Clinical significance of hematologic parameters in non-Hodgkin's lymphoma at diagnosis
Article Abstract:
Much attention has been paid to the prognostic value of bone marrow involvement in cases of non-Hodgkin's lymphomas (cancer of the lymph nodes other than Hodgkin's disease). However, little data is available on the usefulness of standard hematologic (related to the blood) findings at the time of diagnosis. Since standard blood data is quite easy to obtain, this information may be clinically valuable. Hematologic data obtained at the time of diagnostic staging was compiled for 317 patients with non-Hodgkin's lymphoma. Some hematologic abnormality was present in 47 percent of the patients. The most common abnormality was anemia (reduced red blood cells), occurring in 42 percent of the cases. Leukocytosis (excess leukocytes, a type of white blood cell) was present in 26 percent; thrombocytosis (excess platelets, a blood cell responsible for clotting) in 14 percent; thrombocytopenia (abnormal decrease in platelets) in 13 percent; and leukopenia (abnormal decrease in leukocytes) was observed in 6 percent of the cases. While the anemia was more common among patients with higher grade lymphomas, in general, there was little variation of the hematologic abnormalities with different characteristics of the lymphoma. Patients with bone marrow involvement were more likely to have leukopenia or thrombocytopenia. Although more patients with bone marrow involvement had anemia, this difference was not statistically significant. As has been found in some previous studies, bone marrow involvement carries a poorer prognosis in patients with non-Hodgkin's lymphoma. In the present study, patients with anemia had significantly shorter survival times. Although mild leukocytosis was not prognostically significant, patients with a leukocyte count of greater than 20 billion per liter had significantly shorter survivals. When patients with or without bone marrow involvement were considered separately, leukocytosis carried a poorer prognosis only for those patients without bone marrow involvement. It was also found that patients with multiple cytopenias (deficiency of blood cells) or leukoerythroblastosis (anemia with bone marrow infiltrates) had an especially poor prognosis. The authors suggest that these prognostic indicators, evaluated retrospectively in the present study, may have therapeutic implications. Patients with poor prognostic signs may benefit from more aggressive treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
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Pregnancy outcome in hematologic malignancies
Article Abstract:
Pregnancy poses unique dilemmas for the treatment of cancer. The drugs used to treat cancer have the potential for causing birth defects; furthermore, some researchers suspect that neoplastic disease may progress more rapidly in pregnant women. There are three basic situations that must be considered: a woman with cancer may become pregnant, a pregnant woman may be diagnosed with cancer, and a woman who has been treated for cancer in the past may become pregnant. Unfortunately, most of the data concerning the effects of anticancer drugs on the outcome of pregnancy are from animal experiments, with minimal data from humans. For this reason, a survey was taken of 15 hematology services to identify patients who developed lymphoma or leukemia while pregnant, or became pregnant during or after treatment for either of these hematologic malignancies. A total of 56 pregnancies in 48 women were identified in this manner. In seven cases, the patients became pregnant while under treatment. In 22 cases, the disease was diagnosed during the pregnancy, and in 27 cases, the women became pregnant after treatment. The results of these pregnancies were compared to the average outcomes in a healthy population, and it was found that the rate of complications, including birth defects, was no greater for the women with leukemia or lymphoma. Sixty-four percent of the pregnancies went to term and 5 percent ended in premature birth. The remainder ended in spontaneous abortion (miscarriage), therapeutic abortion, or death of mother and fetus from the disease. One major malformation was observed among the pregnancies; the occurrence of one malformation among 56 pregnancies is no different than the expectation in a population of healthy individuals. The data suggest that if chemotherapy is indicated in the treatment of the mother, it need not be delayed because of pregnancy. However, the authors suggest that chemotherapeutic agents that rely on antifolic activity or alkylating activity be avoided, due to their higher potential for causing genetic mutations. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1991
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Complications from long-term indwelling central venous catheters in hematologic patients with special reference to infection
Article Abstract:
The chemotherapeutic protocols for leukemia and other blood cancers often require the use of venous cannulas (tubes) to provide long-term access for injection. The primary complication of these catheters is infection, which begins around the entry wound. Totally implantable systems have been developed in which a venous catheter is connected to a injection port under the skin's surface. In addition, a double-lumen catheter, i.e. one inside another, has been introduced, but little data has accumulated on the risk of infection compared to single catheters. Forty-three patients were enlisted to prospectively evaluate the double-lumen catheter compared to the implantable Portacath system. Twenty-three received double-lumen catheters, and the remainder received the implantable devices. The devices remained in place a mean of around 5 months. The infection rate for double-lumen catheters was 30 percent, and the rate for the implantable devices was 20 percent. The totally implantable system is, therefore, at least as safe as the double-lumen catheters. It is worth noting that infections, which were usually found to be Staphylococcus epidermis, did not always require the removal of the catheter and generally responded to antibiotics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Cancer
Subject: Health
ISSN: 0008-543X
Year: 1989
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