The incidence of bleomycin induced lung toxicity is increased in Hodgkin lymphoma patients over 45 years exposed to granulocyte-colony stimulating growth factor †.

In Hodgkin lymphoma (HL) bleomycin can induce pulmonary toxicity (BPT). BPT consists of respiratory tract symptoms during bleomycin-exposure and radiologic pulmonary lesions without concomitant infection. Older age, bleomycin dose, smoking history and the use of granulocyte-colony stimulating factor (G-CSF) have been suggested as possible risk factors for BPT. It is still debated whether BPT affects overall (OS) and progression-free survival (PFS). We investigated the incidence of BPT along with possible risk factors in 412 HL patients treated in 1990-2014. BPT occurred in 34 patients (8%) and was significantly associated with disseminated disease and B-symptoms. It was more frequent in elderly patients (p = .05) but not significantly correlated with a history of smoking. BPT occurred more often in patients receiving G-CSF (p = .03), particularly the poly-ethylenglycol-bound molecule. All significant risk correlations were limited to the age group >45 years. In the present cohort, BPT did not influence OS or PFS regardless of age.

[Hodgkin and the classification of malignant lymphomas: how the British physician also became associated with later discovered lymphomas]. / Hodgkin en de classificatie van maligne lymfomen.

Thomas Hodgkin was the first to describe a malignant lymphoma, which would later carry his name. Over the course of time, other lymphoid malignancies were recognised that showed no similarity with Hodgkin's disease. They were subsequently named after the - at that time - applicable morphological nomenclature of the associated cells. Later, nomenclature also took immunological features into consideration. However, we still describe the group of lymphomas recognised after Hodgkin's discovery as 'not being Hodgkin's disease', i.e. non-Hodgkin lymphoma. We feel it is unjust that not many people know about the man behind this prominent disease. In this article, an historic overview is given of Thomas Hodgkin, 'his' lymphoma and the other malignant lymphomas.

The role of primary lymph node sites in survival and mortality prediction in Hodgkin lymphoma: a SEER population-based retrospective study.

As diagnostic and therapeutic modalities for Hodgkin's Lymphoma (HL) continue to improve, patient-related factors affecting survival become more difficult to identify. Very little is known about the relationship between the primary site of lymph node (LN) involvement and survival of HL patients. We retrospectively analyzed the United States Surveillance, Epidemiology and End Results (SEER) database for 12,658 HL patients reported between 1973 and 2010 using survival analysis and time-interval multiple logistic regression (MLR) to disclose that relationship. The effect of all primary LN sites on the survival of HL patients was supported. The intra-abdominal (IAB) primary LN site was significantly associated with the worst survival. The pelvic (P) LN sites were significantly and independently associated with nearly 2 times and 2.5 times the probability of having 1-year overall mortality (OM) and 1-year cancer-specific mortality (CSM), respectively. Head, face and neck (HFN) primary LN sites were significant and independent predictors of better overall and HL-specific survival. A worse survival with the intra-abdominal primary LN site was probably related to their association with higher age, or advanced stages of HL. The biological basis behind the aggressiveness of intra-abdominal and pelvic LN sites is yet to be investigated.

Thomas Hodgkin (1798-1866).

Thomas Hodgkin was a diligent, selfless and benevolent man whose name is instantly recognisable in the medical field due to his description of a type of the lymphoma that is named after him, 'Hodgkin's Lymphoma'. Based at Guy's Hospital, London, he created a vast catalogue of specimens in their Medical Museum and facilitated teaching at the establishment. He was dedicated to education, public health and social reform in the 19th century.

Combination chemotherapy of solid tumors: an American-Italian collaboration: a celebration of the work of Gianni Bonadonna.

This article highlights the important collaboration between the U.S. NCI in Bethesda, Maryland and the Istituto Tumori in Milan, Italy that had a major impact on the development of curative regimens for breast cancer, Hodgkin's disease and diffuse large B cell lymphoma.In addition to his contribution to developing new therapies, Gianni Bonadonna played an important role in bringing highly focused, disciplined, ethical clinical trials to the European continent.

Radiotherapy in early stage classical Hodgkin lymphoma: past, present and future.

For early stage classical Hodgkin lymphoma (HL), extended field irradiation (EFRT) alone has shown excellent results in low relapse rate and high long-term survival rate. With the patients achieving long-term survival, the risk of the RT-related late complications was increased, such as secondary malignancies and heart infarctions. According to a series of studies, the combined modality therapy (CMT) as the first-line therapy has replaced the radiotherapy (RT) alone. The recommended regimens are 2 cycles of ABVD followed by involved field radiotherapy (IFRT) (20-30 Gy) for the favorable patients, and 4 cycles of ABVD followed by IFRT (30 Gy) for unfavorable patients. The involved nodular radiotherapy (INRT) has shown the potential to achieve satisfactory primary tumor control with lower RT-related toxicity than EFRT or IFRT in combined therapy. Some prospective randomized studies are going about chemotherapy (CT) plus INRT under the guidance of PET. It is not certain that whether CT alone has more benefits to cure limited HL. Appropriate application of new RT techniques can improve the radiation dose distribution in target fields and protect normal tissues from excess RT-related damage.

Hodgkin disease (1973-2002): long-term survival and cure fractions.

The Nottinghamshire Lymphoma Registry contains the details of all patients diagnosed with lymphoma (since 1 January 1973) within a defined geographical area with a stable population of 1.1 million. The aim of this study was to investigate the relative survival and estimate the cure fraction for patients with Hodgkin disease (HD) using various cure fraction models. Five- and 10-year survival was estimated in comparison to the general population of the same age, gender and year of diagnosis. Relative survival probabilities at 10 years were 52.3% for the 1973-1982 cohort, 67.8% (1983-1992) and 75.7% (1993-2002). The estimated cured fraction (π) was 45%, 65% and 75%, respectively, for the same cohorts. There was very little excess mortality after 4 years from treatment. The prognosis of patients with HD has improved progressively within a defined unselected population over this 30-year period. In the 1993-2002 cohort the prognosis after 4 years of treatment is almost the same as for a normal population.

Linfoma de Hodgkin epidural del raquis lumbar: presentación de un caso / Lumbar epidural spinal Hodgkin lymphoma: a case report

Introducción: La complejidad inherente a las enfermedades demanda de una atención multidisciplinaria que tribute enmejores resultados para los enfermos. Las neoplasias intrarraquídeas no escapan a esta afirmación, y aunque no tienen la mayor frecuencia, sus características clínicas y de neuroimagen pueden significar un reto para el equipo médico.Caso clínico: Paciente masculino, de 31 años, que debutó con lumbociatalgia y parestesias con predominio en el miembro inferior izquierdo y signos de atrapamiento radicular de la cuarta y quinta raíces lumbares. La tomografía axial computarizada y resonancia magnética de la columna lumbosacra demostraron la presencia de una neoplasia que invadía el canal raquídeo e infiltraba el cuerpo de la tercera vértebra lumbar. Se sometió a tratamiento quirúrgico por un equipo deneurocirujanos y ortopédicos. Se realizó laminectomía de la segunda a la cuarta vértebras lumbares, excéresismacroscópica total de la lesión neoformativa, curetaje del cuerpo vertebral afectado, seguido de fusión con apófisis espinosas y fijación por técnica de Luque. El diagnóstico histopatológico transoperatorio fue de un linfoma de Hodgkin. El seguimiento posoperatorio incluyó a la especialidad de hematología con tratamiento quimioterapéutico específico. Laevolución fue favorable y lleva dos años de sobrevida asintomático y sin discapacidad.Conclusiones: El diagnóstico precoz de las enfermedades oncológicas del raquis unido al tratamiento oportuno y adecuado por un equipo médico multidisciplinario, garantiza los mejores resultados, con una repercusión favorable en el pronóstico delos pacientes(AU)

Introduction: The inherent complexity of diseases demands a multidisciplinary attention to assure better results for patients.Intraspinal neoplasms are an example of this affirmation and however they dont have the highest frequency, the clinical and radiological characteristics could become in a challenge for medical staff. Objective: to present a patient with an uncommon lumbar intraspinal neoplasm.Clinical case: A 31 year old white male patient with an onset of back and sciatic pain and left leg paresthesias and signs of radicular entrapment of the fourth and fifth lumbar roots. Lumbar spine radiological study by computerized tomography and magnetic resonance imaging showed the presence of a neoplasm who invaded the spinal canal and infiltrated the third lumbar vertebral body. Surgical treatment was decided by a staff of orthopedics and neurosurgeons. A laminectomy of thesecond to forth lumbar vertebrae was made, total complete removal of the neoplastic lesion, curettage of the affected vertebral body, followed by vertebral fusion with spinous apophysis and Luque technique. The trans-operatory pathological diagnosis was Hodgkin lymphoma. The post-operatory follow up included hematology management with specific chemotherapy. The patient has a favorable evolution with two years of asymptomatic survival and without handicap.Conclusions: The precocious diagnosis of spine neoplasm toward an opportune and suitable treatment by amultidisciplinary team, assures the best results with a favorable repercussion in patients prognosis(AU)

Eponyms in cardiothoracic radiology: Part I. Neoplasms.

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the field of medicine. In this article, the first of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to neoplasms, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake.

Identificação do gene EBER1 e EBNA1 do vírus de Epstein Barr (EBV) em tecidos de pacientes com doença de Hodgkin na região Norte do Brasil / Identification of gene EBER1 and EBNA 1 of Epstein Barr virus (EBV) in tissues of patients with Hodgkin’s disease in Northern Brazil

O vírus de Epstein Barr (EBV) é o agente causador da mononucle¬ose infecciosa e está associado a várias desordens proliferativas malignas tais como: linfoma de Burkitt, linfoma de Hodgkin e lin¬fomas não Hodgkin. Objetivo: detectar o genoma do EBV mediante a identificação dos genes EBER1 e EBNA1 em casos de doença de Hodgkin. Métodos: um total de 65 casos de linfomas diagnosti¬cados no Hospital Ophir Loyola no período de 1996 e 2005 foram analisados no Instituto Evandro Chagas, Ananindeua, Brasil. Todos os espécimes parafinizados foram analisados por hibridização in situ (gene EBER1) e PCR em tempo real (EBNA1). Resultados: do total, 64,6% (42/65) dos pacientes eram do sexo masculino e 35,4% (23/65) do sexo feminino. O EBV foi identificado por HIS nas células Reed Sternberg e variantes em 76,9% (50/65) dos casos com idade média de 28,3 anos (variação 2-84 anos). Os subtipos histológicos de casos EBV-positivos foram os seguintes: esclerose nodular em 50% (25/50), celularidade mista em 28% (14/50), depleção linfocitária em 14% (7/50) e predominância linfocitária em 8% (4/50). O DNA do EBV foi detectado em 53% (26/49) dos casos de doença de Hodgkin com um coeficiente de regressão para a curva padrão de 0,99. Conclusão: este estudo foi a primeira descrição do vírus de Epstein Barr em casos de linfoma de Hodgkin na Amazônia Brasileira, reforçando a hipótese de que o EBV seja um co-fator no processo de transformação neoplásica em conjunto com a predisposição genética e imunidade do paciente

Introduction: EBV is the causative agent of infectious mononucleosis and is associated with several malignant proliferative disorders such as Burkitt’s lymphoma, Hodgkin’s lymphoma, some B and T cell non-Hodgkin’s lymphomas. Objective: The main objective of the study was to determine the prevalence of EBER 1 gene and EBNA1 gene in cases of Hodgkin’s disease. Material and Methods: A total of 65 cases of lymphomas diagnosed between 1996 and 2005 were obtained from “Instituto Ofir Loyola” and analyzed at the “Instituto Evandro Chagas” Ananindeua, Brazil. The EBV antigens using EBER 1 probe in situ hybridization (HIS) and real time quantitative PCR. Results: From the total obtained, 64.6% (42/65) were male and 35.4% (23/65) female. EBV was identified in the Reed- Sternberg cells and variants in 76.9% (50/65) of Hodgkin’s disease cases, the median age were 28.3 years (range 2-84). The histologic subtypes of EBV-positive cases were as follows: nodular sclerosis in 50% (25/50), mixed cellularity in 28% (14/50), lymphocyte depletion in 14% (7/50) and lymphocyte predominance in 8% (4/50). We detected EBV DNA in 53% (26/49) with a coefficient of regression for the standard curve of a minimum of 0.99. Conclusion: These results were the first demonstration of the role of Epstein Barr virus in cases of Hodgkin diseases in northern Brazil and are consistent with the hypothesis that the presence of EBV during neoplasic transformation could be an additional cofactor acting together with both genetic predisposition and immunity of the patient