The role of staging laparotomy in combined modality therapy of Hodgkin's disease: A new treatment plan based on a 6-year experience

1978 ◽  
Vol 2 (1) ◽  
pp. 101-105 ◽  
Author(s):  
Richard E. Wilson ◽  
Robert T. Osteen ◽  
David S. Rosenthal ◽  
Peter M. Mauch ◽  
Robert L. Goodman
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Treatment Plan ◽  
Combined Modality Therapy ◽  
Staging Laparotomy ◽  
Combined Modality ◽  
New Treatment

Splenectomy and the increasing risk of secondary acute leukemia in Hodgkin's disease.

1993 ◽  
Vol 11 (5) ◽  
pp. 925-930 ◽  
Author(s):  
S Tura ◽  
M Fiacchini ◽  
P L Zinzani ◽  
E Brusamolino ◽  
P G Gobbi
Keyword(s):  
Hodgkin's Disease ◽  
Proportional Hazards ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Secondary Leukemia ◽  
Proportional Hazards Regression ◽  
Combined Modality ◽  
Leukemia Development ◽  
Increasing Risk

PURPOSE Following irradiation alone, secondary acute nonlymphocytic leukemia (ANLL) is uncommon; following chemotherapy alone, the risk is increased, but not as much as when combined modality treatments are used. Because ANLL seems more likely to occur in splenectomized patients, attention is focused on an unexpected association between splenectomy and the risk of secondary leukemia. PATIENTS AND METHODS The risk of ANLL was assessed in 503 patients with Hodgkin's disease (HD) homogeneously treated with combined modality therapy (mechlorethamine, vincristine, procarbazine, and prednisone [MOPP] plus radiotherapy). These patients were diagnosed from 1970 through 1984 and monitored until June 1991. RESULTS ANLL was observed in one of 145 (0.69%) patients not splenectomized and in 21 of 358 (5.86%) splenectomized patients, demonstrating a significantly higher frequency of ANLL in the group of patients who underwent splenectomy. The group of patients who developed ANLL received a statistically greater number of MOPP courses than did the group not developing ANLL. ANLL was statistically more frequent in those patients who received more than four cycles of MOPP. Sex, symptoms, extent of radiotherapy, splenectomy, age, and number of MOPP courses were assessed for their impact on ANLL incidence by multivariate analysis. CONCLUSION Cox's proportional hazards regression showed that splenectomy and, as previously described by others, the number of courses of MOPP are prognostic factors that increase the risk of secondary ANLL in HD patients treated with combined modality therapy. These data raise interesting questions regarding the possible role of the spleen in leukemia development.

The role of combined modality therapy in symptomatic Hodgkin's disease, stage IB–IIIB

1980 ◽  
Vol 6 (10) ◽  
pp. 1364-1365
Author(s):  
Peter Mauch ◽  
MaryEllen Ryback ◽  
Alan Lewin ◽  
David Rosenthal ◽  
Samuel Hellman
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Disease Stage ◽  
Stage Ib ◽  
Combined Modality

2161 Reduction of adverse effects of combined modality therapy with subtotal nodal irradiation in stage IIIA Hodgkin's disease

1996 ◽  
Vol 36 (1) ◽  
pp. 356
Author(s):  
Farley E. Yang ◽  
Jaishanker Nautiyal ◽  
Claire Powers ◽  
Dennis Hallahan ◽  
Srinivasan Vijayakumar ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Stage Iiia ◽  
Combined Modality

Stage IIB Hodgkin's disease: the Stanford experience.

1986 ◽  
Vol 4 (4) ◽  
pp. 472-479 ◽  
Author(s):  
M J Crnkovich ◽  
R T Hoppe ◽  
S A Rosenberg
Keyword(s):  
Relapse Rate ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Survival Rates ◽  
Actuarial Survival ◽  
Combined Modality ◽  
Significant Difference ◽  
Ann Arbor ◽  
The Impact

Between 1968 and 1982, 126 patients with pathologic stage (PS) IIB Hodgkin's disease were treated at Stanford University with either irradiation alone or irradiation combined with chemotherapy. Actuarial survival and freedom from relapse rates at 10 years for the overall group were 81% and 74% respectively, with no statistically significant difference between the treatment approaches. The impact of the severity and number of constitutional (B) symptoms, as defined by the Ann Arbor Conference, was analyzed. Patients who presented with all three B symptoms had significantly poorer survival and freedom from relapse compared with those patients with only one or two B symptoms (for survival differences, P = .005 and .007; for freedom from relapse differences, P = .002 and .04). Male sex was the only other prognostic factor that correlated with a poor outcome. At 10 years, the survival rate was 66% for males v 84% for females (P = .01), and the freedom from relapse rate was 75% for males v 89% for females (P = .02). The presence of extralymphatic sites of involvement, age greater than 40, or involvement of greater than three lymphoid sites had no significant adverse effect on either freedom from relapse or survival. Patients with large mediastinal masses treated with irradiation alone had a 10-year freedom from relapse rate of 54% v 81% for those treated with combined-modality therapy (P = .15), but there was no significant difference in survival rates (85% for irradiation alone v 71% for combined modality therapy). Treatment recommendations for stage IIB Hodgkin's disease are discussed.

Successful marrow transplantation for acute myelocytic leukemia following therapy for Hodgkin's disease.

1988 ◽  
Vol 6 (10) ◽  
pp. 1558-1561 ◽  
Author(s):  
R B Geller ◽  
G B Vogelsang ◽  
J R Wingard ◽  
A M Yeager ◽  
W H Burns ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Marrow Transplantation ◽  
Hematologic Malignancy ◽  
Hodgkin’S Disease ◽  
Combined Modality Therapy ◽  
Intensive Therapy ◽  
Acute Myelocytic Leukemia ◽  
Myelocytic Leukemia ◽  
Histocompatibility Locus

Five patients with acute myelocytic leukemia (AML) after combined modality therapy for Hodgkin's disease (HD) were treated with cyclophosphamide and busulfan followed by bone marrow transplantation (BMT). Four patients received allogeneic transplants from histocompatibility locus antigen (HLA)-compatible siblings and the fifth patient received an autologous marrow treated with 4-hydroperoxycyclophosphamide. Two patients died of complications of acute graft-v-host disease (GVHD) despite prophylaxis with either low-dose cyclophosphamide or cyclosporine. The remaining three patients were alive and disease-free 382, 617, and 620 days after transplant. These initial results are encouraging and more patients with treatment-related AML need to be evaluated with both allogeneic and autologous BMT to fully elucidate the potentially curative role of this intensive therapy in an otherwise fatal hematologic malignancy.

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