[Chemotherapy of non-Hodgkin's lymphomas]. / Chemotherapie der Non-Hodgkin-Lymphome.

Guidelines for the treatment of non-Hodgkin's lymphoma are laid down in this paper. Low-grade lymphomas diagnosed at an early stage be cured by adequate extended field radiotherapy, although this is a rare occurrence. Advanced stages are treated only on progression of the disease, whereby these measures can merely be regarded as palliative. Lymphomas of high-grade malignancy should be treated by massive chemotherapy from the very beginning, with additional supportive therapy for any complications which may arise, as necessary. After full remission has been achieved by means of chemotherapy, radiotherapy is applied to the previously worst-affected areas. This strategy aims at cure, as in the case of the acute leukaemias, although it is only very rarely successful. It is becoming increasingly possible to achieve remissions through applying various chemotherapeutic regimens, but the question of optimum maintenance therapy, both with regard to type and duration is still unsettled and urgently requires elucidation.

[Alcohol and changes in the hematopoietic system; an epidemiological contribution to the problem of alcoholic anemia]. / Alkohol und Veränderungen des hämatopoetischen Systems; ein epidemiologischer Beitrag zur Frage der Alkoholanämie.

In the course of the "Vienna Health Study 1979" 1261 males and 1548 females divided into 3 age categories (25, 40 and 60 years), were investigated for serum iron level, RBC, leucocytes, haemoglobin, haematocrit, MCH, MVC, MCHC, GOT, GPT and AP. These parameters were evaluated in correlation to the drinking habits of each proband. Significant correlations were found between alcohol consumption and serum iron (elevation in most cases), RBC (decrease), MCV (elevation) and GOT (elevation).

[Clinical relevance of the Kiel classification of non-Hodgkin's lymphomas (author's transl)]. / Zur klinischen Relevanz der Kieler Klassifikation von Non-Hodgkin-Lymphomen.

The Kiel classification of non-Hodgkin's lymphomas, based on morphological, cytochemical and functional criteria, differentiates between lymphomas of low-grade malignancy and high-grade malignancy, which are themselves subdivided into several distinct entities. The probability of survival, the symptomatology and some important laboratory parameters are described in 138 cases of malignant non-Hodgkin's lymphomas, classified according to the Kiel classification. The results show that this classification has not only prognostic and clinical relevance, but also explains some uncommon clinical courses of malignant lymphomas. It is to be hoped that this classification will also promote further progress in therapy.

[A questionnaire suitable for general practice for detection of the health status and quality of life of patients with hemato-oncologic diseases: psychometric properties. The Study G "Quality of Life" of the International Society for Chemo- and Immunotherapy (I.G.C.I.)]. / Ein praxisgerechter Fragebogen zur Erfassung von Gesundheitsqualität und Lebensqualität bei Patienten mit hämato-onkologischen Erkrankungen: psychometrische Eigenschaften. The Study Group "Quatify of Life" of the International Society for Chemo- and Immunotherapy (I.G.C.I.).

In the evaluation of therapeutic measures it is important to consider the consequences of the proposed treatment on the subjective quality of health and the subjective quality of life. Since no adequate instrument existed to provide such assessments, a short, theoretically based questionnaire was developed and psychometrically tested. The construction phase was based on data of 104 adults with haemato-oncological diseases, leading to the design of a questionnaire which was tested using data of a further 292 patients. The validity of the "questionnaire for attitudes towards quality of health and quality of life" was assessed by comparing it with physicians' ratings and by correlation with the results of an extensive questionnaire. The reliability was satisfactory; the questionnaire met with high acceptance by patients, physicians and health care personnel. It complies with the requirements of clinical trials where the objective is to measure quality of health and quality of life.

[New polymerase gene in pancytopenia (author's transl)]. / Reverse Transkriptase in der Differentialdiagnose leukämischer Erkrankungen

Increasing evidence has accumulated that the direct assay of reverse transcriptase in human blood cells is of value in the diagnosis of leukaemia. The isolation and characterization of this enzyme has shown that it possesses remarkable similarities to the DNA-polymerase of the RNA-tumour virus of simian sarcoma. Hence, leukaemic cells in humans are thought to possess a virus-related gene, namely, reverse transcriptase. Various clinical reports have established the presence of this enzyme in blood cells, not only in the case of morphologically-proven malignant change, but also in cases classified as non-leukaemic from the morphological picture, such as acute leukaemia in remission and in the pre-leukaemic state. In confirmation and augmentation of earlier views we now report on the presence of reverse transcriptase in a patient with pancytopenia, who subsequently developed acute leukaemia i.e. isolation of the enzyme occurred in the pre-leukaemic state.

[Anemias resulting from iron metabolism disorders]. / Anämien durch Störungen im Eisenstoffwechsel.

For the most part iron deficiency, but also disturbances of distribution, transport and utilization of iron, are able to cause anemias. To understand the origin of such anemias, firstly iron metabolism, then the clinical symptomatology as well as the laboratory parameters necessary for diagnosis and finally the usual therapies are described.

Chemotherapy of malignant lymphomas.

In malignant lymphomas generally, radiotherapy is the treatment of choice. Chemotherapy cannot be very effective in lymphomas of the CNS because most of the cytostatic drugs in question are not able to pass the blood-brain barrier. But in cases in which malignant lymphomas are disseminated throughout the body including the CNS, cytostatic chemotherapy is the only means of prolonging the life of the patient. In such cases one has to distinguish between Hodgkin's disease and non-Hodgkin lymphomas. Alkylating agents, metaphase inhibitors and antibiotics are used in the treatment of malignant lymphomas. The best results are achieved with combination schedules. In Hodgkin lymphomas the so-called MOPP-schedule is the most effective. In non-Hodgkin lymphomas the same drugs are ususally given without procarbacine. After having achieved a remission, maintenance therapy is very important. Vinblastine and Chlorambuzil are able to prolonge the remission. When resistance to these drugs occurs Bleomycin, Adriamycin, CCNU and Peptichemio are effective agents. The results as well as the side effects of such regimens are described.

[Clinical aspects and therapy of iron deficiency]. / Klinik und Therapie des Eisenmangels.

Iron deficiency and iron deficiency anemias are very common disturbances of the hematopoiesis. Although symptomatology and therapeutic possibilities are well known, one should keep in mind that iron deficiency is a symptom and not a diagnosis. The causes of iron deficiency are iron loss, malabsorption and insufficient supply. The best therapy is peroral treatment with well absorbable preparations, whereby the bioavailability has to be taken into consideration. Only in few cases a parenteral therapy which has more side effects is necessary. A overview about the possible therapy is given.

[A clinical study of the non-Hodgkin's lymphomas according to the Kiel classification (author's transl)]. / Klinik der Nicht-Hodgkin-Lymphome nach der Kieler Klassifikation.

A study of 138 patients with Non-Hodgkin's lymphomas was performed. The results were compared with retro- and prospective investigations of patients of the Kiel lymphoma study group. The aim of the study is to evaluate the value of the Kiel classification for the therapy and prognosis of malignant lymphomas. The malignant lymphomas of low- and high-grade malignancy differ significantly in their biological behaviour. Especially the clinical progress of the disease and the response to therapy are different. The lymphomas of low-grade malignancy may not need any treatment for long periods in some patients. In contrary, patients with lymphomas of high-grade malignancy need an active treatment immediately after the establishment of the diagnosis. In stages I and II radiotherapy is sufficient, in stages III and IV chemotherapeutic regimens are necessary. Each type of malignant lymphoma may be accompanied by leukemia. Most of the malignant lymphomas, particularly the immunocytomas, may produce monoclonal gammopathies, most of them being macroglobulinemias. Thus the macroglobulinemia Waldenström is just a clinical necessary to evaluate the significance of the subtypes of the Kiel classification for the planning of specific treatment.