scholarly journals Effect of splenectomy on tolerance to combination chemotherapy in patients with lymphoma

Blood ◽  
1976 ◽  
Vol 47 (2) ◽  
pp. 211-222
Author(s):  
DC Ihde ◽  
VT DeVita ◽  
GP Canellos ◽  
RC Young
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Matched Control ◽  
Hodgkin’S Disease ◽  
Effect Of Splenectomy ◽  
Number Of Cycles ◽  
Time Required ◽  
And Control ◽  
Ancillary Benefit ◽  
Initial Combination

Enhanced tolerance to combination chemotherapy has been cited as an ancillary benefit of staging laparotomy and splenectomy in Hodgkin's disease. Seventeen patients with Hodgkin's disease and 15 with non- Hodgkin's lymphoma were subjected to nontherapeutic splenectomy as part of the staging procedure prior to their initial treatment with MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone) or CVP (cyclophosphamide, vincristine, and prednisone) chemotherapy, respectively. Matched control patients of comparable age, pathologically proven stage, and presence or absence of bone marrow lymphoma and previous radiotherapy were selected. Although leukocyte (in non-Hodgkin's patients) and platelet counts (in both groups) were significantly higher in the patients with splenectomy during most of the first six cycles of therapy, there was no difference in the number of cycles during which a leukocyte count below 1000 (or below 2000 in Hodgkin's disease) or platelet count below 50,000 was recorded in the splenectomized and control patients. The total dose of all drugs actually delivered, time required to complete six cycles of treatment, and the portion of patients entering complete remission were not significantly different in the two groups. We have found no evidence that splenectomy per se, in lymphoma patients without findings of hypersplenism, improves the ability to administer planned amounts of drugs during initial combination chemotherapy.

scholarly journals Effect of splenectomy on tolerance to combination chemotherapy in patients with lymphoma

Blood ◽  
1976 ◽  
Vol 47 (2) ◽  
pp. 211-222 ◽  
Author(s):  
DC Ihde ◽  
VT DeVita ◽  
GP Canellos ◽  
RC Young
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Matched Control ◽  
Hodgkin’S Disease ◽  
Effect Of Splenectomy ◽  
Number Of Cycles ◽  
Time Required ◽  
And Control ◽  
Ancillary Benefit ◽  
Initial Combination

Abstract Enhanced tolerance to combination chemotherapy has been cited as an ancillary benefit of staging laparotomy and splenectomy in Hodgkin's disease. Seventeen patients with Hodgkin's disease and 15 with non- Hodgkin's lymphoma were subjected to nontherapeutic splenectomy as part of the staging procedure prior to their initial treatment with MOPP (nitrogen mustard, vincristine, procarbazine, and prednisone) or CVP (cyclophosphamide, vincristine, and prednisone) chemotherapy, respectively. Matched control patients of comparable age, pathologically proven stage, and presence or absence of bone marrow lymphoma and previous radiotherapy were selected. Although leukocyte (in non-Hodgkin's patients) and platelet counts (in both groups) were significantly higher in the patients with splenectomy during most of the first six cycles of therapy, there was no difference in the number of cycles during which a leukocyte count below 1000 (or below 2000 in Hodgkin's disease) or platelet count below 50,000 was recorded in the splenectomized and control patients. The total dose of all drugs actually delivered, time required to complete six cycles of treatment, and the portion of patients entering complete remission were not significantly different in the two groups. We have found no evidence that splenectomy per se, in lymphoma patients without findings of hypersplenism, improves the ability to administer planned amounts of drugs during initial combination chemotherapy.

Combination Chemotherapy of Advanced Hodgkin’s Disease with Adriamycin, DTIC, CCNU, and Bleomycin

Chemotherapy ◽  
1976 ◽  
pp. 513-516
Author(s):  
R. Osieka ◽  
U. Bruntsch ◽  
W. M. Gallmeier ◽  
S. Seeber ◽  
C. G. Schmidt
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Advanced Hodgkin’S Disease

Lung Cancer After Hodgkin’s Disease: A Nested Case-Control Study of the Relation to Treatment

2001 ◽  
Vol 19 (6) ◽  
pp. 1610-1618 ◽  
Author(s):  
A. J. Swerdlow ◽  
M. J. Schoemaker ◽  
R. Allerton ◽  
A. Horwich ◽  
J. A. Barber ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hodgkin's Disease ◽  
Case Control Study ◽  
Hodgkin’S Disease ◽  
Case Control ◽  
Lung Cancers ◽  
Number Of Cycles ◽  
Nested Case Control ◽  
Control Study

PURPOSE: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin’s disease, and in particular the relationship to treatment. PATIENTS AND METHODS: A nested case-control study was conducted within a cohort of 5,519 patients with Hodgkin’s disease treated in Britain during 1963 through 1993. For 88 cases of lung cancer and 176 matched control subjects, information on treatment and other risk factors was extracted from hospital case-notes, and odds ratios for lung cancer in relation to these factors were calculated. RESULTS: Risk of lung cancer was borderline significantly greater in patients treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy than those who did not receive this treatment (relative risk [RR] = 1.66; 95% confidence interval [CI], 0.99 to 2.82), and increased with number of cycles of MOPP (P = .07). Exclusion of lung cancers for which histologic confirmation was not available strengthened these associations (RR = 2.41; 95% CI, 1.33 to 4.51; P = .004 for any MOPP and P = .007 for trend with number of cycles of MOPP). Risks were not raised, however, after chlorambucil, vinblastine, procarbazine, and prednisone treatment. There was evidence that the raised risk of lung cancer occurring in relation to radiotherapy was restricted to histologies other than adenocarcinoma. CONCLUSION: The results suggest that MOPP chemotherapy may lead to elevated risk of lung cancer, at least in certain subgroups of patients. The role of chemotherapy in the etiology of lung cancer after Hodgkin’s disease deserves further investigation.

Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy. A prospectively randomized study by the Cancer and Leukemia Group B.

1986 ◽  
Vol 4 (6) ◽  
pp. 838-846 ◽  
Author(s):  
V Vinciguerra ◽  
K J Propert ◽  
M Coleman ◽  
J R Anderson ◽  
L Stutzman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Disease Free Survival ◽  
Complete Response ◽  
Free Survival ◽  
Group B ◽  
Leukemia Group ◽  
Disease Free

A randomized clinical trial of combination chemotherapy for patients who relapsed following primary radiation therapy for Hodgkin's disease was conducted from 1975 to 1981 by the Cancer and Leukemia Group B (CALGB). One hundred thirteen patients were prospectively randomized to receive 12 cycles of either CVPP (CCNU, vinblastine, procarbazine, and prednisone), ABOS (bleomycin, vincristine [Oncovin; Lilly, Indianapolis], doxorubicin [Adriamycin, Adria Laboratories, Columbus, Ohio], and streptozotocin), or alternating cycles of CVPP and ABOS. The median length of observation for patients in this report is 4 years. Toxicities of the three treatment programs were primarily hematologic. Frequencies of complete response were 72% for CVPP, 70% for ABOS, and 82% for CVPP/ABOS (P = .37). Females and patients who had nodular sclerosing disease at initial diagnosis had significantly higher complete response rates. The 5-year disease-free survival for the complete responders was 55%; the 5-year overall survival was 60%. There were no significant differences among the treatments on disease-free survival (P = .78) or overall survival (P = .18). Age under 40 years was the only significant positive prognostic factor for disease-free survival (P = .095) and overall survival (P = .003). This study demonstrates no statistically significant advantage for alternating cycles of combination chemotherapy in affecting complete response frequency, disease-free survival, or overall survival as compared with therapy with CVPP or ABOS alone. However, the power to detect differences in these outcome parameters is somewhat limited by the sample sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adriamycin in Combination and in Combined Treatment Modalities.

1974 ◽  
Vol 60 (5) ◽  
pp. 393-416 ◽  
Author(s):  
Gianni Bonadonna ◽  
Gianni Beretta ◽  
Gabriele Tancini ◽  
Mario De Lena ◽  
Silvio Monfardini ◽  
...  
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Treatment ◽  
Treatment Modalities ◽  
Random Allocation ◽  
Malignant Lymphomas ◽  
Carcinoma Of The Breast ◽  
Acute Leukemias ◽  
Hodgkin's Lymphomas

The paper reviews the current strategic approach of the Istituto Nazionale Tumori of Milan with adriamycin (ADM) in combination with other drugs as well as in combined treatment modalities for various neoplasias of adults and children. The preliminary results obtained during the past four years in malignant lymphomas, acute leukemias, carcinoma of the breast, and neuroblastoma are reported. With the exception of the group of malignant lymphomas treated with a quintuple drug regimen (MABOP), none of the patients admitted the different trials had received chemotherapy. Most studies were controlled with random allocation to two different combinations. Cross over was carried out on relapse. In advanced Hodgkin's disease, non-Hodgkin's lymphomas, mammary carcinoma, soft tissue sarcomas, embryonal carcinoma of testicle, ovarian carcinoma, and multiple myeloma the main purpose of the study was to develop two independent non cross resistant combinations to be used sequentially in subsequent trials. There is a preliminary evidence that this is being obtained in Hodgkin's disease (ABVD vs. MOPP), in non Hodgkin's lymphomas (ABP vs. CVP) and carcinoma of the breast (ADM + VCR vs. CMF). In the other groups the patients were too few to permit conclusions. In acute lymphoblastic leukemia, in the leukemic phase of non-Hodgkin's lymphomas as well as in the group of solid tumors of children, combination chemotherapy and combined treatment modalities were not designed in a controlled fashion. ADM was introduced in all treatments because of its definite activity when employed as a single agent in refractory disease. Few therapeutic results are as yet available since most studies were started in 1974. However, the remission rate observed in the limited group of acute leukemias treated with ADM + VCR + prednisone is worth noting. The wide spectrum of activity of ADM justifies its use in several protocols of combination chemotherapy and in combined treatment modalities. With both full and reduced regimens drug tolerance was good, and in practically all studies more than 80 % of the optimal dose of ADM could be administered. All trials were properly designed to avoid a total dose of ADM exceeding 550–600 mg/m2 since cardiomyopathy (reversible) was observed in 2 patients after 600 mg/m2.

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