SEOM clinical guidelines for the treatment of Hodgkin's lymphoma

Hodgkin's lymphoma is a malignant disease with an incidence of 2.2 cases/100,000. The main goals of staging are to measure the extent of disease and associated prognostic factors. Distinct recommendations were produced for initial work-up, first-line therapy of early and advanced stage disease and treatment of relapsed or resistant patients (AU)

[Primary large cell thyroid lymphoma. Report of 6 cases treated with chemotherapy]. / Linfoma de células grandes primario de tiroides. A propósito de 6 casos tratados con quimioterapia.

A series of 6 cases with primary thyroid lymphoma of aggressive histologic type (large cell lymphoma) is presented. Two patients had previous diagnosis of chronic lymphocytary thyroiditis and one also had ulcerative colitis. The Ann Arbor stage was I-E in 2 patients and II-E in four. LDH level was high in four patients and three had criteria of bulky disease. All developed compressive symptoms. As primary therapy 3 patients received polychemotherapy (ProMACE-CytaBOM). The remaining underwent surgery prior to cytostatic treatment. In the three patients with large tumoral volume complementary radiotherapy was also carried out. Five patients had rapid complete remission with chemotherapy and the other achieved partial response of 75% (had complete remission upon termination of radiotherapy). Five are alive without disease at 87, 47, 25, 23 and 16 months of the onset of treatment. One patient died due to cerebral infarction after the fourth cycle. Polychemotherapy is a good therapeutic option for primary thyroid lymphoma with unfavourable prognostic factors.

[Subacute paraneoplastic cerebellar degeneration in microcytic carcinoma of the lung. Presentation of 2 cases]. / Degeneración subaguda cerebelosa paraneoplásica en el carcinoma microcítico de pulmón. Presentación de dos casos.

Subacute paraneoplastic cerebellous degeneration is a rare syndrome which is found in less than 1% of patients with cancer. Small cell cancer of the lung and of the ovary are the two neoplasms most frequently associated to this entity. Two patients with small cell lung cancer who initially had a cerebellous syndrome in which no sign of macroscopic cerebellous lesion could be demonstrated by either computerized tomography or nuclear magnetic resonance of the head are presented. One of the patients was evaluated at autopsy. Both patients were treated with polychemotherapy with which partial response was obtained. Neurologic symptomatology was not alleviated in the first patient with death due to bronchopneumonia at 5.5 months of initiation of the disease, while improvement of the cerebellous paraneoplastic syndrome was achieved in the second patient. The different evolution of subacute paraneoplastic cerebellous degeneration in two patients in whom antibodies were not demonstrated and in whom initial response of the tumor to chemotherapy was achieved may be explained by the second patient having undergone prolonged treatment of 6 cycles suggesting a strict relation ship between the tumor and subacute cerebellous degeneration which, to date, remains unknown.

[Chemotherapy with cisplatin, adriamycin, etoposide and ifosfamide in microcytic lung carcinoma]. / Quimioterapia con cisplatino, adriamicina, etopósido e ifosfamida en el carcinoma microcítico pulmonar.

BACKGROUND: The aim of this study was to analyze the results obtained in the treatment of small cell lung cancer (SCLC) with the PAVI chemotherapy protocol (cisplatin, adriamycin, etoposide and ifosfamide). METHODS: Over a period of 3 years, 41 patients with a mean age of 57 years were treated. Twenty-two patients were considered as having limited disease (LD) and 19 disseminated disease (DD). Survival was studied by the Kaplan and Meier method. RESULTS: The percentage of complete response (CR) achieved was 42%, LD 52% and 27% for DD, with partial responses (PR) being achieved in 50%, 43% in LD and 60% in DD. With a mean follow up of 32 months, the mean 2 length of response was 13 months in the patients with CR and 9 months in those with PR. The median of survival in LD was 22 months and 10 months for patients with DD. Prolonged survival of over 2 years, was only achieved in LD (16%). Five patients died in relation with the treatment. Hematologic toxicity was doses-limited with the greatest toxicity being found in patients with DD under the Karnofsky index (KI). CONCLUSIONS: The PAVI protocol is effective in the treatment of small cell lung cancer and a good median of survival may be achieved in patients with limited disease. Toxicity is elevated and is fundamentally found in patients with disseminated disease and under the Karnofsky index, with its use not being recommended in these cases.