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J Ersbøll

Publications and source records attributed to J Ersbøll.

30 records · Page 2Linked to original sources
PubMed1987

Application of quantifiable criteria in the Lukes and Collins classification of non-Hodgkin's lymphomas.

Measurements of nuclear size and differential counts among six lymphoma cell types were performed on H & E stained sections. In differential counting, the definition of cell types was based on nuclear shape, chromatin pattern, and nucleoli. In a pilot study comprising 93 patients we found actual nuclear size inadequate for use in lymphoma classification. This was due to: 1. great overlap among cytological types; 2. no independent prognostic value of mean nuclear area; 3. contradictory terminology; the large cleaved type belonging to the small cell category (mean nuclear area below 40 microns2), and the small non-cleaved type belonging to the large cell category (mean nuclear area above 40 microns2). Differential counting--requiring about 10 min--was an easy way to meet the need for a more objective evaluation of the cellular composition in non-Hodgkin's lymphomas. Quantifiable criteria based on differential counts were applicable in subclassification of three T-cell and seven B-cell types with an intraobserver reproducibility of 80%. More than 25% "large" cell types in a differential count implied an unfavourable prognosis. In test material, using a semi-morphometric classification, a correct prognostic category was obtained in 92% of 461 lymphomas and correct sub-classification obtained in 68%.

Cell Count↗
PubMed1987

Human immunodeficiency virus (HIV) associated non-Hodgkin's lymphomas in Denmark: report of three cases.

High grade malignant non-Hodgkin's lymphoma (NHL) was the presenting manifestation of the acquired immunodeficiency syndrome (AIDS) in 3/81 reported cases of AIDS in Denmark (by April 2, 1986). Asymptomatic HIV infection, 1 and 5 yr prior to the onset of lymphoma, was documented in 2 cases. 1 patient became infected by Factor VIII treatment, 2 were male homosexuals. 2 patients had an uncommon tumour presentation in the oral cavity, 1 patient presented with an abdominal mass. The histologic subtypes were immunoblastic (2), and small noncleaved cell, Burkitt's (1). Helper/suppressor T-cell ratio was decreased at onset of lymphoma in 2 cases. All 3 patients have died, 4, 6, and 24 months after diagnosis of NHL. Only 1 patient died of NHL, 1 died of an unclassified pneumonia and the third developed progressing supranuclear HIV-associated polyneuropathy without evidence of CNS lymphoma. Thus, high grade malignant B-cell NHL is a regular initial manifestation of AIDS, and may develop after years of asymptomatic HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Comparison of the working formulation of non-Hodgkin's lymphoma with the Rappaport, Kiel, and Lukes & Collins classifications. Translational value and prognostic significance based on review of 658 patients treated at a single institution.

Six hundred fifty-eight cases of previously untreated non-Hodgkin's lymphoma seen between 1970 and 1979 at the Medical Department, the Finsen Institute, were the basis for a comparative study of the prognostic value of the Rappaport, Kiel, and Lukes & Collins classifications and the new translation system, the Working Formulation of Non-Hodgkin's Lymphoma. Each histopathologic system proved equally effective in separating patients into subgroups with a spectrum of prognoses ranging from a median survival of less than 1 year to greater than 7 years. The established classifications were compared with the Working Formulation in order to evaluate its translational value. The Working Formulation was more similar to the Rappaport and the Lukes & Collins systems than to the Kiel system, since 82%, 89%, and 75% of the cases, respectively, were translatable following the guidelines outlined in the National Cancer Institute (NCI)-sponsored study. Similarities among the four systems were demonstrated in lymphomas with follicular growth pattern, and in diffuse lymphomas composed of small mature appearing lymphocytes or small cleaved lymphocytes. Incongruity among the systems was more marked in lymphomas composed of large lymphoid cells or in lymphomas of mixed cellular composition. A comparison was performed for each classification against the Working Formulation. All such subdivided subsets were tested for prognostic heterogeneity and the following conclusions were reached: the diffuse poorly differentiated lymphocytic category of Rappaport was separated into two subgroups (malignant lymphoma [ML] small cleaved cell and ML lymphoblastic) with different prognoses (P = 0.01); the diffuse "histiocytic" lymphomas were prognostically homogeneous, since none of the newer systems were able to identify subpopulations with significantly different prognoses; the subtypes of the Kiel classification were prognostically homogeneous; the only weakness of the Lukes & Collins classification was the undefined cell subtype, encompassing two populations with different prognoses; and (5) the importance of follicular growth pattern was confirmed for small cleaved cell and mixed cell cytology, whereas large cell cytology implied a poor prognosis regardless of pattern. By the use of the Cox regression model it could be demonstrated that the Working Formulation can substitute any of the established classifications in terms of prognostic value.

Female↗
PubMed1985

Prognostic significance of architectural patterns in non-Hodgkin lymphomas.

Clinical data and lymphoma biopsies were analyzed in 651 patients with non-Hodgkin lymphoma in order to describe the prognostic influence of different grades of follicular architecture compared to diffuse architecture. The follicularity was graded qualitatively according to the distinctness of the pattern (intra-follicular, infiltrative follicular and traceably follicular patterns). The partially follicular pattern, with co-existence of follicular and diffuse areas in the same biopsy, was graded quantitatively according to the proportion of these areas. The median survival of patients with diffuse pattern was 1.2 years, while that of patients with follicular patterns ranged from 2.5 to 7.3 yr. The prognosis for those with partially follicular pattern was not affected, whether or not more or less than 50% of the lymphoma was diffuse. For cytologically identical lymphomas, only the intra- and infiltrative follicular patterns influenced the prognosis favourably. This conclusion was further substantiated by means of multivariate analysis.

Humans↗
PubMed1985

Predictive value of bone marrow cultures in 48 patients with acute myeloblastic leukaemia or myelodysplasia both secondary to treatment of other malignant diseases.

The growth pattern of bone marrow cells in agar cultures was studied in 48 patients with acute myeloblastic leukaemia or myelodysplasia, secondary to cytoreductive treatment, and compared to other laboratory findings. At diagnosis the status of the patients was: acute myeloblastic leukaemia (AML) in 9, acute myeloproliferative syndrome (AMS) in 13 and preleukaemic syndrome (PL) in 26 patients. 20 of the 39 patients with AMS and PL developed acute leukaemia, 15 of them within 1 year. 15 died of complications to cytopenia and only 4 are still alive and without leukaemia, observed from 8 to 55 months. Progression to AML was predicted from the agar cultures by increased cluster growth. Among 18 patients with increased cluster growth at diagnosis 14 subsequently developed AML. Among 21 patients with normal or decreased cluster growth at diagnosis 6 patients developed AML, but after conversion of the growth pattern to increased cluster growth. In 2 patients the increased cluster growth disappeared spontaneously and the patients are long-term leukaemia-free survivors. Colony growth pattern, conversely, was not related to leukaemic progression. Only 1 patient had normal growth pattern at diagnosis with respect to both clusters and colonies. Survival was short, with a median of about 7 months, unrelated to growth pattern and leukaemic progression.

Adult↗
PubMed1985

Meningeal involvement in non-Hodgkin's lymphoma: symptoms, incidence, risk factors and treatment.

Meningeal involvement (MI) by non-Hodgkin's lymphoma (NHL) was seen in 38/602 patients (6.3%). In relation to histologic subtype the frequency of MI was: Follicular small cleaved and mixed cell 2/128 (1.6%), small lymphocytic and diffuse small cleaved cell 2/83 (2.4%), large cell and immunoblastic 13/295 (4.5%), small noncleaved cell 6/31 (19%), lymphoblastic 15/66 (23%). Risk factors that predict for MI were, besides histologic subtype, age under 40 yr, clinical stage IV, site of involvement (bone marrow, bone, skin gastrointestinal tract), and a poor response to initial therapy. In a Cox multivariate model encompassing the intermediate and high grade malignancy groups of the Working Formulation (WF), the 3 most important risk factors were histology, age, and stage. The estimated 1-yr probability of MI for combinations of the 3 risk factors was: 3 risk factors (61%), 2 risk factors (15-28%), 1 risk factor (4-8%), 0 risk factor (1.5%). At the diagnosis of MI, 84% of the patients had evidence of advanced systemic NHL, and the median survival after MI was 10 wk. CNS prophylaxis with whole-brain irradiation and intrathecal chemotherapy can only be recommended in patients with 2 or 3 risk factors. Improvement of the systemic chemotherapy might be the most important factor for prevention of MI in NHL.

Adult↗
PubMed1985

Risk of acute nonlymphocytic leukemia and preleukemia in patients treated with cyclophosphamide for non-Hodgkin's lymphomas. Comparison with results obtained in patients treated for Hodgkin's disease and ovarian carcinoma with other alkylating agents.

Of 602 patients treated for non-Hodgkin's lymphomas, 9 developed overt acute nonlymphocytic leukemia or preleukemia with refractory cytopenia and cytogenetic abnormalities of the bone marrow. A Kaplan-Meier estimate of the cumulative probability of leukemic complications was 6.3 +/- 2.6% (mean +/- SE) 7 years after start of treatment. All 9 patients with leukemic complications belong to a major subgroup of 498 patients treated with alkylating agents, predominantly cyclophosphamide. The risk of leukemic complications in this subgroup was compared with the risk in 312 patients treated with other alkylating agents for Hodgkin's disease, and with the risk in 553 patients treated with dihydroxybusulfan for ovarian carcinoma. Cumulative 9-year risks were 8.0 +/- 3.3%, 12.8 +/- 3.5%, and 7.1 +/- 1.9%, respectively. The general risk of secondary leukemia after long-term treatment with alkylating agents ranges from 1% to 1.5% per year from 2 to at least 9 years after start of treatment.

Acute Disease↗
PubMed1983

A randomized study of radiotherapy versus radiotherapy plus chemotherapy in stage I-II non-Hodgkin's lymphomas.

In a randomized, prospective trial from 1974-1978, 73 patients with non-Hodgkin's lymphomas in clinical Stage I or II were treated with extended field radiotherapy alone (RT) or RT plus adjuvant chemotherapy with vincristine, streptonigrin, cyclophosphamide and prednisone (RT + CT). With a median follow-up time of five years, 54% have relapsed in the RT group versus only 10% in the RT + CT group (P less than 0.01). There is no statistical difference in the overall survival yet, but 13/14 deaths in the RT group versus only 3/12 in the RT + CT group were due to progressive disease. Among patients with unfavorable histology, 13/22 in the RT group have died from disease progression against 3/34 in the RT + CT group (P less than 0.01). The results are in agreement with those from two other series published in detail. Based on these results we therefore recommend to use adjuvant CT with RT in all Stage I-II patients with unfavorable histology. Further observation is necessary before a conclusion can be drawn for the lymphoma patients with more favorable histology.

Antineoplastic Agents↗
PubMed1980

Abolished production of interferon by leucocytes of patients with the acquired cytogenetic abnormalities 5q -- or -- 5 in secondary and de-novo acute non-lymphocytic leukaemia.

Interferon production by leucocytes on stimulation with inactivated antigens from herpes simplex virus, varicella zoster virus and cytomegalovirus was determined in 19 patients with preleukaemia or acute non-lymphocytic leukaemia, in 15 following treatment for other tumours. Production of interferon was abolished in 10 patients and preserved in nine cases after stimulation with herpes simplex antigen. Cytogenetic studies of bone marrow demonstrated an abnormal karyotype in 13/15 patients with secondary preleukaemia or leukaemia. Characteristics were (a) hypodiploid cell lines demonstrated in eight cases, (b) a B-chromosome defect found in five cases and verified as 5q -- in four, and (c) defects in C-group chromosomes in 10, verified as monosomy 7 in nine. All four patients with de-novo preleukaemia or leukaemia had abnormal cytogenetic findings, two B-chromosome abnormalities verified as monosomy 5. A relationship between abnormalities in chromosome no. 5 and abolished production of interferon was demonstrated, as only one of seven patients with 5q --, --5 or --B produced interferon by the leucocytes, compared with eight of a total of 12 patients with other cytogenetic defects or a normal karyotype (P=0.04). The results are remarkable, as chromosome no. 5 has recently been discovered to contain a gene for interferon production. Furthermore abolished production of interferon by leucocytes seemed correlated to previous irradiation and to disease-related fever.

Acute Disease↗
PubMedDate not supplied

VP-16-213 in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone in the treatment of non-Hodgkin's lymphomas.

VP-16-213 has been used in 5-day courses together with cyclophosphamide, doxorubicin (Adriamycin), vincristine, and prednisone for treatment of 74 consecutive patients with non-Hodgkin's lymphomas. Ninety-one percent of patients with favourable histology and 69% with unfavorable histology achieved complete or partial remissions (overall response rate of 76%). The frequency of complete remission was disappointingly low (22%), possibly due to reduction of doses of the other myelosuppressive agents in the present combination. Further trials with VP-16-213 in other combination chemotherapy are required.

Cyclophosphamide↗