[Malignant lymphomas].
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Antineoplastic Combined Chemotherapy Protocols↗
Biomedical subjects
Christophe Fermé
Publications and source records attributed to Christophe Fermé.
Intensive salvage therapy with high-dose chemotherapy for patients with advanced Hodgkin's disease in relapse or failure after initial chemotherapy: results of the Groupe d'Etudes des Lymphomes de l'Adulte H89 Trial.
PURPOSE: To evaluate prospectively the feasibility and efficacy of early intensive therapy, including intensified cytoreductive chemotherapy (CT) and high-dose CT (HDCT) followed by autologous stem-cell transplantation (ASCT), in patients with advanced Hodgkin's disease (HD) who failed to respond completely or relapsed after initial treatment. PATIENTS AND METHODS: Among 533 eligible patients with newly diagnosed stage IIIB-IV HD enrolled in the H89 trial, all 157 patients with induction failure (IF) (n = 67), partial response (PR) of less than 75% (n = 22), or relapse (n = 68) were included in this study. Planned salvage therapy included mitoguazone, ifosfamide, vinorelbine, and etoposide monthly for two to three cycles followed by high-dose carmustine, etoposide, cytarabine, and melphalan with ASCT. RESULTS: With a median follow-up of 50 months, the 5-year survival estimates were 30%, 72%, and 76% for the IF, PR, and relapse groups, respectively (P =.0001), 71% for the 101 patients given HDCT, and 32% for the 48 patients treated without HDCT (P =.0001). Multivariate analysis using time-dependent Cox model indicated that B symptoms at progression, salvage without HDCT, and chemoresistant disease before HDCT were significantly associated with shorter overall survival. CONCLUSION: Early intensive therapy improves the outcomes of patients with advanced HD who failed to respond completely to initial treatment and those who relapsed with adverse prognostic factors. However, for patients with IF and chemoresistant disease, this approach remains unsatisfactory.
Adolescent↗
Hodgkin's disease primarily involving the oropharynx: case report and review of the literature.
We report a rare case of Hodgkin's disease primarily involving the oropharyngeal region. The patient presented with stage IIEA disease with a favorable response to treatment. Our literature search revealed that this disease affected rarely the lymphoid tissues of Waldeyer's ring. In this atypical location, tonsil and nasopharynx represent the most frequently involved sites. The involvement of the posterior wall of the oropharynx by Hodgkin's disease has been reported only once so far. When Waldeyer's ring is involved, the disease is usually localized, with occasional involvement of cervical lymph nodes. In this location, mixed cellularity is the most frequent histologic subtype and the Epstein-Barr virus is found in the majority of cases. This report is followed by a discussion on the clinical and pathological features, the implication of Epstein-Barrs virus and a literature review for Hodgkin's disease involving Waldeyer's ring.
Antineoplastic Combined Chemotherapy Protocols↗