scholarly journals Hodgkin Lymphoma Management; A 20-year Retrospective Study

2020 ◽  
Author(s):  
Farid Ghazizadeh ◽  
Mehran Noroozi ◽  
Sasan Hejazi ◽  
Amin Sedokani
Keyword(s):  
Radiation Therapy ◽  
Retrospective Study ◽  
Hodgkin Lymphoma ◽  
Survival Rates ◽  
Staging System ◽  
Cross Sectional ◽  
Term Survival ◽  
Resistant Disease ◽  
Ann Arbor ◽  
Stage 1

Abstract Object: Hodgkin lymphoma (HL) is one of the pediatric and adult cancers, with a cure rate of over 90% and high long-term survival rates by treatment with chemotherapy alone or combined with radiotherapy (RT). However, survivors of pediatric HL are at high risk of secondary cancers and cardiovascular disease due to treatment. Considering the complications of RT, we aimed to evaluate the consequences and outcomes of the treatment with and without RT in a retrospective study in the pediatric oncology department of Urmia medical sciences university.Method: We carried a cross-sectional retrospective study by referring and review of records for all patients admitted in Motahari hospital with HL diagnosis from 1995 to 2016. The incomplete records and taking chemotherapy out of protocol were our exclusion criteria. The staging of disease was classified by the Ann Arbor staging system.Results: 35 patients enrolled in our study that 54.3% were female and 45.7% were male patients. The mean age of patients was 10.08±6.38 years. 10 (28.6%) cases classified in stage 1, 13 (37.1%) case in stage 2, 9 (25.7%) cases in stage 3, and 3 (8.6%) cases in stage 4. 30 patients (85.7%) were treated by chemotherapy and 5 (14.3%) patients with chemotherapy and radiation combination. In our study, the overall survival was 97.1% of patients who treated with chemotherapy alone and one patient died due to drug side effects. That is comparable with the result of other studies that treated patients with chemotherapy and radiotherapy.Conclusion: According to our findings chemotherapy without radiotherapy as initial treatment in Hodgkin lymphoma would have similar results of concomitant radiotherapy and chemotherapy, so with consideration of cost and harms of radiation therapy, we suggest a limitation of radiation therapy to patients with resistant disease that do not respond to chemotherapy solo-protocols.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

scholarly journals Inter-relationships between Gender, Frailty and 10-Year Survival in Older Italian Adults: an observational longitudinal study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Graziamaria Corbi ◽  
Francesco Cacciatore ◽  
Klara Komici ◽  
Giuseppe Rengo ◽  
Dino Franco Vitale ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cox Model ◽  
Survival Rates ◽  
Staging System ◽  
Female Gender ◽  
Term Survival ◽  
Fractional Polynomial ◽  
The Impact

AbstractAim of the present study was to assess the impact of gender on the relationship between long-term mortality and clinical frailty. In an observational, longitudinal study on 10-year mortality, we examined 1284 subjects. The Frailty Staging System was used to assess frailty. The Cox model was employed to assess variables independently associated with survival using a backward stepwise algorithm. To investigate the possible interactions between gender and the selected variables, an extension of the multivariable fractional polynomial algorithm was adopted. Women were more likely to be older, have a higher disability, present with more comorbidities, consume more drugs, be frail and have a higher rate of survival at the follow-up than were men. At the Cox multivariate analysis only age (HR 2.26), female gender (HR 0.43), and number of drugs (HR 1.57) were significant and independent factors associated with all-cause mortality. In the survival analyses, only frailty (vs no frailty) showed significant interaction with gender (p < 0.001, HR = 1.92). While the presence of frailty reduced the survival rate in women, no effect was observed in men. Importantly, frail women showed higher survival rates than did both frail and no frail men. The main finding of the present study is that gender shapes up the association between frailty and long-term survival rates.

scholarly journals Risk classification as the basis for clinical staging of diffuse large- cell lymphoma derived from 10-year survival data

Blood ◽  
1989 ◽  
Vol 74 (2) ◽  
pp. 551-557 ◽  
Author(s):  
WS Velasquez ◽  
S Jagannath ◽  
SL Tucker ◽  
LM Fuller ◽  
LB North ◽  
...  
Keyword(s):  
Survival Data ◽  
Risk Model ◽  
Survival Rates ◽  
Staging System ◽  
Large Cell ◽  
Risk Groups ◽  
Lactic Dehydrogenase ◽  
Tumor Burden ◽  
Clinical Staging ◽  
Ann Arbor

Two hundred and fifty previously untreated adult patients with diffuse large-cell lymphomas were treated with a chemotherapy combination of cyclophosphamide, adriamycin, vincristine, prednisone, and low-dose bleomycin (CHOP-Bleo) with or without radiotherapy between 1974 and 1984. The 10-year survival rates for patients with Ann Arbor stages II, III, or IV disease of 55%, 42%, and 40%, respectively, were not significantly different. However, the survival rate of 76% for patients with stage I disease was clearly better. Factors more indicative of prognosis than stage, as found by univariant analysis, were tumor burden, serum lactic dehydrogenase level (LDH), age, and constitutional symptoms. From these, a multivariant analysis selected tumor burden, LDH level, and age as major independent factors for predicting survival (P less than .001). A prognostic risk model constructed on the basis of tumor burden and LDH levels identified four distinct risk groups (A, B, C, D) with 10-year survival rates of 85%, 66%, and 43% for A, B, and C. No patient in group D survived 10 years. These risk groups also had a strong correlation with complete remission rates and with relapse rates. Thus this model proved more effective for identifying patient populations according to their expected responses, durations of remission, and survivals than the Ann Arbor staging system. Detailed information supporting the use of this system for predicting prognosis and for treatment selection for patients with diffuse large-cell lymphomas is provided.

scholarly journals Cognitive impairment across ALS clinical stages in a population-based cohort

Neurology ◽  
2019 ◽  
Vol 93 (10) ◽  
pp. e984-e994 ◽  
Author(s):  
Adriano Chiò ◽  
Cristina Moglia ◽  
Antonio Canosa ◽  
Umberto Manera ◽  
Rosario Vasta ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Motor Impairment ◽  
Staging System ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Cognitive Testing ◽  
Behavioral Impairment ◽  
Cross Sectional ◽  
Stage 1

ObjectiveTo assess the association of the degree of severity of motor impairment to that of cognitive impairment in a large cohort of patients with amyotrophic lateral sclerosis (ALS).MethodsThis is a population-based cross-sectional study on patients with ALS incident in Piemonte, Italy, between 2007 and 2015. Cognitive status was classified according to the revised ALS–FTD Consensus Criteria. The King system and the Milano Torino Staging system (MiToS) were used for defining the severity of motor impairment.ResultsOf the 797 patients included in the study, 163 (20.5%) had ALS–frontotemporal dementia (FTD), 38 (4.8%) cognitive and behavioral impairment (ALScbi), 132 (16.6%) cognitive impairment (ALSci), 63 (7.9%) behavioral impairment (ALSbi), 16 (2.0%) nonexecutive impairment, and 385 (48.2%) were cognitively normal. According to King staging, the frequency of cases with ALS-FTD progressively increased from 16.5% in stage 1–44.4% in stage 4; conversely, the frequency of ALSci, ALSbi, and ALScbi increased from King stage 1 to King stage 3 and decreased thereafter. A similar pattern was observed with the MiToS staging. ALS-FTD was more frequent in patients with bulbar involvement at time of cognitive testing. Patients with C9ORF72 expansion (n = 61) showed more severe cognitive impairment with increasing King and MiToS stages.ConclusionOur findings suggest that ALS motor and cognitive components may worsen in parallel, and that cognitive impairment becomes more pronounced when bulbar function is involved. Our data support the hypothesis that ALS pathology disseminates in a regional ordered sequence, through a cortico-efferent spreading model.

scholarly journals Cisplatin plus capecitabine concomitant with intensity-modulated radiation therapy in non-metastatic anal squamous cell carcinoma: the experience of a single research cancer center

2020 ◽  
Vol 12 ◽  
pp. 175883592094094 ◽  
Author(s):  
Maria Saveria Rotundo ◽  
Maria Giulia Zampino ◽  
Paola Simona Ravenda ◽  
Vincenzo Bagnardi ◽  
Giulia Peveri ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Retrospective Study ◽  
Cell Carcinoma ◽  
Survival Rates ◽  
Intensity Modulated Radiation Therapy ◽  
Curative Intent ◽  
Anal Squamous Cell Carcinoma ◽  
Free Survival ◽  
Intensity Modulated

Background and Aims: The standard treatment of non-metastatic anal squamous cell carcinoma (ASCC) consists of chemotherapy with mitomycin (MMC) plus 5-fluorouracil (5FU) for 1–2 cycles concomitant with pelvic radiotherapy. Subsequent studies introduced cisplatin (CDDP) combined with 5FU, with unclear results. We evaluated the doublet capecitabine (C) and CDDP as a possible alternative to MMC-5FU regimen concomitant with intensity-modulated radiation therapy (IMRT). Patients and Methods: We carried out a retrospective study on 67 patients affected by stage I–III ASCC, treated with CDDP (60–70 mg/m2 every 21 days for two courses) plus C (825 mg/m2 twice daily for 5 days/week) chemotherapy concomitant with IMRT for curative intent. Results: At a median follow up of 41 months, the clinical complete response calculated at the 6-month time-point (6-moCR), the 6-month objective response rate and the 6-month disease control rate were 93%, 94%, and 99%, respectively. Disease-free survival rates at 1, 2, and 3 years were 89%, 87%, and 85%, while the overall survival rates at 1 and 2 years were 100% and 95%. The colostomy-free survival rates were 90% at 1 year and 88% at 2 years. Grade 3–4 acute adverse events were reported in 61% of patients; predominantly skin toxicity (46%) and limited hematological toxicity (12%). Conclusion: In this retrospective study, chemotherapy with C plus CDDP concomitant with IMRT proved safe and effective, and may represent a possible alternative option to standard MMC-containing regimen for curative intent.

Allogeneic Stem Cell Transplantation (AlloSCT) for the Treatment of Therapy-Related Myelodysplastic Syndrome (tMDS) and Acute Myeloid Leukemia (tAML): Results from the Center for International Blood and Marrow Transplant Research (CIBMTR).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3057-3057
Author(s):  
Mark Litzow ◽  
Waleska S. Pérez ◽  
Sergey Tarima ◽  
Armand Keating ◽  
Jorge Sierra ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Hodgkin Lymphoma ◽  
Poor Prognosis ◽  
Clinical Decision Making ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Disease Free Survival ◽  
Unrelated Donor ◽  
Peripheral Blood Stem Cells ◽  
Term Survival

Abstract Cytotoxic chemoradiotherapy may lead to the development of tMDS and tAML. These disorders are associated with a poor prognosis with non-transplant therapy. We report outcomes of alloSCT for tMDS and tAML in 868 subjects transplanted between 1990 and 2004 at 211 centers in 33 countries. Subjects were excluded (n=322) if they had a prior disease predisposing to MDS or AML, if they had a diagnosis of tALL or had received a twin or cord blood transplant. 21% were ≤19 years old (yo); 55% were female and 63% had tAML (including 30% with prior tMDS). Prior diagnoses included Hodgkin lymphoma (23%) and non-Hodgkin lymphoma (21%), breast cancer (16%), ALL (12%), sarcoma (8%), germ cell tumor (6%), and autoimmune disorders (5%). There were rare cases (≤3%) of CLL, plasma cell disorders, neuroblastoma, Wilms and CNS tumors or other cancers. Prior treatment was chemotherapy in 43%, chemotherapy and radiation therapy in 51% and radiation therapy alone in 4%. Cytogenetic data (cd) at the time of transplant were known in 84%: good prognosis 4%, intermediate 61% and poor 34%. The IPSS score at diagnosis for subjects with tMDS was intermediate-2 or high in 54%. At transplant, 51% of subjects with tAML were in first complete remission (CR1), 7% ≥CR2, 15% in relapse and 27% were primary induction failures. For the tMDS pts, 37% had been treated with other modalities before receiving an alloSCT. Pre-transplant conditioning regimen was myeloablative (M) 77% and reduced intensity (RI or non-M) in the remainder. Donors were related 38% and unrelated 62%; 66% of the grafts were bone marrow and 34% peripheral blood stem cells. Cumulative incidence of acute GVHD (grade II-IV) @100 days was 39% (95% confidence interval [CI]), 35–42). Outcomes, with a median follow-up of 61 (range, 3–187) months were: Outcome: 5 year probability (95% CI) Chronic GVHD 30 (27–33) Treatment-related mortality (TRM) 48 (44–51) Relapse 31 (28–34) Disease-free survival (DFS) 21 (18–24) Overall survival (OS) 22 (19–26) In multivariate analysis (MVA), TRM was significantly higher in subjects >35 yo, in those with a poor (<90%) performance score (PS), with untreated MDS or if a mismatched related or unrelated donor was used. Relapse risk was higher for subjects >35 yo, with preceding ALL or poor prognosis cytogenetics or tAML not in CR. DFS and OS were lower in subjects >35 yo, with poor prognosis cd, AML not in CR or untreated MDS, or with a mismatched related or unrelated donor. Of 649 pts who died, the cause of death was tMDS or tAML in 33% and TRM in the others. The use of a RI or non-M conditioning regimen did not improve outcomes in the MVA. Approximately 20% of pts with tMDS and tAML achieve long term survival following alloSCT. Survival was significantly better in pts <35 yo, with good or intermediate risk cd, disease control at the time of transplant and having a matched related or complete or partially matched-unrelated donor. The 5 year survival was 50% (95% CI, 39–61) with all 4 good risk factors (grf); 25% (95% CI, 20–31) with any 3 grf, 19% (95% CI, 14–24) with any 2 grf, 12% (95%CI, 8–18) with only 1 grf, and only 4% (95%CI, 0–15) without any of these factors. In conclusion, these data may be helpful in guiding clinical decision-making on the role of alloSCT in the management of t-AML and t-MDS.

scholarly journals Imaging in Carcinoma Cervix and Revised 2018 FIGO Staging System: Implications in Radiology Reporting

2021 ◽  
Author(s):  
Ekta Dhamija ◽  
Malvika Gulati ◽  
Smita Manchanda ◽  
Seema Singhal ◽  
Dayanand Sharma ◽  
...  
Keyword(s):  
Survival Rates ◽  
Staging System ◽  
Radical Change ◽  
Lymph Node Status ◽  
Carcinoma Cervix ◽  
Disease Extent ◽  
Cross Sectional ◽  
Figo Staging ◽  
Gynecology And Obstetrics ◽  
Pathological Evaluation

AbstractThe International Federation of Gynecology and Obstetrics (FIGO) staging system of carcinoma cervix saw a radical change in 2018 with the inclusion of cross-sectional imaging tools for the assessment of disease extent and staging. One of the major revisions is the inclusion of lymph node status, detected either on imaging or pathological evaluation, in the staging system. The changes were based on long-term patient follow-up and survival rates reported in literature. Thus, it becomes imperative for a radiologist to be well versed with the recent staging system, its limitations, and implications on the patient management.

Sign in / Sign up

Export Citation Format

Share Document