ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Non-Hodgkin lymphoma (NHL) is the fifth most common cancer in the US, with about 55,000 new cases estimated for the year 2000. According to the new Surveillance, Epidemiology, and End Results (SEER) data from 1973 to 1997, the age-adjusted incidence rates rose by about 80%, with an annual percentage increase of nearly 3%, which is faster than for the majority of cancers. The increasing incidence of NHL is largely unexplained. AIDS-related NHL accounts for some but not all of the increase. The American Cancer Society predicts about 7,400 new cases of Hodgkin Disease (HD) in the year 2000 in the US. The incidence of HD is consistently lower than that of NHL, and has decreased about 16% since the 1970s. Only a small portion of the decrease in HD incidence can be explained by misdiagnosis of HD as NHL. Further research is needed on the cofactors that predispose AIDS cases to lymphoma, as well as other possible causes of NHL such as immunosuppression, genetics, viruses, medical conditions, pesticides, solvents, hair dyes, and diet. Further evaluation of the role of viruses, occupational exposures, and genetics in the etiology of HD should prove valuable.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The precise diagnosis of malignant B-cell lymphoproliferations is essential for their appropriate clinical management. Histologic and immunophenotypical features alone are often insufficient in discriminating between various lymphoma entities and subtypes. The analysis of clonally rearranged immunoglobulin chain genes of the tumor cells was therefore suggested as an additional parameter. This article reviews current knowledge and describes which conclusions can be drawn for lymphoma diagnosis based on the type of immunoglobulin chain gene rearrangement, as well as on the number and distribution of somatic immunoglobulin mutations. Although there are striking correlations between the clinical outcome and the immunoglobulin mutations in some entities, many additional studies are required in order to draw final conclusions for most types of lymphoma.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Depending on stage and risk factor profile, more than 80% of patients with Hodgkin disease (HD) will be cured with modern treatment strategies. In early-stage, favorable HD, extended field irradiation has been the standard treatment resulting in cure rates of greater than 90%. However, due to the recognition of fatal long-term effects, especially the high rates of second solid tumors, extended field irradiation therapy is now being abandoned by most study groups. Instead, mild chemotherapy for control of occult disease is combined with involved field irradiation. In early-stage, unfavorable (intermediate) HD, for which combined modality treatment is already the treatment of choice, extended field irradiation is replaced by involved field irradiation for the same reasons. A different situation is found in advanced HD. In this case, standard therapy consists of eight cycles of polychemotherapy. Until recently, modifications of the standard chemotherapy regimens had not changed the poor outcome of advanced-stage patients. The development of a new dose-intensified regimen (BEACOPP) now for the first time has significantly improved the prognosis of these patients. Patients who relapse following radiation therapy alone for early stage HD have satisfactory results with combination chemotherapy and are not considered candidates for high-dose chemotherapy with autologous stem cell transplantation. For patients with relapsed HD after combination chemotherapy, the current data support the use of high-dose chemotherapy with autologous stem cell transplantation.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Preliminary results of new therapies in the areas of cytotoxic agents and immunotherapy for advanced indolent lymphomas have been encouraging. Long-term follow-up on high-dose therapy suggests a potential role for this modality in this group of lymphomas. In aggressive lymphomas, CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) continues to hold ground as first-line therapy when compared against other regimens. Several studies reinforce past findings that patients with chemosensitive relapse are better candidates for high-dose therapy. In relapsed or refractory disease, selected compounds appear to have activity as single agents and others have shown activity in combination therapy. Despite high treatment-related mortality rates, allogeneic transplantation in relapsed aggressive lymphoma warrants further investigation. Last, as patients are surviving longer, complications of therapy are having to be addressed.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Primary cutaneous lymphomas have a distinct clinical behavior and prognosis, and therefore require a different therapeutic approach, as compared with their primary nodal equivalents. The European Organization for Research and Treatment of Cancer (EORTC) classification for primary cutaneous lymphomas recognizes a limited number of cutaneous T-cell lymphomas and cutaneous B-cell lymphomas and is at present the best guide to optimal management and treatment of these conditions. Herein, the relationship between the EORTC classification and the recently published World Health Organization classification is discussed, and recent developments regarding the main types of cutaneous T-cell lymphomas and cutaneous B-cell lymphomas recognized in the EORTC classification are presented.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Thymomas are fascinating tumors because of their multifaceted clinical presentation, including an unrivaled frequency of associated paraneoplastic autoimmune diseases and an astounding histologic heterogeneity. Thus, thymomas challenge the clinician, pathologist, and immunologist alike with complex diagnostic and therapeutic problems in almost all fields of medicine, radiology, nuclear medicine, surgery, radio-oncology, and pathology. This review highlights recent progress in these fields, including the new World Health Organization’s classification of thymomas, and reports on the beginning discovery of the genetic basis of thymoma oncogenesis and the cellular and molecular immunopathology of thymoma-associated paraneoplastic autoimmunity.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Treatment of AIDS-associated non-Hodgkin lymphoma poses a complex and multifaceted challenge for the physician. Treatment responses to cytotoxic chemotherapy are relatively poor, relapse rates are high, and AIDS progression continues to be a major concern in patients receiving dose-intensive antilymphoma therapy. The recent advances in anti-HIV therapy have not seen a clear counterpart in improved antilymphoma therapy, but trials are underway that may help move this field forward. For patients who achieve a complete and durable response to antilymphoma therapy, potent antiretroviral therapy may help improve the prognosis from AIDS progression. Major questions persist, however, on the role of chemotherapy dose intensity, the best use of antiretroviral therapy during the administration of lymphoma therapy, and the optimal design of studies that can address these questions.

ISSN:1040-8746    

出版商:OVID    

年代:2000

数据来源: OVID