scholarly journals Management Considerations of Hodgkin Lymphoma for Patients with Fontan Physiology

2021 ◽  
Author(s):  
Michelle Perry Milligan ◽  
Leslie Kersun
Keyword(s):  
Supportive Care ◽  
Hodgkin Lymphoma ◽  
Clinical Course ◽  
Fontan Procedure ◽  
Treatment Protocols ◽  
Fontan Physiology

While treatment protocols for Hodgkin Lymphoma (HL) are well established, there is no literature available to guide therapy or estimate prognosis for patients with Fontan physiology who develop HL. The physiology of a Fontan procedure can result in the inability to tolerate chemotherapy toxicities, supportive care and infection. We present a series of 3 patients with Fontan physiology who were treated for HL and discuss their clinical course and treatment.

scholarly journals Real-world analysis of cost, health care resource utilization, and supportive care in Hodgkin lymphoma patients with frontline failure

2018 ◽  
Vol Volume 10 ◽  
pp. 629-641 ◽  
Author(s):  
Machaon Bonafede ◽  
Joseph Feliciano ◽  
Qian Cai ◽  
Virginia Noxon ◽  
Nicole Princic ◽  
...  
Keyword(s):  
Health Care ◽  
Supportive Care ◽  
Hodgkin Lymphoma ◽  
Resource Utilization ◽  
Real World ◽  
Health Care Resource ◽  
Health Care Resource Utilization

scholarly journals Protein-Losing Enteropathy and Plastic Bronchitis After the Fontan Operation

2018 ◽  
Vol 38 (6) ◽  
pp. e5-e12 ◽  
Author(s):  
Christine Peyton
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Complex Disease ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Venous Pressure ◽  
Venous Hypertension ◽  
Plastic Bronchitis ◽  
Protein Losing Enteropathy ◽  
Fontan Physiology

Protein-losing enteropathy and plastic bronchitis remain challenging to treat despite recent treatment advances. Protein-losing enteropathy and plastic bronchitis have been diagnosed in patients with cardiomyopathy, constrictive pericarditis, and congestive heart failure. This article focuses on patients with protein-losing enteropathy or plastic bronchitis following the Fontan procedure. Patients with single-ventricle physiology who have undergone the Fontan procedure are at risk for these conditions. Fontan physiology predisposes patients to chronically low cardiac output, increased central venous pressure, and congestive heart failure. These altered hemodynamics lead to increased mesenteric vascular resistance, resulting in venous hypertension and congestion in protein-losing enteropathy. Plastic bronchitis is a complex disease in which chronic high lymphatic pressures from Fontan physiology cause acellular bronchial casts to develop. These entities may also occur in patients with normal Fontan hemodynamics. This article also covers medical and surgical interventions for protein-losing enteropathy and plastic bronchitis. (Critical Care Nurse. 2018;38[6]:e5–e12)

Metabolic Activity of Lymphoma Cells and Clinical Course in Non-Hodgkin Lymphoma (NHL)

2009 ◽  
Vol 27 (5) ◽  
pp. 305-310 ◽  
Author(s):  
M. Monti ◽  
L. Brandt ◽  
J. Ikomi-Kumm ◽  
H. Olsson ◽  
I. Wadö
Keyword(s):  
Hodgkin Lymphoma ◽  
Metabolic Activity ◽  
Clinical Course ◽  
Lymphoma Cells ◽  
Non Hodgkin Lymphoma

scholarly journals Transplant-Amenable Hepatocellular Carcinoma in a Fontan Patient

2019 ◽  
Vol 13 (2) ◽  
pp. 275-279 ◽  
Author(s):  
Brian Patrick Rutledge ◽  
Anupama Devara ◽  
Sindhuri Benjaram ◽  
Stephanie Judd ◽  
Murray Ehrinpreis
Keyword(s):  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Liver Transplant ◽  
Fontan Procedure ◽  
Venous Pressure ◽  
Fontan Patient ◽  
Number Of Patients ◽  
Fontan Physiology ◽  
The Ideal

The Fontan circulation alters a patient’s physiology and imparts long-term risks related to chronically elevated systemic venous pressure. An increasing number of patients with Fontan physiology are surviving into adulthood and are at risk of hepatic sequalae. The ideal timeline and method of hepatic surveillance in the Fontan population remains to be defined. In this case, the patient was diagnosed with hepatocellular carcinoma more than 20 years after undergoing the Fontan procedure and was a candidate for combined heart-liver transplant. That her disease progressed prior to organ availability supports the argument for hepatic surveillance in this population.

scholarly journals Priorities, Barriers, and Facilitators towards International Guidelines for the Delivery of Supportive Clinical Care during an Ebola Outbreak: A Cross-Sectional Survey

Viruses ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 194 ◽  
Author(s):  
Marie-Claude Battista ◽  
Christine Loignon ◽  
Lynda Benhadj ◽  
Elysee Nouvet ◽  
Srinivas Murthy ◽  
...  
Keyword(s):  
Supportive Care ◽  
Ebola Virus ◽  
Health Workers ◽  
Virus Disease ◽  
Clinical Care ◽  
Barriers And Facilitators ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Treatment Protocols ◽  
Key Stakeholders

During the Ebola outbreak, mortality reduction was attributed to multiple improvements in supportive care delivered in Ebola treatment units (ETUs). We aimed to identify high-priority supportive care measures, as well as perceived barriers and facilitators to their implementation, for patients with Ebola Virus Disease (EVD). We conducted a cross-sectional survey of key stakeholders involved in the response to the 2014–2016 West African EVD outbreak. Out of 57 email invitations, 44 responses were received, and 29 respondents completed the survey. The respondents listed insufficient numbers of health workers (23/29, 79%), improper tools for the documentation of clinical data (n = 22/28, 79%), insufficient material resources (n = 22/29, 76%), and unadapted personal protective equipment (n = 20/28, 71%) as the main barriers to the provision of supportive care in ETUs. Facilitators to the provision of supportive care included team camaraderie (n in agreement = 25/28, 89%), ability to speak the local language (22/28, 79%), and having treatment protocols in place (22/28, 79%). This survey highlights a consensus across various stakeholders involved in the response to the 2014–2016 EVD outbreak on a limited number of high-priority supportive care interventions for clinical practice guidelines. Identified barriers and facilitators further inform the application of guidelines.

IMPACT OF AUTOIMMUNE CYTOPENIAS ON THE CLINICAL COURSE AND SURVIVAL OF HODGKIN LYMPHOMA

2019 ◽  
Vol 37 ◽  
pp. 499-499
Author(s):  
L.I. Pinczés ◽  
R. Szabó ◽  
Z. Miltényi ◽  
Á. Illés
Keyword(s):  
Hodgkin Lymphoma ◽  
Clinical Course ◽  
Autoimmune Cytopenias

scholarly journals 3245 Comparison of Health Outcomes in Adolescent and Young Adult (AYA) Oncology Patients Treated at a Pediatric versus Adult Institute

2019 ◽  
Vol 3 (s1) ◽  
pp. 141-142
Author(s):  
Amy Moskop ◽  
Julie Panepinto ◽  
Sadie Dobrozsi
Keyword(s):  
Young Adults ◽  
Supportive Care ◽  
Health Outcomes ◽  
Hodgkin Lymphoma ◽  
Pediatric Cancer ◽  
Germ Cell Tumors ◽  
Adolescents And Young Adults ◽  
Adolescent And Young Adult ◽  
Cancer Center ◽  
Study Population

OBJECTIVES/SPECIFIC AIMS: Objectives: To examine the differences in health outcomes of adolescents and young adults treated for malignancy at a pediatric cancer center compared to an adult cancer center. To determine the differences in receipt of supportive care for adolescents and young adults with malignancy who are treated at a pediatric cancer center compared to an adult cancer center. METHODS/STUDY POPULATION: Methods: This will be a retrospective cohort study of patients from the ages of 15 to 39 years who are diagnosed with a malignancy common between adult and pediatric facilities within 2013-2017. Data will be abstracted from an existing database at MCW containing patient information at the adult and pediatric centers. Study population: Patients ages 15-39 years of age who are categorized as young adolescent and adult patients (AYAs). Patients are eligible for the cohort if they have a diagnosis that is common between adult and pediatric oncology centers and that is made within the years 2013-2017. These diagnoses will include ALL, AML, Hodgkin Lymphoma, Non-Hodgkin Lymphoma, Germ cell tumors, Osteosarcoma, Ewing Sarcoma, other sarcomas, and CNS tumors. RESULTS/ANTICIPATED RESULTS: There will be a difference in health care utilization, clinical trial enrollment and toxicity of therapy in AYAs with malignancies treated at an adult facility than AYAs treated for similar malignancy at pediatric facility. DISCUSSION/SIGNIFICANCE OF IMPACT: There will be a difference in receipt of supportive care referrals, including psychology, social work, sperm banking, initiation of palliative care, in AYAs treated at a pediatric facility compared to AYAs treated at adult facility.

scholarly journals Anaesthetic management of a patient with Fontan physiology for electrophysiology study and catheter ablation

2019 ◽  
Vol 12 (3) ◽  
pp. e228520 ◽  
Author(s):  
Denise Yan Yin Lim ◽  
Thangavelautham Suhitharan ◽  
Harikrishnan Kothandan
Keyword(s):  
Perioperative Complications ◽  
Electrophysiological Study ◽  
Fontan Procedure ◽  
Anaesthetic Management ◽  
Vital Role ◽  
Successful Outcome ◽  
Multidisciplinary Teams ◽  
Good Communication ◽  
Anatomy And Physiology ◽  
Fontan Physiology

The success of the Fontan procedure for congenital single ventricle anatomy has resulted in adult patients with Fontan physiology requiring anaesthesia for cardiac and non-cardiac procedures. We present the perioperative management of a patient with Fontan physiology who underwent electrophysiological study with radiofrequency ablation for atrial tachycardia under general anaesthesia. Good communication between the multidisciplinary teams, a detailed understanding of the patient’s complex cardiac anatomy and physiology, as well as the ability to recognise and manage perioperative complications all play a vital role for a successful outcome.

scholarly journals An Adult Patient with Fontan Physiology: A TEE Perspective

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Edward Gologorsky ◽  
Angela Gologorsky ◽  
Eliot Rosenkranz
Keyword(s):  
Vascular Resistance ◽  
Venous Return ◽  
Fontan Procedure ◽  
Right Atrial ◽  
Cardiac Pathology ◽  
Abrupt Changes ◽  
Adult Congenital ◽  
Systemic Venous Return ◽  
Fontan Physiology ◽  
Train Of Thought

Fontan and Baudet described in 1971 the separation of the pulmonary and systemic circulations resulting in univentricular physiology. The evolution of the Fontan procedure, most notably the substitution of right atrial-to-pulmonary artery anastomosis with cavopulmonary connections, resulted in significantly improved late outcomes. Many patients survive well into adulthood and are able to lead productive lives. While ideally under medical care at specialized centers for adult congenital cardiac pathology, these patients may present to the outside hospitals for emergency surgery, electrophysiologic interventions, and pregnancy. This presentation presents a “train of thought,” linking the TEE images to the perioperative physiologic considerations faced by an anesthesiologist caring for a patient with Fontan circulation in the perioperative settings. Relevant effects of mechanical ventilation on pulmonary vascular resistance, pulmonary blood flow and cardiac preload, presence of coagulopathy and thromboembolic potential, danger of abrupt changes of systemic vascular resistance and systemic venous return are discussed.

Prognostic Factors and Treatment Outcome in Lymphocyte Predominant and Classical Hodgkin’s Lymphoma: A Comprehensive Analysis of the German Hodgkin Study Group.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 97-97
Author(s):  
Lucia Nogova ◽  
Thorsten Reineke ◽  
Corinne Brillant ◽  
Thomas Ruediger ◽  
Hans K. Mueller-Hermelink ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Prognostic Factors ◽  
Hodgkin Lymphoma ◽  
Cox Regression ◽  
White Cell Count ◽  
Advanced Stage ◽  
Treatment Protocols ◽  
Cox Regression Analysis ◽  
Negative Factor ◽  
Advanced Stages

Abstract Introduction: Lymphocyte predominant Hodgkin lymphoma (LPHL) differs in histological and clinical presentation from classical Hodgkin lymphoma (cHL). Treatment of LPHL patients using standard approaches leads to complete remission (CR) in more than 95% of patients. However, differences in terms of relapse rates, overall survival (OS) and freedom from treatment failure (FFTF) between LPHL and cHL patients were suggested by a recent intergroup analysis. To obtain a more comprehensive picture, we reviewed all LPHL-cases registered in the GHSG database comparing patient characteristics and treatment outcome with cHL patients. Patients and methods: We retrospectively analyzed 8298 HL patients treated within the GHSG trials (HD4 to HD12). 394 patients had LPHL and 7904 cHL. From 394 LPHL patients, 63% were in early favorable stage, 16% in early unfavorable and 21% in advanced stage of disease. Of the 7904 cHL patients analyzed, 22% were in early favorable, 39% in early unfavorable and 39% in advanced stages. 9% of LPHL patients had B symptoms compared to 40% in cHL patients. Results: 91% LPHL vs. 86% cHL patients in early favorable stages, 86% vs. 83% in early unfavorable and 79% vs. 75% in advanced stages reached CR/CRu. 0.3% LPHL patients developed progressive disease (PD) compared to 3.7% cHL patients. The relapse rate of LPHL patients was very similar to cHL (8.1% vs. 7.9%). There were 2.5% secondary malignancies in LPHL and 3.7% in cHL patients. 4.3% LPHL patients and 8.8% cHL patients died. The FFTF rates for LPHL and cHL patients at a median observation of 41 or 48 months were 88% and 82% (p=0.0093), respectively. The OS for LPHL and cHL patients was 96% and 92%, respectively (p=0.0166). The analysis between LPHL stages showed significant differences in FFTF (p=0.0239). According to a multiple Cox-regression analysis, advanced stage (p=0.0089) and lymphocytes < 8% of white cell count was shown as negative prognostic factors for FFTF and age ≥ 45 years (p=0.008) as negative factor for OS in LPHL patients. Hb value < 10.5 g/dl was shown as negative factor for both, FFTF and OS (p=0.0125, p=0.0002). Conclusion: This is the largest analysis comparing LPHL and cHL patients. We found differences in FFTF and OS rates between both groups and differences in FFTF between LPHL stages. New treatment protocols for LPHL patients with reduced intensity schedules are to be discussed.

Sign in / Sign up

Export Citation Format

Share Document