Prognostic effect of early diagnostic splenectomy in Hodgkin's disease: a randomized trial

Askergren, J; Björkholm, Magnus; Holm, G.; Johansson, B.; Mellstedt, Håkan; Sundblad, R.; Söderberg, G.

doi:10.1038/bjc.1980.228

Cited by 18 publications

(13 citation statements)

References 18 publications

(9 reference statements)

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“…[36][37] Staging during the period 1972-1988 often included laparotomy and splenectomy. [38][39] The management of frail elderly patients has been more varied. 32,[40][41] During recent years, treatment of HL has been increasingly influenced by the goal of minimizing late therapy-related complications.…”

Section: Treatment Principles Of Hl During the Study Periodmentioning

confidence: 99%

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Sjøberg

Halthur

Kristinsson

et al. 2012

Blood

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In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N ‫؍‬ 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009 IntroductionOver the past 40 years, major advances have been made in the management of patients with Hodgkin lymphoma (HL). These include the introduction of more accurate radiotherapy, effective multiagent chemotherapy, immunotherapy, improved staging procedures, and important developments in supportive measures for myelosuppression and infectious and other complications. 1 Therefore, HL has gone from being an invariably fatal disorder to one of the few malignancies that are now highly curable. This is particularly true for patients with early-stage disease, but today disease control rates also exceed 70% in patients presenting with high-risk features. 2 This therapeutic success has unfortunately been darkened by elevated risks of secondary primary cancers, cardiovascular disease (CVD), cerebrovascular disease, and infections in longterm HL survivors. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] CVD has been reported to be the most important cause of excess mortality after HL and second malignancies. [10][11][13][14] During the last 2-3 decades, treatment strategies have been and are being adapted based on increased knowledge of treatment-related morbidity and mortality. Awaiting novel and less toxic targeted therapies of HL, the largest potential for improving survival and healthrelated quality of life in long-term survivors 17 is by reducing the excess morbidity and mortality from causes other than HL. To evaluate progress in long-term outcome, we studied patient survival among all 6949 HL patients diagnosed in Sweden between 1973 and 2009 and followed up for death to the end of 2010. Our aim was to assess trends in patient survival and long-term excess mortality in the entire population during this 37-year period starting when curative treatment principles were well-established. Methods Central registers and patientsInformation regarding patients diagnosed with a malignant disorder in Sweden is reported to a population-based nationwide Swedish Cancer Register that was established in 1958. The register contains information on diagnosis, sex, date of birth, date of diagnosis, and the hospital where the diagnosis was made, 18-19 but does not contain detailed clinical information such as symptoms, routine laboratory tests, treatment, or comorbidities.In Sweden, every physician and pathologist/cytologist is obliged by law to report each occurrence of cancer to the registry. All deaths are recorded in the nationwide causes of death register. Each person in Sweden is given a unique national registration number used to index a...

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Section: Treatment Principles Of Hl During the Study Periodmentioning

confidence: 99%

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Sjøberg

Halthur

Kristinsson

et al. 2012

Blood

View full text Add to dashboard Cite

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“…Exploratory laparotomy with splenectomy as part of the staging procedure in HD was introduced by Glatstein et a1 (14). However, the increasing number of reports on early and late serious complications following splenectomy has led to a more conservative attitude towards this procedure (3,5). Consequently, there is still a need for better non-invasive methods to define abdominal, including splenic, tumour involvement.…”

Section: Discussionmentioning

confidence: 99%

“…The most apt method for assessing splenic size and tumour involvement is exploratory laparotomy with splenectomy (5,14). Splenectomy in HD may also have other advantages.…”

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confidence: 99%

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Routine Laboratory Tests in Relation to Spleen Size and Tumour Involvement in Untreated Hodgkin's Disease

Wedelin

Björkholm

Holm

et al. 1981

Journal of Internal Medicine

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ABSTRACT. A number of routine laboratory tests were studied in 39 untreated patients with Hodgkin's disease with respect to size and tumour involvement of the spleen. Eighteen patients with tumour‐engaged spleens had lower total lymphocyte counts and IgG and IgM levels than patients with non‐involved spleens. However, no significant differences in these respects were found between patients with tumour‐involved spleens weighing less than 500 g and patients without splenic tumour involvement. Hemoglobin values were inversely and reticulocyte counts positively correlated with the weight of involved spleens. Remaining laboratory variables under study, e.g. total granulocyte counts, platelet counts, ESR and liver enzymes, were not associated with the size or tumour involvement of the spleen. It may be concluded that routine laboratory tests yield no specific information as to splenic tumour involvement or size.

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“…The clinical staging was performed according to the Ann Arbor staging classification (Carbone et al 1971) and the Rye nomenclature was used for histopathologic classification (Lukes et al 1966). 24 patients were part of a randomized trial aimed at evaluating the prognostic effect of early splenectomy (Askergren et al 1980). They were staged by laporatomy with splenectomy after completion of mantle treatment (n = 20) or inverted Y field treatment (n = 4).…”

Section: Methodsmentioning

confidence: 99%

Blood Lymphocyte Functions in Relation to Splenic Weight and Tumor Involvement in Untreated Hodgkin's Disease

Björkholm

Askergren

Wedelin

et al. 1981

Scandinavian Journal of Haematology

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Spontaneous and mitogen induced blood lymphocyte DNA synthesis was studied in relation to weight and tumor involvement of the spleen in 33 untreated patients with Hodgkin's Disease. Splenic tumor involvement was found in 14 patients. In this group there was a strong inverse correlation between spleen weight and lymphocyte DNA synthesis induced by PWM, ConA and PPD. In patients with uninvolved spleens the spontaneous blood lymphocyte DNA synthesis increased with spleen weight. No correlation with the mitogen response was observed in this group.

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Prognostic effect of early diagnostic splenectomy in Hodgkin's disease: a randomized trial

Cited by 18 publications

References 18 publications

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Routine Laboratory Tests in Relation to Spleen Size and Tumour Involvement in Untreated Hodgkin's Disease

Blood Lymphocyte Functions in Relation to Splenic Weight and Tumor Involvement in Untreated Hodgkin's Disease

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