A large-scale study of bone marrow involvement in patients with Hodgkin's lymphoma.

This study was designed to identify variables that can predict bone marrow involvement (BMI) in Hodgkin's lymphoma (HL), and to analyze the benefit of bilateral over unilateral bone marrow trephine biopsy (BMB). From 1982 to 2000, BMB had been performed at diagnosis in 1161 patients with HL who had been followed from the institutions participating in the Piemonte Hodgkin's Disease Registry. Six hundred and sixteen patients (53%) had received bilateral BMB, and the remaining 545 patients (47%) received unilateral BMB. The relationships between BMB results and other clinical features were retrospectively studied with both univariate and multivariate analyses. Ninety-two patients (8%) showed BMI: 51 of them were staged with bilateral and 41 with unilateral BMB. Among the 92 patients with BMI, a second extranodal involvement was present in only 25 patients (27%). In multivariate analysis, the 5 independent factors that predicted for BMI were B symptoms, infradiaphragmatic involvement, mixed cellularity (MC) and lymphocyte depleted (LD) histology, involvement of > or = 4 lymphatic areas, and liver involvement. The probability of BMI according to the presence of these variables was distributed as follows: 0.3%, 2.5%, 7.6%, and 27% in patients positive for 0, 1, 2, and > or = 3 factors, respectively. Among 51 patients staged with bilateral BMB, BMI was shown in both specimens in 33 cases (65%), whereas the positivity was limited to only 1 of the 2 specimens in the remaining 18 cases (35%). A score based on 5 variables can predict the probability of BMI, and BMB could be avoided in patients with a score of 0 and a probability of BMI of < 0.5%. When BMB is needed, the superiority of bilateral over unilateral biopsy is suggested.

[The "Valle Belbo Project" for the prevention of ischemic heart disease: study design and correlations between alcohol and cardiovascular risk factors]. / Il "Progetto Valle Belbo" per la prevenzione della cardiopatia ischemica: disegno dello studio e correlazioni tra alcool e fattori di rischio cardiovascolare.

BACKGROUND: The "Valle Belbo Project" is a primary prevention study on ischemic heart disease, aiming at identifying cardiovascular risk factors. Detailed data about the amount and kind of alcohol beverages used were assessed, too. The aims of the present study were to evaluate the prevalence of cardiovascular risk factors, and the relationships between alcohol and these factors. METHODS: The study enrolled 3123 subjects, aged 20-65 years. Data about consumption of alcoholic drinks (amount and kind of beverages), smoking habits, physical activity during work, clinical and drug history were collected; height, weight, arterial blood pressure, fasting glycemia, and total cholesterol were also measured. RESULTS: About 57% of the subjects consumed alcoholic drinks, mostly < 30 g/day (84%) and red wine only (80%). Prevalence of overweight/obesity, hypertension, hyperglycemia, hypercholesterolemia increased with higher amounts of alcohol consumed. A > 30 g/day alcohol use was independently associated with hypertension (odds ratio-OR 1.48, p = 0.03), hyperglycemia (OR 1.62, p = 0.02) overweight/obesity (OR 1.64, p = 0.003), and hypercholesterolemia (OR 1.69, p = 0.001) in a multiple logistic regression model, after multiple adjustments. A < 30 g/day red wine use was negatively correlated with hyperglycemia (OR 0.54, p < 0.0001) and overweight/obesity (OR 0.71, p = 0.002) with respect to consumption of higher or other kinds of alcoholic beverages in the same model. CONCLUSIONS: Differently from heavy drinkers, < 30 g/day red wine drinkers are less frequently affected by overweight/obesity and hyperglycemia. Follow-up of these subjects may determine the role of alcohol effects in the incidence of ischemic heart disease.