement ◽  
Eastern Cooperative Oncology Group ◽  
Stage Iv ◽  
Hodgkin's Lymphoma ◽  
Stage Iii ◽  
Oncology Group ◽  
Non Hodgkin's Lymphoma

Data from four clinical trials conducted by the Eastern Cooperative Oncology Group (ECOG) were used to investigate the importance of bone marrow involvement as a prognostic factor in patients with non-Hodgkin's lymphoma (NHL). A total of 502 patients, 275 with nodular, poorly differentiated lymphocytic lymphoma (NLPD) and 227 with diffuse histiocytic lymphoma (DHL) or diffuse mixed-cell lymphoma (DML), were included in this analysis. Patients were separated into four categories: stage III, stage IV with bone marrow involvement (stage IV-M), stage IV without marrow involvement (stage IV-O), and stage IV with bone marrow and other organ involvement (stage IV-OM). Among the DHL and DML patients, the incidence of marrow involvement was 23%. However, stage IV-M patients had a prognosis that is similar to stage IV-O and stage IV-OM and worse than stage III patients. In contrast, the incidence of involvement with NLPD was 59% and patients with stage IV-M had a survival not different than stage III and not worse than stage IV-O and stage IV-OM. The results suggest that the current emphasis on bone marrow biopsy(s) as a routine diagnostic staging procedure for patients with NHL should be reevaluated. The necessity for this procedure in stage III patients with NLPD is not apparent from our data. One can still justify a bone marrow biopsy in stage I and II patients and can confirm the complete clinical response when all nodes have regressed in more advanced disease.

Bone marrow involvement in Hodgkin's disease: an analysis of 135 consecutive cases. German Hodgkin's Lymphoma Study Group.

1995 ◽  
Vol 13 (2) ◽  
pp. 403-409 ◽  
Author(s):  
R Munker ◽  
D Hasenclever ◽  
O Brosteanu ◽  
E Hiller ◽  
V Diehl
Keyword(s):  
Bone Marrow ◽  
Hodgkin's Disease ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
Prognostic Relevance ◽  
Lymphoma Study Group

PURPOSE To describe the incidence of primary bone marrow involvement (BMI) in Hodgkin's disease (HD) and its correlation with clinical and laboratory features present at diagnosis, and to evaluate the prognostic relevance of BMI. PATIENTS AND METHODS Between 1983 and 1991, 2,307 patients with HD were treated according to two trial generations (HD1-3 and HD4-6) of the German Hodgkin's Lymphoma Study Group (GHSG). RESULTS One hundred thirty-five cases of primary BMI were observed. The incidence of BMI was 4.8% in the HD4-6 study generation, which included all stages. Among stage IV patients, 32% had BMI. Among those with BMI, other organs were also involved in 33%. Among all patients, the presence of BMI was significantly associated with B symptoms, lymph nodes on both sides of the diaphragm, mixed cellularity histologic subtype, leukocytopenia, anemia, thrombocytopenia, lactate dehydrogenase (LDH) level more than 400 U/L, and erythrocyte sedimentation rate (ESR) more than 40 mm/h. BMI was negatively correlated with a large mediastinal tumor (3.7% v 20.0% in non-BMI cases). Eighty-seven of 108 (81%) assessable patients with BMI achieved a complete remission (CR). This compares favorably with the overall CR rate in all stage IIIB/IV patients. Among stage IV patients, BMI has no prognostic relevance with regard to freedom from treatment failure and overall survival. Twenty-one patients with BMI relapsed after having achieved a CR. Only five of these (24%) again had a positive bone marrow biopsy. CONCLUSION The prognosis of patients with BMI is not worse than the prognosis of other advanced-stage HD patients. BMI alone does not define a special high-risk group in which a different treatment approach is indicated.

Secondary acute myeloid leukemia in children previously treated with alkylating agents, intercalating topoisomerase II inhibitors, and irradiation.

1993 ◽  
Vol 11 (6) ◽  
pp. 1039-1045 ◽  
Author(s):  
C Sandoval ◽  
C H Pui ◽  
L C Bowman ◽  
D Heaton ◽  
C A Hurwitz ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Hodgkin’S Lymphoma ◽  
Topoisomerase Ii ◽  
Alkylating Agents ◽  
Hodgkin's Lymphoma ◽  
Secondary Aml ◽  
Secondary Acute Myeloid Leukemia ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
The Right

PURPOSE Patient records were reviewed to identify cases of secondary acute myeloid leukemia (AML) with clinical and cytogenetic features characteristic of classic epipodophyllotoxin-related AML in patients whose prior treatment for cancer did not include these agents. PATIENTS AND METHODS Four cases of secondary AML with chromosomal abnormalities involving bands 11q23 and 21q22, in the absence of prior treatment with etoposide or teniposide, were identified among patients treated at St Jude Children's Research Hospital between January 1980 and April 1992. RESULTS The four identified patients were initially treated for rhabdomyosarcoma, non-Hodgkin's lymphoma (n = 2), and Hodgkins' disease. Prior chemotherapy included relatively low cumulative doses of doxorubicin (median, 150 mg/m2; range, 120 to 375 mg/m2) and cyclophosphamide (median, 3,100 mg/m2; range, 2,250 to 11,400 mg/m2). All four patients had received radiation therapy: 59.4 Gy to the right middle ear for rhabdomyosarcoma; 15 Gy and 12 Gy to the abdomen and right lower quadrant, respectively, for non-Hodgkin's lymphoma; 27 Gy to the right orbit for non-Hodgkin's lymphoma; and 36.6 Gy to the mantle-paraaortic-spleen regions plus 20.4 Gy inverted-Y radiation at relapse for Hodgkin's disease. Secondary AML was diagnosed a median of 38 months after initial diagnosis (range, 14 to 55). Leukemic cell translocations involved band 11q23 in two cases and band 21q22 in two. Although all patients obtained a complete remission (CR), only one remains disease-free (at 34 months), following an allogeneic bone marrow transplant. CONCLUSION Intercalating topoisomerase II inhibitors (doxorubicin, dactinomycin), when combined with alkylating agents and irradiation, may cause secondary AML.

scholarly journals The treatment of progressive non-Hodgkin's lymphoma with intensive chemoradiotherapy and autologous marrow transplantation

Blood ◽  
1990 ◽  
Vol 75 (4) ◽  
pp. 831-838 ◽  
Author(s):  
GL Phillips ◽  
JW Fay ◽  
RH Herzig ◽  
HM Lazarus ◽  
SN Wolff ◽  
...  
Keyword(s):  
Marrow Transplantation ◽  
Hodgkin’S Lymphoma ◽  
Disease Status ◽  
Hodgkin's Lymphoma ◽  
Prior History ◽  
Resistant Disease ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Cause Of Failure ◽  
History Of

Abstract Intensive chemoradiotherapy, with or without additional local radiotherapy, and unpurged autologous marrow transplantation was given to 68 patients with progressive non-Hodgkin's lymphoma. Responses were attained in 44 patients (65%, 95% confidence intervals [CI], 52% to 76%), including 37 who achieved complete responses. Fifteen patients (22%, 95% C.I. 13% to 34%) remain free of disease (including 11 continuously) at a median of 5.3 (range 3.1 to 9.1) years later. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and the absence of a history of prior radiotherapy (P = .02, chi 2 test) were associated with achievement of complete plus partial responses. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and less resistant disease status at transplantation (P = .04, chi 2 test) were significant when calculations were limited to complete responses. Karnofsky scores were also associated with the probability of freedom from progression (P = .02, log-rank) for responding patients. Also, Karnofsky scores and the absence of prior radiotherapy (P less than .01 and P = .01, respectively, log-rank) were associated with improved survival. Progressive lymphoma was the chief cause of failure; progression usually occurred less than 6 months after transplantation, most often at the sites of active disease before the transplant. However, five patients (including four with high-grade non-Hodgkin's lymphoma) suffered hematogenous patterns of relapse; four of these five patients had no prior history of marrow involvement. Other causes of mortality included interstitial pneumonitis, sepsis, hemorrhage and renal failure. Intensive chemoradiotherapy and autologous marrow transplantation produces durable remissions in some patients with progressive non-Hodgkin's lymphoma. Since such therapy is more effective when given to patients with signs of less advanced disease, earlier treatment would be the simplest way to produce improved results. However, improved conditioning regimens will also be needed, and measures to reduce occult lymphoma stem cell contamination with the autograft may also be required to increase the likelihood of cure in some patients.

Bleomycin Pulmonary Toxicity in Adult Saudi Patients with Hodgkin’s Lymphoma

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5450-5450
Author(s):  
Mubarak M Al-Mansour ◽  
Wafa A Al-jizani ◽  
Turki Al-fayea ◽  
Shafi Ruaa ◽  
Ghieth A Kazkaz ◽  
...  
Keyword(s):  
Pulmonary Toxicity ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Saudi Arabian ◽  
Developed Countries ◽  
Hodgkin's Lymphoma ◽  
First Line ◽  
Future Studies ◽  
Incidence Risk ◽  
History Of

Abstract Background: Bleomycin pulmonary toxicity (BPT) has been well described in Hodgkin's lymphoma (HL) patients treated with bleomycin-containing chemotherapy regimens. As the effects of genetic susceptibility or race on the development of BPT are largely unknown, we intended to examine BPT incidence, risk factors, and its effects on survival in a series of newly diagnosed Saudi Arabian adult HL patients receiving first-line bleomycin-containing chemotherapy. Methods: We carried out a retrospective review of the relevant records of 164 consecutive eligible adult HL patients treated at two centers. Results: BPT was observed in 24 of 164 patients (15%) at a median duration of 4.3 months (range, 1 to 58 months). Older age and history of concomitant lung disease were significantly associated with approximately three- (odds ratio [OR] = 3.38; 95% confidence interval [CI], 1.25-9.13; P = 0.02) and seven-fold (OR = 7.19; 95% CI, 2.64-19.54; P <0.0001) increase in BPT risk, respectively. While more patients in non-BPT group achieved CR as compared with BPT patients (93% vs. 79%; P = 0.048), the actuarial 5-year progression-free (82% vs. 63%; P = 0.29) and overall survival (OS) (94% vs. 76%; P = 0.059) for BPT and non-BPT groups, respectively were not significantly different. Nevertheless, in a multivariate analysis, the earlier incidence time of BPT considered as a time-dependent covariate was the only factor that independently influenced OS (hazard ratio = 0.99; 95% CI, 0.99-1.00; P = 0.002). Conclusion: In Saudi Arabian adult HL patients, the risk of BPT and its effect on survival outcome were comparable to that reported from developed countries. Earlier incidence time of BPT aversely influenced OS. Future studies should consider testing the efficacy and safety of non-bleomycin-containing regimens in HL. Disclosures No relevant conflicts of interest to declare.

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