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2.
Med. clín (Ed. impr.) ; 151(1): 39.e1-39.e17, jul. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-173748

RESUMO

La incidencia de linfoma no hodgkiniano y linfoma de Hodgkin es mayor en pacientes con infección por el VIH que en la población general. Tras la introducción del tratamiento antirretroviral de combinación (TARc) ha disminuido la importancia pronóstica de variables relacionadas con el VIH, adquiriendo mayor peso factores relacionados con el linfoma. Actualmente, los tratamientos de los linfomas en pacientes infectados por VIH no difieren de los empleados en la población general. Pero existen algunos aspectos diferenciales de los pacientes con VIH como la necesidad de TARc, de profilaxis y de tratamientos de algunas infecciones oportunistas. En este documento se actualizan las recomendaciones sobre el diagnóstico y el tratamiento de los linfomas en pacientes infectados por VIH publicadas por GESIDA/PETHEMA en 2008


The incidence of non-Hodgkin's lymphoma and Hodgkin's lymphoma is higher in patients with HIV infection than in the general population. Following the introduction of combination antiretroviral therapy (cART), the prognostic significance of HIV-related variables has decreased, and lymphoma-related factors have become more pronounced. Currently, treatments for lymphomas in HIV-infected patients do not differ from those used in the general population. However, differentiating characteristics of seropositive patients, such as the need for cART and specific prophylaxis and treatment of certain opportunistic infections, should be considered. This document updates recommendations on the diagnosis and treatment of lymphomas in HIV infected patients published by GESIDA/PETHEMA in 2008


Assuntos
Humanos , HIV/imunologia , Linfoma não Hodgkin/diagnóstico , Doença de Hodgkin/diagnóstico , Linfoma não Hodgkin/tratamento farmacológico , Doença de Hodgkin/tratamento farmacológico , Linfoma Relacionado a AIDS , Antirretrovirais/antagonistas & inibidores , Quimioterapia Combinada/métodos
4.
Farm. hosp ; 42(1): 20-21, ene.-feb. 2018.
Artigo em Espanhol | IBECS | ID: ibc-169909

RESUMO

Caso clínico: Mujer de 58 años que presenta una recidiva de un linfoma difuso de células B grandes a nivel intraocular. Inicia tratamiento con rituximab intravítreo (1 mg/0,1 ml) con pauta semanal durante 4 semanas. Tras 12 meses de la última administración de rituximab intravítreo no se observan lesiones compatibles con linfoma ni reacciones adversas asociadas a su administración. Discusión: El rituximab intravítreo ha resultado efectivo y seguro para el tratamiento de la recaída del linfoma no Hodgkin a nivel intraocular, induciendo su remisión completa y resultando ser una buena alternativa respecto a otras opciones terapéuticas con mayor número de reacciones adversas graves (AU)


Clinical case: A 58-year-old woman with intraocular relapse of a diffuse large B cell lymphoma. Weekly intravitreal rituximab (1 mg/0.1 ml) for 4 weeks were administered. 12 months after the last intravitreal rituximab dose, signs and symptoms of lymphomas or adverse reactions associated with intravitreal Rituximab administration were not observed. Discussion: Intravitreal rituximab is an effective and safe treatment of intravitreal lymphoma, by inducing complete remission; it could be a good alternative to other therapeutic options with greater number of serious complications (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Hodgkin/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Rituximab/uso terapêutico , Neoplasias da Retina/tratamento farmacológico , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Metotrexato/uso terapêutico , Corticosteroides/uso terapêutico , Nervo Óptico , Nervo Óptico/efeitos da radiação , Aciclovir/uso terapêutico , Citarabina/uso terapêutico
5.
Rev. clín. med. fam ; 11(1): 28-30, feb. 2018.
Artigo em Espanhol | IBECS | ID: ibc-171573

RESUMO

Presentamos el caso de una mujer de 72 años con antecedente de linfoma de Hodgkin B difuso hace 5 años, tratado con antraciclinas, con remisión completa del cuadro, a la que se le realizó ecocardiogramas de control durante 2 años, sin observarse alteración cardiaca. Consulta por disnea y nicturia. Ante el cuadro que refería y el antecedente del uso de antraciclinas se deriva al Servicio de Cardiología, donde se le realizaron pruebas que objetivaron miocardiopatía dilatada con marcada disminución de la fracción de eyección. Llamamos la atención sobre los efectos secundarios tardíos de este quimioterápico que, debido a la mayor supervivencia del cáncer, vamos a observar con mayor frecuencia cada vez, por lo que los médicos de familia deben conocer y sospecharlos (AU)


We present the case of a 72-year-old woman with a history of diffuse Hodgkin’s lymphoma 5 years ago, treated with anthracyclines with complete remission of the disease, who underwent control echocardiograms during 2 years without any cardiac abnormalities. She consults for dyspnea and nocturia. In view of these symptoms and the history of anthracycline use, she was referred to the cardiology department where tests showed dilated cardiomyopathy with markedly decreased ejection fraction. Attention should be drawn to the late side effects of this chemotherapy which, due to increased survival of cancer patients, will appear more frequently and should therefore be known and suspected by general practitioners (AU)


Assuntos
Humanos , Feminino , Idoso , Antraciclinas/efeitos adversos , Cardiotoxicidade/diagnóstico , Cardiomiopatia Dilatada/induzido quimicamente , Doença de Hodgkin/tratamento farmacológico , Efeitos Adversos de Longa Duração/diagnóstico , Diagnóstico Diferencial , Antineoplásicos/toxicidade
6.
Med. clín (Ed. impr.) ; 150(3): 104-106, feb. 2018.
Artigo em Espanhol | IBECS | ID: ibc-171484

RESUMO

Fundamento y objetivo: Comparar la biopsia de médula ósea (BMO) y la PET/CT en la detección de la afectación medular en el linfoma de Hodgkin. Material y métodos: Análisis retrospectivo de 65 pacientes con realización de ambas pruebas en la estadificación inicial o en recaída con especial atención al patrón de la PET/CT. Resultados: En 3 pacientes (4,6%) la BMO mostró afectación medular, siendo la PET/CT positiva en todos ellos: 2 con patrón difuso+multifocal y uno solo difuso. En 11 pacientes más (total 14/65, 21%) se estimó que había afectación medular ósea por PET/CT al tener un consumo de médula ósea superior al hepático. El patrón fue focal único en 2 casos, multifocal en 5, difuso en 3 casos y difuso+multifocal en uno. En estos últimos 4 casos la BMO mostró una mielopatía inespecífica. Conclusiones: La PET/CT detecta todos los casos con BMO afectada y muchos que se escapan a la biopsia; sin embargo, cuando el patrón de captación es difuso puede ser por afectación o por hiperplasia reactiva y en esos casos debería mantenerse la BMO (AU)


Background and objectives: To compare bone marrow biopsy (BMB) and PET/CT in detecting bone marrow involvement in Hodgkin's lymphoma. Material and methods: Retrospective analysis of 65 patients with both tests in the initial staging or in relapse with special attention to the PET/CT uptake pattern. Results: In 3 patients (4.6%), the BMB showed bone marrow involvement with the PET/CT being positive in them all: 2 with diffuse+multifocal pattern and one diffuse only. In 11 additional patients (total 14/65, 21%), bone marrow involvement was diagnosed by PET/CT because bone marrow uptake was above hepatic one. The pattern was focal only in 2 cases, multifocal in 5, diffuse in 3 and diffuse+multifocal in one. In these last 4 cases the BMB showed an unspecific myelopathy. Conclusions: PET/CT detects all cases with BMB affected and many that escape to biopsy, however when the uptake pattern is diffuse it could be by involvement or reactive hyperplasia and in those cases the BMB should be done (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/cirurgia , Medula Óssea/cirurgia , Biópsia , Doenças da Medula Espinal/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Estudos Retrospectivos , Análise Estatística
8.
An. sist. sanit. Navar ; 40(3): 461-466, sept.-dic. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-169782

RESUMO

El Síndrome de Horner (SH) es un síndrome neurológico que se caracteriza por la triada miosis pupilar incompleta, ptosis palpebral y anhidrosis facial debido a la lesión de la vía oculosimpática, compuesta por tres neuronas, desde el hipotálamo hasta el ojo. Identificar su causa representa un reto diagnóstico ya que, a pesar de su aparente levedad clínica, el SH puede ser la primera o única manifestación de un trastorno grave o incluso potencialmente mortal. Presentamos el caso de un paciente varón de 19 años con una historia de molestias oculares inespecíficas de dos meses de evolución. Acudió a la consulta de urgencias de Oftalmología en la que fue diagnosticado de un SH como primera manifestación clínica de linfoma de Hodgkin (AU)


Horner’s Syndrome (HS) is a neurological síndrome characterised by the triad incomplete pupillary miosis, palpebral ptosis and facial anhidrosis, due to a lesión of the oculosympathetic pathway, formed of three neurons from the hipothalamus to the eye. Identifying its cause is a diagnostic challenge since in spite of its apparent lack of clinical importance, HS can be the first or only manifestation of a serious, or even potentially mortal disorder. We present the case of a 19-year-old male patient with a history of nonspecific ocular pains of two months evolution. He attended the emergency ophthalmological clinic where he was diagnosed with an HS as the first clinical manifestation of Hodgkin lymphoma (AU)


Assuntos
Humanos , Masculino , Adulto Jovem , Síndrome de Horner/complicações , Doença de Hodgkin/diagnóstico , Conjuntivite Alérgica/diagnóstico , Diagnóstico Diferencial , Hiperidrose/etiologia , Blefaroptose/etiologia
11.
Reumatol. clín. (Barc.) ; 12(5): 282-284, sept.-oct. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-155879

RESUMO

Los síndromes paraneoplásicos pueden presentarse de múltiples maneras, dentro de las cuales destacan las manifestaciones endocrinológicas, reumatológicas, hematológicas y nefrológicas. Si bien la mayoría de las publicaciones describen los tumores sólidos como responsables de dichos cuadros, las neoplasias hematológicas son causa importante a considerar como parte del diagnóstico diferencial. Se presenta el caso de un varón de 46 años con un cuadro de poliartritis simétrica seronegativa de grandes y pequeñas articulaciones, asociado a glomerulonefritis membranoproliferativa con depósitos de inmunocomplejos y deterioro agudo de la función renal, como parte de un síndrome paraneoplásico secundario a un linfoma de Hodgkin clásico con invasión medular, el cual revirtió completamente con el tratamiento de quimioterapia (AU)


Paraneoplastic syndromes can be presented in multiple ways, which include endocrinological, hematologic, rheumatologic and nephrologic manifestations. While most of the publications described solid tumors as responsible for these manifestations, hematologic neoplasms are important cause to consider as part of the differential diagnosis. We report the case of a 46 year-old man with seronegative symmetric polyarthritis of large and small joints associated with membranoproliferative glomerulonephritis with deposits of immune complexes and acute impairment of renal function, as part of a paraneoplastic syndrome secondary of a classical Hodgkin lymphoma with bone marrow invasion, which reversed completely with chemotherapy treatment (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Artrite/complicações , Artrite/diagnóstico , Artrite/tratamento farmacológico , Glomerulonefrite/complicações , Glomerulonefrite/tratamento farmacológico , Doença de Hodgkin/complicações , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/patologia , Diagnóstico Diferencial , Doxorrubicina/uso terapêutico , Febre/complicações , Pancitopenia/diagnóstico , Pancitopenia/terapia , Bleomicina/uso terapêutico , Vimblastina/uso terapêutico
13.
Metas enferm ; 19(8): 71-76, oct. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-156919

RESUMO

Caso clínico de una paciente de 49 años de edad, con oligofrenia y diagnosticada de linfoma de Hodgkin en estado avanzado. El avance de la enfermedad, junto con la situación familiar actual, ha provocado la aparición de un afrontamiento familiar comprometido. Dado que la enfermedad está en progresión se decide incluir a la paciente en el proceso de cuidados paliativos, con un nivel de complejidad media. La paciente, portadora de un catéter venoso central con reservorio subcutáneo (Port-A-Cath®), precisa extracciones sanguíneas continuas, así como transfusiones de repetición. El seguimiento es llevado a cabo tanto por el equipo de cuidados paliativos domiciliarios como por el Servicio Hospitalario de Hematología y el equipo de Atención Primaria (enfermera gestora de casos, enfermera y médico de familia). Puesto que son múltiples los profesionales implicados en este proceso, se precisa de una buena coordinación con el resto de profesionales sanitarios, con el objetivo de que la paciente reciba todos los cuidados necesarios y de que lleve una vida lo más digna posible y libre de sufrimiento


A clinical case of a 49-year-old female patient, mentally handicapped and with a diagnosis of advanced Hodgkin’s Lymphoma. The progression of the disease, together with the current situation of her family, has led to the development of compromised family coping. Given that the disease is progressing, it is decided to include the patient in the palliative care process, with an intermediate level of complexity. The patient has a central venous catheter with subcutaneous reservoir (Port-A-Cath®), requires continuous blood extractions, and also repeat transfusions. Follow-up is conducted by the Home Palliative Care Team as well as by the Hospital Haematology Department and the Primary Care team (nurse case manager, nurse, and GP). The involvement of multiple healthcare professionals in this process requires good coordination between all of them, with the objective of providing all necessary care to the patient, so that she can lead a life as dignified as possible and free of suffering


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Cuidados Paliativos na Terminalidade da Vida/organização & administração , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/organização & administração , Doença de Hodgkin/enfermagem , Relações Profissional-Família , Atenção Primária à Saúde/métodos , Adaptação Psicológica , Assistência Integral à Saúde/organização & administração , Equipe de Assistência ao Paciente/organização & administração
15.
An. pediatr. (2003. Ed. impr.) ; 84(3): 154-162, mar. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-147740

RESUMO

Introducción: Ocasionalmente, los pediatras, sobre todo los de Atención Primaria, alertan de la presencia de pequeños agrupamientos de casos de cáncer pediátrico (CP) y con frecuencia sus expectativas se ven frustradas al aplicar los métodos estadísticos. El estudio de áreas pequeñas en epidemiología espacial ha permitido realizar algunos avances en la identificación de clústeres y de los factores de riesgo medioambientales implicados. El objetivo de este trabajo es describir la incidencia del CP y la distribución espacial a nivel de sección censal, así como presentar el primer mapa urbano municipal de CP de España. Material y métodos: Estudio descriptivo de base poblacional, por sexo, grupos de edad, subperiodos y tipo tumoral de los casos de CP diagnosticados en menores de 15 años, entre 1998 y 2013 en el municipio de Murcia. Georreferenciación de casos en el momento del diagnóstico y análisis de clústeres espaciales y espacio-temporales a nivel de sección censal mediante los estadísticos FleXScan y SatScan. Resultados: Un total de 155 casos fueron diagnosticados. La incidencia global (138 por millón de niños menores de 15 años) y por tipos tumorales está dentro de los márgenes de referencia del área europea. Identificación de un clúster espacio-temporal de linfomas de Hodgkin. Conclusiones: El análisis de áreas pequeñas de los casos diagnosticados de CP es una herramienta útil para identificar clústeres de casos que permita plantear hipótesis sobre las causas que originan la enfermedad y desarrollar modelos urbanos de vigilancia ambiental del cáncer infantil (AU)


Introduction: Occasionally, primary care pediatricians notice the presence of small clusters of pediatric cancer (PC), but are often frustrated by the findings after statistical analysis. The study of small areas in spatial epidemiology has led to advances in identifying clusters and the environmental risk factors involved. The purpose of this study was to describe the PC incidence and the spatial distribution at the minimum level of disaggregation possible in Murcia, presenting the first urban municipality map of PC in Spain. Materials and methods: A population-based descriptive study was conducted on the PC cases diagnosed in children younger than 15 years, between 1998 and 2013 in the municipality of Murcia. Cases were classified by sex, age group, and tumor type. Coordinates of home addresses at the time of diagnosis were assigned to each case, and spatial and spatio-temporal analyses were carried out at the level of census tracts, using FleXScan and SatScan. Results: A total of 155 cases of PC were diagnosed during this period. The overall incidence of PC (138/106 of children under the age of 15) and the incidence for individual tumor types were within the expected ranges for Europe. A spatio-temporal cluster of Hodgkin lymphoma was identified. Conclusions: Small area analysis of PC cases may be a useful tool for the identification of PC clusters, which would allow for the generation of hypotheses regarding disease etiology, as well as developing urban models for environmental surveillance of PC (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Neoplasias/epidemiologia , Neoplasias/prevenção & controle , Doença de Hodgkin/epidemiologia , Doença de Hodgkin/prevenção & controle , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Atenção Primária à Saúde , Sobrevivência/fisiologia
16.
Clin. transl. oncol. (Print) ; 18(1): 99-106, ene. 2016. tab, graf
Artigo em Inglês | IBECS | ID: ibc-148058

RESUMO

Purpose. To evaluate the risk factors associated with lung cancer (LC) and other second neoplasms (SN) in Hodgkin lymphoma (HL) survivors. Methods. We retrospectively analyzed the clinical characteristics and outcomes of 604 patients treated in our institution between 1968 and 2012. Results. 90 out of 604 patients developed SN: 27 LC and 63 other SN. The median time elapsed until LC and other SN was 16.5 and 11.8 years, respectively (p = 0.003). In the LC group, 85.5 % of patients were male and 84.6 % smokers (HR 7, 95 % CI 2.4-20.7, p < 0.001). Radiotherapy (RT) doses applied were higher in the SN group with an increased risk of LC (HR: 4.0 95 % CI 1.1-11.6, p = 0.010) and other SN (HR: 3.3 95 % CI 1.6-6.7 p = 0.001) with doses higher than 42 Gy. No association was found between alkylating agents and development of SN. In LC, the most frequent histology was adenocarcinoma with an elapsed time after HL of 13.2 years in early stages and 21.3 in advanced (p = 0.02). Median OS after a diagnosis of LC was 12.6 months ranging from 5.9 (in cases presenting due to symptoms) to 49.1 (incidentally diagnosed cases) (p = 0.005). Conclusions. RT treatment, especially with doses higher than 42 Gy, and smoking increase the risk of SN after HL. In this series, LC patients with early stages had a shorter elapsed time from HL diagnosis and longer OS, therefore the role of LC screening in HL survivors should be prospectively evaluated and smoking cessation counseling ought to be a key aspect during follow-up (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Terapêutica/métodos , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/metabolismo , Fumar/genética , Adenocarcinoma/diagnóstico , Adenocarcinoma/metabolismo , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/terapia , Terapêutica/instrumentação , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Fumar/metabolismo , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Estudos Retrospectivos
17.
Clin. transl. oncol. (Print) ; 17(12): 1005-1013, dic. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-147439

RESUMO

Hodgkin lymphoma (HL) is an uncommon B cell lymphoid malignancy representing approximately 10-15 % of all lymphomas. HL is composed of two distinct disease entities; the more commonly diagnosed classical HL and the rare nodular lymphocyte-predominant HL. An accurate assessment of the stage of disease and prognostic factors that identify patients at low or high risk for recurrence are used to optimize therapy. Patients with early stage disease are treated with combined modality strategies using abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, while those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. Brentuximab vedotin should be considered for patients who fail HDCT with ASCT (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , /normas , Doença de Hodgkin/patologia , Terapêutica/métodos , Linfócitos/citologia , Transplante de Células/métodos , Espanha/etnologia , Doenças Linfáticas/complicações , Doenças Linfáticas/patologia , Linfonodos/metabolismo , Biópsia por Agulha Fina/métodos , Doença de Hodgkin/complicações , Doença de Hodgkin/diagnóstico , Terapêutica/instrumentação , Linfócitos/fisiologia , Transplante de Células/normas , Transplante de Células , Doenças Linfáticas/genética , Linfonodos/anormalidades , Biópsia por Agulha Fina/instrumentação
19.
Rev. esp. patol ; 48(3): 182-189, jul.-sept. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-139264

RESUMO

Hodgkin's lymphoma is characterized by the presence of Reed–Sternberg cells. The majority of cases originate at nodal sites and only rarely does it occur in extranodal locations. Here we report a case of a woman with a classical Hodgkin's lymphoma of the thyroid developed from a Hashimoto thyroiditis. She presented with a mass in her thyroid which was surgically removed. Biopsy showed a nodular sclerosis classical Hodgkin's lymphoma. Our results were similar to previously reported cases. It would appear that the lesions grew over a MALT tissue created by the lymphoid proliferation of the thyroiditis. Differential diagnosis was made between the different types of lymphomas considering those most commonly occurring in extranodal lymphoid tissues. A final diagnosis was reached after consideration of the histopathology, immunophenotyping and molecular biology (AU)


El linfoma de Hodgkin se caracteriza por la presencia de células de Reed–Sternberg. La mayor parte de los casos se originan en ganglios linfáticos y raramente en localizaciones extranodales. Comunicamos un caso de una paciente con un linfoma de Hodgkin clásico desarrollado sobre una tiroiditis de Hashimoto. Se presentó como una masa tiroidea que fue extirpada. Histológicamente mostró un linfoma de Hodgkin clásico de tipo esclerosis nodular. Nuestros resultados concuerdan con casos publicados anteriormente. La lesión posiblemente se originó sobre un tejido MALT creado por la proliferación linfoide relacionada con la tiroiditis. Realizamos diagnósticos diferenciales entre diferentes tipos de linfoma que tienen lugar en tejido linfoide extranodal. El diagnóstico final fue realizado tras considerar su histopatología, inmunofenotipo y genética molecular (AU)


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Doença de Hodgkin/complicações , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/patologia , Células de Reed-Sternberg/patologia , Células de Reed-Sternberg , Doença de Hashimoto/complicações , Glândula Tireoide/anatomia & histologia , Glândula Tireoide/patologia , Doença de Hodgkin , Glândula Tireoide , Excisão de Linfonodo , Hibridização in Situ Fluorescente
20.
Clin. transl. oncol. (Print) ; 17(8): 612-619, ago. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-138176

RESUMO

Purpose. The cure rate in Hodgkin lymphoma is high, but the response along with treatment is still unpredictable and highly variable among patients. Detecting those patients who do not respond to treatment at early stages could bring improvements in their treatment. This research tries to identify the main biological prognostic variables currently gathered at diagnosis and design a simple machine learning methodology to help physicians improve the treatment response assessment. Methods. We carried out a retrospective analysis of the response to treatment of a cohort of 263 Caucasians who were diagnosed with Hodgkin lymphoma in Asturias (Spain). For that purpose, we used a list of 35 clinical and biological variables that are currently measured at diagnosis before any treatment begins. To establish the list of most discriminatory prognostic variables for treatment response, we designed a machine learning approach based on two different feature selection methods (Fisher’s ratio and maximum percentile distance) and backwards recursive feature elimination using a nearest-neighbor classifier (k-NN). The weights of the k-NN classifier were optimized using different terms of the confusion matrix (true- and false-positive rates) to minimize risk in the decisions. Results and conclusions. We found that the optimum strategy to predict treatment response in Hodgkin lymphoma consists in solving two different binary classification problems, discriminating first if the patient is in progressive disease; if not, then discerning among complete and partial remission. Serum ferritin turned to be the most discriminatory variable in predicting treatment response, followed by alanine aminotransferase and alkaline phosphatase. The importance of these prognostic variables suggests a close relationship between inflammation, iron overload, liver damage and the extension of the disease (AU)


No disponible


Assuntos
Idoso , Humanos , Doença de Hodgkin/diagnóstico , Doença de Hodgkin/terapia , Ferritinas/uso terapêutico , Alanina Transaminase , Fosfatase Alcalina/uso terapêutico , Bleomicina/uso terapêutico , Vimblastina/uso terapêutico , Dacarbazina/uso terapêutico , Doxorrubicina/uso terapêutico , Estudos Retrospectivos , Estudos de Coortes , Prognóstico , Estimativa de Kaplan-Meier
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