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Biomedical subjects

A F Abrahamsen

Publications and source records attributed to A F Abrahamsen.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Hodgkin's disease or lymphogranulomatosis. New views on prognosis, complicating conditions and complications after treatment].

Between the years 1968-85, 1,177 patients started treatment for Hodgkins disease at the Norwegian Radium Hospital. In this unselected material from Norway the age distribution was bimodal with the highest incidence between 20-40 years of age. Survival is dependent on age, stage and histology, and was better between the years 1980-85 as compared with the period 1974-79. During the last ten years, treatment has been decentralized in Norway, and all centres cooperate by using the same protocol for staging and treatment. The article summarizes the results of the treatment, and related complications.

Adolescent↗
PubMed1993

[New cancer disease after treatment of Hodgkin's disease].

The risk of a second cancer was assessed in 1,152 patients with Hodgkins disease who were treated at the Norwegian Radium Hospital from 1968-85. 68 patients developed a second cancer more than one year after the diagnosis of Hodgkins disease. These included nine acute non-lymphocytic leukemias, eight non-Hodgkins lymphomas and 51 solid tumours, including 11 lung cancers. The overall relative risk (observed/expected ratios) of developing a second cancer was 1.86. After 18 years the cumulative risk of developing a second cancer was 14.4% +/- 2.9%, of which 11.2% +/- 2.6% referred to solid tumours. The cumulative risk of leukemia appeared to reach a plateau level of 1.5% after 12 years while the risk of non-Hodgkins lymphomas and lung cancer continued to rise with time to 2.1% and 3.3% respectively after 18 years. The risk of developing leukemia increased after treatment with alkylating agents and Procarbazine. The risk of non-Hodgkins lymphoma was not related to any specific type of therapy. Excess lung cancer risk was noted in patients treated with radiotherapy, and the cancers appeared within the treated areas.

Adolescent↗
PubMed1993

Second malignancies after treatment of Hodgkin's disease: the influence of treatment, follow-up time, and age.

PURPOSE: In the period 1968 through 1988, The Norwegian Radium Hospital (NRH) treated an unselected population of 1,152 patients with Hodgkin's disease (HD) that comprised more older patients (mean age, 43 years) than most other institutions. We considered it important to evaluate these patients for development of second cancers (SCs). PATIENTS AND METHODS: The Norwegian Cancer Registry identified previously untreated patients with HD treated at NRH who had developed a SC more than 1 year after diagnosis of HD. The relative risk ratio (RR) (observed/expected cases) and the cumulative risk were calculated. RESULTS: Sixty-eight patients had developed a SC, including nine acute nonlymphocytic leukemias (ANLLs), eight non-Hodgkin's lymphomas (NHLs), and 51 solid tumors, including 11 lung cancers. The RR of SC and leukemia was 1.86 (95% confidence interval [CI], 1.4 to 2.4) and 24.3 (95% CI, 11.1 to 46.2), respectively. The RR of SC was highest in younger patients (< 41 years, RR = 3.8). No significant association between splenectomy and development of ANLL was found. The influence of treatment and follow-up time on the development of SC agrees with data from other large cancer institutions. CONCLUSION: (1) The low RR of developing a SC in this study is probably due to the number of older patients included, who have a lower RR of developing a SC due to less aggressive treatment, shorter follow-up time, and higher incidence of cancer in the expected background population. (2) The low RR and cumulative risk of developing ANLL may be due to the limited use of extensive chemotherapy (CT) in our hospital in the earlier years.

Adolescent↗
PubMed1992

[Infection problems in the leukopenia phase after autologous bone marrow transplantation].

Between 1986 and 1991, 29 patients with malignant lymphomas were treated with total body irradiation and high-dose chemotherapy followed by autologous bone marrow transplantation at the Norwegian Radium Hospital. Owing to treatment-induced bone marrow toxicity, the leucocyte count in peripheral blood rapidly fell to zero. The aplastic phase lasted for 25 days (median). All patients experienced fever in the posttransplant period and needed broad-spectrum antibiotics. 12 patients had documented bacteremia, mostly with Gram-positive isolates. There were seven cases of documented focal infections, and antibiotic-associated colitis was seen in two cases. Other complications included bleedings and skin rashes. Four patients died in the post-transplant period from complications related to the cytotoxic treatment. We discuss guidelines for antimicrobial treatment of suspected and confirmed infections in neutropenic patients.

Adolescent↗
PubMed1992

Bone marrow examination in Hodgkin's disease.

Bone marrow aspiration and biopsy was performed as part of routine staging in 425 patients with primary Hodgkin's disease. Only seven patients were found to have bone marrow disease by biopsy and only four by aspiration. All these patients had B symptoms and stage III or IV before bone marrow examination. Bone marrow infiltration did not influence treatment decision and there was no association between bone marrow findings and outcome of the disease.

Adult↗
PubMed1992

Primary malignant lymphoma of the brain. A report of 24 cases from the Norwegian Radium Hospital.

Between 1975 and 1987, 24 patients with primary central nervous system lymphoma were seen and treated at the Norwegian Radium Hospital. The overall median survival was 24 months. Patients with poor performance status (WHO 3-4) had a median survival of 3 months whereas patients with good performance status (WHO 0-2) had a median survival of 40 months (p < 0.0001). Patients who were not steroid-dependent after operation had a better survival than those patients who were steroid-dependent (p = 0.02). Nine patients were still living without evidence of disease at last follow-up, 18-130 months after the initial treatment.

Adolescent↗
PubMed1991

[Tumor lysis syndrome. A life-threatening complication during cytostatic treatment of chemosensitive types of cancer].

Tumour lysis syndrome is characterized by hyperkalemia, hypermagnesemia, hyperphosphatemia, hyperuricemia and elevated levels of serum creatinine and urea, indicating renal dysfunction due to rapid lysis of a large number of tumour cells. Hypocalcemia is often found as well. Tumour lysis syndrome is most likely to occur after chemotherapy of cancers that are highly responsive to chemotherapeutic drugs, such as malignant lymphomas and acute leukemias, when there is a large burden of tumours. Another risk factor is impaired renal function before treatment. Tumour lysis syndrome is potentially life-threatening. During the first course of chemotherapy in particular, the patient should receive prophylactic treatment, and laboratory tests should be performed daily in order to avoid this serious complication.

Antineoplastic Agents↗
PubMed1991

[Non-Hodgkin's lymphoma in the gastrointestinal tract].

The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphoma. We present a summary of our recommendations as regards treatment. To avoid serious complications, such as perforation and/or bleeding, surgical resection should be considered before chemotherapy or radiation therapy. The laparotomy gives an opportunity to perform an exact staging procedure, including biopsy from the primary site and the lymph nodes. We recommend that gastrointestinal malignant lymphomas should be referred to medical centers with special competence in this field.

Gastrointestinal Neoplasms↗
PubMed1990

[Diagnosis and treatment of solitary plasmacytoma].

Solitary plasmacytomas are rare tumours. We report our experience from 25 solitary osseous and 18 solitary extramedullary plasmacytomas. 41 patients were given high voltage radiotherapy, usually 40 Gy in 20 fractions. Two patients with extramedullary plasmacytoma developed generalized disease, while ten patients with osseous plasmacytoma developed myelomatosis. Extramedullary plasmacytomas are usually cured by adequate local treatment, while in solitary osseous plasmacytomas the prognosis is more dubious.

Adult↗
PubMed1990

Extramedullary plasmacytomas and solitary plasma cell tumours of bone.

We describe clinical features and treatment results in 25 patients with solitary osseous (SOP) and 18 patients with solitary extramedullary plasmacytoma (EMP). 41 patients were treated with high-voltage radiotherapy, median 40 Gy in 20 fractions. Surgery was part of the treatment in 21 and chemotherapy in 5 patients. The median age in both groups was 56 years, with a preponderance of males. Myelomatosis developed in 10 SOP and 2 EMP patients, and this development did not correlate with the presence or absence of an M-component at the time of diagnosis of plasmacytoma. The estimated 5- and 10-y survival was 87% and 76% without a statistical difference between SOP and EMP groups. The patients in the SOP group usually died from myelomatosis while EMP patients died from other causes.

Bence Jones Protein↗
PubMed1990

Interleukin-2 receptor levels in non-Hodgkin's lymphoma. Correlation to histological degree of malignancy and presence of constitutional symptoms.

Serum interleukin-2 receptor (Il-2R) levels were measured in 28 untreated patients with stage III or IV non-Hodgkin's lymphoma (low grade lymphoma: n = 11, high grade lymphoma: n = 17). Markedly higher levels of Il-2R were found in these patients compared to an age- and sex-matched control group. Significant differences were also found between the high grade group and the low grade group, and between patients with and without constitutional (B) symptoms. It has previously been shown that Il-2R levels vary according to tumor burden in patients with non-Hodgkin's lymphoma. Our data indicate that histological degree of malignancy as well as presence or absence of B symptoms may also influence Il-2R levels in these patients. All three parameters should therefore be taken into account when the clinical significance of Il-2R levels is evaluated.

Adolescent↗
PubMed1990

Infection after splenectomy for Hodgkin's disease.

The incidence of non-fatal infections after staging laparotomy in 95 adult patients with Hodgkin's disease was compared with that of 94 non-splenectomized patients. In addition, mortality of infections in 248 splenectomized patients was compared with mortality in 275 non-splenectomized patients. The observation time was 10 years from start of therapy. No difference was found between splenectomized and non-splenectomized adult Hodgkin's patients as to frequency and death from infection. However, the incidence of more serious infections was significantly higher in advanced disease (stage III and IV) as compared with localized disease (stage I and II). Deaths from rapid fatal infection occurred only in patients with advanced disease, unrespective of splenectomy.

Adult↗
PubMed1989

Management of non-Hodgkin lymphoma in adults in Scandinavia, United Kingdom, and The Netherlands. Report from the European School of Oncology intercity meeting at Huddinge Hospital, 3rd June, 1988.

Current treatment strategies in northern Europe of non-Hodgkin lymphoma are presented. High-grade malignant lymphomas have been treated with doxorubicin-containing polychemotherapy in various modes. The advantage of six-drug regimens over CHOP-like therapy is as yet not proven. Patients with the ability to tolerate the calculated dose have good prognosis. High-dose therapy and bone marrow transplantation should be considered in poor-risk patients with lymphoblastic lymphomas in first remission, patients with all high-grade histologies in partial remission after first-line therapy and patients with relapse that are still responsive to therapy. Preliminary results from autologous bone marrow transplantation in follicular lymphoma are also encouraging. Chlorambucil induces multiple remissions in follicular lymphoma, with a median duration of the 1st, 2nd and 3rd remission being the same. The watch and wait strategy seems justified initially in most asymptomatic generalized low-grade malignant lymphomas. Systemic therapy is required in aggressive stage II-IV lymphomas. A meticulous investigation is needed for stage I patients before giving local treatment only. Immune phenotyping is of great value for diagnosis and staging. Liver, but not bone marrow involvement seems to be an adverse prognostic factor. Follicular lymphoma is an example of a dynamic tumour with gradual cellular changes associated with new and more malignant clinical signs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Progressive loss of vision in patients with high-grade non-Hodgkin's lymphoma.

Three cases of double-sided neuritis of the optic nerve in patients with lymphomas are described. Two patients with lymphoblastic lymphoma had no other signs of central nervous system (CNS) relapse. All three cases responded to high doses of corticosteroids and/or radiotherapy, suggesting a lymphomatous cause of the papillitis. Optic nerve involvement is reported to be rare in lymphomas, but may become more prominent with aggressive systemic therapy controlling manifestations outside the CNS. Possible causes of optic neuritis in patients with lymphoma are discussed and therapeutic measures are suggested.

Adolescent↗
PubMed1986

Transient vinblastine-induced thrombocytopenia during chemotherapy with vinblastine, cis-platinum and bleomycin.

An early, transient drop in peripheral blood platelets to a mean nadir value of 49% (range 31-83%) of the pretreatment value was seen in 31 patients during chemotherapy with cis-platinum, vinblastine and bleomycin (PVB). The mean number of platelets dropped by 22% during the first 24 h after the start of chemotherapy, nadir value was seen after 3 d, with recovery to 107% of pretreatment level on d 14-15. Platelet survival studies during PVB chemotherapy showed shortened platelet survival time and indicated increased destruction of platelets. Identical patterns of early, transient thrombocytopenia were seen in 6 patients treated with vinblastine only. The early fall in circulating platelets did not predict subsequent serious thrombocytopenia. There were no bleeding episodes in the 37 patients studied here, but the early thrombocytopenia seen after vinblastine therapy may possibly be of clinical importance in critically ill patients at risk for bleeding episodes. In rats, an early drop in circulating platelets occurred after a high dose of vinblastine, but not after bleomycin. Addition of bleomycin to vinblastine did not increase the vinblastine-induced thrombocytopenia. It is concluded that the early drop in peripheral blood platelets during chemotherapy with PVB is due to vinblastine.

Animals↗
PubMed1986

Hereditary thrombocytopenia with excessively prolonged bleeding time, corrected by infusions of platelet poor plasma.

In a family with hereditary thrombocytopenia, transfused normal platelets as well as their own platelets had a shortened survival in the patients' circulation (11). On the other hand, the patients' platelets survived normally when transfused to a normal recipient. Platelet-associated immunoglobulins or circulating platelet antibodies were not detected (immunofluorescence method). About 200 ml platelet poor plasma (PPP) from each of 4 normal donors was infused daily for 5 consecutive d to 1 afflicted family member, causing a rise of platelet count from 65 X 10(9)/l to 163 X 10(9)/l and a decrease of bleeding time from 28 to 11 min 7 d after the PPP was discontinued. The platelet count then gradually decreased and was 65 X 10(9)/l with a bleeding time of 30 min 16 d after the PPP was discontinued. In a repeated PPP infusion experiment a similar response was evoked. It is concluded that the afflicted family members must have a deficiency of some plasma principle necessary to keep platelets fit and circulating.

Antibodies↗