AIDS-Related Malignancies: State of the Art and Therapeutic Challenges

2008 ◽  
Vol 26 (29) ◽  
pp. 4834-4842 ◽  
Author(s):  
Jean-Philippe Spano ◽  
Dominique Costagliola ◽  
Christine Katlama ◽  
Nicolas Mounier ◽  
Eric Oksenhendler ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Hodgkin’S Lymphoma ◽  
Advanced Disease ◽  
State Of The Art ◽  
Hodgkin's Lymphoma ◽  
Increased Risk ◽  
Therapeutic Recommendations ◽  
The Subject ◽  
The Impact ◽  
Related Mortality

Despite the impact of combination antiretroviral therapy (cART) on HIV-related mortality, malignancy remains an important cause of death in the current era. Although the advent of cART has resulted in reductions in the incidence of Kaposi's sarcoma and non-Hodgkin's lymphoma, non–AIDS-defining malignancies present an increased risk for HIV-infected patients, characterized by some common clinical features, generally with a more aggressive behavior and a more advanced disease at diagnosis, which is responsible for poorer patient outcomes. Specific therapeutic recommendations are lacking for these new nonopportunistic malignancies, such as Hodgkin's lymphoma, anal cancer, lung cancer, hepatocarcinoma, and many others. Antiretroviral agents have a propensity for causing drug interactions as a result of their ability to either inhibit or induce the cytochrome P450 (CYP) enzyme system. Because many antineoplastic drugs are also metabolized by the CYP system, coadministration with cART could result in either drug accumulation with increased toxicity, or decreased efficacy of one or both classes of drugs. Further research delineating the combined safety and pharmacokinetics of antiretrovirals and antineoplastic therapy is necessary. Special considerations of these AIDS-related and non–AIDS-related malignancies and their clinical and therapeutic aspects constitute the subject of this review.

scholarly journals Physician Experience and Risk of Rituximab Discontinuation in Older Adults With Non-Hodgkin’s Lymphoma

2019 ◽  
Vol 17 (10) ◽  
pp. 1194-1202
Author(s):  
Scott F. Huntington ◽  
Jessica R. Hoag ◽  
Rong Wang ◽  
Amer M. Zeidan ◽  
Smith Giri ◽  
...  
Keyword(s):  
Older Adults ◽  
Hodgkin’S Lymphoma ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hodgkin's Lymphoma ◽  
Risk Of Death ◽  
Non Hodgkin’S Lymphoma ◽  
Increased Risk ◽  
Non Hodgkin's Lymphoma ◽  
The Impact

Background: Provider experience, or clinical volume, is associated with improved outcomes in many complex healthcare settings. Despite increased complexity of anticancer therapies, studies evaluating physician-level experience and cancer treatment outcomes are lacking. Methods: A population-based study was conducted of older adults (aged ≥66 years) diagnosed with B-cell non-Hodgkin’s lymphoma in 2004 through 2011 using SEER-Medicare data. Analysis focused on outcomes in patients receiving rituximab, the first approved monoclonal anticancer immunotherapy. We hypothesized that lower physician experience using rituximab and managing its infusion-related reactions would be associated with early treatment discontinuation. A 12-month look-back from each initiation of rituximab was used to categorize physician volume (0, 1–2, or ≥3 initiations per year). Modified Poisson regression was used to account for provider-level correlation and estimated relative risk (RR) of early rituximab discontinuation (<3 cycles within 180 days of rituximab initiation). Cox proportional hazards were used to measure the impact of rituximab discontinuation on survival. Results: Among 15,110 patients who initiated rituximab with 2,684 physicians, 7.6% experienced early rituximab discontinuation. Approximately one-fourth of patients (26.1%) initiated rituximab with a physician who had no rituximab initiations during the preceding 12 months. Compared with patients treated by physicians who had ≥3 rituximab initiations in the prior year, those treated by physicians without initiations were 57% more likely to experience early discontinuation (adjusted RR [aRR], 1.57; 95% CI, 1.35–1.82; P<.001 for 0 vs ≥3, and aRR, 1.19; 95% CI, 1.03–1.37; P=.02 for 1–2 vs ≥3). Additionally, rituximab discontinuation was associated with higher risk of death (adjusted hazard ratio, 1.39; 95% CI, 1.28–1.52; P<.001). Conclusions: Lower oncologist experience with rituximab was associated with increased risk of early rituximab discontinuation in Medicare beneficiaries with non-Hodgkin’s lymphoma. Physician-level volume may be an important factor in providing high-quality cancer care in the modern era.

scholarly journals Spectrum of lymphomas across different drug treatment groups in rheumatoid arthritis: a European registries collaborative project

2017 ◽  
Vol 76 (12) ◽  
pp. 2025-2030 ◽  
Author(s):  
Louise K Mercer ◽  
Anne C Regierer ◽  
Xavier Mariette ◽  
William G Dixon ◽  
Eva Baecklund ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cell ◽  
General Population ◽  
B Cell ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Treatment Groups ◽  
Increased Risk

BackgroundLymphomas comprise a heterogeneous group of malignant diseases with highly variable prognosis. Rheumatoid arthritis (RA) is associated with a twofold increased risk of both Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). It is unknown whether treatment with biologic disease-modifying antirheumatic drugs (bDMARDs) affect the risk of specific lymphoma subtypes.MethodsPatients never exposed to (bionaïve) or ever treated with bDMARDs from 12 European biologic registers were followed prospectively for the occurrence of first ever histologically confirmed lymphoma. Patients were considered exposed to a bDMARD after having received the first dose. Lymphomas were attributed to the most recently received bDMARD.ResultsAmong 124 997 patients (mean age 59 years; 73.7% female), 533 lymphomas were reported. Of these, 9.5% were HL, 83.8% B-cell NHL and 6.8% T-cell NHL. No cases of hepatosplenic T-cell lymphoma were observed. Diffuse large B-cell lymphoma (DLBCL) was the most frequent B-cell NHL subtype (55.8% of all B-cell NHLs). The subtype distributions were similar between bionaïve patients and those treated with tumour necrosis factor inhibitors (TNFi). For other bDMARDs, the numbers of cases were too small to draw any conclusions. Patients with RA developed more DLBCLs and less chronic lymphocytic leukaemia compared with the general population.ConclusionThis large collaborative analysis of European registries has successfully collated subtype information on 533 lymphomas. While the subtype distribution differs between RA and the general population, there was no evidence of any modification of the distribution of lymphoma subtypes in patients with RA treated with TNFi compared with bionaïve patients.

The State of the Art in Management Education Applicable to Aerospace Activities

1967 ◽  
Vol 71 (677) ◽  
pp. 344-348
Author(s):  
J. V. Connolly
Keyword(s):  
Management Education ◽  
State Of The Art ◽  
Aerospace Industry ◽  
List Type ◽  
Industrial Training ◽  
The Past ◽  
The Subject ◽  
Economic Necessity ◽  
The Uk ◽  
The Impact

During the past two years, there has been a sharp acceleration to the interest which industry has displayed in the subject of management education. This can be attributed to these factors: —(a) A more widespread realisation of the gap developing between the UK and a number of foreign economies, as manifested by diverging rates of the major economic indicators.(b) The attainment of top-management responsibilities by a younger generation of managers, many of whom had been given some earlier training and who were more conscious of its value than the incumbents of the job from earlier generations.(c) The publication of the Franks, Robbins and (in the aerospace industry) the Plowden reports.(d) The impact of the Industrial Training Boards making it manifest, in terms of serious levies, that training was an economic necessity and therefore must be investigated thoroughly.Notwithstanding the widespread awakening of interest, it is very belated and sets numerous problems. The problems are in two areas—scale and quality.

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 Recent Advances in Diagnostic Approaches for Epstein–Barr Virus

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 226 ◽  
Author(s):  
Mai Abdel Haleem Abusalah ◽  
Siew Hua Gan ◽  
Mohammad A. I. Al-Hatamleh ◽  
Ahmad Adebayo Irekeola ◽  
Rafidah Hanim Shueb ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Epstein Barr Virus ◽  
Antibody Test ◽  
Hodgkin's Lymphoma ◽  
Sample Type ◽  
Barr Virus ◽  
Advantages And Disadvantages ◽  
Negative Results ◽  
Epstein Barr ◽  
The Impact

Epstein–Barr virus (EBV) is the causative agent of many diseases including infectious mononucleosis (IM), and it is associated with different subtypes of lymphoma, sarcoma and carcinoma such as Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, nasopharyngeal carcinoma, and gastric carcinoma. With the advent of improved laboratory tests for EBV, a timelier and accurate diagnosis could be made to aid better prognosis and effective treatment. For histopathological lesions, the in situ hybridization (ISH) of EBV-encoded RNA (EBER) in biopsy tissues remains the gold standard for detecting EBV. Methods such as the heterophile antibody test, immunofluorescence assays, enzyme immunoassays, Western blot, and polymerase chain reaction (PCR) are also employed in the detection of EBV in different types of samples. The determination of EBV viral load using PCR, however, is gaining more prominence in the diagnosis of EBV-associated diseases. Given the challenge of false positive/negative results that are sometimes experienced during the detection of EBV, variability in results from different laboratories, and the impact of factors such as sample type and the immunological status of patients from whom samples are collected, the need to critically examine these present methods is invaluable. This review thus presents current advances in the detection of EBV, detailing the advantages and disadvantages of the various techniques. In addition, fundamental virological concepts are highlighted to enhance the greater understanding, the proper application, and the interpretation of EBV tests.

scholarly journals The impact of systemic chemotherapy on testicular FDG activity in young men with Hodgkin’s lymphoma

2013 ◽  
Vol 40 (5) ◽  
pp. 701-707
Author(s):  
Irene A. Burger ◽  
Hebert Alberto Vargas ◽  
Debra A. Goldman ◽  
Mithat Gonen ◽  
Anita Kumar ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Systemic Chemotherapy ◽  
Young Men ◽  
Hodgkin's Lymphoma ◽  
The Impact

Latent Epstein-Barr Virus Infection of Tumor Cells in Classical Hodgkin's Lymphoma Predicts Adverse Outcome in Older Adult Patients

2009 ◽  
Vol 27 (23) ◽  
pp. 3815-3821 ◽  
Author(s):  
Arjan Diepstra ◽  
Gustaaf W. van Imhoff ◽  
Michael Schaapveld ◽  
Henrike Karim-Kos ◽  
Anke van den Berg ◽  
...  
Keyword(s):  
Tumor Cell ◽  
Tumor Cells ◽  
Older Adult ◽  
Hodgkin’S Lymphoma ◽  
Epstein Barr Virus ◽  
Adult Patients ◽  
Hodgkin's Lymphoma ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

Purpose In classical Hodgkin's lymphoma (cHL), the impact of tumor cell Epstein-Barr virus (EBV) status on clinical outcome is controversial. Patients and Methods We assessed failure-free survival (FFS) and relative survival (RS) in 412 patients with cHL and age-defined subgroups in a population-based study in the northern Netherlands. Tumor cell EBV status was positive in 34%, and the median follow-up time was 7.1 years. Patients' median age at diagnosis was 35 years (range, 7 to 91 years), and 63% had Ann Arbor stage I or II, 24% had stage III, and 12% had stage IV disease. Results EBV status influenced 5-year FFS and RS only in patients from the age group 50 to 74 years. Five-year FFS was 60% in patients with EBV-positive versus 85% in EBV-negative tumors (P = .01). Five-year RS was 69% in patients with EBV-positive versus 82% in EBV-negative tumors (P = .03). After adjusting for histology, HLA class II expression by tumor cells, stage, presence of extranodal localizations and treatment, and the effect of positive EBV tumor status remained significant in FFS multivariate analysis (hazard ratio, 3.11; 95% CI, 1.28 to 7.53; P = .01). Conclusion This study indicates that treatment failure in older adult patients with cHL is associated with positive tumor cell EBV status.

Increased Risk of Second Lung Cancer in Hodgkin’s Lymphoma Survivors: A Meta-analysis

Lung ◽  
2012 ◽  
Vol 191 (1) ◽  
pp. 117-134 ◽  
Author(s):  
Ezzeldin M. Ibrahim ◽  
Ghieth A. Kazkaz ◽  
Khaled M. Abouelkhair ◽  
Mubarak M. Al-Mansour ◽  
Turki M. Al-Fayea ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Hodgkin’S Lymphoma ◽  
Meta Analysis ◽  
Hodgkin's Lymphoma ◽  
Increased Risk ◽  
Lymphoma Survivors
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