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1. Jones GL, Taylor PR, Windebank KP, Hoye NA, Lucraft H, Wood K, Angus B, Proctor SJ: Outcome of a risk-related therapeutic strategy used prospectively in a population-based study of Hodgkin's lymphoma in adolescents. Br J Cancer; 2007 Jul 2;97(1):29-36
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  • [Title] Outcome of a risk-related therapeutic strategy used prospectively in a population-based study of Hodgkin's lymphoma in adolescents.
  • The aim was to assess outcome in a population-based cohort of adolescents with Hodgkin's lymphoma (HL) diagnosed in the UK's northern region over a 10-year period.
  • Seven had nodular lymphocyte-predominant HL, 48 classical HL (cHL).
  • Application of the Scottish and Newcastle Lymphoma Group (SNLG) prognostic index meant 21 patients were considered high risk (index >or=0.5).
  • They received PVACEBOP multi-agent chemotherapy as primary therapy.
  • Standard risk patients (SNLG index <0.5) were treated with standard ChlVPP or ABVD chemotherapy+/-radiotherapy.
  • Scottish and Newcastle Lymphoma Group indexing is not valid for patients under 16.
  • Seven patients relapsed but all entered complete remission after salvage therapy.
  • Five- and 10-year overall survival was 93 and 86%, respectively; disease-specific survival was 95 and 92%.
  • The data suggest that older adolescents with high-risk HL require intensive protocols as primary therapy to secure optimal outcome.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / therapeutic use. Cohort Studies. Dacarbazine / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Male. Survival Analysis. Treatment Outcome. Vinblastine / therapeutic use

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  • (PMID = 17533403.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin; ABVD protocol
  • [Other-IDs] NLM/ PMC2359673
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2. Wu SJ, Chen CY, Su IJ, Tang JL, Chou WC, Ko BS, Huang SY, Yao M, Tsay W, Chen YC, Wang CH, Tien HF: Clinical characteristics and treatment response of Hodgkin's lymphoma in Taiwan. J Formos Med Assoc; 2008 Jan;107(1):4-12
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  • [Title] Clinical characteristics and treatment response of Hodgkin's lymphoma in Taiwan.
  • BACKGROUND/PURPOSE: Hodgkin's lymphoma (HL) is particularly rare in Asia, including Taiwan.
  • The report concerning its clinical features and treatment outcomes in Asians is limited.
  • The nodular sclerosis type (NS-HL) was the most common histopathologic subtype (45%), followed by mixed cellularity (29%), lymphocyte predominant (13%), and lymphocyte depleted subtype (2%).
  • The male to female ratio was approximately 1:2 in patients with NS-HL, in contrast to the male predominance in patients with other subtypes.
  • Induction therapy led to complete remission (CR) in 87% of patients.
  • CONCLUSION: The treatment response of HL in Taiwan is good and comparable to that in Western countries.

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  • (PMID = 18218572.001).
  • [ISSN] 0929-6646
  • [Journal-full-title] Journal of the Formosan Medical Association = Taiwan yi zhi
  • [ISO-abbreviation] J. Formos. Med. Assoc.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Singapore
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3. van Grotel M, Lam KH, de Man R, Beishuizen A, Pieters R, van den Heuvel-Eibrink MM: High relapse rate in children with non-advanced nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL or nodular paragranuloma) treated with chemotherapy only. Leuk Lymphoma; 2006 Aug;47(8):1504-10
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  • [Title] High relapse rate in children with non-advanced nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL or nodular paragranuloma) treated with chemotherapy only.
  • Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) is a rare variant of Hodgkin's lymphoma (HL) in children.
  • Since specific immunohistochemical staining has become available, NLPHL can be separated from classical Hodgkin's lymphoma (cHL) more accurately.
  • Scarce information is available about pediatric NLPHL treated with chemotherapy only.
  • Therefore, clinical characteristics, treatment, response and outcome of seven pediatric NLPHL patients, median age 9.2 years (range 7.5 - 14.2 years), diagnosed between 1986 - 2003 among 58 HL patients, uniformly treated in a single center with chemotherapy only, were evaluated.
  • The median follow-up time was 4.2 years (range 2.1 - 10.2 years).
  • Upfront treatment of NLPHL patients consisted of six courses of epirubicin, bleomycin, vinblastine and dacarbazine (EBVD) without radiotherapy, whereas cHL patients received six courses of EBVD (n = 14) or 4 - 6 courses of EBVD/MOPP (mitoxin, oncovin, procarbazine, prednison; n = 21).
  • Chemotherapy was used as primary treatment thereby aiming to avoid radiotherapy with potential serious side effects to growing jaws and thyroid.
  • These three were salvaged with second-line chemotherapy without radiation therapy (RT) and are in second CR.
  • One patient relapsing with stage III disease was salvaged by EBVD/MOPP followed by autologous BMT and is also in second CR for 36 months.
  • Moreover, it illustrates that although cure of pediatric NLPHL is feasible with chemotherapy only, high dosages of cytotoxic drugs are necessary as salvage treatment in a relatively high proportion of patients after relapse.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / drug therapy. Lymphoma, B-Cell / drug therapy
  • [MeSH-minor] Adolescent. Bleomycin / administration & dosage. Child. Dacarbazine / administration & dosage. Epirubicin / administration & dosage. Female. Follow-Up Studies. Humans. Male. Recurrence. Remission Induction / methods. Retrospective Studies. Salvage Therapy / methods. Survival Analysis. Treatment Outcome. Vinblastine / administration & dosage

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  • [CommentIn] Leuk Lymphoma. 2006 Aug;47(8):1450-1 [16966251.001]
  • (PMID = 16966260.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 3Z8479ZZ5X / Epirubicin; 5V9KLZ54CY / Vinblastine; 7GR28W0FJI / Dacarbazine
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4. Illés A, Simon Z, Tóth E, Rosta A, Miltényi Z, Molnár Z: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)-clinicopathological features based on the data of two Hungarian lymphoma centres. Pathol Oncol Res; 2008 Dec;14(4):411-21
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  • [Title] Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL)-clinicopathological features based on the data of two Hungarian lymphoma centres.
  • Clinicopathological features of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) differ from those of the classical Hodgkin lymphoma (cHL).
  • Our aim was to examine clinical presentation, therapeutic and survival results of NLPHL patients in Hungary based on the data of two centres, and incidentally we analyzed the clinicopathological characteristics and differential diagnostic difficulties of this rare entity.
  • We analyzed the clinical features, treatment and survival data of 536 Hodgkin lymphoma patients who had been diagnosed and primarily treated in our institutes between 1995 and 2004.
  • Mean follow-up time was 82.7 (3-144) months of the total 536 HL patients.
  • Sixteen (3%) of the patients were diagnosed with NLPHL, 93% of them presented with early-stage disease.
  • None of the patients showed extranodal or splenic involvement or bulky disease.
  • One patient received chemotherapy alone, six received only involved field radiotherapy while six underwent combined modality treatment.
  • Two NLPHL cases transformed to non-Hodgkin's lymphoma.
  • CONCLUSIONS: NLPHL is a rare disease, thus these are limited experiences with its diagnosis and treatment.
  • Since the disease has an excellent outcome, it is very important to prefer less toxic or local therapies to reach long term survival similar to that of the normal population.
  • [MeSH-major] Hodgkin Disease / diagnosis. Hodgkin Disease / mortality. Hodgkin Disease / therapy
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Diagnosis, Differential. Disease-Free Survival. Female. Humans. Hungary. Immunohistochemistry. Lymphoma / pathology. Male. Middle Aged. Survival Rate

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  • (PMID = 18431694.001).
  • [ISSN] 1219-4956
  • [Journal-full-title] Pathology oncology research : POR
  • [ISO-abbreviation] Pathol. Oncol. Res.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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5. Pijuan L, Vicioso L, Bellosillo B, Ferrer MD, Baró T, Pedro C, Lloreta-Trull J, Munné A, Serrano S: CD20-negative T-cell-rich B-cell lymphoma as a progression of a nodular lymphocyte-predominant Hodgkin's lymphoma treated with rituximab: a molecular analysis using laser capture microdissection. Am J Surg Pathol; 2005 Oct;29(10):1399-403
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  • [Title] CD20-negative T-cell-rich B-cell lymphoma as a progression of a nodular lymphocyte-predominant Hodgkin's lymphoma treated with rituximab: a molecular analysis using laser capture microdissection.
  • It has shown efficacy in patients with B-cell non-Hodgkin lymphoma and also in CD20-positive Hodgkin lymphoma.
  • Recently, CD20-negative tumors have been described after Rituximab therapy.
  • We report a 34-year-old man with a history of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), treated with different chemotherapy regimens, including anthracyclines and Rituximab.
  • After 4 years in complete remission, he developed a CD20-negative T-cell-rich B-cell lymphoma (TCRBCL) presenting as multiple lung lesions.
  • This case shows the difficulties in the diagnosis of CD20-negative lymphomas when the number of tumor cells is low and when they are found in a predominant T-cell context.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Antigens, CD20 / metabolism. Antineoplastic Agents / therapeutic use. Hodgkin Disease / drug therapy. Lung Neoplasms / pathology. Lymphoma, B-Cell / pathology. Neoplasms, Second Primary / pathology. T-Lymphocytes / immunology

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  • (PMID = 16160485.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antigens, CD20; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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6. Niu Y, Shi YK, He XH, Feng FY, Zhou LQ, Gu DZ: [Combined-modality therapy for 150 cases of early-stage Hodgkin's lymphoma]. Zhonghua Zhong Liu Za Zhi; 2008 Aug;30(8):630-4
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  • [Title] [Combined-modality therapy for 150 cases of early-stage Hodgkin's lymphoma].
  • OBJECTIVE: To compare the efficacy of chemotherapy alone, radiotherapy alone and combined-modality therapy in the treatment for early-stage Hodgkin's lymphoma (HL).
  • They were stratified into several groups based on initial treatment strategy: chemotherapy alone (CT group, n = 22), radiotherapy alone (RT group, n = 18), combined-modality therapy (CMT group, n = 109) and surgical resection (SR group, n = 1).
  • Chemotherapy regimens were mainly ABVD (adriamycin, bleomycin, vinblastine and dacarbazine) and MOPP (mechlorethamine, vincristine, procarbazine and prednisone).
  • RESULTS: The pathological types included nodular sclerosis (NS, n = 84), mixed-cellularity (MC, n = 39), lymphocyte-predominant (LP, n = 23), lymphocyte-depleted (LD, n = 3) and nodular lymphocyte predominant Hodgkin's disease (NLPHD, n = 1).
  • There were 33 patients with complete response (CR), 109 with partial response (PR), 5 with stable disease (SD) and 3 with progressive disease (PD) after initial therapy.
  • The overall 7-yr survival rate was 89.3%, and treatment failure rate at 6 years was 18.8%.
  • The response rate of CMT group was superior to that of CT group, and the patients with nodular sclerosis or mixed-cellularity type had significantly lower risk of treatment failure (P = 0.009 and 0.019, respectively).
  • The multivariate analysis revealed that the treatment strategies affected the prognosis significantly.
  • The risk of failure of chemotherapy alone was 2.52 times higher than that of combined-modality therapy (P = 0.004).
  • CONCLUSION: Combined-modality therapy is more effective than chemotherapy alone or radiotherapy alone in the treatment for early stage Hodgkin's lymphoma.
  • Though its acute adverse effects are more severe than that of chemotherapy or radiotherapy alone, it may reduce the risk of treatment failure.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / drug therapy. Hodgkin Disease / radiotherapy. Radiotherapy / methods
  • [MeSH-minor] Adolescent. Adult. Aged. Alopecia / chemically induced. Bleomycin / adverse effects. Bleomycin / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Dacarbazine / adverse effects. Dacarbazine / therapeutic use. Doxorubicin / adverse effects. Doxorubicin / therapeutic use. Female. Follow-Up Studies. Humans. Leukopenia / chemically induced. Male. Mechlorethamine / adverse effects. Mechlorethamine / therapeutic use. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Prednisone / adverse effects. Prednisone / therapeutic use. Procarbazine / adverse effects. Procarbazine / therapeutic use. Proportional Hazards Models. Remission Induction. Retrospective Studies. Survival Rate. Vinblastine / adverse effects. Vinblastine / therapeutic use. Vincristine / adverse effects. Vincristine / therapeutic use. Young Adult


7. Kotila TR, Aken'ova YA, Shokunbi WA, Akingbola TS, Fasola FA: Hodgkin's disease after treatment for Burkitt's lymphoma: case report. East Afr Med J; 2001 Jun;78(6):334-6
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  • [Title] Hodgkin's disease after treatment for Burkitt's lymphoma: case report.
  • Hodgkin's disease and non-Hodgkin's lymphomas are interrelated disorders which have been reported to occur either simultaneously or sequentially in the same patient.
  • We report here the development of nodular sclerosing type Hodgkin's disease in a patient two decades after successful treatment for Burkitt's lymphoma with cyclophosphomide and abdominal resection (AR).
  • While the onset of symptoms after treatment for Burkitt's lymphoma was seven years definitive diagnosis of Hodgkin's disease was only made 22 years after the initial diagnosis of Burkitt's lymphoma.
  • The recurrent and solitary nature ofthe lymphadenopathy and the fact that it was initially reported as reactive hyperplasia is typical of nodular lymphocyte predominant Hodgkin's disease.
  • We believe that there was a transitory period of the malignancy as nodular lymphocyte predominant Hodgkin's disease.
  • [MeSH-major] Antineoplastic Agents, Alkylating / adverse effects. Burkitt Lymphoma / drug therapy. Cyclophosphamide / adverse effects. Hodgkin Disease / diagnosis. Neoplasms, Second Primary / diagnosis

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  • (PMID = 12002116.001).
  • [ISSN] 0012-835X
  • [Journal-full-title] East African medical journal
  • [ISO-abbreviation] East Afr Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Kenya
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 8N3DW7272P / Cyclophosphamide
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8. Galán L, Sánchez AC, Cantos B, Provencio M: Rituximab monotherapy in relapsed lymphocyte-predominant Hodgkin's lymphoma. Clin Transl Oncol; 2010 May;12(5):384-6
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  • [Title] Rituximab monotherapy in relapsed lymphocyte-predominant Hodgkin's lymphoma.
  • Nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) accounts for approximately 5% of Hodgkin's lymphoma, presents with early-stage disease and has an indolent course.
  • Treatment is not well established.
  • We present a patient diagnosed with NLPHL and treated with Rituximab second-line therapy after chemotherapy.
  • [MeSH-major] Antibodies, Monoclonal / therapeutic use. Hodgkin Disease / drug therapy
  • [MeSH-minor] Aged. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Female. Humans. Lymphocyte Activation / drug effects. Recurrence. Rituximab

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  • (PMID = 20466624.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 0 / Antineoplastic Agents; 4F4X42SYQ6 / Rituximab
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9. Harris MA, Radford JA, Deakin DP, James RD, Swindell R, Cowan RA: Limited field radiotherapy for early stage, infra-diaphragmatic Hodgkin's lymphoma. Clin Oncol (R Coll Radiol); 2004 Feb;16(1):53-7
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  • [Title] Limited field radiotherapy for early stage, infra-diaphragmatic Hodgkin's lymphoma.
  • AIMS: To analyse the treatment outcome for patients with stage I and II infra-diaphragmatic Hodgkin's lymphoma.
  • Twenty-five out of 33 patients received radiotherapy alone, three out of 33 patients received minimal initial chemotherapy (MIT) (4 weeks VAPEC B) and five patients received six cycles of ChlVPP EVA hybrid chemotherapy before radiotherapy.
  • Histological subtype was lymphocyte predominant (15/33), nodular sclerosis (11/33), mixed cellularity (4/33), lymphocyte-rich classical (1/33) and unclassifiable (2/33).
  • The median time to relapse was 37 months (range 7-65 months).
  • All five relapses had received radiotherapy alone and four were salvaged with chemotherapy.
  • There have been four second malignancies and one patient transformed to high-grade non-Hodgkin's lymphoma.
  • No patient has died of Hodgkin's lymphoma.
  • CONCLUSIONS: In our cohort of patients with infra-diaphragmatic stage I and II Hodgkin's lymphoma treated with limited-field radiotherapy, no patients died from uncontrolled disease.
  • The use of MIT may reduce the risk of relapse and obviate the need for conventional salvage chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / radiotherapy. Neoplasm Staging
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Bleomycin / administration & dosage. Chemotherapy, Adjuvant. Chlorambucil / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Prednisolone / administration & dosage. Procarbazine / administration & dosage. Retrospective Studies. Vinblastine / administration & dosage. Vincristine / administration & dosage

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  • (PMID = 14768756.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 18D0SL7309 / Chlorambucil; 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; ChlVPP-EVA regimen; VAPEC-B protocol
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10. Yildiz F, Zengin N, Engin H, Güllü I, Barista I, Caglar M, Ozyar E, Cengiz M, Gürkaynak M, Zorlu F, Caner B, Atahan IL, Tekuzman G: Prospective study of combined modality treatment or radiotherapy alone in the management of early-stage adult Hodgkin's disease. Int J Radiat Oncol Biol Phys; 2004 Nov 1;60(3):839-46
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  • [Title] Prospective study of combined modality treatment or radiotherapy alone in the management of early-stage adult Hodgkin's disease.
  • PURPOSE: To determine the efficacy and toxicity of combined modality treatment (CMT) or radiotherapy (RT) alone in the management of clinical Stage I-IIA adult Hodgkin's disease patients.
  • METHODS AND MATERIALS: Forty-seven patients with supradiaphragmatic clinical Stage I-IIA Hodgkin's disease without bulky mediastinal lymphadenopathy were enrolled into this prospective study between September 1997 and February 2002.
  • Patients with very favorable criteria presenting with one or two nonbulky nodal areas involved, an erythrocyte sedimentation rate of <50 mm/h, age <40 years, and either lymphocyte predominant or nodular sclerosing histologic findings were treated by RT alone.
  • Patients missing any of these favorable criteria were classified as the other favorable group and were treated with three courses of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy followed by involved-field RT.
  • Only 2 patients developed recurrence, both out of the irradiated field, one in the contralateral neck and the other in the abdomen.
  • Although none of the prognostic factors were statistically significant for relapse-free survival, a trend was noted for the response to chemotherapy (p = 0.06).
  • Only 2 patients developed treatment-related complications.
  • One patient treated with mantle RT alone developed severe ischemic heart disease and one in the CMT arm developed subclinical hypothyroidism.
  • CONCLUSION: Despite the short follow-up, CMT or RT alone tailored according to the clinical prognostic factors were successful in terms of disease control in clinical Stage I-IIA Hodgkin's disease.
  • Longer follow-up is required to make definitive conclusions.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / drug therapy. Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Combined Modality Therapy. Dacarbazine / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Male. Middle Aged. Multivariate Analysis. Prognosis. Prospective Studies. Recurrence. Regression Analysis. Salvage Therapy. Survival Rate. Vinblastine / administration & dosage

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  • (PMID = 15465201.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin
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11. Petera J, Macharová H, Pohanková R, Malír A, Coupek P, Konecný M, Patera J, Pecina J, Drbal J, Koukalová H, Vásová I: Radiotherapy of early stages Hodgkin's disease. 10 years experience of the Masaryk Memorial Cancer Institute. Neoplasma; 2000;47(2):129-32
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  • [Title] Radiotherapy of early stages Hodgkin's disease. 10 years experience of the Masaryk Memorial Cancer Institute.
  • Radiotherapy and chemotherapy, alone or in combination, are curative treatment methods in early stages of Hodgkin's disease (HD).
  • The choice of treatment depends on the stage of the disease, histological type and localization of the tumor, as well as on other prognostic factors.
  • A retrospective study was conducted including 145 patients with clinical Stages I and II of HD according to Ann Arbor classification, all treated in the Masaryk Memorial Cancer Institute in Brno during the years 1985 through 1994.
  • 41 patients were diagnosed with Stage IA tumor, 1 patient with Stage IB, 75 patients with Stage IIA and 28 with Stage IIB disease.
  • The histological types of the disease were lymphocyte predominant in 23 patients, nodular sclerosis in 49 patients, mixed cellularity in 65 cases and lymphocyte depletion in 8 cases.
  • 39 patients were treated with combination of radiotherapy and chemotherapy.
  • 15 patients were given chemotherapy alone, 7 patients from this group experienced a relapse.
  • The five-year survival was 81% in patients with Stages IA and IIA disease, 65% in Stages IB and IIB disease.
  • Radiotherapy remains the curative method of choice in highly selected group of patients with early stages of Hodgkin's disease.
  • The results of radiotherapy alone are unsatisfactory in unselected clinical Stage I--II patients because of the presence of patients with adverse prognostic factors, particularly B symptomatology, mixed cellularity/lymphocyte depletion histology, higher age.
  • These patients are candidates for combined treatment.
  • Modern equipment and meticulous treatment are conditions crucial for the outcome of curative radiotherapy in patients with Hodgkin's disease.
  • Combination chemotherapy is very effective in the treatment of relapse following the primary radiotherapy.
  • [MeSH-major] Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Child. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Female. Humans. Male. Mechlorethamine / administration & dosage. Middle Aged. Neoplasm Staging. Prednisone / administration & dosage. Procarbazine / administration & dosage. Retrospective Studies. Survival Analysis. Treatment Outcome. Vinblastine / administration & dosage. Vincristine / administration & dosage

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  • (PMID = 10985481.001).
  • [ISSN] 0028-2685
  • [Journal-full-title] Neoplasma
  • [ISO-abbreviation] Neoplasma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] SLOVAKIA
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 35S93Y190K / Procarbazine; 50D9XSG0VR / Mechlorethamine; 5J49Q6B70F / Vincristine; 5V9KLZ54CY / Vinblastine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; COPP protocol; MOPP protocol; VBA protocol
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12. MacKenzie RG, Franssen E, Wong R, Sawka C, Berinstein N, Cowan DH, Senn J, Poldre P: Risk-adapted therapy for clinical stage I-II Hodgkin's disease: 7-years results of radiotherapy alone for low-risk disease, and ABVD and radiotherapy for high-risk disease. Clin Oncol (R Coll Radiol); 2000;12(5):278-88
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  • [Title] Risk-adapted therapy for clinical stage I-II Hodgkin's disease: 7-years results of radiotherapy alone for low-risk disease, and ABVD and radiotherapy for high-risk disease.
  • Treatment outcomes were documented for 204 adult patients with clinical Stage I-II Hodgkin's disease who were treated with risk-adapted ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) and radiotherapy (RT) at the Toronto-Sunnybrook Regional Cancer Centre between 1984 and 1994.
  • Forty-nine patients with clinical Stage I disease (excluding bulky mediastinal presentations) and 50 patients with a combination of clinical Stage IIA disease, age 50 years or less, and favourable pathology (lymphocyte predominant or nodular sclerosing histology) were identified as low risk and treated with RT alone to 35 Gy.
  • One hundred and five high-risk patients were treated with chemotherapy (86 with ABVD) followed by RT to 25 Gy.
  • The 7-year cause-specific, overall and disease-free survivals were 95%, 90% and 75% respectively for the low-risk cohort, and 91%, 90% and 88% respectively for the high-risk cohort.
  • Sixteen of 24 (67%) patients with RT failure and 6/14 (43%) with combined modality therapy (CMT) failure were salvaged.
  • Twenty-eight per cent of the patients treated with RT and 21% of those treated with CMT developed hypothyroidism by 7 years.
  • Septic death and second malignancy accounted for the majority of treatment-related fatalities.
  • Risk-adapted therapy emphasizing RT alone for selected patients with favourable prognostic factors and CMT based on ABVD provides excellent long-term disease control.
  • Further treatment refinements, including the wider application of CMT with lower doses of chemotherapy and RT, will be required to reduce the rate of fatal complications to more acceptable levels.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / drug therapy. Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adult. Bleomycin / administration & dosage. Cause of Death. Combined Modality Therapy. Dacarbazine / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Risk Factors. Salvage Therapy. Treatment Outcome. Vinblastine / administration & dosage

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  • (PMID = 11315710.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin; ABVD protocol
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13. Dunleavy KM, Butrynski J, Steinberg S, Grant N, White T, Jaffe ES, Wilson WH: Phase II study of EPOCH infusional chemotherapy in relapsed or refractory Hodgkin's lymphoma (HL). A report on toxicity, efficacy and prognostic indicators of outcome. J Clin Oncol; 2004 Jul 15;22(14_suppl):6598

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  • [Title] Phase II study of EPOCH infusional chemotherapy in relapsed or refractory Hodgkin's lymphoma (HL). A report on toxicity, efficacy and prognostic indicators of outcome.
  • : 6598 Background: In relapsed/refractory HL, an effective and well tolerated salvage regimen has important roles both prior to autologous stem cell transplant (SCT) and as palliative therapy in patients (pts) who are ineligible for or have failed SCT.
  • Pts received fixed dose EPOCH chemotherapy (etoposide 200 mg/m<sup>2</sup>, vincristine 1.6 mg/m<sup>2</sup> (no cap) and doxorubicin 40 mg/m<sup>2</sup> CIVI x 96-hrs D1-4; cyclophosphamide 750 mg/m<sup>2</sup> IV D5 and prednisone 60 mg/m<sup>2</sup> qd D1-6 ) with G-CSF q21 days until disease progression or stabilization over ≥ 2 cycles.
  • Histology included nodular sclerosis 34 (64%), mixed cellularity 3 (25%), and lymphocyte depleted 5 (9%) classical HL, and nodular lymphocyte predominant HL 1 (2%).
  • 24 (45%) pts had had ≥ 2 prior regimens, 27 (51%) pts received chemotherapy within the previous 10 mos, and 40 (75%) pts had responded to their last treatment.
  • There was one treatment related death.
  • With a median follow-up of 68 mos, the median progression-free (PFS) and overall survivals (OS) are 10 and 40 mos, and at 68 mos median follow-up, PFS and OS are 21% and 41%.
  • Multivariate analysis revealed that the no. of prior drugs and response to the preceding regimen significantly influenced OS and PFS; in addition PFS was significantly influenced by performance status and mos since previous chemotherapy.
  • It should be considered as salvage therapy prior to SCT or for palliation in incurable HL.

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  • (PMID = 28016222.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Hull MC, Mendenhall NP, Colgan ME: Subdiaphragmatic Hodgkin's disease: the University of Florida experience. Int J Radiat Oncol Biol Phys; 2002 Jan 1;52(1):161-6
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  • [Title] Subdiaphragmatic Hodgkin's disease: the University of Florida experience.
  • PURPOSE: To assess the long-term outcomes and late effects of patients with subdiaphragmatic Hodgkin's disease.
  • METHODS AND MATERIALS: Twenty-one patients with Stage I and II subdiaphragmatic Hodgkin's disease were treated with curative intent between February 1966 and February 1998 at the University of Florida.
  • Patient characteristics were as follows: mean age, 38.7 years (range, 3-75 years); 20 males and 1 female; 33% lymphocyte predominant, 43% nodular sclerosing, 14% mixed cellularity, 5% lymphocyte depletion, and 5% unclassified Hodgkin's disease.
  • Treatment included inverted Y irradiation (InY) (8 patients), total nodal irradiation (TNI) (7 patients), and combined modality irradiation and chemotherapy (CMT) (6 patients).
  • There were no deaths from Hodgkin's disease.
  • Treatment failures occurred in 1 of 8 patients after InY, 1 of 7 after TNI, and 1 of 6 after CMT.
  • There were 5 second malignant neoplasms and 3 cardiac events, including 4 second malignant neoplasms and 2 cardiac events in the 9 patients > or =40 years old at diagnosis and 1 second malignant neoplasm and 1 cardiac event in the 12 patients <40 years old.
  • All 3 second solid malignancies in this study occurred 7-14 years after treatment in areas receiving 10-20 Gy.
  • CONCLUSIONS: Subdiaphragmatic Hodgkin's disease is an uncommon manifestation with excellent disease control achieved with InY, TNI, and CMT.
  • This subgroup of patients with Hodgkin's disease is predominantly male and older than subgroups with other presentations, which may predispose the group to a higher risk for serious adverse events after treatment.
  • We recommend InY with spleen for clinical Stages IA and nodular sclerosis or lymphocyte-predominant clinical Stage IIA, InY alone for pathologic Stages IA and IIA, and CMT for all Stage I/II patients with greater than three involved sites, B symptoms, bulky disease (>6 cm), central (para-aortic) presentation, or splenic involvement.
  • [MeSH-major] Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Diaphragm. Disease-Free Survival. Female. Florida. Follow-Up Studies. Humans. Inguinal Canal. Male. Mechlorethamine / administration & dosage. Middle Aged. Myocardial Infarction / etiology. Neoplasm Staging. Prednisone / administration & dosage. Procarbazine / administration & dosage. Vincristine / administration & dosage

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  • (PMID = 11777634.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 35S93Y190K / Procarbazine; 50D9XSG0VR / Mechlorethamine; 5J49Q6B70F / Vincristine; VB0R961HZT / Prednisone; MOPP protocol
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15. Schwartz CL: Special issues in pediatric Hodgkin's disease. Eur J Haematol Suppl; 2005 Jul;(66):55-62
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  • [Title] Special issues in pediatric Hodgkin's disease.
  • Childhood Hodgkin's disease (HD) is not a biologically unique disease; it differs from adult HD primarily in the relative incidence of disease histology.
  • Preadolescent children are more likely to have Mixed Cellularity and nodular lymphocyte predominant HD.
  • Adolescent and young adult HD is indistinguishable, with a predominance of nodular sclerosing (NS) HD.
  • Nonetheless, treatment paradigms have diverged over the years as pediatric oncologists responded first to developmental issues in the young child, and later to the long-term treatment consequences in all young survivors.
  • The increasing convergence of treatment approaches in the past decade is therefore most appropriate.
  • Reproductive potential, risk of secondary malignancy and cardiopulmonary consequences of therapy have driven the pediatric treatment paradigm of care.
  • Chemotherapy with low dose, limited field radiation is standard, with low-stage patients often treated by chemotherapy alone.
  • Algorithms tailor therapy to response.
  • The prognostic importance of very early chemotherapy response rather than end-of-chemotherapy response has led the Children's Oncology Group to use early response (after 6 wk) to titrate individual therapy and dense regimens to maximize the early response rates.
  • Although the dose dense regimens of adult groups are similar, the pediatric algorithms emphasize using the enhanced efficacy to limit cumulative therapy.
  • This review intends to address the special issues of childhood HD, with the intent of further encouraging understanding that will foster convergence of pediatric and adult treatment paradigms.
  • [MeSH-major] Hodgkin Disease / pathology. Hodgkin Disease / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / standards. Child. Child, Preschool. Combined Modality Therapy / adverse effects. Combined Modality Therapy / standards. Humans. Infant. Infant, Newborn. Radiotherapy / adverse effects. Radiotherapy / standards

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  • (PMID = 16007870.001).
  • [ISSN] 0902-4506
  • [Journal-full-title] European journal of haematology. Supplementum
  • [ISO-abbreviation] Eur J Haematol Suppl
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 80
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16. Itami J: [Hodgkin lymphoma]. Nihon Igaku Hoshasen Gakkai Zasshi; 2002 Apr;62(5):215-20
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  • [Title] [Hodgkin lymphoma].
  • In the newly published WHO classification for tumors of the hematopoietic and lymphoid tissues, Hodgkin's disease has been renamed Hodgkin lymphoma, which reflects the recent confirmation of its germinal center B-cell origin.
  • In the classification, nodular lymphocyte-predominant Hodgkin lymphoma has been added as a new entity with an excellent prognosis.
  • For management of the disease, a risk-adapted classification is employed without staging laparotomy.
  • Multimodality therapy with chemo- plus radiotherapy can improve disease-free survival, but overall survival remains unchanged.
  • In advanced stages, chemotherapy plays a decisive role, with radiation therapy used as an adjuvant for bulky and/or slowly responding tumors.
  • Long-term follow-up of cured Hodgkin patients has revealed increased incidences of solid malignancies and ischemic heart disease more than 15 years after therapy.
  • Breast cancer and ischemic heart disease appear to be related to mantle irradiation, although sophisticated modern radiation therapy techniques are demonstrated to lower the incidence of these long-term morbidities.
  • Meticulous radiation therapy remains the most effective tool for local control of Hodgkin lymphoma.
  • [MeSH-major] Evidence-Based Medicine. Hodgkin Disease / radiotherapy

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  • (PMID = 12043226.001).
  • [ISSN] 0048-0428
  • [Journal-full-title] Nihon Igaku Hōshasen Gakkai zasshi. Nippon acta radiologica
  • [ISO-abbreviation] Nihon Igaku Hoshasen Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 28
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